Psychological demand and control of the work process of public university servants

Denise Cristina Alves de Moura Rosangela Maria Greco Heloisa Campos Paschoalin Luciana Fernandes Portela Cristina Arreguy-Sena Alfredo Chaoubah About the authors

Resumo

Pesquisa transversal que objetivou analisar a demanda psicológica e o controle do trabalho autorreferido pelos Técnicos Administrativos em Educação de uma universidade pública. Amostra de seleção completa composta por 833 Técnicos Administrativos em Educação, que auto preencheram um questionário com questões estruturadas em 2013/2014. Realizada análise descritiva e bivariada com cálculo do estresse psicossocial no trabalho, utilizando os quadrantes do Modelo Demanda-Controle categorizados como: trabalho de baixa exigência (baixa demanda e alto controle) grupo de referência, trabalho passivo (baixa demanda e baixo controle), trabalho ativo (alta demanda e alto controle), alta exigência (alta demanda e baixo controle) grupo de maior exposição. Foram atendidos todos os requisitos éticos e legais de pesquisa envolvendo seres humanos. Houve predomínio da categoria de trabalhadores que executam trabalho passivo (n = 319; 39,7%), trabalho de baixa exigência (n = 274; 34,1%), trabalho de alta exigência (n = 116; 14,4%) e trabalho ativo (n = 95; 11,8%). Houve contribuições da investigação para a saúde destes trabalhadores, na medida em que propiciou um diagnóstico da categoria. Há recomendação para que tais dados subsidiem intervenções no sentido de empoderálos e fazer readequação dos postos de trabalho.

Palavras-chave
Saúde do trabalhador; Condições de trabalho; Esgotamento profissional

Abstract

This cross-sectional research aimed to analyze the psychological demand and work control self-reported by the Education Administrative Technicians of a public university. This is a complete sample selection consisting of 833 Education Administrative Technicians who self-completed a questionnaire with questions structured in 2013/2014. A descriptive bivariate analysis was performed with the calculation of psychosocial stress at work, using the Demand-Control Model quadrants categorized as: low-demand work (low-demand and high-control), reference group, passive work (low-demand and low-control), active work (high-demand and high-control), high-demand (high-demand and low-control) – group with the highest exposure. The study complies with all ethical and legal research requirements involving human beings. There was a predominance of the category of workers performing passive work (n = 319, 39.7%), low work demand (n = 274, 34.1%), high work demand (n = 116, 14.4%) and active work (n = 95, 11.8%). There were contributions from the investigation on the health of these workers insofar as they provided a diagnosis of the category. There is a recommendation for such data to support interventions to empower them and retailor jobs.

