Gender differentiates the predictors of an intention to leave the workplace: a meta-analysis of the effort-reward imbalance workplace stress studies

Figures & data

Figure 1. Flowchart of the Study Selection Process.

Note. ERI = effort-reward imbalance. ITL = intention to leave.

Table 1. Exclusion Criteria for Study Inclusion in the Meta-analysis.

The paper was qualitative. The paper was not published in a peer-reviewed journal. The paper contained no original data. The paper discussed the descriptive, theoretical, or psychometric properties of the ERI model. The participants were not a working population. The paper did not utilise the ERI model. The paper did not measure turnover intentions The paper measured exiting the paid workforce due to retirement or disability. The paper did not report the effect size and the corresponding author did not provide the requested effect sizes

Note. ERI = effort-reward imbalance

Table 2. Summary of Characteristics of Studies Included in the Meta-analysis.

Author, Year	Sample size, sex, age range (M, SD), study location	Occupation	Study design	Specific predictors, ERI Mean	Outcome	Key findings
(Anker & Krill, 2021)	N = 2,863, ♀ = 51%, (Age♀ ≤ 30yrs = 11.7%, 31-40yrs = 27.9%, 41-50yrs = 25.2%, 51-60yrs = 21.4%, 61-70yrs  = 11.9%, > 70yrs = 1.9%. Age♂ ≤ 30yrs = 6%, 31-40yrs = 23.5%, 41-50yrs = 19.2%, 51-60yrs = 22.8%, 61-70yrs = 20.4%, > 70yrs = 8.2%), US	Attorneys	Cross-sectional	ERI - categorical. OC - categorical.	ITLP	Women had higher ERI and OC scores than men. OC positively related to ITLP, and this was stronger for men than women.
(Bianchi et al., 2018)^a	N = 257, ♀ = 76%, (M = 44.84, SD = 10.46), Switzerland	Teachers	Cross-sectional	ERI – continuous (M = 1.25, SD = 0.56). Effort - continuous. Reward - continuous.	ITLJ	Effort and ERI positively correlated with ITL. Reward negatively correlated with ITL.
(de Oliveira et al., 2017)	N = 3,229, ♀ = 87.3%, (M = 40yrs, SD = 10), Brazil	Nurses	Cross-sectional	ERI - categorical. OC - categorical.	ITLJ	Males more likely to report ITL than females. Younger employees more likely than older employees to report ITL. ITL increased with high ERI and OC.
(Devonish, 2018)	N = 323, ♀ = 67%, (18-34yrs = 42%, ≥ 35yrs = 58%), Barbados	Full-time employees	Cross-sectional	ERI – continuous (M = 1.15, SD = 0.47). Effort - continuous. Reward - continuous.	ITLJ	ERI had a direct positive effect on ITL.
(Dorenkamp & Weiß, 2018)	N = 421, ♀ = 53%, (M = 36.49yrs, SD = 6.01yrs), Germany	Academics	Cross-sectional	ERI – continuous (M = 1.56, SD = 0.56) OC - continuous	ITLP	Three-path-mediation showed an ERI-ITL link via strain and job satisfaction. OC-strain relationship is stronger for females than males. The direct ERI-ITL link is significant for females only.
(Fei et al., 2022)	N = 17,582, ♀ = 89.8%, (<25yrs = 19.9%, 25-34yrs = 60.0%, > 35yrs = 20.2%), China	Nurses	Cross-sectional	ERI – continuous (M = 1.26, SD = 0.61). Effort – continuous. Reward – continuous.	ITLJ	ERI and effort were positively related to ITL. Rewards negatively related to ITL. Depressive symptoms partially mediated the effects of ERI on ITL.
(Greenham et al., 2019)	N = 98, ♀ = 78.57%, 27-63yrs (M = 43.48yrs, SD = 7.62yrs), UK	School guidance counsellors	Cross-sectional	OC - continuous. Effort - continuous. Reward - continuous.	ITLJ	ITL positively related with greater effort.
(Hämmig, 2018)	N = 1,840, ♀ > 85%, < 45yrs = 58%, Switzerland	Health professionals	Cross-sectional	ERI - continuous.	ITLP	ERI was positively associated with ITL.
(Hasselhorn et al., 2004)^a	N = 21,729, ♀ = 87.3%, Belgium, Germany, France, Italy, The Netherlands, Poland, Slovakia	Nurses	Cross-sectional	ERI – continuous (M = 0.71, SD = 0.36). OC.	ITLP	High ERI was associated with high odds ratios for ITL. Small positive OC-ITL association.
(Jiang et al., 2022)	N = 10,457, ♀ = 27.02%, (≤31yrs = 29.75%, 32-35yrs = 20.56%, 36-40yrs = 24.71%, ≥ 41yrs = 24.98%), China	Emergency Physicians	Cross-sectional	ERI – continuous (M = 1.55, SD = 0.79). OC.	ITLJ	ERI and OC were positively associated with ITL.
