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Relationship between stress-related psychosocial work factors and suboptimal health among Chinese medical staff: a cross-sectional study

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      ObjectivesThe study aimed to develop and validate a model to measure psychosocial factors at work among medical staff in China based on confirmatory factor analysis (CFA). The second aim of the current study was to clarify the association between stress-related psychosocial work factors and suboptimal health status.DesignThe cross-sectional study was conducted using clustered sampling method.SettingXuanwu Hospital, a 3A grade hospital in Beijing.ParticipantsNine hundred and fourteen medical staff aged over 40 years were sampled. Seven hundred and ninety-seven valid questionnaires were collected and used for further analyses. The sample included 94% of the Han population.Main outcome measuresThe Copenhagen Psychosocial Questionnaire (COPSOQ) and the Suboptimal Health Status Questionnaires-25 were used to assess the psychosocial factors at work and suboptimal health status, respectively. CFA was conducted to establish the evaluating method of COPSOQ. A multivariate logistic regression model was used to estimate the relationship between suboptimal health status and stress-related psychosocial work factors among Chinese medical staff.ResultsThere was a strong correlation among the five dimensions of COPSOQ based on the first-order factor model. Then, we established two second-order factors including negative and positive psychosocial work stress factors to evaluate psychosocial factors at work, and the second-order factor model fit well. The high score in negative (OR (95% CI)=1.47 (1.34 to 1.62), P<0.001) and positive (OR (95% CI)=0.96 (0.94 to 0.98), P<0.001) psychosocial work factors increased and decreased the risk of suboptimal health, respectively. This relationship remained statistically significant after adjusting for confounders and when using different cut-offs of suboptimal health status.ConclusionsAmong medical staff, the second-order factor model was a suitable method to evaluate the COPSOQ. The negative and positive psychosocial work stress factors might be the risk and protective factors of suboptimal health, respectively. Moreover, negative psychosocial work stress was the most associated factor to predict suboptimal health.

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            Author and article information

            [1 ] departmentDepartment of Epidemiology and Biostatistics, School of Public Health , Capital Medical University , Beijing, China
            [2 ] Municipal Key Laboratory of Clinical Epidemiology , Beijing, China
            [3 ] departmentHealth Management Center , Xuanwu Hospital, Capital Medical University , Beijing, China
            [4 ] departmentDepartment of Education , Tiantan Hospital, Capital Medical University , Beijing, China
            Author notes
            [Correspondence to ] Professor Yu-Xiang Yan; yanyxepi@
            BMJ Open
            BMJ Open
            BMJ Open
            BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
            6 March 2018
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            : 3
            © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

            This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

            Funded by: the Beijing Municipal Nature Science Foundation (7162020);
            Funded by: the Scientific Research Project of Beijing Municipal Educational Committee (KM201510025006);
            Funded by: the National Key Research and Development Plan (2016YFC0900603);
            Funded by: the National Science Foundation (81573214);
            Mental Health
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