Kjærgaard Asta, Rudolf Emilie Marie, Palmqvist Julie, Jakobsen Mikala Ernebjerg, Ajslev Jeppe Zielinski Nguyen
The National Research Centre for the Working Environment, Copenhagen, Denmark.
Am J Ind Med. 2025 Mar;68(3):250-263. doi: 10.1002/ajim.23694. Epub 2024 Dec 21.
Psychosocial hazards in the workplace contribute to mental disorders, cardiovascular diseases, and musculoskeletal ill-health. The Hierarchy of Controls applied to NIOSH Total Worker Health (TWH HOC) aims to mitigate these hazards through effective interventions. This study proposes a revision of the model resulting in a HOC for psychosocial hazards (P-HOC) and explores its application in improving the working environment.
We reviewed recent literature on organizational and individual interventions to revise the TWH HOC to a psychosocial HOC framework. Subsequently, the modified P-HOC was applied to a qualitative case study of nine Danish companies participating in the Danish "Agreement to problem-solve" labor inspection strategy. We analyzed the types of initiatives implemented and gathered qualitative data on employee and management perspectives on their effectiveness.
The study led to a revision of the TWH HOC resulting in a P-HOC prioritizing organizational measures with documented effect, and indicating the importance of comprehensive measures. Findings from the qualitative study indicate a predominant contemporary focus on lower-level P-HOC initiatives, such as individual-based approaches and administrative controls. While these interventions show some improvements in mental well-being and work culture, they seem insufficient to enhance the comprehensive psychosocial environment. Companies implementing higher-level interventions experienced greater efficacy, particularly when employing multifaceted approaches.
The study emphasizes the need for a more robust application of higher-level measures and multifaceted interventions to better improve the psychosocial working environment. Future research should investigate the P-HOC's varying impact and explore alternative frameworks for better intervention outcomes.
工作场所的社会心理危害会导致精神障碍、心血管疾病和肌肉骨骼健康问题。应用于美国国家职业安全与健康研究所全职工人健康（TWH HOC）的控制层级旨在通过有效的干预措施减轻这些危害。本研究提议对该模型进行修订，形成社会心理危害控制层级（P-HOC），并探讨其在改善工作环境中的应用。
我们回顾了近期关于组织和个体干预的文献，将TWH HOC修订为社会心理HOC框架。随后，将修订后的P-HOC应用于对九家参与丹麦“问题解决协议”劳动监察策略的丹麦公司的定性案例研究。我们分析了所实施举措的类型，并收集了关于员工和管理层对其有效性看法的定性数据。
该研究导致对TWH HOC进行了修订，形成了P-HOC，优先考虑有记录效果的组织措施，并表明了综合措施的重要性。定性研究结果表明，当代主要关注较低层级的P-HOC举措，如基于个体的方法和行政控制。虽然这些干预措施在心理健康和工作文化方面有一些改善，但似乎不足以改善整体社会心理环境。实施较高层级干预措施的公司效果更佳，尤其是采用多方面方法时。
该研究强调需要更有力地应用较高层级的措施和多方面的干预措施，以更好地改善社会心理工作环境。未来的研究应调查P-HOC的不同影响，并探索替代框架以获得更好的干预效果。
