职业倦怠在工作压力与健康功能间的中介效应

目的研究城市男性职业人群工作压力对其身心健康功能的影响,并探讨职业倦怠在其间的中介效应。方法从某城市中心城区随机抽取30～65岁的1133名男性职工进行横断面调查,用哥本哈根社会心理问卷（COPSOQ）、哥本哈根倦怠问卷（CBI）、以及SF－8分别测试工作压力、职业倦怠、和健康功能,运用中介分析研究工作压力和职业倦怠对职工身心健康的影响。结果工作压力的增加与男性职业人群生理健康和心理健康的下降有显著性关联（P〈0．01）,并可见明显的剂量一反应关系;职业倦怠作为中介变量,对生理健康和心理健康的下降分别起到了15．08％和23．84％的间接效应。结论工作压力对男性职业人群的身心健康均造成了不利影响,职业倦怠部分中介了上述作用。     

Comparison between the first and second versions of the Copenhagen Psychosocial Questionnaire: psychosocial risk factors for a high need for recovery after work

Purpose

The Copenhagen Psychosocial Questionnaire (COPSOQ I) was developed as a tool to assess a broad range of psychosocial work environment factors and was recently revised (COPSOQ II). The research question in this study was: Do COPSOQ II-scales predict a high need for recovery (NFR) after work better than COPSOQ I-scales?

Methods

A cross-sectional questionnaire study was conducted in 990 subjects (84.5% response), employed in the public sector. Psychosocial factors were assessed by COPSOQ I and COPSOQ II. Multivariate logistic regression analysis was used to calculate the odds ratios for the presence of a high NFR, controlled for gender, age, physical workload and other relevant occupational and non-occupational factors. Analyses were performed for COPSOQ I and COPSOQ II separately.

Results

In both COPSOQ versions, ‘quantitative demands’ (p < 0.001) and ‘job insecurity’ (p < 0.005) were significantly associated with a high NFR. Additionally, in the COPSOQ I model, ‘demands for hiding emotions’ (p < 0.05) and ‘degrees of freedom’ (p < 0.05), and in the COPSOQ II model ‘emotional demands’ (p < 0.05) and ‘commitment to the workplace’ (p < 0.005) were significant as well. ‘Degrees of freedom’ was omitted by the developers in the revised COPSOQ II. Reintroducing it into the COPSOQ II model did not alter the existing associations, but pointed out ‘degrees of freedom’ to be an additional important dimension (p < 0.05). The COPSOQ II model with ‘degrees of freedom’ included also had the best data fit.

Conclusions

The results suggested the COPSOQ II to be better predictive than COPSOQ I for a high NFR, but also indicated that ‘degrees of freedom’ should be included into the COPSOQ II when studying the NFR as outcome parameter.     

哥本哈根社会心理问卷的信度和效度研究

目的检验哥本哈根社会心理问卷（COPSOQ）的中文短版的信度和效度,评价其与亚健康症状评价问卷（SHSQ-25）联合使用的应用价值。方法以参加2012年度北京市宣武医院健康体检的本院在职职工（≥40岁）作为调查对象进行问卷调查,运用Cronbach′sα系数、因子分析、Spearman相关分析评价COPSOQ中工作应激相关的5个模块（工作要求、个人影响和发展、人际关系和领导能力、工作不稳定性以及工作满意度）的同质信度、结构效度和其与亚健康症状评价问卷结果的关联性。结果问卷5个模块的Cronbach′sα系数在0.791～0.891之间,因子分析结果示问卷的结构效度与理论模式基本吻合。此外,Spearman相关分析提示问卷中工作应激相关的5个模块与亚健康症状具有相关性（P〈0.05）。结论 COPSOQ中文版的信度与效度良好,其与SHSQ-25联合可应用于评价工作应激与亚健康的关联。     

COPSOQ International Network: Co-operation for research and assessment of psychosocial factors at work

