Scandinavian Journal of Psychology, 2015, 56, 105–113
DOI: 10.1111/sjop.12177
Personality and Social Psychology Associations between work family conflict, emotional exhaustion, musculoskeletal pain, and gastrointestinal problems in a sample of business travelers MARIA THERESE JENSEN and TORBJØRN RUNDMO Department of Psychology, Faculty of Social Sciences and Technology Management, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
Jensen, M. T. & Rundmo, T. (2015). Associations between work family conflict, emotional exhaustion, musculoskeletal pain, and gastrointestinal problems in a sample of business travelers. Scandinavian Journal of Psychology, 56, 105–113. The aim of the study was to examine the associations among work-family conflict (WFC), emotional exhaustion, musculoskeletal (MS) pain, and gastrointestinal problems on a sample of business travelers (n = 2,093). An additional aim was to examine differences in the mentioned relationships among three traveler groups: commuters, national travelers, and international travelers. The study was conducted in a large Norwegian oil and gas company, and the company’s business travel database was utilized to examine business travel. Structural equation modeling (SEM) revealed significant relations between WFC and emotional exhaustion and between emotional exhaustion and health problems. Contrary to the expectations, no direct association was found between WFC and health problems. However, we found that emotional exhaustion mediated the relation between WFC and health outcomes. The results from multi-group analysis revealed that associations among WFC, emotional exhaustion, and health-outcomes showed a similar pattern for commuters, national travelers, and international travelers. However, the association between emotional exhaustion and MS pain proved to be significantly stronger for the commuter group compared to the national and international travel groups. Practical implications and the consequences of these findings for future research are discussed. Key words: Business travel, work-family conflict, burnout, musculoskeletal pain, gastrointestinal problems. Maria Therese Jensen, Department of Psychology, Faculty of Social Sciences and Technology Management, Norwegian University of Science and Technology (NTNU), N-7491 Trondheim, Norway. Tel: +4792020913; e-mail: [email protected]
INTRODUCTION In the constant search for economic success, organizations are becoming increasingly global. One consequence of globalization and international growth is an increase in business traveling. In 2012, over 15 million overnight stays in Norway were directly related to business travel (Statistics Norway, 2013, http:// www.ssb.no), indicating that business travel is a common phenomenon. Although business travel is seen as both profitable and necessary for the company, it has also been suggested that excessive traveling may have negative consequences on employees’ physical and psychological health. A review of epidemiological studies on travel-related morbidity showed that overseas travel was related to several health problems, such as gastrointestinal disorders, skin disorders, cardiovascular disease, infections, malaria, and psychological disorders (Patel, 2011). However, most studies referred to in this particular study related to tourist travels, humanitarian aid workers, or expats living abroad. Moreover, compared to the literature on expatriates, which is very thorough, research on the effects of business travel on the traveler, family, and organization is sparse (Westman, 2005). Thus, only a few studies investigated the effect of business travel on the traveler and the family. Two studies conducted in the World Bank Group in Washington (Dimberg, Striker, Noranlycke-Yoo, Nagy, Mundt & Sulsky, 2002; Espino, Sundstrøm, Frick, Jacobs & Peters, 2002) revealed that frequent business traveling puts strain not only on the employees, but also on their families, which again increases stress for the © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd
employee. Another study by the World Bank Group found that infectious disease together with psychological disorders had the strongest association with the frequency of travel (Liese, Mundt, Dell, Nagy & Demure, 1997). Business travel has also been found to be related to work-family conflict and the emotional exhaustion component of burnout (Westman, Etzion & Gortler, 2004). Work-family conflict (henceforth referred to as WFC) is “a form of inter-role conflict in which the role pressures from the work and family domains are mutually incompatible in some respect. That is, participation in the work (family) role is made more difficult by virtue of participation in the family (work) role” (Greenhaus & Beutell, 1985, p. 77). Moreover, emotional exhaustion is a component of burnout, which manifests itself by lack of energy, with emotional resources being fully consumed by work (Maslach, Jackson, Leiter, Schaufeli & Schwab, 1986). One study confirmed a negative relation between business travel and the emotional component of burnout (Westman & Etzion, 2002). However, in Westman and Etzion’s (2002) study, burnout was studied only during a single trip, implying that the chronic strain, which could relate to business travel, was not necessarily captured.
Limitations of previous research The abovementioned previous studies had certain limitations in terms of the measurement of business travel, sample size, and generalizability of results. First, most studies have utilized selfreported measures (Espino et al., 2002; Striker, Luippold, Nagy,
106 M. T. Jensen and T. Rundmo Liese, Bigelow & Mundt, 1999), increasing the likelihood of self-report error. Studies have also utilized expense reports Dimberg et al., 2002; Liese et al., 1997), which have the advantage of being more “objective.” However, the categorization of business trips in these studies has been quite narrow, with “four business trips or more” being the highest category. Moreover, most previous studies referred only to the number of travels and not the number of overnight stays. It is essential to include the number of overnight stays to obtain more accurate information regarding the actual time the traveler is away from home, which again may have implications for WFC and potential health outcomes. Second, several of the studies referred to applied small samples (e.g., Westman & Etzion, 2002; Westman et al., 2004). Third, several studies have been conducted within the same organization (the World Bank Group), which could limit the generalizability of the findings. Finally, nearly all of the abovementioned studies have focused on the amount of traveling, whereas less attention has been paid to business travel patterns. However, regardless of the amount of traveling, business travel pattern alone may exert significant influences on various outcomes. For instance, short business trips have different characteristics compared to long international business trips. For international business trips, the employee often needs to spend time away from the family for longer periods, which may cause work-family conflict. In addition, crossing time zones may also cause jet lag, which again may cause fatigue and gastrointestinal problems (Patel, 2011). On the other hand, compared to international travel, short national travel perhaps involve more time spent on traveling itself rather than the stay, which can be experienced as stressful. Thus, it seems to be essential to gain more knowledge of how business travel pattern is related to, for instance, WFC, emotional exhaustion, and health outcomes.
Background for the current study A more recent study on business travel and its relation to WFC and burnout (Jensen, 2013) addressed several of the abovementioned methodological limitations, utilizing company specific register data on business travel, thereby eliminating self-report error. Moreover, it included the number of overnight stays to measure business travel and a relatively large sample. The results revealed positive associations between business travel frequency (defined as the number of overnight stays) and WFC, and between WFC and emotional exhaustion but no direct association between business travel and emotional exhaustion. To the best of our knowledge, this study was the only one to investigate business travel pattern in relation to WFC and emotional exhaustion. More specifically, cluster analysis identified three groups of travelers, commuters (n = 153), national travelers (n = 1434), and international travelers (n = 506). Comparison of mean scores between commuters, national travelers, and international travelers showed that commuters reported significantly higher WFC compared to both national and international travelers, whereas no differences were found with regard to emotional exhaustion. However, concerning business travel pattern, one shortcoming of the study referred to was that business travel groups were © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd
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compared only with regard to mean differences on WFC and emotional exhaustion, whereas differences in the associations among groups were not examined. Additionally, physical health outcomes were not included in the study. It is vital to include physical health outcomes when studying samples of business travelers. As referred to previously, studies on tourist travels, expats, and the like, revealed an increase in physical health outcomes related to travel (Patel, 2011). Moreover, the abovementioned research suggests that business travelers can be vulnerable to experiencing WFC. WFC can again have negative consequences on individual’s physical health. For instance, Thomas and Ganster (1995) found that WFC was associated with several somatic complaints, such as headaches, insomnia, and sweat palms. Additionally, Haynes, Eaker and Fenlieb (1984) found that WFC was related to coronary heart disease. Moreover, WFC has been found to be related to an increase in stress hormones (Frankenhaeuser, Lundberg, Fredrikson et al., 1989). Previous research has also found that WFC is negatively associated with psychological health (Allen, Herst, Bruck & Sutton, 2000; Amstad, Meler, Fasel, Efering & Semmer, 2011) and positively related to burnout burnout (e.g., Demerouti, Bakker & Bulters., 2004; Geurts, Rutte & Peeters, 1999). Hence, it becomes relevant to identify health outcomes that should be included when studying business travelers. Gastrointestinal problems can be considered one relevant health outcome, as they have been found to be associated specifically to international travel in general (Patel, 2011). Due to its excessiveness, musculoskeletal (MS) pain can be considered another relevant health outcome worth investigating. MS pain is one of the most common non-malignant conditions in the Western World, and occurs frequently among employees who do not perform physical work (Sprigg, Stride, Wall, Holman & Smith, 2007). For instance, in a study of 2,000 office workers, the prevalence of self-reported MS pain in head/neck and both lower and upper back regions was 63% (Janwantanakul, Pensri, Jiamjarasrangsri & Sinsongsook, 2008). One review study found that each year, MS pain in the neck impose limitations on approximately 11% and 14% of workers (Cote, van der Velde, Cassidy, Carroll, Hogg-Johansson & Peloso, 2008). Moreover, MS pain has been found to be the most frequent cause of sick leave and work disability in Norway (Ihlebæk, Brage & Natvig, 2010). Thus, it is essential to understand the antecedents of MS pain. Based on the mentioned facts, we decided to include both MS pain and gastrointestinal problems as health outcomes in the current study. The aims of the present study were twofold. First, we wanted to examine the relation among WFC, emotional exhaustion, MS pain, and gastrointestinal problems using a sample of business travelers as a whole. Second, we wanted to investigate differences in the associations among commuters, international travelers, and national travelers. The current study is based on the same data as the study by Jensen (2013). WFC is a bidirectional concept. Accordingly, family interference with work has been referred to as family-work conflict (Netemeyer, Boles & McMurrian, 1996). However, in the current study, we focused on WFC. The reason for this restriction was the fact that stressors related to work, such as business travel, are more likely to influence WFC (see Michel, Kotrba, Michelson, Clark & Baltes, 2011, for a meta-analysis).
