Health-related quality of life and working conditions among nursing providers

• Published in: Revista de saúde pública Vol. 44; no. 4; pp. 718 - 725
• Main Authors: Silva, A A, de Souza, JMP, da Silva Borges, FN, Fischer, F M
• Format: Journal Article
• Language: Portuguese
• Published: 01.08.2010
• Subjects: Brazil; Brazil, Sao Paulo
• ISSN: 0034-8910

OBJECTIVE: To evaluate working conditions associated with health-related quality of life (HRQL) among nursing providers. METHODS: Cross-sectional study conducted in a university hospital in the city of Sao Paulo, Southeastern Brazil, during 2004-2005. The study sample comprised 696 registered nurses, nurse technicians and nurse assistants, predominantly females (87.8%), who worked day and/or night shifts. Data on sociodemographic information, working and living conditions, lifestyles, and health symptoms were collected using self-administered questionnaires. The following questionnaires were also used: Job Stress Scale, Effort-Reward Imbalance (ERI) and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Ordinal logistic regression analysis using proportional odds model was performed to evaluate each dimension of the SF-36. RESULTS: Around 22% of the sample was found to be have high strain and 8% showed an effort-reward imbalance at work. The dimensions with the lowest mean scores in the SF-36 were vitality, bodily pain and mental health. High-strain job, effort-reward imbalance (ERI>1.01), and being a registered nurse were independently associated with low scores on the role emotional dimension. Those dimensions associated to mental health were the ones most affected by psychosocial factors at work. CONCLUSIONS: Effort-reward imbalance was more associated with health than high-strain (high demand and low control). The study results suggest that the joint analysis of psychosocial factors at work such as effort-reward imbalance and demand-control can provide more insight to the discussion of professional roles, working conditions and HRQL of nursing providers.Original Abstract: OBJETIVO: Avaliar condicoes de trabalho associadas a qualidade de vida relacionada a saude entre profissionais de enfermagem. METODOS: Estudo transversal realizado em um hospital universitario de Sao Paulo, SP, em 2004-2005. A populacao estudada foi de 696 enfermeiros, tecnicos e auxiliares de enfermagem, predominantemente feminina (87,8%) e que trabalhava em turnos diurnos e/ou noturnos. Os dados sociodemograficos, de condicoes de trabalho e de vida, habitos de vida e sintomas de saude auto-referidos foram obtidos por meio de questionarios auto-aplicados: Resultados de Estudos de Saude - versao reduzida, Escala de Estresse no Trabalho e Desequilfbrio Esforco-Recompensa. Valores do coeficiente . 1,01 significam mais esforcos do que recompensas no trabalho. Modelos de regressao logistica ordinal de chances proporcionais foram ajustados para cada dimensao do SF-36. RESULTADOS: Aproximadamente 22% da populacao foi classificada como trabalhando em condicoes de alto desgaste e 8% com mais esforcos do que recompensas no trabalho. As dimensoes com piores escores medios no SF-36 foram vitalidade, dor e saude mental. Alto desgaste no trabalho, ter mais esforcos que recompensas e ser enfermeira associaram-se de maneira independente aos baixos escores da dimensao de aspectos emocionais. As dimensoes relacionadas a saude mental foram as que mais sofreram influencia dos fatores psicossociais do trabalho. CONCLUSOES: Apresentar mais esforcos do que recompensas no trabalho foi mais significativo para a qualidade de vida associada a saude do que o alto desgaste no trabalho (altas demandas e baixo controle). Os resultados indicam que a analise conjunta dos fatores psicossociais de desequilibrio esforco-recompensa e demanda-controle contribuiu para a discussao sobre os papeis profissionais, condicoes de trabalho e qualidade de vida relacionada a saude de profissionais de enfermagem.