Autoavaliação do estado de saúde e fatores associados: um estudo em trabalhadores bancários

Self-rated health status and associated factors in rural workers

BACKGROUND

Self-rated health status can be considered a good predictor of morbidity and mortality and has been used due to its easy assessment and applicability. The instrument is efficient for understanding sociodemographic, environmental and clinical conditions that may be related to the self-rated health status. Thus, this study aims to analyze the self-assessment of health status in rural workers and its association with socioeconomic characteristics, lifestyle, clinical condition and work characteristics.

METHODS

This is a cross-sectional study carried out with 787 male and female rural reporting agriculture as their main source of income in the municipality of Santa Maria de Jetibá. A simple and direct question was used "In general, compared to people your age, how do you rate your own state of health?" to see how rural workers rate their current health status. The independent variables analyzed were socioeconomic, clinical, health and work conditions. The magnitude of the associations was evaluated by means of hierarchical logistic regression.

RESULTS

It was found that 42.1% of rural workers self-rated their health status as regular or poor. Belonging to socioeconomic classes C (OR = 1.937; 95% CI = 1.009-3.720) or D/E (OR = 2.280; 95% CI = 1.178-4.415), being overweight (or having excess weight) (OR = 1.477; 95% CI = 1.086-2.008), multimorbidity (OR = 1.715; 95% CI = 1.201-2.447) and complex multimorbidity (OR = 1.738; 95% CI = 1.097-2.751) were risk factors for worse self-rated health.

CONCLUSION

It was concluded that chronic diseases, socioeconomic status and overweight are risk factors for negative self-rated health. The identification of these determinants through self-rated status can support the planning of actions aimed at improving the health of the rural population.

TRIAL REGISTRATION

This study was approved by the Research Ethics Committee of the Health Sciences Center of the Federal University of Espírito Santo (Protocol No. 2091172; CAAE No. 52839116.3.0000.5060). All research participants gave their informed consent.

TRABALHO E SAÚDE NO SETOR BANCÁRIO: RESGATE DO PENSAMENTO CRÍTICO MARXISTA DA MEDICINA SOCIAL LATINO-AMERICANA

RESUMO Objetivou-se analisar os elementos da determinação do processo de trabalho do setor financeiro brasileiro nas manifestações de saúde-doença dos seus trabalhadores e das suas trabalhadoras sob a reprodução ampliada do capital. O resgate do pensamento desenvolvido pela Medicina Social Latino-Americana (MSLA), particularmente o da Escola de Xochimilco, que agregou pesquisadoras e pesquisadores marxistas no debate da relação trabalho e saúde nas décadas de 1970 e 1980, permitiu analisar os dados quantitativos e qualitativos coletados na pesquisa. Entrevistas e análises documentais de relatórios foram utilizadas para identificar, nas funções do dinheiro no sistema capitalista, o germe do caráter adoecedor do setor. É dele que se desenvolve a necessidade da digitalização dos processos de trabalho, a consequente intensificação da gestão por metas e a constituição de cargas digitais. Concluímos que a luta pela saúde dos trabalhadores e das trabalhadoras do setor bancário passa necessariamente por superar as condições concretas que sustentam o fetichismo do dinheiro.

Self-assessment of the health status and leisure activities of individuals on haemodialysis

Self-assessment of health status is an important marker of social and health aspects. Haemodialysis is an option for renal replacement therapy that alters daily life and impacts social participation and the performance of tasks that give the subject a socially accepted role. In this scenario, leisure activities have the potential to generate well-being and are associated with several aspects of daily life, but few studies have analysed their relationship with the self-assessment of health status. This is a cross-sectional, census study with 1024 individuals from haemodialysis units of a Southeast Brazilian region, with the application of a questionnaire in 2019. We calculated the difference between the proportions of self-assessment of health status (positive and negative) and the two logistic regression models. The chances of individuals on haemodialysis negatively evaluating their health increase when they do not perform artistic leisure activities (OR 2.15; 95% CI 1.35-3.43), physical and sports activities (OR 3.20; 95% CI 1.86-5.52), intellectual (OR 2.21; 95% CI 1.44-3.41), manuals (OR 1.82; 95% CI 1.22-2.72), social (OR 2.74; 95% CI 1.74-4.31), tourist (OR 2.08; 95% CI 1.37-3.17) and idleness and contemplative (OR 1.92; 95% CI 1.29-2.85). Negative health self-assessment is associated with not practicing artistic, manual, physical and sporting, social, intellectual, tourist, and contemplative leisure activities, which have the function of providing social participation and giving meaning to life.

