Effects of web-based supervisor training on job stressors and psychological distress among workers: a workplace-based randomized controlled trial

Using workplaces as a unit for randomization, a randomized controlled trial was conducted to determine the effects of web-based supervisor training on the subject of worksite mental health on job stressors, supervisor support and psychological distress among subordinate workers. A total of eight workplaces of a sales and service company were randomly assigned to either training workplaces or non-training workplaces. Supervisors (n=23) at the training workplaces participated in web-based self-learning training on worksite mental health; supervisors (n=23) at the non-training workplaces did not. A total of 81 subordinate workers under the trained supervisors (the intervention group) and 108 subordinate workers under the non-trained supervisors (the control group) completed the Brief Job Stress Questionnaire (BJSQ) at baseline and at a three-month follow-up. No significant intervention effect was observed for any scale of the BJSQ measuring job stressors, supervisor or coworker support, or psychological distress among subordinate workers (p<0.05). The item score of work autonomy changed very little in the intervention group, while it decreased in the control group during the follow-up period, yielding a significant intervention effect (p=0.02). The item score for a friendly atmosphere in the workplace increased in the intervention group, while the score remained stable in the control group, yielding a significant intervention effect (p=0.02). While the present study failed to show any clear effect of the web-based training of supervisors on reduction of job stressors, it may be useful for maintaining worker autonomy and improving the friendliness of the worksite atmosphere.     

Effects of the job stress education for supervisors on psychological distress and job performance among their immediate subordinates: a supervisor-based randomized controlled trial

As job stress is now one of the biggest health-related problems in the workplace, several education programs for supervisors have been conducted to reduce job stress. We conducted a supervisor-based randomized controlled trial to evaluate the effects of an education program on their subordinates' psychological distress and job performance. The subjects were 301 employees (46 supervisors and 255 subordinates) in a Japanese sake brewery. First, we randomly allocated supervisors to the education group (24 supervisors) and the waiting-list group (22 supervisors). Then, for the allocated supervisors we introduced a single-session, 60-min education program according to the guidelines for employee mental health promotion along with training that provided consulting skills combined with role-playing exercises. We conducted pre- and post-intervention (after 3 months) surveys for all subordinates to examine psychological distress and job performance. We defined the intervention group as those subordinates whose immediate supervisors received the education, and the control group was defined as those subordinates whose supervisors did not. To evaluate the effects, we employed a repeated measures analysis of variance (ANOVA). Overall, the intervention effects (time x group) were not significant for psychological distress or job performance among both male (p=0.456 and 0.252) and female (p=0.714 and 0.106) subordinates. However, young male subordinates engaged in white-collar occupations showed significant intervention effects for psychological distress (p=0.012) and job performance (p=0.029). In conclusion, our study indicated a possible beneficial effect of supervisor education on the psychological distress and job performance of subordinates. This effect may vary according to specific groups.     

Epidemiology of job stress and health in Japan: review of current evidence and future direction.

With the increasing concern about job stress, there is a growing body of literature addressing psychosocial job stress and its adverse effects on health in Japan. This paper reviews research findings over the past 15 years concerning the assessment of job stress, the relationship of job stress to mental and physical health, and the effects of worksite stress reduction activities in Japan. Although studies were conducted in the past using ad-hoc job stress questionnaires, well-established job stressor scales have since been translated into Japanese, their psychometric properties tested and these scales extensively used in recent epidemiologic studies. While the impact of overtime and quantitative job overload on mental health seems moderate, job control, skill use and worksite support, as well as qualitative job demands, had greater effects on psychological distress and drinking problems in cross-sectional and prospective studies. These job stressors also indicated a strong association with psychiatric disorders, including major depression, even with a prospective study design. Long working hours were associated with a higher risk of myocardial infarction, diabetes mellitus and hypertension. There is evidence that the job demands-control model, as well as the use of new technology at work, is associated with higher levels of blood pressure and serum lipids among Japanese working populations. Fibrinolytic activity, blood glucose levels, immune functions and medical consultation rates were also affected by job stressors. It is further suggested that Japanese workers tend to suppress expression of positive feelings, which results in apparently higher psychological distress and lower job satisfaction among Japanese workers compared with workers in the U.S. Future epidemiologic studies in Japan should focus more on a prospective study design, theoretical models of job stress, job stress among women, and cultural difference and well-designed intervention studies of various types of worksite stress reduction.     

