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Int Arch Occup Environ Health. 2017 Jan;90(1):83-92. doi: 10.1007/s00420-016-1176-9. Epub 2016 Oct 28.

Emotional dissonance and sickness absence: a prospective study of employees working with clients.

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National Institute of Occupational Health, Oslo, Norway.
National Institute of Occupational Health, Oslo, Norway.



(1) Determine the relationship between emotional dissonance and medically certified sickness absence among employees working with clients and (2) compare the impact of emotional dissonance on medically certified sickness absence with the impact of other psychological and social work factors.


A sample of 7758 employees was recruited from 96 Norwegian organizations in the period 2004 to 2014, all working with clients. The study design was prospective with emotional dissonance measured at baseline and then linked to official registry data of medically certified sickness absence for the year following the survey assessment. Quantitative demands, decision demands, role clarity, role conflict, control over work intensity, and decision control were included as additional work exposures. The impact of the study variables on the presence and duration of medically certified sickness absence was investigated with a negative binomial hurdle model.


In the fully adjusted model, emotional dissonance and role conflict significantly predicted the presence of medically certified sickness absence. Control over work intensity and decision control were negatively related to presence of sickness absence. Only role conflict was a risk factor for the duration of sickness absence when all factors were analysed simultaneously.


Emotional dissonance is a risk factor for the presence of medically certified sickness absence in client-driven work environments. Theoretical models of sickness absence, as well as interventions aiming to prevent sickness absence in such environments, should be aware of the effect emotional dissonance may have on employees.


Absenteeism; Emotional labour; Employee health; Psychosocial work factor

[Indexed for MEDLINE]

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