Emotional dissonance and mental health among home-care workers: A nationwide prospective study of the moderating role of leadership behaviors

OBJECTIVES: Evidence suggests that emotional dissonance, the imbalance between true feelings and those displayed to meet work standards, heightens the risk of mental distress. In nursing occupations, exerting such emotional effort is a part of the job role. Drawing from the job demands–resources mod...

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Main Authors: Håkon A Johannessen, Morten Birkeland Nielsen, Rigmor Harang Knutsen, Øivind Skare, Jan Olav Christensen
Format: Article
Language:English
Published: Nordic Association of Occupational Safety and Health (NOROSH) 2025-01-01
Series:Scandinavian Journal of Work, Environment & Health
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Online Access: https://www.sjweh.fi/article/4197
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author Håkon A Johannessen
Morten Birkeland Nielsen
Rigmor Harang Knutsen
Øivind Skare
Jan Olav Christensen
author_facet Håkon A Johannessen
Morten Birkeland Nielsen
Rigmor Harang Knutsen
Øivind Skare
Jan Olav Christensen
author_sort Håkon A Johannessen
collection DOAJ
description OBJECTIVES: Evidence suggests that emotional dissonance, the imbalance between true feelings and those displayed to meet work standards, heightens the risk of mental distress. In nursing occupations, exerting such emotional effort is a part of the job role. Drawing from the job demands–resources model, high-quality leadership is a resource that may assist employees in coping with stressors. We examined whether quality of leadership mitigated the potential adverse impact of emotional dissonance on mental health. METHODS: In 2019, 1426 home-care workers from 130 organizational units were surveyed, with follow-ups after 8 and 14 months. Prospective associations between emotional dissonance (the Frankfurt Emotion Work Scales) and mental distress (Hopkins Symptom Checklist, HSCL-5), including interactions between emotional dissonance and leadership behaviors (Nordic Questionnaire for Psychological and Social Factors at Work), were determined using lagged linear mixed models. RESULTS: Emotional dissonance was positively associated with mental distress (adjusted P<0.05), whereas supportive, empowering, and fair leadership were negatively associated with mental distress (adjusted P<0.05). All three investigated sources of leadership behaviors moderated the direct association between emotional dissonance and mental distress (adjusted P<0.05). Emotional dissonance and mental distress were reciprocally related; an increase in either will heighten the level of the other. Leadership behaviors did not moderate the reversed association between emotional dissonance and mental distress (adjusted P>0.05). CONCLUSIONS: Supportive, empowering, and fair leadership buffers the association of emotional dissonance on mental distress. Strategic interventions that enhance the quality of leadership may help prevent mental distress among employees in professions with emotionally demanding tasks.
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publishDate 2025-01-01
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spelling doaj-art-33e99b3f0a8446db978f64cd8912eb482025-08-20T02:51:15ZengNordic Association of Occupational Safety and Health (NOROSH)Scandinavian Journal of Work, Environment & Health0355-31401795-990X2025-01-01511152510.5271/sjweh.41974197Emotional dissonance and mental health among home-care workers: A nationwide prospective study of the moderating role of leadership behaviorsHåkon A Johannessen0Morten Birkeland Nielsen1Rigmor Harang Knutsen2Øivind Skare3Jan Olav Christensen4National Institute of Occupational Health in Norway, Pb 5330 Majorstuen, 0304 Oslo, Norway.National Institute of Occupational Health in Norway, Pb 5330 Majorstuen, 0304 Oslo, Norway.National Institute of Occupational Health in Norway, Pb 5330 Majorstuen, 0304 Oslo, Norway.National Institute of Occupational Health in Norway, Pb 5330 Majorstuen, 0304 Oslo, Norway.National Institute of Occupational Health in Norway, Pb 5330 Majorstuen, 0304 Oslo, Norway.OBJECTIVES: Evidence suggests that emotional dissonance, the imbalance between true feelings and those displayed to meet work standards, heightens the risk of mental distress. In nursing occupations, exerting such emotional effort is a part of the job role. Drawing from the job demands–resources model, high-quality leadership is a resource that may assist employees in coping with stressors. We examined whether quality of leadership mitigated the potential adverse impact of emotional dissonance on mental health. METHODS: In 2019, 1426 home-care workers from 130 organizational units were surveyed, with follow-ups after 8 and 14 months. Prospective associations between emotional dissonance (the Frankfurt Emotion Work Scales) and mental distress (Hopkins Symptom Checklist, HSCL-5), including interactions between emotional dissonance and leadership behaviors (Nordic Questionnaire for Psychological and Social Factors at Work), were determined using lagged linear mixed models. RESULTS: Emotional dissonance was positively associated with mental distress (adjusted P<0.05), whereas supportive, empowering, and fair leadership were negatively associated with mental distress (adjusted P<0.05). All three investigated sources of leadership behaviors moderated the direct association between emotional dissonance and mental distress (adjusted P<0.05). Emotional dissonance and mental distress were reciprocally related; an increase in either will heighten the level of the other. Leadership behaviors did not moderate the reversed association between emotional dissonance and mental distress (adjusted P>0.05). CONCLUSIONS: Supportive, empowering, and fair leadership buffers the association of emotional dissonance on mental distress. Strategic interventions that enhance the quality of leadership may help prevent mental distress among employees in professions with emotionally demanding tasks. https://www.sjweh.fi/article/4197 mental healthstressprospective studyworkjob demandwell-beingemotional demandprospectivecommon mental disorderleadershipemotional dissonancehome-care workeremotion work
spellingShingle Håkon A Johannessen
Morten Birkeland Nielsen
Rigmor Harang Knutsen
Øivind Skare
Jan Olav Christensen
Emotional dissonance and mental health among home-care workers: A nationwide prospective study of the moderating role of leadership behaviors
Scandinavian Journal of Work, Environment & Health
mental health
stress
prospective study
work
job demand
well-being
emotional demand
prospective
common mental disorder
leadership
emotional dissonance
home-care worker
emotion work
title Emotional dissonance and mental health among home-care workers: A nationwide prospective study of the moderating role of leadership behaviors
title_full Emotional dissonance and mental health among home-care workers: A nationwide prospective study of the moderating role of leadership behaviors
title_fullStr Emotional dissonance and mental health among home-care workers: A nationwide prospective study of the moderating role of leadership behaviors
title_full_unstemmed Emotional dissonance and mental health among home-care workers: A nationwide prospective study of the moderating role of leadership behaviors
title_short Emotional dissonance and mental health among home-care workers: A nationwide prospective study of the moderating role of leadership behaviors
title_sort emotional dissonance and mental health among home care workers a nationwide prospective study of the moderating role of leadership behaviors
topic mental health
stress
prospective study
work
job demand
well-being
emotional demand
prospective
common mental disorder
leadership
emotional dissonance
home-care worker
emotion work
url https://www.sjweh.fi/article/4197
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