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首页> 外文期刊>Occupational and environmental medicine >Effort-reward imbalance and medically certified absence for mental health problems: A prospective study of white-collar workers
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Effort-reward imbalance and medically certified absence for mental health problems: A prospective study of white-collar workers

机译：努力奖赏不平衡和医学认证的精神健康问题缺勤：对白领的前瞻性研究

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Objective Little is known about the effects of psychosocial work factors on objectively assessed mental health problems leading to medically certifi ed absence. Only one study has evaluated the prospective effects of effort-reward imbalance (ERI) at work with regards to this outcome. The present study aimed to evaluate the effects of ERI on the incidence of medically certified absence for mental health problems. Methods The study included 2086 white-collar workers (63.3% women) employed in public organisations in Quebec city. Participants were followed over a 9-year period. Medical absences from work were collected from employers' files and psychosocial factors were measured using the ERI questionnaire. Cox regression models were used to estimate the incidence of certi fied sickness absence due to mental health problems that lasted 5 workdays or more, while controlling for confounders. Results Workers exposed to ERI had a higher risk of a first spell of medically certified absence for mental health problems (HR=1.38, 95% CI 1.08 to 1.76) compared with unexposed workers. Low reward was significantly associated with a high risk among men (HR=2.80, 95% CI 1.34 to 5.89) but not in women. (HR=1.24, 95% CI 0.90 to 1.73). Effort at work had no effect on certified absence. All these effects were adjusted for potential confounders. Conclusions ERI and low reward at work were prospectively associated with medically certified absence for mental health problems. These effects seem to differ by gender. Primary prevention that is aimed at reducing these stressors should be considered to help reduce the incidence of such severe mental health problems.
机译：目的关于社会心理工作因素对客观评估的心理健康问题（导致医疗证明的缺勤）的影响知之甚少。仅有一项研究评估了努力回报不平衡（ERI）在工作中对这一结果的预期影响。本研究旨在评估ERI对精神健康问题经医学认证的缺勤发生率的影响。方法该研究包括魁北克市公共组织中雇用的2086名白领工人（女性占63.3％）。参与者被追踪了9年。从雇主的档案中收集工作中的医疗缺勤情况，并使用ERI调查表测量社会心理因素。使用Cox回归模型来估计持续5个工作日或更长时间的精神健康问题引起的确诊疾病的发生率，同时控制混杂因素。结果与未暴露的工人相比，暴露于ERI的工人发生精神疾病的第一时间经医学认证缺勤的风险更高（HR = 1.38，95％CI 1.08至1.76）。男性的低报酬与高风险显着相关（HR = 2.80，95％CI 1.34至5.89），而女性则没有。 （HR = 1.24，95％CI 0.90至1.73）。工作的努力对认证的缺勤没有影响。所有这些影响都针对潜在的混杂因素进行了调整。结论ERI和低工作报酬与精神健康问题的医学证明缺席有关。这些影响似乎因性别而异。应该考虑采取旨在减少这些压力源的一级预防措施，以帮助减少此类严重的精神健康问题的发生率。

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