Koch Peter, Kersten Jan Felix, Stranzinger Johanna, Nienhaus Albert
Centre of Excellence for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
Health Protection Division (FBG), Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Pappelallee 33, 22089 Hamburg, Germany.
J Occup Med Toxicol. 2017 Jun 26;12:16. doi: 10.1186/s12995-017-0163-8. eCollection 2017.
The prevalence of effort-reward imbalance (ERI) among qualified childcare workers in Germany is currently estimated at around 65%. High rates of burnout and musculoskeletal symptoms (MS) have also been reported for this group. Previous longitudinal studies show inconsistent results with regard to the association between ERI and MS. As yet, no longitudinal studies have been conducted to investigate the association between ERI and burnout or MS in childcare workers. This study aims to investigate the extent to which a relationship between ERI and MS or burnout can be observed in childcare workers in Germany on a longitudinal basis.
In 2014 childcare workers ( = 199, response rate: 57%) of a provider of facilities for children and youth in Hamburg were asked about stress and health effects in the workplace. Follow-up was completed one year later ( = 106, follow-up rate: 53%) For the baseline assessment, ERI was determined as the primary influencing factor. Data on MS was recorded using the Nordic questionnaire, and burnout using the personal burnout scale of the Copenhagen Burnout Inventory (CBI). The statistical analysis was carried out using multivariate linear and logistic regression.
At baseline ERI was present in 65% of the sample population. The mean burnout score at the time of follow-up was 53.7 (SD: 20.7); the prevalence of MS was between 19% and 62%. ERI was identified as a statistically significant factor for MS, after adjusting especially for physical stress (lower back: OR 4.2; 95% CI: 1.14 to 15.50, neck: OR 4.3; 95% CI: 1.25 to 15.0, total MS: OR 4.0; 95% CI: 1.20 to 13.49). With regard to burnout, a relative increase of 10% in the ERI ratio score increased the burnout score by 1.1 points ( = 0.034).
ERI was revealed to be a major factor in relation to MS and burnout in childcare workers. Based on this observation worksite interventions on the individual and organizational level should be introduced in order to prevent ERI.
目前估计德国合格的儿童保育工作者中努力-回报失衡（ERI）的患病率约为65%。据报道，该群体的倦怠率和肌肉骨骼症状（MS）也很高。以往的纵向研究在ERI与MS之间的关联方面结果不一致。迄今为止，尚未进行纵向研究来调查儿童保育工作者中ERI与倦怠或MS之间的关联。本研究旨在纵向调查在德国儿童保育工作者中能在多大程度上观察到ERI与MS或倦怠之间的关系。
2014年，汉堡一家儿童和青年设施提供商的儿童保育工作者（n = 199，回复率：57%）被问及工作场所的压力和健康影响。一年后完成随访（n = 106，随访率：53%）。在基线评估时，将ERI确定为主要影响因素。使用北欧问卷记录MS数据，使用哥本哈根倦怠量表（CBI）的个人倦怠量表记录倦怠数据。采用多元线性和逻辑回归进行统计分析。
在基线时，65%的样本人群存在ERI。随访时的平均倦怠得分是53.7（标准差：20.7）；MS的患病率在19%至62%之间。在特别调整了身体压力后，ERI被确定为MS的一个具有统计学意义的因素（下背部：比值比4.2；95%置信区间：1.14至15.50，颈部：比值比4.3；95%置信区间：1.25至15.0，总MS：比值比4.0；95%置信区间：1.20至13.49）。关于倦怠，ERI比率得分相对增加10%会使倦怠得分增加1.1分（P = 0.034）。
ERI被证明是儿童保育工作者中与MS和倦怠相关的一个主要因素。基于这一观察结果，应在个人和组织层面引入工作场所干预措施以预防ERI。