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COR theory and hypothesis development It has been suggested that business travel research should be studied in the light of Hobfoll’s (2001) conservation of resources (COR) theory (Westman, 2005). The basis of the theory of Conservation of Resources is that individuals strive to obtain, retain, protect, and foster “things” that they value (Hobfoll, 2001, p. 341). “Things” means resources, including personal characteristics, objects, conditions, and energies (Hobfoll, 2001). Further, COR theory states, “Those who lack resources are not only more vulnerable to resource loss, but initial loss begets future loss” (Hobfoll, 2001, p. 354). Previous research has shown that after a travel mission, many workers experience a heavy workload because tasks pile up while they are away (Striker et al., 1999), implying that business travel increases demands on the employee. Employees often cope with high work demands by spending less time with family and even more time at work in order to get the job done, which according to COR theory results in resource loss (Hobfoll, 2001). Individuals who experience such resource loss are prone to experience WFC and go into negative states, with decrease their well-being. Previous studies have found support for this view (e.g., Espino et al., 2002; Jensen, 2013). Moreover, when traveling, the employee will spend even more time away from the family, which again will give rise to WFC. Thus, business travelers can be more exposed to resource drain, as business travel is a demand that can drain resources from family time. COR theory can also be used to explain the process of burnout in work settings (Grandey & Cropanzano, 1999), which develops from a lack of resource gain and sometimes exposure to minor chronic losses (Hobfoll, 2001). As we have already noted above, previous research has found that WFC is related to burnout, (e.g., Demerouti et al., 2004; Geurts et al., 1999) in addition to physical health (Frankenhaeuser et al., 1989; Thomas & Ganster, 1995) and psychological health (Allen et al., 2000; Amstad et al., 2011). However, when looking at previous research conducted on WFC and health outcomes, little attention has been paid to studying the relation between WFC and MS pain or between WFC and gastrointestinal problems. Since WFC has been found to relate to several other health outcomes in previous research, it can be assumed that WFC will relate positively to MS pain and gastrointestinal problems. Moreover, neck pain has been found to relate to psychosocial factors and particularly to role-conflict (Christensen & Knardahl, 2010). Thus, it can be expected that WFC will relate positively to MS pain. Based on COR theory and evidence from previous research, we formulated the following hypothesis: Hypothesis 1: WFC is positively related to emotional exhaustion, MS pain, and gastrointestinal problems. The relation between burnout and health outcomes has been well established. A number of studies have found that burnout relates to numerous somatic symptoms, including headaches, gastrointestinal afflictions, and sleep disturbances (e.g., Gorter, Eijkman & Hoogstraten, 2000; Kahill, 1988). Moreover, increasing evidence suggests a positive association between burnout and mental health, such as anxiety (e.g., Turnipseed, 1998) or depression (Hakanen, Schaufeli & Ahola, 2008; Schaufeli &
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Business travel, work-family conflict and health outcomes 107 Enzmann, 1998). Both positive relations between MS pain and burnout have been demonstrated in cross sectional studies, (Honkonen, Ahola, Pertovaara et al., 2006; Langballe, Innstrand, Hagtvet, Falkum & Gjerlow Aasland, 2009), case-control studies (Soares & Jablonska, 2004), and longitudinal studies (Armon, Melamed, Shirom & Shapira, 2010; Melamed, 2009), even after adjusting for depression and anxiety (Melamed, 2009). Accordingly, we formulated the following hypothesis: Hypothesis 2: Emotional exhaustion is positively related to MS pain and gastrointestinal problems. Chronic job demands may deplete employees’ energy and resources and thus may lead to burnout followed by ill health. Moreover, burnout can be considered a mediator in the energy draining process, which leads to health impairment (Schaufeli & Bakker, 2004). Previous longitudinal studies have also confirmed that burnout is a mediator of the relation between demands and ill health (e.g., Demerouti et al., 2004; Hakanen et al., 2008). Accordingly, we expect to see that the emotional exhaustion component of burnout will mediate the association between WFC and health outcomes. However, as already noted above, previous research found WFC to be directly associated with physical health (Frankenhaeuser et al., 1989; Thomas & Ganster, 1995). Thus, we expect to see that WFC has both direct and indirect effects via emotional exhaustion on health outcomes. Accordingly, the following hypothesis was proposed: Hypothesis 3: Emotional exhaustion will partially mediate the association between WFC and health outcomes (MS pain and gastrointestinal problems). As noted previously, some travel patterns might be more resource draining compared to other travel patterns, which again could have implications for the degree of perceived WFC and its association with health outcomes. Thus, we also wanted to investigate whether different business travel patterns may have different influences on the associations among WFC, emotional exhaustion, and health outcomes. In a previous study by Jensen (2013), commuters reported significantly higher WFC compared to both national and international travelers. This is partly in line with Morrice and Taylor’s (1978) early research on home and work patterns of offshore workers. Morrice and Taylor (1978) found that travel patterns characterized by frequent leaving and returning disrupted family life more. Frequent leaving and returning characterizes particularly commuters. Based on these findings, we therefore expect to find significantly stronger associations among WFC, emotional exhaustion, and health outcomes for commuters compared to national and international travelers. Thus, we proposed the following hypothesis: Hypothesis 4: The associations among WFC, emotional exhaustion, MS pain, and gastrointestinal problems are stronger for commuters compared to national and international travelers. Figure 1 depicts a working model of the expected associations in the present study. The model reflects the hypotheses specified and discussed above.
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Musculoskeletal pain
+ + Work-family conflict
+
Emotional exhaustion
+
Gastrointestinal problems
+
Fig. 1. Working model of the current study.
METHOD Participants, selection criteria and overview of sample The study was conducted in two business units of a large Norwegian oil and gas company. The data utilized was from a previous study by Jensen (2013). Most employees in the first business unit worked as advisors within their special field, delivering technical and safety expertise to business, primarily within the fields of subsea equipment, drilling, and facilities. Employees in the second unit worked primarily within trading and marketing of oil and gas. All employees were clerical workers and in general, they were highly educated. The sample was selected from the company’s register data on business travel. Information is automatically entered into the company’s database when employees book their trips through the company’s data system. Based on the available information, the generated data reports contained the type of travel, number of business trips, and number of overnight stays. The criteria for drawing the sample was based on travel frequency during the preceding 6 months and was set to a minimum of five or more business travels or 10 or more overnight stays within the specified period. The number of journeys ranged from 1 to 61 (Mean = 13, Standard deviation = 8.1), whereas the number of overnight stays ranged from 5 to 173 (Mean = 32.7, Standard deviation = 25.1). 3078 business travelers were selected based on these criterions. Additionally, a self-reported questionnaire was utilized to measure the remaining variables. The questionnaires were distributed to respondents via e-mail, and the data collection was carried out during May–June 2011; 2,093 responded to the questionnaire, giving a response rate of 68%. Of the respondents, 460 (22%) were females and 1633 (78%) were males. Furthermore, 7.6% of participants were under 30 years old, followed by 30–39 years old (22.8%), 40–49 years old (35.1%), 50– 59 years old (31.6%), and over 60 years old (2.9%). Moreover, 19.5% had worked in the company for 1–3 years, 28.2% for 3–10 years, and 52.3% for more than 10 years. Overall, 55.5% of the total sample had parental responsibility for preschool and school aged children, and 21.6% were managers with personnel responsibility.
