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Associação entre a atividade física e o distress psicológico: dados do 1º Inquérito Nacional de Saúde com exame físico
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Advisor(s)
Abstract(s)
Enquadramento: O distress psicológico é um conceito multifatorial, que tem sido utilizado como um indicador de saúde mental das populações. Associado a pior qualidade de vida, a sua avaliação permite identificar as pessoas com pior saúde mental. Por sua vez, a prática de atividade física, nomeadamente o exercício físico, tem sido indicada a nível internacional como tendo um efeito protetor na saúde mental, diminuindo o distress psicológico do indivíduo. Considerando que em Portugal, o distress psicológico tem apresentado prevalências elevadas, de cerca de um quarto da população, e que se tem verificado igualmente uma elevada prevalência da inatividade física no país, há necessidade de investigação adicional a nível nacional sobre a associação entre estes dois problemas de saúde pública. Objetivos: O objetivo geral consiste em: verificar a relação entre a ocorrência de distress psicológico e a prática de exercício físico na população adulta residente em Portugal em 2015. Foram estipulados os seguintes objetivos específicos: a) estimar a prevalência e caracterizar a prática de exercício físico na população portuguesa em 2015; b) estimar a prevalência de distress psicológico na população portuguesa em 2015; c) medir a associação entre o distress psicológico e a prática de exercício físico, estratificada por sexo na população portuguesa em 2015. Metodologia: Estudo epidemiológico, quantitativo, transversal e descritivo com uma componente analítica realizado através da análise secundária de dados do primeiro Inquérito Nacional de Saúde com Exame Físico (INSEF). A população-alvo é constituída por adultos, entre 25 a 74 anos de idade, residentes em alojamentos familiares em Portugal. Para a amostra do presente estudo apenas foram considerados os participantes no INSEF que responderam a todas as questões do Mental Health Inventory versão de 5 itens. A amostra utilizada na presente análise compreendeu 4858 indivíduos, 2613 mulheres e 2245 homens. Na análise descritiva, foi realizada uma caracterização da amostra e foram estimadas as prevalências de distress psicológico e da prática exercício físico, estratificadas por sexo. Na análise analítica foram construídos, para ambos os sexos, os modelos preditores de distress psicológico através de regressão logística multivariada. Resultados: Em 2015 a população residente em Portugal apresentava uma prevalência de distress psicológico de 22,5%, observando-se uma prevalência mais elevada nas mulheres (30,5%) do que nos homens (13,8%). Cerca de 14,4% da população praticou exercício físico pelo menos 3 dias por semana, com os homens (18,6%) a serem iii fisicamente mais ativos que as mulheres (10,7%). Segundo o modelo estatístico multivariado, os homens fisicamente ativos tiveram uma possibilidade 45% menor de reportar distress psicológico do que os homens fisicamente inativos. Nas mulheres não foi observada associação estatisticamente significativa. Os fatores que mais mostraram contribuir para a presença de distress nas mulheres foram viuvez, baixo rendimento, rede de suporte social pouco alargada (< 6 pessoas), pior estado de saúde auto-percecionado e presença de doença crónica. Nos homens esses fatores foram a inatividade física, o baixo nível de escolaridade, o desemprego, o divórcio, o pior estado de saúde auto-percecionado e ter idades compreendidas entre os 25 e os 34 anos. Discussão/Conclusão: Verificou-se que nos homens o exercício físico é um determinante no distress psicológico, mesmo depois de considerar o efeito de outras variáveis sociodemográficas. Nas mulheres, os resultados sugerem que o exercício físico não tem influência no distress psicológico quando considerado o efeito de outras variáveis sociodemográficas, pelo que outros fatores poderão ser mais relevantes. As intervenções para prevenção do distress psicológico e promoção da saúde mental devem ter em consideração as diferenças observadas, pelo que devem ser específicas para cada sexo.
