National Yang Ming Chao Tung University, Taipei, Taiwan (Institute of Environmental and Occupational Health Sciences).
Ministry of Health and Welfare, Taipei, Taiwan (Health Promotion Administration).
Int J Occup Med Environ Health. 2022 Aug 1;35(4):425-436. doi: 10.13075/ijomeh.1896.01894. Epub 2022 Jul 1.
Work-related stress (WRS) is significantly associated with health-related quality of life (HRQoL), but the amounts of evidence on differences of effort-reward imbalance (ERI) and job strain index (JSI) remain sparse and have limited generalizability. Therefore, we aimed to assess the association between ERI and JSI with HRQoL and assess the mediation effect of social support (JS) and over-commitment (OC) on this association in Taiwan's civil servants.
A cross-sectional national survey was given to registered civil servants in Taiwan - 20 046 civil servants from 647 institutions were enrolled using multistage stratified random cluster sampling. A web-questionnaire collected demographic information, job characteristics, and different indexes of ERI and job-control-demand-support (JCDS) models. Structural equation model (SEM) was used to examine the association between ERI and JSI with HRQoL, and the mediation effect of JS and OC on the associations.
In the ERI model, ERI and OC were consistently negatively associated with the mental component score (MCS) (r = -0.46 and r = -0.37) and physical component score (PCS) (r = -0.45 and r = -0.34), which were higher than job demand (r = -0.28 and r = -0.22) and JSI (r = -0.38 and r = -0.29). Using hierarchical multiple regression analyses, ERI was significantly correlated with MCS and PCS, which was consistently higher than JSI. The ERI and JSI were significantly correlated with MCS (β = -0.170 and β = -0.140) and PCS (β = -0.150 and β = -0.082) using SEM analysis, whereas ERI was considerably higher than in JSI. In addition, OC and JS mediated the association between The ERI and JSI with HRQoL.
We found the ERI index is significantly correlated with HRQoL superior to JSI, in particular among Taiwan civil servants. Further longitudinal studies are needed to determine the causality and spatiotemporal relation of these differences. Int J Occup Med Environ Health. 2022;35(4):425-36.
工作相关压力（WRS）与健康相关生活质量（HRQoL）显著相关，但关于努力-回报失衡（ERI）和工作紧张指数（JSI）差异的证据仍然很少，且具有有限的普遍性。因此，我们旨在评估 ERI 和 JSI 与 HRQoL 的关系，并评估社会支持（JS）和过度承诺（OC）在此关联中的中介作用在台湾公务员中的作用。
采用横断面全国性调查，对台湾注册公务员进行调查 - 采用多阶段分层随机聚类抽样方法，共纳入 647 个机构的 20046 名公务员。采用网络问卷调查收集人口统计学信息、工作特征以及不同 ERI 和工作控制需求支持（JCDS）模型的指标。结构方程模型（SEM）用于检验 ERI 和 JSI 与 HRQoL 的关系，以及 JS 和 OC 对这些关系的中介作用。
在 ERI 模型中，ERI 和 OC 与心理成分评分（MCS）（r = -0.46 和 r = -0.37）和生理成分评分（PCS）（r = -0.45 和 r = -0.34）持续负相关，高于工作需求（r = -0.28 和 r = -0.22）和 JSI（r = -0.38 和 r = -0.29）。使用分层多元回归分析，ERI 与 MCS 和 PCS 显著相关，始终高于 JSI。ERI 和 JSI 与 MCS（β = -0.170 和 β = -0.140）和 PCS（β = -0.150 和 β = -0.082）的 SEM 分析结果显著相关，而 ERI 则明显高于 JSI。此外，OC 和 JS 介导了 ERI 和 JSI 与 HRQoL 之间的关联。
我们发现 ERI 指数与 HRQoL 的相关性显著高于 JSI，尤其是在台湾公务员中。需要进一步的纵向研究来确定这些差异的因果关系和时空关系。国际职业医学与环境卫生杂志。2022；35（4）：425-36。