Key words
Workers’ health; Work conditions; Professional exhaustion

Introduction

In the last four decades, some researchers have turned their attention to the study of work psychosocial factors. Thus, theoretical and methodological proposals were developed to support investigative models11. Prochnow A, Magnago TSBS, Urbanetto JS, Beck CLC, Lima SBS, Greco PBT. Capacidade para o trabalho na enfermagem: relação com demandas psicológicas e controle sobre o trabalho. Rev. Latino-Am. Enfermagem [periódico na Internet]. 2013 [acessado 2013 Jul 13]; 21(6):1298-305. Disponível em: http://www.scielo.br/pdf/rlae/v21n6/pt_0104-1169-rlae-21-06-01298.pdf
http://www.scielo.br/pdf/rlae/v21n6/pt_0...
,22. Karasek R, Theorell T. Healthy work: stress, productivity and the reconstruction of working life. New York: Basic Books; 1990.. Among the theoretical models that evaluate stress at work are the Demand-Control Model (DCM)22. Karasek R, Theorell T. Healthy work: stress, productivity and the reconstruction of working life. New York: Basic Books; 1990. and the Effort-Reward Imbalance (ERI)33. Siegrist J. Adverse health effects of high-effort/low-re-ward conditions. J Occup Health Psychol [periódico na Internet]. 1996 [acessado 2013 Jun 24] 1(1):27-41. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/9547031
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Karasek proposed a model that emphasizes the way work is organized and that involves two realms, namely, demand and control. Demand is understood as work requirements of a psychological nature, time, speed, productivity and conflicts over contradictory demands. Control refers to workers’ power over work, characterized by the possibility of autonomy, decision-making and cognitive abilities22. Karasek R, Theorell T. Healthy work: stress, productivity and the reconstruction of working life. New York: Basic Books; 1990.,44. Griep RH, Rotenberg L, Landsbergis P, VasconcellosSilva PR. Uso combinado de modelos de estresse no trabalho e a saúde auto-referida na enfermagem. Rev Saúde Publica [periódico na Internet]. 2011 [acessado 2013 Maio 8]; 45(1):145-152. Disponível em: http://www.scielo.br/scielo.php?pid=S0034-89102011000100017&script=sci_arttext
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66. Karasek R. Job demands, job decision latitude and mental strain: Implications for job redesign. Administrative Science Quarterly [periódico na Internet]. 1979 [acessado 2014 Mai 20]; 24 (2):285-308. Disponível em: http://connection.ebscohost.com/c/articles/4009891/job-demands-job-decision-latitude-mental-strain-implications-job-redesign
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In 1988, Johnson and Hall included another realm in the model, namely, social support, which refers to the interaction between colleagues and bosses in the cooperation for the accomplishment of work, which can contribute to reduced workers’ wear and health risks77. Johnson JV, Hall EM. Job strain, workplace social support and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population. Am J Public Health. [periódico na Internet]. 1988 [acessado 2013 Jun 8]; 78(10):1336-1342. Disponível em: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1349434/
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Currently, two different instruments in their respective Brazilian versions are used in the country for the Demand-Control Model, and they are: “Job Content Questionnaire (JCQ)” and the reduced scale called the Swedish Demand-Control-Social-Support Scale (DCS), developed by Theorell in 198822. Karasek R, Theorell T. Healthy work: stress, productivity and the reconstruction of working life. New York: Basic Books; 1990.,44. Griep RH, Rotenberg L, Landsbergis P, VasconcellosSilva PR. Uso combinado de modelos de estresse no trabalho e a saúde auto-referida na enfermagem. Rev Saúde Publica [periódico na Internet]. 2011 [acessado 2013 Maio 8]; 45(1):145-152. Disponível em: http://www.scielo.br/scielo.php?pid=S0034-89102011000100017&script=sci_arttext
http://www.scielo.br/scielo.php?pid=S003...
,55. Alves MGM, Chor D, Faerstein E, Lopes CS, Werneck GL. Versão resumida da “job stress scale”: adaptação para o português. Rev. Saude Publica [periódico na Internet]. 2004 [acessado 2013 Jun 15]; 38(2):164-171. Disponível em: http://www.revistas.usp.br/rsp/article/viewFile/31697/33584
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,88. Araujo TM, Karasek R. Validity and reliability of the job content questionnaire in formal and informal jobs in Brazil. SJWEH Suppl [periódico na Internet]. 2008 [acessado 2013 Jul 15]; Suppl (6):52-59. Disponível em: file:///C:/Users/Usu%C3%A1rio/Downloads/52_araujo%20(1).pdf
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,99. Theorell T, Karasek R. Current issues relating to psychosocial job strain and cardiovascular disease research. J Occup Health Psychol periódico na Internet]. 1996 [acessado 2013 Jun 21]; 1(1):9-26. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/9547038
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Stress at work is the result of the combination of high psychological demand, low work process control and low social support from peers and bosses at the workplace22. Karasek R, Theorell T. Healthy work: stress, productivity and the reconstruction of working life. New York: Basic Books; 1990.,1010. Aguiar OB, Fonseca MJM, Valente JG. Confiabilidade (teste-reteste) da escala sueca do Questionário Demanda-Controle entre Trabalhadores de Restaurantes Industriais do Estado do Rio de Janeiro. Rev Bras Epidemiol [periódico na Internet]. 2010 [acessado 2013 Maio 10]; 13(2):212-22. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S-1415-790X2010000200004
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1212. Alves MGM. Pressão no Trabalho: Estresse no Trabalho e Hipertensão Arterial em Mulheres no Estudo Pró-Saúde [tese]. Rio de Janeiro: Fundação Oswaldo Cruz; 2004..