COPSOQ is a comprehensive questionnaire on psychosocial factors at work which is internationally widely used since approx. 10 years for risk assessments in organisations. The International COPSOQ-Network was established in 2009 by scientific and empirical users of the COPSOQ. Main aim is the international scientific exchange concerning the use of COPSOQ. A second goal lies in the coordination of research and further development of the questionnaire (content and measurement qualities), to facilitate international comparison studies. Further information: www.copsoq-network.org     

The Copenhagen Psychosocial Questionnaire--a tool for the assessment and improvement of the psychosocial work environment

OBJECTIVES: The aim of this article is to present the Copenhagen Psychosocial Questionnaire (COPSOQ), a questionnaire developed in three different lengths for assessing psychosocial factors at work, stress, and the well-being of employees and some personality factors. The purpose of the COPSOQ concept is to improve and facilitate research, as well as practical interventions at workplaces. METHODS: The development of the questionnaire was based on a survey of a representative sample of 1858 Danish employees aged 20-59 years. The response rate was 62%; 49% were women. Altogether 145 questions from some international and Danish questionnaires and 20 self-developed questions were tested with factor analyses, analyses of internal reliability, and analyses of response patterns. RESULTS: The analyses resulted in a long research version of the questionnaire with 141 questions and 30 dimensions, a medium-length version for work environment professionals with 95 questions and 26 dimensions, and a short version for workplaces with 44 questions and 8 dimensions. Most of the scales have good reliability, and there seems to be very little overlap between the scales. A novel feature of the COPSOQ is the development of five different scales on demands at work. CONCLUSIONS: The COPSOQ concept is a valid and reliable tool for workplace surveys, analytic research, interventions, and international comparisons. The questionnaire seems to be comprehensive and to include most of the relevant dimensions according to several important theories on psychosocial factors at work. The three versions facilitate communication between researchers, work environment professionals, and workplaces.     

广州市1 545名医务人员职业紧张、职业倦怠和抑郁症状的关系研究

  目的  探讨医务人员职业紧张、职业倦怠和抑郁症状的关系,为促进医务人员身心健康提供理论指导。
  方法  采用整群随机抽样方法,选取广州市三家医院的1 545名医务人员为研究对象,应用付出-回报失衡问卷、职业倦怠通用量表和病人健康问卷抑郁量表对其职业紧张、职业倦怠和抑郁症状水平进行自填式问卷调查。采用逐步回归方法,以职业紧张为自变量,职业倦怠为中介,抑郁症状为因变量构建多元线性模型,分析医务人员职业紧张、职业倦怠和抑郁症状的关系。
  结果  1 545名医务人员平均年龄（34.2 ±8.8）岁,平均岗位工作时间（7.6 ±6.8）年。其职业紧张付出、回报、内在投入维度平均得分分别为（3.0 ±0.8）分、（3.9 ±0.6）分、（2.5 ±0.8）分,付出-回报失衡指数平均得分为0.8 ±0.4,检出付出-回报失衡模式高职业紧张308人,检出率为19.9%;职业倦怠得分为（1.8 ±1.1）分,情绪耗竭、人格解体、工作成就感各维度得分分别为（2.2 ±1.6）分、（1.5 ±1.4）分、（4.4 ±1.5）分,检出有职业倦怠感133人,检出率为8.6%;抑郁症状得分为（7.8 ±4.5）分,检出有抑郁症状者391人,检出率为25.3%。Pearson相关分析显示,医务人员职业倦怠得分与职业紧张的付出、内在投入维度以及抑郁症状得分均呈正相关（r_s=0.412、0.542、0.667,P < 0.01）;抑郁症状得分与职业紧张的付出、内在投入维度得分均呈正相关（r_s=0.436、0.542,P < 0.01）,与职业紧张的回报维度得分呈负相关（r_s=-0.514,P < 0.01）。多元分层回归分析显示,职业紧张、职业倦怠对抑郁症状的预测作用均有统计学意义（P < 0.01）,职业紧张和职业倦怠对抑郁症状变化解释量分别为33.2%和13.9%。
  结论  广州市医务人员的职业紧张对其抑郁症状具有直接作用;职业倦怠作为职业紧张的负面结果,在职业紧张影响抑郁症状中发挥部分中介作用;减轻医务人员职业倦怠,有助于改善抑郁症状。
     

