Mental and physical health-related functioning mediates between psychological job demands and sickness absence among nurses

J Adv Nurs. 2014 Aug;70(8):1780-92. doi: 10.1111/jan.12335. Epub 2013 Dec 23.


Aims: To investigate whether health-related functioning mediates the effect of psychological job demands on sickness absence in nurses.

Background: Nurses face high job demands that can have adverse health effects resulting in sickness absence.

Design: Prospective cohort study with 1-year follow-up.

Methods: Data for 2964 Norwegian nurses were collected in the period 2008-2010. At baseline, psychological job demands were measured with the Demand-Control-Support Questionnaire. Health-related functioning was assessed by the Mental Composite Score and the Physical Composite Score of the SF-12 Health Survey (2nd version). Sickness absence (no = 0, yes = 1) was self-reported at 1-year follow-up. Interaction and mediation analyses were conducted stratified by tenure (<1-year, 1-2 years, 3-6 years, >6 years) as a registered nurse.

Results: A total of 2180 nurses (74%) with complete data were eligible for analysis. A significant three-way interaction between job demands, control and support was found in newly licensed nurses (tenure <1-year). Baseline psychological job demands were positively associated with sickness absence at 1-year follow-up. This association was substantially weakened when Mental Composite Score and Physical Composite Score were introduced as mediator variables, indicating a partial mediation effect that was particularly pronounced in newly licensed nurses. Psychological job demands did not modify the effect of health-related functioning on sickness absence.

Conclusion: Both mental and physical health-related functioning mediated between psychological job demands and sickness absence. Nurse managers should pay attention to health-related functioning, because poor health-related functioning may predict sickness absence, especially in newly licensed nurses.

Keywords: SF-12; absenteeism; mediation analysis; mental health; nurses; nursing; physical health; sickness absence.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Humans
  • Nursing Staff / psychology*
  • Sick Leave*
  • Surveys and Questionnaires