Job stress in agents at the socio-educational service centers in the state of Rio Grande do Sul

Abstracts

Estudo que teve por objetivo verificar a associação entre estresse no trabalho, características sociodemográficas, laborais, hábitos e condições de saúde dos agentes socioeducadores do Rio Grande do Sul, Brasil. Trata-se de um estudo transversal com 381 agentes dos Centros de Atendimento Socioeducativo do Rio Grande do Sul. Utilizou-se a versão brasileira da Job Stress Scale, para avaliação do estresse no trabalho. Foram classificados, em situação de alta exigência no trabalho, 19,2% dos agentes. Mostraram-se associados ao estresse no trabalho: necessidade de acompanhamento psicológico, falta de tempo para lazer, turno diurno de trabalho, insatisfação com o local de trabalho, necessidade de afastamento do trabalho, por problemas de saúde, e escala de trabalho insuficiente. Há necessidade de buscar melhores condições de trabalho e a efetivação de um Serviço de Saúde do Trabalhador atuante, no sentido de minimizar os efeitos das demandas psicológicas no trabalho do agente socioeducador.

Trabalho; Saúde do trabalhador; Estresse psicológico; Condições de trabalho; Estudos transversais

ORIGINAL ARTICLE

Job stress in agents at the socio-educational service centers in the State of Rio Grande do Sul

Estrés en el trabajo en agentes en los centros de atención socioeducativa de Rio Grande do Sul

Patrícia Bitencourt Toscani Greco^I; Tânia Solange Bosi de Souza Magnago^II; Carmem Lúcia Colomé Beck^III; Janete de Souza Urbanetto^IV; Andrea Prochnow^V

^IMaster of Nursing. Nurse. Professor, Undergraduate Nursing Course of the Regional Integrated University of "Alto Uruguai e das Missões", Santiago Campus, Santiago, Rio Grande do Sul. Brazil

^IIDoctor of Nursing. Adjunct Professor, Department of Nursing, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil

^IIIDoctor of Nursing. Associate Professor II, Department of Nursing, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil

^IVDoctor of Health Sciences. Adjunct Professor, School of Nursing, Physiotherapy and Nutrition, Catholic Pontifical University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

^VMaster of Nursing. Nurse. Santa Maria. Rio Grande do Sul Brazil

Author's address

ABSTRACT

The study was both to understand the association of work stress, socio-demographic and labor characteristics, habits and working conditions of the Socio-educational agents in the state of Rio Grande do Sul, Brazil. It was a cross-sectional study with 381 agents of the Socio-educational Service Centers in the state of Rio Grande do Sul. The Brazilian version of the Job Stress Scale for assessment of work stress has been applied. Were classified in a situation of high strain 19.2% of the agents. The following factors were related to job stress: the need for counseling, lack of leisure time, day shift work, dissatisfaction with the workplace, the need for absence from work due to health problems and insufficient scale work. There is a need to further research working conditions and execution of Occupational Health Service acting in order to minimize the effects of psychological demands at work of a socio-educational agent.

Descriptors: Work. Occupational health. Stress, psychological. Working conditions. Cross-sectional studies.

RESUMEN

El estudo tenía el objetivo de verificar la asociación entre estrés en el trabajo, rasgos sociodemográficos, laborales, hábitos y condiciones de salud de los agentes socioeducadores de Rio Grande do Sul, Brasil. Es un estudio transversal con 381 agentes de Centros de Atención Socioeducativa de Rio Grande do Sul. Se utilizó la versión brasileña de Job Stress Scale para evaluación de estrés en el trabajo. El 19, 2% de los agentes se clasificó en situación de alta exigencia laboral. Se mostraron asociadas al estrés en el trabajo: necesidad de acompañamiento psicológico, falta de tiempo para el ocio, tiempo diurno de trabajo, insatisfacción con el lugar de trabajo, necesidad de alejamiento del trabajo por problemas de salud y escala de trabajo insuficiente. Existe la necesidad de buscar mejores condiciones de trabajo y la efectuación de un Servicio de Salud del Trabajador actuante, para minimizar los efectos de las demandas psicológicas en trabajo del agente.

Descriptores: Trabajo. Salud laboral. Estrés psicológico. Condiciones de trabajo. Estudios transversales.

