Pélissier C, Fontana L, Fort E, Vohito M, Sellier B, Perrier C, Glerant V, Couprie F, Agard J P, Charbotel B
Université Lyon 1, UMRESTTE (IFSTTAR/UCLB joint unit), Domaine Rockefeller, Lyon, France Service de Santé au Travail, CHU de Saint-Etienne, Saint-Etienne, France.
Université Lyon 1, UMRESTTE (IFSTTAR/UCLB joint unit), Domaine Rockefeller, Lyon, France.
BMJ Open. 2015 Mar 31;5(3):e007190. doi: 10.1136/bmjopen-2014-007190.
The present study sought to quantify the impaired mental well-being and psychosocial stress experienced by nursing home staff and to determine the relationship between impaired mental well-being assessed on the 12-item General Health Questionnaire (GHQ-12) and exposure to psychosocial stress assessed on Siegrist's effort/reward and overcommitment model.
A transverse study was conducted in France on 2471 female employees in 105 nursing homes for the elderly. Personal and occupational data were collected by questionnaire for 668 housekeepers, 1454 nursing assistants and 349 nurses.
36.8% of participants (n=896) showed impaired mental well-being, 42.7% (n=1039) overcommitment and 9% (n=224) effort/reward imbalance. Overcommitment (prevalence ratio (PR)=1.27; 95% CI (1.21 to 1.34)) and effort-reward imbalance (PR=1.19; 95% CI (1.12 to 1.27)) were significantly associated with presence of impaired mental well-being after adjustment for personal factors (age and private life events). Taking effort and reward levels into account, the frequency of impaired mental well-being was highest in case of exposure to great extrinsic effort and low rewards of any type: esteem, PR=3.53, 95% CI (3.06 to 4.08); earnings, PR=3.48, 95% CI (2.99 to 4.06); or job security, PR=3.30, 95% CI (2.88 to 3.78). Participants in situations of overcommitment and of effort/reward imbalance were at the highest risk of impaired mental well-being: PR=3.86, 95% CI (3.42 to 4.35).
Several changes in nursing home organisation can be suggested to reduce staff exposure to factors of psychosocial stress. Qualitative studies of the relation between impaired mental well-being and psychosocial stress in nursing home staff could guide prevention of impaired mental well-being at work.
本研究旨在量化养老院工作人员心理健康受损和心理社会压力的情况，并确定通过12项一般健康问卷（GHQ - 12）评估的心理健康受损与通过西格里斯特的努力/回报及过度投入模型评估的心理社会压力暴露之间的关系。
在法国对105家养老院的2471名女性员工进行了一项横断面研究。通过问卷收集了668名家政人员、1454名护理助理和349名护士的个人和职业数据。
36.8%的参与者（n = 896）心理健康受损，42.7%（n = 1039）过度投入，9%（n = 224）存在努力/回报失衡。在对个人因素（年龄和私人生活事件）进行调整后，过度投入（患病率比值（PR）= 1.27；95%置信区间（CI）（1.21至1.34））和努力 - 回报失衡（PR = 1.19；95% CI（1.12至1.27））与心理健康受损显著相关。考虑到努力和回报水平，在面临巨大的外在努力和任何类型（自尊、PR = 3.53，95% CI（3.06至4.08）；收入、PR = 3.48，95% CI（2.99至4.06）；或工作保障、PR = 3.30，95% CI（2.88至3.78））的低回报时，心理健康受损的频率最高。处于过度投入和努力/回报失衡状况的参与者心理健康受损风险最高：PR = 3.86，95% CI（3.42至4.35）。
可以提出养老院组织的一些变革，以减少工作人员面临心理社会压力因素的情况。对养老院工作人员心理健康受损与心理社会压力之间关系的定性研究可为工作中心理健康受损的预防提供指导。
