Bean Christopher G, Winefield Helen R, Sargent Charli, Hutchinson Amanda D
School of Psychology, University of Adelaide, Australia.
School of Psychology, University of Adelaide, Australia.
Soc Sci Med. 2015 Oct;143:1-8. doi: 10.1016/j.socscimed.2015.08.034. Epub 2015 Aug 20.
The Job Demand-Control-Support (JDCS) model is commonly used to investigate associations between psychosocial work factors and employee health, yet research considering obesity using the JDCS model remains inconclusive.
This study investigates which parts of the JDCS model are associated with measures of obesity and provides a comparison between waist circumference (higher values imply central obesity) and body mass index (BMI, higher values imply overall obesity).
Contrary to common practice, in this study the JDCS components are not reduced into composite or global scores. In light of emerging evidence that the two components of job control (skill discretion and decision authority) could have differential associations with related health outcomes, components of the JDCS model were analysed at the subscale level. A cross-sectional design with a South Australian cohort (N = 450) combined computer-assisted telephone interview data and clinic-measured height, weight and waist circumference.
After controlling for sex, age, household income, work hours and job nature (blue vs. white-collar), the two components of job control were the only parts of the JDCS model to hold significant associations with measures of obesity. Notably, the associations between skill discretion and waist circumference (b = -.502, p = .001), and skill discretion and BMI (b = -.163, p = .005) were negative. Conversely, the association between decision authority and waist circumference (b = .282, p = .022) was positive.
These findings are significant since skill discretion and decision authority are typically combined into a composite measure of job control or decision latitude. Our findings suggest skill discretion and decision authority should be treated separately since combining these theoretically distinct components may conceal their differential associations with measures of obesity, masking their individual importance. Psychosocial work factors displayed stronger associations and explained greater variance in waist circumference compared with BMI, and possible reasons for this are discussed.
工作需求-控制-支持（JDCS）模型常用于研究心理社会工作因素与员工健康之间的关联，但使用JDCS模型对肥胖问题进行的研究尚无定论。
本研究调查JDCS模型的哪些部分与肥胖指标相关，并比较腰围（数值越高意味着中心性肥胖）和体重指数（BMI，数值越高意味着整体肥胖）。
与常规做法不同，本研究中JDCS的各个组成部分并未简化为综合得分或总体得分。鉴于新出现的证据表明工作控制的两个组成部分（技能酌处权和决策权）可能与相关健康结果存在不同关联，因此在子量表层面分析了JDCS模型的各个组成部分。采用南澳大利亚队列（N = 450）的横断面设计，结合了计算机辅助电话访谈数据以及诊所测量的身高、体重和腰围。
在控制了性别、年龄、家庭收入、工作时长和工作性质（蓝领与白领）之后，工作控制的两个组成部分是JDCS模型中与肥胖指标存在显著关联的唯一部分。值得注意的是，技能酌处权与腰围之间的关联（b = -0.502，p = 0.001）以及技能酌处权与BMI之间的关联（b = -0.163，p = 0.005）均为负相关。相反，决策权与腰围之间的关联（b = 0.282，p = 0.022）为正相关。
这些发现具有重要意义，因为技能酌处权和决策权通常被合并为工作控制或决策自由度的综合指标。我们的研究结果表明，应将技能酌处权和决策权分开对待，因为将这些理论上不同的组成部分合并可能会掩盖它们与肥胖指标的不同关联，从而掩盖它们各自的重要性。心理社会工作因素与腰围的关联更强，且相比BMI能解释更大的方差，并讨论了其中可能的原因。