Measures and questionnaires The variables were measured using a self-reported questionnaire. The questionnaires were distributed to respondents via e-mail, and the data collection was carried out during May–June 2011. All data were derived from the study by Jensen (2013). Work-Family conflict, WFC, was assessed using 5 items developed by Netemeyer et al., (1996). The respondents were asked to indicate on a 5-point scale ranging from 1 (totally disagree) to 5 (totally agree) the extent to which they agreed with items such as, “The demands of my work interfere with my home and family life.” Higher scores indicated greater WFC. A translated version of the General survey (MBI-GS) from the Maslach Burnout Inventory was used to assess emotional exhaustion (Maslach, Jackson & Leiter, 1996). The original version was translated to Norwegian in a previous study, and the translated version demon© 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd
strated good validity (Jensen, 2013). The scale comprises 5 items (e.g., I feel emotionally drained from my work, working all day is a real strain for me) measured on a seven-point scale where 0 = never, 1 = a few times a year or less, 2 = once a month or less, 3 = a few times a week, 4 = once a week, 5 = a few times a week, and 6 = every day. MS pain comprised 8 questions from the Subjective Health Complaint Inventory (Eriksen, Ihlebæk & Ursin, 1999). The respondents were asked to indicate on a 4 point scale (0 = none, 1 = some, 2 = much, 3 = severe) the severity of their symptoms, including headache, migraine, neck pain, upper back pain, low back pain, arm pain, shoulder pain, and pain in feet, experienced during the last 30 days. The Subjective Health Complaint Inventory measured gastrointestinal problems, including heartburn, stomach discomfort, ulcer/non-ulcer dyspepsia, stomach pain, gas discomfort, diarrhea, and obstipation. Both scales have demonstrated acceptable validity in previous studies conducted with the Norwegian population (Eriksen et al., 1999). Travel pattern consisted of three traveler groups: Commuters (n = 153), national travelers (n = 1,434), and international travelers (n = 506). See Jensen (2013) for more details.
Statistical analysis First, to validate the model shown in Fig. 1, confirmatory factor analysis (CFA) with maximum likelihood estimation was applied using AMOS version 21.0 (Arbuckle, 2012). Confirmatory factor analysis (CFA) is a statistical technique used to verify the factor structure of a set of observed variables. CFA makes it possible to test the relationship between observed variables and their underlying latent constructs. Each indicator was assigned to the measurement instrument to which it originally belonged. Second, structural equation modeling (SEM) was utilized to test the structural model of the relationships among WFC, emotional exhaustion, MS pain, and gastrointestinal problems. SEM makes it possible to analyze a set of regression equations simultaneously while also controlling for measurement error. Third, to test the significance of the mediational effect of emotional exhaustion on the relation between WFC and health outcomes, we used the bias-corrected bootstrap test of mediation in AMOS version 21.0 (IBM, Armonk, NY). MacKinnon, Lockwood and Williams (2004) suggested the bias-corrected bootstrap approach as the most optimal method, as it corrects for skewness in the population. Specifically, 1,000 bootstrap samples and 95% bias-corrected confidence intervals were applied. Fourth, a multi-group path analysis using SEM was applied to examine whether model parameters varied across travel groups. The fit of an unconstrained model was tested, examining the assumption that the path coefficients differed across different clusters. This model was compared to a constrained model in which coefficients were set to be equal across travel groups. Model comparison was conducted using v² difference test (J€ oreskog & S€ orbom, 1993). To determine whether the parameters differed by travel groups, the critical ratio difference test was applied. We applied the criteria suggested by Arbuckle (2012), where the critical ratio that exceeds 1.96 in magnitude is significant at the 0.05 level. Finally, SPSS (Statistical programs for Social scientists) version 21 (IBM, Armonk, NY) was used to determine the means, standard deviations, correlations, reliability, and internal consistency of measures.
Business travel, work-family conflict and health outcomes 109
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tion turned out to be significantly related to both MS pain (b = 0.42, p < 0.001) and gastrointestinal problems (b = 0.49, p < 0.001), supporting Hypothesis 2. The examination of the indirect effects of emotional exhaustion on MS pain and gastrointestinal problems, using the bias-corrected bootstrap test of mediation, demonstrated that emotional exhaustion mediated the relation between WFC and MS pain (b = 0.20, 95% CI [0.17, 0.24], SE 0.02, p < 0.001) and also between WFC and gastrointestinal problems (b = 0.20, 95% CI [0.16, 0.24], SE 0.02, p < 0.001). Moreover, when emotional exhaustion was omitted from our model results revealed no significant direct association between WFC and MS pain, or between WFC and gastrointestinal problems. This indicates that the relation between WFC and both MS pain and gastrointestinal problems, are completely mediated by emotional exhaustion. The fit of the mediation model was found to be generally satisfactory (v² = 21.262; df = 270, RMSEA = 0.057, CFI = 0.909, NFI = 987, IFI = 0.909). Thus, Hypothesis 3 was partially supported.
CFA and SEM rely on several statistical tests to determine the adequacy of model fit to the data. In the current study, the model fit was determined using several fit indices, the comparative fit index (CFI), root means square error of approximation (RMSEA), normative fit index (NFI), and incremental fit index (IFI). Acceptable model fit is indicated by a CFI value of 0.90 or greater and RMSEA value of 0.06 or less (Hu & Bentler, 1999). The recommended values of NFI and IFI are 0.90 or greater (Bentler & Bonnet, 1980).
RESULTS Descriptive statistics and internal consistency reliability Means, standard deviations, correlations, and internal consistency reliabilities (Cronbach’s alphas) were computed for all measurement concepts. As shown in Table 1, the Cronbach’s alpha scores ranged from 0.66 to 0.90, which is acceptable (Nunnally, 1978). The alpha scores were 0.90 for WFC, 0.90 for Emotional exhaustion, 0.70 for MS pain, and 0.66 for gastrointestinal problems. Moreover, our study variables, WFC, emotional exhaustion, MS pain, and gastrointestinal problems, all correlated positively with each other.
Testing of group differences Multi-group path analyses were conducted to determine whether the structural path coefficients differed among the three travel groups. The results from the multi-group path analysis revealed that the unconstrained model fit the data relatively well (v² = 3302.58; df = 807; RMSEA = 0.038, CFI = 0.88; NFI = 0.85, IFI = 0.88). Moreover, a v² difference test confirmed that the unconstrained model provided significantly better fit to the data compared to the constrained model (v² difference = 373.35, df = 42, p < 0.01). Hence, the results confirmed that the structural path coefficients differ among travel groups. Moreover, the results revealed positive associations between WFC and emotional exhaustion, as well as between emotional exhaustion and MS pain and gastrointestinal problems. The path coefficients for the different groups are shown in Fig. 3. To examine path differences between groups on the associations between constructs, the critical ratio (CR) difference test was applied. The results demonstrated that only the path between emotional exhaustion and MS pain differed significantly across groups. More specifically, significant differences were found between national travelers and commuters (CR = 2.529) and between international travelers and commuters (CR = 2.476). This implies that the association between emotional exhaustion and MS pain is stronger for commuters compared to national travelers and international travelers. Thus, Hypothesis 4 was partially supported.
Confirmatory factor analysis Confirmatory factorial analysis (CFA) was conducted to further validate our measurement concepts, and to test whether our data fit the hypothesized measurement model. In our measurement model, the concepts were considered as latent factors that explain the variances in their associated manifest variables. The results indicated that our model provided a good fit to the data (v² = 1977.18; df = 269; RMSEA = 0.055, CFI = 0.916; NFI = 0.904, IFI = 0.916). Thus, results support the relationship between our manifest variables and the underlying constructs. Finally, all manifest variables loaded on their expected factors, indicating that the concepts are separate from each other.
Testing of structural relationships The next step involved the development of a structural model. The results shown in Fig. 2 indicate that the suggested structural model fitted the data well (v² = 2169.884; df = 293, RMSEA = 0.055, CFI = 0.908, NFI = 901, IFI = 0.909). Moreover, SEM analyses revealed a positive relation between WFC and emotional exhaustion (b = 0.50, p < 0.001). However, no significant relation was found between WFC and MS pain or between WFC and gastrointestinal problems. Hypothesis 1 was therefore only partially supported. Moreover, emotional exhaus-
Table 1. Means (M), standard deviations (SD) Cronbach’s a (on the diagonal) and correlations for the study variables Variable
n
M
SD
1.
2.
3.
4.
1. 2. 3. 4.
