Siegrist J
Institute of Medical Sociology, University of Düsseldorf, Germany.
J Occup Health Psychol. 1996 Jan;1(1):27-41. doi: 10.1037//1076-8998.1.1.27.
In addition to the person-environment fit model (J. R. French, R. D. Caplan, & R. V. Harrison, 1982) and the demand-control model (R. A. Karasek & T. Theorell, 1990), a third theoretical concept is proposed to assess adverse health effects of stressful experience at work: the effort-reward imbalance model. The focus of this model is on reciprocity of exchange in occupational life where high-cost/low-gain conditions are considered particularly stressful. Variables measuring low reward in terms of low status control (e.g., lack of promotion prospects, job insecurity) in association with high extrinsic (e.g., work pressure) or intrinsic (personal coping pattern, e.g., high need for control) effort independently predict new cardiovascular events in a prospective study on blue-collar men. Furthermore, these variables partly explain prevalence of cardiovascular risk factors (hypertension, atherogenic lipids) in 2 independent studies. Studying adverse health effects of high-effort/low-reward conditions seems well justified, especially in view of recent developments of the labor market.
除了人-环境匹配模型（J.R. 弗伦奇、R.D. 卡普兰和R.V. 哈里森，1982年）以及需求-控制模型（R.A. 卡拉塞克和T. 泰勒尔，1990年）之外，还提出了第三个理论概念来评估工作压力经历对健康的不利影响：努力-回报失衡模型。该模型的重点在于职业生活中交换的互惠性，其中高成本/低收益的情况被认为特别有压力。在一项针对蓝领男性的前瞻性研究中，用低地位控制（如缺乏晋升前景、工作不安全感）来衡量低回报，再结合高外部（如工作压力）或内部（个人应对模式，如高度的控制需求）努力的变量，能独立预测新的心血管事件。此外，在两项独立研究中，这些变量部分解释了心血管危险因素（高血压、致动脉粥样硬化脂质）的患病率。研究高努力/低回报状况对健康的不利影响似乎很有必要，尤其是鉴于劳动力市场的最新发展。
