Niedhammer Isabelle, Quatrevaux Maël, Bertrais Sandrine
INSERM, Univ Angers, Univ Rennes, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, ESTER Team, Angers, France.
INSERM, Univ Angers, Univ Rennes, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, ESTER Team, Angers, France.
Public Health. 2025 May;242:399-405. doi: 10.1016/j.puhe.2025.03.023. Epub 2025 Apr 7.
Organisational changes have been found to be associated with health outcomes but the underlying mechanisms remain understudied. The study aimed at exploring the prospective associations of organisational changes with self-rated health and the mediating effect of psychosocial work factors in these associations.
The study had a prospective design.
The study was based on a nationally representative sample of 14,989 employees surveyed in 2013, 2016, and 2019 (national French working conditions survey). The associations between seven organisational changes, a large set of psychosocial work factors, and the incidence of poor self-rated health were studied using weighted robust Poisson regression models and the Karlson, Holm and Breen (KHB) method. Covariates included gender, age, marital status, stressful life events, social support outside work, occupation, and economic activity of the company.
The exposure to any organisational change predicted the incidence of poor self-rated health (covariate-adjusted incidence rate ratio: 1.30, 95 % CI: 1.16-1.46). All types of organisational changes were predictors of the incidence of poor self-rated health. There was a linear trend between the number of changes and the incidence of poor self-rated health. Mismanagement of changes increased the incidence still further. Psychosocial work factors had a mediating effect of 18.4-51.8 % in the associations between organisational changes and the incidence of poor self-rated health. The most contributing factors were those related to quantitative demands, role stressors, job insecurity, and internal violence.
Prevention oriented towards organisational changes may be useful to improve psychosocial working conditions and health among working populations.
已发现组织变革与健康结果相关，但潜在机制仍未得到充分研究。本研究旨在探讨组织变革与自评健康之间的前瞻性关联，以及心理社会工作因素在这些关联中的中介作用。
本研究采用前瞻性设计。
该研究基于2013年、2016年和2019年对14989名员工进行的具有全国代表性的抽样调查（法国全国工作条件调查）。使用加权稳健泊松回归模型和卡尔森、霍尔姆和布林（KHB）方法研究了七种组织变革、大量心理社会工作因素与自评健康状况不佳发生率之间的关联。协变量包括性别、年龄、婚姻状况、生活压力事件、工作之外的社会支持、职业以及公司的经济活动。
经历任何组织变革都预示着自评健康状况不佳的发生率（经协变量调整的发生率比：1.30，95%置信区间：1.16 - 1.46）。所有类型的组织变革都是自评健康状况不佳发生率的预测因素。变革数量与自评健康状况不佳发生率之间存在线性趋势。变革管理不善会进一步增加发生率。心理社会工作因素在组织变革与自评健康状况不佳发生率之间的关联中具有18.4%至51.8%的中介作用。最具影响的因素是与定量需求、角色压力源、工作不安全感和内部暴力相关的因素。
针对组织变革的预防措施可能有助于改善工作人群的心理社会工作条件和健康状况。
