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三种工作压力模型及其与蓝领和白领工人肌肉骨骼疼痛的关系。

Three job stress models and their relationship with musculoskeletal pain in blue- and white-collar workers.

机构信息

Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.

Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.

出版信息

J Psychosom Res. 2015 Nov;79(5):340-7. doi: 10.1016/j.jpsychores.2015.08.001. Epub 2015 Aug 8.

Abstract

OBJECTIVES

Musculoskeletal pain has been found to co-occur with psychosocial job stress. However, different conceptualizations of job stress exist, each emphasizing different aspects of the work environment, and it is unknown which of these aspects show the strongest associations with musculoskeletal pain. Further, these associations may differ for white-collar vs. blue-collar job types, but this has not been tested. The present study examined the independent and combined contributions of Effort-RewardImbalance (ERI), Job-Demand-Control (JDC) and Organizational Justice (OJ) to musculoskeletal pain symptoms among white- and blue-collar workers.

METHODS

Participants of a cross-sectional study (n=1634) completed validated questionnaires measuring ERI, JDC, and OJ, and reported the frequency of pain during the previous year at four anatomical locations (lower back, neck or shoulder, arms and hands, and knees/feet). Pain reports were summarized into a single musculoskeletal symptom score (MSS). Analyses were stratified for white- and blue-collar workers.

RESULTS

Among white-collar workers, ERI and OJ were independently associated with MSS. In addition to these additive effects, significant 2-way and 3-way interactions indicated a synergistic effect of job stressors in relation to reported pain. In blue-collar workers, ERI and JDC independently associated with MSS, and a significant 3-way interaction was observed showing that the combination of job stressors exceeded an additive effect.

CONCLUSION

ERI influences pain symptoms in both occupational groups. OJ was independent significant predictor only among white-collar workers, whereas JDC had additive predictive utility exclusively among blue-collar workers. Simultaneous exposure to multiple job stress factors appeared to synergize pain symptom reporting.

摘要

目的

肌肉骨骼疼痛已被发现与心理社会工作压力同时发生。然而,工作压力存在不同的概念化,每个概念都强调工作环境的不同方面,目前尚不清楚这些方面中的哪一个与肌肉骨骼疼痛关联最强。此外,这些关联可能因白领和蓝领工作类型而异,但尚未对此进行测试。本研究检验了努力-回报失衡(ERI)、工作需求-控制(JDC)和组织公平(OJ)对白领和蓝领工人肌肉骨骼疼痛症状的独立和综合贡献。

方法

一项横断面研究的参与者(n=1634)完成了测量 ERI、JDC 和 OJ 的有效问卷,并报告了前一年四个解剖部位(下背部、颈部或肩部、手臂和手部以及膝盖/脚部)的疼痛频率。疼痛报告汇总为一个肌肉骨骼症状评分(MSS)。分析按白领和蓝领工人分层。

结果

在白领工人中,ERI 和 OJ 与 MSS 独立相关。除了这些累加效应外,显著的 2 路和 3 路相互作用表明,与报告的疼痛相关的工作压力源存在协同作用。在蓝领工人中,ERI 和 JDC 与 MSS 独立相关,观察到显著的 3 路相互作用表明,工作压力源的组合超过了累加效应。

结论

ERI 影响两个职业群体的疼痛症状。OJ 仅在白领工人中是独立的显著预测因子,而 JDC 在蓝领工人中具有累加的预测效用。同时暴露于多种工作压力因素似乎会协同增强疼痛症状报告。

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