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Psychosoziale Belastungen und Erkrankungsrisiken im Erwerbsleben

Befunde aus internationalen Studien zum Anforderungs-Kontroll-Modell und zum Modell beruflicher Gratifikationskrisen

Psychosocial stress and disease risks in occupational life. Results of international studies on the demand-control and the effort-reward imbalance models

Zusammenfassung

Mit den Veränderungen moderner Erwerbsarbeit sind psychosoziale Arbeitsbelastungen in den Vordergrund gerückt. Ihr Einfluss auf stressassoziierte Erkrankungsrisiken wird mittels standardisierter Messverfahren anhand zweier theoretischer Modelle ermittelt. Im Zentrum aktueller Forschung stehen das Anforderungs-Kontroll-Modell und das Modell beruflicher Gratifikationskrisen. Ersteres bezieht sich auf eine spezifische Kombination Stress auslösender Tätigkeitsmerkmale, Letzteres auf das Missverhältnis zwischen erbrachter Arbeitsleistung und im Gegenzug gewährter Belohnungen. In mehreren prospektiven epidemiologischen Studien wurden beide Modelle auf ihre Vorhersagekraft in Bezug auf die Inzidenz koronarer bzw. kardiovaskulärer Krankheiten sowie depressiver Störungen getestet. Zusammenfassend lässt sich feststellen, dass mit diesen Arbeitsstressformen eine Risikoverdoppelung für die Ausprägung der untersuchten Erkrankungen einhergeht. Effekte auf kardiovaskuläre Krankheiten sind besonders ausgeprägt bei Männern, während bezüglich depressiver Störungen keine Geschlechtsunterschiede beobachtet werden. Zusätzliche Evidenz zu stressphysiologischen Mechanismen liegt aus experimentellen Untersuchungen und aus Studien vor, die ambulante Registrierverfahren einsetzen. Die vorliegende wissenschaftliche Evidenz in Bezug auf stressassoziierte Erkrankungsrisiken rechtfertigt eine verstärkte Beachtung und Erfassung dieser neu identifizierten Risikobedingungen im Erwerbsleben, insbesondere im Rahmen der betriebsärztlichen Tätigkeit. Darauf aufbauend, sollten Maßnahmen theoriebasierter Stressprävention als Bestandteil betrieblicher Gesundheitsförderung sowohl auf struktureller als auch auf interpersoneller Ebene entwickelt und – unter Berücksichtigung geschlechtsspezifischer Aspekte – umgesetzt werden.

Abstract

Given the far-reaching changes of modern working life, psychosocial stress at work has received increased attention. Its influence on stress-related disease risks is analysed with the help of standardised measurements based on theoretical models. Two such models have gained special prominence in recent years, the demand-control model and the effort-reward imbalance model. The former model places its emphasis on a distinct combination of job characteristics, whereas the latter model's focus is on the imbalance between efforts spent and rewards received in turn. The predictive power of these models with respect to coronary or cardiovascular disease and depression was tested in a number of prospective epidemiological investigations. In summary, twofold elevated disease risks are observed. Effects on cardiovascular disease are particularly pronounced among men, whereas no gender differences are observed for depression. Additional evidence derived from experimental and ambulatory monitoring studies supplements this body of findings. Current scientific evidence justifies an increased awareness and assessment of these newly discovered occupational risks, in particular by occupational health professionals. Moreover, structural and interpersonal measures of stress prevention and health promotion at work are warranted, with special emphasis on gender differences.

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Siegrist, J., Dragano, N. Psychosoziale Belastungen und Erkrankungsrisiken im Erwerbsleben. Bundesgesundheitsbl. 51, 305–312 (2008). https://doi.org/10.1007/s00103-008-0461-5

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  • DOI: https://doi.org/10.1007/s00103-008-0461-5

Schlüsselwörter

  • Psychosozialer Stress
  • Anforderungs-Kontroll-Modell
  • Modell beruflicher Gratifikationskrisen
  • Stress assoziierte Erkrankungen

Keywords

  • psychosocial stress
  • demand-control model
  • effort-reward imbalance model
  • stress-related diseases