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芬兰全科医生和专家的社会心理因素和健康状况:一项 10 年随访研究。

Psychosocial factors and well-being among Finnish GPs and specialists: a 10-year follow-up.

机构信息

National Institute for Health and Welfare, PO Box 30, Helsinki 271, Finland.

出版信息

Occup Environ Med. 2013 Apr;70(4):246-51. doi: 10.1136/oemed-2012-100996. Epub 2013 Jan 15.

Abstract

BACKGROUND

Identifying factors that determine well-being among physicians may help to improve the functioning of hospitals and healthcare centres. We examined associations of psychosocial factors with psychological distress and sleep problems in Finnish general practitioners (GPs) and specialists.

METHODS

In this prospective cohort study, data from repeated measures over 10 years, related to 886 physicians followed-up from 2000 to 2010 (the Finnish Public Sector Cohort Study). Psychological distress was assessed repeatedly using the 12-item General Health Questionnaire, and sleeping problems using the Jenkins scale in three or in four surveys. Psychosocial factors and potential confounders were measured in four surveys over the same period.

RESULTS

High job demands were associated with psychological distress in GPs but not in specialists (p for interaction 0.005). This association was slightly stronger in the within-individual analysis than in the ordinary (total effects) regression, suggesting that the association was not confounded by stable differences between individuals. There was suggestive evidence for a stronger association between effort/reward imbalance and psychological distress in GPs compared with specialists (p for interaction 0.06). High demands and effort-reward-imbalance were associated with elevated sleeping problems in both groups, whereas high job control was associated with lower psychological distress but not sleeping problems.

CONCLUSIONS

These findings suggest that work-related psychosocial factors are partly responsible for the rise of health problems in physicians, such as psychological distress and sleeping problems. Increasing job demands may be a health risk, especially in GPs.

摘要

背景

确定影响医生幸福感的因素有助于改善医院和医疗中心的运作。我们研究了心理社会因素与芬兰全科医生和专家的心理困扰和睡眠问题之间的关联。

方法

在这项前瞻性队列研究中,我们对 2000 年至 2010 年间随访的 886 名医生进行了重复测量,这些数据来自于为期 10 年的重复测量(芬兰公共部门队列研究)。使用 12 项一般健康问卷反复评估心理困扰,使用 Jenkins 量表在三次或四次调查中评估睡眠问题。在同一时期的四次调查中测量心理社会因素和潜在的混杂因素。

结果

高工作要求与全科医生的心理困扰有关,但与专家无关(p 交互作用=0.005)。在个体内分析中,这种关联比普通(总效应)回归更强,这表明这种关联不受个体之间稳定差异的混淆。努力-回报失衡与全科医生心理困扰之间的关联比专家更强,这表明存在交互作用(p 交互作用=0.06)。高需求和努力-回报失衡与两组的睡眠问题增加有关,而高工作控制与较低的心理困扰有关,但与睡眠问题无关。

结论

这些发现表明,与工作相关的心理社会因素是导致医生健康问题(如心理困扰和睡眠问题)上升的部分原因。增加工作要求可能是一个健康风险,尤其是在全科医生中。

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