(Kinman, 2016)^a	N = 649, ♀ = 42%, > 41yrs = 79%, UK	Academics	Cross-sectional	OC - continuous. Effort - continuous. Financial reward, esteem reward, security reward - continuous.	ITLJ	Efforts and OC positively related to ITL. Rewards negatively related to ITL. The strongest predictor of ITL was esteem rewards.
(Kinnunen et al., 2008)^a	N = 323, ♀ = 30%, M = 47.88yrs, SD = 8.52yrs, Finland	Managers	Cross-sectional	ERI – continuous (M = .55). OC - continuous. Effort - continuous. Reward - continuous.	ITLJ	Efforts, ERI, and OC positively correlated with ITL. Reward negatively correlated with ITL. ERI-ITL strongest under high OC and perceived organisational support.
(Lang et al., 2010)	N = 789, ♀ = 6.3%, (M = 32yrs, SD = 9.12yrs), US	Military reservists	Cross-sectional	Effort - continuous. Financial reward, esteem reward, meaning of military reward - continuous.	ITLP	High efforts/low financial reward positively associated with increased ITL.
(Lavoie-Tremblay et al., 2008)	N = 309, ♀ = 96.4%, 20-25yrs (M = 22.6yrs, SD = 1.28yrs), Canada	Nurses	Cross-sectional	ERI - categorical.	ITLJ ITLP	ERI positively related to both ITLJ and ITLP.
(Loerbroks et al., 2014)	N = 425, ♀ = 80.24%, Age (M = 35.74yrs, SD = 6.65yrs), China	Teachers	Cross-sectional	ERI – categorical (M = 1.17, SD = 0.35). Effort. Reward.	ITLP	ERI positively related to burnout and ITL.
(Leineweber et al., 2021)^a	N = 7,375, ♀ = 58.79%, Age (M = 49.94yrs, SD = 8.69yrs), Sweden	Employees	Prospective^b	ERI – continuous (M = 1.08, SD = 0.43).	ITLJ	ERI, OC and Effort positively related to ITLJ. Rewards negatively related to ITLJ. Higher income related to lower ERI. Higher income related to higher ITLJ.
(Martinez et al., 2022)^a	N = 605, ♀ = 85%, (≤30yrs = 17.02%, 31-40yrs = 36.86%, ≥ 41yrs = 46.12%), Brazil	Nurses	Cross-sectional	ERI – continuous (M = 0.74, SD = 0.43). OC - categorical.	ITLP	ERI and Effort positively related to ITLJ. Rewards negatively related to ITLJ.
(Panatik et al., 2012)	N = 267, Malaysia	Academics	Cross-sectional	OC - continuous. Effort - continuous. Reward - continuous.	ITLJ	Reward was negatively correlated with ITL. OC positively related to ITL. Effort not associated with ITL.
(Scanlan et al., 2013)^a	N = 103, ♀ = 91.3%, (<25yrs = 15.55%, 25-35yrs = 42.7%, 35-45yrs = 18.4%, > 45yrs = 21.4%), Australia	Occupational therapists	Cross-sectional	Effort - continuous. Reward - continuous.	ITLJ	Higher efforts, lower rewards related to higher well-being at work. Well-being at work was negatively related to ITL.
(Schug et al., 2022)	N = 757, ♀ = 76.9%, (18-30yrs = 24.2%, 31-40yrs = 23.8%, 41-50yrs = 20.9%, ≥ 41yrs = 31.2%), German	Nurses	Cross-sectional	Effort - continuous. Reward - continuous.	ITLJ	Higher rewards were related to lower ITL.
(Tei-Tominaga et al., 2018)^a	N = 5,074, ♀ = 100%, (M = 36.24yrs), Japan	Nurses	Cross-sectional	ERI (M = 0.43, SD = 0.15). OC - continuous. Effort - continuous. Monetary reward, Esteem reward, career opportunity reward - continuous.	ITLJ	Participants categorised into four age groups (≥50yrs, 39-49yrs, 25-34yrs, < 24yrs) Effort and monetary reward were associated with ITL across all age groups. Career opportunity reward was only associated with ITL for the 39-49yrs group. Esteem reward was not related to ITL. OC was associated with ITL in all but ≥50yrs group.
(Tominaga & Miki, 2011)^a	N = 1364, ♀ = 91.5%, (M♂ = 22.4yrs, SD = 2.06yrs; M♀ = 22.2yrs, SD = 1.43yrs), Japan	Nurses	Cross-sectional	OC - continuous. Effort - continuous. Money reward, esteem reward, career opportunity reward - continuous.	ITLJ	Effort was positively related to ITL. OC and reward were not related to ITL.
(Vu-Eickmann et al., 2018)	N = 887, ♀ = 98.41%, (M = 39.23yrs, SD = 11.43yrs), Germany	Physician assistants	Cross-sectional	ERI –categorical (M = 1.28, SD = 0.42). Effort - continuous. Reward - continuous.	ITLP	ERI associated with poorer self-reported health, elevated symptoms of depression and anxiety, poorer quality of care, increased ITL.

