بررسی رابطه بین استرس شغلی با سلامت عمومی در میان کارکنان دانشگاه علوم پزشکی ایلام در سال 1394

زمینه و هدف: استرس یکی از مولفه‌های مهم و تاثیرگذار در ایجاد اختلال در سلامت افراد است، به‌طوریکه باعث می‌شود شخص نتواند وظایف و تعهدات فردی، خانوادگی و اجتماعی خود را به‌طور مطلوب انجام دهد. سلامت عمومی به‌معنای رفاه و آسایش کامل جسمی، روانی و اجتماعی (نه فقط نداشتن بیماری و معلولیت) است. یکی از مقیاس‌های اصلی اثر بخشی در سازمان‌ها، سلامت کارکنان است. امروزه کارکنان دانشگاه در اثر مواجهه با استرس‌های محیط کاری، سلامتی آن‌ها در معرض آسیب و صدمه قرار گرفته است. این مطالعه‌ با هدف تعیین تعیین رابطه بین سلامت عمومی با عوامل استرس‌زای شغلی و فاکتورهای تاثیرگذار بر آن در میان کارکنان دانشگاه علوم پزشکی ایلام انجام گرفت. روش بررسی: این مطالعه‌ به‌صورت توصیفی تحلیلی و از نوع همبستگی، بر روی 153 نفر از کارمندان و اعضای هیئت علمی شاغل در دو بخش ستاد و پردیس دانشگاه علوم پزشکی ایلام انجام گرفت. تعداد نمونه‌های مورد مطالعه با استفاده از فرمول آماری کوکران و به روش نمونه‌گیری تصادفی ساده (srs) انتخاب گردید. ابزار جمع‌آوری داده‌ها شامل پرسشنامه سلامت عمومی گلدبرگ و هیلر (ghq28)، پرسشنامه استرس شغلی فیلیپ‌ال‌رایس و پرسشنامه مشخصات دموگرافیک بود. پرسشنامه‌ی ghq از 28 سوال و 4 خرده مقیاس هفت سوالی، شامل علائم جسمانی، اضطراب و بی‌خوابی، اختلال در کارکرد اجتماعی‌ و افسردگی حاد تشکیل شده است؛ همچنین پرسشنامه استرس شغلی فیلیپ‌ال‌رایس شامل 57 سوال و سه خرده‌مقیاس روابط بین فردی (26 سوال)، شرایط فیزیکی محیط کار (22 سوال) و علایق شغلی (9 سوال) است. در نهایت تجزیه و تحلیل داده‌های جمع‌آوری شده با استفاده از نرم‌افزار آماری spss نسخه 22 و آزمون‌های آماری تی‌تست، کای‌دو، آنالیز واریانس، همبستگی پیرسون و رگرسیون صورت گرفت. یافته‌ها: میانگین نمره کلی استرس شغلی و سلامت عمومی در جامعه مورد مطالعه به‌ترتیب 31.29 ± 152.25 و 14.81 ± 25.09 به‌دست آمد؛ همچنین 50.3 % از افراد مورد مطالعه از لحاظ سلامت عمومی در حیطه اختلال هیچ یا کمترین حد و 68.6 % افراد شرکت کننده در مطالعه در سطح متوسطی از استرس شغلی قرار داشتند. آزمو‌ن‌های همبستگی پیرسون و رگرسیون نشان دادند که بین استرس شغلی و سلامت عمومی همبستگی معنی‌داری وجود داشته و استرس شغلی قادر به پیش‌بینی تغییرات سلامت عمومی است (0.05>p). آزمون تی‌تست بین میانگین نمره مولفه‌های علائم جسمانی، روابط بین فردی و استرس شغلی با وضعیت تاهل تفاوت معنی‌داری نشان داد (p<0.05)؛ همچنین براساس نتایج این آزمون، بین خرده مقیاس علائم جسمانی با متغیر جنسیت تفاوت معنی‌داری وجود داشت (p<0.05). آزمون آنالیز واریانس، بین خرده مقیاس روابط بین فردی با گروه‌های سنی تفاوت معنی‌داری نشان داد (0.05>p). آزمون کای‌دو، بین تمامی ابعاد و خرده مقیاس‌های استرس شغلی و سلامت عمومی با سطح تحصیلات و نوع استخدامی، هیچ گونه ارتباط معنی‌دار نشان نداد (p>0.05).نتیجه‌گیری: متغیرهای وضعیت تاهل و سن افراد به‌عنوان مهم‌ترین عوامل تاثیر گذار بر روی استرس شغلی و سلامت عمومی معرفی شدند و همچنین ابعاد روابط بین فردی و علائم جسمانی به‌عنوان مهم‌ترین خرده مقیاس در میان خرده مقیاس‌های استرس شغلی و سلامت عمومی مشخص شدند. به‌منظور بهبود وضعیت سلامت عمومی و کاهش میزان استرس شغلی، انجام اقداماتی از قبیل ایجاد برنامه جامع مدیریت استرس توصیه می‌گردد.

