Solis-Soto Maria Teresa, Schön Anabel, Parra Manuel, Radon Katja
Instituto de Ciencias de la Salud, Universidad de O'Higgins, Rancagua, Chile.
Doctoral Academic Committee, Universidad San Francisco Xavier de Chuquisaca, Sucre, Bolivia.
BMJ Open. 2019 Mar 8;9(3):e025121. doi: 10.1136/bmjopen-2018-025121.
To assess the association between effort-reward imbalance (ERI) and health indicators among Bolivian school teachers.
School-based cross-sectional study.
Sixty randomly selected schools from rural (33) and urban (27) schools in Chuquisaca, Bolivia.
A total of 1062 school teachers were invited to participate, of which 597 answered the questionnaire (response 56.2%).
Psychosocial factors at work were explored through the short version of the Effort-Reward Questionnaire.
Health outcomes included self-rated overall health, mental distress (12-item General Health Questionnaire ≥5) and the 7-day prevalence of low back pain (LBP) as well as neck or shoulder pain (Nordic Questionnaire). Crude and adjusted ORs and their 95% CIs for each health outcome were calculated using logistic regression models.
The median value for the effort-reward ratio was 0.91 (range: 0.3-2.3) with higher values for teachers from rural versus urban schools. Overall, about 43% of the teachers reported their overall health as fair or poor; 45% suffered mental distress, 17% reported LBP and 29% neck or shoulder pain. Prevalences were higher for teachers employed at rural schools compared with those at urban schools. After adjusting for potential confounders and school location, ERI was statistically significantly associated with fair/poor self-rated health (adjusted OR 1.7, 95% CI 1.0 to 2.9); mental distress (1.9; 95% CI 1.2 to 3.1) and LBP (2.3; 95% CI 1.3 to 4.1).
Our results indicate the urgent need to improve psychosocial working conditions among Bolivian school teachers, in order to promote their health and well-being.
评估玻利维亚学校教师中工作付出-回报失衡（ERI）与健康指标之间的关联。
基于学校的横断面研究。
从玻利维亚丘基萨卡省的农村（33所）和城市（27所）学校中随机选取60所学校。
共邀请1062名学校教师参与，其中597人回答了问卷（回复率56.2%）。
通过工作付出-回报问卷简版探究工作中的社会心理因素。
健康结局包括自我评定的总体健康状况、心理困扰（12项一般健康问卷得分≥5）以及腰痛（LBP）和颈部或肩部疼痛的7天患病率（北欧问卷）。使用逻辑回归模型计算每个健康结局的粗OR值和调整后的OR值及其95%可信区间。
工作付出-回报比的中位数为0.91（范围：0.3 - 2.3），农村学校教师的该比值高于城市学校教师。总体而言，约43%的教师报告其总体健康状况为一般或较差；45%存在心理困扰，17%报告有腰痛，29%报告有颈部或肩部疼痛。农村学校教师的患病率高于城市学校教师。在对潜在混杂因素和学校地点进行调整后，ERI与自我评定的健康状况一般/较差（调整后的OR值为1.7，95%可信区间为1.0至2.9）、心理困扰（1.9；95%可信区间为1.2至3.1）和腰痛（2.3；95%可信区间为1.3至4.1）在统计学上显著相关。
我们的结果表明迫切需要改善玻利维亚学校教师的社会心理工作条件，以促进他们的健康和福祉。
