Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
Monash University Centre For Health Economics, Clayton, Victoria, Australia.
Occup Environ Med. 2019 May;76(5):295-301. doi: 10.1136/oemed-2018-105440. Epub 2019 Mar 9.
There is strong evidence of a relationship between psychosocial job stressors and mental health at the population level. There has been no longitudinal research on whether the experience of job stressors is also associated with greater mental health service use. We seek to fill this gap.
The Household Income Labour Dynamics in Australia survey cohort was used to assess the relationship between exposure to self-reported psychosocial job quality and reporting attendance at a mental health professional during the past 12 months. We adjusted for time-varying and time-invariant confounders. The study was conducted in 2009 and 2013.
In the random effects logistic regression model, increasing exposure to psychosocial job stressors was associated with an increased odds of mental health service use after adjustment (one stressor: OR 1.26, 95% CI 1.01 to 1.56; two stressors: OR 1.33, 95% CI 1.02 to 1.73; three stressors: OR 1.82, 95% CI 1.28 to 2.57). However, once the between person effects were controlled in a fixed effects model, the within-person association between change in job stressors and change in mental health service use was estimated to be close to zero and not significant.
More work is needed to understand the relationship between job stressors and service use. However, when taken with past findings on job stressors and mental health, these findings highlight the importance of considering policy and clinical practice responses to adverse working contexts.
有强有力的证据表明，人群层面的心理社会工作压力源与心理健康之间存在关联。目前还没有关于工作压力源的体验是否也与更多的精神卫生服务利用相关的纵向研究。我们旨在填补这一空白。
使用澳大利亚家庭收入劳动力动态调查队列评估自我报告的心理社会工作质量暴露与过去 12 个月内寻求心理健康专业人员就诊之间的关系。我们调整了时变和时不变的混杂因素。该研究于 2009 年和 2013 年进行。
在随机效应逻辑回归模型中，调整后，暴露于心理社会工作压力源与精神卫生服务利用的可能性增加相关（一个压力源：OR 1.26，95%CI 1.01 至 1.56；两个压力源：OR 1.33，95%CI 1.02 至 1.73；三个压力源：OR 1.82，95%CI 1.28 至 2.57）。然而，一旦在固定效应模型中控制了个体间效应，就估计出工作压力源变化与精神卫生服务利用变化之间的个体内关联接近零且不显著。
需要进一步研究以了解工作压力源与服务利用之间的关系。然而，结合过去关于工作压力源和心理健康的研究结果，这些发现强调了考虑针对不利工作环境的政策和临床实践应对措施的重要性。