INTRODUCTION

The relationship between work and ill-health associated with stress and worker weariness is the scenario for discussions and studies in various countries, which has led to international concern about the need to recognize, prevent or control job strain⁽¹⁾.

Of the models used for evaluating job stress and its repercussions on the health of persons, the Demand-Control Model (DCM), proposed Karasek in the late 1970s is outstanding. This model proposes the investigation of two psychosocial dimensions in the workplace - the psychological demands and control of work - by the combination of high and low levels, forming four work situations (low strain, active work, passive work and high strain) which configure differentiated risks to health. Low strain and active work experiences are considered lower risk of ill-health; however, high strain and passive work experiences are those that present greater association with physical or psychic ill-health⁽²⁾.

One study⁽³⁾ showed the importance of the DCM in investigating the psychosocial environment of work and the effects of occupational stress on health. In addition, it stated that in Latin America, the DCM has been a theoretical and methodological referential frequently used in studies with health workers and docents. In this study, the proposal was to conduct an investigation in socio-educational agents, who are workers at the Foundation of Socio-Educational Services of Rio Grande do Sul ("Fundação de Atendimento Socioeducativo do Rio Grande do Sul - FASE/RS)". These agents perform activities in connection with adolescents to fulfill the socio-educational measure at the Socio-Educational Service Centers ("Centros de Atendimento Socioeducativo - CASE").

They assume the role of guiding and protecting the adolescents in fulfilling the socio-educational measure^(4-5). Among the activities the agents perform, the following are mentioned⁽⁴⁾: responsibility for the safety, preservation of physical and psychological integrity of the adolescents; performing or following-up routine pedagogical activities; following-up the care provided by the health technicians and professionals (within or outside of the unit); performing routine reviews; following-up the sun-bathing activities in the institution patio; participate in accompanying adolescents during audiences, family visits and outside activities.

From this aspect, the goal of their function is to guarantee that the adolescent's basic procedures for well-being and self-care are carried out, as well as procedures of moving about, to guarantee the safety of the adolescents and the institution as a whole⁽⁶⁾. This direct follow-up of the adolescent makes the agent more prone to receiving threats, aggressions, intimidations, and become a hostage in case o mutiny.

In order to perform their activities, the agents use instruments of work appropriate for the prison, such as: locks, keys, iron gates, hand-cuffs, book of occurrences (to make notes of happenings during shifts), in addition to pedagogical or recreational materials used in workshops or leisure activities, which they frequently prepare and accompany. Among the features of the job of socio-educational agent, the following are pointed out: accelerated rhythm, pressure due to time, unpredictability and constantly seeking the role of educator.

Therefore, the socio-educational agent uses his/her mental and physical capacity so that this system (institution) carries on working, and reaches the goal of re-socialization of the adolescent.

Firstly, the purpose of this study is justified, bearing in mind that these characteristics of the agents' work place, associated with the need for physical agility and quick thinking, constant attention and vigilance, responsibility for the safety of the adolescents and unit staff may favor stress. Secondly, because there has been little investigation into the relationship existent between the socio-educational agents' work and ill-health. Only one study⁽⁷⁾ related to work-loads in this population was found in the LILACS and SCIELO databases, in 2011.

The aim was to verify the association between stress at work; sociodemographic and labor characteristics; and habits and health conditions of the socio-educational agents in Rio Grande do Sul, Brazil, based on the guiding questions: Do socio-educational agents identify their work as stressful? If affirmative, is the stress related to sociodemographic, labor and health characteristics?

METHOD:

This was a cross-sectional epidemiological study, which originated from a master's degree dissertation⁽⁸⁾ , conducted with socio-educational agents at CASEs/RS. Of the total of 819 agents, the sample was composed of 381, considering a sampling error of 3.68%, an estimated proportion of 50% and an interval of confidence of 95%. The sample was randomly selected by CASE. The CASEs are distributed in the capital (Porto Alegre I, Porto Alegre II, Socio-Educational Community Carlos Santos, Padre Cacique, and the Female Socio-Educational Service Center), metropolitan region (Novo Hamburgo Unit) and in the interior of the State (Units:Santa Maria, Santo Ângelo, Pelotas, Passo Fundo, Uruguaiana, Caxias do Sul).

Agents who had been laid off work on leave for health treatment or for other reasons were excluded from the study. Recruitment was done individually, at the work place, after being provided with information about the aims, risks and benefits of the research. After assent and signature of the Term of Free and Informed Consent, the workers were given the research questionnaire to fill out.

