【作者】 张文静；

【导师】 张秀敏； 王丹；

【作者基本信息】 吉林大学 ， 公共卫生硕士（专业学位）， 2025， 硕士

【摘要】 目的:本研究旨在了解和掌握长春市职业人群心理健康状况(焦虑症状、抑郁症状)的检出情况,探索长春市职业人群焦虑症状、抑郁症状的影响因素,并进一步使用随机森林模型对焦虑症状、抑郁症状的影响因素进行重要性排序。此外,在文献综述和理论框架的基础上,深入探讨职业紧张对焦虑症状、抑郁症状的影响以及职业健康素养在职业紧张与焦虑症状、抑郁症状之间的调节作用,以期为制定全方面改善职业人群心理健康状况的措施提供参考依据。方法:本研究数据来自中国疾病预防控制中心“2023年全国重点人群职业健康素养监测与干预项目”中的长春市重点人群职业健康素养监测数据,最终选取6059人作为研究对象。通过软件IBM SPSS 24.0、R 4.1.2进行数据处理和统计分析。采用频数、构成比对长春市职业人群的基本情况进行描述性分析;采用卡方检验比较职业人群焦虑症状、抑郁症状检出率在不同组别之间的差异;采用二元Logistic回归分析焦虑症状、抑郁症状的影响因素;使用随机森林模型探讨影响因素对焦虑症状、抑郁症状的相对贡献度大小;使用SPSS-PROCESS宏程序分析职业健康素养在职业紧张与焦虑症状、抑郁症状关系中的调节作用。结果:(1)研究对象中焦虑症状检出率为11.40%,抑郁症状检出率为27.00%,职业紧张检出率为28.19%,职业健康素养具备率为45.19%。(2)多因素回归分析结果显示年龄、受教育程度、平均月收入、自评身体健康状况、夜班、职业紧张、职业健康素养是影响职业人群焦虑症状检出率的因素(P<0.05);年龄、婚姻状况、受教育程度、自评身体健康状况、在岗年限、夜班、职业紧张、职业健康素养是影响职业人群抑郁症状检出率的因素(P<0.05)。(3)随机森林模型结果显示影响职业人群焦虑症状的因素重要程度排序依次为职业紧张、自评身体健康状况、受教育程度、平均月收入、年龄、职业健康素养、夜班;影响职业人群抑郁症状的因素重要程度排序依次为自评身体健康状况、职业紧张、受教育程度、年龄、在岗年限、夜班、职业健康素养、婚姻状况。(4)调节效应分析结果显示职业紧张正向显著影响焦虑症状(β=0.326,P<0.001),职业健康素养负向显著影响焦虑症状(β=-0.099,P<0.001),职业紧张与职业健康素养的交互项对焦虑症状的负向影响作用显著(β=-0.044,P<0.001);职业紧张正向显著影响抑郁症状(β=0.392,P<0.001),职业健康素养负向显著影响抑郁症状(β=-0.063,P<0.001),职业紧张与职业健康素养的交互项对抑郁症状的负向影响作用显著(β=-0.048,P<0.001)。结论:(1)长春市职业人群的心理健康状况不容乐观,职业紧张检出率较高,职业健康素养水平有待进一步提升。(2)年龄、受教育程度、平均月收入、自评身体健康状况、职业健康素养、夜班、职业紧张是研究对象焦虑症状的独立影响因素;年龄、婚姻状况、受教育程度、自评身体健康状况、在岗年限、夜班、职业紧张、职业健康素养是研究对象抑郁症状的独立影响因素。(3)职业紧张、自评身体健康状况、受教育程度、年龄、职业健康素养、夜班对研究对象焦虑症状、抑郁症状的影响程度均较大。(4)职业紧张对焦虑症状、抑郁症状均存在显著正向影响作用,职业健康素养在职业紧张对焦虑症状、抑郁症状的影响路径中均起调节作用,高水平职业健康素养能有效缓解职业紧张对职业人群焦虑症状、抑郁症状的影响。更多还原