Psychological distress and associated factors among Japanese nursery school and kindergarten teachers: a cross-sectional study

The understaffing of nursery schools and kindergartens and the increasing workload of childcare workers are becoming significant issues in Japan. In this study, a cross-sectional survey was conducted to investigate the stress experienced by childcare workers and its antecedents. We distributed 2,640 questionnaires to childcare workers in Miyagi prefecture, obtaining a response rate of 51.9% (n=1,370). Finally, 1,210 valid questionnaires were used in the analysis. As a stress indicator, psychological distress was measured with the Kessler Screening Scale for Psychological Distress (K6). The mean K6 score was 7.0 (SD=5.4), and the prevalence of psychological distress (K6 score ≥5) was 60.0%. Considering work-related factors, the mean scores were as follows: supervisor support 11.8 (2.6), coworker support 12.1 (2.0), work engagement 3.2 (1.2), and effort-reward ratio 0.93 (0.53). A multivariate logistic regression analysis with adjustment for possible confounders revealed that increased psychological distress was associated with higher effort-reward ratio, lower support from supervisors and coworkers, lower work engagement, and insufficient sleep. These results suggest that elevated psychological distress is strongly associated with effort-reward imbalance, while high work engagement in childcare workers helped to reduce their distress.     

The relationship between hardiness,supervisor support,group cohesion,and job stress as predictors of job satisfaction

PURPOSE: This study tested a conceptual model based on research supporting the relationship between the predictors of hardiness, supervisor support, and group cohesion and the criterions of job stress and job satisfaction and between the predictor of job stress and the criterion of job satisfaction. DESIGN: The study employed a cross-sectional research design. Survey data were collected as part of the baseline measures assessed prior to an organizational hardiness intervention. SETTING: Worksite of Dell Computer Corporation in Austin, Texas. SUBJECTS: The subjects included 160 full-time Dell employees recruited from a convenience sample representing nine work groups (response rate = 90%). MEASURES: Hardiness was measured using the Dispositional Resilience Scale (DRS), job stress was measured using the Perceived Work Stress Scale (PWSS), and supervisor support, group cohesion, and job satisfaction were measured using a proprietary employee attitude survey. RESULTS: In the proposed model, high hardiness, supervisor support, and group cohesion were related to lower levels of job stress, which in turn was related to higher levels of job satisfaction. The model also proposed direct paths from hardiness, supervisor support, and group cohesion to job satisfaction. Path analysis was used to examine the goodness of fit of the model. The proposed model was a good fit for the data (chi 2[1, N = 160] = 1.85, p = .174) with the exception of the direct path between group cohesion and job satisfaction. Substantial portions of the variances in job stress (R2 = .19) and job satisfaction (R2 = .44) were accounted for by the predictors. CONCLUSION: Implications for targeted worksite health promotion efforts to lower job stress and enhance job satisfaction are discussed.     

Effects of an education program for stress reduction on supervisor knowledge, attitudes, and behavior in the workplace: a randomized controlled trial

