Abstract
The main purpose of this study was to investigate the role of the extrinsic component of the Effort-Reward Imbalance Model (ERI_Siegrist, 1996), i.e., high effort and low reward in burnout, among the doctors in Pakistan. The study also examined the effect of effort-reward imbalance on psychosomatic health complaints and general physical health. Moreover, the study investigated: (a) the main effects of social support on burnout, and (b) the potential moderating effect of three sources of social support (supervisor, co-workers, and family) on the relationship between effort-reward imbalance and burnout. The study sample comprised of 250 doctors (104 females and 146 males) working in different hospitals of Pakistan. The mean age of the participants was 34.18 years. About sixty percent of the doctors had done their medicine degree (MBBS), whereas, 40.4 percent of the doctors had also specialized (Fellowship_FRCS). On average, doctors worked for nine and a half hours (range= 8 to 15 hours) per day. The mean tenure of their jobs was 6.11 years ranging from 2 to 12 years. Data were collected by questionnaires comprising of the Effort Scale, the Reward Scale, the Social Support Scales, the Psychosomatic Health Scale, the Physical Health Scale, and the MBI-GS Scale. All scales were found very reliable for the present sample with Cronbach's alphas ranging from .83 to .91. The general assumption of the study was that doctors who experience effort-reward imbalance and lack social support are likely to report burnout, psychosomatic health complaints, and poor status of physical health. The findings of the study showed that high effort and low reward had significant positive correlation with burnout dimensions (exhaustion, cynicism, and reduced professional efficacy), high psychosomatic health complaints, and poor physical health. Moreover, social support from supervisor, co-workers, and family had significant negative correlations with burnout dimensions, as was hypothesized. The step-wise hierarchical regression analyses indicated that interaction of high effort and low reward significantly predicted exhaustion and cynicism, whereas the results for professional efficacy, psychosomatic health complaints, and poor physical health were not found significant. The hierarchical regression analyses regarding the social support indicated that the significant interaction terms were supervisor support x reward for low cynicism and co-worker support x reward for high professional efficacy. A three-way interaction term of family support x effort x reward was found significant for exhaustion and cynicism. Thus, the result supported the hypothesis that family support moderated the relationship between effort-reward imbalance i.e., high effort and low reward and two burnout dimensions i.e., exhaustion and cynicism. Overall, the findings of the present study lend partial support to the robustness of the ERI model and the hypotheses of the study, among Pakistani doctors. The results are discussed in terms of organizational interventions.