患有常见精神障碍但仍在工作：关于病假规定不同时期的纵向研究

Suffering of Common Mental Disorders but Still at Work: A Longitudinal Study During Periods of Differences in Regulations for Having Sick Leave.

作者信息

Helgesson Magnus, Gustafsson Klas, Leineweber Constanze

机构信息

Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-17177, Stockholm, Sweden.

Department of Public Health and Caring Sciences, Public Health, Working Life and Rehabilitation, Uppsala University, SE-75122, Uppsala, Sweden.

出版信息

J Occup Rehabil. 2025 Jan 31. doi: 10.1007/s10926-025-10269-4.

DOI:10.1007/s10926-025-10269-4

PMID:39890734

Abstract

PURPOSE

The aim was to analyse the relationships between work environment characteristics and periods of sick leave (> 14 days) in individuals diagnosed with common mental disorders (CMDs) across 1993-2014. Additionally, the study describes changes in the work environment and sick leave trends over these two periods.

METHODS

From the Swedish Work Environment Surveys (SWES) 1993-2013, participants with a diagnosis of a CMD up to five years before the interview were drawn (n = 3795). Risk ratios (RRs) of the annual average number of sick leave days one year after the interview in SWES (1993-2014) were calculated for various work environment characteristics, along with 95% confidence intervals (CIs).

RESULTS

Having flexible working hours (RR 0.65: 0.46-0.91) and having an active job (RR 0.60: 0.41-0.88), that is, high job demands and high job control, were associated with a significantly decreased risk for a spell of sick leave > 14 days after adjusting for interview year, age, sex, and educational level. There was a tendency that also some aspects of job control, i.e. influence over working hours (RR 0.79: 0.62-1.01) and influence over work pace (0.80: 0.62-1.03), were associated with a lower risk of having > 14 days of sick leave. There was a more substantial effect on these work environment factors in 2009-2013 than 1993-2007.

CONCLUSION

Enabling flexible working hours and influencing work pace and working hours can decrease the risk of sick leave among employees diagnosed with a CMD.

摘要

目的

旨在分析1993 - 2014年间被诊断患有常见精神障碍（CMD）的个体的工作环境特征与病假时长（> 14天）之间的关系。此外，该研究还描述了这两个时期工作环境的变化以及病假趋势。

方法

从1993 - 2013年瑞典工作环境调查（SWES）中，选取在访谈前五年内被诊断患有CMD的参与者（n = 3795）。针对各种工作环境特征，计算了SWES（1993 - 2014）中访谈一年后的年平均病假天数的风险比（RRs）以及95%置信区间（CIs）。

结果

在对访谈年份、年龄、性别和教育水平进行调整后，拥有灵活的工作时间（RR 0.65: 0.46 - 0.91）以及从事积极型工作（RR 0.60: 0.41 - 0.88），即高工作要求和高工作控制，与病假时长> 14天的风险显著降低相关。工作控制的某些方面，即对工作时间的影响（RR 0.79: 0.62 - 1.01）和对工作节奏的影响（0.80: 0.62 - 1.03），也存在与病假时长> 14天风险较低相关的趋势。2009 - 2013年这些工作环境因素的影响比1993 - 2007年更为显著。