Engels J A, van der Beek A J, van der Gulden J W
Department of Occupational Medicine, University of Nijmegen, The Netherlands.
Int Arch Occup Environ Health. 1998 Nov;71(8):537-42. doi: 10.1007/s004200050320.
To fit a model which describes the complex interaction between various work-related factors and both musculoskeletal and psychosomatic complaints of nurses simultaneously and to compare the results with those of two LISREL models, in which the health outcome variables are analyzed separately in terms of their correlation with the same set of work-related factors.
Nurses (n=718) working in four Dutch nursing homes completed a questionnaire about work-related factors and musculoskeletal and psychosomatic complaints (response 81%). LISREL was used to describe and analyse the models.
The full model had a reasonable overall fit. The strongest (and statistically significant) correlations were found between work postures and musculoskeletal complaints and between psychosocial work demands and psychosomatic complaints. In the two single models, health outcomes showed statistically significant correlations with the same work-related factors as they did in the full model. The full model could be slightly improved when the variable somatized complaints (e.g., dizzyness, headache) was related both to musculoskeletal complaints and to psychosomatic complaints.
Although a model that simultaneously describes more dependent variables appears to provide a better approximation of the complexity of the actual relationship between work-related factors and health effects, the models in which only one health outcome is studied seem to give a proper description of the data at hand. This is an important finding because these single health outcome models resemble the usual analysis strategy by means of standard regression analysis. The adapted version of the full model suggests that musculoskeletal complaints of nurses can partly be understood as non-specific health complaints.
构建一个模型，该模型能够同时描述各种与工作相关的因素与护士的肌肉骨骼和身心不适之间的复杂相互作用，并将结果与两个LISREL模型的结果进行比较，在这两个LISREL模型中，健康结果变量根据其与同一组与工作相关的因素的相关性进行单独分析。
在荷兰四家养老院工作的护士（n = 718）完成了一份关于与工作相关的因素以及肌肉骨骼和身心不适的问卷（回复率81%）。使用LISREL来描述和分析模型。
完整模型具有合理的整体拟合度。在工作姿势与肌肉骨骼不适之间以及心理社会工作需求与身心不适之间发现了最强（且具有统计学意义）的相关性。在两个单一模型中，健康结果与完整模型中与相同工作相关因素的相关性具有统计学意义。当将躯体化不适变量（如头晕、头痛）与肌肉骨骼不适和身心不适都相关联时，完整模型可以得到轻微改进。
尽管一个同时描述更多因变量的模型似乎能更好地逼近与工作相关的因素和健康影响之间实际关系的复杂性，但仅研究一种健康结果的模型似乎能对手头数据给出恰当描述。这是一个重要发现，因为这些单一健康结果模型类似于通过标准回归分析的通常分析策略。完整模型的改进版本表明，护士的肌肉骨骼不适在一定程度上可被理解为非特异性健康不适。