Self-Assessment of Health among the Citizens of Serbia in the Transition Period

Background

The aim of the research was to compare the differences between the self-assessment of the health in the latest National Health Surveys research and in the one before that.

Methods

We used the database of the latest National Health Survey in the Republic of Serbia (2013) and of the one before that (2006), as cross-sectional studies (n=29485). Logistic regression was used to predict the relationship between self-assessment of health and independent predictors.

Results

Health condition of the interviewees improved according to their self-assessment. With aging respondents who poorly assessed their health; women assessed their health 1.7 and 1.6 times poorer in the latest research and in the one before that respectively. The odds ratio in patients diagnosed with some disease in the previous 12 months ranged from 2.15 (1.85 - 2.51) to 4.03 (3.22 - 5.05) in the latest research. The strongest predictor was sick leave in the past 12 months with 95% CI = 3.19 (1.87-5.44) in the latest research and 95% CI = 2.27 (1.67-3.08) in the one before that.

Conclusion

There was an improvement of the health condition of individuals. Female interviewees, less educated, unemployed, the ones who have some disease and who were on a sick leave rated their health as bad.

Organização do trabalho e adoecimento dos bancários: uma revisão de literatura

RESUMO Este artigo apresenta uma análise de produções científicas das relações entre saúde e trabalho dos trabalhadores bancários, encontradas em teses, dissertações, artigos das literaturas nacional e inter nacional, produzidos nas línguas portuguesa, inglesa e espanhola, no período de 2008 a 2018. A pesquisa foi feita em bases de dados da Biblioteca Virtual em Saúde e da PubMed, utilizando-se os temas ‘bank workers’ e ‘bank employees’, assim como os descritores ‘environmental health’, ‘antidepressive agents’, ‘occupational diseases’, ‘stress, psychological’, ‘depressive disorder’, ‘burnout, professional’, ‘cumulative trauma disorders’ e os termos livres ‘occupational stress’, ‘stress’, ‘ psychological distress’ e ‘psychosocial work environment’. Foram encontrados 120 estudos, dos quais, 37 tratavam especificamente do tema. A análise permitiu encontrar uma descrição da visão predominante na literatura acerca das características do trabalho nos bancos que se relacionam ao sofrimento, ao desgaste e ao adoecimento dos trabalhadores. A forma de organização do processo de trabalho no setor bancário se relaciona com o sofrimento e o adoecimento, podendo levar ao suicídio. Apesar da relação estabelecida entre trabalho e adoecimento, a descrição da organização do trabalho é superficial nos estudos, sendo seu aprofundamento importante para a compreensão e a transformação desse panorama.

Factors associated with health dissatisfaction of elementary school teachers

OBJECTIVE

To evaluate factors associated with health dissatisfaction of public elementary school teachers.

METHODS

Cross-sectional study conducted among teachers from a Midwest capital, in 2017. A self-administered questionnaire composed of a collection of validated instruments and additional questions was used. Poisson Regression was performed, considering significance p <0.05.

RESULTS

sample composed of 326 teachers, with an average age of 43 years, 87.1% female. Concerning health conditions, 19.5% were dissatisfied and 31.5% were indifferent. In a simultaneous analysis of the factors of interest, a statistically significant association was found among teacher's health dissatisfaction and the presence of symptoms of common mental disorders (PRa= 2.28), musculoskeletal symptoms in the last 12 months (PRa= 1.71), voice disorders (PRa= 1.29), never/rarely waking up rested (PRa= 1.45), never/rarely engage in physical activity/sports (PRa= 1.57), among other factors.

