煤矿工人职业倦怠评价方案建立及易感性研究

With the development of modern society,accelerated pace of modern life and work competition,job burnout has become an important occupational health problem which has negative effects on the life quality and work efficiency. According to some studies,job burnout has been the most serious psychological problems among the coal miners.Job burnout is mainly measured by questionnaires.However， it is lack of physiological and biochemical indicators of objective measurement of burnout.Job Demands-Resources model(JD-R)has been the mainstream model in explaining job burnout.However,it ignores the individual resources and family environment in the research.So it is lack of an effective assessment system for job burnout.The individual variations of burnout were not completely explained with only an environmental factor in mechanisms of burnout.Genetic variation may play a very important role in individual differences of burnout,but not completely explained the reason of the mechanism of individual difference.The study is eager to improve and optimize the assessment system for influencing factors,mediators and reactions of job burnout by objective and subjective indicators.Meanwhile,it wants to interpret the network regulation mechanisms and establish optimization scheme.With using candidate gene strategy of behavioral genetics combining case-control　and case-only study,the study wants to detect genetic susceptibility and specific physiological and biochemical indicators.On the basis of genetic markers combining candidate gene strategy and structural equation modeling,the study aims to investigate main effects and interactions of gene-environment,gene-gene and environment-environment.The aim of the study is to reveal individual differences of burnout and screen susceptible populations.Meanwhile,it will provide scientific foundation for establishment evaluation criteria,individual assessment,relative intervention policies and measures of job burnout for coal miners.

职业倦怠己经成为影响工作生活质量和工作效率的重要的职业卫生问题。职业倦怠是煤矿工人中最严重的心理问题之一。由于目前研究主要依靠量表测量、缺乏客观测量的评价指标、主流理论JD-R模型不完善、忽视个体资源和家庭环境等因素，因此对于职业倦怠如何进行系统评价尚缺乏有效的方案。大量研究发现环境因素并不能完全解释职业倦怠发生的个体差异，遗传因素对于解释职业倦怠反应的个体差异具有重要的意义。本研究利用客观和主观指标相结合的方法拟建立和优化职业倦怠因素、调节因素、职业倦怠反应的评价方法，并借助数学模型勾勒职业倦怠网络调节机制，预期建立职业倦怠评价的优化方案。同时结合病例对照研究、单纯病例研究探讨倦怠反应的个体易感性。利用候选基因策略和结构方程模型探讨倦怠反应的基因、环境主效应及交互作用，拟为进一步建立职业倦怠评价标准、进行个体化评估、揭示职业倦怠发生的个体差异、筛选易感人群，制定相关干预措施提供科学依据。

职业倦怠是煤矿工人中最严重的心理问题之一。目前研究缺乏客观测量的评价指标、主流理论JD-R模型不完善、忽视个体资源和家庭环境等因素，因此对于职业倦怠如何进行系统评价尚缺乏有效的方案。研究发现环境因素并不能完全解释职业倦怠发生个体差异，遗传因素对解释职业倦怠反应的个体差异具有重要的意义。. 本研究将工作特征、家庭环境等因素共同引入对JD-R模型进行拓展和完善，优化了职业倦怠因素评价。情绪智力、自尊、乐观主义对情感耗竭、人格解体、成就感降低和职业倦怠均做出了有效预测。职业倦怠反应评价指标主要由心理倦怠反应（抑郁、幸福感）、生理倦怠反应（皮质醇、血糖、血脂）和职业性肌肉骨骼损伤指标组成。通过结构方程模型，优化了职业倦怠评价方案。GCCR基因rs41423247位点的GG基因型、rs17209237位点的AA基因型、rs258747位点的GA基因型可能为职业倦怠的易感基因型。CA和GG单体型为职业倦怠的保护因素单体型，GA为职业倦怠危险因素单体型。MR基因rs2070950位点CC基因型，特别是C型等位基因可能是易感基因型。其中CG、TG为保护因素单倍型，TC为危险因素单倍型。SLC6A4基因rs11080122位点的CT基因型和CC基因型可能是易感基因型，TT单体型为保护因素单体型，TC为危险因素单体型。BDNF基因rs12273539位点的CT基因型发生职业倦怠的风险是CC基因型的1.654倍，可能是易感基因型，T-C-G为危险因素单倍型。未发现基因-基因交互作用对职业倦怠的影响。rs41423247、rs11080122位点、职业紧张、工作家庭冲突会使煤矿工人发生职业倦怠的风险增加；位点rs41423247、rs17209237与职业紧张的交互作用会使职业倦怠的患病风险增加。rs5522位点、rs2070950位点、职业紧张、积极应对与消极应对之间的交互作用可影响职业倦怠水平。

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