Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.
MEDIAN Klinik Heiligendamm, Bad Doberan, Germany.
Disabil Rehabil. 2021 May;43(9):1299-1306. doi: 10.1080/09638288.2019.1662496. Epub 2019 Sep 14.
The present study set out to examine whether low job decision latitude (JDL, i.e., limited work autonomy) and low social support at work are related to a poor subjective prognosis of gainful employment (SPE) among working rehabilitants with asthma.
JDL and support were assessed by the Copenhagen Psychosocial Questionnaire. The SPE was measured by a validated three-item scale. Separate logistic regression analyses were conducted for all variables to calculate odds ratios (ORs) with 95% confidence intervals (CIs).
Among the 221 participants (response rate = 29.3%), those reporting low JDL or low support had more than doubled odds of being unsure that they would be working until retirement age (OR = 2.28; 95% CI = 1.19-4.37; OR = 2.78; 95% CI = 1.43-5.40, respectively) and of considering their work ability permanently at risk due to ill-health (OR = 3.89; 95% CI = 2.03-7.46; OR = 2.05; 95% CI = 1.08-3.90, respectively) compared to those with good working conditions. The associations of JDL or support were weaker with one's consideration to apply for premature pension (OR = 1.54; 95% CI = 0.60-3.98; OR = 2.18; 95% CI = 0.83-5.77, respectively). Additional analyses identified job satisfaction as a possible explanatory factor for the observed relationships.
Adverse psychosocial working conditions are related to a poor SPE, and low job satisfaction may explain those relationships. Future prospective research is needed to confirm our findings.Implications for rehabilitationEarlier research suggested that asthma increases the risk of disability retirement and thus causes high direct and indirect costs.Prior findings showed that adverse psychosocial working conditions are related to poorer asthma self-management and increased asthma morbidity among rehabilitants with asthma.Consistent with earlier work the present study found that job decision latitude and social support at work are associated with the subjective prognosis of gainful employment among working rehabilitants with asthma.If the reported findings are confirmed by prospective studies, interventions could be developed to improve the working conditions for rehabilitants with asthma and to thereby reduce their risk of disability retirement.
本研究旨在探讨工作中较低的工作决策权(即工作自主性有限)和较低的社会支持是否与哮喘康复者对有酬就业的不良主观预后(SPE)相关。
采用哥本哈根心理社会问卷评估工作决策权和支持度,采用经过验证的三项目量表评估 SPE。对所有变量进行独立的逻辑回归分析,计算优势比(OR)及其 95%置信区间(CI)。
在 221 名参与者中(应答率为 29.3%),报告工作决策权或社会支持较低的人,对能否工作到退休年龄表示不确定的可能性是工作条件良好者的两倍以上(OR=2.28;95%CI=1.19-4.37;OR=2.78;95%CI=1.43-5.40),认为由于健康状况不佳而使工作能力永久处于危险之中的可能性也是工作条件良好者的两倍以上(OR=3.89;95%CI=2.03-7.46;OR=2.05;95%CI=1.08-3.90)。工作决策权或社会支持与提前申请养老金的可能性较弱(OR=1.54;95%CI=0.60-3.98;OR=2.18;95%CI=0.83-5.77)。进一步的分析表明,工作满意度可能是造成这种关系的一个解释因素。
不良的心理社会工作条件与不良的 SPE 相关,而工作满意度低可能解释了这些关系。需要进一步的前瞻性研究来证实我们的发现。
早期研究表明,哮喘会增加残疾退休的风险,从而造成高额的直接和间接成本。先前的研究结果表明,不良的心理社会工作条件与哮喘康复者的自我管理能力较差和哮喘发病率增加有关。与早期研究一致,本研究发现工作决策权和工作中的社会支持与哮喘康复者的有酬就业主观预后相关。如果前瞻性研究证实了这些发现,就可以开发干预措施来改善哮喘康复者的工作条件,从而降低他们残疾退休的风险。