Note. ^aAdditional data provided by author/s. ^bbaseline data used in meta-analysis. ERI = effort-reward imbalance, ITL = intention to leave, ITLJ = intention to leave the job, ITLP = intention to leave the profession, OC = overcommitment

Figure 2. Forest Plot of the Association Between Effort-Reward Imbalance and Intention to Leave.

Note. ITLJ = intention to leave the job, ITLP = intention to leave the profession.

Figure 3. Forest Plot of the Association Between Overcommitment and Intention to Leave.

Note. ITLJ = intention to leave the job, ITLP = intention to leave the profession.

Figure 4. Forest Plot of the Association Between Effort and Intention to Leave.

Note. ITLJ = intention to leave the job, ITLP = intention to leave the profession.

Figure 5. Forest Plot of the Association Between Reward and Intention to Leave.

Note. ITLJ = intention to leave the job, ITLP = intention to leave the profession.

Table 3. Associations Between Effort-Reward Imbalance, Overcommitment, Efforts, and Rewards and Intentions to Leave by Occupation.

Association by occupation		r	95% CI	I^2	K	N	Contrast
ERI	Academics	.29**	.20, .38	0.00	1	421
	Health workers	.37**	.24, .48	99.55	10	61,756
	Educators	.37**	.12, .58	92.93	2	682	Q = 1.37
	Other	.29**	.17, .40	93.33	4	9853	p = .71
OC	Academics	.15**	.09, .20	2.96	3	1337
	Health workers	.32**	.22, .42	98.87	6	49,413
	Educators	.19	-.01, .37	0.00	1	98	Q = 9.38
	Other	.18**	.13, .22	0.00	3	2892	p = .03
Efforts	Academics	.17*	.01, .33	82.63	2	916
	Health workers	.28**	.21, .36	98.22	8	46,587
	Educators	.22**	.13, .31	42.97	3	780	Q = 4.34
	Other	.17**	.07, .26	91.62	3	9465	p = .28
Rewards	Academics	-.37**	-.42, -.31	0.00	2	916
	Health workers	-.36**	-.48, -.22	99.59	8	47,504
	Educators	-.34**	-.53, -.11	89.90	3	780	Q = 3.36
	Other	-.45**	-.52, -.37	90.34	2	8676	p = .34

Note. * = p < .05, ** = p < .001. ERI = effort-reward imbalance, OC = overcommitment,

Academics [academics], Health workers [nurses, occupational therapists, physician assistants, health professionals], Educators [teachers, school counsellors], Others [managers, military reservists, attorneys, mixed samples].

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