心理资本在疾病预防控制人员职业紧张与抑郁症状间的中介效应分析

Mediating role of psychological capital between occupational stress and depressive symptoms in disease prevention and control personnel

  • 摘要:
    背景 目前疾病预防控制(以下简称“疾控”)人员的职业紧张和抑郁症状情况较为严重。

    目的 了解疾控人员职业紧张、心理资本抑郁症状的关系,分析心理资本在职业紧张与抑郁症状间的中介效应。

    方法 于2020年7月—9月,采用整群随机抽样的方法,在江苏省内抽取21家各级疾病预防控制中心的2201名工作人员为研究对象,共回收有效问卷2036份,有效问卷回收率为92.5%。采用“职业紧张测量核心量表”“患者健康问卷”和“心理资本问卷”对其职业紧张、抑郁症状、心理资本情况进行调查;采用分层回归分析探究职业紧张和心理资本对抑郁症状的影响;采用中介效应模型分析并验证心理资本在职业紧张与抑郁症状间的中介效应。

    结果 研究对象的职业紧张总分MP25P75)为42.0(37.0,48.0)分,抑郁症状总分MP25P75)为8.0(4.0,9.0)分,心理资本得分MP25P75)为4.6(4.0,5.0)分;职业紧张检出率为31.0%(631/2036),抑郁症状检出率为22.0%(448/2036)。职业紧张的组织与回报、要求与付出维度得分与抑郁症状总分均呈正相关Spearman相关系数(rs)分别为0.371、0.269,P<0.05;职业紧张的社会支持、自主性维度和心理资本得分与抑郁症状总分均呈负相关(rs=−0.373、−0.112、−0.494,P<0.05)。组织与回报得分、要求与付出得分均与抑郁症状得分呈正向关联(b=0.188、0.177,P<0.05),社会支持、自主性得分均与抑郁症状得分呈负向关联(b=−0.290、−0.078,P<0.05),解释变异量增加了22.5%;心理资本得分与抑郁症状得分呈负向关联(b=−0.368,P<0.05),解释量增加了11.0%。心理资本分别在社会支持、组织与回报、自主性与抑郁症状间具有中介效应,中介效应值分别为−0.210(95%CI:−0.253~−0.171)、0.096(95%CI:0.071~0.122)和−0.164(95%CI:−0.229~−0.103),中介效应百分比分别为40.23%、26.97%和45.56%。

    结论 疾控人员职业紧张可直接作用于抑郁症状,也可通过心理资本间接作用于抑郁症状;心理资本在职业紧张的社会支持、组织与回报、自主性维度与抑郁症状间具有部分中介作用。降低疾控人员职业紧张程度,增加心理资本,可减少抑郁症状的发生。

     

    Abstract:
    Background Occupational stress and depressive symptoms of disease prevention and control personnel are serious.

    Objective To investigate the relationship between occupational stress, psychological capital, and depressive symptoms of disease prevention and control personnel, and analyze the potential mediating effect of psychological capital on the relationship between occupational stress and depressive symptoms.

    Methods From July to September 2020, a cluster random sampling method was used to select 2201 employees from 21 centers for disease control and prevention as study subjects covering all levels of administrative divisions in Jiangsu Province. A total of 2036 valid questionnaires were collected with a recovery rate of 92.5%. The Core Occupational Stress Scale, Patient Health Questionnaire, and Psychological Capital Questionnaire were used to investigate their occupational stress, depressive symptoms, and psychological capital. Stratified regression analysis was used to explore the effects of occupational stress and psychological capital on depressive symptoms. A mediating effect model was used to analyze and verify the potential mediating effect of psychological capital on the relationship between occupational stress and depressive symptoms.

    Results The total scores in M (P25, P75) of occupational stress, depressive symptoms, and psychological capital in the target population were 42.0 (37.0, 48.0), 8.0 (4.0, 9.0), and 4.6 (4.0, 5.0) respectively. The positive rate of occupational stress was 31.0% (631/2036), and the positive rate of depressive symptoms was 22.0% (448/2036). The dimensional scores of organization and reward, and demand and effort of occupational stress were positively correlated with the total score of depressive symptoms Spearman correlation coefficients (rs) were 0.371 and 0.269, P<0.05. The dimensional scores of social support and autonomy of occupational stress and the score of psychological capital were negatively correlated with the total score of depressive symptoms (rs=−0.373, −0.112, −0.494, P<0.05). The organization and reward, and demand and effort had positive effects on depressive symptoms (b=0.188, 0.177, P<0.05), while social support and autonomy had negative effects on depressive symptoms (b=−0.290, −0.078, P<0.05), and associated with a 22.5% increase of explanatory variance. Psychological capital had a negative effect on depressive symptoms (b=−0.368, P<0.05), and associated with an 11.0% increase of explanatory variance. Psychological capital had mediating effects on the associations of social support, organization and reward, and autonomy with depressive symptoms, and the mediating effect values were −0.210 (95%CI: −0.253-−0.171), 0.096 (95%CI: 0.071-0.122), and −0.164 (95%CI: −0.229-−0.103), respectively. The corresponding mediating effect percentages were 40.23%, 26.97%, and 45.56%, respectively.

    Conclusion Occupational stress of disease prevention and control personnel can directly affect depressive symptoms, but also indirectly through psychological capital. Psychological capital plays a partial mediating role in the associations of social support, organization and reward, and autonomy of occupational stress with depressive symptoms. The occurrence of depressive symptoms can be reduced by decreasing occupational stress and increasing psychological capital.

     

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