Supervisors at work play a large role in stress management at the workplace. Providing supervisors with necessary information and useful skills might be one effective approach that will lead to stress reduction. However, very few studies have investigated the effect of supervisor education by using a rigorous study design. In a randomized controlled trial, we tried to clarify how an education program for stress reduction influences supervisor knowledge, attitudes, and behavior concerning stress management. The subjects were 46 supervisors of an old, established sake brewery manufacturer of 301 employees. The supervisors were assigned to either the intervention group (24 supervisors) or the control group (22 supervisors). We conducted a single-session education program that included the guidelines for worker mental health promotion to the intervention group. The education program was composed of a basic education lecture and active listening training. The effects of this program on supervisor knowledge, attitudes, and behavior were measured using an original, self-administered questionnaire. The intervention effect was tested by examining an interaction effect between groups and time (before education, three and six months after education). The education favorably affected supervisor knowledge (F=7.92; p=.001). As for behavior, the intervention effect was marginally statistically significant (F=2.51; p=.088). For the attitude score, however, there were no beneficial effects. In conclusion, the provision of necessary information and useful skills to supervisors seems to improve supervisor knowledge and behavior regarding stress management at the workplace for at least six months.     

Stress prevention and supervisor training]

This article surveys available literature addressing the role of supervisors (corporate administrators) in stress prevention activities within the workplace and describes some desirable training courses. In most successful stress management programs or programs that promote mental health, the provision of training for supervisors has been an important strategy. Several reports have asserted that proper training is an effective method of reducing worksite stress and improving job satisfaction in workers, but few prospective intervention studies investigating the truth of these reports have been made. Additional research is necessary to assess the validity of various training programs. The structure of organizations and employment systems has recently begun to change, and the traditional employee-supervisor relationship is slowly disappearing in some enterprises, so that the role of supervisors with regard to stress management may need to be revised.     

南水北调中老年移民心理干预效果分析

摘要:目的 探索南水北调中老年移民群体的心理干预效果及其心理健康、社会心理应激、社会支持的关系。方法 采用分层整群抽样,将辉县、荥阳、宝丰3个安置地的35岁以上991名中老年移民进行为期2年的心理干预。实验组移民进行心理健康讲座以及个体及团体心理咨询、心理治疗、建议精神科治疗3个层次的心理干预,对照组移民仅接受定期的心理健康讲座和团体心理咨询,干预前后均对2组移民使用心理健康状况自评量表（SCL-90）、心理社会应激调查表（PSSG）以及社会支持评定量表（SSRS）进行心理测量。结果 (1)经过不同的干预处理后,2组移民心理的健康状况自评量表(SCL-90)在躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对等10个因子得分及总分上差异均有统计学意义(P＜0.05);心理社会应激调查表(PSSG)的得分除积极情绪体验因子的得分差异无统计学意义以外(Z=-1.587,P=0.112),生活事件、消极情绪体验、消极应对、积极应对因子以及总分上差异均有统计学意义(P＜0.05);社会支持评定量表(SSRS)除在客观支持因子上的得分差异无统计学意义以外(t=-0.738,P=0.461),主观支持、对支持的利用度因子以及总分上差异均有统计学意义(P＜0.05)。(2)关联规则模型和神经网络模型分析结果显示,中老年移民的社会支持、心理社会应激以及心理健康有较强的关联性,并且较低的社会支持和较高的心理社会应激会对中老年移民的心理健康产生不利影响。结论 接受3层次心理干预等措施的实验组中老年移民心理状况好于对照组中老年移民。中老年移民的心理健康受社会心理应激、社会支持的影响较大。因此,调动移民的主观积极情绪,引导积极应对方式,提高主观社会支持感是增强中老年移民心理健康的关键举措。     

Increasing fruit and vegetable consumption through worksites and families in the treatwell 5-a-day study.

OBJECTIVES: We report on the results of the Treatwell 5-a-Day study, a worksite intervention aimed at increasing consumption of fruits and vegetables. METHODS: Twenty-two worksites were randomly assigned to 3 groups: (1) a minimal intervention control group, (2) a worksite intervention, and (3) a worksite-plus-family intervention. The interventions used community-organizing strategies and were structured to target multiple levels of influence, following a socioecological model. Data were collected by self-administered employee surveys before and after the intervention; the response rate was 87% (n = 1359) at baseline and 76% (n = 1306) at follow-up. A process tracking system was used to document intervention delivery. RESULTS: After control for worksite, gender, education, occupation, race/ethnicity, and living situation, total fruit and vegetable intake increased by 19% in the worksite-plus-family group, 7% in the worksite intervention group and 0% in the control group (P = .05). These changes reflect a one half serving increase among workers in the worksite-plus-family group compared with the control group (P = .018). CONCLUSIONS: The worksite-plus-family intervention was more successful in increasing fruit and vegetable consumption than was the worksite intervention. Worksite interventions involving family members appear to be a promising strategy for influencing workers' dietary habits.     

