Estresse ocupacional e saúde: contribuições do Modelo Demanda-Controle

Abstract

Nos últimos anos registra-se marcado esforço de construção de modelos teórico-metodológicos para avaliar características do trabalho e efeitos à saúde dos trabalhadores. Dentre os modelos propostos, o Modelo Demanda-Controle tem alcançado destaque. Esse modelo recorta duas dimensões no ambiente laboral: as demandas psicológicas e o controle do trabalhador sobre o próprio trabalho. O Job Content Questionnaire (JCQ) é o instrumento proposto para medir essas dimensões do trabalho. Este estudo objetiva apresentar as bases teóricas e metodológicas do modelo demanda-controle, e discutir sua capacidade para identificar diferentes situações de trabalho no contexto brasileiro, a partir do uso do JCQ. Achados preliminares de dois estudos epidemiológicos, de corte transversal, são apresentados e discutidos. Os estudos avaliaram aspectos psicossociais do trabalho, utilizando o JCQ, e a saúde mental dos trabalhadores, usando o SRQ-20. Os resultados apontaram boa capacidade do modelo demanda-controle para identificar diferentes situações de risco à saúde mental dos trabalhadores. Aspectos relacionados à demanda psicológica do trabalho estavam mais fortemente associados a elevadas prevalências de distúrbios psíquicos menores do que os aspectos referentes ao controle.

Fatores psicossociais do trabalho e transtornos mentais comuns em eletricitários

“…A standardized questionnaire was used, including four blocks of questions with general information about sociodemographic and lifestyle characteristics; general information about work; questions related to psychosocial work factors (measured by the Job Content Questionnaire -JCQ) 4,6 and information about general health (including questions about perception of health status, use of anxiolytic drugs and previous medical diagnosis of diseases) and mental health aspects (using the Self-Reporting Questionnaire -SRQ-20 to assess CMDs). 8,26 The CAGE questionnaire 9,10 was included in the block of questions about lifestyle to detect alcohol abuse.…”

“…10 To achieve greater specifi city (lower number of false positives), the cut-off point of two or more positive responses was used. 9 The JCQ measures aspects associated with the social and psychological structure and it can be applied to different types of work, 3,5,7 including as a form to relate work to certain ways individuals become ill. 4 A version that has been translated to Portuguese and recently validated was used. 6 The aspects of work situations identifi ed by the JCQ are: decision latitude, psychological demand, physical demand and social support.…”

“…Based on two dichotomized dimensions (demand and decision latitude), four categories of the model were obtained: low-strain job, passive job, active job and high-strain job. 4 The SRQ-20, developed to study common mental disorders in primary health care units, was applied to different occupational groups. 3,22,26 This questionnaire is comprised of 20 binary response questions (yes or no), classifi ed in groups of physical symptoms and groups of psycho-emotional disorders (decrease in energy, depressive mood and depressive thoughts).…”

“…Workers with a high level of stress in the workplace (high-strain job) and low social support showed a higher risk of becoming ill. 2,24 The prevalence of CMDs was higher in the active job category (24.3%) than in the passive job one (17.6%). Workers in active jobs were expected to be less likely to become ill. 4,6 Such result could be due to the fact that the model considers indicators of the demand-control dimension as independent variables. However, it is possible that the work environment with high demand can become greater than the benefi ts of high job control.…”

“…The main model prediction is that the majority of adverse effects on health occurs when the work demand is high and the worker's control over his job is low. 4,14 Aspects associated with work organization may cause mental strain in workers. 11 In the context of work of maintenance of electrical transmission and equipment, situations that can affect workers' mental health are common: living in danger, meeting the formal prescriptions, achieving the required productivity, and being responsible for maintaining the electrical system functioning well.…”