Aspectos psicossociais do trabalho e transtornos mentais comuns entre trabalhadores da saúde do Estado da Bahia

Abstract

The importance of work in people's lives has been consistently reported in the literature. However, the work may also contribute to changes in physical and mental health of the individuals. Mental disorders related to work, has reached a significant portion of the Brazilian population, in this context, it is highlight common mental disorders (CMD), which under the health work are configured as a highly relevant problem because imply commitment of care provided to the user. In the field of occupational health, psychosocial aspects of work have been the subject of numerous studies, showing that there is at work risk factors invisible capable of causing suffering and illness. Among the tools to evaluate the psychosocial aspects of work is the demand-control model (MDC) and the model of effort-reward imbalance (effort-reward imbalance model - ERI), both widely used in the literature and whose proposals are to show different work stressors and their relationship to outcomes on health. This study has the following objectives: evaluate the contribution of analysis models combined psychosocial work stress and its association with TMC and highlight the interaction between psychosocial aspects of work and the occurrence of TMC. This was a cross-sectional study conducted with a representative sample of primary care workers in five counties of the state of Bahia. The outcome variable was the TMC measured by SRQ-20 and exposure models were demand-control-support social and effort-reward imbalance. We evaluated the performance of partial and complete models and combination of partial models, the interaction was verified by the departure from additivity of effects for the factors studied by calculating the excess risk due to interaction, proportion of cases attributed to the interaction and synergy index. The adjusted prevalence ratios with 95% confidence limits were obtained by Poisson regression with robust variance method. The overall prevalence of CMDs was 21.0% and was associated with high strain and effort-reward imbalance high and showed greater magnitude in the combined exposure group. The results showed better performance than full effort-reward imbalance model and the combination of partial models to predict the event, showed still exist interaction between psychosocial aspects of work and TMC, directed to the synergy of effects.