【Abstract】 Objective: This study aimed to understand and grasp the detection of mental health conditions(anxiety symptoms and depressive symptoms)in key occupational populations in Changchun City,to explore the influencing factors of anxiety symptoms and depressive symptoms in occupational populations in Changchun City,and to further rank the importance of the influencing factors of anxiety symptoms and depressive symptoms using the random forest model.In addition,on the basis of the literature review and theoretical framework,the impact of occupational stress on anxiety symptoms and depressive symptoms as well as the moderating role of occupational health literacy in the relationship between occupational stress and anxiety symptoms and depressive symptoms are explored in depth,with a view to providing a reference basis for the development of measures to improve the mental health status of occupational populations in an all-round way.Methods: The data of this study came from the occupational health literacy surveillance data of Changchun City in the "2023 National Occupational Health Literacy Surveillance and Intervention Program for Key Populations" of the Chinese Center for Disease Control and Prevention(CDC),and 6,059 people were finally selected as the study subjects.The data were processed and statistically analyzed by IBM SPSS 24.0 and R 4.1.2.Frequency counts and composition ratios were used to descriptively analyze the basic conditions of key occupational populations in Changchun City;the chi-square test was used to compare the differences in the detection rates of anxiety symptoms and depressive symptoms among occupational populations in different groups;binary logistic regression was used to analyze the influencing factors of anxiety symptoms and depressive symptoms;and the Random Forest Model was used to explore the magnitude of the relative contribution of the influencing factors to the anxiety symptoms and depressive symptoms;The moderating role of occupational health literacy in the relationship between occupational stress and anxiety symptoms and depressive symptoms was analyzed using the SPSS-PROCESS macro program.Results:(1)The detection rate of anxiety symptoms in the study population was 11.40%,depression symptoms was 27.00%,occupational stress was 28.19% and occupational health literacy was 45.19%.(2)The results of multiple regression analysis showed that age,education,average monthly income,self-assessed physical health,night shifts,occupational stress,and occupational health literacy were the factors affecting the detection rate of anxiety symptoms in the occupational population(P<0.05);and that age,marital status,education,self-assessed physical health,years on the job,night shifts,occupational stress,and occupational health literacy were the factors affecting the detection rate of depressive symptoms in the occupational population factors(P<0.05).(3)The results of the random forest model showed that the order of importance of the factors affecting the anxiety symptoms of the occupational population was occupational stress,self-assessed physical health,education,average monthly income,age,occupational health literacy,and night shifts in descending order;and the order of importance of the factors affecting the depressive symptoms of the occupational population was self-assessed physical health,occupational stress,education,age,years on the job,night shifts,occupational health literacy,and marital status.(4)Moderated effects analysis showed that occupational stress positively and significantly affected anxiety symptoms(β=0.326,P<0.001),occupational health literacy negatively and significantly affected anxiety symptoms(β=-0.099,P<0.001),and the interaction term between occupational stress and occupational health literacy had a significant negative effect on anxiety symptoms(β=-0.044,P<0.001);occupational stress positively and significantly affected depressive symptoms(β=0.392,P<0.001),occupational health literacy negatively and significantly affected depressive symptoms(β=-0.063,P<0.001),and the interaction term between occupational tension and occupational health literacy had a significant role in negatively affecting depressive symptoms(β=-0.048,P<0.001)..Conclusions:(1)The mental health of key occupational populations in Changchun was not optimistic,the detection rate of occupational stress was high,and the level of occupational health literacy needed to be further improved.(2)Age,education,average monthly income,self-assessed physical health,occupational health literacy,night shifts,and occupational stress were independent influences on anxiety symptoms of the study subjects;age,marital status,education,self-assessed physical health,years on the job,night shifts,occupational stress,and occupational health literacy were independent influences on depressive symptoms of the study subjects.(3)Occupational stress,self-assessed physical health,education,age,occupational health literacy,and night shifts had a greater influence on anxiety symptoms and depressive symptoms in the study participants.(4)Occupational stress had a significant positive effect on anxiety symptoms and depression symptoms,occupational health literacy played a moderating role in the path of occupational stress on anxiety symptoms and depression symptoms,and a high level of occupational health literacy could effectively alleviate the effect of occupational stress on anxiety symptoms and depression symptoms of occupational populations.更多还原