Finnish Institute of Occupational Health, 00032 Työterveyslaitos, Finland.
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70210 Kuopio, Finland.
Int J Environ Res Public Health. 2022 Oct 27;19(21):13991. doi: 10.3390/ijerph192113991.
Psychosocial job stressors increase the risk of mental health problems for the workers in health and social services (HSS). Although previous studies suggest that the accumulation of two or more stressors is detrimental to mental health, few studies have examined the synergistic interaction of accumulating job stressors. We examined survey responses from 9855 Finnish HSS workers in a cross-sectional study design from 2021. We conducted an interaction analysis of high job demands, low rewards and low workplace social capital on psychological distress, focusing on the relative excess risk due to interaction (RERI). Additionally, we analysed the interaction of job demands, low rewards and COVID-19 burden (extra workload and emotional load). Our analysis showed that the total RERI for the job stressors on psychological distress was considerable (6.27, 95% CI 3.14, 9.39). The total excess risk was caused by two-way interactions, especially between high demands and low rewards and by the three-way interaction of all stressors. The total RERI for job demands, low reward and COVID-19 burden (3.93, 95% CI 1.15, 6.72), however, was caused entirely by two-way interaction between high demands and low rewards. Mental health interventions tackling high demands, low rewards and low social capital are jointly needed.
心理社会工作压力源会增加卫生和社会服务（HSS）工作者心理健康问题的风险。尽管先前的研究表明，两种或更多压力源的积累对心理健康有害，但很少有研究检验过积累工作压力源的协同相互作用。我们在 2021 年的一项横断面研究设计中，对 9855 名芬兰 HSS 工作者的调查回复进行了分析。我们对高工作要求、低回报和低工作场所社会资本对心理困扰的交互作用进行了分析，重点关注交互作用的相对超额风险（RERI）。此外，我们还分析了工作需求、低回报和 COVID-19 负担（额外工作量和情绪负担）之间的交互作用。我们的分析表明，工作压力源对心理困扰的总 RERI 相当可观（6.27，95%CI 3.14，9.39）。超额风险主要由双向交互作用引起，特别是高需求和低回报之间的交互作用，以及所有压力源的三向交互作用。然而，工作需求、低回报和 COVID-19 负担（3.93，95%CI 1.15，6.72）的总 RERI 完全是由高需求和低回报之间的双向交互作用引起的。需要联合采取干预措施来解决高需求、低回报和低社会资本问题，以维护工作者的心理健康。
