The mediating effect of psychosocial work factors in the prospective associations between organisational changes and self-rated health: Results from the national French working conditions survey

Objectives

Organisational changes have been found to be associated with health outcomes but the underlying mechanisms remain understudied. The study aimed at exploring the prospective associations of organisational changes with self-rated health and the mediating effect of psychosocial work factors in these associations.

Study design

The study had a prospective design.

Methods

The study was based on a nationally representative sample of 14,989 employees surveyed in 2013, 2016, and 2019 (national French working conditions survey). The associations between seven organisational changes, a large set of psychosocial work factors, and the incidence of poor self-rated health were studied using weighted robust Poisson regression models and the Karlson, Holm and Breen (KHB) method. Covariates included gender, age, marital status, stressful life events, social support outside work, occupation, and economic activity of the company.

Results

The exposure to any organisational change predicted the incidence of poor self-rated health (covariate-adjusted incidence rate ratio: 1.30, 95 % CI: 1.16–1.46). All types of organisational changes were predictors of the incidence of poor self-rated health. There was a linear trend between the number of changes and the incidence of poor self-rated health. Mismanagement of changes increased the incidence still further. Psychosocial work factors had a mediating effect of 18.4–51.8 % in the associations between organisational changes and the incidence of poor self-rated health. The most contributing factors were those related to quantitative demands, role stressors, job insecurity, and internal violence.

Conclusions

Prevention oriented towards organisational changes may be useful to improve psychosocial working conditions and health among working populations.