In the tertiary sector of the economy, which is responsible for services, we find university workers who, because they work in the public sector, are often devalued and considered by the population to be inefficient, disinterested and privileged because they have steady job1313. França BH. Barnabé: consciência política do pequeno funcionário público. São Paulo: Cortez; 1993.,1414. Ribeiro CVS, Mancebo DO. Servidor Público no Mundo do Trabalho do Século XXI. Psicologia: Ciência e Profissão [periódico na Internet]. 2013 [acessado 2014 Jun 20]; 33(1):192-207. Disponível em: http://www.scielo.br/pdf/pcp/v33n1/v33n1a15.pdf
http://www.scielo.br/pdf/pcp/v33n1/v33n1...
. However, these workers may also be subjected to poor working conditions, with levels of demand and control over work that can lead to psychosocial stress at work, suffering and sickness1414. Ribeiro CVS, Mancebo DO. Servidor Público no Mundo do Trabalho do Século XXI. Psicologia: Ciência e Profissão [periódico na Internet]. 2013 [acessado 2014 Jun 20]; 33(1):192-207. Disponível em: http://www.scielo.br/pdf/pcp/v33n1/v33n1a15.pdf
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,1515. Filho JMJ, Marçal J. Desenho do trabalho e patologia organizacional: um estudo de caso no serviço público. Revista Produção [periódico na Internet]. 2004 [acessado 2014 Maio 8]; 14(3):58-66. Disponível em: http://www.prod.org.br/doi/10.1590/S0103-65132004000300007
http://www.prod.org.br/doi/10.1590/S0103...
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Thus, considering that working and living conditions interfere in workers’ health-disease process, this study aimed to analyze the psychological demand and control of work of Education Administrative Technicians (TAEs) from a Public university of the state of Minas Gerais.

Methods

This is a cross-sectional study with full selection composed of the population of Education Administrative Technicians (TAEs) from a public university of Minas Gerais that is part of a broader investigation, called “Education Administrative Technical Workers: Working and Life Conditions” (English free translation from the Portuguese).

The following were considered to be eligible: full-time active TAEs from the university that is the setting of the research, of the Juiz de Fora campus. The following were considered ineligible: workers absent due to medical leave, qualification/training leave and travelling to another institution. Of the 1,154 eligible workers, 833 (72.2%) adhered to the study.

A structured questionnaire was used, containing the following sociodemographic variables: age, gender, schooling, marital status, family income in minimum wages.

Issues related to the characteristics and working conditions surveyed were: number of jobs, working hours, weekly workload, university working time, night work and unhealthy, painful and dangerous work, besides issues about psychological demand, work process control and social support through the Brazilian version of the reduced scale of stress at work (Demand-control social support Model). The Summarized Demand-Control Model scale contains 17 questions previously validated for Brazilian Portuguese, with five for assessing demand, six for evaluating control and six for social support22. Karasek R, Theorell T. Healthy work: stress, productivity and the reconstruction of working life. New York: Basic Books; 1990.,55. Alves MGM, Chor D, Faerstein E, Lopes CS, Werneck GL. Versão resumida da “job stress scale”: adaptação para o português. Rev. Saude Publica [periódico na Internet]. 2004 [acessado 2013 Jun 15]; 38(2):164-171. Disponível em: http://www.revistas.usp.br/rsp/article/viewFile/31697/33584
http://www.revistas.usp.br/rsp/article/v...
,1616. Faerstein E, Chor D, Lopes CS, Werneck GL. Estudo Pró-Saúde: características gerais e aspectos metodológicos. Rev Bras Epidemiol [periódico na Internet]. 2005 [acessado 2013 Maio 7]; 8(4):454-466. Disponível em: http://www.scielosp.org/pdf/rbepid/v8n4/12.pdf
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Data collection was performed through the application of self-administered questionnaires delivered to participants, in the institution where they worked. Servants completed the questionnaire only after reading and signing the Informed Consent Form (ICF).

Occupational and sociodemographic characteristics were selected as independent variables, and the Demand-Control Model variables as dependent variables. Data were addressed in the Statistical Package for the Social Sciences (Soft-ware SPSS®) version 20. Data analysis was performed using descriptive and bivariate statistics of socioeconomic and demographic data, work characteristics, social support, stress at work and characterization according to the activities developed.

