Gilbert-Ouimet Mahée, Brisson Chantal, Vézina Michel, Trudel Louis, Bourbonnais Renée, Masse Benoît, Baril-Gingras Geneviève, Dionne Clermont E
MSc, Santé des Populations: URESP, Centre de recherche FRSQ du CHA, universitaire de Québec City, Québec, Canada.
PhD, Santé des Populations: URESP, Centre de recherche FRSQ du CHA, universitaire de Québec City, Québec, Canada, Département de médecine sociale et préventive, Université Laval, Québec City, Québec, Canada.
Healthc Pap. 2011;11 Spec No:47-66. doi: 10.12927/hcpap.2011.22410.
Organizations are facing ever-stiffer competition in the current globalized economy, and employees are consequently being exposed to increasingly adverse psychosocial work factors. Psychosocial work factors, also called psychosocial stressors, refer to all organizational factors and interpersonal relationships in the workplace that may affect workers' health. Two well-defined and internationally recognized theoretical models are used to assess these factors: the Karasek demand-latitude-support model and the Siegrist effort-reward imbalance model. The Karasek and Siegrist models reflect specific components of the work environment for which there is empirical evidence of a deleterious effect on health. Preventive interventions targeting these factors are conducted in workplaces. However, few studies have rigorously documented these interventions and their effectiveness in reducing adverse work factors and improving health outcomes. Most previous intervention studies were limited by (1) a short follow-up that may not have provided sufficient time for effects to appear, (2) small sample sizes (N ≤ 100) that limited the statistical power and the possibility of detecting results and (3) rare assessment of the Siegrist model. The current paper presents the overall design and the main results of an intervention study on psychosocial work factors and related mental health and musculoskeletal outcomes. The study integrated (1) a development phase that aimed at identifying the changes needed to reduce psychosocial factors in the target population and the best ways to bring about these changes, (2) an implementation phase that systematically documented how the intervention was carried out and (3) an effectiveness phase that evaluated whether the intervention was successful in reducing adverse psychosocial work factors and health problems. In addition, the study used repeated measurements of psychosocial work factors and health indicators at baseline and six and 30 months post-intervention to assess short- and medium-term effects of the intervention.
在当前全球化经济中,组织面临着日益激烈的竞争,因此员工正暴露于越来越不利的心理社会工作因素之中。心理社会工作因素,也称为心理社会压力源,是指工作场所中可能影响工人健康的所有组织因素和人际关系。有两种明确界定且国际公认的理论模型用于评估这些因素:Karasek需求-控制-支持模型和Siegrist付出-回报失衡模型。Karasek模型和Siegrist模型反映了工作环境的特定组成部分,有实证证据表明这些部分对健康有有害影响。针对这些因素的预防性干预措施在工作场所中实施。然而,很少有研究严格记录这些干预措施及其在减少不利工作因素和改善健康结果方面的有效性。以前的大多数干预研究受到以下限制:(1)随访时间短,可能没有提供足够的时间让效果显现;(2)样本量小(N≤100),限制了统计效力和检测结果的可能性;(3)对Siegrist模型的评估很少。本文介绍了一项关于心理社会工作因素以及相关心理健康和肌肉骨骼结果的干预研究的总体设计和主要结果。该研究整合了:(1)一个发展阶段,旨在确定减少目标人群心理社会因素所需的变化以及实现这些变化的最佳方法;(2)一个实施阶段,系统记录干预措施的实施方式;(3)一个有效性阶段,评估干预措施是否成功减少了不利的心理社会工作因素和健康问题。此外,该研究在基线以及干预后6个月和30个月对心理社会工作因素和健康指标进行了重复测量,以评估干预措施的短期和中期效果。