Data collection occurred in the period from March to August 2011, by previously trained members of the research team. The instrument used was a self completed questionnaire, with questions related to the sociodemographic and labor profiles, the summarized version of the Job Content Questionnaire, the Job Stress Scale⁽⁹⁾, and questions about health habits and conditions (for the use of alcohol the CAGE was used⁽¹⁰⁾).

To dichotomize the psychosocial work variables – psychological demand and control of work, the means (15.2 ±2.38; 14.9 ±2.53, respectively) were used as cut-off. From these two dimensions dichotomized as "high" and "low", the four categories were constituted as follows: low strain (high control and low demand – reference category), active work (high control and high demand), passive work (low control and low demand) and high strain (low control and high demand – greater exposure category)⁽²⁾.

The data were inserted into the software program Epi-info®, version 6.4. After verification of errors and inconsistencies, analysis was performed in PASW Statistics® (Predictive Analytics Software, from SPSS Inc., Chicago - USA) 18.0 for Windows.

The internal consistency of JSS, measured by Cronbach's Alpha Coefficient, was 0,62 (psychological demand α=0.74 and control of work α= 0.55). The Chi-square Test or Fisher's Exact Test was used to verify statistical significance (p<0.05).

This research was authorized by FASE/RS and by the Research Ethics Committee of the proponent institution, CAAE No. 0333.0.243.000-10, on 12/14/2010, and is in accordance with Resolution 196/96 of the National Health Council.

RESULTS

The Socio-educational agents at the CASEs/RS were predominantly of the female sex (55.8%), aged up to 44 years (51.9%) (mean= 44.4 years; SD=8.17), skin color self mentioned as white (75%), with undergraduate or post-graduate education (54.3%), married or with a partner (64.4%) and with up to two children (62.4%).

As regards life habits, a higher percentage of the agents have never smoked (58.2%) and had no suspected alcoholism (89.3%); slept from five to eight hours per day (89.8%); did not do regular physical activity (67.2%) and reported that they sometimes had time for leisure (50.3%). With regard to the workers' health conditions, 62.8% mentioned making use of some type of medication. Of these, 92% affirmed that its use was indicated by the doctor. When asked about the need for medical and psychological attendance in the last year, 79.6% and 35.5%, respectively responded affirmatively.

In the characterization of the labor profile, 70.1% had been working as agents for up to ten years and 53.7% had remained in the same work shift for up to eight years. The percentage of agents in the two shifts was similar. Of the total number of agents, 67.5% worked a weekly hour load of up to 40 hours and 9.2% had another job. Of these, 71.4% worked an hourly load in the other job of up to 20 hours and 53.4% had been working for at least six years in the other job. A higher percentage (55%) affirmed that they had received no training or qualification with reference to their work; that there were an insufficient number of agents in the scale of work (80.3%), and that they were not satisfied with their place of work (52.3%). With respect to being laid off work in the last year due to health problems, 36.1% needed up to nine days off, and 16.6%, from 10 to 24 days off.

The frequency of agents, according to the quadrants of the DCM occurred in the following manner: 30.2% were classified in the low strain quadrant, 29.7% in active work, 21% in passive work and 19.2% in high strain.

When the sociodemographic variables were evaluated according to the quadrants of the D-C Model (Table 1) no statistically significant differences were identified among the groups.

According to Table 2, the need for psychological follow-up in the last year and time for leisure showed difference among the groups evaluated (p<0.0001). With reference to suspected alcoholism, a tendency towards alcoholism was demonstrated among the agents classified in the high strain quadrant (p=0.057). The other variables pointed out no statistically significant difference among the groups evaluated (p>0.05).

In Table 3, there is significant evidence that among the agents who worked on night shift, among those dissatisfied with the work place and among those who needed from 25 to 99 days off work, there were higher percentages in the active work quadrant (p<0.05). Among those with up to six years of time worked in the other job, a higher percentage was verified in the passive work quadrant (p=0.001). Higher frequency was recorded in the low strain quadrant (p<0.0001) among the night shift agents, those who affirmed that the number of workers in the scale of work was sufficient, and those satisfied with the place of work. Higher frequency was also found for the high strain quadrant (p=0.047) among those with 10 to 24 days off work.

