Association between job stress and quality of life in nutritionists working in public hospitals in Rio de Janeiro, Brazil

Canazaro, Bruna Cardoso; Aguiar, Odaleia Barbosa de; Moreno, Arlinda B.; Alves, Márcia Guimarães de Mello; Fonseca, Maria de Jesus Mendes da

doi:10.1590/1413-81232022275.11642021

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Brasil

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FREE THEMES • Ciênc. saúde coletiva 27 (05) • May 2022 • https://doi.org/10.1590/1413-81232022275.11642021 copy

Association between job stress and quality of life in nutritionists working in public hospitals in Rio de Janeiro, Brazil

Associação entre estresse no trabalho e qualidade de vida em nutricionistas que trabalham em hospitais públicos do Rio de Janeiro, Brasil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Occupational stress has been the object of research in different populations. The aim of this study is to analyze the association between psychosocial job stress and quality of life of nutritionists working in public hospitals in Rio de Janeiro, Brazil. Cross-sectional study in public hospitals with nutritionists working as civil servants and CLT. Psychosocial job stress was assessed through the Demand-Control-Support Questionnaire. Quality of life was assessed through the WHOQOL-Bref. The outcome was modeled by means of multiple linear regression and adjusted by covariates. Job demands were inversely associated with quality of life in the physical and environment domains. Job control was directly associated with quality of life in the psychological domain. High strain, in comparison to low strain, was inversely associated with quality of life in the physical and psychological domains. Social support was directly associated with all fields of quality of life domains. Psychosocial job stress, as expressed by psychological job demands and job control, affects self-assessed quality of life, especially in the physical domain.

Key words:
Quality of life; Nutritionists; Psychological stress; Hospitals

Variables		Total	Frequency
Variables		Total	n	%
Sex		290
	Female		282	97.2
	Male		8	2.8
Marital Status		285
	Single		99	34.4
	Married		151	52.4
	Divorced/widowed		38	13.2
Children		285
	None		128	44.9
	Yes		157	55.1
Race/Skin color		290
	Black		25	8.6
	Brown		59	20.4
	White		206	71
Level of Education		290
	Undergraduate		148	51.0
	Graduate		142	49.0
Smoking		286
	Has never smoked		239	82.4
	Has already smoked		36	12.4
	Smokes		15	5.2
Alcohol consumption		272
	Low risk		179	65.8
	Risk use		58	21.3
	Harmful use and probable dependence		35	12.9
Physical Activity Level		290
	Low and moderate intensity		226	77.9
	High Intensity		64	22.1
BMI		286
	Normal weight		149	52.1
	Overweight		93	32.5
	Obese		44	15.4
Health self-assessment		289
	Very good		76	26.3
	Good		164	56.8
	Fair/poor		49	16.9
Chronic Diseases		290
	2 or more		21	7.3
	At least one		96	33.1
	None		173	59.6
Work arrangement		289
	Civil servant		189	79.9
	Private worker		100	20.1
Working time		288
	Daytime work		69	24.0
	Shift work		219	76.0
Workplace		289
	One place		174	60.2
	Two places		95	32.9
	Three or more places		20	6.9
Holds a management position		289
	None		231	79.9
	Yes		58	20.1
Type of Hospital		290
	Children’s hospital		71	24.5
	Emergency hospital		118	40.7
	Specialist		101	34.8

Variable	Categories	Quality of Life - WHOQOL-bref
		Physical Domain			Psychological Domain			Environment Domain			Social Relationships Domain
		Mean	SD	p- value	Mean	SD	p- value	Mean	SD	p- value	Mean	SD	p- value
Sex*	Males	73.2	11.0	0.413	66.7	13.0	0.739	55.5	9.7	0.306	61.5	19.9	0.507
	Females	69.8	14.5		65.1	14.5		57.9	13.0		69.3	17.5
Age** (Tercile)	<37 years	70.2	13.6	0.822	64.8	13.7	0.230	56.7	13.1	0.158	73.4	18.2	0.011
	>37 and <47 years	69.1	14.9		63.5	15.2		56.9	12.4		67.3	16.9
	<47 years	70.3	14.8		67.0	14.2		59.9	13.0		66.5	16.8
Level of education*	Undergraduate	69.5	13.5	0.668	65.6	14.3	0.496	56.5	12.4	0.400	68.2	16.1	0.052
Level of education*	Graduate	70.3	15.4		64.5	14.6	0.496	59.4	13.1		70.0	19.1
Per capita income (minimum wage)**	0-2.75	67.9	14.2	0.146	62.2	14.3	0.004	52.5	12.4	0.000	67.6	19.5	0.006
	2.76-4.16	69.5	13.8		63.8	13.9		57.6	10.6		65.7	16.5
	4.17-15	72.0	15.3		68.8	14.4		62.5	13.4		73.4	16.6
Marital status**	Single	70.9	13.4	0.692	64.3	14.1	0.704	54.5	13.2	0.002	66.8	17.7	0.236
	Married	69.3	14.8		65.8	14.3		60.2	11.7		70.3	17.1
	Divorced/Widowed	69.5	15.6		64.4	16.2		57.5	14.6		71.1	18.7
Children*	None	69.7	13.9	0.909	65.5	13.5	0.629	56.9	13.3	0.223	70.5	17.8	0.224
Children*	Yes	70.7	10.5		64.7	15.1	0.629	58.8	12.5		67.9	17.4
Race/Skin color**	Black	72.9	14.6	0.281	68.7	17.4	0.175	60.4	15.9	0.834	66.7	20.6	0.606
	Brown	70.2	15.2		65.7	12.3		56.2	12.3		72.7	14.9
	White	69.4	14.2		64.5	14.6		58.0	12.6		68.3	17.8

