Work stress, caregiving, and allostatic load: prospective results from the Whitehall II cohort study.
Work stress, caregiving, and allostatic load: prospective results from the Whitehall II cohort study.
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DOI：
10.1097/psy.0000000000000191
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发表时间：
2015-06
影响因子：
3.3
通讯作者：
Rod NH
中科院分区：
文献类型：
--
作者：
Dich N;Lange T;Head J;Rod NH
调查工作和家庭压力对健康影响的研究通常孤立地考虑这些因素。本研究探讨了工作紧张和非正式工作对非稳态负荷（AL）的预期交互作用，AL是生理失调的多系统指标。受试者是来自白厅II队列研究的7，007名英国公务员。第3阶段（1991-1994年）作为基线，第5阶段（1997-1999年）和第7阶段（2002-2004年）作为后续阶段。工作压力（高工作要求与低控制相结合）和照顾（照顾老年或残疾亲属）在基线进行了评估。基于9种心血管、代谢和免疫生物标志物，在基线和两次随访时评估AL指数（可能范围为0-9）。线性混合效应模型被用来检验工作压力和工作负担与AL的关系。（高于样本中每周提供护理的平均小时数）预测更高的AL水平，在那些也报告工作压力的人中效果最强[B = 0.36，95%CI：0.01- 0.71）];然而，工作紧张和工作压力之间的交互作用不显著（p = 0.56）。不考虑工作压力，低养育负担（低于样本中位数）的参与者随后的AL水平低于非照顾者[B = 0.22，95% CI：0.06-0.37]。这项研究提供了一些证据，证明工作压力和家庭要求对生理功能的不利影响。然而，为他人提供护理，如果不涉及过多的时间承诺，也可能具有健康保护作用。
Studies investigating health effects of work and family stress usually consider these factors in isolation. The present study investigated prospective interactive effects of job strain and informal caregiving on allostatic load (AL), a multisystem indicator of physiological dysregulation. Subjects were 7,007 British civil servants from the Whitehall II cohort study. Phase 3 (1991-1994) served as the baseline, Phases 5 (1997-1999) and 7 (2002-2004) as follow-ups. Job strain (high job demands combined with low control) and caregiving (providing care to aged or disabled relatives) were assessed at baseline. AL index (possible range 0-9) was assessed at baseline and both follow-ups based on 9 cardiovascular, metabolic and immune biomarkers. Linear mixed effect models were used to examine the association of job strain and caregiving with AL. High caregiving burden (above the sample median weekly hours of providing care) predicted higher AL levels, with the effect strongest in those also reporting job strain [b = 0.36, 95% CI: 0.01– 0.71)]; however, the interaction between job strain and caregiving was not significant (p = 0.56). Regardless of job strain, participants with low caregiving burden (below sample median) had lower subsequent AL levels than non-caregivers [b = 0.22, 95% CI: 0.06–0.37]. The study provides some evidence for adverse effects of stress at work combined with family demands on physiological functioning. However, providing care to others may also have health protective effects if it does not involve excessive time commitment.