2,090 2,078 2,065 2,033
2.92 2.37 0.40 0.16
0.86 1.17 0.45 0.30
(0.90) 0.45* 0.21* 0.14**
(0.90) 0.36* 0.29*
(0.70) 0.41*
(0.66)
Work-family conflict Emotional exhaustion Musculoskeletal pain Gastrointestinal problems
Note: *p < 0.01. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd
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Musculoskeletal pain 0.42* 0.53*
Work-family conflict
Emotional exhaustion 0.49*
Gastrointestinal problems
ns
Fig. 2. Structural relationships among work-family conflict, emotional exhaustion, musculoskeletal pain, and gastrointestinal problems (v² = 2169.884; df = 293; RMSEA = 0.055, CFI = 0.908; NFI 0.901, IFI = 0.909), *p < 0.001, n.s. = non-significant. n = 2,093. ns
Work-family conflict
NT = 0.53*
NT = 0.42*
CO = 0.52*
CO = 0.74*
INT = 0.46*
INT = 0.39*
Musculoskeletal pain
Emotional exhaustion NT = 0.42* CO = 0.40*
Gastrointestinal problems
INT = 0.30*
ns
Fig. 3. Unconstrained multi-group path model. Associations among work-family conflict, emotional exhaustion, musculoskeletal pain, and gastrointestinal problems for the three travel groups (v² = 3302.58; df = 807; RMSEA = 0.038, CFI = 0.88; NFI = 0.85, IFI = 0.88), *p < 0.001, n.s. = nonsignificant, NT = national travellers, CO = commuters, INT = international travellers. n = 2,093.
DISCUSSION The primary purpose of the current study was to assess the associations among WFC, emotional exhaustion, MS pain, and gastrointestinal problems on a sample of business travelers and to examine whether these associations differed by travel groups. First, we expected WFC to be positively related to emotional exhaustion, MS pain, and gastrointestinal problems. The results revealed a positive relation between WFC and emotional exhaustion, which has also been confirmed in previous research (Demerouti et al., 2004; Geurts et al., 1999; Jensen, 2013). However, contrary to our expectations, WFC did not relate to MS pain or gastrointestinal problems. This was surprising, as WFC in previous research has been proven to be positively associated with a number of physical health outcomes (e.g., Frankenhaeuser et al., 1989; Thomas & Ganster, 1995). Further, we also found that emotional exhaustion was related positively to both MS pain and gastrointestinal problems, which was consistent with our expectations as well as previous research (Armon et al., 2010; Melamed, 2009). In spite of the lack of direct association between WFC and health outcomes, the results revealed a full mediation between WFC and health outcomes via emotional exhaustion. This indicates that business travelers who perceive WFC will not necessarily experience MS pain or gastrointestinal problems. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd
However, business travelers who experience WFC in combination with emotional exhaustion are at a greater risk of having MS pain and gastrointestinal problems. According to COR theory, burnout develops from a lack of resource gain (Hobfoll, 2001). Hence, when interpreting our findings in light of COR theory, we could claim that WFC is associated with loss of resources, which is in turn associated with emotional exhaustion and ill health. Moreover, our results are in line with previous research, which indicated that emotional exhaustion is an important mediator in the health impairment process (e.g., Demerouti et al., 2004; Hakanen et al., 2008). Our findings suggest that the associations among WFC, emotional exhaustion, and health-outcomes show a similar pattern for commuters, national travelers, and international travelers. However, the association between emotional exhaustion and MS pain proved to be significantly stronger for the commuter group compared to the national and international travel groups. This is an interesting finding and implies that commuters who experience emotional exhaustion are more prone to MS pain compared to other business travelers. It is not clear to us why the association between emotional exhaustion and MS pain proved to be stronger for commuters. Nevertheless, this finding partly confirms our initial assumption that commuters are perhaps more
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prone to ill health compared to other groups of travelers. Several explanations could elucidate this finding. First, as we have already pointed out, traveling involving frequent leaving and returning, which is characteristic for commuters, can place a strain on both the individual and the family (Morrice & Taylor, 1978). Previous analysis conducted on the same data set revealed that, commuters reported higher WFC compared to other business travelers, see Jensen (2013) for more details. These results might imply that commuters need to take more resources away from family time when they travel for business. In light of COR theory, such chronic resource loss can result in burnout and ill health (Hobfoll, 2001), which could explain the stronger association between emotional exhaustion and MS pain for commuters. Second, the nature of the travel itself might also explain our findings. For instance, it has been stated that business travel can offer a dual experience with contradictory effects, allowing individuals to view a trip as a positive or a negative experience (Westman, 2005). The current study viewed business travel mainly as a demand that can drain resources from the individual. Previous studies have however suggested that exposure to new cultures and places could be a positive aspect of business travel (DeFrank, Konopaske & Ivancevich, 2000), indicating that it can even be a resource rather than a demand. Westman and Etzion (2002) confirmed this assumption in a study, which found a decrease in burnout during a single trip. The authors concluded that detachment from one’s regular work environment when on business travel might reduce strain. It is worth noting that the findings of the current study show no evidence that some travel patterns are more rewarding compared to others. However, based on the stronger association between emotional exhaustion and MS pain for commuters, we could argue that perhaps some business travel patterns, as international travels and national travels, are to some extent less resource draining compared to commuters’ travel. Perhaps there are some aspects of international business travel and national travel that makes it somewhat easier to detach from the regular work environment. For instance, commuters who travel for business reasons travel primarily to or from their workplace. Thus, they are not detached from their “regular work environment,” as much as international business travelers and national business travelers. At least international business travelers use less time on the travel itself, and more on the stay, which perhaps gives a greater opportunity for relaxation.
Practical implications The current study may have several practical implications. Business travelers who experience WFC are more prone to emotional exhaustion, which again influences MS pain and gastrointestinal problems. It is therefore important for organizations to focus on finding ways to reduce WFC among business travelers in order to prevent emotional exhaustion and other negative health outcomes. A previous study found that giving employees the opportunity to control when and how often they travel reduced WFC (Jensen, 2013), which would benefit the employee, their family and the organization. Moreover, our study showed that commuters might be slightly more vulnerable to negative health © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd
Business travel, work-family conflict and health outcomes 111 outcomes compared to national and international travelers. A general impression is that organizations focus mostly on negative health effects related to international business traveling. For instance, international business traveling has often been perceived as very exhausting, having detrimental effects on health due to, for instance, jet lag or physical diseases, such as gastrointestinal infections, and the like. The focus on commuters has perhaps been less prominent. However, based on the current study, organizations should start paying more attention not only to international travelers, but also to employees who travel shorter distances on a regular basis, ensuring that work and traveling do not lead to negative health outcomes.
Limitations and future research The present study has some limitations. First, the study was cross-sectional, meaning we cannot draw causal inferences concerning the hypothesized relationships. Future longitudinal studies on business travelers need to make more solid conclusions regarding our hypothesized relationships. Second, a large part of our study relied on self-report measures, which can increase the problem of common method variance. All health symptom measures were based on self-reports administered at one time point; thus, the common method bias could have influenced the results. It has been suggested that to reduce the problem of common method variance, researchers should attempt to obtain the independent and the dependent variable from different sources (Podsakoff & Organ, 1986). In the planning of the study this was considered to be important. Thus, it was decided to utilize register data rather than self-report questionnaires when measuring business travel. It was also considered whether other more objective methods could be applied when measuring the remaining variables. For instance in the case of health symptoms more objective indicators could be used. However, considering the large size of the sample, this would have been much cost and time consuming. Moreover, self-reported health indicators have turned out to accord well, for example, with health status as evaluated by a physician (Kehoe, Wu, Leske & Chylack, 1994). Additionally several researchers have provided evidence for a relation between objective demands and self-reports of these demands (e.g., Semmer, Zapf & Greif, 1996). Moreover, there is evidence that under some circumstances, self-reports may provide more accurate estimates of population parameters than behavioral measures (Howard, Maxwell, Wiener, Boynton & Rooney, 1980). Finally, the study was conducted only in one company; therefore, caution should be taken when generalizing the results. Nonetheless, the results could be generalizable to a certain degree due to the large sample and the fact that employees from different departments participated in our study. Nevertheless, future studies should test the same relations with different occupational groups.
