Association between social psychological factors and depressive symptoms among healthcare workers


To explore the association between the effort-reward imbalance at work and depressive symptoms among healthcare workers.
The effort-reward imbalance at work was conceptualized in terms of the Chinese version of the effort-reward imbalance (ERI) model. Depressive symptoms were assessed by the Chinese version of the Center of Epidemiology Survey Depression (CES-D) scale. The data came from the cross-sectional survey of 1 179 healthcare workers aged between 18 and 73 employed in 6 affiliated hospitals of Zhejiang University. The questionnaire comprised questions on the effort-reward at work, over-commitment, the full CES-D scale of depression and a range of other characteristics. Univariate analyses were used with Spearman's correlation, Mann-Whitney test, Pearson chi(2) test and likelihood chi(2) test. Multivariate logistic regression analyses was used to discover factors associated with depressive symptoms.
The prevalence of depressive symptoms among healthcare workers was 48.12% (95% CI: 45.08% to 51.16%). The prevalence of depressive symptoms among nurses was 52.40% (95% CI: 47.87% to 56.93%) higher than doctors' 44.70% (95% CI: 10.64% to 48.77%) with the significant difference (chi(2) = 6.077, P = 0.014). Positive associations were found between the high effort-low reward, level of work-related over commitment and depressive symptoms (OR = 1.859, 95% CI: 1.337 to 2.585; OR = 2.207, 95% CI: 1.656 to 2.942) among healthcare workers, respectively.
The high effort-low reward and the work-related over-commitment have a negative impact on healthcare workers' health.

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    • "The summed score ranged from 0 to 60, which increased with the severity of depressive symptoms. The CES-D has been extensively validated in Chinese occupational groups [8,30]. For example, an acceptable Cronbach’s alpha of 0.88 was reported among health workers [30]. "
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    ABSTRACT: Although occupational stress is an identified predictor of depressive symptoms, the mechanism behind the association is not well understood. The purpose of this study was to examine how psychological capital (PsyCap), a positive psychological state, mediates the association between occupational stress and depressive symptoms among Chinese physicians. A cross-sectional survey was conducted in Liaoning Province, China, during September-October 2010. Self-administered questionnaires including items on depressive symptoms assessed by the Center for Epidemiologic Studies Depression Scale, occupational stress assessed by the effort-reward imbalance scale and PsyCap estimated by a 24-item Psychological Capital Questionnaire, together with age, gender, marital status and education were distributed to 1300 physicians employed in large general hospitals. The final sample consisted of 998 participants. Asymptotic and resampling strategies were used to examine how PsyCap mediates the association between occupational stress and depressive symptoms. Both the effort/reward ratio (ERR) and overcommitment were significantly associated with depressive symptoms among male and female physicians. There was a gender difference in the mediating role of PsyCap on the occupational stress-depressive symptoms association. For male physicians, PsyCap did not mediate the association between occupational stress and depressive symptoms. For female physicians, ERR and overcommitment were negatively associated with PsyCap, and PsyCap was negatively associated with depressive symptoms. As a result, PsyCap significantly mediated the associations of ERR and overcommitment with depressive symptoms. The proportion of PsyCap mediation was 19.07% for ERR, and 24.29% for overcommitment. PsyCap could be a positive resource for combating depressive symptoms in Chinese physicians. In addition to reducing occupational stress, PsyCap development should be included in depression prevention and treatment strategies, especially for female physicians.
    BMC Public Health 03/2012; 12(1):219. DOI:10.1186/1471-2458-12-219 · 2.26 Impact Factor
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    • "Guo, Lu, Wang, & Chen, 2006; Yu et al., 2006; Zhang et al., 2010). For example, a Cronbach's alpha of .88 has been reported for internal consistency reliability (X.Y. Li et al., 2006). Zhang et al. (2010) "
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    ABSTRACT: The study reported here was designed to investigate the relationship between depressive symptoms and occupational stress in female nurses in China during the period June-July 2008. The hypothesis tested was that social support and rational coping would mediate the effects of occupational stress on depressive symptoms. Our structural equation modeling revealed that social support and rational coping were negatively correlated with depressive symptoms. Social support and rational coping mediated the effects of occupational stress on depressive symptoms. Role overload, role insufficiency, and role boundary were predictive of depressive symptoms. These results indicated that lessening occupational stress and strengthening social support and rational coping could decrease depressive symptoms among Chinese female nurses.
    Research in Nursing & Health 10/2011; 34(5):401-7. DOI:10.1002/nur.20449 · 1.27 Impact Factor
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    ABSTRACT:   This article is a report of exploration of depressive symptoms and the associated factors among Chinese nurses working at public city hospitals.   Hospital nurses are known to work in psychologically and physically demanding work environment, which may lead to depressive symptoms. However, little research has been done to address this problem in Chinese nurses.   A cross-sectional survey was carried out in seven randomly selected city hospitals of Liaoning Province, northeast of China in 2009. Depressive symptoms of the nurses were measured with the Chinese version of the Center for Epidemiologic Studies Depression Scale. Job Content Questionnaire and the effort-reward imbalance, demographic features, life style and work conditions were measured as the related factors.   A total of 1592 nurses participated in the study and the effective response rate was 79·5%. The prevalence of depressive symptoms among the nurses was 61·7% (n = 886), of whom 74·9% (n = 664) had mild depressive symptoms. Multivariate logistic regression analysis showed that lower job rank, higher over commitment, alcohol consumption, worse nurse-patient relationship and higher education background were positively associated with depressive symptoms, whereas supervisor support, taking regular meals, doing physical exercises, higher skill discretion and higher job satisfaction were negatively associated with depressive symptoms.   More than half of the Chinese nurses had depressive symptoms. As depressive symptoms may adversely affect quality of life and quality of care, consultation for the nurses with healthy life styles, work stress coping techniques and advice to administrator to improve social aspects of the work environment might be helpful to reduce the depressive symptoms in nurses.
    Journal of Advanced Nursing 09/2011; 68(5):1166-75. DOI:10.1111/j.1365-2648.2011.05832.x · 1.74 Impact Factor
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