Objective Occupational stress is considered a worldwide epidemic experienced by a large proportion of the working population. The identification of characteristics that place people at high risk for occupational stress is the basis of managing and intervening in this condition. In this study, we aimed to identify and validate the risk features for occupational stress among medical workers using a risk model and nomogram. Methods This cross-sectional study included 1988 eligible participants from Henan Province in China. Occupational stress and worker-occupation fit were measured with the Depression, Anxiety and Stress Scales (DASS-21) and Worker-Occupation Fit Inventory (WOFI). The identification of risk features was achieved through constructing multiple logistic regression model, and the risk features were used to develop the risk model and nomogram. Receiver operating characteristic (ROC) curves and calibration plots were generated to assess the effectiveness and calibration of the risk model. Results Among 1988 participants in our study, there were 42.5% (845/1988) medical workers experienced occupational stress. The risk features for occupational stress included poor work-occupation fit (WOF score < 25, expected risk: 77.3%), nurse population (expected risk: 63.1%), male sex (expected risk: 67.2%), work experience duration of 11–19 years (expected risk: 54.5%), experience of a traumatic event (expected risk: 65.3%) and the lack of a regular exercise habit (expected risk: 60.2%). For medical workers who have these risk features, the expected risk probability of occupational stress would be 90.2%. Conclusion The current data can be used to identify medical workers at risk of developing occupational stress. Identifying risk features for occupational stress and the work-occupation fit can support hierarchical stress management in hospitals. Supplementary Information The online version contains supplementary material available at 10.1007/s00420-021-01762-3.

ObjectiveOccupational stress is generally acknowledged as a global phenomenon with significant health and economic consequences. The medical worker is a vulnerable group at a high-level risk for depression symptoms. This study aimed to examine the mediating effect of worker-occupation fit (WOF) in relation to occupational stress and depression symptoms among 1988 medical workers in China.MethodsA multi-center cross-sectional study was conducted during June and October 2020 in Henan Province, China. The participants were medical workers from four targeted hospitals (included one general and three specialized hospitals). The Depression, Anxiety, and Stress Scale (DASS-21 Scale), Worker-Occupation Fit Inventory (WOFI), as well as questions about demographic and occupational information were administered in questionnaires distributed to 1988 medical workers. Hierarchical linear regression analysis was used to examine the mediating role of worker occupation fit.ResultsIn this study, there are 43.5% (n = 864) of medical workers experienced depression symptoms. The mean score of WOF was 31.6 ± 7.1, characteristic fit, need supply fit and demand ability fit were 11.3 ± 2.5, 10.1 ± 2.7, 12.9 ± 2.2, respectively. The occupational stress was negatively related to worker occupation fit (r = −0.395, P &lt; 0.001), characteristic fit (r = −0.529, P &lt; 0.001), need supply fit (r = −0.500, P &lt; 0.001), and demand ability fit (r = −0.345, P &lt; 0.001). The occupational stress and depression symptoms have a positive relationship (r = 0.798, P &lt; 0.001). The proportion of worker occupation fit mediation was 6.5% of total effect for depression symptoms.ConclusionOccupational stress has been identified as a risk factor for depression symptoms. Practical strategies for improving medical workers' WOF level would help them better cope with various work-related stressors to reduce depression symptoms. Hospital administrators could reduce medical workers' depression symptoms by taking comprehensive measures to improve the WOF.