工作中的工作压力和心理健康之间的关系【外文翻译】

外文翻译原文The Relationship between Job Stress and Mental Health at Work Material Source:Industrial Health 1997, 35, 29-35 Author:Jun Shigemi, Yoshio Mino, Toshihide Tsuda, Akira Babazono and Hideyasu Aoyama Selyel defined stress as the state manifested by a specific syndrome which consists of all the nonspecifically induced changes within a biologic system. Using an experimental study, he proved that stress induces a common pathological change which he called "general adaptation syndrome." He did not specify the character of stress. Stress which was comfortable to the individual and essential for development and growth was called eustress, while stress which was unpleasant or harmful to the individual was called distress.Holmes and his collaborator weighted and scored stressful life events. They proved that severe health impairment is likely to occur if people have severe stressful life events and if the life events score exceeded 300 points in the previous year. Nevertheless, it was reported that there was only a weak relationship between the strength of stress and the incidence of psychiatric or somatic diseases. Knowing these facts, researchers attempted to identify other stress factors which affected psychiatric or somatic diseases.Lazarus and his collaborators reported that the daily hassles of living having continuous and chronic characteristics are a significant stress. These "daily hassles" appeared to be better predictors of health outcomes than life events. Recently, the causal relationship between job stress and psychiatric illness or cardiovascular disease was studied. The job-demand-control-support model suggests that psychological strain and subsequent somatic diseases resulted from the interaction of three types of job characteristics: job demand, job decision latitude, and work related social support. In Japan, causal relationship between job stress and mental health has been drawing the attention of researchers who are currently studying job stress. Therefore, the study of job stress is important to develop strategies for the prevention of stress related diseases and for health promotion. However, the relationship between job stress and problematic mental health state has not beenestablished in Japan. We hypothesized that adverse effects of subjective job stress on mental health state is great, and we estimated that some types of prevalence odds ratios between job stress and mental health would be more than two. The purpose of this study is to clarify the relationship between job stress and problematic mental health state quantitatively using prevalence odds ratios.A cross-sectional study was performed using a self-administered questionnaire given to the employees of an electric company in Okayama city, Japan. All subjects were workers producing minute electric parts. We selected this company because of its different work places, which allowed us to examine the characteristics of workers more precisely. Among 782 workers, 763 responded to the questionnaire satisfactorily. The response rate was 97.6%. The questionnaire consisted of demographic questions such as gender, age, marital status, and employment section as well as questions taken from the Japanese version of the 30-item General Health Questionnaire (GHQ) , and a questionnaire about subjective job stress developed by Uehata et al. We added questions about satisfaction with family life and physical health states.We used the 30 item Japanese version of the GHQ as a measure of the mental health state. A cut-off score of 718 points using GHQ method was considered reasonable in Kitamura's study on the validity of the 30-item GHQ. Therefore, we defined response showing a GHQ score of 8 points or more as representing individuals with problematic mental health states, and responses showing 7 points or less as representing individuals without any mental health problems.We treated the items of physical health status and satisfaction with family life as categorical data. We weighted two points on individuals who answered "very healthy" or "healthy," weighted one points on individuals who answered "ordinary" and weighted zero points on individuals who answered "not healthy so much" or "not healthy." We weighted two points on individuals whose answers were "dissatisfied very much" or "dissatisfied" and weighted one point on individuals whose responses indicated neither satisfied nor dissatisfied, and zero points on individuals whose answers were "very satisfied" or "satisfied." We employed a multiple logistic regression model controlling for potential confounding factors: gender, age, marital status, satisfaction with family life, and physical health state.In the logistic regression model, we used all items of subjective job stress in spite of the high value of the alpha coefficient, because we thought that the interrelationship between subjective job stress and problematic mental health stateshould be analyzed with respect to every item of subjective job stress. Adjusted odds ratio and 95% confidence intervals for the odds ratios of each level of subjective job stress to mental health state were calculated.Although we thought that sex was a potential confounding factor, sex was not a significant variable in the multiple logistic regression analysis. Crude data analysis between subjective job stress and GHQ score showed same tendency by each sex.In the correlation matrix coefficients of the logistic regression model, marital status showed a strong negative correlation (more than 0.5 in absolute value) to the subgroups with age range of 30-39 years and 40-49 years. Then, we excluded the variable regarding marital status from the multiple logistic regression model because of its multicollinearity.In our study, the proportion of individuals with problematic mental health state was 37.8% in the total subjects, 41.7% in males and 34.3% in females. Iwata reported on the prevalence of depressive symptoms in a Japanese tax office using the Japanese version of the Center for Epidemiologic Studies Depression Scale. He found that 15.2% of males and 10.6% of females had high levels of depressive symptoms. Our study measured problematic mental health states by use of the GHQ. We could detect the cases from the GHQ more than cases of depressive symptoms and then our concept of problematic mental health state was broader than Iwata's depressive symptoms. Therefore, our prevalence was higher than depressive symptom.This study investigated the relationship between subjective job stress and problematic mental health state. Therefore, we used multiple logistic regression to estimate quantitative measures of subjective job stress and problematic mental health state, adjusted by potential confounding factors of gender, age, satisfaction with family life and physical health state. Our results showed that the items related to subjective job stress because of "too much trouble at work," "too much responsibility," "poor relationship with superiors," "are not allowed to make mistakes" and "cannot keep up with new technology" were related to mental health state. Consequently, it is suggested that subjective job stress can be harmful to a worker's mental health state and cause "distress," which was caused by an injury from the nonspecific response of a living body to negative stimuli, according to Selye.We recognized that interpersonal conflict between the worker and his superiors might be an important risk factor for mental health in our cross-sectionalstudy. In the model of National Institute for Occupational Safety and Health, this type of interpersonal conflict is involved in job stressors. Therefore, cooperative relationships with superiors and colleagues as job support might be important in maintaining healthy mental state. Our study suggests that "Cannot keep up with new technology" is another risk factor for mental health, especially in male workers. In Japanese industries such as electrical factories, workers are placed in highly automated circumstances. Therefore, work related to highly developed technology might be a source of job stress.Our quantitative estimation of job stress might have under or over-estimated the magnitude of job stress because job stress may be affected by familial stress. Therefore, we hypothesized multiplicative interaction between subjective job stress and feeling of dissatisfaction with family life, and analyzed the logistic regression using an interaction model. Adjusted odds ratio with interaction between subjective job stress and mental health showed the quantitative measure of multiplicative terms between job stress and familial stress and those interaction terms. But the positive multiplicative interaction model was not significant. From another point of view, there was a space to analyze the additive interaction model.The purpose of this study is to clarify the relationship between subjective job stress and mental health. From the result of the multiple logistic regression analysis controlling confounding factors, some kinds of subjective recognition of job stress were shown to possibly be related to problematic mental health state because of the more than double degrees of prevalence odds ratio. Accordingly, our prevalence odds ratios with values above double would have more than 50% of attributable proportion in the causal inference between subjective job stress and problematic mental health state. Therefore, further studies to clarify causal relationship between job stress and mental health are required to prove it.译文工作中的工作压力和心理健康之间的关系资料来源：产业健康，1997年，35期，29-35页作者：Jun Shigemi, Yoshio Mino, Toshihide Tsuda, Akira Babazono and Hideyasu Aoyama 赛亚将压力定义为一个特定的综合征，包括引起生物体系内的非特异性的变化。