| Objective:This study investigated the long-term working hours and occupational stress exposure status of medical staff in tertiary hospitals in Xinjiang,and analyzed the impact of weekly working hours on occupational stress,insomnia,fatigue accumulation,and depression symptoms in this population.Exploring the mediating effect of occupational stress on the relationship between weekly work hours and insomnia,fatigue accumulation,and depressive symptoms,exploring the interaction between long work hours and occupational stress and the correlation between insomnia,fatigue accumulation,and depressive symptoms,providing scientific basis for ensuring the physical and mental health of medical personnel.Methods:A questionnaire was used to investigate the basic situation,weekly working hours,occupational stress,insomnia,fatigue accumulation,and depressive symptoms of medical staff in two tertiary hospitals in Xinjiang.Use chi square test for inter group comparison.Using multivariate logistic regression analysis to explore the relationship between weekly work hours and occupational stress,insomnia,fatigue accumulation,and the occurrence of depressive symptoms.Using mediation analysis to study the mediating effect of occupational stress on weekly work hours,insomnia,fatigue accumulation,and depressive symptoms.Using multiplication and addition models to analyze the impact of the interaction between long working hours and occupational stress on insomnia,fatigue accumulation,and depressive symptoms.Results:1.Long-term working hours:There were 1867 long-working medical personnel,accounting for78.94%,individual characteristics include 30-39 years old,male,bachelor’s degree or above,smoking 6～10cigarettes/day,drinking 1～3 times/month,no physical exercise,average monthly income ≥ 9000 yuan,10-19 years of service,and a higher proportion of doctors working long hours..2.Occupational stress: The detection rate of occupational stress among 668 medical staff was 28.24%.Among the individual characteristics,the detection rate of occupational stress was higher among those aged30～39,no physical exercise,10～19 years of service,nurses,shift workers and those who worked >60 hours a week.Logistic regression results showed that compared with the group with weekly working hours ≤40hours,the weekly working hours of 41～48 hours,49～54 hours,55～60 hours and>60 hours were the risk factors for occupational stress of medical staff(OR=1.89,95%CI:1.38-2.59,P<0.001);(OR=2.39,95%CI:1.74-3.30,P<0.001);(OR=2.91,95%CI:2.11-4.04,P<0.001);(OR=4.68,95%CI:3.33-6.56,P<0.001),and with the increase of working hours per week,the risk of occupational stress among medical staff increases.3.Insomnia,fatigue accumulation and depressive symptoms: 1149 medical staff had insomnia,the detection rate was 48.58%.The results of logistic regression showed that compared with the group of working hours ≤40 hours per week,49～54 hours per week,55～60 hours per week and>60 hours per week were risk factors for insomnia among medical staff(OR=1.83,95%CI:1.41-2.38,P<0.001);(OR=1.88,95%CI:1.43-2.46,P<0.001);(OR=2.02,95%CI:1.51-2.71,P<0.001).After the weekly working hours are more than 48 hours,the risk of insomnia of medical staff increases with the increase of the weekly working hours;1512 medical staff had fatigue accumulation,the detection rate was 63.93%.Logistic regression results showed that compared with the group with weekly working hours ≤40 hours,the weekly working hours of 41～48 hours,49～54 hours,55～60 hours and>60 hours were the risk factors for fatigue accumulation of medical staff(OR=1.47,95%CI:1.15-1.89,P=0.002);(OR=3.28,95%CI:2.49-4.33,P<0.001);(OR=3.69,95%CI:2.76-4.94,P<0.001);(OR=8.00,95%CI:5.56-11.50,P<0.001).and with the increase of working hours per week,the risk of fatigue accumulation of medical staff increases.878 medical staff had depressive symptoms,the detection rate was 37.12%.The results of logistic regression showed that compared with the group of working hours ≤40 hours per week,the working hours of 49～54hours,55～60 hours and>60 hours per week were the risk factors for the occurrence of depression in medicalstaff(OR=1.89,95%CI:1.43-2.50,P<0.001);(OR=1.93,95%CI:1.45-2.57,P<0.001);(OR=3.78,95%CI:2.79-5.12,P<0.001).After the weekly working hours are more than 48 hours,the risk of depression of medical staff increases with the increase of the weekly working hours;4.Relationship between occupational stress and insomnia,fatigue accumulation and depressive symptoms: occupational stress is related to insomnia,fatigue accumulation and depressive symptoms.Occupational stress is a risk factor for insomnia,fatigue accumulation and depressive symptoms of medical staff(OR=1.87,95%CI:1.54-2.27,P<0.001);(OR=7.13,95%CI:5.34-9.52,P<0.001);(OR=6.52,95%CI:5.30-8.04,P<0.001).5.Intermediary effect of occupational stress: occupational stress plays an intermediary role between the length of work week and insomnia,fatigue accumulation and depression,with the intermediary effect values of 0.107,0.308 and 0.117,OR were 1.11(95%CI:1.05-1.18,P<0.001);1.36(95%CI:1.28-1.45,P<0.001);1.12(95%CI:1.06-1.19,P<0.001),and the percentage of intermediary effect of 59.75%,66.40%and 41.51% respectively.6.The interaction between long working hours and occupational tension: There is an additive interaction between long working hours and occupational tension on the occurrence of fatigue accumulation.The risk of fatigue accumulation in healthcare workers with long working hours and occupational stress was 18.44 times higher than neither,RERI=11.67(95%CI:4.87-18.4,P<0.001),AP=0.63(95%CI:0.43-0.83,P<0.001),S=3.02(95%CI:1.62-5.64,P<0.001).Long working hours and occupational stress did not interact with insomnia and depressive symptoms.Conclusion:1.The proportion of long-term working hours among medical staff in tertiary hospitals in Xinjiang is relatively high,and the detection of occupational stress is relatively good.The detection rates of insomnia,fatigue accumulation,and depression symptoms are all at high levels.There is a correlation between prolonged working hours of medical personnel and the occurrence of occupational stress,insomnia,fatigue accumulation,and depression symptoms.There is a correlation between occupational stress and the occurrence of insomnia,fatigue accumulation,and depressive symptoms.2.Occupational stress plays a mediating role between weekly working hours and symptoms of insomnia,fatigue accumulation,and depression.This suggests that when it is difficult to reduce the weekly working hours of medical staff,the risk of insomnia,fatigue accumulation,and depression symptoms can be reduced by alleviating their occupational stress level.3.Long working hours and occupational stress have a cumulative interaction on the occurrence of fatigue accumulation in medical personnel.This suggests that developing a reasonable work system and providing targeted psychological counseling to medical personnel in a timely manner can help reduce the likelihood of fatigue accumulation. |
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