ABSTRACT
<p><b>OBJECTIVE</b>To explore the association between the effort-reward imbalance at work and depressive symptoms among healthcare workers.</p><p><b>METHODS</b>The effort-reward imbalance at work was conceptualized in terms of the Chinese version of the effort-reward imbalance (ERI) model. Depressive symptoms were assessed by the Chinese version of the Center of Epidemiology Survey Depression (CES-D) scale. The data came from the cross-sectional survey of 1 179 healthcare workers aged between 18 and 73 employed in 6 affiliated hospitals of Zhejiang University. The questionnaire comprised questions on the effort-reward at work, over-commitment, the full CES-D scale of depression and a range of other characteristics. Univariate analyses were used with Spearman's correlation, Mann-Whitney test, Pearson chi(2) test and likelihood chi(2) test. Multivariate logistic regression analyses was used to discover factors associated with depressive symptoms.</p><p><b>RESULTS</b>The prevalence of depressive symptoms among healthcare workers was 48.12% (95% CI: 45.08% to 51.16%). The prevalence of depressive symptoms among nurses was 52.40% (95% CI: 47.87% to 56.93%) higher than doctors' 44.70% (95% CI: 10.64% to 48.77%) with the significant difference (chi(2) = 6.077, P = 0.014). Positive associations were found between the high effort-low reward, level of work-related over commitment and depressive symptoms (OR = 1.859, 95% CI: 1.337 to 2.585; OR = 2.207, 95% CI: 1.656 to 2.942) among healthcare workers, respectively.</p><p><b>CONCLUSION</b>The high effort-low reward and the work-related over-commitment have a negative impact on healthcare workers' health.</p>