中老年职工肌肉骨骼功能与工作能力的关系

为了探索肌肉骨骼功能测定在评价工作能力方面的作用，在成都地区对８８名不同职业的中老年职工（４０～６０岁）进行肌肉骨骼功能测定和工作能力指数（ＷＡＩ）测量。结果显示，肌肉骨骼功能指标中，力量指标的平均水平男性显著高于女性，而柔韧性指标女性高于男性。从劳动类型来看，肌肉骨骼功能男性以体力劳动者平均水平最低，女性则以体脑混合型最低。肌肉骨骼功能与工作能力之间存在着密切的相关关系。提示肌肉骨骼功能的测定对评价职工工作能力可能是一组有价值的指标。     

Psychosocial factors at work and perceived health among agricultural meat industry workers in France

Objective  The objective of this study was to describe the perceived health status of the meat industry employees—i.e., working in the slaughtering, cutting, and boning of large animals and poultry—and its relation to their organisational and psychosocial constraints at work. Methods  This postal survey included all 3,000 employees of the meat industry (beef, pork and poultry) in four districts in Brittany, France, whose companies were affiliated with the agricultural branch of the national health insurance fund. The questionnaire asked for social and demographic data and information describing their job and the organisation of their work. The psychosocial factors at work were described according to Karasek’s questionnaire (demand, latitude and social support at work). Perceived health was measured with the Nottingham Health Profile perceived health indicator. Results  This study shows the high prevalence of poor health reported by the workers in this industry. This poor perceived health was worse in women and increased regularly with age. Among the psychosocial factors studied, high quantitative and qualitative demand at work, inadequate resources for good work and to a lesser extent, inadequate prospects for promotion appear especially associated with poor perceived health. Other factors often associated with poor perceived health included young age at the first job and work hours that disrupt sleep rhythms (especially for women). Conclusion  Our results show that this population of workers is especially vulnerable from the point of view of perceived physical and psychological health and is exposed to strong physical, organisational and psychosocial constraints at work. They also demonstrate that poor perceived health is associated with some psychosocial (such as high psychological demand and insufficient resources) and organisational factors at work. These results, in conjunction with those from other disciplines involved in studying this industry, may help the companies to develop preventive activities.     

中老年职工最大呼气流量与工作能力的关系

目的探索中老年职工最大呼气流量在评价工作能力方面的作用。Ｖ·２５方法采用现场调查法，对成都地区２８５名不同职业的中老年职工（４０～６０岁）进行最大呼气流量（ＰＥＦ、Ｖ·７５、Ｖ·５０、Ｖ·２５、Ｖ·５０／Ｖ·２５，将前三项指标等级化值之和得最大呼气流量指数ＭＥＦＩ）和工作能力指数（ＷＡＩ）测量。结果按工作类型，除Ｖ·２５外，各最大呼气流量指标均以脑力劳动组平均水平最高，体力劳动组最低（Ｐ＜０．０５）；ＰＥＦ、Ｖ·７５、Ｖ·５０／Ｖ·２５在ＷＡＩ分级间差异具有显著性（Ｐ＜０．０５）。男女职工各最大呼气流量指标（Ｖ·２５除外）与ＷＡＩ具有密切的相关关系（Ｐ＜０．０５）；ＭＥＦＩ较其所包容的三个指标与ＷＡＩ分级的一致率最高（４７．７２％）；同时Ｖ·７５与ＷＡＩ分级具有显著一致性（Ｐ＜０．０５）。结论最大呼气流量在中老年职工工作能力评价中可能是一组有价值的指标。     

心理社会因素对慢性乙肝病毒携带者心理健康影响的调查

目的探讨认知评价、应对方式、社会支持等心理社会因素对慢性乙肝病毒携带者(AsC)心理健康影响及相关分析。方法采用SCL-90、SAS、SDS、SSRS、CPS及一般情况问卷调查,对124例AsC进行心理健康水平、应对方式、社会支持测试并与对照组进行比较及相关分析。结果AsC组ScL-90,9组症状群中7组得分均明显高于对照组,SAS、SDS所得标准分亦明显高于对照组,两组比较有显著差异性(P<0.01),CPS显示积极应对方式低于对照组(P<0.05)而消极应对方式显著高于对照组(P<0.01),SSRS显示社会支持总分、主观支持及对支持利用度与对照组比较呈显著性差异(P<0.05)。结论慢性乙肝病毒携带者对HBV感染存在认识偏差、社会支持度低和应对方式不良的现象,分析表明AsC出现不同程度的心身症状与应对方式、社会支持等心理社会因素存在有高度相关性。     