The formulation of the Demand-Control Model (DCM) quadrants was used to calculate the psychosocial stress at work, which defines the following categories: low-demand work (low demand and high control), reference group for psychosocial stress at work; passive work (low demand and low control), which can cause reduced ability to solve daily work problems; active work (high demand and high control) are those that enable the worker to develop competences and abilities in their work; high demand (high demand and low control), a group with the highest exposure to stress at work22. Karasek R, Theorell T. Healthy work: stress, productivity and the reconstruction of working life. New York: Basic Books; 1990.,55. Alves MGM, Chor D, Faerstein E, Lopes CS, Werneck GL. Versão resumida da “job stress scale”: adaptação para o português. Rev. Saude Publica [periódico na Internet]. 2004 [acessado 2013 Jun 15]; 38(2):164-171. Disponível em: http://www.revistas.usp.br/rsp/article/viewFile/31697/33584
http://www.revistas.usp.br/rsp/article/v...
,1010. Aguiar OB, Fonseca MJM, Valente JG. Confiabilidade (teste-reteste) da escala sueca do Questionário Demanda-Controle entre Trabalhadores de Restaurantes Industriais do Estado do Rio de Janeiro. Rev Bras Epidemiol [periódico na Internet]. 2010 [acessado 2013 Maio 10]; 13(2):212-22. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S-1415-790X2010000200004
http://www.scielo.br/scielo.php?script=s...
,1111. Scalco GPC, Abegg C, Celeste RK, Hökerberg YHM, Faerstein E. Occupational stress and self-perceived oral health in Brazilian adults: a Pro-Saude study. Ciência & Saúde Coletiva [periódico na Internet]. 2013 [acessado 2015 Maio 21]; 18(7):2069-2074. Disponível em: http://www.scielo.br/pdf/csc/v18n7/22.pdf
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The scores of each realm were obtained by adding the scores of answers and, later, dividing them into two categories from the median, according to Alves et al.1717. Alves MGM, Chor D, Faerstein E, Werneck GL, Lopes CS. Estresse no trabalho e hipertensão arterial em mulheres no Estudo Pró-Saúde. Rev Saude Publica [periódico na Internet]. 2009 [acessado 2013 Maio 15]; 43(5):893-896. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102009000500019
http://www.scielo.br/scielo.php?script=s...
. With regard to the demand, the cutoff point was 14 points and workers that obtained results of 5 to 14 points had their jobs classified in the low-demand, and values above 14 points were ranked in the high-demand category. With respect to control, the cutoff point was 17 points, and those individuals who obtained a total score between 6 and 17 points were classified as having low-control at work and those with scores above 17 points were classified under high-control at work. Similarly, the cutoff point for social support at work was 17 points, classifying individuals with scores up to 17 points as with low-social support and those above 17 points with high-social support.

We considered a significant association between the variables studied when p-value was ≤ 0.05 according to the chi-square statistical test. The reference group was the low requirement category and the exposure group was the high requirement category (stress at work) in the bivariate analyses.

The Ethics and Research Committee of the university approved the aforementioned project, meeting the fundamental ethical and scientific requirements for conducting research with human beings. In 2013, this same Committee authorized the extension of the research schedule.

Results

Results show that the population of this study consisted of 51.5% of men, with the mean age of workers of 46.1 years (standard deviation ± 10.9 years and variability from 22 to 72 years). Regarding schooling level, 54.4% had postgraduate degrees, and as for marital status, 63.7% of the workers were married or had a stable union. Regarding the economic classification, 45.8% of workers reported receiving between five and ten minimum wages.

The labor characteristics made it possible to identify that 83.9% of workers had only one job, 82.8% worked fixed hours and 79.1% had a weekly workload ≤ 40 hours. As for length of service, 63.9% had more than ten years of employment. Regarding work shifts, 82.8% of workers did not work at night and 38.3% reported receiving additional wages because they performed dangerous, distressing or unhealthy activities.

TAEs’ main activities and posts were characterized as follows: administrative activities (33.9%), specialized technical support (28.2%), health-related activities (25.5%) and logistical support (12.2%).

With regard to demand, control and social support at work, 73.8% of workers showed low-demand and 26.2%, high-demand. Regarding control, 54.1% had low-control and 45.9% had high-control. Most workers showed high-social support (77.4%) and low-social support at work (22.6%) (Table 1).

Table 1
Characterization of TAEs according to the psychological demands, control and social support at work, dichotomized in the distribution median - Juiz de Fora, 2015 (N = 833)*.

Table 2 shows the distribution of TAEs in the Demand-Control Model quadrants. The category of quadrants that included the largest number of workers was passive labor, which combined low-demand and low-control (39.7%), followed by low-demand, characterized by low-demand and high-control (34.1%). High-demand work (high-demand and low-control) included 14.4% of workers of the study population. On the other hand, the group with the lowest number of workers was active work, characterized by high psychological demand and high control over work, with 11.8% of workers.

