Svedberg Pia, Mather Lisa, Bergström Gunnar, Lindfors Petra, Blom Victoria
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzeliusv. 3, 171 77, Stockholm, Sweden.
Division of Intervention and Implementation Research, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Int J Behav Med. 2018 Feb;25(1):103-111. doi: 10.1007/s12529-017-9669-9.
Work-home interference has been proposed as an important explanation for sickness absence (SA). Previous studies show mixed results, have not accounted for familial factors (genetics and shared everyday environment), or investigated diagnosis specific SA. The aim was to study whether work-home interference and perceived total workload predict SA due to stress-related mental diagnoses, or SA due to other mental diagnoses, among women and men, when adjusting for various confounders and familial factors.
This study included 11,916 twins, 19-47 years (49% women). Data on work-to-home and home-to-work conflicts, perceived total workload, and relevant confounders were derived from a 2005 survey, and national register data on SA spells until 2013 were obtained. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Discordant twin pair design was applied to adjust for familial factors.
Each one unit increase in work-to-home and home-to-work conflicts, and perceived total workload was associated with higher odds for SA due to stress-related mental diagnoses and to SA due to other mental diagnoses among women, when adjusting for sociodemographic factors (ORs 1.15-1.31). Including health or familial factors, no associations remained. For men, each one unit increase in work-to-home conflicts was associated with higher odds for SA due to stress-related diagnoses (ORs 1.23-1.35), independently of confounders.
Work-to-home conflict was independently associated with future SA due to stress-related diagnoses among men only. Health- and work-related factors seem to be important confounders when researching work-home interference, perceived total workload, and SA. Not including such confounders involves risking drawing incorrect conclusions. Further studies are needed to confirm sex differences and whether genetic factors are important for the associations studied.
工作-家庭干扰被认为是病假缺勤（SA）的一个重要解释。先前的研究结果不一，未考虑家庭因素（遗传和共同的日常环境），也未对特定诊断的病假缺勤情况进行调查。本研究旨在探讨在调整各种混杂因素和家庭因素后，工作-家庭干扰和感知到的总工作量是否能预测因压力相关精神诊断导致的病假缺勤，或因其他精神诊断导致的病假缺勤，研究对象包括男性和女性。
本研究纳入了11916对双胞胎，年龄在19至47岁之间（女性占49%）。工作至家庭和家庭至工作冲突、感知到的总工作量以及相关混杂因素的数据来自2005年的一项调查，并获取了截至2013年的国家病假缺勤登记数据。计算了95%置信区间（CIs）的比值比（ORs）。采用不一致双胞胎对设计来调整家庭因素。
在调整社会人口学因素后（ORs为1.15 - 1.31），工作至家庭和家庭至工作冲突以及感知到的总工作量每增加一个单位，与女性因压力相关精神诊断导致的病假缺勤以及因其他精神诊断导致的病假缺勤的较高几率相关。纳入健康或家庭因素后，不再存在关联。对于男性，工作至家庭冲突每增加一个单位，与因压力相关诊断导致的病假缺勤几率较高相关（ORs为1.23 - 1.35），独立于混杂因素。
仅在男性中，工作至家庭冲突与未来因压力相关诊断导致的病假缺勤独立相关。在研究工作-家庭干扰、感知到的总工作量和病假缺勤时，健康和工作相关因素似乎是重要的混杂因素。不纳入这些混杂因素可能会得出错误结论。需要进一步研究来证实性别差异以及遗传因素对所研究关联是否重要。
