A balance theory of job design for stress reduction

doi:10.1016/0169-8141(89)90051-6

International Journal of Industrial Ergonomics

Volume 4, Issue 1, July 1989, Pages 67-79

https://doi.org/10.1016/0169-8141(89)90051-6 Get rights and content

Abstract

This paper proposes a new way of conceptualizing job design and job stress based on the balance among job elements. It integrates social psychological theories of job design with job stress concepts to develop a model of job balance that addresses how organization and job design can influence worker health. The model defines how job design can improve “loading” factors on the worker by “balancing” aspects of the job which can produce stress. The implications of this model for enhancing worker health by controlling workplace stress are discussed. The model provides a holistic approach for designing workplaces that balance production and stress considerations.

References (67)

J.R. Hackman et al.
Motivation through the design of work: test of a theory
Organ. Behav. Hum. Perform.
(1976)
R.J. Arthur et al.
Promotion and mental illness in the Navy
J. Occup. Med.
(1965)
L. Breslow et al.
Mortality and coronary heart disease and physical activity on work in California
J. Chronic Dis.
(1960)
R.D. Caplan et al.
Job Demands and Worker Health
(1975)
S. Cobb et al.
Termination: the Consequences of Job Loss
(1977)
D. Coburn
Job alienation and well-being
Int. J. Health Serv.
(1979)
L. Coch et al.
Overcoming resistance to change
Hum. Rel.
(1948)
S. Cohen et al.
Nonauditory effects of noise on behavior and health
J. Soc. Issues
(1981)
M.J. Colligan et al.
Mass psychogenic illness in organizations: an overview
J. Occup. Psychol.
(1979)
C.L. Cooper et al.
Occupational sources of stress: A review of the literature relating to coronary heart disease and mental ill health
J. Occup. Psychol.
(1976)

C.L. Cooper et al.

Job Stress and Blue Collar Work

(1985)

T. Cox

Repetitive work: Occupational stress and health

L.E. Davis

Individuals and the organization

Calif. Manage. Rev.

(1980)

L.E. Davis et al.

Current job design criteria

J. Ind. Eng.

(1955)

F.E. Emery et al.

The Form and Content in Industrial Democracy

(1969)

P.H. Engelstad

Sociotechnical approach to problems of process control

J. Enqvist

The verdict: Overload injuries still common

Work Environ.

(1986)

S. Fisher

Control and blue-collar work

M. Frankenhaueser et al.

Underload and overload in working life: outline of a multidisciplinary approach

J. Hum. Stress

(1976)

J.R.P. French

The social environment and mental health

J. Soc. Issues

(1963)

H.L. Gantt

Organizing for Work

(1919)

B. Gardell

Alienation and mental health in the modern industrial environment

B. Gardell

Autonomy and participation at work

Hum. Rel.

(1977)

B. Gardell

Worker participation and autonomy: a multilevel approach to democracy at the workplace

Int. J. Health Serv.

(1982)

D.C. Glass et al.

Urban Stress: Experiments on Noise and Social Stressors

(1972)

E. Grandjean et al.

VDT workstation design: Preferred settings and their effects

Hum. Factors

(1983)

J.R. Hackman et al.

A new strategy for job enrichment

Calif. Manage. Rev.

(1975)

A.P. Hare

R.V. Harrison

Person-environment fit and job stress

F. Herzberg

Work and the Nature of Man

(1966)

G. Johansson et al.

Stress reactions in computerized administrative work

J. Occup. Behav.

(1984)

R. Kalimo et al.

Feedback from video display terminals, performance control and stress in text preparation in the printing industry

J. Occup. Psychol.

(1985)

R.A. Karasek et al.

Job decision latitude, job demands, and cardiovascular disease

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A balance theory of job design for stress reduction

Abstract

Organ. Behav. Hum. Perform.

Promotion and mental illness in the Navy

J. Occup. Med.

Mortality and coronary heart disease and physical activity on work in California

J. Chronic Dis.

Job Demands and Worker Health

Termination: the Consequences of Job Loss

Job alienation and well-being

Int. J. Health Serv.

Overcoming resistance to change

Hum. Rel.

Nonauditory effects of noise on behavior and health

J. Soc. Issues

Mass psychogenic illness in organizations: an overview

J. Occup. Psychol.

Occupational sources of stress: A review of the literature relating to coronary heart disease and mental ill health

J. Occup. Psychol.

Job Stress and Blue Collar Work

Repetitive work: Occupational stress and health

Individuals and the organization

Calif. Manage. Rev.

Current job design criteria

J. Ind. Eng.

The Form and Content in Industrial Democracy

Sociotechnical approach to problems of process control

The verdict: Overload injuries still common

Work Environ.

Control and blue-collar work

Underload and overload in working life: outline of a multidisciplinary approach

J. Hum. Stress

The social environment and mental health

J. Soc. Issues

Organizing for Work

Alienation and mental health in the modern industrial environment

Autonomy and participation at work

Hum. Rel.

Worker participation and autonomy: a multilevel approach to democracy at the workplace

Int. J. Health Serv.

Urban Stress: Experiments on Noise and Social Stressors

VDT workstation design: Preferred settings and their effects

Hum. Factors

A new strategy for job enrichment

Calif. Manage. Rev.

Person-environment fit and job stress

Work and the Nature of Man

Stress reactions in computerized administrative work

J. Occup. Behav.

Feedback from video display terminals, performance control and stress in text preparation in the printing industry

J. Occup. Psychol.

Job decision latitude, job demands, and cardiovascular disease