Stress research has been hampered by confusing two distinct job characteristics--psychological demands and decision latitude. For example, "responsibility" is often defined as a stressor, despite the evidence that decision-making authority has the opposite, or stress reducing effect. Such conceptual confusion and neglect of workers' decision-making opportunities have helped to maintain myths such as "executive stress", despite the evidence that higher socioeconomic status is associated with lower risk of coronary heart disease (CHD).

A new model of occupational stress developed by Dr. Robert Karasek clarifies the nature of job characteristics and has successfully predicted rates of CHD, psychological strain and non-work behavior using national data bases in the U.S. and Sweden.

A survey instrument derived from the model was distributed to 771 employees in two hospitals and one nursing home in New Jersey, and 289 (37%) were returned. The respondents did not significantly differ from the total sample by age, job tenure, sex or union membership status.

The results support the hypothesis that reported job strain (burnout, job dissatisfaction, depression and physical problems) is higher in jobs that combine high psychological demands and low decision latitude. The association between these job characteristics and strain is significant after controlling for age, sex, and education, marital status, hours worked per week, shift, and number of dependent children. In addition, adding other job measures (social support, physical exertion, job insecurity, hazard exposure) to the model significantly increases the explained variance of strain measures.

The survey instrument includes 53 items from the national Quality of Employment Surveys conducted in 1969, 1972 and 1977. Thus, national averages of job characteristics or psychological strain for any occupation can be compared to the scores for any jobtitle within a workplace. Comparisons conducted in the present sample identified LPNs and nurses' aides as high strain jobtitles as well as identifying the job characteristics associated with strain in those jobtitles.