CONCLUSION

never/rarely waking up rested and engaging in physical activity/sports, the presence of common mental disorders, musculoskeletal symptoms and voice disorders were associated with health dissatisfaction.

Weight gain in public hospital workers: a retrospective cohort study

This study assessed changes in the nutrition profile of public hospital workers over a period of three decades and the association between nutritional status and occupational factors. A retrospective cohort study was conducted with staff taken on in 1980, 1990, and 2000 still working in the hospital in 2013. The following data was obtained from staff records: sociodemographic characteristics; and body weight and height, recorded during pre-employment and periodic medical examinations. The latter was used to calculate body mass index (BMI).The final sample consisted of 386 workers (76.4% women and 88.1% white) with a mean age of 29.3 ± 7.3 years. Mean body weight and BMI at admission were highest in the 2000 cohort (W = 66.3 ± 12.5kg; BMI = 21.3 ± 2.5 kg/m2), compared to 1980 (W = 56.7 ± 10.2 kg; BMI = 21.3 ± 2.5 kg/m2)and 1990 (W = 62.2 ± 11.5 kg; BMI = 22.9 ± 3.3 kg/m2) cohorts. Variation in weight and BMI between the pre-employment examination and final periodic examination was highest in the 2000 cohort. When stratified by sex, this difference in variation was observed only in men. No association was found between variation in body weight and BMI and work shift and occupation. The increase in weight and BMI reflects the nutritional transition in Brazil, underscoring the need for nutritional surveillance and the implementation of health education programs directed at staff.

How cutaneous leishmaniasis and treatment impacts in the patients' lives: A cross-sectional study

Background

Until now, few studies have evaluated the effect of cutaneous leishmaniasis (CL) on patients' quality of life, and none have used a specific instrument to measure this effect. The objective of this study was to identify factors that may be associated with the high impact of CL and to assess patients’ satisfaction with treatment and health services by utilizing a disease-specific questionnaire.

Methodology

Between December 2015 and May 2017, 100 patients with localized cutaneous leishmaniasis were interviewed at a leishmaniasis referral center in Brazil. Data were collected by two questionnaires. One questionnaire compiled the sociodemographic, economic, and clinical information related to the disease. The second questionnaire was the Cutaneous Leishmaniasis Impact Questionnaire (CLIQ), which consisted of two subscales that measured 1) the general impact of CL and 2) patients’ perceptions of treatment and health services. The median scores from each of these two subscales were used to dichotomize the dependent variables. Risk factors for the high impact of CL and for low patient satisfaction with treatment and health services were analyzed with a logistic regression analysis.

Results

The chance of higher impact of CL was increased in patients with the presence of comorbidities (OR: 3.9; CI 1.25–12.36), in those with absences from work (OR: 12.0; CI 3.78–42.55), in those who relied on public transportation by a municipal bus (OR: 5.8; CI 1.27–26.77), and in those who had illness-related expenses greater than U$137 (OR: 3.5; CI 1.17–10.24). The chance of patient dissatisfaction with treatment and health services increased with higher education (OR: 5.0; CI 1.19–21.03) and with illness-related expenses exceeding U$137 (OR: 4.64; CI 1.49–14.48). Once the sample was non-probabilistic, findings are not representative of CL patients in general.

Conclusions

CL and its treatment have a negative impact on patients’ quality of life. Considering these effects during public health planning may help patients to confront the disease.

