The Mediating Role of Cumulative Fatigue on the Association between Occupational Stress and Depressive Symptoms: A Cross-Sectional Study among 1327 Chinese Primary Healthcare Professionals

The interaction of occupational stress and job burnout on depressive symptoms in railway workers in Fuzhou city

BACKGROUND

To explore the relationship between occupational stress, burnout and depressive symptoms among railroad workers in Fuzhou, and to analyze the interaction of burnout and occupational stress on depressive symptoms.

METHODS

In this study, 861 railway employees of Fuzhou railway bureau were randomly selected from January to April, 2022. Occupational stress inventory revised edition (OSI-R), China job burnout inventory (CMBI) and Symptom Checklist-90 (SCL-90) were used to investigate the occupational stress, job burnout and depressive symptoms of railway workers. Interactions associated with depressive symptoms were assessed by linear hierarchical regression analysis and SPSS macros (PROCESS).

RESULTS

Occupational stress, job burnout and depressive symptoms accounted for 50.58%, 93.47%, and 11.19% of the study population, respectively. There were intergroup differences between age, marriage status, and length of service (P < 0.05). Occupational stress and job burnout are the main risk factors for depressive symptoms (OR: 2.01, 95% CI: 1.17-3.45; 1.94, 1.69-2.23, respectively). More importantly, further analysis of the interaction between occupational stress and job burnout showed that those with high levels of job burnout had a high-risk effect on depressive symptoms at high levels of occupational stress.

CONCLUSION

Occupational stress and job burnout are risk factors for depressive symptoms among railroad workers in Fuzhou City. The interaction of job burnout and occupational stress increases the risk of depressive symptoms.

Association of working hours and cumulative fatigue among Chinese primary health care professionals

Introduction

The association between long working hours and cumulative fatigue is widely acknowledged in the literature. However, there are few studies on the mediating effect of working hours on cumulative fatigue using occupational stress as a mediating variable. The present study aimed at investigating the mediating role of occupational stress in the relationship between working hours and cumulative fatigue in a sample of 1,327 primary health care professionals.

Methods

The Core Occupational Stress Scale and the Workers' Fatigue Accumulation Self-Diagnosis Scale were utilized in this study. The mediating effect of occupational stress was examined using hierarchical regression analysis and the Bootstrap test.

Results

Working hours were positively associated with cumulative fatigue via occupational stress (p < 0.01). Occupational stress was found to partially mediate the relationship between working hours and cumulative fatigue, with a mediating effect of 0.078 (95% CI: 0.043-0.115, p < 0.01), and the percentage of occupational stress mediating effect was 28.3%.

Discussion

Working hours can be associated with cumulative fatigue either directly or indirectly via occupational stress. As a result, by reducing occupational stress, primary health care professionals may reduce the cumulative fatigue symptoms caused by long hours of work.