Background: Psychological distress is a multifactorial concept that has been used as an indicator of populations’ mental health. Associated with poorer quality of life, its evaluation allows the identification of people with worse mental health. In turn, the practice of physical activity, namely physical exercise, has been suggested, at international level, as having a protective effect on mental health, reducing the psychological distress. Taking into account that, one hand, in Portugal psychological distress has presented high prevalence values, present at about a quarter of the population and that there is also a high prevalence of physical inactivity, further research is needed at national level on the association between these two public health problems. Objectives: The general objective is to verify the relationship between the psychological distress and the practice of physical activity in the adult population resident in Portugal in 2015. The following specific objectives were stipulated: a) to estimate the prevalence and to characterize the practice of physical exercise in the Portuguese population in 2015; b) estimate the prevalence of psychological distress in the Portuguese population in 2015; c) to measure the association between the psychological distress and the practice of physical exercise, stratified by sex in the Portuguese population in 2015. Methodology: Epidemiological, quantitative, cross-sectional and descriptive study with an analytical component performed through the secondary data analysis of the first National Health Survey with Physical Examination (INSEF). The target population consists of adults aged 25 to 74, residing in family housing in Portugal. For the sample of the present study only the participants of the INSEF who answered all questions of the Mental Health Inventory version of 5 items were considered. The sample used in the present analysis consisted of 4858 individuals, 2613 women and 2245 men. In the descriptive analysis, a sample characterization was performed and the prevalence of psychological distress and physical exercise practice, stratified by sex, were estimated. In the analytical analysis, the predictive models of psychological distress through multivariate logistic regression were constructed for both sexes. Results: In 2015, the population living in Portugal had a prevalence of psychological distress of 22,5%, with a higher prevalence in women (30,5%) than in men (13,8%). About 14,4% of the population practiced physical exercise at least 3 days a week, with men (18,6%) being physically more active than women (10,7%). According to the multivariate statistical model, physically active men had a 45% lower chance of reporting psychological distress than physically inactive women. In women, no statistically v significant association was observed. The factors that most contributed to the presence of distress in the women were widowhood, low income, little social support network (<6 people), poorer self-perceived health status and presence of chronic disease. In men, these factors were physical inactivity, low level of schooling, unemployment, divorce, the worst self-perceived health status, and between 25 and 34 years of age. Discussion / Conclusion: It has been found that in men physical exercise is a determinant of psychological distress, even after considering the effect of other sociodemographic variables. In women, the results suggest that physical exercise has no influence on psychological distress when considering the effect of other sociodemographic variables, so other factors may be more relevant. Interventions for prevention of psychological distress and promotion of mental health should take into account the differences observed and should therefore be gender specific.
Background: Psychological distress is a multifactorial concept that has been used as an indicator of populations’ mental health. Associated with poorer quality of life, its evaluation allows the identification of people with worse mental health. In turn, the practice of physical activity, namely physical exercise, has been suggested, at international level, as having a protective effect on mental health, reducing the psychological distress. Taking into account that, one hand, in Portugal psychological distress has presented high prevalence values, present at about a quarter of the population and that there is also a high prevalence of physical inactivity, further research is needed at national level on the association between these two public health problems. Objectives: The general objective is to verify the relationship between the psychological distress and the practice of physical activity in the adult population resident in Portugal in 2015. The following specific objectives were stipulated: a) to estimate the prevalence and to characterize the practice of physical exercise in the Portuguese population in 2015; b) estimate the prevalence of psychological distress in the Portuguese population in 2015; c) to measure the association between the psychological distress and the practice of physical exercise, stratified by sex in the Portuguese population in 2015. Methodology: Epidemiological, quantitative, cross-sectional and descriptive study with an analytical component performed through the secondary data analysis of the first National Health Survey with Physical Examination (INSEF). The target population consists of adults aged 25 to 74, residing in family housing in Portugal. For the sample of the present study only the participants of the INSEF who answered all questions of the Mental Health Inventory version of 5 items were considered. The sample used in the present analysis consisted of 4858 individuals, 2613 women and 2245 men. In the descriptive analysis, a sample characterization was performed and the prevalence of psychological distress and physical exercise practice, stratified by sex, were estimated. In the analytical analysis, the predictive models of psychological distress through multivariate logistic regression were constructed for both sexes. Results: In 2015, the population living in Portugal had a prevalence of psychological distress of 22,5%, with a higher prevalence in women (30,5%) than in men (13,8%). About 14,4% of the population practiced physical exercise at least 3 days a week, with men (18,6%) being physically more active than women (10,7%). According to the multivariate statistical model, physically active men had a 45% lower chance of reporting psychological distress than physically inactive women. In women, no statistically v significant association was observed. The factors that most contributed to the presence of distress in the women were widowhood, low income, little social support network (<6 people), poorer self-perceived health status and presence of chronic disease. In men, these factors were physical inactivity, low level of schooling, unemployment, divorce, the worst self-perceived health status, and between 25 and 34 years of age. Discussion / Conclusion: It has been found that in men physical exercise is a determinant of psychological distress, even after considering the effect of other sociodemographic variables. In women, the results suggest that physical exercise has no influence on psychological distress when considering the effect of other sociodemographic variables, so other factors may be more relevant. Interventions for prevention of psychological distress and promotion of mental health should take into account the differences observed and should therefore be gender specific.
Description
Dissertações de Mestrado em Saúde Pública, apresentada à Escola Nacional de Saúde Pública da Universidade Nova de Lisboa, 2018.
Keywords
Distress Psicológico Saúde Mental Atividade Física Exercício Físico Associação Adultos População Portuguesa Determinantes da Saúde e da Doença INSEF Inquérito Nacional de Saúde com Exame Físico Psychological Distress Mental Health Physical Activity Exercise Association Adults