Workplace Supervisory Social Interactions and Blood Pressure Outcome
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What Happens at Work Stays at Work? Workplace Supervisory Social Interactions and Blood Pressure Outcomes Jennifer H. K. Wong and E. Kevin Kelloway Saint Mary’s University We investigated the relationship between workplace supervisory social interactions and blood pressure outcomes using hourly diary entries and ambulatory blood pressure data from an experience sampling study of 55 long-term care employees. After accounting for relevant cardiovascular controls, significant effects of supervisory interactions on cardiovascular reactivity and recovery were found. Multilevel analyses revealed that negatively perceived supervisory interactions predicted higher systolic blood pressure at work ( B 52 1.59, p , .05, N observations 5 422). Using time-lagged hierarchical regression analyses, the average perceived valence of supervisory interactions at work predicted average systolic blood pressure recovery after work ( B 52 14.52, p , .05, N 5 33). Specifically, negatively perceived supervisory interactions at work predicted poorer cardiovascular recovery after work. Suggestions for improving practices in organizations and in experience sampling research are discussed. Keywords: social interactions, supervisory relationships, cardiovascular health, blood pressure Interactions with supervisors in the workplace can be both a rich resource of social support ( Eisenberger, Stinglhamber, Vandenber- ghe, Sucharski, & Rhoades, 2002 ) or a significant stressor ( Kel- loway, Sivanathan, Francis, & Barling, 2005 ) for employees. A growing body of literature has identified the effects of leadership style on a variety of health outcomes (for a review see Kelloway & Barling, 2010 ). Of particular note for the current study, negative supervisory work relationships play an important role in the etiol- ogy of stress-related cardiovascular disorders such as coronary heart disease ( Kuper, Marmot, & Hemingway, 2002 ), myocardial infarction ( Bosma, Peter, Siegrist, & Marmot, 1998 ), and cardio- vascular mortality ( Kivimäki et al., 2002 ). How these relationships influence the progressive development of such conditions remains unclear. In the current study we examined the effect of negative supervisory interactions on both cardiovascular reactivity and car- diovascular recovery. In particular, we coupled an hourly diary study with measures of ambulatory blood pressure over a working day. Experience sam- pling with diaries has been used in organizational research to examine momentary moods and states (e.g., Fullagar & Kelloway, 2009 ; Ilies, Dimotakis, & Watson, 2010 ). The research design allows for subjective behaviors and experiences to be captured in real-time and eliminates the bias of retrospective recall ( Shiffman, Stone, & Hufford, 2008 ). In the current context, the use of diaries allowed for the immediate recording of interactions with supervi- sors as they occurred during the working day. Measures of in situ ambulatory blood pressure, both throughout the work shift and after work, served as our primary dependent measures. As such, we are able to examine both the immediate effect of supervisory interactions on health (i.e., cardiovascular reactivity) as well as cardiovascular recovery after work (i.e., the natural nocturnal drop in blood pressure in the evening; Van Egeren, 1992 ). The use of sampling in a field setting is particularly important for cardiovascular outcomes because laboratory mea- surement may not adequately capture the critical dips and highs of daily work experiences. Moreover, physiological measures may be reactive in highly controlled environments. In the phenomenon of “white-coat hypertension,” the presence of physicians or research- ers elevates blood pressure readings in normally healthy individ- uals ( Pickering & Friedman, 1991 ). Cardiovascular Measures and Their Implications for Health The general model of a stress response is that the body exhibits the well-known “fight or flight” behaviors ( Cannon, 1915 ). The biological changes that are associated with this response are the activation of the sympathetic and parasympathetic nervous sys- tems, the release of epinephrine and norepinephrine, and a result- ing increase in blood pressure to prepare the body for evolutionary-adaptive actions ( Sapolsky, 1994 ). The allostatic load model of stress physiology posits three stages in the progression of stress ( McEwen & Stellar, 1993 ; for a review see Ganster & Rosen, 2013 ). The initial adaptations to stress are primary allo- static load processes consisting of psychological, physiological, and psychosomatic changes in the central nervous system. Over time, continuous activation of primary allostatic load processes leads to secondary allostatic load processes, which are adjustments This article was published Online First December 7, 2015. Jennifer H. K. Wong and E. Kevin Kelloway, Department of Psychol- ogy, Saint Mary’s University. This article is based on data collected by the first author as a M.Sc. thesis under the supervision of the second author. We thank Lori Francis, Mar- garet McKee, and Catherine Loughlin for comments on an earlier version of this article and acknowledge the financial support of the Nova Scotia Health Research Foundation and the Social Sciences and Humanities Research Council of Canada for this research. Correspondence concerning this article should be addressed to E. Kevin Kelloway, Department of Psychology, Saint Mary’s University, 923 Robie Street, Halifax, NS, Canada, B3H 3C3. E-mail: kevin.kelloway@smu.ca This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. Journal of Occupational Health Psychology © 2015 American Psychological Association 2016, Vol. 21, No. 2, 133–141 1076-8998/16/$12.00 http://dx.doi.org/10.1037/a0039900 133
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