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Trajetórias do bem-estar: efeitos temporais dos determinantes psicossociais da saúde em contexto laboral
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Authors
Abstract(s)
Introdução: Um ambiente psicossocial adverso no trabalho está associado a alterações da saúde
relacionadas com o stresse, indicando vários inquéritos europeus que cerca de 25%
dos trabalhadores vivenciam situações de stresse e que metade estão expostos a algum
tipo de exigências excessivas.
Para efeitos do estudo, foi desenvolvido com base na revisão da literatura científica,
um modelo simplificado do ambiente psicossocial do trabalho, segundo três
dimensões: (1) condições de trabalho, onde foram incluídos os fatores previstos no
modelo Job Demands Control (Support) de Karasek/Jonhson, (2) a interface trabalhofamilia,
que incluiu os fatores decorrentes do Conflito Trabalho-Família e (3)
características pessoais como o Sentido da Coerência, de Antonovsky e os Traços de
Personalidade de Costa e McCrae.
Este estudo pretende contribuir para o conhecimento relativo à forma como se
comportam ao longo do tempo os determinantes psicossociais relacionados com o
trabalho, considerados em separado e em conjunto, como se influenciam mutuamente
e de que modo se conjugam na produção de efeitos negativos ou positivos na trajetória
do Bem-Estar dos trabalhadores, tendo em conta efeitos populacionais e individuais.
Método: Realizou-se um estudo longitudinal com medições repetidas em 3 momentos de
observação espaçados de aproximadamente 6 meses, com recolha de dados através de
questionário de aplicação CAWI (Computer Assisted Web Interview) a 5344
trabalhadores de uma empresa tecnológica.
Estudaram-se os efeitos sobre o Bem-Estar ao longo do tempo exercidos pelas
Condições de Trabalho (Exigências, Controlo, Suporte da Chefia e Suporte dos Colegas),
Conflito Trabalho-Família (Conflito baseado no Strain e Conflito baseado no Tempo),
Traços de Personalidade e Sentido da Coerência, recorrendo a equações de estimação
generalizadas (Generalized Estimating Equations – GEE) e modelos de curvas de
crescimento latente (Latent Growth Curve Models – LGCM), utilizando uma abordagem
de modelos de equações estruturais. Resultados
O Bem-Estar aumentou significativamente ao longo do tempo, tanto no estudo por GEE
como por LGCM, permitindo este último distinguir que o aumento ocorreu ao nível do
grupo (empresa), mas não ao nível do indivíduo. Este aumento não foi influenciado
pelo Género ou pelos Traços de Personalidade. Os participantes mais velhos tinham
maior probabilidade de apresentar perda de Bem-Estar.
Os Traços de Personalidade e o Conflito baseado no Strain revelaram inconsistências
diversas pelo que não foram retidos para a fase final do estudo. Ao longo do tempo, as
Exigências e o Conflito Baseado no Tempo diminuíram, o Sentido da Coerência e o
Suporte dos Colegas aumentaram, e o Controlo e o Suporte da Chefia mantiveram-se
estáveis.
O aumento do Bem-Estar ao longo do tempo foi influenciado pela diminuição da
influência temporal específica das Exigências e do Controlo, respetivamente, e pelo
aumento da influência do Suporte da Chefia, não se registando qualquer influência do
Suporte dos Colegas.
O Conflito Baseado no Tempo diminuiu, influenciando positivamente a trajetória do
Bem-Estar. Esta sofreu a maior influência temporal específica positiva por parte do
Sentido da Coerência quando comparado com os restantes fatores, embora este efeito
tenha diminuído ao longo do tempo.
Conclusões: Os resultados obtidos por GEE e por LGCM são consistentes. A GEE é uma técnica de
mais fácil execução uma vez acautelada a possibilidade de existência de uma falácia
ecológica e a LGCM permite uma análise mais detalhada com distinção entre efeitos de
grupo e efeitos individuais.
Os resultados sugerem que os fatores do ambiente de trabalho exercem uma
intervenção diferenciada independentemente das suas trajetórias, numa dinâmica
compatível com um mecanismo sistémico do tipo homeostático e adaptativo, com
capacidade de ativar recursos adequados à manutenção do melhor estado de Bem-Estar.