Variable	Categories	Quality of Life - WHOQOL-bref
		Physical Domain			Psychological Domain			Environment Domain			Social Relations Domain
		Mean	SD	p- value	Mean	SD	p- value	Mean	SD	p- value	Mean	SD	p- value
Alcohol Consumption**	Low risk	69.4	15.1	0.936	65.3	15.2	0.760	58.1	13.3	0.874	68.2	17.9	0.517
	Risky use	70.2	14.5		63.9	13.9		57.4	12.3		71.0	17.1
	Harmful use and probable dependence	69.6	11.8		63.9	12.3		57.0	11.6		70.5	14.9
Smoking**	Has never smoked	70.6	14.2	0.173	65.1	14.7	0.711	57.6	13.4	0.766	69.3	17.5	0.782
	Has already smoked	65.9	16.7		64.1	14.8		58.3	11.1		67.1	18.1
	Smokes	68.3	11.0		67.8	8.5		60.0	8.1		69.4	17.7
Self-reported health**	Very good	78.0	12.4	<0.001	71.7	13.5	0.000	61.7	13.5	0.004	73.1	15.5	0.002
	Good	69.7	12.3		65.1	13.1		57.1	13.2		69.4	18.1
	Fair or poor	58.1	15.9		55.0	14.4		54.4	9.2		62.1	16.8
Presence of diseases**	None	72.2	13.8	0.001	67.1	13.5	0.005	60.1	12.6	0.001	70.6	16.9	0.026
	At least 1	67.2	13.8		63.1	14.5		54.7	13.3		68.2	17.2
	2 or more	62.8	18.3		57.7	18.1		53.6	8.8		59.9	21.5
Physical Activity* Level	Low and moderate intensity	68.5	14.5	0.001	63.9	14.6	0.006	57.6	12.7	0.154	68.3	17.7	0.547
Physical Activity* Level	High intensity	74.6	13.0		69.2	12.9	0.006	58.7	13.6		71.7	16.8
BMI**	Normal weight	70.7	13.2	0.346	66.3	11.7	0.093	57.5	12.1	0.911	71.1	15.6	0.100
	Overweight	69.5	14.8		65.1	15.9		58.2	13.4		68.0	18.8
	Obese	67.1	16.6		61.0	17.6		57.7	13.0		65.2	19.1

Variable	Categories	Quality of Life - WHOQOL-bref
		Physical Domain			Psychological Domain			Environment Domain			Social Relationships Domain
		Mean	SD	p- value	Mean	SD	p- value	Mean	SD	p- value	Mean	SD	p- value
Demand*	High	66.7	15.1	0.000	63.0	14.5	0.005	55.5	13.0	0.190	67.9	18.3	0,0003
	Low	73.9	12.4		67.7	13.9		60.8	12.1		70.5	16.4
Control*	High	72.2	12.9	<0.000	67.8	12.8	0.000	59.3	12.1	0.030	70.8	17.1	0.019
	Low	66.0	15.9		60.6	15.9		55.5	13.7		66.2	17.9
Quadrants**	Low strain	72.8	12.3	<0.001	69.6	12.0	0.000	60.9	11.0	0.012	70.6	15.2	0.154
	Active	69.2	14.2		64.4	12.4		56.4	11.7		70.6	19.1
	Passive	72.5	13.1		65.4	13.7		58.4	12.5		70.0	17.6
	High strain	63.5	16.6		59.6	17.4		54.3	15.3		64.9	18.7
Social support in the workplace*	High support	73.0	13.6	<0.001	68.5	13.3	<0.000	60.7	12.2	<0.000	73.0	16.5	<0.000
	Low support	64.9	14.4		59.7	14.5		53.3	12.7		62.6	17.4
Hospital Specialty**	Emergency Hospital	71.5	12.8	0.026	64.7	13.3	0.536	57.4	13.8	0.495	70.8	14.6	0.542
	Specialist	67.1	16.3		64.3	16.3		57.1	13.0		67.9	19.4
	Children’s Hospital	71.9	12.7		66.4	12.7		59.1	12.0		69.2	17.1
Length of employment - municipality/company**	0 to 8.93	69.0	14.3	0.568	64.1	14.7	0.248	54.8	13.7	0.007	72.3	18.5	0.035
	8.94 to 16	69.5	14.1		64.0	13.8		58.2	11.1		69.1	16.2
	16.1 to 44.26	71.1	15.0		67.0	14.7		60.6	13.0		65.8	17.6
Management position*	None	69.6	14.7	0.427	64.7	14.6	0.379	58.0	13.2	0.108	68.3	17.8	0.850
Management position*	Yes	71.2	13.1		66.5	13.7	0.379	57.7	11.0		72.3	16.6
Nº of workplaces**	One	69.9	14.6	0.963	64.5	14.6	0.250	57.6	12.9	0.659	68.5	18.2	0.455
	Two	69.7	14.5		65.0	14.5		58.1	12.6		69.0	16.7
	Three or more places	70.7	13.0		70.2	11.6		60.3	11.9		73.7	16.5
Work arrangement*	Private worker	69.2	12.8	0.539	63.7	14.1	0.222	53.6	12.6	0.568	69.9	18.8	0.00
Work arrangement*	Civil servant	70.2	15.2		65.9	14.5	0.222	60.1	12.5		68.6	16.9
Working time*	Daytime work	69.7	14.5	0.862	65.5	16.2	0.796	57.8	12.5	0.588	68.0	17.7	0.986
Working time*	Shift work	70.0	14.4		65.0	13.9	0.796	57.8	13.0		69.3	17.5