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Business travel, work-family conflict and health outcomes 113 Westman, M. (2005). The impact of short business travels on the individual, the family and the organization. In A. S. G. Antoniou & C. L. Cooper (Eds.), Research companion to organizational health psychology (pp. 478–491). Cheltenham, UK: Edward Elgar Publishing. Westman, M. & Etzion, D. (2002). The impact of short overseas business trips and job stress and burnout. Applied Psychology: An International Review, 4, 582–592. Westman, M., Etzion, D. & Gortler, E. (2004). The work-family interface and burnout. International Journal of Stress Management, 4, 413–428. Received 25 March 2014, accepted 2 September 2014
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DOI: 10.1111/sjop.12177
Personality and Social Psychology Associations between work family conflict, emotional exhaustion, musculoskeletal pain, and gastrointestinal problems in a sample of business travelers MARIA THERESE JENSEN and TORBJØRN RUNDMO Department of Psychology, Faculty of Social Sciences and Technology Management, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
Jensen, M. T. & Rundmo, T. (2015). Associations between work family conflict, emotional exhaustion, musculoskeletal pain, and gastrointestinal problems in a sample of business travelers. Scandinavian Journal of Psychology, 56, 105–113. The aim of the study was to examine the associations among work-family conflict (WFC), emotional exhaustion, musculoskeletal (MS) pain, and gastrointestinal problems on a sample of business travelers (n = 2,093). An additional aim was to examine differences in the mentioned relationships among three traveler groups: commuters, national travelers, and international travelers. The study was conducted in a large Norwegian oil and gas company, and the company’s business travel database was utilized to examine business travel. Structural equation modeling (SEM) revealed significant relations between WFC and emotional exhaustion and between emotional exhaustion and health problems. Contrary to the expectations, no direct association was found between WFC and health problems. However, we found that emotional exhaustion mediated the relation between WFC and health outcomes. The results from multi-group analysis revealed that associations among WFC, emotional exhaustion, and health-outcomes showed a similar pattern for commuters, national travelers, and international travelers. However, the association between emotional exhaustion and MS pain proved to be significantly stronger for the commuter group compared to the national and international travel groups. Practical implications and the consequences of these findings for future research are discussed. Key words: Business travel, work-family conflict, burnout, musculoskeletal pain, gastrointestinal problems. Maria Therese Jensen, Department of Psychology, Faculty of Social Sciences and Technology Management, Norwegian University of Science and Technology (NTNU), N-7491 Trondheim, Norway. Tel: +4792020913; e-mail: [email protected]
INTRODUCTION In the constant search for economic success, organizations are becoming increasingly global. One consequence of globalization and international growth is an increase in business traveling. In 2012, over 15 million overnight stays in Norway were directly related to business travel (Statistics Norway, 2013, http:// www.ssb.no), indicating that business travel is a common phenomenon. Although business travel is seen as both profitable and necessary for the company, it has also been suggested that excessive traveling may have negative consequences on employees’ physical and psychological health. A review of epidemiological studies on travel-related morbidity showed that overseas travel was related to several health problems, such as gastrointestinal disorders, skin disorders, cardiovascular disease, infections, malaria, and psychological disorders (Patel, 2011). However, most studies referred to in this particular study related to tourist travels, humanitarian aid workers, or expats living abroad. Moreover, compared to the literature on expatriates, which is very thorough, research on the effects of business travel on the traveler, family, and organization is sparse (Westman, 2005). Thus, only a few studies investigated the effect of business travel on the traveler and the family. Two studies conducted in the World Bank Group in Washington (Dimberg, Striker, Noranlycke-Yoo, Nagy, Mundt & Sulsky, 2002; Espino, Sundstrøm, Frick, Jacobs & Peters, 2002) revealed that frequent business traveling puts strain not only on the employees, but also on their families, which again increases stress for the © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd
employee. Another study by the World Bank Group found that infectious disease together with psychological disorders had the strongest association with the frequency of travel (Liese, Mundt, Dell, Nagy & Demure, 1997). Business travel has also been found to be related to work-family conflict and the emotional exhaustion component of burnout (Westman, Etzion & Gortler, 2004). Work-family conflict (henceforth referred to as WFC) is “a form of inter-role conflict in which the role pressures from the work and family domains are mutually incompatible in some respect. That is, participation in the work (family) role is made more difficult by virtue of participation in the family (work) role” (Greenhaus & Beutell, 1985, p. 77). Moreover, emotional exhaustion is a component of burnout, which manifests itself by lack of energy, with emotional resources being fully consumed by work (Maslach, Jackson, Leiter, Schaufeli & Schwab, 1986). One study confirmed a negative relation between business travel and the emotional component of burnout (Westman & Etzion, 2002). However, in Westman and Etzion’s (2002) study, burnout was studied only during a single trip, implying that the chronic strain, which could relate to business travel, was not necessarily captured.
Limitations of previous research The abovementioned previous studies had certain limitations in terms of the measurement of business travel, sample size, and generalizability of results. First, most studies have utilized selfreported measures (Espino et al., 2002; Striker, Luippold, Nagy,
106 M. T. Jensen and T. Rundmo Liese, Bigelow & Mundt, 1999), increasing the likelihood of self-report error. Studies have also utilized expense reports Dimberg et al., 2002; Liese et al., 1997), which have the advantage of being more “objective.” However, the categorization of business trips in these studies has been quite narrow, with “four business trips or more” being the highest category. Moreover, most previous studies referred only to the number of travels and not the number of overnight stays. It is essential to include the number of overnight stays to obtain more accurate information regarding the actual time the traveler is away from home, which again may have implications for WFC and potential health outcomes. Second, several of the studies referred to applied small samples (e.g., Westman & Etzion, 2002; Westman et al., 2004). Third, several studies have been conducted within the same organization (the World Bank Group), which could limit the generalizability of the findings. Finally, nearly all of the abovementioned studies have focused on the amount of traveling, whereas less attention has been paid to business travel patterns. However, regardless of the amount of traveling, business travel pattern alone may exert significant influences on various outcomes. For instance, short business trips have different characteristics compared to long international business trips. For international business trips, the employee often needs to spend time away from the family for longer periods, which may cause work-family conflict. In addition, crossing time zones may also cause jet lag, which again may cause fatigue and gastrointestinal problems (Patel, 2011). On the other hand, compared to international travel, short national travel perhaps involve more time spent on traveling itself rather than the stay, which can be experienced as stressful. Thus, it seems to be essential to gain more knowledge of how business travel pattern is related to, for instance, WFC, emotional exhaustion, and health outcomes.
Background for the current study A more recent study on business travel and its relation to WFC and burnout (Jensen, 2013) addressed several of the abovementioned methodological limitations, utilizing company specific register data on business travel, thereby eliminating self-report error. Moreover, it included the number of overnight stays to measure business travel and a relatively large sample. The results revealed positive associations between business travel frequency (defined as the number of overnight stays) and WFC, and between WFC and emotional exhaustion but no direct association between business travel and emotional exhaustion. To the best of our knowledge, this study was the only one to investigate business travel pattern in relation to WFC and emotional exhaustion. More specifically, cluster analysis identified three groups of travelers, commuters (n = 153), national travelers (n = 1434), and international travelers (n = 506). Comparison of mean scores between commuters, national travelers, and international travelers showed that commuters reported significantly higher WFC compared to both national and international travelers, whereas no differences were found with regard to emotional exhaustion. However, concerning business travel pattern, one shortcoming of the study referred to was that business travel groups were © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd
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compared only with regard to mean differences on WFC and emotional exhaustion, whereas differences in the associations among groups were not examined. Additionally, physical health outcomes were not included in the study. It is vital to include physical health outcomes when studying samples of business travelers. As referred to previously, studies on tourist travels, expats, and the like, revealed an increase in physical health outcomes related to travel (Patel, 2011). Moreover, the abovementioned research suggests that business travelers can be vulnerable to experiencing WFC. WFC can again have negative consequences on individual’s physical health. For instance, Thomas and Ganster (1995) found that WFC was associated with several somatic complaints, such as headaches, insomnia, and sweat palms. Additionally, Haynes, Eaker and Fenlieb (1984) found that WFC was related to coronary heart disease. Moreover, WFC has been found to be related to an increase in stress hormones (Frankenhaeuser, Lundberg, Fredrikson et al., 1989). Previous research has also found that WFC is negatively associated with psychological health (Allen, Herst, Bruck & Sutton, 2000; Amstad, Meler, Fasel, Efering & Semmer, 2011) and positively related to burnout burnout (e.g., Demerouti, Bakker & Bulters., 2004; Geurts, Rutte & Peeters, 1999). Hence, it becomes relevant to identify health outcomes that should be included when studying business travelers. Gastrointestinal problems can be considered one relevant health outcome, as they have been found to be associated specifically to international travel in general (Patel, 2011). Due to its excessiveness, musculoskeletal (MS) pain can be considered another relevant health outcome worth investigating. MS pain is one of the most common non-malignant conditions in the Western World, and occurs frequently among employees who do not perform physical work (Sprigg, Stride, Wall, Holman & Smith, 2007). For instance, in a study of 2,000 office workers, the prevalence of self-reported MS pain in head/neck and both lower and upper back regions was 63% (Janwantanakul, Pensri, Jiamjarasrangsri & Sinsongsook, 2008). One review study found that each year, MS pain in the neck impose limitations on approximately 11% and 14% of workers (Cote, van der Velde, Cassidy, Carroll, Hogg-Johansson & Peloso, 2008). Moreover, MS pain has been found to be the most frequent cause of sick leave and work disability in Norway (Ihlebæk, Brage & Natvig, 2010). Thus, it is essential to understand the antecedents of MS pain. Based on the mentioned facts, we decided to include both MS pain and gastrointestinal problems as health outcomes in the current study. The aims of the present study were twofold. First, we wanted to examine the relation among WFC, emotional exhaustion, MS pain, and gastrointestinal problems using a sample of business travelers as a whole. Second, we wanted to investigate differences in the associations among commuters, international travelers, and national travelers. The current study is based on the same data as the study by Jensen (2013). WFC is a bidirectional concept. Accordingly, family interference with work has been referred to as family-work conflict (Netemeyer, Boles & McMurrian, 1996). However, in the current study, we focused on WFC. The reason for this restriction was the fact that stressors related to work, such as business travel, are more likely to influence WFC (see Michel, Kotrba, Michelson, Clark & Baltes, 2011, for a meta-analysis).
