Außerberuflicher Stress und kardiovaskuläre Erkrankungen

Zusammenfassung

Dieser Beitrag resümiert die Bedeutung außerberuflicher Stressoren für kardiovaskuläre Erkrankungen im Hinblick auf die psychosozialen Faktoren „soziale Beziehungen“, „kritische Lebensereignisse“, „Arbeitslosigkeit und finanzielle Belastungen“, „soziale Diskriminierung“, „unbezahlte Pflegetätigkeit“, „Haus- und Familienarbeit“ sowie „Vereinbarkeit von Beruf und Familie“, die auf der Grundlage einer systematischen Literaturrecherche ermittelt wurden. Die Sichtung der Studien ergab eine hohe empirische Evidenz für einen Zusammenhang zwischen unzureichender sozialer Unterstützung und kardiovaskulären Erkrankungen, während die empirische Beweislage insbesondere für soziale Diskriminierungserfahrungen, unbezahlte Pflege- bzw. Haus- und Familienarbeit sowie die Vereinbarkeit von Beruf und Familie geringer ausfällt. Die vorliegenden Ergebnisse verweisen jedoch grundsätzlich auf die Bedeutung dieser Stressoren für die Entstehung von kardiovaskulären Risikofaktoren sowie die Inzidenz und Prognose von kardiovaskulären Erkrankungen. Weiterführende Studien sind angezeigt, um die Evidenzlage zu fundieren und weiterführende Aussagen über genderspezifische Einflüsse und besonders belastete Personengruppen treffen zu können.

Abstract

This contribution summarizes the significance of stressors beyond paid work for cardiovascular diseases considering the psychosocial factors “social relationships”, “critical life events”, “unemployment and financial worries”, “social discrimination”, “informal caregiving”, “unpaid household and family work” and “reconciling work and family life” which were established by means of systematic literature research. The review reveals a strong and consistent empirical evidence of an association between lack of social support and cardiovascular diseases, while evidence is less conclusive in particular for the relevance of social discrimination, caregiving, domestic work and reconciling work and family life. Overall, the available studies indicate the importance of psychosocial stressors beyond work for the onset and prognosis of cardiovascular diseases. Further studies are warranted in order to increase evidence on these stressors and to get a more precise picture of gender-specific effects and groups at high stress levels.

Was ist wichtig?

• Außerberufliche Stressoren beeinflussen die Inzidenz und den Verlauf von kardiovaskulären Erkrankungen, jedoch variiert die empirische Evidenz deutlich zwischen den untersuchten lebensweltlichen Stressoren. Eine hohe theoretische, aber geringe empirische Evidenz liegt vor allem für soziale Diskriminierungserfahrungen vor.

• Es liegen Hinweise vor, dass auch die unbezahlte Pflege- bzw. Haus- und Familienarbeit sowie Vereinbarkeitsprobleme zwischen beruflichen und familiären Verpflichtungen bedeutsame psychosoziale Stressoren darstellen, die im jungen und mittleren Lebensalter zur Entwicklung von Risikofaktoren für die Entstehung von Herzerkrankungen beitragen können. Präventive Bemühungen sollten diese Stressoren stärker berücksichtigen.

• Vor dem Hintergrund, dass berufliche und außerberufliche Belastungen häufig kombiniert auftreten und diese Kumulation psychosozialer Stressoren das Risiko für kardiovaskuläre Erkrankungen erhöht, kommt der ganzheitlichen Sicht auf die Lebenswelt des Patienten im Rahmen der Sozialanamnese besondere Bedeutung zu.

Schlüsselwörter

kardiovaskuläre Erkrankungen - unbezahlte Pflegetätigkeit - Haus- und Familienarbeit - Vereinbarkeit von Beruf und Familie

Key words

cardiovascular diseases - caregiving - household and family work - work-family conflict

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