Weight loss among female health care workers- a 1-year workplace based randomized controlled trial in the FINALE-health study

ABSTRACT: Background Weight management constitutes a substantial problem particularly among groups of low socio-economic status. Interventions at work places may be a solution, but high quality worksite interventions documenting prolonged weight loss are lacking. This paper presents results of an intervention aimed to achieve a 12 months weight loss among overweight health care workers. Methods Ninety-eight overweight female health care workers were randomized into an intervention or a reference group. The intervention consisted of diet, physical exercise and cognitive behavioral training during working hours 1 hour/week. The reference group was offered monthly oral presentations. Several anthropometric measures, blood pressure, cardiorespiratory fitness, maximal muscle strength, and musculoskeletal pain were measured before and after the 12-months intervention period. Data were analyzed by intention-to-treat analysis. Results The intervention group significantly reduced body weight by 6.1 kg (p<0.001), BMI by 2.2 (p<0.001) and body fat percentage by 2.8 (p<0.001). There were no statistical reductions in the control group, resulting in significant differences between the two groups over time. Conclusion The intervention generated solid reductions in body weight, BMI and body fat percentage among overweight female health care workers over 12 months. The positive results support the workplace as an efficient arena for weight loss among overweight females. Trial registration: NCT01015716.     

煤工尘肺患者心理健康状况调查及分析

目的评估煤工尘肺患者的心理健康状况,从而进行必要的心理干预并做好心理健康教育,提高患者生活质量。方法采用症状自测量表（SCL-90）测评煤工尘肺患者的心理健康状况,运用SPSS14．0统计分析软件,将本组因子得分与对照组及全国常模进行比较分析。结果煤工尘肺患者各因子得分均高于国内常模组;除因子6（敌对症状）外,煤工尘肺患者各因子得分均高于对照组。结论煤工尘肺患者在心理健康方面存在严重问题,应加强心理健康教育和心理治疗。     

心理健康教育对大学生手机依赖及心理健康的干预效果

目的 分析心理健康教育干预(抑制控制训练联合积极情绪训练)对大学生手机依赖的干预效果。方法 对河南省3所高校600名大学生采用大学生手机成瘾倾向量表对其手机依赖情况进行调查,筛选存在手机依赖大学生随机分为对照组(66人)与观察组(67人),对照组给予抑制控制训练干预,观察组在此基础上联合积极情绪训练干预,比较2组干预前后手机依赖程度及心理健康状况的变化。结果 干预前2组手机成瘾量表评分、手机使用时间、心理弹性量表评分、认知情绪调节量表评分、抑制冲突效应量对比差异均无统计学意义(P>0.05)。干预后3个月,观察组手机成瘾量表评分(37.11±5.01)分,低于对照组的(41.25±6.33)分;观察组手机使用时间(2.72±0.71)h,低于对照组的(3.37±0.55)h;观察组认知情绪调节量表评分(88.79±5.66)分、心理弹性量表评分(76.63±3.97)分,高于对照组的(81.14±4.79)分、(71.75±4.55)分;观察组抑制冲突效应量(40.35±10.22)ms,低于对照组的(45.14±5.66)ms,差异均有统计学意义(P<0.01)。大学生手机成瘾倾向量表评分与认知情绪调节量表、心理弹性量表评分呈负相关(r=-0.397、-0.453,P<0.01),与冲突抑制效应量呈正相关(r=0.498,P<0.01)。结论 手机依赖直接影响大学生认知情绪调节及心理韧性;而以积极心理学为指导,开展抑制控制训练联合积极情绪训练,可减轻大学生手机依赖,提升认知情绪调节能力及心理韧性,改善自我控制能力,有助于促进其心理健康发展。     

Effects of mailed advice on stress reduction among employees in Japan: a randomized controlled trial.

