Stansfeld S A, Bosma H, Hemingway H, Marmot M G
International Centre for Health and Society, Department of Epidemiology and Public Health, University College London Medical School, England.
Psychosom Med. 1998 May-Jun;60(3):247-55. doi: 10.1097/00006842-199805000-00004.
To assess whether work characteristics and social support are predictors of physical, psychological, and social functioning.
Work characteristics (Karasek and Siegrist models) and social support at baseline were used to predict health functioning measured by the SF-36 General Health Survey 5 years later in a prospective cohort study of 10,308 British male and female civil servants.
Effort-reward imbalance and negative aspects of close relationships predicted poor physical, psychological, and social functioning after adjustment for the potential confounding effects of age, employment grade, baseline ill health, and negative affectivity. These psychosocial characteristics seem to act in a similar way in the healthy and those with existing illness. Psychological demands at work in women, and low confiding/emotional support in men, also predicted poor functioning. Etiologically. these effects are not mediated through health-related behaviors.
Negative aspects of work (high demands and effort-reward imbalance) and negative aspects of close relationships are independent powerful predictors of poor health functioning. They may have an etiological role, which is independent of baseline illness.
评估工作特征和社会支持是否为身体、心理和社会功能的预测因素。
在一项对10308名英国男女公务员的前瞻性队列研究中，使用基线时的工作特征（Karasek和Siegrist模型）和社会支持来预测5年后通过SF-36健康调查所测量的健康功能。
在对年龄、就业级别、基线健康状况不佳和消极情感等潜在混杂效应进行调整后，努力-回报失衡和亲密关系的消极方面预示着较差的身体、心理和社会功能。这些心理社会特征在健康人群和已有疾病的人群中似乎以相似的方式起作用。女性工作中的心理需求以及男性低倾诉/情感支持也预示着功能较差。从病因学角度来看，这些影响并非通过与健康相关的行为介导。
工作的消极方面（高要求和努力-回报失衡）以及亲密关系的消极方面是健康功能不佳的独立且有力的预测因素。它们可能具有病因学作用，且独立于基线疾病。