Table 2
Characterization of TAEs according to DCM quadrants – Juiz de Fora, 2015 (N = 804)*.

The socioeconomic and demographic variables and DCM quadrants that maintained association with significance were schooling (p = 0.001) and monthly income (p <0.001) (Table 3). This study did not show any association with statistical significance between the variables gender, age and marital status and the DCM quadrants.

Table 3
Comparison between sociodemographic and occupational variables and the DCM quadrants. TAEs – Juiz de Fora, 2015 (N = 833).

Variables related to work characteristics and DCM quadrants that were associated with significance were number of jobs (p = 0.001), working hours (p = 0.012), weekly workload (p < 0.001), night work < 0.001) and time of service (p = 0.002) (Table 3). The additional variable for working with unhealthy, dangerous and distressing activities and DCM quadrants were not significantly associated (p = 0.27).

Workers with schooling up to full secondary education, low wages, single job, day work, steady shift, weekly workload ≤ 40 hours focused on passive work. The variable length of service at the university for those with lower length of service (1 to 5 years) concentrated in the low demand category.

Table 4 shows the distribution of the study population according to DCM quadrants and social support. The social support variable was significantly associated with DCM quadrants (p < 0.001).

Table 4
Comparison between the social support variable and the DCM quadrants. TAEs – Juiz de Fora, 2015 (N = 794)**.

It can be noted that the category of quadrants that included the largest number of workers was passive work associated with high social support (n = 259, 42.2%). However, regarding low social support, the category of quadrants that included the largest number of workers was high-demand (n = 62; 34.4%), which combines high-demand and low-control, and is the exposure group. The group with the lowest number of workers in the low social support category was active work (high-demand and high control over work), with n = 23 (12.8%).

Discussion

Data showed that, in the studied population, a proportional distribution of men and women was noted among workers, and while the difference was small between genders (51.5% and 48.5%, respectively), men predominated. However, we should outline women's work, because in addition to paid work, women still have to devote part of their time to domestic work, to caring for their children and other family members, which can lead to an overload of activities for such workers1818. Landerdahl MC, Vieira LB, Cortes LF, Padoin SMM. Processo de empoderamento feminino mediado pela qualificação para o trabalho na construção civil. Esc. Anna Nery [periódico na Internet]. 2013 [acessado 2014 Jun 13]; 17(2):306-312. Disponível em: http://www.scielo.br/scielo.php?pid=S1414-81452013000200015&script=sci_arttext
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2020. Elias MA, Navarro VL. A relação entre o trabalho, a saúde e as condições de vida: negatividade e positividade no trabalho das profissionais de enfermagem de um hospital escola. Rev. Latino-Am. Enfermagem [periódico na Internet]. 2006 [acessado 2013 Jul 14]; 14(4):517-25. Disponível em: http://www.scielo.br/pdf/rlae/v14n4/v14n4a08.pdf
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Regarding schooling, 54.4% of the workers had a postgraduate degree, which can be explained by the fact that they work in a public university, have a steady employment, compete for the proportion of vacancies allocated to servants for postgraduate studies that are offered at this university, which encourage their participation in the training process and the development of additional competences.

