医务人员工作中社会心理因素与抑郁症状的关系

目的 探讨医务人员工作上的付出-获得不平衡与抑郁症状之间的关系.方法 付出-获得不平衡采用付出-获得不平衡（the Effort-Reward Imbalance,ERI）量表测量,抑郁情绪调查采用美国流调中心的抑郁自评（Center of Epidemiology Survey Depression,CES-D）量表测量医务人员的抑郁症状.研究对象来自在浙江大学6个附属医院工作的1 179名医务人员.调查表包括ERI量表、CES-D量表和一些基本特征.使用Spearman相关分析、Mann-Whitney检验、Pearson χ^2检验或似然比χ^2检验进行单因素分析;用多元Logistic回归方法分析医务人员中工作上的付出-获得不平衡与抑郁症状之间的关系.结果 医务人员抑郁症状的阳性率为48.12%（95% CI：45.08%～51.16%）,护士抑郁症状的阳性率为52.40%（95%CI：47.87%～56.93%）,较医生抑郁症状的阳性率44.70%（95%CI：10.64%～48.77%）]高,差异有统计学意义（χ^2=6.077,P=0.014）.工作高付出-低获得和超负荷是医务人员抑郁症状发生的相关因素（OR=1.859,95%CI：1.337～2.585;OR=2.207,95%CI：1.656～2.942）.结论 医务人员抑郁症状的发生与工作高付出-低获得、超负荷有关.

Association between social psychological factors and depressive symptoms among healthcare workers

OBJECTIVE: To explore the association between the effort-reward imbalance at work and depressive symptoms among healthcare workers. METHODS: The effort-reward imbalance at work was conceptualized in terms of the Chinese version of the effort-reward imbalance (ERI) model. Depressive symptoms were assessed by the Chinese version of the Center of Epidemiology Survey Depression (CES-D) scale. The data came from the cross-sectional survey of 1 179 healthcare workers aged between 18 and 73 employed in 6 affiliated hospitals of Zhejiang University. The questionnaire comprised questions on the effort-reward at work, over-commitment, the full CES-D scale of depression and a range of other characteristics. Univariate analyses were used with Spearman's correlation, Mann-Whitney test, Pearson chi(2) test and likelihood chi(2) test. Multivariate logistic regression analyses was used to discover factors associated with depressive symptoms. RESULTS: The prevalence of depressive symptoms among healthcare workers was 48.12% (95% CI: 45.08% to 51.16%). The prevalence of depressive symptoms among nurses was 52.40% (95% CI: 47.87% to 56.93%) higher than doctors' 44.70% (95% CI: 10.64% to 48.77%) with the significant difference (chi(2) = 6.077, P = 0.014). Positive associations were found between the high effort-low reward, level of work-related over commitment and depressive symptoms (OR = 1.859, 95% CI: 1.337 to 2.585; OR = 2.207, 95% CI: 1.656 to 2.942) among healthcare workers, respectively. CONCLUSION: The high effort-low reward and the work-related over-commitment have a negative impact on healthcare workers' health.