Rehabilitation Department, Medicine Faculty, Laval University, Québec, QC G1K7P4, Canada.
Occup Environ Med. 2011 Jul;68(7):479-86. doi: 10.1136/oem.2010.055202. Epub 2010 Nov 23.
This study assessed the long-term effects of a workplace intervention aimed at reducing adverse psychosocial work factors (psychological demands, decision latitude, social support and effort-reward imbalance) and mental health problems among health care professionals in an acute care hospital.
A quasi-experimental design with a control group was used. Pre-intervention (71% response rate) and 3-year post-intervention measures (60% response rate) were collected by telephone interviews with validated instruments.
Three years after the intervention, all adverse psychosocial factors except one were reduced in the experimental group, and the improvement was statistically significant for 5/9 factors: psychological demands, effort-reward imbalance, quality of work, physical load and emotional demands. In addition, all health indicators improved and 2/5 significantly: work-related and personal burnout. In the control hospital, three work factors improved significantly but two deteriorated significantly: decision latitude and social support. All health problem deteriorated, although not significantly, in the control hospital. Moreover, 3 years after the intervention, the mean of all adverse factors except one (psychological demands) and all health indicators was significantly more favourable in the experimental than the control hospital, after adjusting for pre-intervention measures.
These results support the long-term effectiveness of the intervention. The reduction in many psychosocial factors in the experimental hospital may have clinical significance since most health indicators also improved in this hospital. These results support the whole process of the intervention given that significant improvements in psychosocial factors and health problems were observed in the experimental hospital but not in the control hospital.
本研究评估了一项旨在减少医疗保健专业人员在急症医院工作中不利心理社会因素（心理需求、决策自由度、社会支持和努力-回报失衡）和心理健康问题的工作场所干预的长期效果。
采用对照组的准实验设计。通过电话访谈使用验证工具收集干预前（应答率为 71%）和 3 年后（应答率为 60%）的措施。
干预 3 年后，实验组除 1 项外所有不利心理社会因素均有所减少，5/9 项因素的改善具有统计学意义：心理需求、努力-回报失衡、工作质量、体力负荷和情绪需求。此外，所有健康指标均有所改善，其中 2/5 项显著改善：与工作相关和个人倦怠。在对照组医院，3 项工作因素显著改善，但 2 项显著恶化：决策自由度和社会支持。所有健康问题在对照组医院均恶化，尽管无统计学意义。此外，干预 3 年后，实验组除 1 项（心理需求）外所有不利因素和所有健康指标的平均值均显著优于对照组医院，调整干预前措施后。
这些结果支持干预的长期有效性。实验组中许多心理社会因素的减少可能具有临床意义，因为该医院的大多数健康指标也有所改善。这些结果支持干预的全过程，因为实验组观察到心理社会因素和健康问题的显著改善，而对照组医院则没有。