We conducted a randomized controlled trial (RCT) to examine the effects of mailed advice on reducing psychological distress, blood pressure, serum lipids, and sick leave of workers employed in a manufacturing plant in Japan. Those who indicated higher psychological distress (defined as having GHQ scores of three or greater) in the baseline questionnaire survey (n = 226) were randomly assigned to an intervention group or a control group. Individualized letters were sent to the subjects of the intervention group, informing them of their stress levels and recommending an improvement in daily habits and other behaviors to reduce stress. Eighty-one and 77 subjects in the intervention and control groups, respectively, responded to the one-year follow-up survey. No significant intervention effect was observed for the GHQ scores, blood pressure, serum lipids, or sick leave (p > 0.05). The intervention effect was marginally significant for changes in regular breakfasts and daily alcohol consumption (p = 0.09). The intervention effect was marginally significant for the GHQ scores among those who initially did not eat breakfast regularly (p = 0.06). The study suggests that only sending mailed advice is not an effective measure for worksite stress reduction. Mailed advice which focuses on a particular subgroup (e.g., those who do not eat breakfast regularly) may be more effective.     

The effectiveness of the mental health training including active listening for managers]

We carried out mental health training with Active Listening for managers of A company, which was the electronics manufacturing company with 1,900 employees. The purpose of the present study was to examine the effect on managers and employees in the workplace on the training. The subjects were all persons who managed regular employees directly in A company. We performed the investigation from May 2006 to February 2007 and carried out the training from September to November in 2006. The contents of the training were from the chapter on "The education and training of managers" in the "The guideline for maintenance and promotion of mental health for workers" issued by the Ministry of Health, Labour and Welfare in Japan in 2006. We divided the contents and implemented them in two sessions. "Responding to worker consultation" was one of the contents of Active Listening. In the first session, we explained about Active Listening, and in the second session we ran a practical involving Inventive Experiential Listening. One month later, we distributed material summarizing the training to all the participants. To evaluate the effect of the training, we conducted surveys of the participants using the Active Listening Attitude Scale (ALAS), prior to and after the training, and distributed questionnaires, post-training about the contents of the training and changes of consciousness and action. Furthermore, we performed surveys pre- and post-training using the Brief Job Stress Questionnaire (BJSQ) 12 items version, distributed to all employees. We evaluated the effect of the training on 124 managers and 908 workers by the investigation. The score of each subscale was analyzed by repeated measures analysis of variance. There were no significant differences in the scores of both the "Listening attitude" and "Listening skill" subscales of ALAS between pre-training and post-training, but the mean scores post-training were higher than those pre-training on both subscales. There were significant increases post-training in "Job demands", "Worksite support by supervisor" and "Worksite support by co-worker", subscales of the BJSQ 12 items version. Particularly, the "Worksite support by supervisor" subscale increased significantly in 8 of the 47 sections in a comparison among sections. In this present study, we investigated the effectiveness of mental health training including Active Listening for managers, and suggest that to train Active Listening and use it at the worksite possibly strengthens "Worksite support by supervisor".     