农民工心理健康影响因素分析

目的 探讨农民工心理健康状况及其影响因素.方法 应用精神症状自评量表(SCL-90)和艾森克个性问卷(EPQ)对广州市518名农民工进行测试.结果 农民工心理问题检出率为36.5％.不同个性类型的SCL各因子均分及心理健康问题检出率间的差异有统计学意义(P＜0.01).多因素logistic回归分析结果显示,工龄、是否饮酒、性别、P分、E分、N分是心理问题的主要预测因素,不同行业、工龄、P分、N分是躯体化症状的主要预测因素,不同行业、P分、N分是强迫症状的主要预测因素,是否吸烟、P分、N分是人际关系敏感症状的主要预测因素,工龄、P分是抑郁症状的主要预测因素,P分是焦虑症状的主要预测因素,P分、E分、N分是敌对症状的主要预测因素,工龄、是否吸烟、P分、E分、N分是恐怖症状的主要预测因素,工龄、P分是偏执症状的主要预测因素,工龄、P分、N分是精神病性症状的主要预测因素.结论 农民工的心理健康水平与人格密切相关,不同行业、性别、工龄、吸烟、饮酒对精神卫生影响不同,具有精神质倾向、神经质倾向和性格内向的个性特征者身心健康状况较差.     

A case-control study of psycholotical and psychosocial risk factors for shoulder and neck pain at the workplace

Risk factors associated with work-related shoulder and neck myalgia were investigated in a case-control study with pairs matched for age, gender, and physical exposure. Guided interviews with standardized and self-constructed questionnaires were performed among manual (n = 15 pairs) and office (n = 24 pairs) workers. Perceived general tension was the variable with the strongest association with shoulder and neck pain in both work groups. Otherwise, the results in the two groups were very different, indicating that different risk factors and mechanisms were associated with shoulder and neck pain in the two work groups. The study provides background information for future attempts to establish causal relationships between physical and psychosocial exposure and shoulder and neck pain, which can be more accurately investigated in a longitudinal rather than a cross-sectional experimental design.     

Differences in physical workload,psychosocial factors and musculoskeletal disorders between two groups of female hospital cleaners with two diverse organizational models

Objectives To clarify if differences in the physical workload, the psychosocial factors and in musculoskeletal disorders can be attributed to work organizational factors. Methods The physical workload (muscular activity of m. trapezius, positions and movements of the head, upper arms and wrists and heart rate) was assessed in 24 female hospital cleaners working in a traditional work organization (TO) and in 22 working in an extended one (i.e. with an enlarged work content and more responsibilities; EO). The psychosocial work environment was assessed as job demand, decision latitude and social support in 135 (TO) and 111 (EO) cleaners, and disorders of the neck and upper extremity by a physical examination. Results The EO group was associated with lower physical workload, in terms of heart rate ratio (23 vs 32; P < 0.001), head and upper arm positions and movements (right upper arm, 50th percentile, 35°/s vs 71°/s; P < 0.001) and wrist movements (20°/s vs 27°/s; P = 0.001), than the TO group. The EO group reported higher decision latitude and lower work demand than the TO one, while we found no difference in social support. The prevalence of complaints and diagnoses in neck/shoulders were lower in the EO group (diagnoses 35% vs 48%; P = 0.04). Moreover, the prevalence of subjects with at least ten physical finding in elbows/hands was lower in the EO group (10 vs 29; P < 0.001). Conclusion Hospital cleaners have a high prevalence of neck and upper limb disorders and a high physical workload. Comparing two groups of cleaners, with differences in the way of organizing the work, lower physical workload, more beneficial psychosocial factors and a better musculoskeletal health was found in the group with an extended organization. Hence, the differences found can be attributed to the organizational factors.     

Appraised leadership styles,psychosocial work factors,and musculoskeletal pain among public employees

Objectives The main aim of this study was to explore the associations between appraised leadership styles, psychosocial work factors and musculoskeletal pain among subordinates in four different public service sectors from an epidemiological perspective. Methods A cross-sectional questionnaire study was conducted; data from 2,403 public sector employees in subordinate positions (86% women) were analysed. The appraised leadership styles were measured through items from a modified version of the CPE questionnaire (C change, P production/structure, E employee/relation). The structure validity of the CPE-model was examined by principal component analysis (PCA). Univariate and multivariate analyses of associations between levels of musculoskeletal pain and appraised leadership styles and with psychosocial work factors were conducted. Odds ratios (ORs) with confidence intervals (CIs) of 95% were used as a measure of associations. Results There were small variations in the appraisals of the immediate manager among the subordinates. However, the associations between musculoskeletal pain and leadership styles varied according to sector. Poor appraisals (low scores) on “change” and “employee relation” dimensions were associated with high levels of musculoskeletal pain in two sectors: home and health care services. In the domestic catering services, poor appraisals of managers in the “production/structure” dimension had the strongest association with high levels of pain. In general, poor appraisals of the “change” dimension was most strongly associated with high levels of musculoskeletal pain. “High work demands” had the strongest association with high levels of pain, particularly among the men. Conclusions Poor appraisals of managers and their leadership styles were associated with high levels of musculoskeletal pain among both female and male subordinates in different public service sectors. There is therefore a great need of further studies of the mechanisms behind the relationships between the leadership styles and their impact on health among the genders.     

