Résumé
Resumo Introdução Os aspectos psicossociais do trabalho são fontes de estresse ocupacional, com impactos na saúde mental. Esta relação pode ser determinada pelo gênero e pela raça/cor da pele. Objetivo Avaliar associação entre estressores ocupacionais e saúde mental, focalizando desigualdades de gênero e raça/cor da pele entre trabalhadores da saúde. Método Estudo transversal com 3.084 trabalhadores de saúde da Bahia. Estressores ocupacionais foram avaliados pelo modelo demanda-controle (MDC), utilizando o Job Content Questionnaire. A variável desfecho, transtornos mentais comuns (TMC), foi avaliada pelo SRQ-20. Conduziu-se análise descritiva, bivariada e multivariada, estratificada por gênero e raça/cor da pele. Resultados A prevalência de TMC foi maior entre as mulheres (negras: 23,7%, e não negras: 19,6%), quando comparada com a verificada entre os homens (negros: 17,6%, e não negros: 14,7%). Observou-se associação de TMC com todos os grupos do MDC, para as mulheres negras, e com trabalho ativo e de alta exigência entre mulheres não negras. Entre os homens, a associação não foi estatisticamente significante. Conclusão Observaram-se diferenciais de gênero e raça/cor da pele na ocorrência de TMC e na associação com estressores ocupacionais, com prevalências mais elevadas entre as mulheres, principalmente as mulheres negras.
Abstract Background The psychosocial aspects of work are sources of occupational stress, with impacts on mental health. This relationship can be determined by gender and race/skin color. Objective To evaluate the association between occupational stressors and mental health, focusing on gender and race/skin color inequalities among healthcare workers. Method Cross-sectional study with 3,084 healthcare workers from Bahia. Occupational stressors were assessed using the demand-control (CDM) model, using the Job Content Questionnaire. The outcome variable, common mental disorders (CDM), was assessed by the SRQ-20. A descriptive, bivariate, and multivariate analysis was carried out, stratified by gender and race/skin color. Results The prevalence of CMD was higher among women (black: 23.7%, and non-black: 19.6%) than among men (blacks: 17.6%, and non-blacks: 14.7%). There was an association of CMD with all groups of the MDC, for black women, and with active and highly demanding work among non-black women. Among men, the association was not statistically significant. Conclusion Differences in gender and race/skin color were observed in the occurrence of CMD and in the association with occupational stressors, with higher prevalence among women, especially black women.
Résumé
Abstract Objective: The purpose of this study is to evaluate the association between psychosocial aspects at work and dissatisfaction among health workers in five cities in Bahia, Brazil. Methods: The evaluation was based on different models proposed to measuring occupational stress and possible combinations between them: demand-control model (DCM) and effort-reward imbalance (ERI). We conducted a cross-sectional epidemiological study including 3084 health workers. The analysis considered the association between partial/full/partial (combined) occupational stress models (the variable "exposure") and job dissatisfaction (the variable "outcome"). Results: Dissatisfaction rate was 26%. Full DCM and ERI models were better than partial ones to investigate job dissatisfaction. After adjustments, the combined models presented more robust measures of prevalence ratio than models evaluated separately (PR 2.93; CI 2.26-3.80). Conclusions: The combination of models has shown greater capacity to identify situations of job dissatisfaction and provided more potential information to support actions for workers' health. (AU)