Prevalence and Associations of Work Stress and Llfe Stress with Depressive Symptoms among Female Hospital Day Workers and Shift Workers

Abstract

Background: Women working in healthcare experience higher levels of work stress compared to the general population. Life stress may also be higher among this population due to how the nature of the job affects workers’ personal lives. Depressive symptoms and depression are also generally higher among female healthcare workers compared to the general population. Objectives: To determine the prevalence of work stress, life stress, and depressive symptoms among female hospital employees and their associations among shift workers and day workers. Methods: A cross-sectional study was conducted at Kingston Health Sciences Centre in Southeastern Ontario between 2011 and 2014 with 168 rotating shift workers and 160 day workers. Levels of work stress were measured using the Job Content Questionnaire and the Siegrist Effort-Reward ratio, life stress was measured using the Derogatis Stress Profile, and depressive symptoms were measured with the Center for Epidemiological Studies Depression Scale. Logistic regression examined associations separately for day and shift workers. Results: Compared to day workers, shift workers experienced higher levels of psychological job demands (p<0.01), physical exertion (p<0.01), and effort spent (p<0.01) on average, and lower levels of overall support at work (p<0.01). Day workers experienced higher job insecurity (p<0.01), over-commitment (p=0.01) and life stress (p=0.03). The prevalence of moderate to severe depressive symptoms was 27% among day workers and 19% among shift workers. Perceived support resulted in reduced prevalence of depressive symptoms (OR 0.74, 95%CI 0.64 to 0.85) among day workers, whereas perceived job insecurity was associated with higher risk of depressive symptoms (OR 1.39, 95%CI 1.06 to 1.83). Over-commitment was associated with higher prevalence of depressive symptoms (day: OR 1.12, 95%CI 1.00 to 1.26; shift: OR 1.18, 95% CI 1.01 to 1.38), whereas higher esteem was associated with lower prevalence of depressive symptoms (day: OR 0.85, 95%CI 0.77 to 0.94; shift: OR 0.87, 95%CI 0.77 to 0.98). Conclusions: Prevalence of depressive symptoms was like that seen in previous studies of female healthcare professionals. Although work status did not meet the statistical criteria as an effect modifier in the association between stress measures and moderate to severe depressive symptoms, some differences were apparent.