Conflito trabalho-família e síndrome metabólica: resultados do estudo longitudinal de saúde do adulto (ELSA-Brasil)
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2023-08-18
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Universidade Federal de Viçosa
Resumo
A síndrome metabólica (SM) é uma condição clínica caracterizada por um conjunto de alterações fisiopatológicas relacionadas ao aumento do risco cardiovascular. Os estudos a respeito do conceito conflito trabalho-família (CTF), desajuste em conciliar as demandas da vida profissional e familiar, aumentaram nos últimos anos, demonstrando a necessidade de entender suas possíveis consequências negativas à saúde. Estudos apontam o CTF como um fator associado a comportamentos não saudáveis e piores desfechos em saúde, mas não foram identificadas investigações sobre sua associação com a SM. Assim, esta investigação se propôs a estudar a associação entre o CTF e a incidência de SM a partir de dados do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Para isso, foi realizada uma análise longitudinal, combinando dados da linha de base (2008-2010) e da segunda onda (2012-2014) de 2.565 homens e 3.576 mulheres participantes do ELSA-Brasil. A variável de exposição principal foi definida por quatro indicadores de CTF, mensurados por um instrumento validado para o português e aplicado na linha de base da coorte, que avaliam o conflito do trabalho para a família (T→F) baseado no tempo (i) e no desgaste (ii), da família para o trabalho (F→T) (iii), e o tempo disponível para o autocuidado e lazer (iv). A variável desfecho foi a incidência de SM entre linha de base e segunda onda. As covariáveis foram características sociodemográficas (gênero, idade, escolaridade, raça/cor e situação conjugal) e relacionadas ao contexto familiar e de trabalho (cuida de pessoa doente ou com deficiência, tem filhos menores de 5 anos, tem empregada doméstica mensalista, e jornada de trabalho semanal). As associações entre o CTF e a incidência de SM foram testadas por meio de modelos de regressão de Poisson, com variância robusta, ajustados por potenciais fatores de confusão. Todas as análises foram estratificadas por gênero, e foram testadas interações multiplicativas de cada indicador de CTF com escolaridade e jornada semanal de trabalho. Os resultados deste estudo indicam maior frequência de conflito T→F, tanto baseado no tempo (33,0% vs. 26,5%) como no desgaste (25,6% vs. 16,8%), assim como maior falta de tempo para autocuidado e lazer (35,7% vs. 25,8%) nas mulheres comparadas aos homens. A incidência de SM, por sua vez, foi de 24,4% nos homens e 17,1% nas mulheres. Os modelos de regressão para a amostra total não evidenciaram associação entre os indicadores de CTF e a incidência de SM, em ambos os gêneros. As análises de interação, no entanto, revelaram que a jornada semanal de trabalho atua como um modificador de efeito da relação estudada entre mulheres: o conflito T→F baseado no desgaste foi associado a um aumento no risco de SM (RR = 1,45, IC95% = 1,09-1,92) naquelas com jornada semanal superior a 40 horas. Logo, conclui-se que nossos achados contribuem para o conjunto de evidências sobre os efeitos deletérios do CTF sobre a saúde cardiometabólica ao apontar que a percepção de que o trabalho dificulta cumprir responsabilidades domésticas se associa a um aumento no risco de SM entre mulheres com maior jornada de trabalho.
Palavras-chave: Síndrome metabólica. Conflito trabalho-família. Estudos longitudinais. Jornada de trabalho. Equilíbrio trabalho-vida. Saúde ocupacional. Gênero.