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COR theory and hypothesis development It has been suggested that business travel research should be studied in the light of Hobfoll’s (2001) conservation of resources (COR) theory (Westman, 2005). The basis of the theory of Conservation of Resources is that individuals strive to obtain, retain, protect, and foster “things” that they value (Hobfoll, 2001, p. 341). “Things” means resources, including personal characteristics, objects, conditions, and energies (Hobfoll, 2001). Further, COR theory states, “Those who lack resources are not only more vulnerable to resource loss, but initial loss begets future loss” (Hobfoll, 2001, p. 354). Previous research has shown that after a travel mission, many workers experience a heavy workload because tasks pile up while they are away (Striker et al., 1999), implying that business travel increases demands on the employee. Employees often cope with high work demands by spending less time with family and even more time at work in order to get the job done, which according to COR theory results in resource loss (Hobfoll, 2001). Individuals who experience such resource loss are prone to experience WFC and go into negative states, with decrease their well-being. Previous studies have found support for this view (e.g., Espino et al., 2002; Jensen, 2013). Moreover, when traveling, the employee will spend even more time away from the family, which again will give rise to WFC. Thus, business travelers can be more exposed to resource drain, as business travel is a demand that can drain resources from family time. COR theory can also be used to explain the process of burnout in work settings (Grandey & Cropanzano, 1999), which develops from a lack of resource gain and sometimes exposure to minor chronic losses (Hobfoll, 2001). As we have already noted above, previous research has found that WFC is related to burnout, (e.g., Demerouti et al., 2004; Geurts et al., 1999) in addition to physical health (Frankenhaeuser et al., 1989; Thomas & Ganster, 1995) and psychological health (Allen et al., 2000; Amstad et al., 2011). However, when looking at previous research conducted on WFC and health outcomes, little attention has been paid to studying the relation between WFC and MS pain or between WFC and gastrointestinal problems. Since WFC has been found to relate to several other health outcomes in previous research, it can be assumed that WFC will relate positively to MS pain and gastrointestinal problems. Moreover, neck pain has been found to relate to psychosocial factors and particularly to role-conflict (Christensen & Knardahl, 2010). Thus, it can be expected that WFC will relate positively to MS pain. Based on COR theory and evidence from previous research, we formulated the following hypothesis: Hypothesis 1: WFC is positively related to emotional exhaustion, MS pain, and gastrointestinal problems. The relation between burnout and health outcomes has been well established. A number of studies have found that burnout relates to numerous somatic symptoms, including headaches, gastrointestinal afflictions, and sleep disturbances (e.g., Gorter, Eijkman & Hoogstraten, 2000; Kahill, 1988). Moreover, increasing evidence suggests a positive association between burnout and mental health, such as anxiety (e.g., Turnipseed, 1998) or depression (Hakanen, Schaufeli & Ahola, 2008; Schaufeli &
© 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd
Business travel, work-family conflict and health outcomes 107 Enzmann, 1998). Both positive relations between MS pain and burnout have been demonstrated in cross sectional studies, (Honkonen, Ahola, Pertovaara et al., 2006; Langballe, Innstrand, Hagtvet, Falkum & Gjerlow Aasland, 2009), case-control studies (Soares & Jablonska, 2004), and longitudinal studies (Armon, Melamed, Shirom & Shapira, 2010; Melamed, 2009), even after adjusting for depression and anxiety (Melamed, 2009). Accordingly, we formulated the following hypothesis: Hypothesis 2: Emotional exhaustion is positively related to MS pain and gastrointestinal problems. Chronic job demands may deplete employees’ energy and resources and thus may lead to burnout followed by ill health. Moreover, burnout can be considered a mediator in the energy draining process, which leads to health impairment (Schaufeli & Bakker, 2004). Previous longitudinal studies have also confirmed that burnout is a mediator of the relation between demands and ill health (e.g., Demerouti et al., 2004; Hakanen et al., 2008). Accordingly, we expect to see that the emotional exhaustion component of burnout will mediate the association between WFC and health outcomes. However, as already noted above, previous research found WFC to be directly associated with physical health (Frankenhaeuser et al., 1989; Thomas & Ganster, 1995). Thus, we expect to see that WFC has both direct and indirect effects via emotional exhaustion on health outcomes. Accordingly, the following hypothesis was proposed: Hypothesis 3: Emotional exhaustion will partially mediate the association between WFC and health outcomes (MS pain and gastrointestinal problems). As noted previously, some travel patterns might be more resource draining compared to other travel patterns, which again could have implications for the degree of perceived WFC and its association with health outcomes. Thus, we also wanted to investigate whether different business travel patterns may have different influences on the associations among WFC, emotional exhaustion, and health outcomes. In a previous study by Jensen (2013), commuters reported significantly higher WFC compared to both national and international travelers. This is partly in line with Morrice and Taylor’s (1978) early research on home and work patterns of offshore workers. Morrice and Taylor (1978) found that travel patterns characterized by frequent leaving and returning disrupted family life more. Frequent leaving and returning characterizes particularly commuters. Based on these findings, we therefore expect to find significantly stronger associations among WFC, emotional exhaustion, and health outcomes for commuters compared to national and international travelers. Thus, we proposed the following hypothesis: Hypothesis 4: The associations among WFC, emotional exhaustion, MS pain, and gastrointestinal problems are stronger for commuters compared to national and international travelers. Figure 1 depicts a working model of the expected associations in the present study. The model reflects the hypotheses specified and discussed above.
108 M. T. Jensen and T. Rundmo
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Musculoskeletal pain
+ + Work-family conflict
+
Emotional exhaustion
+
Gastrointestinal problems
+
Fig. 1. Working model of the current study.
METHOD Participants, selection criteria and overview of sample The study was conducted in two business units of a large Norwegian oil and gas company. The data utilized was from a previous study by Jensen (2013). Most employees in the first business unit worked as advisors within their special field, delivering technical and safety expertise to business, primarily within the fields of subsea equipment, drilling, and facilities. Employees in the second unit worked primarily within trading and marketing of oil and gas. All employees were clerical workers and in general, they were highly educated. The sample was selected from the company’s register data on business travel. Information is automatically entered into the company’s database when employees book their trips through the company’s data system. Based on the available information, the generated data reports contained the type of travel, number of business trips, and number of overnight stays. The criteria for drawing the sample was based on travel frequency during the preceding 6 months and was set to a minimum of five or more business travels or 10 or more overnight stays within the specified period. The number of journeys ranged from 1 to 61 (Mean = 13, Standard deviation = 8.1), whereas the number of overnight stays ranged from 5 to 173 (Mean = 32.7, Standard deviation = 25.1). 3078 business travelers were selected based on these criterions. Additionally, a self-reported questionnaire was utilized to measure the remaining variables. The questionnaires were distributed to respondents via e-mail, and the data collection was carried out during May–June 2011; 2,093 responded to the questionnaire, giving a response rate of 68%. Of the respondents, 460 (22%) were females and 1633 (78%) were males. Furthermore, 7.6% of participants were under 30 years old, followed by 30–39 years old (22.8%), 40–49 years old (35.1%), 50– 59 years old (31.6%), and over 60 years old (2.9%). Moreover, 19.5% had worked in the company for 1–3 years, 28.2% for 3–10 years, and 52.3% for more than 10 years. Overall, 55.5% of the total sample had parental responsibility for preschool and school aged children, and 21.6% were managers with personnel responsibility.
