河北省基层疾控人员职业紧张、焦虑、抑郁现状：基于模糊集的定性比较分析
Occupational stress, anxiety, and depression among grassroots disease control and prevention staff in Hebei Province: A qualitative comparative analysis based on fuzzy sets
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摘要:
背景 基层疾控人员承担着繁重的疾病预防控制工作，易出现职业紧张、焦虑、抑郁等健康问题。
目的 了解基层疾控人员职业紧张、焦虑、抑郁现状，运用模糊集定性比较分析（fsQCA）技术探讨高危因素组态类型，为有效干预提供基础依据。
方法 以河北省县（区）疾控中心为研究对象，采用分层随机整群抽样方法，抽取1860名工作人员为样本，使用一般情况调查表、《工作内容量表》《7项广泛性焦虑障碍量表》《9条目患者健康问卷》进行问卷调查，采用fsQCA 3.0软件，运用fsQCA方法分析识别其高危因素组态。
结果 基层疾控人员的职业紧张、焦虑、抑郁检出率分别为42.69%、44.25%、47.96%。有婚史的婚姻状况是基层疾控人员产生职业紧张、焦虑、抑郁的必要条件（必要性数值分别为0.911、0.939、0.933）。产生职业紧张的高危因素组态主要表现为“自身提升型”和“疾病负担型”，产生焦虑的高危因素组态为“疾病负担型”和“经济-疾病负担型”，产生抑郁的高危因素组态为“疾病负担型”“经济-疾病负担型”和“自身提升型”。职业紧张、焦虑、抑郁组态总体一致性分别为0.941、0.820、0.774。“自身提升型”主要体现了个人在工作要求和晋升方面的压力；“疾病负担型”反映了慢性疾病会对疾控人员心理状态造成影响；“经济-疾病负担型”不仅反映了慢性疾病造成的影响，也体现了资金支持对疾控工作人员工作生活质量的重要性。
结论 河北省基层疾控人员的职业紧张、焦虑、抑郁检出率均较高。基层疾控人员职业紧张、焦虑、抑郁是多个影响因素综合作用的结果，应制定具有针对性的干预措施。
Abstract:Background Grassroots center for disease control and prevention (CDC) staff undertake intensive work of disease prevention and control, and may be susceptible to occupational stress, anxiety, depression, and other health problems.
Objective To understand the current situation of occupational stress, anxiety, and depression among grassroots CDC staff, and to identify potential risk factor configurations for occupational stress, anxiety, and depression using fuzzy set qualitative comparative analysis (fsQCA), so as to provide a basis for effective intervention.
Methods The staff working in county/district-level CDCs in Hebei Province were the target population of the current study. Stratified random cluster sampling method was used to select 1860 staff members of the target population. A questionnaire of general situation, Job Content Scale, 7-item Generalized Anxiety Disorder Scale, and Patient Health Questionnaire-9 were used. Risk factor configurations associated with health outcomes of interest were identified by fsQCA3.0 software.
Results The positive rates of occupational stress, anxiety, and depression were 42.69%, 44.25%, and 47.96%, respectively. Marital status was a necessary condition for occupational stress, anxiety, and depression in the grassroots CDC staff (the necessity values were 0.911, 0.939, and 0.933, respectively). There were two types of risk factor configurations for occupational stress: "self-improvement" and "disease burden"; the risk factor configurations for anxiety were "disease burden" and "economic-disease burden"; while the risk factor configurations for depression were "disease burden", "economic-disease burden", and "self-improvement". The overall consistency scores of occupational stress, anxiety, and depression were 0.941, 0.820, and 0.774, respectively. Regarding outstanding components, "self-improvement" included pressure of job requirements and promotion, "disease burden" included impact of chronic illness on psychological state, and "economic-disease burden" included not only impact of chronic illness but also financial support for CDC staff.
Conclusion All positive rates of occupational stress, anxiety, and depression are high among grassroots CDC staff in Hebei Province. Occupational stress, anxiety, and depression of grassroots CDC staff are the results of multiple influencing factors, so targeted intervention measures should be formulated.
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