Work characteristics and health of correctional officers

BACKGROUND: The association between the psychosocial work environment and mental health problems has been well documented over the past years. Karasek and Theorell's job strain model and Siegrist's effort/reward imbalance model have been associated to several physical and mental health problems. Moreover, in the last decade, the Quebec correctional services sector has known an important increase in sickness benefit claims for mental health problems. This study aimed to describe the psychosocial work characteristics and health of Quebec correctional officers and to determine the occupational risk factors associated to psychological distress among them. METHODS: This cross-sectional study was realized among 1034 correctional officers from 18 prisons in the province of Quebec, 668 men and 366 women. The response rate was 76%. Psychological demands, decision latitude, social support at work, reward, and psychological distress have been documented by telephone interviews during spring 2000. RESULTS: Correctional officers were more exposed to adverse psychosocial factors at work than a comparable sample of Quebec workers and they reported more health problems. Results showed that the same sources of psychological distress affected men and women, but sometimes at different degrees. High psychological demands combined with low or high decision latitude, and effort/reward imbalance were associated to psychological distress independently of potential confounding factors. Among other work factors associated to the report of high psychological distress among correctional officers were low social support at work, and conflicts with colleagues and superiors. CONCLUSION: Many adverse psychosocial factors at work were in excess among correctional officers compared to workers from the general population. These factors, also related to high levels of psychological distress, could be addressed with the goal of primary prevention of mental health problems at work.     

One-year randomized controlled trial with different physical-activity programs to reduce musculoskeletal symptoms in the neck and shoulders among office workers

OBJECTIVES: This study evaluates the effect of two different worksite physical-activity interventions on neck-shoulder symptoms, together with perceived work ability and sick leave among office workers. METHODS: An examiner-blinded randomized controlled trial was conducted with 549 office workers allocated to one of three intervention groups: one with specific resistance training (SRT) of the neck-shoulder region (N=180), one with all-round physical exercise (APE) (N=187), and one which acted as a reference group, which was informed about general health-promoting activities but did not include a physical activity program (N=182). Questionnaires were filled out at baseline and after 1 year of training. RESULTS: The duration and intensity of neck and shoulder symptoms was lower after the specified worksite physical-activity interventions than in the reference group. On an intervention group level, SRT was not more effective than APE in reducing the duration and intensity of neck and shoulder symptoms. However, those asymptomatic at baseline had a significant lower prevalence of neck-shoulder symptoms at follow-up when allocated to the SRT group than placed in the APE group or reference group. At baseline the work ability index (WAI) was close to 90% of the maximum score, and the mean sick leave was 5 days per year, both being unaffected by the interventions. CONCLUSIONS: Different physical-activity interventions were successful in reducing neck-shoulder symptoms, and SRT was superior to APE in the primary prevention of such symptoms. The initially relatively high WAI was the most probable reason for no further increase in WAI. Likewise the mean sick leave the year before the intervention was very low, and it was probably not possible to reduce it further.     

急诊室医护人员心理健康状况及干预效果评价

目的了解综合医院急诊室医护人员的心理健康状况,并探索心理干预的方法和结果,为建立针对性的心理干预措施提供科学依据。方法对辽宁省沈阳市6所综合医院急诊室医护人员进行症状自评量表(SCL-90)测评,筛选出209人测评结果超出全国常模组;将其随机分为2组,干预组108人,对照组101人。对干预组进行心理干预治疗。在干预3,6,12个月时分别进行症状自评量表(SCL-90)的双盲评估。结果急诊室医护人员SCL-90测评结果中躯体化、强迫、人际敏感、焦虑、敌对、恐怖、偏执和精神病性8项因子分均高于全国成人常模(P0.05)。女性较男性症状明显,护士较医生明显。干预组通过综合心理干预治疗,随访期间SCL-90总分值呈逐步下降趋势,结束时达(130.69±39.09),趋于正常水平。对照组随访前后各项数值变化不大,结束时为(134.96±39.31),仍明显高于常人,2组干预后差异有统计学意义(P0.05)。结论急诊室紧张的工作特点和工作环境使医护人员形成较大精神压力,易引发心理问题。有针对性的进行心理干预,可提高医护人员心理健康水平。     

Sample size considerations for studies of intervention efficacy in the occupational setting