Listening to the rural health workers in Papua New Guinea - the social factors that influence their motivation to work

Despite rural health services being situated and integrated within communities in which people work and live, the complex interaction of the social environment on health worker motivation and performance in Low Middle Income Countries has been neglected in research. In this article we investigate how social factors impact on health worker motivation and performance in rural health services in Papua New Guinea (PNG). Face-to-face in-depth interviews were conducted with 33 health workers from three provinces (Central, Madang, and Milne Bay) in PNG between August and November 2009. They included health extension officers, community health workers and nursing officers, some of whom were in charge of the health centres. The health centres were a selection across church based, government and private enterprise health facilities. Qualitative analysis identified the key social factors impacting on health worker motivation and performance to be the local community context, gender roles and family related issues, safety and security and health beliefs and attitudes of patients and community members. Our study identified the importance of strong supportive communities on health worker motivation. These findings have implications for developing sustainable strategies for motivation and performance enhancement of rural health workers in resource poor settings.     

绩效管理对基层卫生人员工作绩效的影响机制研究——工作动机的中介作用

目的：分析基层医疗卫生机构绩效管理制度运行现状,探究绩效管理对基层卫生人员工作绩效的影响及其作用机制。方法：采用多阶段整群抽样,对山东省青岛、东营与枣庄三市18家社区卫生服务中心和20家乡镇卫生院的基层卫生人员进行问卷调查和个人深入访谈,共计回收有效问卷870份,访谈175人。结果：绩效管理各维度(考核规范性、考核意义感、反馈及时性、分配公平性)中,有三个维度给予正面评价的人员比例未过半数,对四个维度给予负面评价的人员比例均在10%～20%之间,其中分配公平性的得分相对最低。绩效管理对任务绩效无显著影响,对关系绩效与学习绩效有显著弱影响。卫生人员工作动机的主导类型为控制性动机,工作动机在绩效管理要素和工作绩效之间起完全中介作用,且自主性动机对关系绩效和学习绩效的影响强于控制性动机。结论：当前基层医疗卫生机构绩效管理存在指标设置不合理、考核过程形式化、考核结果反馈不及时等问题,激励作用有限,对基层卫生人员工作绩效影响较弱。为此,应通过制定合理的考核指标、加强针对考核结果的沟通与反馈、发挥绩效工资的激励作用、培育发展性的绩效管理文化等举措完善基层医疗卫生机构绩效管理,提高基层卫生人员工作动机与绩效。     

不同特征脑力劳动者职业紧张与工作能力的关系

目的探讨不同特征脑力劳动者的职业紧张和工作能力的变化。方法采用工作紧张测量量表（Job Stress Survey,JSS）和工作能力指数表（WorkAbility Index,WAI）,测量某市1363名脑力劳动者的职业紧张水平和工作能力,并探讨职业紧张与工作能力的关系。结果①职业紧张水平：男性高于女性（P〈0．01）;工龄〈10a者高于工龄〉10a者（P〈0．01）。②工作能力：工龄〈10a者好于工龄〉10a者（P〈0．01）;文化程度本科及以上者好于本科以下者（P〈0．05）。③汉族与少数民族职工职业紧张水平和工作能力差异无统计学意义（P〉0．05）。④不同职业紧张分组,工作能力得分差异有统计学意义（P〈0．01）。工作紧张指数、工作压力指数、组织支持缺乏指数与工作能力呈负相关（r=-0．14,,=-0．11,,=-0．12;P〈0．01）;随着各项紧张指数的增加,工作能力有所下降。结论性别、工龄是脑力劳动者的职业紧张影响因素;工龄、文化程度、职业紧张水平是脑力劳动者工作能力的影响因素。紧张水平增加,工作能力下降。     