A study carried out with administrative technicians of a State Higher Education Institution revealed that workers’ improved level of education is a positive aspect for the quality of life at work. However, when workers’ education level exceeds that required for their jobs and their remuneration is not compatible with their educational background, demotivation, decreased productivity, conflicts with the manager may emerge, among other aspects2121. Freitas ALP, Souza RGB, Quintella HLMM. Qualidade de Vida no Trabalho do técnico-administrativo em IES públicas: uma análise exploratória. Revista Brasileira de Qualidade de Vida [periódico na Internet]. 2013 [acessado 2013 Jul 14]; 05(02):1-12. Disponível em: https://periodicos.utfpr.edu.br/rbqv/article/view/1382
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The Demand-Control Model quadrants category that included the largest number of people was passive work (39.7%), which combined low-demand and low-control, which is the second most problematic exposure to health, since it does not allow workers to develop further and propitiates a gradual atrophy of skills learning1212. Alves MGM. Pressão no Trabalho: Estresse no Trabalho e Hipertensão Arterial em Mulheres no Estudo Pró-Saúde [tese]. Rio de Janeiro: Fundação Oswaldo Cruz; 2004.,2222. Alves MGM, Braga VM, Faerstein E, Lopes CS, Junger W. Modelo demanda-controle de estresse no trabalho: considerações sobre diferentes formas de operacionalizar a variável de exposição. Cad Saude Publica [periódico na Internet]. 2015 [acessado 2015 Jul 24]; 31(1):208-212. Disponível em: http://www.scielosp.org/pdf/csp/v31n1/pt_0102-311X-csp-31-01-00208.pdf
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There is evidence of association between stress at work with various outcomes using the DCM, such as hypertension1717. Alves MGM, Chor D, Faerstein E, Werneck GL, Lopes CS. Estresse no trabalho e hipertensão arterial em mulheres no Estudo Pró-Saúde. Rev Saude Publica [periódico na Internet]. 2009 [acessado 2013 Maio 15]; 43(5):893-896. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102009000500019
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, among others.

In a research conducted in the Pró-Saúde Study, which associated DCM with hypertension in a female population, there was a higher prevalence of hypertension among the group with passive work (28.3%), showing the impact on the health of these workers1717. Alves MGM, Chor D, Faerstein E, Werneck GL, Lopes CS. Estresse no trabalho e hipertensão arterial em mulheres no Estudo Pró-Saúde. Rev Saude Publica [periódico na Internet]. 2009 [acessado 2013 Maio 15]; 43(5):893-896. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102009000500019
http://www.scielo.br/scielo.php?script=s...
.

On the other hand, the Longitudinal Study on Adult Health (ELSA Brazil), carried out with public servants from five universities, observed that individuals with passive, active and high-demand work were more likely to have a diagnosis of migraine when compared to individuals with low demand work2525. Santos IS, Griep RH, Alves MGM, Goulart AC, Lotufo PA, Barreto SM, Chor D, Benseñor IM. Job stress is associated with migraine in current workers: The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Eur J Pain [periódico na Internet]. 2014. [acessado 2015 Dez 13]; 18(9):1290-7. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/24700516
http://www.ncbi.nlm.nih.gov/pubmed/24700...
.

Results similar to this study were found among workers from Finland, where passive work was also predominant in 34% of men and 33% of women2929. Kujala V, Tammelin T, Remes J, Vammavaara E, Ek E, Laitinen J. Work ability index of young employees and their sickness absence during the following year. Scand J Work Environ Health [periódico na Internet]. 2006 [acessado 2015 Dez 13];32(1):75-84. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/16539175
http://www.ncbi.nlm.nih.gov/pubmed/16539...
.

However, different results were found with public servants from the Whitehall II study in London, Helsinki Health Study and the Study with Japanese Public Servants, which associated stress at work with adverse health and obesity behaviors. In London, men with passive work were more likely to be physically inactive; the same outcome was found with women in Helsinki. In addition, London women exposed to passive work were less likely to consume alcoholic beverages and smokers3030. Lallukka T, Lahelma E, Rahkonen O, Roos E, Laaksonen E, Martikainen P. Associations of job strain and working overtime with adverse health behaviors and obesity: evidence from the Whitehall II Study, Helsinki Health Study, and the Japanese Civil Servants Study. Soc Sci Med [periódico na Internet].2008 [acessado 2015 Dez 13]; 66(8):1681-1698. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/18261833
http://www.ncbi.nlm.nih.gov/pubmed/18261...
.

In addition, low-control over the work process and low-demand, that is, the category of passive work, can behave as a discouraging factor, contributing to the increase of job dissatisfaction3131. Filha MMT, Costa MAS, Guilam MCR. Estresse ocupacional e autoavaliação de saúde entre profissionais de enfermagem. Rev. Latino-Am. Enfermagem [periódico na Internet]. 2013 [acessado 2014 Jul 20]; 21(2):[9 telas]. Disponível em: http://www.scielo.br/scielo.php?pid=S0104-11692013000200475&script=sci_arttext&tlng=pt
http://www.scielo.br/scielo.php?pid=S010...
.