OBJECTIVE: Due to a shared environment and similarities among workers within a worksite, the strongest analytical design to evaluate the efficacy of an intervention to reduce occupational health or safety hazards is to randomly assign worksites, not workers, to the intervention and comparison conditions. Statistical methods are well described for estimating the sample size when the unit of assignment is a group but these methods have not been applied in the evaluation of occupational health and safety interventions. We review and apply the statistical methods for group-randomized trials in planning a study to evaluate the effectiveness of technical/behavioral interventions to reduce wood dust levels among small woodworking businesses. METHODS: We conducted a pilot study in five small woodworking businesses to estimate variance components between and within worksites and between and within workers. In each worksite, 8 h time-weighted dust concentrations were obtained for each production employee on between two and five occasions. With these data, we estimated the parameters necessary to calculate the percent change in dust concentrations that we could detect (alpha = 0.05, power = 80%) for a range of worksites per condition, workers per worksite and repeat measurements per worker. RESULTS: The mean wood dust concentration across woodworking businesses was 4.53 mg/m3. The measure of similarity among workers within a woodworking business was large (intraclass correlation = 0.5086). Repeated measurements within a worker were weakly correlated (r = 0.1927) while repeated measurements within a worksite were strongly correlated (r = 0.8925). The dominant factor in the sample size calculation was the number of worksites per condition, with the number of workers per worksite playing a lesser role. We also observed that increasing the number of repeat measurements per person had little benefit given the low within-worker correlation in our data. We found that 30 worksites per condition and 10 workers per worksite would give us 80% power to detect a reduction of approximately 30% in wood dust levels (alpha = 0.05). CONCLUSIONS: Our results demonstrate the application of the group-randomized trials methodology to evaluate interventions to reduce occupational hazards. The methodology is widely applicable and not limited to the context of wood dust reduction.     

Reducing occupational psychological distress: a randomized controlled trial of a mailed intervention

There are increasing levels of psychological distress among general practitioners (GPs). The purpose of this study is to evaluate the effectiveness of a mailed intervention to reduce distress among 'at-risk' GPs. A questionnaire was sent to 1356 GPs from eight Divisions of General Practice. Out of 819 (60%) who responded, 233 GPs were recruited with scores indicative of psychological distress. These GPs were randomized to intervention (n = 120) or control (n = 113). The intervention consisted of a simple letter feeding back and interpreting the psychological score together with a self-help sheet. During the study, an educational program was offered to GPs by Divisions of General Practice. The main outcome measure used was changes in psychological distress (General Health Questionnaire 12) score after 3 months. Significance was set at P < 0.05. Initial analysis of the data showed borderline significance (P = 0.05). However, analysis of the data post hoc excluding GPs who participated in the educational program showed a significant reduction in psychological distress (P = 0.03). It appears that there may have been a dilution of the intervention effect. Mailed interventions are a cost-effective way of reaching at-risk GPs and may contribute to a reduction in psychological morbidity.     

深圳市宝安区计划免疫工作者的SCL-90量表调查及影响因素分析

目的 了解宝安区计划免疫工作者心理健康状况,提出改善措施. 方法 使用SCL-90量表和自制的问卷进行调查,调查结果与全国常模比较. 结果 83名计划免疫工作者的症状总体情况良好,总均分与全国常模基本一致,躯体化、强迫症状较全国常模分值高.不同程度的家庭支持对计划免疫工作者的躯体化症状没有影响（F=1.74,P＞0.05）,但对计划免疫工作者的强迫症状分值有影响（F=4.269,P＜0.05）;对计划免疫工作意义认识度越高,躯体化、强迫症状分值越低;对工作待遇的不同感知者对其躯体化症状分值和强迫症状分值均没有影响（t躯体=0.87,P＞0.05;t强迫=-0.15,PP＞0.05）. 结论 当前宝安区计划免疫人员工作压力较大,应给他们适当减压,同时应大力宣传计划免疫工作的必要性和重要性,提高计划免疫工作者的工作自豪感和荣誉感,鼓励社会、家庭成员支持计划免疫工作.