Nahit E S, Pritchard C M, Cherry N M, Silman A J, Macfarlane G J
Arthritis Research Campaign Epidemiology Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, UK.
J Rheumatol. 2001 Jun;28(6):1378-84.
To determine the influence of short term work related psychosocial factors (work demands, job control, and social support) and psychological distress on regional pain syndromes.
Newly employed workers were recruited from 12 occupational groups and information collected by questionnaire. Subjects indicated on a blank body manikin any low back, shoulder, wrist/forearm, or knee pain that had occurred during the past month and lasted more than one day. Data were also collected on work related psychosocial factors and on levels of psychological distress [using the General Health Questionnaire (GHQ)]. The relationships between psychosocial factors and psychological distress and each area of pain were calculated as odds ratios with 95% confidence intervals. Adjustment was made for age, sex, and occupational group.
1081 subjects (median age 23; interquartile range 20-27) were recruited to the study shortly after commencing employment: 261 (24%) reported low back pain, 221 (20%) reported shoulder pain, 93 (9%) reported wrist/forearm pain, and 222 (21%) reported knee pain. High levels of psychological distress were associated with increased likelihood of pain, with a trend observed between scores on the GHQ and the odds of pain in each of the 4 sites. Those who perceived their work as stressful most of the time were more likely to report back (OR 1.8, 95% CI 1.01-3.1) or shoulder pain (OR 1.9, 95% CI 1.02-3.4) than those who considered their work seldom stressful. Pace of work or job autonomy was less markedly related to pain at individual sites. Strong relationships were observed between psychological distress, job demands (stressful work, hectic work), low job control, and pain at multiple sites.
The study has shown that adverse work related psychosocial factors, in particular aspects of job demand and control, influence the reporting of regional musculoskeletal pain. This occurs even after only short term exposure. The odds of reporting these adverse exposures are increased when pain is reported at multiple sites.
确定短期工作相关的社会心理因素（工作要求、工作控制和社会支持）及心理困扰对区域性疼痛综合征的影响。
从12个职业群体中招募新入职员工，通过问卷调查收集信息。受试者在空白人体模型上指出过去一个月内发生且持续超过一天的任何下背部、肩部、手腕/前臂或膝盖疼痛。还收集了与工作相关的社会心理因素及心理困扰水平的数据[使用一般健康问卷（GHQ）]。计算社会心理因素与心理困扰及各疼痛部位之间的关系，以比值比及其95%置信区间表示。对年龄、性别和职业群体进行了校正。
1081名受试者（年龄中位数23岁；四分位间距20 - 27岁）在入职后不久被纳入研究：261人（24%）报告有下背部疼痛，221人（20%）报告有肩部疼痛，93人（9%）报告有手腕/前臂疼痛，222人（21%）报告有膝盖疼痛。高水平的心理困扰与疼痛可能性增加相关，在GHQ得分与4个部位中每个部位的疼痛比值之间观察到一种趋势。那些认为自己大部分时间工作压力大的人比那些认为自己工作很少有压力的人更有可能报告背部（比值比1.8，95%置信区间1.01 - 3.1）或肩部疼痛（比值比1.9，95%置信区间1.02 - 3.4）。工作节奏或工作自主性与各个部位的疼痛关系不太明显。在心理困扰、工作要求（压力大的工作、忙碌的工作）、低工作控制与多个部位的疼痛之间观察到密切关系。
该研究表明，与工作相关的不良社会心理因素，特别是工作要求和控制方面，会影响区域性肌肉骨骼疼痛的报告。即使仅短期接触后也会出现这种情况。当报告多个部位疼痛时，报告这些不良暴露的几率会增加。
