Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong, China.
Front Public Health. 2023 Mar 30;11:1138380. doi: 10.3389/fpubh.2023.1138380. eCollection 2023.
Depressive status of medical personnel worldwide and especially in China is an important public health and social problem. There is a strong relationship between education and depression, but no studies have studied grouping healthcare workers (HCWs) with different educational degree to discuss whether there are differences in the factors that affect depression. This study aims to examine the role of job satisfaction and sleep quality in the relationship between work stress and depression among Chinese HCWs, and teste whether the mediation models are differed by the differences of educational degree.
Patient Health Questionnaire-9 (PHQ-9) scale was used to test depression. Work stress was assessed using the Challenge-blocking stress scale (CBSS). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). HCWs' satisfaction with their current work was assessed using the Job Satisfaction Index (JSI). The representative sample of HCWs was chosen using a multi-stage stratified cluster random sampling procedure and 844 HCWs were utilized to the statistical analysis of the study.
In the overall sample, sleep quality could mediate the relationship between work stress and depression in healthcare workers ( < 0.001, CMIN/DF = 3.816, GFI = 0.911, AGFI = 0.886, IFI = 0.943, TLI = 0.933, CFI = 0.942, RMSEA = 0.058, SRMR = 0.055, AIC = 1039.144), and the mediating effect accounted for 36.5%. After grouping educational qualifications, the model with sleep quality and job satisfaction as mediating variables reported a better fit in the group with low educational qualifications. The intermediary effect accounted for 50.6 and 4.43%, respectively. The highly educated group only has sleep quality as an intermediary variable in the structural model, and the mediating effect accounted for 75.4% ( < 0.001, CMIN/DF = 2.596, GFI = 0.887, AGFI = 0.857, IFI = 0.937, TLI = 0.926, CFI = 0.937, RMSEA = 0.044, SRMR = 0.056, AIC = 1481.322).
In the overall sample, sleep quality could mediate the relationship between work stress and depression in HCWs. Among HCWs with technical secondary school education and below, job satisfaction can mediate the positive relationship between work stress and depression, while this mediating effect is not significant among HCWs with college degree and above.
全球范围内，尤其是在中国，医务人员的抑郁状况是一个重要的公共卫生和社会问题。教育与抑郁之间存在很强的关系，但没有研究对具有不同教育程度的医护人员进行分组，以探讨影响抑郁的因素是否存在差异。本研究旨在探讨工作满意度和睡眠质量在中国医护人员工作压力与抑郁之间的关系中的作用，并检验中介模型是否因教育程度的差异而不同。
采用患者健康问卷-9（PHQ-9）量表测试抑郁情况。采用挑战-阻塞压力量表（CBSS）评估工作压力。采用匹兹堡睡眠质量指数（PSQI）评估睡眠质量。采用工作满意度指数（JSI）评估医护人员对当前工作的满意度。采用多阶段分层聚类随机抽样程序选择具有代表性的医护人员样本，共 844 名医护人员参与了本研究的统计分析。
在总体样本中，睡眠质量可以在医护人员的工作压力与抑郁之间起中介作用（ < 0.001，CMIN/DF=3.816，GFI=0.911，AGFI=0.886，IFI=0.943，TLI=0.933，CFI=0.942，RMSEA=0.058，SRMR=0.055，AIC=1039.144），中介效应占 36.5%。按教育程度分组后，睡眠质量和工作满意度作为中介变量的模型在低教育程度组中的拟合度更好。中介效应分别占 50.6%和 4.43%。高学历组仅在结构模型中以睡眠质量作为中介变量，中介效应占 75.4%（ < 0.001，CMIN/DF=2.596，GFI=0.887，AGFI=0.857，IFI=0.937，TLI=0.926，CFI=0.937，RMSEA=0.044，SRMR=0.056，AIC=1481.322）。
在总体样本中，睡眠质量可以在医护人员的工作压力与抑郁之间起中介作用。在具有中等专业学校及以下学历的医护人员中，工作满意度可以中介工作压力与抑郁之间的正相关关系，而在具有大专及以上学历的医护人员中，这种中介效应不显著。