The lack of challenging situations that are relevant to workers can lead to decreased production of the individual and a lower capacity to produce solutions for the activities and problems faced in the daily work life22. Karasek R, Theorell T. Healthy work: stress, productivity and the reconstruction of working life. New York: Basic Books; 1990.,3232. Magnago TSBS, Lisboa MTL, Griep RH, Zeitoune RCG, Tavares JP. Condições de trabalho de profissionais da enfermagem: avaliação baseada no modelo demanda-controle. Acta Paul Enferm [periódico na Internet]. 2010 [acessado 2013 Jun 10]; 23(6):811-817. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-21002010000600015
http://www.scielo.br/scielo.php?script=s...
.

Reducing control over work and increasing work demand negative influence on private life were the most important factors associated with reduced work capacity3333. Boström M, Sluiter JK, Hagberg M. Changes in work situation and work ability in young female and male workers. A prospective cohort study. BMC Public Health [periódico na Internet]. 2012 [acessado 2015 Dez 13]; 12:694. Disponível em: http://www.biomedcentral.com/content/pdf/1471-2458-12-694.pdf
http://www.biomedcentral.com/content/pdf...
.

By associating the sociodemographic and economic variables with the DCM variables, we obtained significant associations with schooling and monthly income. In the category of schooling (until secondary education) and income in minimum wages “from one to five minimum wages” and “from five to ten minimum wages” were concentrated in the passive work category. On the other hand, low demand work prevailed in the income range of “more than ten minimum wages”. Therefore, workers with schooling up to full secondary education and with lower income strata have less control over the work process.

Studies with nursing workers corroborated this study, since a higher frequency of workers in the passive work and high demand categories was identified among subjects of this research, non-graduates and those with lower per capita income. This is to say that both categories involve work with low control. In the study, low-control workers were 1.67 times more likely to develop minor psychiatric disorders when compared to high-control workers, showing how low-control work is harmful to health3434. Kirchhof ALC, Magnago TSBS, Camponogara S, Griep RH, Tavares JP, Prestes FC, Paes LG. Condições de trabalho e características sócio demográficas relacionadas à presença de distúrbios psíquicos menores em trabalhadores de enfermagem. Texto Contexto Enferm [periódico na Internet]. 2009 [acessado 2014 Maio 23]; 18(2):215-23. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-07072009000200003
http://www.scielo.br/scielo.php?script=s...
.

On the other hand, while workers in this study showed predominantly passive work, they have high social support (77.4%) and only 22.6% of them had low social support when working with employees and bosses. Low social support can negatively affect workers’ health55. Alves MGM, Chor D, Faerstein E, Lopes CS, Werneck GL. Versão resumida da “job stress scale”: adaptação para o português. Rev. Saude Publica [periódico na Internet]. 2004 [acessado 2013 Jun 15]; 38(2):164-171. Disponível em: http://www.revistas.usp.br/rsp/article/viewFile/31697/33584
http://www.revistas.usp.br/rsp/article/v...
,3535. Urbanetto JS, Silva PC, Hoffmeister E, Negri BS, Costa BEC, Figueiredo CEP. Estresse no trabalho da enfermagem em hospital de pronto-socorro: análise usando a Job Stress Scale. Rev. Latino-Am. Enfermagem [periódico na Internet]. 2011 [acessado 2015 Maio 21]; 19(5):[10 páginas]. Disponível em: http://www.scielo.br/scielo.php?pid=S0104-11692011000500009&script=sci_arttext&tlng=pt.
http://www.scielo.br/scielo.php?pid=S010...
.

In an investigation with hospital workers (public servants) using the DCM, social support and burnout to identify the length of sickness-related absenteeism according to Sick Leave (LTS), a 2.04 increase in the expected LTS days due to low colleague support was noted, which presupposes that, regardless of whether it is related to passive work or not, low social support can contribute to sickness3636. Santos K. Absenteísmo-doença, estresse ocupacional e fatores associados: um estudo caso-controle aninhado em uma coorte de trabalhadores de hospitais estaduais públicos de Santa Catarina [dissertação]. Florianópolis: Programa de Pós-Graduação em Saúde Coletiva; 2010..

Repeated occupational stress and low work social support among British public servants of the Whitehall II study increased the risk of major depressive disorder (MDD), which demonstrates the relevance of social support at work2828. Stansfeld SA, Shipley MJ, Head J, Fuhrer R. Repeated Job Strain and the Risk of Depression: Longitudinal Analyses From the Whitehall II Study. Am J Public Health [periódico na Internet]. 2012 [acessado 2014 Jun 03]; 102(12):2360-2366. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/23078508
http://www.ncbi.nlm.nih.gov/pubmed/23078...
.

