医护人员职业紧张与抑郁症状的关系：焦虑症状的中介作用
The Relationship between Various Dimensions of Occupational Stress and Occupational Depression in Health Care Workers: The Mediating Role of Occupational Anxiety

[目的]探究职业紧张(社会支持、组织与回报、要求和付出与自主性)对抑郁症状的影响效应以及焦虑症状的中介作用，以便在临床实践中采取更有针对性的预防或干预措施，帮助医护人员更好的应对抑郁或者亚抑郁问题。[方法]采用比例抽样法，随机抽取重庆市内4个县(区)的1833名一线医护人员。以问卷调查的形式，获得其相关资料。采用结构方程模型(SEM)探究职业紧张各个维度对抑郁症状的影响效应以及焦虑症状的中介作用。[结果]重庆市医护人员的抑郁症状检出率为25.37%，社会支持得分、组织与回报得分、要求和付出得分与自主性得分对焦虑症状有直接正向作用(β = 0.186, β = 0.092, β = 0.202, β = 0.076, P < 0.001)。社会支持得分、组织与回报得分、要求和付出得分对抑郁症状有直接正向作用(β = 0.103, β = 0.044, β = 0.078, P < 0.001)。焦虑症状对抑郁症状有直接正向作用(β = 0.447, P < 0.001)。职业紧张的各个维度对抑郁症状均有间接正向作用。各个维度总效应分别为0.186，0.085，0.168，0.034。[结论]重庆市医护人员的抑郁症状水平相对较高，社会支持、要求与付出对抑郁症状的影响较大，职业紧张的四个子维度(社会支持、组织与回报、要求和付出与自主性)会通过焦虑症状的中介作用对抑郁症状有间接作用。
[Objective] To explore the effects of occupational stress (social support, organization and reward, demand and commitment and autonomy) on depressive symptoms and the mediating role of anxiety symptoms, in order to take more targeted prevention or intervention measures in clinical practice, to help medical staff better deal with depression or subdepression. [Methods] A total of 1833 front-line medical workers from 4 counties (districts) in Chongqing were randomly selected by proportional sampling method. In the form of questionnaire survey, the relevant information was obtained. Structural equation model (SEM) was used to explore the effects of occupational stress on depressive symptoms and the mediating role of anxiety symptoms. [Results] The detection rate of depressive symptoms in Chongqing medical staff was 25.37%, and the scores of social support, organization and reward, demand and effort and autonomy had direct positive effects on anxiety symptoms (β = 0.186, β = 0.092, β = 0.202, β = 0.076, P < 0.001). Social support score, organization and reward score, demand and effort score had a direct positive effect on depressive symptoms (β = 0.103, β = 0.044, β = 0.078, P < 0.001). Anxiety symptoms had a direct positive effect on depression symptoms (β = 0.447, P < 0.001). All dimensions of occupational stress have indirect positive effects on depressive symptoms. The total effect of each dimension was 0.186, 0.085, 0.168, 0.034, respectively. [Conclusion] The level of depressive symptoms among medical workers in Chongqing is relatively high, and social support, demand and effort have great influence on depressive symptoms. The four sub-dimensions of occupational stress (social support, organization and reward, demand and effort and autonomy)