Metabolic syndrome (MetS) is a clinical condition characterized by a set of pathophysiological changes related to increased cardiovascular risk. Studies regarding the concept of work-family conflict (WFC), a maladjustment in reconciling the demands of professional and family life, have increased in recent years, demonstrating the need to understand its possible negative consequences for health. Studies point to WFC as a factor associated with unhealthy behaviors and worse health outcomes, but no investigations into its association with MetS have been identified. Thus, this investigation aimed to study the association between WFC and the incidence of MetS using data from the Longitudinal Study of Adult Health (ELSA-Brazil). For this, a longitudinal analysis was carried out, combining data from the baseline (2008-2010) and the second wave (2012-2014) of 2,565 men and 3,576 women participating in ELSA-Brazil. The main exposure variable was defined by four WFC indicators, measured by an instrument validated for Portuguese and applied at the cohort's baseline, which assess work-family conflict (W→F) based on time (i) and wear and tear (ii), from family to work (F→W) (iii), and the time available for self-care and leisure (iv). The outcome variable was the incidence of MetS between baseline and second wave. The covariates were sociodemographic characteristics (gender, age, education, race/color and marital status) and related to the family and work context (care for a sick or disabled person, have children under 5 years of age, have a monthly domestic worker, and working hours weekly working hours). The associations between WFC and the incidence of MetS were tested using Poisson regression models, with robust variance, adjusted for potential confounding factors. All analyzes were stratified by gender, and multiplicative interactions of each WFC indicator with education and weekly working hours were tested. The results of this study indicate a higher frequency of W→F conflict, both based on time (33.0% vs. 26.5%) and exhaustion (25.6% vs. 16.8%), as well as a greater lack of time for self-care and leisure (35.7% vs. 25.8%) in women compared to men. The incidence of MetS, in turn, was 24.4% in men and 17.1% in women. The regression models for the total sample did not show an association between WFC indicators and the incidence of MetS, in both genders. Interaction analyses, however, revealed that weekly working hours act as an effect modifier of the relationship studied among women: the wear-based W→F conflict was associated with an increase in the risk of MetS (RR = 1.45, 95%CI = 1.09-1.92) in those with a weekly working day of more than 40 hours. Therefore, it is concluded that our findings contribute to the body of evidence on the deleterious effects of WFC on cardiometabolic health by pointing out that the perception that work makes it difficult to fulfill domestic responsibilities is associated with an increase in the risk of MetS among women with higher working day. Keywords: Metabolic syndrome. Work-family conflict. Longitudinal studies. Working hours. Work-life balance. Occupational health. Gender.
Metabolic syndrome (MetS) is a clinical condition characterized by a set of pathophysiological changes related to increased cardiovascular risk. Studies regarding the concept of work-family conflict (WFC), a maladjustment in reconciling the demands of professional and family life, have increased in recent years, demonstrating the need to understand its possible negative consequences for health. Studies point to WFC as a factor associated with unhealthy behaviors and worse health outcomes, but no investigations into its association with MetS have been identified. Thus, this investigation aimed to study the association between WFC and the incidence of MetS using data from the Longitudinal Study of Adult Health (ELSA-Brazil). For this, a longitudinal analysis was carried out, combining data from the baseline (2008-2010) and the second wave (2012-2014) of 2,565 men and 3,576 women participating in ELSA-Brazil. The main exposure variable was defined by four WFC indicators, measured by an instrument validated for Portuguese and applied at the cohort's baseline, which assess work-family conflict (W→F) based on time (i) and wear and tear (ii), from family to work (F→W) (iii), and the time available for self-care and leisure (iv). The outcome variable was the incidence of MetS between baseline and second wave. The covariates were sociodemographic characteristics (gender, age, education, race/color and marital status) and related to the family and work context (care for a sick or disabled person, have children under 5 years of age, have a monthly domestic worker, and working hours weekly working hours). The associations between WFC and the incidence of MetS were tested using Poisson regression models, with robust variance, adjusted for potential confounding factors. All analyzes were stratified by gender, and multiplicative interactions of each WFC indicator with education and weekly working hours were tested. The results of this study indicate a higher frequency of W→F conflict, both based on time (33.0% vs. 26.5%) and exhaustion (25.6% vs. 16.8%), as well as a greater lack of time for self-care and leisure (35.7% vs. 25.8%) in women compared to men. The incidence of MetS, in turn, was 24.4% in men and 17.1% in women. The regression models for the total sample did not show an association between WFC indicators and the incidence of MetS, in both genders. Interaction analyses, however, revealed that weekly working hours act as an effect modifier of the relationship studied among women: the wear-based W→F conflict was associated with an increase in the risk of MetS (RR = 1.45, 95%CI = 1.09-1.92) in those with a weekly working day of more than 40 hours. Therefore, it is concluded that our findings contribute to the body of evidence on the deleterious effects of WFC on cardiometabolic health by pointing out that the perception that work makes it difficult to fulfill domestic responsibilities is associated with an increase in the risk of MetS among women with higher working day. Keywords: Metabolic syndrome. Work-family conflict. Longitudinal studies. Working hours. Work-life balance. Occupational health. Gender.
Descrição
Palavras-chave
Síndrome metabólica, Trabalho e família - Aspectos da saúde
Citação
ALMEIDA, Maria Isabel Lopes. Conflito trabalho-família e síndrome metabólica: resultados do estudo longitudinal de saúde do adulto (ELSA-Brasil). 2023. 54 f. Dissertação (Mestrado em Ciência da Nutrição) - Universidade Federal de Viçosa, Viçosa. 2023.