A survey carried out in France on annual health care costs and sick leave related to work-related stress concluded that the economic effect of work stress-derived illnesses contribute to the formulation of public policies with emphasis on preventive actions3737. Sultan-Taïeb H, Chastang JF, Mansouri M, Niedhammer I. The annual costs of cardiovascular diseases and mental disorders attributable to job strain in France. BMC Public Health [periódico na Internet]. 2013 [acessado 2015 Jun 12]; 13:748. Disponível em: http://www.biomedcentral.com/1471-2458/13/748.
http://www.biomedcentral.com/1471-2458/1...
.

Study limitations

Among the limitations of this study, we can mention that the fact that the population studied has a public job, is part of the university, characterized as being a tertiary sector service and having a steady job in the labor market does not allow data to include the general population, although it allows comparisons with populations with similar characteristics.

The type of design used is also a limitation of the study, since cross-sectional studies do not allow the establishment of a temporal relationship between events, that is, causality cannot be assigned to the exposure-outcome relationship3838. Portela LF. Relações entre o estresse psicossocial no trabalho segundo o modelo demanda-controle e a pressão arterial monitorada: o papel do trabalho doméstico [tese]. Rio de Janeiro: Fundação Oswaldo Cruz; 2012..

Another limitation inherent to this study is the different ways of assessing exposure to stress found in literature. In other words, there are multiple ways to categorize psychological demand and control scores. In addition to the formulation of quadrants, it is common to use the continuous forms of the model's realms3939. Griep RH, Nobre AA, Alves MG, Fonseca MJ, Cardoso LO, Giatti L, Melo EC, Toivanen S, Chor D. Job strain and unhealthy lifestyle: results from the baseline cohort study, Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). BMC Public Health 2015; 15:309., the demand-control ratio, in addition to the logarithmic formulations of subtraction4040. Kondo K, Kobayashi Y, Hirokawa K, Tsutsumi A, Kobayashi F, Haratani T, Araki S, Kawakami N. Job strain and sick leave among Japanese employees: a longitudinal study. Int Arch Occup Environ Health 2006; 79(3):213-219.. It may be that the different categorization methods found in literature have hampered the comparison of studies3838. Portela LF. Relações entre o estresse psicossocial no trabalho segundo o modelo demanda-controle e a pressão arterial monitorada: o papel do trabalho doméstico [tese]. Rio de Janeiro: Fundação Oswaldo Cruz; 2012.,4141. Courvoisier DS, Perneger TV. Validation of alternative formulations of job strain. J Occup Health. [periódico na Internet]. 2010 [acessado 2015 Dez 12]; 52(1):5-13. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/19915315.
http://www.ncbi.nlm.nih.gov/pubmed/19915...
.

Final considerations

When analyzing the psychological demand and control of TAEs’ work of a public university in the state of Minas Gerais, it was possible to identify that the category of passive work predominated among the study population.

The positive aspects of this research are: socio-demographic heterogeneity and employment stability, which contributed, respectively, to the variability of social determinants of health in this population and to the possibility of monitoring workers in the long term and to the variety of occupations performed by the TAEs, since it is appropriate for the theoretical model used in this research (Demand-Control Model Social Support).

As contributions to the health of these workers, interventions are suggested so that these workers become agents of change in the work processes they perform and so be responsible for the decisions made in their daily work routine. Jobs re-adaptation is suggested, considering the results found in this research, according to the four DCM quadrants, so that workers can perform activities that are appropriate to their profiles.

In order to be able to think about public policies in universities, in addition to epidemiological studies such as this one, it is important to carry out research with qualitative approaches to verify workers’ perceptions about their work process, to answer questions that include human beings complexity, verticalizing in subjective aspects. In addition, it is necessary to involve the higher levels of the university and unions of the professional categories in order to raise people's awareness on the necessary changes.

Thus, we emphasize that this study is the first stage of a broader research that intends to support a prospective cohort study, which may contribute to remedy some of the hardships shown above and enable other analyses and discussions on TAEs’ health.

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Publication Dates

  • Publication in this collection
    Feb 2018

History

  • Received
    25 July 2015
  • Reviewed
    14 Jan 2016
  • Accepted
    16 Jan 2016
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