Investigative of the Relationship between job Stress and General Health among staffs of Ilam University of Medical Sciences in 2015

Background and aims: One of the major problems facing human societies in recent decades is the stress phenomenon, especially in the workplace. Job stress is the harmful responses that result from a mismatch between one #39;s abilities and knowledge with job pressures and demands. Stress is one of the most important and effective factors in disturbing people #39;s health, that makes a person unable to perform his or her individual, family and social duties and commitments optimally. Public health means complete physical, mental and social welfare (Not just lack of illness and disability). One of the most common disorders in general and occupational groups is mental disorders. The most important signs and symptoms of mental health include selfreliance, independence, the ability to cope with others, the ability to accept responsibility and the duty, to express love and affection, the ability to endure failure, and so on. Manpower is one of the most important resources and the most significant asset of any organization; also, staffs health is one of the key Scales of effectiveness of any organization. Today, university staff are exposed to workplace stress, their health has been harmed. In addition, it is essential for lecturers and staff to be healthy individuals to ensure that those who educate and deliver the community have adequate health and expertise. The aim of this study was to determine the relationship between public health and occupational stressors and its influencing factors among staffs of Ilam University of Medical Sciences.Methods: This descriptiveanalytic and correlation type study was conducted on 153 staffs (employees and faculty members) of Ilam University of Medical Sciences. The samples were selected using Cochran statistical formula and simple random sampling. Data collection tools were Goldberg and Hiller General Health Questionnaire, Philippe L. Rice Job Stress Questionnaire and Demographic Questionnaire. The GHQ questionnaire was designed by Goldberg and Hiller and localized by Taghavi in ​​Iran. The questionnaire consisted of 28 questions and 4 subscales of seven questions, including somatic symptoms, anxiety and insomnia, social dysfunction and severe depression, in which general health and its dimensions are divided into four domains: none or least, mild disorder, moderate disorder and severe disorder. In this study, 4point Likert scale, from 0 to 3, was used to score GHQ28 questionnaires; also, cutoff point 6 was used for each subscale and cutoff point 22 for overall score. The Philip L. Rice Job Stress Questionnaire is one of the validated job stress questionnaires approved by the American Institute of Mental Health (NIMH). This questionnaire was designed by Philip L. Rice and localized by Hatami in Iran. The Philip L. Rice Job Stress Questionnaire contains 57 questions and three subscales of interpersonal relationships (26 questions), workplace physical conditions (22 questions) and job interests (9 questions) that job stress and each of its subscales are divided into three levels of low, moderate and severe stress. Occupational Stress Questionnaire scores were scored on a 5point Likert scale from one (never) to five (always). In the present study, in interpreting occupational stress (total), a score less than 120.96 indicates low stress, a score between 120.96 183.54 moderate stress and a score above 183.54 indicates severe stress. Finally, the data were analyzed using SPSS software version 22 and ttest, chisquare, ANOVA, Pearson correlation and regression tests.Results: The total mean score of general health and occupational stress in the study population was 25.09 (14.81) and 25.152 (31.29), respectively. Also, 50.3% of the studied subjects had no or least impairment in scope of general health and 68.6% of the study participants had moderate level of job stress. In the survey of general health dimensions, the highest score belonged to social dysfunction with mean score of 7.49 (3.58) and also mean score of all three subscales of occupational stress was in average level, although, the highest score among the subscales belonged to the subscale of interpersonal relationships. Pearson correlation test showed a significant and direct correlation between job stress and general health (p<0.05). Also, the highest and lowest correlation coefficients were observed between severe depression with interpersonal relationships (r = 0.462) and severe depression with job interests (r = 0.250), respectively. The results of linear regression test showed that job stress was able to predict 22% of changes in somatic symptoms, 21.4% of changes in anxiety and insomnia, 19.1% of changes in social dysfunction, 18% of changes in severe depression and 27.5% of public health changes. According to the results of stepwise linear regression test, job interests subscale was not able to predict changes in general health and its dimensions (p> 0.05). Also, subscales of interpersonal relationships and physical conditions of workplace with 22.3% and 5.5% respectively are able to predict changes in public health. According to the results of this test, only the interpersonal relationship subscale predicted 20.9% of the changes in the severe depression subscale. Ttest showed a significant difference between the mean score of the components of somatic symptoms, interpersonal relationships and job stress with marital status (p <0.05), so that the mean score of all three components was higher in single than married individuals. Also, according to the results of this test, there was a significant difference between the somatic symptoms subscales and the gender variables in the study population (p <0.05). The mean score of this subscale was higher in females than males. Chisquare test showed no significant relationship between all dimensions and subscales of job stress and general health with educational level and type of employment (p> 0.05). According to the results of analysis of variance (ANOVA), there was a significant difference between subscales of interpersonal relationships and age groups (p <0.05). This difference was found between the age groups under 30 years with 3040 years and under 30 years with 4050 years, so that the mean score of this component in persons with age group under 30 years was higher than the other two groups. Also, according to the results of this test, no statistically significant differences were found between mean scores of all dimensions and subscales of occupational stress and general health with work experience (p> 0.05). Conclusion: The staff of Ilam University of Medical Sciences were in the range of unhealthy (mild disorder) and moderate level of general health and job stress, respectively. Marital status and age were identified as the most important factors affecting job stress and general health, and interpersonal relationships and somatic symptoms were determined as the most important subscales among job stress and general health subscales. To improve general health and reduce job stress, such as developing a comprehensive stress management program, avoiding the use of highstress and with little experience people in highstress and highrisk jobs, prioritized to married people and men when to operate in sensitive and stressful jobs, providing consulting services to staffs within the organization, as well as regular and periodic physical and psychological staff monitoring are recommended.