Sjögren Elaine, Kristenson Margareta
Department of Health and Society, Linköping University, Linköping, Sweden.
Scand J Public Health. 2006;34(1):59-68. doi: 10.1080/14034940510006049.
The aims of this study were to examine (1) if associations between gender and psychosocial factors could be explained by socioeconomic status (SES) and (2) if associations between gender and psychosocial factors are more salient at lower levels of SES.
Psychosocial factors such as decision latitude and social integration were studied in a cross-sectional study in two steps. In a public health survey, 4,086 randomly selected men and women aged 30-64 participated. Of these, 257 men and women also participated in an in-depth study. SES was measured in terms of education and occupation. Linear regression models were used to test associations between gender, SES, and a broad range of psychosocial factors.
Women reported lower scale scores on decision latitude, coping, and self-esteem, as well as more job strain, depression, and vital exhaustion, while men reported more cynicism (all p<0.05). Observed gender differences were still significant after control for effect of education, while after control for occupational status the effect of gender was lost for decision latitude and job strain. Significant interaction factors were found between gender and educational status for psychological demands, decision latitude, social integration, coping, and hopelessness.
Gender differences, found for a broad range of psychosocial factors, could not be explained by SES. However, associations between gender and psychosocial factors were more salient at lower levels of SES. Psychosocial factors, especially decision latitude and social integration, may help explain why women with low SES experience poorer health.
本研究的目的是检验：（1）社会经济地位（SES）能否解释性别与心理社会因素之间的关联；（2）在较低社会经济地位水平上，性别与心理社会因素之间的关联是否更为显著。
在一项横断面研究中分两步对决策自由度和社会融合等心理社会因素进行了研究。在一项公共卫生调查中，随机选取了4086名年龄在30 - 64岁之间的男性和女性参与。其中，257名男性和女性还参与了一项深入研究。社会经济地位通过教育程度和职业来衡量。使用线性回归模型来检验性别、社会经济地位与一系列广泛的心理社会因素之间的关联。
女性在决策自由度、应对能力和自尊方面的量表得分较低，同时工作压力、抑郁和精力耗竭程度更高，而男性则表现出更多的愤世嫉俗情绪（所有p<0.05）。在控制教育程度的影响后，观察到的性别差异仍然显著，而在控制职业地位后，决策自由度和工作压力方面的性别影响消失。在心理需求、决策自由度、社会融合、应对能力和绝望感方面，发现性别与教育程度之间存在显著的交互作用因素。
在一系列广泛的心理社会因素中发现的性别差异无法用社会经济地位来解释。然而，在较低社会经济地位水平上，性别与心理社会因素之间的关联更为显著。心理社会因素，尤其是决策自由度和社会融合，可能有助于解释社会经济地位较低的女性健康状况较差的原因。