Measures and questionnaires The variables were measured using a self-reported questionnaire. The questionnaires were distributed to respondents via e-mail, and the data collection was carried out during May–June 2011. All data were derived from the study by Jensen (2013). Work-Family conflict, WFC, was assessed using 5 items developed by Netemeyer et al., (1996). The respondents were asked to indicate on a 5-point scale ranging from 1 (totally disagree) to 5 (totally agree) the extent to which they agreed with items such as, “The demands of my work interfere with my home and family life.” Higher scores indicated greater WFC. A translated version of the General survey (MBI-GS) from the Maslach Burnout Inventory was used to assess emotional exhaustion (Maslach, Jackson & Leiter, 1996). The original version was translated to Norwegian in a previous study, and the translated version demon© 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd
strated good validity (Jensen, 2013). The scale comprises 5 items (e.g., I feel emotionally drained from my work, working all day is a real strain for me) measured on a seven-point scale where 0 = never, 1 = a few times a year or less, 2 = once a month or less, 3 = a few times a week, 4 = once a week, 5 = a few times a week, and 6 = every day. MS pain comprised 8 questions from the Subjective Health Complaint Inventory (Eriksen, Ihlebæk & Ursin, 1999). The respondents were asked to indicate on a 4 point scale (0 = none, 1 = some, 2 = much, 3 = severe) the severity of their symptoms, including headache, migraine, neck pain, upper back pain, low back pain, arm pain, shoulder pain, and pain in feet, experienced during the last 30 days. The Subjective Health Complaint Inventory measured gastrointestinal problems, including heartburn, stomach discomfort, ulcer/non-ulcer dyspepsia, stomach pain, gas discomfort, diarrhea, and obstipation. Both scales have demonstrated acceptable validity in previous studies conducted with the Norwegian population (Eriksen et al., 1999). Travel pattern consisted of three traveler groups: Commuters (n = 153), national travelers (n = 1,434), and international travelers (n = 506). See Jensen (2013) for more details.
Statistical analysis First, to validate the model shown in Fig. 1, confirmatory factor analysis (CFA) with maximum likelihood estimation was applied using AMOS version 21.0 (Arbuckle, 2012). Confirmatory factor analysis (CFA) is a statistical technique used to verify the factor structure of a set of observed variables. CFA makes it possible to test the relationship between observed variables and their underlying latent constructs. Each indicator was assigned to the measurement instrument to which it originally belonged. Second, structural equation modeling (SEM) was utilized to test the structural model of the relationships among WFC, emotional exhaustion, MS pain, and gastrointestinal problems. SEM makes it possible to analyze a set of regression equations simultaneously while also controlling for measurement error. Third, to test the significance of the mediational effect of emotional exhaustion on the relation between WFC and health outcomes, we used the bias-corrected bootstrap test of mediation in AMOS version 21.0 (IBM, Armonk, NY). MacKinnon, Lockwood and Williams (2004) suggested the bias-corrected bootstrap approach as the most optimal method, as it corrects for skewness in the population. Specifically, 1,000 bootstrap samples and 95% bias-corrected confidence intervals were applied. Fourth, a multi-group path analysis using SEM was applied to examine whether model parameters varied across travel groups. The fit of an unconstrained model was tested, examining the assumption that the path coefficients differed across different clusters. This model was compared to a constrained model in which coefficients were set to be equal across travel groups. Model comparison was conducted using v² difference test (J€ oreskog & S€ orbom, 1993). To determine whether the parameters differed by travel groups, the critical ratio difference test was applied. We applied the criteria suggested by Arbuckle (2012), where the critical ratio that exceeds 1.96 in magnitude is significant at the 0.05 level. Finally, SPSS (Statistical programs for Social scientists) version 21 (IBM, Armonk, NY) was used to determine the means, standard deviations, correlations, reliability, and internal consistency of measures.
Business travel, work-family conflict and health outcomes 109
Scand J Psychol 56 (2015)
tion turned out to be significantly related to both MS pain (b = 0.42, p < 0.001) and gastrointestinal problems (b = 0.49, p < 0.001), supporting Hypothesis 2. The examination of the indirect effects of emotional exhaustion on MS pain and gastrointestinal problems, using the bias-corrected bootstrap test of mediation, demonstrated that emotional exhaustion mediated the relation between WFC and MS pain (b = 0.20, 95% CI [0.17, 0.24], SE 0.02, p < 0.001) and also between WFC and gastrointestinal problems (b = 0.20, 95% CI [0.16, 0.24], SE 0.02, p < 0.001). Moreover, when emotional exhaustion was omitted from our model results revealed no significant direct association between WFC and MS pain, or between WFC and gastrointestinal problems. This indicates that the relation between WFC and both MS pain and gastrointestinal problems, are completely mediated by emotional exhaustion. The fit of the mediation model was found to be generally satisfactory (v² = 21.262; df = 270, RMSEA = 0.057, CFI = 0.909, NFI = 987, IFI = 0.909). Thus, Hypothesis 3 was partially supported.
CFA and SEM rely on several statistical tests to determine the adequacy of model fit to the data. In the current study, the model fit was determined using several fit indices, the comparative fit index (CFI), root means square error of approximation (RMSEA), normative fit index (NFI), and incremental fit index (IFI). Acceptable model fit is indicated by a CFI value of 0.90 or greater and RMSEA value of 0.06 or less (Hu & Bentler, 1999). The recommended values of NFI and IFI are 0.90 or greater (Bentler & Bonnet, 1980).
RESULTS Descriptive statistics and internal consistency reliability Means, standard deviations, correlations, and internal consistency reliabilities (Cronbach’s alphas) were computed for all measurement concepts. As shown in Table 1, the Cronbach’s alpha scores ranged from 0.66 to 0.90, which is acceptable (Nunnally, 1978). The alpha scores were 0.90 for WFC, 0.90 for Emotional exhaustion, 0.70 for MS pain, and 0.66 for gastrointestinal problems. Moreover, our study variables, WFC, emotional exhaustion, MS pain, and gastrointestinal problems, all correlated positively with each other.
Testing of group differences Multi-group path analyses were conducted to determine whether the structural path coefficients differed among the three travel groups. The results from the multi-group path analysis revealed that the unconstrained model fit the data relatively well (v² = 3302.58; df = 807; RMSEA = 0.038, CFI = 0.88; NFI = 0.85, IFI = 0.88). Moreover, a v² difference test confirmed that the unconstrained model provided significantly better fit to the data compared to the constrained model (v² difference = 373.35, df = 42, p < 0.01). Hence, the results confirmed that the structural path coefficients differ among travel groups. Moreover, the results revealed positive associations between WFC and emotional exhaustion, as well as between emotional exhaustion and MS pain and gastrointestinal problems. The path coefficients for the different groups are shown in Fig. 3. To examine path differences between groups on the associations between constructs, the critical ratio (CR) difference test was applied. The results demonstrated that only the path between emotional exhaustion and MS pain differed significantly across groups. More specifically, significant differences were found between national travelers and commuters (CR = 2.529) and between international travelers and commuters (CR = 2.476). This implies that the association between emotional exhaustion and MS pain is stronger for commuters compared to national travelers and international travelers. Thus, Hypothesis 4 was partially supported.
Confirmatory factor analysis Confirmatory factorial analysis (CFA) was conducted to further validate our measurement concepts, and to test whether our data fit the hypothesized measurement model. In our measurement model, the concepts were considered as latent factors that explain the variances in their associated manifest variables. The results indicated that our model provided a good fit to the data (v² = 1977.18; df = 269; RMSEA = 0.055, CFI = 0.916; NFI = 0.904, IFI = 0.916). Thus, results support the relationship between our manifest variables and the underlying constructs. Finally, all manifest variables loaded on their expected factors, indicating that the concepts are separate from each other.
Testing of structural relationships The next step involved the development of a structural model. The results shown in Fig. 2 indicate that the suggested structural model fitted the data well (v² = 2169.884; df = 293, RMSEA = 0.055, CFI = 0.908, NFI = 901, IFI = 0.909). Moreover, SEM analyses revealed a positive relation between WFC and emotional exhaustion (b = 0.50, p < 0.001). However, no significant relation was found between WFC and MS pain or between WFC and gastrointestinal problems. Hypothesis 1 was therefore only partially supported. Moreover, emotional exhaus-
Table 1. Means (M), standard deviations (SD) Cronbach’s a (on the diagonal) and correlations for the study variables Variable
n
M
SD
1.
