体力活动在女性护士职业应激与抑郁症状关系中的调节作用
Moderating effects of physical activity on relationship between occupational stress and depressive symptoms in female nurses
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摘要:
背景 目前关于体力活动在职业应激与抑郁症状之间调节作用的研究较少，探讨不同类型体力活动对二者调节作用的研究更为欠缺。女性护士是职业应激和抑郁症状的高发人群，对该职业人群开展研究，可以为制订减轻护士职业应激和抑郁症状的干预决策提供依据。
目的 了解医院女性护士职业应激、体力活动与抑郁症状的关系，探讨不同类型体力活动对职业应激与抑郁症状关系的调节作用。
方法 于2018年4—6月，采用3阶段分层抽样方法抽取某市3所三甲医院、5所二甲医院和11所社区卫生服务中心的716名女护士进行问卷调查，共获取有效问卷649份，有效回收率为90.6%。采用职业紧张问卷、中文版国际体力活动问卷和抑郁自评量表进行职业应激、体力活动和抑郁症状调查，采用线性分层回归分析体力活动对职业应激与抑郁症状关系的调节作用。
结果 女性护士职业应激检出率为80.4%，抑郁症状检出率为50.8%。职业应激与抑郁症状呈正相关关系（
r s =0.325，P < 0.01），职业相关体力活动与职业应激、抑郁症状呈正相关关系（r s =0.225、0.248，P < 0.01），休闲相关体力活动与职业应激、抑郁症状呈负相关关系（r s =-0.241、-0.216，P < 0.01）。回归模型中，职业相关和家务相关体力活动对抑郁症状有正向影响（b =0.251、0.194，P < 0.05），休闲相关体力活动对抑郁症状有负向影响（b =-0.234，P < 0.01）。职业相关体力活动对职业应激与抑郁症状关系有正向调节作用（b =0.197，P < 0.01），休闲相关体力活动对职业应激与抑郁症状关系有负向调节作用（b =-0.160，P < 0.01）。调节作用斜率显示，随着职业应激水平增加，抑郁症状检出率出现上升，与低水平组比较，职业相关体力活动高水平组的上升趋势明显（b =1.435，P < 0.05），而休闲相关体力活动高水平组的上升趋势则较平缓（b =0.875，P < 0.05）。结论 不同类型体力活动对职业应激与抑郁症状的调节作用存在差异，职业相关体力活动具有正向调节作用，而休闲相关体力活动具有负向调节作用。
Abstract:Background There are few studies on the moderating role of physical activity (PA) between occupational stress and depressive symptoms, and even fewer studies evaluating the roles of different types of PA. Female nurses are a high-risk group with occupational stress and depressive symptoms. Studies of this occupational group will provide a basis for making intervention programs to reduce their occupational stress and depressive symptoms.
Objective This study investigates the relationship among occupational stress, PA, and depressive symptoms, and explores the potential role of PA moderating the relationship between occupational stress and depressive symptoms.
Methods A three-stage stratified random sampling method was applied to select 716 female nurses from 3 tertiary class-A hospitals, 5 secondary class-A hospitals, and 11 community health service centers from April to June 2018. They were asked to complete the Occupational Stress Questionnaire, the International Physical Activity Questionnaire (IPAQ), and the Selfrating Depressive Symptoms Scale (SDS) to assess occupational stress, PA, and depressive symptoms; a total of 649 valid questionnaires were returned, and the valid return rate was 90.6%. A linear stratified regression model was used to analyze the moderating effect of PA on the relationship between occupational stress and depressive symptoms.
Results The positive rates of occupational stress and depressive symptoms of selected female nurses were 80.4% and 50.8% respectively. Occupational stress was positively correlated with depressive symptoms (
r s =0.325,P < 0.01); occupation-related PA was positively correlated with occupational stress and depressive symptoms (r s =0.225, 0.248,P < 0.01); however, leisure-related PA was negatively related to occupational stress and depressive symptoms (r s =-0.241, -0.216,P < 0.01). Occupation-related and housework-related PA had positive impacts on depressive symptoms (b =0.251, 0.194,P < 0.05), while leisure-related PA had a negative impact (b =-0.234,P < 0.05). Occupation-related PA showed a positive regulating role between occupational stress and depressive symptoms (b =0.197,P < 0.01), while leisure-related PA showed a negative regulating role (b =-0.160,P < 0.01). The moderating effect slope showed that with increasing occupational stress level, the positive rate of depressive symptom showed an upward trend, and compared with the low-level group, the upward trend of the high-level occupation-related PA group was steeper (b =1.435,P < 0.05), while that of the high-level leisure-related PA group became flatter (b =0.875,P < 0.05).Conclusion Different types of PA have varied moderating effects on the relationship between occupational stress and depressive symptoms. Occupation-related PA has a positive moderating effect, while leisure-related PA has a negative moderating effect.
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