劳动密集型企业女工职业紧张与职业倦怠、抑郁症状关系研究

目的探讨劳动密集型企业女工职业紧张、职业倦怠和抑郁症状的关系。方法采用整群随机抽样方法,选取广东省佛山市5家劳动密集型企业的665名女工作为研究对象,应用工作付出-回报失衡紧张量表、职业倦怠通用量表、患者健康问卷对其职业紧张、职业倦怠和抑郁症状水平进行调查。结果女工付出-回报失衡(ERI)指数中位数(M)为0.80,ERI模式高职业紧张检出率为28.6%;职业倦怠、抑郁症状得分M分别为35.0和8.0分,职业倦怠感检出率为7.4%,抑郁症状检出率为32.8%。偏相关分析显示,女工职业倦怠得分与职业紧张的付出、内在投入维度以及抑郁症状得分均呈正相关(P0.05),与职业紧张的回报维度得分呈负相关(P0.01)。职业紧张和职业倦怠对抑郁症状变化解释量分别为7.4%和7.7%。结论劳动密集型企业女工职业倦怠在职业紧张和抑郁症状之间具有某些中介作用,降低其职业紧张与职业倦怠水平有助于缓解抑郁症状。     

医生职业紧张、工作倦怠、抑郁症状关系的研究

目的探讨医生的职业紧张、工作倦怠对抑郁症状的影响,改善医生身心健康,降低抑郁症状的发生,提高医疗服务质量。方法采用横断面调查方法,于2010年10-11月随机抽取辽宁省具有代表性的三个大、中、小城市的6所综合医院工作六个月以上的373名医生进行自填式问卷调查。问卷包括付出-回报失衡问卷(ERI),工作倦怠问卷(MBI-GS),流行病调查用抑郁自评量表(CES-D)。应用多元分层回归分析探讨医生职业紧张、工作倦怠对抑郁症状的影响,验证工作倦怠在职业紧张对抑郁症状影响中的中介作用。结果外在付出、内在投入、情绪衰竭和消极怠慢与抑郁症状呈显著正相关,回报、个人成就感与抑郁症状呈显著负相关。外在付出和回报对抑郁症状的解释变异量为15.5%,加入工作倦怠后,解释变异量为43.7%。结论医生职业紧张、工作倦怠与抑郁症状密切相关,工作倦怠在职业紧张对抑郁症状影响中起中介作用。     

哥本哈根社会心理问卷信度与效度的测评

[目的]对哥本哈根社会心理问卷(COPSOQ)的中文版本进行信度和效度的测评,为职业紧张研究提供一种新的调查问卷.[方法]从云南省昆明市中心城区随机抽取30～65岁的常住居民2178名进行大样本横断面问卷调查,运用相关分析、因子分析和Logistic回归分析评价COPSOQ 5个模块(工作要求、个人影响和发展、人际关系和领导能力、工作不稳定性以及工作满意度)的同质信度、结构效度和关联效标.[结果]问卷5个模块的克朗巴赫(Cronhach's)系数在0.48～0.84之间,除"工作要求"和"工作不稳定性"2个模块外,其余模块内部一致性信度良好;因子分析结果显示问卷的结构效度与理论模式基本吻合,但部分条目需要进一步修订.此外,Pearson相关和Logistic回归分析提示问卷主要模块与生理、心理健康均具有显著相关性(P<0.05或P<0.01).[结论]COPSOQ中文版的信度与效度良好,在对部分条目进行进一步完善之后可以应用于对中国工作场所社会心理因素的测量.     

