The effect of depressive and anxiety symptoms exposures on the correlation between worker occupation fit (WOF) and occupational stress in healthcare workers (HCWs): the models of chain mediation

Low-level worker occupation fit (WOF) is the high-risk feature of occupational stress. In many industries, mental disorders are commonly associated with occupational stress. This study aimed to examine whether depressive and anxiety symptoms play a chain mediating role in the association between WOF and occupational stress. This study is a cross-sectional study and the stratified whole-population sampling was used to implement the survey of 1988 healthcare workers (HCWs) in four target hospitals. The measurement of WOF by the Worker-occupation fit inventory (WOFI) consists of three sub-scales, including characteristic fit (CF), need supply fit (NSF), and demand ability fit (DAF). The anxiety symptoms, depressive symptoms, and occupational stress were measured by the 21-item Depression, Anxiety, and Stress Scale (DASS-21). Descriptive statistics, Pearson correlation analysis, hierarchical regression models, and bootstrap methods were used for data analysis. The prevalence of occupational stress in this study was indicated to be 42.5%. The depressive symptoms (B = 0.361, P < 0.001) and anxiety symptoms (B = 0.606, P < 0.001) had a positive relationship with occupational stress, respectively. The depressive symptoms and anxiety symptoms accounted for 73.7% of the variance in occupational stress (RMSE = 2.83). For the WOF, CF and DAF models, depressive and anxiety symptoms have a suppression effect, as the direct and indirect effects had opposite signs. The main effect pathway was the chain mediated effect of depressive and anxiety symptoms between WOF (including CF, NSF and DAF) and occupational stress, with the proportion of the chain mediated effect were 51.8%, 53.7%, 57.7% and 52.6%, respectively. Based on the prevalence of occupational stress among Chinese HCWs, it is clear that they need to pay more attention to preventing low-level WOF and high-risk occupational stress. The findings indicate that, while improving WOF as an upstream factor remains important, the early identification of depressive and anxiety symptoms is a key strategy for preventing occupational stress in the workplace.