DISCUSSION

It is important to point out that the gap in studies with socio-educational agents was a limitation in the discussion of the results, and it is necessary to make comparisons and reference to studies with other populations (prison agents, doctors, nursing teams and docents).

In this study, when the psychological demand and control of work were combined to form the quadrants of the DCM, higher frequency of socio-educational agents was found in the low strain and active work quadrants. These results are similar to those found with professors⁽¹¹⁾. This similarity may be due to the routine pedagogical activities that the agents develop with the adolescents^(4-5). It is pointed out that the workers allocated to these two quadrants presented high control of their own work, which provides the worker with greater possibilities of making decisions and using skills.

Nevertheless, in general, there is no convergence in the studies with the various populations evaluated by means of the DCM as regards the percentages in each quadrant. In studies with nursing workers a higher percentage was found in the passive work⁽⁹⁾, active work⁽¹²⁾ and high strain quadrants^(13-14).

In some studies, work involving high strain was associated with the occurrence of ill-health (minor psychic disorders^(9,11-13,15) and musculoskeletal diseases⁽¹⁶⁾), confirming the main prediction of the DCM that the greatest risk to health is concentrated in work under high strain. In this study, when this quadrant was broken down, important percentages of women agents over the age of 45, with post-graduate education, single, without children were observed classified as working under high strain (p>0.05). Where sex and age are concerned, it is pointed out that to do the job of socio-educational agent, it is necessary to be prepared to face situations of violence, immobilization of adolescents, dug abstinence crises, among others. Therefore, planning and inclusion of strategies to minimize stress generated in the work environment are necessary, such as, for example, the inclusion of work physical activity, which may maintain/develop physical vigor and mental health, so important in the development of the day to day actions of these agents.

The DCM describes that workers exposed to prolonged and high psychological demands in the work environment and to low control of the work, may become physically or psychically ill⁽²⁾, so that the need arises for follow-up and intervention by health professionals. To corroborate this presupposition, it was shown in this study that higher percentages of socio-educational agents who needed psychological follow-up in the last year were classified in the active work and high strain quadrants (31.8%; 29.5% respectively), and both are situations that cause high psychological demands.

From this aspect it is worth emphasizing some of the characteristics of the socio-educational agent's work, such as: pressure of time (having to develop various tasks during his/her work shift: pedagogical activities, reviews, accompanying adolescents within and outside of the institution, etc.), the high level of concentration (responsibility for the safety and preservation of the physical and psychological integrity of the adolescent; physical agility and quick thinking, etc.), constant state of alert (attention to conflicts among the adolescents, situations of mutiny, aggressions, intimidations, constant vigilance, etc.) and conflict of roles (need for restrained and prudent conduct, in spite of the type of offense committed by the adolescent). These are situations that constantly arise in the day to day life of these workers, and they contribute to the high levels of psychological demand.

In many of these situations, the workers have use coping strategies that are not compatible with health promotion, as in the case of using alcoholic beverages. When the consumption of alcoholic beverages was evaluated, 10.7% of the socio-educational agents were suspected of presenting alcoholism. Nevertheless, the percentage here shown was lower than that observed in a study that used the same evaluation instrument (CAGE) with prison agents (68.5%)⁽¹⁷⁾. These results, in spite of being negative for two professionals, seem to suggest that the specificity of the labor context of socio-educational agents differs from that of prison agents, because the percentages show a considerable difference in favor of the agents.

This datum suggests the need for a more in-depth approach in future studies, because the socio-educational agents work in an environment that is sometimes similar to that of prison agents, a characteristic that has been pointed out in the text. Bearing in mind the context of the work and the finding of a lower percentage of suspected alcoholism in the agents, some questions arise: the difference showing less alcoholism in socio-educational agents lies in the type of population served?, in the type of offense committed?, in the type of activity developed? Perhaps the fact that the socio-educational agents serve as model, and that they play a role of educator, in order to provide the adolescent's reinsertion into society, lessens the development of alcoholism in these workers.

Another important factor in minimizing the harmful effects of job stress in the individual is the stimulus to perform leisure or physical activities . In this study, it was observed that a higher percentage of the agents who reported having time for leisure were classified in the low strain quadrant (44.2%), and those who did not have time, in the active work (36.9%) and high strain (32.1%) quadrants. In a study with nursing workers, association was also found between insufficient time for leisure and high strain at work (82.7%)⁽⁷⁾. Leisure and physical activities act as compensatory mechanisms in the face of stress, anguish and anxiety, working as stress relievers, providing pleasure, relaxation and well-being⁽¹⁸⁾.

