The Mediating Role of Worker-Occupation Fit in the Relationship Between Occupational Stress and Depression Symptoms in 1988 Medical Workers: A Cross-Sectional Study

Association between occupational stress, occupational burnout, and depressive symptoms among medical staff during COVID-19: A cross-sectional study in Chongqing, China

BACKGROUND

Studies have extensively examined the factors contributing to the onset of occupational stress, burnout, and depression. However, the relationship between these variables is limited.

OBJECTIVE

This study aimed to explore the association between occupational stress, burnout, and depressive symptoms and to investigate the mediating effect of burnout between occupational stress and depressive symptoms in medical staff.

METHODS

A cross-sectional survey was conducted among medical staff in Chongqing, China. The Core Occupational Stress Scale (COSS), Maslach Burnout Inventory: General Survey (MBI-GS), and Patient Health Questionnaire-9 (PHQ-9) were used to assess the status of occupational stress, burnout, and depressive symptoms, respectively. The bootstrapping analyses using SPSS PROCESS macros version 3 were conducted to examine mediating effects.

RESULTS

The study conducted on medical staff in Chongqing revealed that the detection rates of occupational stress, occupational burnout, and depressive symptoms were 31.8%, 23.3%, and 30.3%, respectively. Hierarchical regression analysis revealed that occupational stress and burnout accounted for 19.3% (p < 0.001) and 18.8% (p < 0.001) of the variance in depressive symptoms, respectively. Mediation analysis showed that occupational stress indirectly affected depressive symptoms through the mediating effect of occupational burnout, with a mediation effect value of 0.13 (bootstrap 95% CI: 0.116-0.144) and the mediation effect accounting for 44.8% of the total effect.

CONCLUSION

Our results indicated that occupational stress and burnout were predictors of depressive symptoms. Occupational stress had a significant indirect effect on depressive symptoms via burnout. These results suggest that reducing occupational stress and burnout could be effective strategies for preventing depression among medical staff.

Association between occupational stress and subclinical depression in Chinese primary healthcare workers

Background

Wellbeing of healthcare workers is crucial for the effective functioning of primary health systems. This study aimed to examine the association between occupational stress and subclinical depression among primary healthcare workers, and to establish the foundation for future preventive strategies.

Methods

A cross-sectional study was conducted in Tai'an City, Shandong Province, China. Data were collected from 832 medical staff in primary health institutions using a structured self-administered questionnaire. The participants completed the Challenge and Hindrance-Related Self-Reported Stress (C-HSS) Scale and Patient Health Questionnaire-9. Multivariable logistic regression analysis was conducted to explore the relationship between occupational stress and subclinical depression among primary healthcare workers.

Results

The prevalence of subclinical depression among primary healthcare workers was 11.66%. Participants with subclinical depression have a significant higher level of occupational stress (including challenge-stress and hindrance-stress). Regression analysis result indicated that higher level of occupational stress was significantly associated with more severe subclinical depression, and the risk of subclinical depression remained after adjusting other covariates (OR = 4.57, 95%CI, 3.14-6.63). The association between challenge-stress and subclinical depression was not statistically significant when controlling for hindrance-stress. Subgroup analysis showed that male healthcare workers who perceived higher level of challenge stress were more likely to develop subclinical depression than female healthcare workers.

Conclusion

The level of subclinical depression among Chinese primary healthcare workers was high, and occupational stress especially hindrance stress may contribute to subclinical depression. Findings were also robust in subgroup analysis after adjusting for other covariates. These findings emphasize the importance of occupational stress psychosocial interventions to decrease the risk of developing depression among the primary healthcare workers.

The development and evaluation of the worker-occupation fit inventory

BACKGROUND

Person-environment fit (PEF) theory, one of the foundational theories of occupational stress, has primarily found applications in organizational behavior and human resource management. Given the alignment between the definition of occupational stress and the essence of PEF, we introduced the concept of worker-occupation fit (WOF). To validate our theoretical model, the development of an instrument to measure WOF becomes imperative.

METHODS

The Worker-Occupation Fit Inventory (WOFI) comprises three dimensions: personal trait fit (PTF), need-supply fit (NSF) and demand-ability fit (DAF). Job-related mental disorders (JRMDs) were assessed using the DASS-21. During the pre-investigation, items of the WOFI underwent screening through classic test theory (CTT) analysis. In the formal investigation, item response theory (IRT) analysis was employed to evaluate the selected items. The relationship between WOF and JRMD was verified by Pearson's correlation analysis and multiple logistic regression analysis.

RESULTS

The initial version consisted of 26 items. Three common factors were extracted by exploratory factor analysis (EFA): 6 items were included in the PTF, 6 items were included in the NSF, 4 items were included in the DAF, and 10 items were deleted because of unacceptable factor loadings. The confirmatory factor analysis (CFA) verified the structure of the WOFI with χ2/df = 1.822, CFI = 0.947, and SRMSR = 0.056. The Cronbach's alpha coefficients of the PTF, NSF, and DAF were 0.91, 0.92, and 0.80, respectively. In IRT analysis, the discrimination values of all items ranged from 1.25 to 2.53, and the difficulty values of all items ranged from -6.28 to 1.30 (with no difficulty of reversal). The WOF was negatively related to job-related stress (r = -0.34, p<0.001), anxiety (r = -0.37, p<0.001), and depression (r = -0.41, p<0.001). The multiple logistic regression analysis suggested that a high level of WOF was a protective factor against job-related mental disorders, with ORs all less than 1 (p<0.001), and a low level of WOF was a risk factor for job-related mental disorders, with ORs all more than 1.0 (p<0.001).

CONCLUSIONS

The results of CTT and IRT analysis indicated that the WOFI exhibits reliability and validation. The WOF effectively predicted job-related mental disorders. Subsequent studies will delve into the influence of WOFI on diverse professions and various health outcomes.