Li Jian, Weigl Matthias, Glaser Jürgen, Petru Raluca, Siegrist Johannes, Angerer Peter
Institute of Occupational and Social Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany; Institute of Medical Sociology, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.
Am J Ind Med. 2013 Dec;56(12):1414-22. doi: 10.1002/ajim.22246. Epub 2013 Sep 3.
We examined the impact of changes in the psychosocial work environment on depressive symptoms in a sample of junior physicians, a high risk group for stress and mental disorders.
This is a three-wave prospective study in 417 junior physicians during their residency in German hospitals. The psychosocial work environment was measured by the Effort-Reward Imbalance (ERI) Questionnaire at Waves 1 and 2, and the depressive symptoms were assessed with the State-Trait Depression Scales at all three waves. Multivariate linear regression was applied for prospective associations between ERI across Waves 1 and 2, and baseline-adjusted depressive symptoms at Wave 3.
Compared with the ERI scores at Wave 1, at Wave 2, and mean scores between the two waves, the baseline-adjusted ERI change scores between the two waves showed slightly better statistical power, predicting depressive symptoms at Wave 3 (β = 0.78, 95% CI = 0.38-1.18 for increased ERI per SD, β = 0.64, 95% CI = 0.22-1.06 for increased effort per SD, β = -0.65, 95% CI = -1.06 to -0.24 for increased reward per SD, and β = 0.68, 95% CI = 0.27-1.09 for increased overcommitment per SD).
Negative changes in the psychosocial work environment, specifically increased ERI, are associated with depressive symptoms in German junior physicians. Reducing the non-reciprocity of working life, particularly improving reward at work, may have beneficial effects on prevention of mental health problems in the hospital workplace.
我们在初级医生样本中研究了心理社会工作环境变化对抑郁症状的影响，初级医生是压力和精神障碍的高危群体。
这是一项对417名在德国医院住院实习的初级医生进行的三波前瞻性研究。在第1波和第2波时通过努力-回报失衡（ERI）问卷测量心理社会工作环境，在所有三波时用状态-特质抑郁量表评估抑郁症状。应用多变量线性回归分析第1波和第2波之间的ERI与第3波经基线调整的抑郁症状之间的前瞻性关联。
与第1波时的ERI得分、第2波时的得分以及两波之间的平均得分相比，两波之间经基线调整的ERI变化得分显示出稍强的统计效力，可预测第3波时的抑郁症状（每标准差ERI增加时β = 0.78，95%置信区间 = 0.38 - 1.18；每标准差努力增加时β = 0.64，95%置信区间 = 0.22 - 1.06；每标准差回报增加时β = -0.65，95%置信区间 = -1.06至 -0.24；每标准差过度投入增加时β = 0.68，95%置信区间 = 0.27 - 1.09）。
心理社会工作环境的负面变化，特别是ERI增加，与德国初级医生的抑郁症状相关。减少工作生活中的非互惠性，尤其是提高工作回报，可能对预防医院工作场所的心理健康问题有有益影响。
