Psychosocial aspects of work and minor psychic disorders in nursing: use of combined models

Rev. Latino-Am. Enfermagem Original Article 2018;26:e3068 DOI: 10.1590/1518-8345.2769.3068 www.eerp.usp.br/rlae Psychosocial aspects of work and minor psychic disorders in nursing: use of combined models* Evelin Daiane Gabriel Pinhatti1 Renata Perfeito Ribeiro1 Marcos Hirata Soares1 Júlia Trevisan Martins1 Maria Ribeiro Lacerda2 Maria José Quina Galdino3,4 Objective: to analyze the combined use of models for the evaluation of work-related psychosocial aspects and their association with the prevalence of Minor Psychics Disorders among nursing workers. Method: cross-sectional study with a sample of 285 nursing workers. Data collection was performed through the application of a structured sociodemographic and occupational questionnaire and the Demand-Control-Support, Effort-Reward Imbalance and Self-Reporting Questionnaire. Descriptive analysis and a multiple logistic regression were performed. Results: the prevalence of suspicion of minor psychics disorders was 32.6%. The dimensions of both models were associated with mental health. The full Effort-Reward Imbalance and DemandControl and Social Support models predict Minor Psychics Disorders to a greater extent than the combined use of partial models. Conclusion: it was found that the Effort-Reward Imbalance model captured better the magnitude of the Minor Psychics Disorders in this sample of workers compared to the Demand-Control and Social Support model. However, the concomitant use of the theoretical models revealed unique contributions in the evaluation of Minor Psychics Disorders. Considering the complexity of mental illnesses, it is important that different factors be evaluated. Descriptors: Occupational Health; Working Environment; Psychological Stress; Mental Disorders; Health Personnel; Nursing Team. * Paper extracted from master’s thesis “Aspectos psicossociais do trabalho e distúrbios psíquicos menores em trabalhadores de enfermagem”, presented to Programa de Pós-Graduação em Enfermagem, Universidade Estadual de Londrina, Londrina, PR, Brazil. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001. 1 Universidade Estadual de Londrina, Departamento de Enfermagem, Londrina, PR, Brazil. 2 Universidade Federal do Paraná, Departamento de Enfermagem, Curitiba, PR, Brazil. 3 Universidade Estadual de Maringá, Departamento de Enfermagem, Maringá, PR, Brazil. 4 Universidade Estadual do Norte do Paraná, Departamento de Enfermagem, Bandeirantes, PR, Brazil. How to cite this article Pinhatti EDG, Ribeiro RP, Soares MH, Martins JT, Lacerda MR, Galdino MJQ. Psychosocial aspects of work and minor psychic disorders in nursing: use of combined models. Rev. Latino-Am. Enfermagem. 2018;26:e3068. [Access ___ __ ____]; Available in: ___________________. DOI: http://dx.doi.org/10.1590/1518-8345.2769.3068. month day year URL Rev. Latino-Am. Enfermagem 2018;26:e3068. 2 Introduction According to the ERI model, in the event that efforts arising from external demands or internal motivations Work has been the focus of attention of scholars are high and rewards low, unfavorable health outcomes because it is considered a relevant factor both in the are more likely to occur. The model also predicts that onset of diseases and in the well-being of individuals(1). the imbalance between effort-reward will be experienced Psychosocial risks stand out among the risks to which more often by those who have overcommitment at work workers are exposed, being recognized as world-wide because they present a greater need for approval from problems affecting all professions(2). Such factors can be their colleagues(11). perceived as the interaction between work and worker, Despite the similarities between the two models, environment, and on the satisfaction with the activity considering that both assess psychosocial imbalance performed and with the conditions of the organization. at work, they have differences. The DCS model refers They can also include the capacity of workers, besides to the structural characteristics of the psychosocial their needs, culture and personal situations(3). Increasing environment, emphasizing democracy and the division of flexibility and precarious of job conditions, labor work. In turn, the ERI model distinguishes personal and intensification and interpersonal relationship problems macro social characteristics; it considers the individual’s in the work environment favor these factors(2). They motivational pattern, as well as reciprocity perceptions, may play an important role in the health and work incorporated by salary, esteem and safety at work(11). performance of workers and their seriousness can Previous studies have compared the DCS and be identified in terms of physical and mental health ERI models or used them in combination to predict consequences(1,4). cardiovascular risk (12), burnout (13), musculoskeletal In the occupational environment of nursing, the disorders (14), self-reported health (15), and mental demands are high. These workers deal with complex health(16-17). However, the authors did not identify situations, time pressure, shortage of personnel and studies that evaluated Minor Psychics Disorders (MPD) material resources, and increasing demand of high performance in order to guarantee the quality of care. Thus, nursing is a profession that characteristically encompasses a physically and emotionally demanding work structure(5-6). In a recent systematic review, it was evidenced that exposure to adverse experiences at work is a risk factor for mental health(4). Two theories have been used to evaluate the psychosocial aspects of work: the Demand-Control and Social Support (DCS)(7) model and the Effort-Reward Imbalance (ERI) (8) model. The DCS model predicts that individuals exposed to high levels of psychological demand, associated with low levels of control at work, are more likely to develop a high stress, which predispose them to deleterious effects on their health(9). In contrast, the high control involved in decision making and authority and the greater use of skills can mitigate the consequences of the high demands on the health of those workers(7). The addition of social support at work by supervisors and peers acts as a moderator of stress, reducing the exhaustion of workers(10). The ERI model emphasizes social reciprocity and proposes that high levels of work effort must be accompanied by high levels of reward, be they economic benefits, recognition, promotion prospects, or job security. When the individual experiences an imbalance in nursing, using the combination of the two models. MPD are used to describe depressive and anxious symptoms characterized by non-specific and nonpsychotic clinical conditions. These conditions include symptoms such as insomnia, fatigue, irritability, forgetfulness, difficulty concentrating and somatic complaints - headache, sto (...truncated)