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女性医护人员的社会心理和组织工作因素与动脉高血压发病率:医护人员护理与健康队列研究结果

Psychosocial and organizational work factors and incidence of arterial hypertension among female healthcare workers: results of the Organisation des Soins et Santé des Soignants cohort.

作者信息

Lamy Sébastien, De Gaudemaris Régis, Lepage Benoit, Sobaszek Annie, Caroly Sandrine, Kelly-Irving Michelle, Lang Thierry

机构信息

aINSERM, UMR 1027, Maladies Chroniques, Pratiques de Soins et Facteurs Socio-économiques bUniversité Paul Sabatier, UMR 1027, Toulouse cCNRS, UMR 5525, Laboratoire TIMC-IMAG, Equipe Environnement et Prédiction de la Santé des Populations dUniversité Joseph Fourier, UMR 5525, Grenoble eCHRU Lille, Clinique de Santé Publique, Médecine du Travail et Pathologies Professionnelles fUniversité Lille 2, Lille gCNRS, UMR 5194, Laboratoire PACTE (Politiques Publiques, Action Publique, Territoires), hUniversité Joseph Fourier, UMR 5194, Grenoble, France.

出版信息

J Hypertens. 2014 Jun;32(6):1229-36. doi: 10.1097/HJH.0000000000000155.

Abstract

BACKGROUND

Many studies have supported the role of organizational work factors (OWFs) on the risk of cardiovascular diseases (CVDs) and CVD risk factors, including arterial hypertension. However, a little information is available concerning the role of collective stressors deriving from work organization on nurse's risk of hypertension. This study aimed to test the independent longitudinal relationships linking the 2-year incidence of arterial hypertension to collective stressors at the work unit level, among baseline normotensive female hospital registered nurses and nursing assistants, after adjusting for known individual predictors of CVDs and for occupational stress.

METHOD

Arterial hypertension was defined as the intake of antihypertensive drug or as blood pressure (BP) measures higher than 140  mmHg (SBP) or 90  mmHg (DBP) at both the clinical visit and 1 month later. We analyzed the effect of OWFs at the work unit level, constraints related to the physical work environment and the individual perception of the work environment in 2006 on the risk of arterial hypertension in 2008 among 1882 initially normotensive female healthcare workers followed in the French Organisation des soins et santé des soignants (ORSOSA) cohort.

RESULTS

We showed that OWFs at the work unit level may influence the 2-year risk of arterial hypertension independently of work factors at the worker level, baseline BP, age and BMI. In this study, OWFs affected 2-year risk of arterial hypertension only through direct effects.

CONCLUSION

Our results pointed out the possibility of a primary prevention of arterial hypertension through interventions based at the work unit level among healthcare workers.

摘要

背景

许多研究支持组织工作因素(OWFs)在心血管疾病(CVDs)风险及CVD风险因素(包括动脉高血压)方面所起的作用。然而,关于工作组织产生的集体压力源对护士患高血压风险的作用,现有信息较少。本研究旨在检验在调整已知的CVD个体预测因素和职业压力后,工作单位层面的集体压力源与基线血压正常的女性医院注册护士及护理助理中动脉高血压2年发病率之间的独立纵向关系。

方法

动脉高血压定义为服用降压药,或在临床就诊时及1个月后血压(BP)测量值高于140 mmHg(收缩压)或90 mmHg(舒张压)。我们分析了2006年工作单位层面的OWFs、与体力工作环境相关的限制因素以及个体对工作环境的感知对1882名最初血压正常的女性医护人员在2008年患动脉高血压风险的影响,这些人员来自法国医护人员健康与护理组织(ORSOSA)队列。

结果

我们发现,工作单位层面的OWFs可能独立于个体层面的工作因素、基线血压、年龄和体重指数,影响动脉高血压的2年风险。在本研究中,OWFs仅通过直接效应影响动脉高血压的2年风险。

结论

我们的结果指出,通过在医护人员中开展基于工作单位层面的干预措施,有可能对动脉高血压进行一级预防。

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