城市农民工生命质量及影响因素分析

目的了解城市农民工生命质量(QOL)现状及其影响因素,为制定相应的政策和措施提供理论依据。方法采用健康调查量表(SF-36)对贵州省贵阳市522名农民工进行QOL测定。结果共发放调查表570份,收回558份,其中合格调查表522份,合格率为93.55%;522名农民工中男、女性分别为248和274人,平均年龄(28.43±8.06)岁;未婚、已婚和其他(离异或/和丧偶)分别为223,282,17人;小学及以下、初中、高中及以上文化程度者分别为73,255和194人;SF-36量表的分半信度和Cronbach’sα系数分别为0.806 7(P0.01)和0.777;躯体疼痛、总体健康、活力和精神维度上男性高于女性,仅总体健康维度上不同年龄、教育程度和婚姻状况间差异有统计学意义(P0.01);多元逐步回归分析结果提示,两周患病、住处更换次数、自评健康和主观、客观支持是影响城市农民工QOL的重要因素。结论农民工整体健康水平较差,生理、心理和社会适应等方面均不同程度地影响其QOL。     

Physical activity, psychosocial health and life goals among youth

The main goal of the present study is to investigate the relationship between youth’s physical activity, their psychosocial health and well-being, and their life goals. Data were collected among students (n = 1109, age range between 14 and 21 years of age, mean: 16.5 years, SD = 1.3 years) enrolled in the secondary schools of the Southern Plain Region (three counties), Hungary. Our findings support previous results that more active students have a better self-perceived health and fitness, lower levels of depressive symptoms and higher levels of life satisfaction. In addition, students who are regularly active prefer less extrinsic values as life goals for their future. However, there are no significant differences by physical activity status in terms of intrinsic values (except for physical health). These findings suggest that physical activity is not per se a beneficial health behavior only through its functions. In community health programs, a health-related physical education approach should be addressed to improve the psychosocial benefits of physical activity.Bettina F. Piko is Associate Professor of Behavioral Sciences and Public Health at the University of Szeged, Faculty of Medicine, Hungary, and Noemi Keresztes is Research Assistant and PhD Student both at the University of Szeged, Faculty of Medicine, and at Semmelweis University, Institute of Behavioral Sciences, Budapest, Hungary     

The relations between work demands and health complaints in lorry drivers

In this study, data of a questionnaire study among 439 lorry drivers were fitted to a model in which work demands and the worker's decision latitude are related to musculoskeletal complaints and general psychosomatic complaints. Structural analysis with LISREL was used to investigate the hypothesized relations. Two modifications resulted in a ² of overall fit equal to 77.35 with 47 degrees of freedom. The quality of model fit was considered to be satisfactory when the sample size was taken into account. The values of the Adjusted Goodness of Fit Index (0.948) and the Root Mean Square Residuals (0.029) indicated the same. The standardized solution of LISREL showed that work demands with respect to task contents were significantly related to musculoskeletal complaints as well as to general psychosomatic complaints (0.75 and 0.34 respectively, both P < 0.001). This conceptual variable was indicated by physical activities that the drivers had to perform. The relations between work-related psychosocial factors and musculoskeletal complaints were weak. Another significant effect on general psychosomatic complaints was found for work demands with respect to terms of employment (0.30, P < 0.001). This conceptual variable was indicated by variables concerning working hours and pressure of the work. It is recommended that in future occupational epidemiology, both physical and psychosocial aspects of the working situation be related to health effects, rather than solely a single exposure variable.     

Complementary value of functional capacity evaluation for physicians in assessing the physical work ability of workers with musculoskeletal disorders

Objective  To study the complementary value of information from functional capacity evaluation (FCE) for insurance physicians (IPs) who assess the physical work ability of claimants with long-term musculoskeletal disorders (MSD). Method  A post-test only design was used in the context of disability claims. Twenty-eight IPs participated in the study. Claimants with MSD formed the patient population. For each IP, the first claimant who agreed to participate was included in the study, and underwent FCE in addition to the regular disability claim assessment. Firstly, the IP performed the statutory disability claim assessment. Secondly, the FCE assessment took place. Finally, a self-formulated questionnaire was presented to the IPs after they viewed the FCE report. IPs were asked whether they perceived FCE information to be of complementary value to their judgment of the claimant’s physical work ability investigated. We considered FCE information to be of complementary value if more than 66% of the IPs indicated as such. IPs were also asked whether FCE information led them to change their initial judgment about the claimant’s physical work ability, and whether they felt this information made them more confident about their ultimate judgement. Finally, they were asked whether they planned to include FCE information in future disability claims and for what type of claimants. Differences between IPs who did or did not experience complementary value were explored. Results  Of the 28, 19 (nearly 68%) IPs considered FCE information to be of complementary value for their assessment of claimants with MSD. Half of the IPs stated that FCE information reinforced their judgment. All but four IPs changed their assessment after reading the FCE report. Sixteen IPs intended to involve FCE information in future disability claim assessments. There were no observed differences between the IPs who did or did not consider the FCE information to be of complementary value. Conclusion  FCE information was found to have complementary value at present and in the future according to most IPs in the assessment of the physical work ability of claimants with MSD. Half of the IPs felt that this information reinforces their judgment in this context.     

