Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, 3010, Australia.
Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, 3010, Australia.
Soc Psychiatry Psychiatr Epidemiol. 2021 Jul;56(7):1147-1160. doi: 10.1007/s00127-021-02077-x. Epub 2021 Apr 17.
To assess the quality of the research about how employment conditions and psychosocial workplace exposures impact the mental health of young workers, and to summarize the available evidence.
We undertook a systematic search of three databases using a tiered search strategy. Studies were included if they: (a) assessed employment conditions such as working hours, precarious employment, contract type, insecurity, and flexible work, or psychosocial workplace exposures such as violence, harassment and bullying, social support, job demand and control, effort-reward imbalance, and organizational justice; (b) included a validated mental health measure; and (c) presented results specific to young people aged ≤ 30 years or were stratified by age group to provide an estimate for young people aged ≤ 30 years. The quality of included studies was assessed using the Risk of Bias in Non-randomized Studies of Exposures (ROBINS-E) tool.
Nine studies were included in the review. Four were related to employment conditions, capturing contract type and working hours. Five studies captured concepts relevant to psychosocial workplace exposures including workplace sexual harassment, psychosocial job quality, work stressors, and job control. The quality of the included studies was generally low, with six of the nine at serious risk of bias. Three studies at moderate risk of bias were included in the qualitative synthesis, and results of these showed contemporaneous exposure to sexual harassment and poor psychosocial job quality was associated with poorer mental health outcomes among young workers. Longitudinal evidence showed that exposure to low job control was associated with incident depression diagnosis among young workers.
The findings of this review illustrate that even better studies are at moderate risk of bias. Addressing issues related to confounding, selection of participants, measurement of exposures and outcomes, and missing data will improve the quality of future research in this area and lead to a clearer understanding of how employment conditions and psychosocial workplace exposures impact the mental health of young people. Generating high-quality evidence is particularly critical given the disproportionate impact of COVID-19 on young people's employment. In preparing for a post-pandemic world where poor-quality employment conditions and exposure to psychosocial workplace exposures may become more prevalent, rigorous research must exist to inform policy to protect the mental health of young workers.
评估就业条件和心理社会工作场所暴露如何影响年轻工人心理健康的研究质量，并总结现有证据。
我们采用分层搜索策略对三个数据库进行了系统搜索。如果研究符合以下标准，则纳入研究：（a）评估就业条件，如工作时间、不稳定就业、合同类型、不安全感和灵活工作，或心理社会工作场所暴露，如暴力、骚扰和欺凌、社会支持、工作需求和控制、努力-回报失衡和组织公平；（b）包括经过验证的心理健康测量方法；（c）提供特定于年轻人（≤30 岁）的结果，或按年龄组分层以提供年轻人（≤30 岁）的估计值。使用非随机暴露研究中的偏倚风险（ROBINS-E）工具评估纳入研究的质量。
本综述纳入了 9 项研究。其中 4 项与就业条件有关，涉及合同类型和工作时间。五项研究涉及与心理社会工作场所暴露相关的概念，包括工作场所性骚扰、心理社会工作质量、工作压力源和工作控制。纳入研究的质量普遍较低，其中 9 项中有 6 项存在严重偏倚风险。纳入了 3 项中度偏倚风险的研究进行定性综合分析，结果表明，同期暴露于性骚扰和较差的心理社会工作质量与年轻工人较差的心理健康结果有关。纵向证据表明，低工作控制暴露与年轻工人抑郁诊断的发生有关。
本综述的结果表明，即使是更好的研究也存在中度偏倚风险。解决与混杂、参与者选择、暴露和结果测量以及缺失数据相关的问题将提高该领域未来研究的质量，并更清楚地了解就业条件和心理社会工作场所暴露如何影响年轻人的心理健康。鉴于 COVID-19 对年轻人就业的不成比例影响，因此需要制定高质量的证据。在为一个可能出现较差就业条件和心理社会工作场所暴露的后大流行世界做准备时，必须进行严格的研究，以为保护年轻工人的心理健康提供政策信息。
