Toomingas A, Theorell T, Michélsen H, Nordemar R
Karolinska Institute, Department of Medicine, Huddinge, Sweden.
Scand J Work Environ Health. 1997 Apr;23(2):130-9. doi: 10.5271/sjweh.190.
The aim was to study the associations between self-rated psychosocial work conditions and the characteristics and location of musculoskeletal symptoms, signs, and syndromes.
Perceived psychosocial work conditions were recorded in a cross-sectional study with 358 men and women in various occupations. Symptoms were recorded from the musculoskeletal system with a questionnaire, and signs were detected in a medical examination of all body regions. The analyses of statistical associations between the psychosocial factors and musculoskeletal disorders were performed with control for age, gender, and physical load.
The most consistent and pronounced associations were mainly seen between poor psychosocial work conditions and coexisting symptoms and signs of the neck and back regions. Poor psychosocial work conditions were more consistently and strongly associated with signs of muscular (soft tissue) tenderness than with signs of tenderness in the joints, tendons, or muscular insertions or signs in nerve compression tests. Mainly low social support at work, but also high psychological demands and high job strain, were associated with such symptoms and signs, whereas decision latitude at work showed few associations with musculoskeletal disorders.
Perceived poor psychosocial work conditions are statistically associated mainly with symptoms and signs of muscular tenderness in the central body regions. Studies on associations between psychosocial work conditions and musculoskeletal disorders should separate effect measures of different clinical signs and different body regions in order to avoid attenuation of the risk estimates.
本研究旨在探讨自我评定的心理社会工作条件与肌肉骨骼症状、体征及综合征的特征和部位之间的关联。
在一项横断面研究中,对358名从事不同职业的男性和女性的心理社会工作条件进行记录。通过问卷调查记录肌肉骨骼系统的症状,并对所有身体部位进行医学检查以检测体征。在控制年龄、性别和体力负荷的情况下,对心理社会因素与肌肉骨骼疾病之间的统计关联进行分析。
最一致且显著的关联主要出现在心理社会工作条件较差与颈背部同时存在的症状和体征之间。心理社会工作条件较差与肌肉(软组织)压痛体征的关联比与关节、肌腱或肌肉附着点压痛体征或神经压迫试验体征的关联更为一致和强烈。主要是工作中的社会支持较低,但心理需求高和工作压力大也与这些症状和体征相关,而工作中的决策自由度与肌肉骨骼疾病的关联较少。
自我评定的心理社会工作条件较差在统计学上主要与身体中心部位的肌肉压痛症状和体征相关。关于心理社会工作条件与肌肉骨骼疾病之间关联的研究应区分不同临床体征和不同身体部位的效应指标,以避免风险估计的衰减。