Linking hospital workers' organisational work environment to depressive symptoms: A mediating effect of effort-reward imbalance? The ORSOSA study
Linking hospital workers' organisational work environment to depressive symptoms: A mediating effect of effort-reward imbalance? The ORSOSA study
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DOI：
10.1016/j.socscimed.2010.04.003
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发表时间：
2010-08-01
影响因子：
5.4
通讯作者：
Lang, Thierry
中科院分区：
文献类型：
--
作者：
Jolivet, Anne;Caroly, Sandrine;Lang, Thierry
很少有研究分析医院工作人员的组织工作环境和抑郁之间的联系，我们仍然很少理解实践环境中的过程如何与抑郁障碍有关。然而，个体对所做努力和预期回报之间不平衡的看法与事件抑郁有关。这项研究的主要目的是检验这一假设，即工作单位水平上的一些组织约束可能与医院工作人员的抑郁症状有关，直接或通过个人对努力-回报不平衡(ERI)的感知。2006年，从流行病学队列研究(ORSOSA研究)的基线筛选中招募了在七所法国大学医院的190个工作单位工作的3316名注册护士和护理辅助工具，她们于2006年回答了有效的自我报告问卷(CES-D，ERI)。组织工作环境通过在工作单位级别汇总的自评护理工作指数-扩展组织(NWI-EO)进行评估。采用多水平模型。我们发现，工作单位内员工之间的关系不佳与CES-D得分较高有关，与感知的ERI无关。单位工作人员之间的沟通水平低与个人对ERI的看法有关，并间接与抑郁症状有关。人员不足和不尊重计划的休息日和假期与感知的ERI相关，但这些组织限制与抑郁症状无关。我们的研究使我们能够识别和量化组织因素，这些因素对医院工作人员的抑郁症状有直接影响，或通过感知的ERI产生间接影响。通过感知的ERI更好地理解组织因素对健康的影响，将为成功的干预提供目标。组织方法在改善工作中的心理健康方面可能更有效，也可能比个人方法产生更持久的影响。(C)2010爱思唯尔有限公司。保留所有权利。
Few studies have analysed the association between the organisational work environment and depression in hospital workers and we still have little understanding of how processes in the practice environment are related to depressive disorders. However, individual perception of an imbalance between efforts made and expected rewards has been associated with incident depression. The main goal of this study was to test the hypothesis that some organisational constraints at the work-unit level may be related to depressive symptoms in hospital workers, either directly or through individual perceptions of effort-reward imbalance (ERI). In 2006, 3316 female registered nurses and nursing aids working in 190 work units in seven French university hospitals, recruited from the baseline screening of an epidemiological cohort study (the ORSOSA study), responded in 2006 to valid self-report questionnaires (CES-D, ERI). The organisational work environment was assessed with the self-rated Nursing Work Index - Extended Organisation (NWI-EO) aggregated at the work unit level. Multilevel models were used. We found that poor relations between workers within work units were associated with higher CES-D score, independently of perceived ERI. Low level of communication between workers in the unit was associated with individual perceptions of ERI and indirectly associated with depressive symptoms. Understaffing and non-respect of planned days off and vacations were associated with perceived ERI but these organisational constraints were not associated with depressive symptoms. Our study allowed us to identify and quantify organisational factors that have a direct effect on hospital workers' depressive symptoms, or an indirect effect through perceived ERI. Better understanding of the effect of organisational factors on health through perceived ERI would provide targets for successful interventions. Organisational approaches may be more effective in improving mental health at work and may also have a longer-lasting impact than individual approaches. (C) 2010 Elsevier Ltd. All rights reserved.