Exploring the Michigan model: the relationship of personality, managerial support and organizational structure with health outcomes in entrants to the healthcare environment

Few studies have examined the role of managerial support in the adaptation of entrants to healthcare. The purpose of this study was to identify the job characteristic and role-related variables that mediate the effects of managerial support and personality on the mental and physical health and sickness absence in two independent groups of new recruits to a healthcare organization. Entrants to a healthcare environment (student nurses) were surveyed 25 weeks after entry. Latent variables represented neuroticism, demand, control, role clarity and affective outcome variables in a simplified version of the Michigan model of work stress (House, 1981). This study used a two-stage approach to structural equation modelling, exploring hypothesized structural models on an initial data set (N = 195) prior to confirmation on an independent replication data set (N = 239) using multi-sample methods. Finally the confirmed model of choice was evaluated using the combined data (N = 434). Emotional distress reported at 6 months was found to be associated with dispositional characteristics of the entrant and indirectly, via job satisfaction, with managerial support from academic and clinical sources. Managerial support from academic and clinical sources had an indirect influence on job satisfaction, but by differing mechanisms involving role clarity and control. The demands perceived by the entrants arose from neuroticism and were independent of any other variable. Emotional distress had its deleterious association with sickness absence via somatic health. This study details a series of mechanisms that will subsequently be tested longitudinally.