The Portuguese long version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II) – a validation study

Background

Psychosocial risks are now widely recognised as one of the biggest challenges for occupational safety and health (OSH) and a major public health concern. The aim of this paper is to investigate the Portuguese long version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II), in order to analyse the psychometric properties of the instrument and to validate it.

Methods

The Portuguese COPSOQ II was issued to a total of 745 Portuguese employees from both private and public organisations across several economic sectors at a baseline and then 2 weeks later. Methodological quality appraisal was based on COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) recommendations. An analysis of the psychometric properties of the long version of COPSOQ II (internal consistency, intraclass correlation coefficient, floor and ceiling effects, response rate, missing values, mean and standard deviation, exploratory factor analysis) was performed to determine the validity and reliability of the instrument.

Results

The COPSOQ II had a response rate of 60.6% (test) and a follow-up response rate of 59.5% (retest). In general, a Cronbach’s alpha of the COPSOQ scales (test and retest) was above the conventional threshold of 0.70. The test-retest reliability estimated by the intraclass correlation coefficient (ICC) showed a higher reliability for most of the scales, above the conventional 0.7, except for eight scales. The proportion of the missing values was less than 1.3%, except for two scales. The average scores and standard deviations showed similar results to the original Danish study, except for eight scales. All of the scales had low floor and ceiling effects, with one exception. Overall, the exploratory factor analysis presented good results in 27 scales assuming a reflective measurement model. The hypothesized factor structure under a reflective model was not supported in 14 scales and for some but not all of these scales the explanation may be a formative measurement model.

Conclusion

The Portuguese long version of COPSOQ II is a reliable and valid instrument for assessing psychosocial risks in the workplace. Although the results are good for most of the scales, there are those that should be evaluated in greater depth in future studies. This instrument may contribute to the promotion of a healthy working environment and workforce, providing clear benefits for companies and employees.

     

A Cross-sectional Multicentre Qualitative Study Exploring Attitudes and Burnout Knowledge in Intensive Care Nurses with Burnout

AimAlthough nurses in intensive care units (ICUs) are exposed to prolonged stress, no burnout prevention policy has yet been established. This study aims to determine the attitudes and “sense” of knowledge of burnout in nurses with burnout.MethodsThe study, which has a qualitative exploratory phenomenological design, was carried out in several Croatian ICUs in 2017. ICU nurses suffering from burnout according to their score on the Maslach Burnout Inventory were chosen randomly from five hospitals. Their participation was voluntary. Of the 28 participants, 86% were women (n=24) and 14% men (n=4). They were aged mainly between 36 and 45 (n=11 (40%)) and between 26 and 35 (n=10 (36%)). Semi-structured interviews were conducted up to the saturation point. The conversations were audio-recorded and transcribed verbatim. The text was analysed using inductive thematic analysis, with codes derived and grouped into clusters by similarities in meaning, and interpretation as the final stage.ResultsEmergent themes, compromised private life, stressful work demands, stress reduction options, protective workplace measures and sense of knowledge reflected a variety of experiences, attitudes and knowledge of burnout.DiscussionNurses with burnout provided an insight into their experience and attitudes, and the problems created by burnout. Given the poor sense of knowledge about this syndrome, there is a need to implement education on burnout in nursing school curricula, and clear strategies in the ICU environment, i.e. information, awareness-raising, and specific guidelines on coping, burnout detection and prevention. Approaching burnout prevention through attitudes/social learning may be a novel and feasible model of addressing this issue.     

A cross-sectional study of psychosocial work environment and stress in the Danish symphony orchestras

Purpose

To investigate psychosocial work environment and stress in Danish symphony orchestra musicians.

Methods

This was a cross-sectional questionnaire survey of psychosocial work factors and stress symptoms among 441 musicians in six Danish symphony orchestras. The response rate was 78% (n?=?342). The questions were from COPSOQ (Copenhagen Psychosocial Questionnaire). Mean values of 19 COPSOQ-scales were compared by gender and instrument group. The results for the musicians were compared with results for the general Danish work force (COPSOQ database).

