目的 分析医务工作者职业幸福感在职业紧张和抑郁症状关系间的中介效应.方法 采用分层整群抽样,选取某省4家医院医务工作者为研究对象,使用抑郁-焦虑-紧张量表(DASS-21量表)和自行设计的可视化评分调查医务工作者职业紧张、抑郁症状和职业幸福感水平,采用逐步回归法和结构方程模型分析职业幸福感对职业紧张和抑郁症状关系间的中介作用.结果 1 988名医护工作者职业紧张和抑郁症状阳性检出率分别为42.5％(845/1 988)、43.5％(864/1 988).医务工作者抑郁症状与职业紧张呈正相关(r=0.794,P＜0.001),与职业幸福感呈负相关(r=-0.443,P＜0.001),职业幸福感与职业紧张呈负相关(r=-0.352,P＜0.001).中介效应分析显示,职业幸福感在职业紧张和抑郁症状间具有中介效应,中介效应值为0.054(BCa 95％CI:0.066～0.423),中介效应占比为7.4％.结论 医务工作者的职业紧张可直接作用于抑郁症状,也可通过职业幸福感间接作用于抑郁症状,职业幸福感在职业紧张和抑郁症状间具有部分中介的作用,但主要以直接作用为主.

Person-environment fit (PEF) theory, one of the foundational theories of occupational stress, has primarily found applications in organizational behavior and human resource management. Given the alignment between the definition of occupational stress and the essence of PEF, we introduced the concept of worker-occupation fit (WOF). To validate our theoretical model, the development of an instrument to measure WOF becomes imperative. The Worker-Occupation Fit Inventory (WOFI) comprises three dimensions: personal trait fit (PTF), need-supply fit (NSF) and demand-ability fit (DAF). Job-related mental disorders (JRMDs) were assessed using the DASS-21. During the pre-investigation, items of the WOFI underwent screening through classic test theory (CTT) analysis. In the formal investigation, item response theory (IRT) analysis was employed to evaluate the selected items. The relationship between WOF and JRMD was verified by Pearson’s correlation analysis and multiple logistic regression analysis. The initial version consisted of 26 items. Three common factors were extracted by exploratory factor analysis (EFA): 6 items were included in the PTF, 6 items were included in the NSF, 4 items were included in the DAF, and 10 items were deleted because of unacceptable factor loadings. The confirmatory factor analysis (CFA) verified the structure of the WOFI with χ2/df = 1.822, CFI = 0.947, and SRMSR = 0.056. The Cronbach's alpha coefficients of the PTF, NSF, and DAF were 0.91, 0.92, and 0.80, respectively. In IRT analysis, the discrimination values of all items ranged from 1.25 to 2.53, and the difficulty values of all items ranged from -6.28 to 1.30 (with no difficulty of reversal). The WOF was negatively related to job-related stress (r = -0.34, p<0.001), anxiety (r = -0.37, p<0.001), and depression (r = -0.41, p<0.001). The multiple logistic regression analysis suggested that a high level of WOF was a protective factor against job-related mental disorders, with ORs all less than 1 (p<0.001), and a low level of WOF was a risk factor for job-related mental disorders, with ORs all more than 1.0 (p<0.001). The results of CTT and IRT analysis indicated that the WOFI exhibits reliability and validation. The WOF effectively predicted job-related mental disorders. Subsequent studies will delve into the influence of WOFI on diverse professions and various health outcomes.

Background With the transformation of job characteristics, Worker-occupation fit (WOF) is a significant protective factor for stress of workers. Cortisol is an essential hormone secreted by the hypothalamic-pituitary-adrenal axis and can fluctuate in the body under stress. The aim of this study was to explore the relationship between WOF and cortisol among medical workers. Methods A total of 161 medical workers take part in this cross-sectional study and 156 data were finally included in the analysis. Occupational stress was measured by the Depression, Anxiety, and Stress Scale (DASS-21), and WOF was surveyed by the Worker-Occupation Fit Inventory. The detection of hair and plasma cortisol concentration was carried out by automated Electrochemiluminescence immunoassay. Spearman correlation analysis and linear regression models after log transformation of data were used to analysis association between WOF and cortisol concentration of hair plasma among 156 Chinese medical workers. Results In this study, the hair cortisol concentration of female with high fit level was lower than that of women with low fit level ( p = 0.025). The correlation analyses show that WOF was negative related to hair cortisol concentration ( r =-0.185, p = 0.021), but not with plasma cortisol concentration ( p > 0.05). The linear regression analysis show that WOF was negative associated with hair cortisol concentration in crude model ( β =-0.192, p = 0.016) and adjusted model ( β =-0.181, p = 0.022), but not with plasma cortisol concentration ( p > 0.05). Conclusion WOF is negative correlated with hair cortisol concentration, but not with plasma cortisol concentration. The causal relationship between WOF and cortisol needs further exploration in future prospective study.

目的 基于文献计量学分析个人-环境适配理论的研究现状及研究热点,探索适配理论与职业紧张的关系类别,为该理论在职业卫生领域的应用发展提供思路和依据.方法 检索Web of Science数据库中的个人-环境适配相关的文献,检索时间为1900-2021年.使用Excel 2016、R 4.1.2软件和Cite Space 5.8 R3软件对数据进行整理并分析.结果 经检索和筛选,最终纳入929篇个人-环境适配相关文献,发表时间在1992-2021年,发文量呈逐年上升趋势.研究领域主要集中于商业经济学、心理学、社会科学;职业健康领域排在第7位.总发文量最多的国家为美国232篇(25.36％);中国79篇(8.63％)居第2位,且近年来中国的研究量有追赶美国的趋势;总被引频次最高文献是Edwards,JR等人的"The Value of Value Congruence",总被引频次为563.关键词分析显示个人-环境适配研究主要集中于理论框架、个人、组织3个方面,对个人的研究中关注了职业紧张,但总体来说与职业卫生相关文献较少(20篇).结论 个人-环境适配理论与职业紧张内涵较为一致,适配对职业紧张研究有重要意义.后续研究应建立起工作适配-职业紧张的完整理论框架,并将其运用于实证研究中.