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Do the work unit characteristics directly or indirectly affect psychological distress in female call-handlers?

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Abstract

Purpose

This study aimed to test if work unit characteristics (WUCs) reported by call-center managers were directly related to the psychological distress reported by call-handlers or if these associations were mediated by the psychosocial working conditions (PWC).

Methods

Managers of 105 call-centers were interviewed about their call-center’s WUCs by occupational physicians. 2719 female call-handlers from these call-centers completed self-reported questionnaires to evaluate PWC (Karasek, Siegrist, and other specific workplace stressors) and psychological distress (GHQ12 score). A two-level analysis tested the relationships between the 14 WUCs and GHQ12 score, with and without adding PWC as confounders. Unchanged coefficients between WUCs and GHQ12 score were assumed to flag a direct association between WUCs and psychological distress. In the case of changed coefficients, the mediated proportion was estimated using multiple mixed models.

Results

Five out of fourteen WUCs were related to GHQ12 score: outbound-call type, call-center size, number of activity parameters displayed on the screen, the existence of a fixed break, and the assigned role of the supervisor being the monitoring/supervision of call-handler activities. After adding PWC, the association remained statistically significant only for outbound calls. For the other WUCs, the proportion of mediation by stressor ranged from 56 to 66%. Mediation was mostly through job demand, lack of reward and ethical conflict dimensions.

Conclusion

The main results were that (1) associations exist between the WUCs reported by managers and the psychological distress reported by call-handlers, and (2) that most of these associations are mediated by psychosocial working conditions.

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Acknowledgements

We thank all of the occupational physicians who contributed to the design of the protocol and the questionnaire about work unit characteristics and who performed the data collection. We thank all of the managers/supervisors and call-handlers who participated in this study as well as all of the personnel from the Department of Epidemiology who were involved in the study. Special thanks is owed to the members of the group involved in the study protocol preparation, the design of the questionnaire on work unit characteristics and the data collection logistics.

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Authors and Affiliations

  1. Occupational Epidemiology Division, Epidémiologie en entreprise, French National Research and Safety Institute (INRS), 1 rue du Morvan, CS 60027, 54519, Vandœuvre-lès-Nancy, France

    Stéphanie Boini, Dominique Chouaniere & Pascal Wild

Authors
  1. Stéphanie Boini
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  2. Dominique Chouaniere
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  3. Pascal Wild
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Correspondence to Stéphanie Boini.

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Appendices

Appendix 1

See in Tables 6, 7.

Table 6 Tetrachoric correlations between the work unit characteristics
Full size table
Table 7 Comparison of mean score for the assigned role by the other work unit characteristics
Full size table

Appendix 2

See in Table 8.

Table 8 Pearson correlations between the psychosocial working conditions
Full size table

Appendix 3

The steps of the mediation analysis

The mediation analysis proceeded in three steps

The first step explored the effect of the WUCs reported by the manager for each call-center on PWC reported by call-handlers. This model was a linear mixed model with the call-center as a random effect to account for the correlation induced by the fact that the WUCs were identical for all call-handlers from each call-center. These analyses (one for each PWC) was adjusted on a series of confounders (see methods). The coefficients used for the mediation analysis were the regression coefficients for the WUCs on each of the PWC. (see results in Table 5).

The second step explored the effect of the WUCs reported by manager for each call-center on the GHQ12 score reported by call-handlers. This model was again a linear mixed model with the call-center as a random effect to account for the correlation induced by the fact that the WUCs were identical for all call-handlers from each call-center. This single analysis was adjusted on a series of confounders (see methods). The coefficients used for the mediation analysis were the regression coefficients for the WUCs on the GHQ12. (see results in Table 4—model B).

The third step explored the effect of the WUCs reported by the manager for each call-center on the GHQ12 score reported by call-handlers, adjusting for all the PWC. This model was again a linear mixed model with the call-center as a random effect to account for the correlation induced by the fact that the WUCs were identical for all call-handlers from each call-center. This single analysis was adjusted on a series of confounders (see methods). The coefficients used for the mediation analysis were the regression coefficients for the WUCs on the GHQ12 but adjusted for the PWC (see results in Table 4—model C).

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Boini, S., Chouaniere, D. & Wild, P. Do the work unit characteristics directly or indirectly affect psychological distress in female call-handlers?. Int Arch Occup Environ Health 94, 707–721 (2021). https://doi.org/10.1007/s00420-020-01614-6

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