Results

Female musicians reported higher work demands and higher stress symptoms than their male colleagues. Between instrument groups, 2nd violinists seemed to be of particular risk compared with the other instrumental groups in aspects of work pace, work organization, and content, whereas 1st violinists perceived higher emotional stress compared with 2nd violinists. The musicians’ experience of increased work demands as well as deteriorated, work organization and job content, interpersonal relations and leadership, and work-individual interface was significantly associated with increasing stress symptoms. Compared to the general workforce independently of gender, Danish symphony orchestra musicians reported higher emotional demands, lower influence, lower social support, lower sense of community, and lower job satisfaction. However, the musicians reported a higher commitment to the workplace.

Conclusions

The findings indicate a more demanding psychosocial work environment exposure among symphony orchestra musicians than among Danish workers in general. Critical results are the relatively high work demands, low influence, and low social support, females being of higher risk than males.     

肿瘤病人临终关怀护士的职业倦怠及其心理症状

目的探讨肿瘤病人临终关怀护士的职业倦怠、心理症状及其之间的关系,为制定干预措施和提高临终关怀服务质量提供依据。方法采用随机抽样方法,对西安市3所三级甲等医院肿瘤科从事临终关怀工作的178名护士的职业倦怠和心理症状进行测评,并采用皮尔逊相关检验方法分析变量之间的关系。结果护士的职业倦怠程度得分为176.6±7.9,抑郁和焦虑症状得分分别为59.7±5.7和56.3±6.9。职业倦怠和抑郁症状、焦虑症状呈正相关,相关系数(r)分别为0.67、0.65,P0.01。等级线性模型分析结果表明,抑郁症状是导致护士职业倦怠的主要原因(Beta=0.45)。结论肿瘤病人临终关怀护士群体呈现出较高程度的职业倦怠,并伴有明显的抑郁和焦虑症状,抑郁症状是导致其职业倦怠的主要原因。     

科技期刊编辑职业倦怠与功能性躯体不适的关系研究

【目的】 了解科技期刊编辑目前的职业倦怠与功能性躯体不适的关系,以期为改善这一群体的身心健康提供依据。【方法】 采用职业倦怠普适性量表和健康问卷身体症状群量表,以现场或网络调查的方式对广东省科技期刊编辑的职业倦怠与功能性躯体不适的现状进行调查。采用单因素方差分析、t检验、秩和检验进行数据统计处理,同时运用多因素Logistic回归分析期刊编辑职业倦怠与功能性躯体不适的相关关系。【结果】 共纳入211名研究对象,其中58.8%的编辑无职业倦怠表现,34.1%属中度倦怠,7.1%呈高度倦怠状态;有躯体症状困扰的编辑共152名,其中102名属于轻度困扰,43名属于中度困扰,7名属于重度困扰。四肢或关节疼痛、感觉心跳剧烈或快速、气短、感觉疲劳或精力不足是科技期刊编辑职业倦怠的影响因素(P<0.05或0.01)。【结论】 科技期刊编辑职业倦怠心理与躯体症状的困扰程度有关,倦怠组受功能性躯体不适的影响更严重;在保持良好的职业氛围下或可通过缓解编辑躯体不适症状,预防或者缓解期刊编辑的职业倦怠情绪,保持编辑对其工作的热情。     

护士职业倦怠原因与调节

职业倦怠是指在以人为服务对象的职业领域中,个体的一种情感耗竭、人格解体和个人成就感降低的症状。由于护士是一种典型的以人为服务对象的职业,因此,护士是职业倦怠的高发人群,也一直是职业倦怠研究中重点关注的职业人群之一,医护人员发生职业倦怠机会高,尤其以护士更为突出,影响护士职业倦怠主要相关因素有年龄、护龄、婚姻、工作之余的家务劳动、学历、职称、劳动关系、收入、工作量、工作岗位和轮班等因素,由于护理模式向整体护理的转变,以患者为中心,护理角色职能发生质的改变,对护士提出了更高的要求,加重护士职业倦怠的发生。作者就护理职业倦怠的概念及内涵、危害、原因、职业倦怠现状及预防,同时指出干预医护人员职业倦怠的不同影响因素探索有效的方法。     

