Krantz Gunilla, Ostergren Per-Olof
Nordic School of Public Health, Göteborg, Sweden.
Scand J Public Health. 2002;30(3):176-83. doi: 10.1080/14034940210133816.
To investigate whether a high level of commonly experienced physical and mental symptoms could predict long spells of sickness absence in Swedish women and, further, to investigate the causal pattern of socioeconomic and psychosocial factors in relation to long spells of sickness absence.
A questionnaire containing items on socioeconomic and psychosocial variables was sent to a random population of women, 40 to 50 years of age, living in a rural Swedish community. The response rate was 81.7% (397 women). Data on long spells of sickness absence (>14 days) for the year following the baseline survey were obtained from the social insurance office. Odds ratios (OR) were used to estimate bivariate associations. Multiple logistic regression analysis was used to test for confounding and effect modification.
Women suffering from a high level of common symptoms were at risk of subsequent long spells of sickness absence, OR = 3.39 (1.86-6.17). High demands at work and an active job position (i.e. the combination of high demands and a high degree of job control) were both associated with long spells of sickness absence, OR = 2.16 (1.12-4.17) and OR = 1.92 (1.01-3.67). The combined exposure (high level of common symptoms and an active job position) increased the odds for long spells of sickness absence (OR = 9.13; 3.39-24.58) with synergy noted.
The finding that women with common symptoms are at risk of future sickness absence is of particular importance in a primary health care setting. The finding that women in active job positions had a higher risk of sickness absence might be an effect of modern working conditions for women.
调查高水平的常见身心症状是否能预测瑞典女性的长期病假情况,并进一步研究社会经济和心理社会因素与长期病假之间的因果关系模式。
向居住在瑞典农村社区的40至50岁女性随机人群发放了一份包含社会经济和心理社会变量项目的问卷。回复率为81.7%(397名女性)。基线调查后一年的长期病假(>14天)数据来自社会保险办公室。比值比(OR)用于估计双变量关联。多元逻辑回归分析用于检验混杂因素和效应修正。
患有高水平常见症状的女性有随后长期病假的风险,OR = 3.39(1.86 - 6.17)。工作要求高和工作职位活跃(即高要求与高度工作控制的结合)均与长期病假有关,OR = 2.16(1.12 - 4.17)和OR = 1.92(1.01 - 3.67)。联合暴露(高水平常见症状和工作职位活跃)增加了长期病假的几率(OR = 9.13;3.39 - 24.58),并观察到协同作用。
在初级卫生保健环境中,有常见症状女性有未来病假风险这一发现尤为重要。工作职位活跃的女性病假风险较高这一发现可能是现代女性工作条件的影响。