Institute of Rehabilitation Medicine, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany.
Z Evid Fortbild Qual Gesundhwes. 2021 May;162:32-39. doi: 10.1016/j.zefq.2021.02.007. Epub 2021 Apr 10.
The gender-specific unequal distribution of paid employment and unpaid household and family work may entail specific implications for women's and men's health and work ability. Medical rehabilitation is provided to maintain or restore work ability and to prevent disability pensioning. However, more than half of the employees who receive disability pension have not utilized any pre-retirement rehabilitation services. The study was conducted to examine associations between strain due to unpaid work and the subjective need for rehabilitation among employees with an increased risk of early retirement due to adverse health conditions.
Cross-sectional data from the "Third German Sociomedical Panel of Employees" (GSPE-III) were analysed. The sample comprises 1,908 German employees aged between 42 and 56 years. Logistic regression analyses were conducted separately for women and men to explore the association between the strain level and the subjective need for rehabilitation.
Overall, women reported a higher strain level compared to men. Strain due to housework was not associated with the subjective need for rehabilitation in men and women. However, after adjustment for socio-demographic, work- and health-related characteristics the odds for a subjective need for rehabilitation were three times higher for women (OR=2.9, p <0.001) and two times higher for men (OR=2.0, p=0.027) with a high level of strain due to family work compared to persons with a low strain level.
This study analysed the strain of unpaid work in the context of the utilization of medical rehabilitation services. Although women report a gender-specific higher strain due to unpaid work, a high strain level due to family work seems to be an additional and independent factor influencing the subjective need for rehabilitation for both genders equally.
To prevent disability pensioning, more consideration should be given to the strain factors associated with unpaid family work when designing and organising interventions to promote access to medical rehabilitation services.
有偿就业和无偿家庭及家务工作的性别分配不均，可能对女性和男性的健康和工作能力产生特殊影响。医疗康复旨在维持或恢复工作能力，预防残疾抚恤金的发放。然而，超过一半领取残疾抚恤金的员工并未使用任何退休前康复服务。本研究旨在调查因无偿工作而产生的压力与因健康状况不佳而提前退休风险增加的员工对康复的主观需求之间的关联。
使用横断面数据分析了“第三次德国社会医学员工小组调查（GSPE-III）”的数据。样本包括 1908 名年龄在 42 至 56 岁之间的德国员工。分别对女性和男性进行逻辑回归分析，以探讨压力水平与康复主观需求之间的关系。
总体而言，女性报告的压力水平高于男性。家务劳动带来的压力与男女康复主观需求无关。然而，在调整了社会人口学、工作和健康相关特征后，与压力水平低的人相比，女性因家庭工作而产生高强度压力的康复主观需求的几率高 3 倍（OR=2.9，p<0.001），男性的几率高 2 倍（OR=2.0，p=0.027）。
本研究分析了无偿工作压力对医疗康复服务利用的影响。尽管女性报告因无偿工作而承受更大的性别特定压力，但因家庭工作而产生高强度压力似乎是影响两性康复主观需求的另一个独立因素。
为了预防残疾抚恤金的发放，在设计和组织促进获得医疗康复服务的干预措施时，应更多地考虑与无偿家庭工作相关的压力因素。
