[The influence of effort-reward imbalance and sleep quality on depressive symptoms in train drivers].

Objective: To investigate the current situation of depressive symptoms, effort-reward imbalance (ERI), and sleep quality among train drivers, explore the interaction mechanism between various factors and depressive symptoms, and provide a certain theoretical basis for reducing the level of depressive symptoms among train drivers. Methods: From January to December 2022, train drivers were selected as the research subjects from the locomotive depot of a certain railway bureau through cluster sampling, with a total of 1392 people. A questionnaire survey was conducted to assess the basic situation, ERI, sleep quality and depressive symptoms of train drivers. Multiple stepwise regression was used to analyze the effects of each dimension of ERI and sleep quality on depressive symptoms, and binary logistic regression was used to analyze the effects of ERI and sleep quality on depressive symptoms. Results: Among 1392 train drivers, 897 (64.4%) were classified as having depressive symptoms. The results of multiple stepwise regression analysis showed that the dimensions of external effort, reward and overcommitment of ERI explained 10.3% of the variation in depressive symptoms (P<0.01). Sleep quality explained 9.9% of the variation in depressive symptoms (P< 0.01). The results of binary logistic regression analysis showed that after adjusting for confounding variables such as age, length of service, and educational level, high external effort (OR=2.22, 95%CI: 1.76-2.79) and high overcommitment (OR=1.90, 95%CI: 1.50-2.39) and poor sleep quality (OR=5.82, 95%CI: 4.52-7.49) increased the risk of depressive symptoms for train drivers (P<0.01), while reward was a protective factor for depressive symptoms (OR=0.44, 95%CI: 0.35-0.55, P<0.01). In the ERI model, high effort and low reward was the greatest risk factor for depressive symptoms (OR=4.77, 95%CI: 3.41-6.69, P<0.01). In the interaction between ERI and sleep quality, high ERI and poor sleep quality had the greatest negative impact on depressive symptoms (OR=15.90, 95% CI: 7.27-34.76, P<0.01) . Conclusion: The influence of ERI on depressive symptoms of train drivers has both direct and indirect effects, and sleep quality plays a partial mediating role in the influence of ERI on depressive symptoms.