Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark; Copenhagen Stress Research Center, Copenhagen, Denmark; Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, United States.
Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark.
J Affect Disord. 2020 Nov 1;276:53-61. doi: 10.1016/j.jad.2020.07.004. Epub 2020 Jul 11.
Whether workplace social capital affects employees' mental health is debated. We examined the association between work-unit aggregated social capital and incident purchase of psychotropic medications among employees.
We used data from the WHALE (Well-being in Hospital Employees) cohort study. The study population comprised 21,711 employees without recent psychotropic purchase-history nested within 2283 work units in the Capital Region of Denmark. Employees were invited to participate in a survey in March 2014 (86% response). We assessed workplace social capital by eight items (covering trust/justice and collaboration) and aggregated the mean of responses up to each work unit and categorized the scores into quartiles. Data on psychotropic purchases (antidepressants and anxiolytics/hypnotics/sedatives) were extracted via linkage to national registers. Using two-level mixed-effects survival models, we analyzed the association between work-unit social capital and psychotropic purchases during a one-year follow-up period adjusting for individual-level workplace social capital.
Low work-unit social capital was associated with higher purchases of overall psychotropic medications in a dose-response manner (low-versus-high: HR=1.32, 95% CI=1.05-1.65), but this effect attenuated after adjusting for individual-level workplace social capital (HR=1.14, 95% CI=0.88-1.46). Low work-unit social capital was associated with higher purchases of antidepressants (HR=1.78, 95% CI=1.16-2.73) even after adjusting for individual-level workplace social capital (HR=1.69, 95% CI=1.05-2.73).
Medical doctors/dentists were underrepresented in the data on workplace social capital.
Low work-unit social capital may be associated with higher use of antidepressants among healthcare employees. Interventions to improve social capital could potentially promote mental health at work in the healthcare setting.
工作场所社会资本是否会影响员工的心理健康存在争议。我们研究了工作单位聚集的社会资本与员工购买精神药物之间的关联。
我们使用了来自丹麦首都地区 WHALE（医院员工福利）队列研究的数据。该研究人群包括 21711 名无近期购买精神药物史的员工，他们嵌套在 2283 个工作单位中。员工于 2014 年 3 月受邀参加一项调查（回应率为 86%）。我们通过八项指标评估了工作场所的社会资本（涵盖信任/公正和协作），将每个工作单位的响应平均值进行汇总，并将分数分为四分位数。通过与国家登记册的链接，提取了精神药物购买（抗抑郁药和抗焦虑药/催眠药/镇静剂）的数据。使用两级混合效应生存模型，我们在一年的随访期间分析了工作单位社会资本与精神药物购买之间的关联，调整了个体层面的工作场所社会资本。
低工作单位社会资本与精神药物总购买量呈剂量反应关系（低与高：HR=1.32，95%CI=1.05-1.65），但在调整个体层面的工作场所社会资本后，这种关联减弱（HR=1.14，95%CI=0.88-1.46）。即使在调整了个体层面的工作场所社会资本后，低工作单位社会资本与抗抑郁药购买量增加相关（HR=1.78，95%CI=1.16-2.73）。
工作场所社会资本的数据中医生/牙医代表性不足。
低工作单位社会资本可能与医疗保健员工中抗抑郁药使用量增加有关。改善社会资本的干预措施可能会在医疗保健环境中促进工作场所的心理健康。
