Niedhammer I, Siegrist J
INSERM U88, Hôpital National de Saint-Maurice.
Rev Epidemiol Sante Publique. 1998 Nov;46(5):398-410.
The effect of psychosocial factors at work on health, especially cardiovascular health, has given rise to growing concern in occupational epidemiology over the last few years. Two theoretical models, Karasek's model and the Effort-Reward Imbalance model, have been developed to evaluate psychosocial factors at work within specific conceptual frameworks in an attempt to take into account the serious methodological difficulties inherent in the evaluation of such factors. Karasek's model, the most widely used model, measures three factors: psychological demands, decision latitude and social support at work. Many studies have shown the predictive effects of these factors on cardiovascular diseases independently of well-known cardiovascular risk factors. More recently, the Effort-Reward Imbalance model takes into account the role of individual coping characteristics which was neglected in the Karasek model. The effort-reward imbalance model focuses on the reciprocity of exchange in occupational life where high-cost/low-gain conditions are considered particularly stressful. Three dimensions of rewards are distinguished: money, esteem and gratifications in terms of promotion prospects and job security. Some studies already support that high-effort/low reward-conditions are predictive of cardiovascular diseases.
过去几年里，工作中的社会心理因素对健康尤其是心血管健康的影响，已引起职业流行病学领域越来越多的关注。为在特定概念框架内评估工作中的社会心理因素，已发展出两种理论模型，即 Karasek 模型和努力-回报失衡模型，旨在考虑评估此类因素时固有的严重方法学难题。Karasek 模型是使用最广泛的模型，它衡量三个因素：心理需求、决策自由度和工作中的社会支持。许多研究表明，这些因素对心血管疾病具有预测作用，且独立于众所周知的心血管风险因素。最近，努力-回报失衡模型考虑到了 Karasek 模型中被忽视的个体应对特征的作用。努力-回报失衡模型关注职业生活中交换的互惠性，其中高成本/低收益状况被认为特别有压力。奖励分为三个维度：金钱、尊重以及晋升前景和工作保障方面的满足感。一些研究已证实，高努力/低回报状况可预测心血管疾病。
