[논문]Effort-reward Imbalance at Work, Parental Support, and Suicidal Ideation in Adolescents: A Cross-sectional Study from Chinese Dual-earner Families

Li, Jian; Loerbroks, Adrian; Siegrist, Johannes

doi:10.1016/j.shaw.2016.09.003

Effort-reward Imbalance at Work, Parental Support, and Suicidal Ideation in Adolescents: A Cross-sectional Study from Chinese Dual-earner Families 원문보기

Safety and health at work : SH@W, v.8 no.1, 2017년, pp.77 - 83

Li, Jian (Institute of Occupational, Social and Environmental Medicine, Center for Health and Society, Faculty of Medicine, University of Dusseldorf) , Loerbroks, Adrian (Institute of Occupational, Social and Environmental Medicine, Center for Health and Society, Faculty of Medicine, University of Dusseldorf) , Siegrist, Johannes (Life-Science Center, University of Dusseldorf)

Abstract ▼ AI-Helper

Background: In contemporary China, most parents are dual-earner couples and there is only one child in the family. We aimed to examine the associations of parents' work stress with suicidal ideation among the corresponding adolescent. We further hypothesized that low parental support experienced by adolescents may mediate the associations. Methods: Cross-sectional data from school students and their working parents were used, with 907 families from Kunming City, China. Stress at work was measured by the effort-reward imbalance questionnaire. Perceived parental support was assessed by an item on parental empathy and their willingness to communicate with the adolescent. Suicidal ideation was considered positive if students reported thoughts about suicide every month or more frequently during the previous 6 months. Logistic regression was used to examine the associations. Results: We observed that parents' work stress was positively associated with low parental support, which was in turn associated with adolescent suicidal ideation. The odds ratio for parents' work stress and adolescent suicidal ideation was 2.91 (95% confidence interval: 1.53-5.53), and this association was markedly attenuated to 2.24 (95% confidence interval: 1.15-4.36) after additional adjustment for parental support. Notably, mothers' work stress levels exerted stronger effects on children's suicidal ideation than those of fathers. Conclusion: Parents' work stress (particularly mother's work stress) was strongly associated with adolescent's suicidal ideation, and the association was partially mediated by low parental support. These results need to be replicated and extended in prospective investigations within and beyond China, in order to explore potential causal pathways as a basis of preventive action.

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가설 설정

Model of the mediating role of low parental support on the association between parents’ effort-reward imbalance at work and adolescent’s suicidal ideation.

제안 방법

According to a predefined algorithm, a ratio between the two scales “effort” and “reward” (weighted by item numbers) was calculated in order to quantify the degree of mismatch between high “cost” and low “gain” at individual level.
In this study, we set out to analyze the associations of fathers’ and mothers’ stress at work, as measured by the effort-reward imbalance model, with adolescents’ suicidal ideations, and to explore a potential mediating role of low parental social support.
Step 1: we examined the association of parents’ ERI at work with parental support, as perceived by the corresponding adolescent; Step 2: we assessed whether parental support was linked to their adolescents’ suicidal ideation; Step 3: we investigated whether parents’ ERI at work was related to the prevalence of suicidal ideation; and Step 4: whether this association was attenuated after adjustment for parental support. The results are displayed as odd ratios (ORs) and 95% confidence intervals (CIs), four logistic regression models were calculated for crude analysis, and another four multivariate logistic regression models were applied for adjustment for relevant covariates (see above paragraph).
Thirdly, as this study collected data exclusively from dual-earner parents we were in a unique position to compare fathers’ and mothers’ work stress with regard to perceived parental support and adolescent’s suicidal ideation.
This current contribution, for the first time, analyzed the data of parental questionnaires linking to children’s suicidal ideation, with a two-generation familial approach.

대상 데이터

We randomly selected one class from every grade in every school to participate in our study, resulting in a total of 21 classes included. A total of 1,249 students together with their parents from 21 classes were invited to participate. With support from the local education authority, a trained researcher from the University majoring in public health visited the classes to explain the study and distribute questionnaires (see below) to the students.
All participants (fathers, mothers, and adolescents) gave individual written informed consent prior to their inclusion in the study, and both parents gave permission for their child’s participation. The current report is based on a sample of 907 families without missing values. We have no indication that this sample was biased in terms of selection criteria, i.
Three of the four schools taught students in Grades 7 through 12, and one school had students in Grades 10 through 12 only. We randomly selected one class from every grade in every school to participate in our study, resulting in a total of 21 classes included. A total of 1,249 students together with their parents from 21 classes were invited to participate.

이론/모형

In order to examine the associations between fathers’ and mothers’ ERI at work and children’s suicidal ideation mediated by parental support, the four-step mediation analysis was applied according to the recommendations by Baron and Kenny [53], using the entire sample.
, parents’ work stress in our study) [54]. We confirmed the model fit with the Hosmer-Leme-how goodness-of-fit test. In all cases, appropriate model fits of the data were indicated (p > 0.

성능/효과

In conclusion, this study provides new knowledge on a topic of considerable public health interest, the associations of parents’ work stress, parental social support, and adolescent’s suicidal ideation, specifically in the context of dual-earner couples and a one-child family policy, as realized in China.
The lower bounds of the 95% CIs for the indirect effects exceeded zero [fathers’ high work stress only: indirect effect = 15.53% (95% CI = 4.92%, 30.36%); mothers’ high work stress only: 23.38% (7.97%, 42.91%); both parents’ high work stress: 27.82% (10.36%, 46.87%)], indicating significantly partial mediation.

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