Birgit Enberg, Gunnevi Sundelin, Ann Öhman
Department of Community Medicine and Rehabilitation, Division of Physiotherapy, Umeå University, Sweden.
Scand J Caring Sci. 2013 Mar;27(1):36-43. doi: 10.1111/j.1471-6712.2012.00997.x. Epub 2012 Apr 25.
The aim of the study was to scrutinise how nurses and physicians, employed by the county councils in Sweden, assess their work environment in terms of effort and reward at the start of their career. The aim was also to estimate associations between work satisfaction and the potential outcomes from the effort-reward imbalance (ERI) questionnaire. The study group, 198 nurses and 242 physicians who graduated in 1999, is a subsample drawn from a national cross-sectional survey. Data were collected in the third year after graduation among the nurses and in the fourth year after graduation among registered physicians. The effort-reward imbalance questionnaire, together with a question on work satisfaction, was used to evaluate psychosocial factors at work. The results reveal that nurses scored higher on effort, lower on reward and experienced higher effort-reward imbalance, compared with physicians. Women scored higher on work-related overcommitment (WOC) compared with men. Among the physicians, logistic regression analysis revealed a statistically significant association between WOC and ERI, sex, effort and reward. Logistic regression analysis also revealed a statistically significant association between WOC and ERI and between WOC and effort among the nurses. Dissatisfaction with work was significantly higher among those who scored worst on all three ERI subscales (effort, reward and WOC) and also among those with the highest ERI ratios compared with the other respondents. In conclusion, to prevent future work-related health problems and work dissatisfaction among nurses and physicians in the beginning of their professional careers, signs of poor psychosocial working conditions have to been taken seriously. In future work-related stress research among healthcare personnel, gender-specific aspects of working conditions must be further highlighted to develop more gender-sensitive analyses.
该研究的目的是仔细审查瑞典县议会雇佣的护士和医生在职业生涯开始时如何根据付出与回报来评估他们的工作环境。其目的还在于估计工作满意度与付出-回报失衡（ERI）问卷潜在结果之间的关联。研究组由198名护士和242名1999年毕业的医生组成，是从一项全国性横断面调查中抽取的子样本。数据在护士毕业第三年以及注册医生毕业第四年收集。付出-回报失衡问卷以及一个关于工作满意度的问题被用于评估工作中的社会心理因素。结果显示，与医生相比，护士在付出方面得分更高，在回报方面得分更低，且经历的付出-回报失衡程度更高。女性在与工作相关的过度投入（WOC）方面得分高于男性。在医生中，逻辑回归分析显示WOC与ERI、性别、付出和回报之间存在统计学上的显著关联。逻辑回归分析还显示护士中WOC与ERI之间以及WOC与付出之间存在统计学上的显著关联。在所有三个ERI分量表（付出、回报和WOC）得分最差的人以及ERI比率最高的人中，工作不满程度明显高于其他受访者。总之，为防止护士和医生在职业生涯初期出现未来与工作相关的健康问题和工作不满，必须认真对待社会心理工作条件不佳的迹象。在未来针对医护人员与工作相关压力的研究中，必须进一步突出工作条件的性别特定方面，以开展更具性别敏感性的分析。