Variables		Quality of Life - WHOQOL-bref
		Physical		Psychological		Environment		Social Relationships
		Model 1 β (CI95%)	Final Model β (CI95%)	Model 1 β (CI95%)	Final Model β (CI95%)	Model 1 β (CI95%)	Final Model β (CI95%)	Model 1 β (CI95%)	Final Model β (CI95%)
Continuous
	Demand	-1.13 (-1.72 - -0.54)	-1.07 (-1.65 - -0.48)	-0.61 (-1.20 - -0.02)	-0.49 (-1.06 - 0.08)	-0.61 (-1.13 - -0.08)	-0.68 (-1.17 - -0.19)	0.10 (-0.62 - 0.83)	0.06 (-0.65 - 0.76)
	Control	0.42 (-0.26 - 1.11)	0.50 (-0.19 - 1.19)	0.85 (0.17 - 1.54)	0.94 (0.27 - 1.62)	0.42 (-0.19 - 1.04)	0.47 (-0.11 - 1.06)	-0.10 (-0.94 - 0.74)	0.07 (-0.77 - 0.92)
	Social Support	1.02 (0.49 - 1.54)	0.98 (0.45 - 1.51)	1.12 (0.60 - 1.65)	0.99 (0.47 - 1.51)	1.14 (0.67 - 1.61)	0.84 (0.39 - 1.28)	2.04 (1.39 - 2.68)	1.95 (1.31 - 2.59)
Quadrants
	Low strain	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00
	Active	-2.87 (-7.61 - 1.87)	-1.96 (-6.59 - 2.66)	-4.57 (-9.29 - 0.15)	-2.78 (-7.38 - 1.83)	-3.81 (-8.04 - 0.42)	-3.88 (-7.88 - 0.13)	0.95 (-4.81 - 6.72)	1.85 (-3.84 - 7.53)
	Passive	1.66 (-2.44 - 5.76)	1.56 (-2.42 - 5.55)	-2.21 (-6.29 - 1.88)	-2.82 (-6.78 - 1.15)	-0.55 (-4.21 - 3.11)	-0.91 (-4.33 - 2.50)	2.32 (-2.67 - 7.31)	1.45 (-3.47 - 6.38)
	High strain	-5.77 (-10.26 - -1.28)	-5.91 (-10.29 - -1.53)	-6.31 (-10.78 - -1.83)	-6.69 (-11.05 - -2.34)	-2.83 (-6.84 - 1.18)	-3.56 (-7.33 - 0.20)	-0.24 (-5.70 - 5.23)	-1.04 (-6.44 - 4.36)
	Social Support in the workplace	1.26 (0.77 - 1.76)	1.12 (0.63 - 1.61)	1.33 (0.83 - 1.82)	1.18 (0.70 - 1.67)	1.34 (0.90 - 1.79)	1.05 (0.63 - 1.47)	1.98 (1.38 - 2.59)	1.92 (1.32 - 2.52)

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[1] Collaborations

OB Aguiar designed the study. OB Aguiar and MJM Fonseca planned and carried out the collect of data. OB Aguiar and BC Canazaro contributed to analysis and interpretation of data to the writing of the drafted the manuscript. OB Aguiar, BC Canazaro, MJM Fonseca, AB Moreno and MGM Alves aided in interpreting the results and worked on the manuscript. All authors approved the final manuscript.