高原官兵职业紧张及其影响因素:基于付出-回报失衡模式  

Occupational stress and its influencing factors of plateau-stationed officers and soldiers:Based on effort-reward imbalance model

作　　者：罗贤峰 周丹妮 赵芯瑞 马媛媛 张本忠[1] LUO Xianfeng;ZHOU Danni;ZHAO Xinrui;MA Yuanyuan;ZHANG Benzhong(School of Public Health,Lanzhou University,Lanzhou,Gansu 730000,China)

机构地区：[1]兰州大学公共卫生学院,甘肃兰州730000

出　　处：《环境与职业医学》2024年第11期1213-1220,共8页Journal of Environmental and Occupational Medicine

摘　　要：[背景]职业紧张已成为军队重要的公共卫生问题之一。目前对我国部队官兵职业紧张研究较少,特别是高原环境下官兵职业紧张的影响方面。[目的]探讨高原官兵职业紧张现状及其影响因素,为降低高原官兵职业紧张发生提供科学依据。[方法]2023年4月采用分层整群抽样方法,根据医学上对高原的定义,将本研究海拔高度在500~3000 m的高原部队划分为低海拔(<2500 m)和高海拔(≥2500 m)2层,分别从每层驻地部队各随机抽取2个团级单位,再从每个团级单位随机抽取1个营级单位,将抽取的4个营级单位的全体官兵作为研究对象,最终共纳入2284名官兵。根据高原官兵特点设计一般情况问卷收集基本信息,并采用付出-回报失衡量表对职业紧张进行评估。采用多因素logistic回归分析职业紧张的影响因素。[结果]本次研究高原官兵发生职业紧张的有508人,检出率为22.2%。研究对象付出-回报失衡量表总得分和付出、回报以及内在投入3个维度的得分M(P25,P75)分别是0.9(0.7,1.0)、16.0(13.0,19.0)、36.0(33.0,39.0)和18.0(15.0,19.0)。不同性别、年龄、军龄、婚姻状况、是否独生子女、体质状况、有无基础疾病、入伍前锻炼情况、进高原后心理变化和是否发生高原反应的职业紧张检出率差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,女性官兵(OR=1.532,95%CI:1.061~2.213)、独生子女(OR=1.281,95%CI:1.038~1.581)和有基础性疾病(OR=1.950,95%CI:1.340~2.839)的官兵发生职业紧张风险较高;以军龄0~<3年为对照组,3~<9年(OR=1.380,95%CI:1.113~1.710)和≥9年(OR=2.141,95%CI:1.461~3.137)发生职业紧张风险高;进入高原的心理变化,与无变化相比,出现紧张恐惧(OR=1.728,95%CI:1.133~2.635)和激动兴奋(OR=1.380,95%CI:1.113~1.710)的官兵发生职业紧张的风险较高;而入伍前经常锻炼(OR=0.670,95%CI:0.492~0.913)、良好体质状况(OR=0.572,95%CI:0.426~0.767)和优秀体质[Background]Occupational stress is an important public health problem in the military.At present,there are few studies about occupational stress of officers and soldiers of the armed forces in China,especially the effects of plateau related environmental factors on occupational stress.[Objective]To understand current status and identify influencing factors of occupational stress among officers and soldiers stationed in plateaus,and provide a scientific basis for managing occupational stress.[Methods]In April 2023,stratified cluster sampling was used to recruit troops by deployed altitudes ranging from 500 to 3000 m intotwo strata of low altitude(<2500 m)and high altitude(≥2500 m)based on the medical definition of plateau.Two regimental units wererandomly selected from each stratum respectively,and one battalion unit was randomly selected from each regimental unit with all theofficers and soldiers.Four selected battalion units were surveyed with a total of 2284 officers and soldiers.We designed a general questionnaireto collect their basic information,and distributed effort-reward imbalance questionnaires to evaluate occupational stress.Weused logistic regression to identify potential influencing factors of occupational stress.[Results]Positive occupational stress was reported in 508 plateau-stationed officers and soldiers,with a prevalence rate of 22.2%.Thetotal effort-reward imbalance score and the dimensional scores of effort,reward,and overcommitment in M(P25,P75)were 0.9(0.7,1.0),16.0(13.0,19.0),36.0(33.0,39.0),and 18.0(15.0,19.0),respectively.There were significant differences in the positive rate of occupationalstress by gender,age,military service length,marital status,only child or not,physical fitness condition,reporting underlying diseases ornot,exercise frequency before conscription,psychological changes after entering the plateaus,and having altitude sickness or not(P<0.05).The results of logistic regression showed that being female(OR=1.532,95%CI:1.061,2.213),only child(OR=1.281,95%CI:1.038,1.581),

关 键 词：高原 官兵 职业紧张 付出-回报失衡 影响因素 

分 类 号：R13[医药卫生—劳动卫生]