AUTOAVALIAÇÃO NEGATIVA DA SAÚDE EM TRABALHADORAS DE ENFERMAGEM DA ATENÇÃO BÁSICA

Resumo O objetivo deste estudo é avaliar os fatores associados à autoavaliação negativa da saúde entre trabalhadoras de enfermagem. Realizou-se estudo transversal exploratório, com amostra probabilística de 451 trabalhadoras de enfermagem da Atenção Básica à Saúde. Foi aplicado questionário com informações sociodemográficas, de hábitos de vida, ocupacionais, aspectos psicossociais e satisfação no trabalho e morbidade das trabalhadoras. A autoavaliação da saúde foi aferida por meio da questão “De modo geral, em comparação às pessoas da sua idade, como você considera o seu próprio estado de saúde?”. Os dados foram analisados por meio do modelo de regressão logística em blocos. Identificou-se prevalência de 15,8% de autoavaliação negativa da saúde. Os fatores associados foram: incompatibilidade das atividades desenvolvidas com o cargo, média e alta sobrecarga doméstica, situação de trabalho ativo (alto controle, alta demanda), avaliação ruim da qualidade de vida e transtornos mentais comuns. Os achados corroboram a relação entre processo saúde-doença e condições de vida e trabalho e indicam a necessidade de políticas públicas de prevenção e promoção da saúde das trabalhadoras de enfermagem. Essas politicas, ao constituir situações favoráveis de trabalho, podem ser muito relevantes para a qualidade da assistência prestada aos usuários do Sistema Único de Saúde.

Prevalence and risk factors for latent tuberculosis infection among primary health care workers in Brazil

Health care workers (HCW) are at increased risk of latent tuberculosis infection (LTBI) from occupational exposure to Mycobacterium tuberculosis. The objective was to determine the prevalence of and risk factors for LTBI among primary HCW in five Brazilian cities. We conducted a cross-sectional study, from 2011 to 2013, among primary HCW, using a structured questionnaire and an evaluated for LTBI using the Quantiferon-TB Gold in-tube test. The magnitude of the associations was assessed using hierarchical logistic regression models. Among 708 HCW, the LTBI prevalence was 27% (n = 196; 95%CI: 24%-31%). We found that the following factors were positively associated with LTBI in primary HCW: age > 50 years (OR = 2.94; 95%CI: 1.44-5.99), absence of a BCG scar (OR = 2.10; 95%CI: 1.28-3.43), self-reported ex-smoker status (OR = 1.80; 95%CI: 1.04-3.11), being a nurse (OR = 2.97; 95%CI: 1.13-7.83), being a nurse technician (OR = 3.10; 95%CI: 1.26-7.60), being a community health agent (OR = 2.60; 95%CI: 1.06-6.40), and irregular use of N95 masks (OR = 2.51; 95%CI: 1.11-5.98). In contrast, HCWs who do not work in health care facilities with a TB control program were less likely to have LTBI (OR = 0.66; 95%CI: 0.45-0.97). This study demonstrated a substantial occupational risk of LTBI among primary HCW in Brazil. The Brazilian TB control program, as well as local programs, need to target these high-risk HCW with education, as well as with better personal protective equipment to prevent acquisition of new TB infection.

Work-Related Stress in the Banking Sector: A Review of Incidence, Correlated Factors, and Major Consequences

For a number of years now, banks have been going through enormous changes in organization and structure. New technology and new ways of structuring the operation have left their mark on the working conditions and daily lives of employees. Deregulation of labor markets, emerging technologies and new types of jobs have significantly reshaping working lives by continuous changes on employment and working conditions. Such a scenario has a relevant impact not only on companies' organization but also on working population's health. The banking sector is particularly well-deserved of a specific and thorough analysis, in view of the recent increase in psycho-social disorders of employees. This may be related to the major organizational changes affecting this sector and, in particular, to the restructuring processes resulting from the global economic crisis. Our aim is to assess the scale of the phenomenon and how far it relates specifically to the processes of bank organization. With this in mind, through a review of the literature, we selected the main studies dealing with work-related stress in banking, so that we could reach a better understanding of the phenomenon as it relates specifically to this set of workers. The search took place on the MEDLINE® database; in total 20 articles were chosen. There was uniform agreement among the studies that stress in the banking workplace is now at critical levels, and that it can have deleterious psychological effects on workers, and on their physical health, and that organizations, too, are affected. Most studies showed that mental health problems had increased in the banking sector, and that they were stress-related. Examples began with anxiety and depression, carried on through maladaptive behaviors, and ended in job burnout. The reviewed studies' limitations were then discussed, and possible ways forward considered.