Introduction: An adverse psychosocial environment at work is associated with stress-related health problems. Several European surveys indicate that about 25% of working individuals experience stress situations and that half are exposed to some kind of excessive demands. For research purposes we developed a simplified model of psychosocial work environment based on the literature review, according to three dimensions: (1) working conditions, which included the factors of the Job Demands Control (Support) Karasek / Jonhson model, (2) the work-family interface, which included the factors of Work-Family Conflict model and (3) personal characteristics such as Antonovsky’s Sense of Coherence and Personality Traits from Costa and McCrae. This study aims to contribute to the knowledge on how work-related psychosocial determinants behave over time, when considered separately and together, how they mutually influence each other and how they combine to produce negative or positive effects on workers well-being trajectory, taking into account population and individual effects. Methods: We conducted a three-wave longitudinal survey with repeated measurements, with data collection approximately each 6 months through CAWI (Computer Assisted Web Interview) to 5344 workers of a technology company. Working Conditions (Job Demands, Job Control, Supervisor Support and Co-worker Support), Work-Family Conflict (Conflict based on Strain and Conflict based on Time), Personality Traits and Sense of Coherence effects on Well-Being over time were studied using generalized estimating equations (GEE) models and latent growth curves models (LGCM) with structural equations modelling approach. Results: Both GEE and LGCM approaches shown that Well-being significantly increased over time, but the last one allowed the further understanding that this growth occurred at the group level (company) and not at the individual level. This increase on Well-being was not influenced by Gender or by Personality Traits. Older participants were more likely to report a loss of Well-being. Personality Traits and Conflict based on Strain revealed several inconsistencies and therefore have not been retained for the final phase of the study. Job Demands and Conflict Based on Time decreased over time, Sense of Coherence and Co-Workers Support increased, and Job Control and Supervisor Support remained stable. The increase in Well-Being trajectory was influenced by the decrease in the time-specific effect of Job Demands and Job Control, respectively, and by the increase of the time-specific effect of the Supervisor Support. The Co-Worker Support time-specific effect on Well-Being trajectory is not statistically significant. Conflict based on Time declined over time, but its time-specific effect positively influenced Well-Being trajectory. The Sense of Coherence has the strongest positive time-specific effect on Well-Being trajectory when compared with other factors, but this effect diminished over time. Conclusions: GEE and LGCM results are consistent, but GEE is easier to perform taking care about ecological fallacy and LGCM gives more detailed results allowing the distinction between individual and group effects over time. The results suggest that working environment factors have a differentiated intervention regardless of their isolated trajectories in a dynamic compatible with a systemic mechanism of homeostatic and adaptive type, with the ability to activate resources necessary to maintain the highest possible Well-Being level. Knowledge of this adaptive dynamics is a critical issue to the adoption of company’s policy favorable to employees Well-Being and individual resources improvement. The results also highlight the importance of supervisor’s role in stress management, and the critical influence they can have in facilitating non-working life and strengthening the Sense of Coherence. Consequently, this knowledge will allow the adoption of corporate policies and occupational health measures focused on organizational aspects and the adoption of programs with accompanying components individualized to develop through the health and safety services, the effects of which have the potential to extend beyond the company, thereby helping to reduce inequalities in health.
Introduction: An adverse psychosocial environment at work is associated with stress-related health problems. Several European surveys indicate that about 25% of working individuals experience stress situations and that half are exposed to some kind of excessive demands. For research purposes we developed a simplified model of psychosocial work environment based on the literature review, according to three dimensions: (1) working conditions, which included the factors of the Job Demands Control (Support) Karasek / Jonhson model, (2) the work-family interface, which included the factors of Work-Family Conflict model and (3) personal characteristics such as Antonovsky’s Sense of Coherence and Personality Traits from Costa and McCrae. This study aims to contribute to the knowledge on how work-related psychosocial determinants behave over time, when considered separately and together, how they mutually influence each other and how they combine to produce negative or positive effects on workers well-being trajectory, taking into account population and individual effects. Methods: We conducted a three-wave longitudinal survey with repeated measurements, with data collection approximately each 6 months through CAWI (Computer Assisted Web Interview) to 5344 workers of a technology company. Working Conditions (Job Demands, Job Control, Supervisor Support and Co-worker Support), Work-Family Conflict (Conflict based on Strain and Conflict based on Time), Personality Traits and Sense of Coherence effects on Well-Being over time were studied using generalized estimating equations (GEE) models and latent growth curves models (LGCM) with structural equations modelling approach. Results: Both GEE and LGCM approaches shown that Well-being significantly increased over time, but the last one allowed the further understanding that this growth occurred at the group level (company) and not at the individual level. This increase on Well-being was not influenced by Gender or by Personality Traits. Older participants were more likely to report a loss of Well-being. Personality Traits and Conflict based on Strain revealed several inconsistencies and therefore have not been retained for the final phase of the study. Job Demands and Conflict Based on Time decreased over time, Sense of Coherence and Co-Workers Support increased, and Job Control and Supervisor Support remained stable. The increase in Well-Being trajectory was influenced by the decrease in the time-specific effect of Job Demands and Job Control, respectively, and by the increase of the time-specific effect of the Supervisor Support. The Co-Worker Support time-specific effect on Well-Being trajectory is not statistically significant. Conflict based on Time declined over time, but its time-specific effect positively influenced Well-Being trajectory. The Sense of Coherence has the strongest positive time-specific effect on Well-Being trajectory when compared with other factors, but this effect diminished over time. Conclusions: GEE and LGCM results are consistent, but GEE is easier to perform taking care about ecological fallacy and LGCM gives more detailed results allowing the distinction between individual and group effects over time. The results suggest that working environment factors have a differentiated intervention regardless of their isolated trajectories in a dynamic compatible with a systemic mechanism of homeostatic and adaptive type, with the ability to activate resources necessary to maintain the highest possible Well-Being level. Knowledge of this adaptive dynamics is a critical issue to the adoption of company’s policy favorable to employees Well-Being and individual resources improvement. The results also highlight the importance of supervisor’s role in stress management, and the critical influence they can have in facilitating non-working life and strengthening the Sense of Coherence. Consequently, this knowledge will allow the adoption of corporate policies and occupational health measures focused on organizational aspects and the adoption of programs with accompanying components individualized to develop through the health and safety services, the effects of which have the potential to extend beyond the company, thereby helping to reduce inequalities in health.
Description
Tese de doutoramento em Ciências e Tecnologias da Saúde, especialidade de Saúde Ambiental, apresentada à Faculdade de Medicina da Universidade de Lisboa, 2017.
Keywords
Determinantes Psicossociais da Saúde Modelo Exigências-Controlo-Suporte Conflito Trabalho-Família Sentido da Coerência Estudo Longitudinal Determinantes da Saúde e da Doença Social Determinants of Health Occupational Health Longitudinal Studies Sense of Coherence Psychological Stress