2.
3.
4.
1. 2. 3. 4.
2,090 2,078 2,065 2,033
2.92 2.37 0.40 0.16
0.86 1.17 0.45 0.30
(0.90) 0.45* 0.21* 0.14**
(0.90) 0.36* 0.29*
(0.70) 0.41*
(0.66)
Work-family conflict Emotional exhaustion Musculoskeletal pain Gastrointestinal problems
Note: *p < 0.01. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd
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Scand J Psychol 56 (2015) ns
Musculoskeletal pain 0.42* 0.53*
Work-family conflict
Emotional exhaustion 0.49*
Gastrointestinal problems
ns
Fig. 2. Structural relationships among work-family conflict, emotional exhaustion, musculoskeletal pain, and gastrointestinal problems (v² = 2169.884; df = 293; RMSEA = 0.055, CFI = 0.908; NFI 0.901, IFI = 0.909), *p < 0.001, n.s. = non-significant. n = 2,093. ns
Work-family conflict
NT = 0.53*
NT = 0.42*
CO = 0.52*
CO = 0.74*
INT = 0.46*
INT = 0.39*
Musculoskeletal pain
Emotional exhaustion NT = 0.42* CO = 0.40*
Gastrointestinal problems
INT = 0.30*
ns
Fig. 3. Unconstrained multi-group path model. Associations among work-family conflict, emotional exhaustion, musculoskeletal pain, and gastrointestinal problems for the three travel groups (v² = 3302.58; df = 807; RMSEA = 0.038, CFI = 0.88; NFI = 0.85, IFI = 0.88), *p < 0.001, n.s. = nonsignificant, NT = national travellers, CO = commuters, INT = international travellers. n = 2,093.
DISCUSSION The primary purpose of the current study was to assess the associations among WFC, emotional exhaustion, MS pain, and gastrointestinal problems on a sample of business travelers and to examine whether these associations differed by travel groups. First, we expected WFC to be positively related to emotional exhaustion, MS pain, and gastrointestinal problems. The results revealed a positive relation between WFC and emotional exhaustion, which has also been confirmed in previous research (Demerouti et al., 2004; Geurts et al., 1999; Jensen, 2013). However, contrary to our expectations, WFC did not relate to MS pain or gastrointestinal problems. This was surprising, as WFC in previous research has been proven to be positively associated with a number of physical health outcomes (e.g., Frankenhaeuser et al., 1989; Thomas & Ganster, 1995). Further, we also found that emotional exhaustion was related positively to both MS pain and gastrointestinal problems, which was consistent with our expectations as well as previous research (Armon et al., 2010; Melamed, 2009). In spite of the lack of direct association between WFC and health outcomes, the results revealed a full mediation between WFC and health outcomes via emotional exhaustion. This indicates that business travelers who perceive WFC will not necessarily experience MS pain or gastrointestinal problems. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd
However, business travelers who experience WFC in combination with emotional exhaustion are at a greater risk of having MS pain and gastrointestinal problems. According to COR theory, burnout develops from a lack of resource gain (Hobfoll, 2001). Hence, when interpreting our findings in light of COR theory, we could claim that WFC is associated with loss of resources, which is in turn associated with emotional exhaustion and ill health. Moreover, our results are in line with previous research, which indicated that emotional exhaustion is an important mediator in the health impairment process (e.g., Demerouti et al., 2004; Hakanen et al., 2008). Our findings suggest that the associations among WFC, emotional exhaustion, and health-outcomes show a similar pattern for commuters, national travelers, and international travelers. However, the association between emotional exhaustion and MS pain proved to be significantly stronger for the commuter group compared to the national and international travel groups. This is an interesting finding and implies that commuters who experience emotional exhaustion are more prone to MS pain compared to other business travelers. It is not clear to us why the association between emotional exhaustion and MS pain proved to be stronger for commuters. Nevertheless, this finding partly confirms our initial assumption that commuters are perhaps more
Scand J Psychol 56 (2015)
prone to ill health compared to other groups of travelers. Several explanations could elucidate this finding. First, as we have already pointed out, traveling involving frequent leaving and returning, which is characteristic for commuters, can place a strain on both the individual and the family (Morrice & Taylor, 1978). Previous analysis conducted on the same data set revealed that, commuters reported higher WFC compared to other business travelers, see Jensen (2013) for more details. These results might imply that commuters need to take more resources away from family time when they travel for business. In light of COR theory, such chronic resource loss can result in burnout and ill health (Hobfoll, 2001), which could explain the stronger association between emotional exhaustion and MS pain for commuters. Second, the nature of the travel itself might also explain our findings. For instance, it has been stated that business travel can offer a dual experience with contradictory effects, allowing individuals to view a trip as a positive or a negative experience (Westman, 2005). The current study viewed business travel mainly as a demand that can drain resources from the individual. Previous studies have however suggested that exposure to new cultures and places could be a positive aspect of business travel (DeFrank, Konopaske & Ivancevich, 2000), indicating that it can even be a resource rather than a demand. Westman and Etzion (2002) confirmed this assumption in a study, which found a decrease in burnout during a single trip. The authors concluded that detachment from one’s regular work environment when on business travel might reduce strain. It is worth noting that the findings of the current study show no evidence that some travel patterns are more rewarding compared to others. However, based on the stronger association between emotional exhaustion and MS pain for commuters, we could argue that perhaps some business travel patterns, as international travels and national travels, are to some extent less resource draining compared to commuters’ travel. Perhaps there are some aspects of international business travel and national travel that makes it somewhat easier to detach from the regular work environment. For instance, commuters who travel for business reasons travel primarily to or from their workplace. Thus, they are not detached from their “regular work environment,” as much as international business travelers and national business travelers. At least international business travelers use less time on the travel itself, and more on the stay, which perhaps gives a greater opportunity for relaxation.
Practical implications The current study may have several practical implications. Business travelers who experience WFC are more prone to emotional exhaustion, which again influences MS pain and gastrointestinal problems. It is therefore important for organizations to focus on finding ways to reduce WFC among business travelers in order to prevent emotional exhaustion and other negative health outcomes. A previous study found that giving employees the opportunity to control when and how often they travel reduced WFC (Jensen, 2013), which would benefit the employee, their family and the organization. Moreover, our study showed that commuters might be slightly more vulnerable to negative health © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd
Business travel, work-family conflict and health outcomes 111 outcomes compared to national and international travelers. A general impression is that organizations focus mostly on negative health effects related to international business traveling. For instance, international business traveling has often been perceived as very exhausting, having detrimental effects on health due to, for instance, jet lag or physical diseases, such as gastrointestinal infections, and the like. The focus on commuters has perhaps been less prominent. However, based on the current study, organizations should start paying more attention not only to international travelers, but also to employees who travel shorter distances on a regular basis, ensuring that work and traveling do not lead to negative health outcomes.
Limitations and future research The present study has some limitations. First, the study was cross-sectional, meaning we cannot draw causal inferences concerning the hypothesized relationships. Future longitudinal studies on business travelers need to make more solid conclusions regarding our hypothesized relationships. Second, a large part of our study relied on self-report measures, which can increase the problem of common method variance. All health symptom measures were based on self-reports administered at one time point; thus, the common method bias could have influenced the results. It has been suggested that to reduce the problem of common method variance, researchers should attempt to obtain the independent and the dependent variable from different sources (Podsakoff & Organ, 1986). In the planning of the study this was considered to be important. Thus, it was decided to utilize register data rather than self-report questionnaires when measuring business travel. It was also considered whether other more objective methods could be applied when measuring the remaining variables. For instance in the case of health symptoms more objective indicators could be used. However, considering the large size of the sample, this would have been much cost and time consuming. Moreover, self-reported health indicators have turned out to accord well, for example, with health status as evaluated by a physician (Kehoe, Wu, Leske & Chylack, 1994). Additionally several researchers have provided evidence for a relation between objective demands and self-reports of these demands (e.g., Semmer, Zapf & Greif, 1996). Moreover, there is evidence that under some circumstances, self-reports may provide more accurate estimates of population parameters than behavioral measures (Howard, Maxwell, Wiener, Boynton & Rooney, 1980). Finally, the study was conducted only in one company; therefore, caution should be taken when generalizing the results. Nonetheless, the results could be generalizable to a certain degree due to the large sample and the fact that employees from different departments participated in our study. Nevertheless, future studies should test the same relations with different occupational groups.
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