Stress and Burnout Among Finnish Dairy Farmers

Psychosocial risks among farmers have increasingly been examined because of the ongoing changes in agriculture, such as restructuring of the industry, transition from family farming towards entrepreneurship, and climate change. The aims of the study were to determine the stressors, prevalence of stress and burnout, and variables associated with these symptoms among Finnish dairy farmers. In total 265 respondents completed a postal survey; their average age was 48 years, 44% were females and 56% males. The farms of the survey sample were larger (54 field hectares, 29 cows) than an average farm in Finland (37 hectares, 24 cows) in 2010. The most common stressors were external, such as “agricultural policy of the EU” (European Union) and “the treatment of farmers in society and the media.” In addition, common stressors were related to farm and work, e.g., “amount of work,” unpredictability, and “animal diseases.” The prevalence of stress (42%) was found to have increased compared with earlier studies and was greater than among the general working population. All respondents as a group were classified as having slight symptoms of burnout, and one tenth (9%) of dairy farmers had experienced severe burnout. Stressors related to the workload and health were associated with stress and burnout symptoms. Also, a poor economic situation and loneliness were related to stress. Burnout correlated with a tie stall barn type and with a farm not being involved in the milk production record system. Factors protecting against burnout included positive features of the work and living environment. The study revealed changes during the past decade and new features of the well-being at work on dairy farms in Finland.     

Reducing your risk of burnout

Burnout is a common phenomenon of today's workplace. Burnout is attributed to stress in the work environment. Today's health care environment with its rapidly changing requirements is an especially obvious example. Prevention of burnout, then, becomes particularly crucial. Certain personality types are resistant to burnout; unfortunately, other personality types are susceptible to burnout. However, managers and supervisors can use knowledge of personality types and their corresponding strengths and vulnerabilities to protect themselves and their subordinates from burnout. There are also general and type-specific coping efforts that people can use.     

Knowledge jobs--how to manage without burnout?

The working world is progressing from the industrial era to the era of knowledge. The critical factor of success in work is shifting from machines to the human mind. All work that essentially uses and produces knowledge during and as a result of the work process can be defined as knowledge work. Knowledge jobs involve many health-promoting features, but stress and burnout may be caused by the rapid increase in the knowledge-intensity of work, new job demands, and emerging new professional subcultures emphasizing excessive commitment to work. Very little empirical evidence is available on these developments. Much more research is needed to understand the essential features of knowledge work, the change in organizational cultures, and the values guiding this process from the point of view of human resources. Research is also needed to develop organizational strategies for the prevention of stress and burnout in knowledge jobs.     

Stress,Lebenszufriedenheit und Gesundheitswahrnehmung

Objective

The study examines the impact of stress experiences among members of the professional fire brigade. It was assumed that members who feel burdened show a lower life satisfaction, evaluate their health condition worse, and experience themselves as less confident and active.

Method

In a cross-sectional study, 102 members of the fire department Berlin-Süd were evaluated using the so-called Copenhagen Psychological Questionnaire (COPSOQ), a standardized questionnaire for detecting occupational stress.

Results

It became apparent that stress burdens are primarily less due to firefighting operations but rather relate to everyday activities at the station. Members with high stress levels show a significantly lower life satisfaction and experience themselves as less active and confident. Members with little behavioral and cognitive stress symptoms described themselves as more confident. In the same manner, cognitive stress symptoms correlate with perceived activity. Surprisingly, firefighters with a high stress level describe their health condition in more positive terms than those who are not stressed.