Eskildsen Anita, Fentz Hanne Nørr, Andersen Lars Peter, Pedersen Anders Degn, Kristensen Simon Bang, Andersen Johan Hviid
a Department of Occupational Medicine , Danish Ramazzini Centre, The Regional Hospital West Jutland - University Research Clinic , Herning , Denmark.
b Department of Psychology and Behavioral Sciences, School of Business and Social Sciences , Aarhus University , Aarhus C , Denmark.
Stress. 2017 Jul;20(4):371-378. doi: 10.1080/10253890.2017.1341484. Epub 2017 Jun 29.
Patients on sick leave due to work-related stress often present with cognitive impairments as well as sleep disturbances. The aim of this longitudinal study was to examine the role of perceived stress and sleep disturbances in the longitudinal development in cognitive impairments in a group of patients with prolonged work-related stress (N = 60) during a period of 12 months following initial professional care-seeking. Objective cognitive impairments (neuropsychological tests) were measured on two occasions - at initial professional care-seeking and at 12-month follow-up. Questionnaires on perceived stress, sleep disturbances, and cognitive complaints were completed seven times during the 12 months which facilitated multilevel analysis with segregation of within-person (change) and between-person (baseline level) components of the time-varying predictors (perceived stress and sleep disturbances). Change in perceived stress was associated with concurrent and subsequent change in self-reported cognitive complaints over the period of 12 months and to a lesser extent the change in performance on neuropsychological tests of processing speed from baseline to 12-month follow-up. Change in sleep disturbances was also associated with concurrent and subsequent change in self-reported cognitive complaints over the 12 months but not with change on neuropsychological test performance. Although the mechanism behind the improvement in cognitive impairments in patients with work-related stress should be further explored in future studies, the results could suggest that improvement in cognitive impairments is partly mediated by decreasing levels of perceived stress and, to a lesser extent, decreasing levels of sleep disturbances. Lay summary This study examines the role of perceived stress and sleep disturbances in respect to the development of cognitive impairments (e.g. memory and concentration) in a group of patients with work-related stress. We found that change in cognitive impairments seems to be partly explained by change in perceived stress and, to a lesser extent, sleep disturbances over time. This could suggest that cognitive impairments can be reduced by stress management interventions which aim to reduce perceived stress and sleep disturbances but future studies are needed to confirm this interpretation.
因工作压力而休病假的患者常常伴有认知障碍以及睡眠障碍。这项纵向研究的目的是，在一组患有长期工作压力的患者（N = 60）中，探讨感知压力和睡眠障碍在初次寻求专业护理后的12个月期间认知障碍纵向发展中的作用。在两个时间点测量客观认知障碍（神经心理学测试）——初次寻求专业护理时和12个月随访时。在12个月内完成了七次关于感知压力、睡眠障碍和认知主诉的问卷调查，这有助于进行多水平分析，将时变预测因素（感知压力和睡眠障碍）的个体内（变化）和个体间（基线水平）成分区分开来。在12个月期间，感知压力的变化与自我报告的认知主诉的同时期及后续变化相关，并且在较小程度上与从基线到12个月随访期间处理速度的神经心理学测试表现的变化相关。睡眠障碍的变化在12个月内也与自我报告的认知主诉的同时期及后续变化相关，但与神经心理学测试表现的变化无关。尽管未来研究应进一步探讨与工作压力相关的患者认知障碍改善背后的机制，但研究结果表明，认知障碍的改善部分是由感知压力水平的降低介导的，在较小程度上是由睡眠障碍水平的降低介导的。通俗总结 本研究探讨了感知压力和睡眠障碍在一组患有工作压力的患者认知障碍（如记忆力和注意力）发展方面的作用。我们发现，认知障碍的变化似乎部分可以由感知压力的变化来解释，在较小程度上也可以由睡眠障碍随时间的变化来解释。这可能表明，旨在减轻感知压力和睡眠障碍的压力管理干预措施可以减少认知障碍，但需要未来的研究来证实这一解释。
