Schreiner Philipp, Biedermann Luc, Rossel Jean-Benoit, Rogler Gerhard, Pittet Valérie, von Känel Roland
*Division of Gastroenterology and Hepatology, University Hospital of Zurich, Zurich, Switzerland; †Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland; ‡Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland; and §Department of Neurology, Bern University Hospital, and University of Bern, Inselspital, Bern, Switzerland.
Inflamm Bowel Dis. 2017 Feb;23(2):310-317. doi: 10.1097/MIB.0000000000001012.
Psychosocial factors have been shown to predict a poor disease course in patients with inflammatory bowel disease (IBD), but whether this applies to job stress is currently unknown. We assessed the prevalence of job stress and its correlates in a large cohort of patients with IBD.
We included all adult, professionally active patients enrolled between 2006 and 2015 in the Swiss IBD Cohort. Job stress was measured through the self-report effort-reward imbalance ratio and overcommitment (OC) to work questionnaires. We used multiple linear regressions to assess association with sociodemographic, lifestyle, psychosocial, and disease-related factors.
Altogether 1656 patients completed the questionnaires (905 Crohn's disease and 751 ulcerative colitis/IBD unclassified). Only 91 (5.7%) of patients had an effort-reward imbalance ratio >1. Effort-reward imbalance and OC scores were higher in full-time versus part-time employees (coef = 0.050, P = 0.002; coef = 0.906, P < 0.001) and among those absent from the workplace in the previous 3 months (coef = 0.049, P = 0.010; coef = 1.062, P < 0.001). Higher OC scores were associated with sex (women vs. men: coef = 0.568, P = 0.014), being in a relationship (coef = 0.805, P = 0.001), higher level of occupation (director vs. trainee: coef = 1.447, P < 0.001), and extraintestinal manifestations (coef = 0.623, P = 0.005). Patients hospitalized in the previous 12 months had lower OC scores (coef = 0.560, P = 0.038).
The average level of job stress seems to be remarkably low in patients with IBD from Switzerland. The clinician should turn attention especially to women, full-time employees with a high level of education, and patients with extraintestinal manifestations to identify those with the most vulnerability to suffer from job stress.
心理社会因素已被证明可预测炎症性肠病(IBD)患者的不良病程,但这是否适用于工作压力目前尚不清楚。我们评估了一大群IBD患者的工作压力患病率及其相关因素。
我们纳入了2006年至2015年期间在瑞士IBD队列中登记的所有成年、有职业活动的患者。通过自我报告的努力-回报失衡比率和工作过度投入(OC)问卷来衡量工作压力。我们使用多元线性回归来评估与社会人口统计学、生活方式、心理社会和疾病相关因素的关联。
共有1656名患者完成了问卷(905例克罗恩病和751例未分类的溃疡性结肠炎/IBD)。只有91名(5.7%)患者的努力-回报失衡比率>1。全职员工的努力-回报失衡和OC得分高于兼职员工(系数=0.050,P=0.002;系数=0.906,P<0.001),并且在过去3个月内缺勤的员工中也是如此(系数=0.049,P=0.010;系数=1.062,P<0.001)。较高的OC得分与性别(女性与男性:系数=0.568,P=0.014)、处于恋爱关系(系数=0.805,P=0.001)、较高的职业水平(主任与实习生:系数=1.447,P<0.001)以及肠外表现(系数=0.623,P=0.005)有关。过去12个月内住院的患者OC得分较低(系数=0.560,P=0.038)。
瑞士IBD患者的工作压力平均水平似乎非常低。临床医生应特别关注女性、高学历的全职员工以及有肠外表现的患者,以识别那些最易遭受工作压力的人群。