The structural relationship among occupational dysfunction, stress coping, and occupational participation for healthcare workers in Japan

Purpose: The purpose of this study was to analyze the structural relationship among occupational dysfunction, stress coping, and occupational participation in healthcare workers.Method: This cross-sectional study included 601 subjects. Personal characteristics (such as age, gender, job category, opportunities for refreshment, time spent on leisure activities, and work relationships) were obtained. The Classification and Assessment of Occupational Dysfunction (CAOD), Coping Scale (CS), and Self-completed Occupational Performance Index (SOPI) were used for measurements. Descriptive statistics were analyzed, and item analysis, confirmatory factor analysis (CFA), correlation analysis, and path analysis using a structural equation modeling (SEM) were performed. CFA was performed to determine the factor structure for CAOD, CS, and SOPI. Correlation analysis was performed to determine the correlation among the factor scores of CAOD, CS, and SOPI. Path analysis was performed to examine the structural relationship among CS, SOPI, and CAOD. Results: CFA of CAOD, CS, and SOPI indicated a good fit to the predicted models. Correlation analysis of CAOD and SOPI showed a strong negative correlation and a moderate negative correlation. CAOD and emotion-focused coping showed a weak negative correlation. Path analysis suggested that SOPI (self-care, leisure, and productivity) and CS (emotion-focused coping) had a negative structural relationship with occupational dysfunction (RMSEA = 0.053, CFI = 0.958, and TLI = 0.954, χ2 = 1808.032, df = 677, p = 0.000). Conclusion: Occupational participation and stress coping can decrease occupational dysfunction. Occupational therapists can contribute to the reduction of occupational dysfunction in healthcare workers by instigating preventive occupational therapy.