产后抑郁症的心理社会因素调查研究

目的:研究产后抑郁症的发生率及其相关的心理社会因素。方法:选取2008～2009年在该院分娩的无产前抑郁症的120例初产妇,采用汉密尔顿抑郁量表(HAMD-17)、爱丁堡产后抑郁量表(EPDS)、自编心理社会因素调查表对产妇产后的抑郁情况进行分析。结果:产后抑郁发生率为18.33%,而年龄、家庭经济状况、分娩方式、新生儿性别、居住条件、夫妻关系、婆媳关系、产后睡眠情况等的不同对产后抑郁症的影响有明显统计学差异(P<0.05或P<0.01)。结论:心理社会因素对产后抑郁的影响不容忽视。临床上,我们应减少相关危险因素的发生,对已经存在的危险因素及时进行干预,从而减少产后抑郁的发生。     

Retaining the ability to work-associated factors at work

BACKGROUND: Prevention of work-related sickness absence has traditionally dealt with reduction of exposures to known risk factors. However, there is reason to believe that there are also factors at work that act as health supportive. This study aimed to identify workplace factors predicting retained work ability. METHODS: The present prospective cohort study included the follow-up of 6337 randomly chosen, gainfully employed Swedish women and men for 1 year. Uni- and multivariate logistic regression analyses odds ratios (ORs) together with 95% confidence interval were calculated in order to estimate the strength of the associations between different factors reported in a baseline questionnaire, and retained work ability was defined as not being on long-term sick leave (> 14 days) during the follow-up. RESULTS: Work-related factors significantly associated with retained work ability were as follows: reporting the work as physically non-strenuous (women: OR 1.6; men: OR 2.1), working at a workplace where there are no plans to close down (w: OR 2.3) and feeling recuperated and full of energy (w : = R1.5), and often being in the mood for work (m : 1.4). Significant associations with retained work ability were also found for age, socioeconomic level, household composition, employment sector, and previous sick leave patterns. CONCLUSION: The findings highlight some factors at work, but also some in the personal sphere that are influential for retained work ability, regardless of sick leave patterns prior to the study period. Identifying such factors can provide valuable knowledge for workplace health promotion.     

A comparison of the relationships between psychosocial factors,occupational strain,and work ability among 4 ethnic teacher groups in China

The present study compared the level of occupational strain and work ability among Han, Hui, Uygur, Hui, and Kazakh teachers, and explored ethnic differences based on the associations of psychosocial factors at work, occupational strain, and work ability. A cross-sectional survey was conducted among 2,941 teachers in primary and secondary schools in Xinjiang Province, China. Psychosocial factors, occupational strain, and work ability were measured using the Occupation Stress Inventory—Revised Edition (OSI-R) and Work Ability Index. Han and Hui teachers experienced reduced work ability compared with Uygur and Kazakh teachers, and this finding was caused, in part, by exposure to psychosocial factors at work. The vocational and psychological strains caused by these factors play an important role in reduced work ability among all ethnic teacher groups. The findings indicate the importance of taking action to reduce occupational strain for promoting teachers' work ability in multiethnic workplaces.     

Importance of psychosocial work factors on general health outcomes in the national French SUMER survey

AIM: To examine the associations between psychosocial work factors and general health outcomes, taking into account other occupational risk factors, within the national French working population. METHODS: The study was based on a large national sample of 24 486 women and men of the French working population who filled in a self-administered questionnaire in 2003 (response rate: 96.5%). Psychosocial work exposures included psychological demands, decision latitude, social support, workplace bullying and violence from the public. The three health indicators studied were self-reported health, long sickness absence (>8 days of absence) and work injury. Adjustment was made for covariates: age, occupation, work status, working hours, time schedules, physical, ergonomic, biological and chemical exposures. Men and women were studied separately. RESULTS: Low levels of decision latitude, and of social support, and high psychological demands were found to be risk factors for poor self-reported health and long sickness absence. High demands were also found to be associated with work injury. Workplace bullying and/or violence from the public also increased the risk of poor health, long sickness absence and work injury. CONCLUSION: Psychosocial work factors were found to be strong risk factors for health outcomes; the results were unchanged after adjustment for other occupational risk factors. Preventive efforts should be intensified towards reducing these psychosocial work exposures.