With reference to the specific questions of the agents' work, the results of this study showed that day workers presented significantly different percentages for classification in the high strain quadrant (26.9%, p=0.001), when compared with night workers (11.2%). These results corroborate those of a study conducted with nursing workers, in which it was found that day workers were more exposed to high strain ⁽¹¹⁾.

Specifically in the day work of the agents in the CASEs, there is a larger contingent of workers, bearing in mind the larger number of activities developed in this period (hygiene procedures, school, workshops, leisure activities, visits, consultations, among others). It is in this period also that agents need to pay more attention, due to the large number of persons circulating in the unit, among them family members, servants and the adolescents themselves. Thus, day work has a more accelerated rhythm, requiring constant attention and a state of alert. These are psychic loads that may favor greater stress and fatigue in these workers. From this aspect, programming short intervals, or developing an entertaining activity (work gymnastics) during the shift may be a form of relaxation for the agents, reducing the effects of this psychic load.

The agents that had a longer time in another job (over six years) are allocated to the active work and high strain quadrants (50.0% and 43.8% respectively), quadrants with high levels of psychological demand, which have a greater impact on the negative results for health⁽²⁾. The option to maintain another employment link may reduce the individual's time spent on leisure and family life. For some workers this accumulation of responsibilities may increase the work overload and be harmful to their health⁽¹⁹⁾.

Moreover, it is pointed out that the socio-educational agents with working time in another job of up to six years, and those who reported a sufficient scale of work, were predominantly classified in passive work (36.8%; 33.3% respectively). Passive work is also a harmful work situation, because it may generate loss of skills and interest by the worker⁽¹⁹⁾. The gradual loss of skills produced by passive work, lack of motivation and restrictions on creativity are situations that may make it difficult for workers to try out their own ideas in order to improve the work process, which may result in a loss of productivity⁽²⁾.

The agents that considered the number of workers in the scale of work insufficient, and those dissatisfied with the work place, were predominantly classified in active work (33.0%, 32.6% respectively; p=<0.001). "The challenging situations, typical of professional work, require higher levels of performance, however, without psychological stress, which correspond to active work"^(2:35). However, some studies have demonstrated that workers who are doing active work are also exposed to psychic ill-health^(7,11,12). The evidence of these studies signals the need for greater attention to this group of workers as well, because to consider the contingent of workers insufficient and not being satisfied with the work place, allied to the other characteristics of the Agent's work, may be factors of discouragement and ill-health.

With regard to this, in the present study, it was observed that the workers who have been laid off work because of health problems were in the groups with high levels of psychological demand (active work and high strain). The absences from work may provide data with respect to the state of health of a group of workers, and may also be related to factors of work organization, such as duration of the day's work, shift and autonomy at work⁽²⁰⁾. The absences from work may have a relationship with the high psychological and physical demand resulting from the characteristics of the work of socio-educational agents.

CONCLUSION

A high percentage of socio-educational agents allocated in the active work and high strain quadrants was identified. In spite of the limitations imposed by the cross-sectional design, and by the difficulty of finding studies with this population, this study presents an initial panorama of the sociodemographic conditions, habits and health, and of the psychosocial aspects of the work of socio-educational agents.

This study portrays a facet that has still not been studied very much in this population, which is constantly demanded in the sense of professional attitudes and conduct consistent with the context of the work (state of alert, mediation of conflicts, emotional balance, need for restrained and prudent conduct). It also points out the direction for the development of qualitative studies that enable reflection about autonomy, creativity and coping with the various work situations.

Lastly, the importance of effectuating an active interdisciplinary Workers' Health Service should be emphasized, which could pay attention to the psychological demands arising from the work at the CASEs. In this context, the nurse in this service could work to reduce the rates of morbidity and risk of ill-health of socio-educational agents, and in conjunction with the other professionals, seek to provide these workers with a better quality of life.

Acknowledgement: Financial support from CNPq, universal tender Process No. 479042/2010-1.

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Publication Dates

• Publication in this collection
  03 Apr 2013
• Date of issue
  Mar 2013

History

• Received
  16 Sept 2012
• Accepted
  22 Jan 2013