上海部分企业职业人群健康素养与抑郁情绪的相关性研究
Association between health literacy and depressive emotion among occupational groups in Shanghai
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摘要:
背景 现阶段，企业健康环境与职业发展支撑保障不足，导致企业职业人群可能存在较为严重的抑郁情绪。
目的 为了解上海市企业职业人群抑郁情绪状态及健康素养与抑郁水平的相关性，为缓解职业人群抑郁情绪提供健康管理措施依据。
方法 本研究为横断面调查，采用分层二阶段抽样法，于2022年12月—2023年2月期间展开，抽取上海151家企业的2548名在岗职业人群。回收2489份有效问卷，回收率为97.68%。采用《健康素养调查表》《心理控制源内控性量表-内控性健康量表》（MHLC-IHLC）对其健康素养、内源性健康观念进行调查。对职业人群的抑郁情绪采用《患者健康问卷抑郁量表》（PHQ-9）进行分析。数据采用R 4.2.2 进行统计分析，采用二分类logistic回归模型分析健康素养、内源性健康观念与职业人群抑郁情绪患病风险的相关关系，利用多元线性模型分析健康素养、内源性健康观念与职业人群PHQ-9总分、情感得分、躯干症状得分水平的相关性。
结果 分析共纳入18岁及以上的上海市职业人员2489人，存在抑郁情绪者共868人，抑郁情绪的检出率为34.9%。抑郁情绪总得分及其情感、躯干症状维度得分的
M （P 25，P 75）分别为3.00（0.00, 6.00）、1.00（0.00, 4.00）、1.00（0.00, 3.00）分。二元多因素logistic回归分析结果显示，在校正了相关的混杂因素后，不具备健康素养（OR=1.32，95%CI：1.10~1.60，P =0.004）、低水平内源性健康观念（OR=1.66，95%CI：1.35~2.05，P < 0.001）与职业人群抑郁情绪的风险上升相关。多元线性模型结果显示，不具备健康素养、内源性健康观念低与总体PHQ-9总分、情感得分、躯干症状得分水平均呈正相关。结论 上海市企业职业人群的抑郁情绪问题突出，超过1/3的人存在抑郁情绪。企业职业人群较低的健康素养、内源性健康观念与企业职业人群抑郁情绪风险上升相关。提高企业职业人群健康素养水平，增强内源性健康观念，有望预防抑郁情绪的发生。
Abstract:Background At present, insufficient support for enterprise health environment and career development may lead to severe depressive emotion among occupational groups.
Objective To investigate current state of depressive emotion and the relationship between health literacy and depressive emotion among occupational groups in Shanghai, and to provide evidence for formulating health management measures to alleviate depressive emotion among the occupational population.
Methods This cross-sectional survey, using two-stage stratified sampling, was from December 2022 to February 2023, and selected 2548 active workers from 151 enterprises in Shanghai. A total of 2489 valid questionnaires were returned, with a recovery rate of 97.68%. Health literacy, internality health locus of control, and depressive emotion were evaluated by the Health Literacy Questionnaire, the Multidimensional Health Locus of Control Scale-Internality Health Locus of Control, and the Patient Health Questionnaire Depression Scale-9 item (PHQ-9), respectively. R 4.2.2 software was used for statistical analysis, binary logistic regression model was used to analyze the association between health literacy, internality health locus of control, and the risk of depressive emotion, and multiple linear model was used to analyze the correlation between health literacy, internality health locus of control, and PHQ-9 related indicators (total score, affective score, and somatic score).
Results A total of 2489 workers aged 18 years and above in Shanghai were included in the analysis, 868 of them reported depressive emotion, and the positive rate of depressive emotion was 34.9%. The total score, affective score, and somatic score of PHQ-9 in
M (P 25,P 75) were 3.00 (0.00, 6.00), 1.00 (0.00, 4.00), and 1.00 (0.00, 3.00), respectively. The results of binary multiple logistic regression analysis showed that after adjusting for selected confounders, no health literacy (OR=1.32, 95%CI: 1.10, 1.60;P =0.004) and low level of internality health locus of control (OR=1.66, 95%CI: 1.35, 2.05;P < 0.001) were associated with an increased risk of reporting depressive emotion. The results of multiple linear model showed that the lack of health literacy and low internality health locus of control were positively correlated with the total score, affective score, and somatic score of PHQ-9.Conclusion Depressive emotion among the working population in Shanghai is prominent, and more than 1/3 of them report depressive emotion. Lower health literacy and internality health locus of control are related to an increased risk of depressive emotion in the study population. Improving occupational health literacy and enhancing internality health locus of control are expected to prevent depressive emotion in occupational groups.
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