Elisa Ansoleaga

Malestar psicofisiológico en profesionales de la salud pública de la Región Metropolitana

Background: The public health reform in Chile resulted in changes in working conditions and organization of health centers. Aim : To examine the presence of psychophysiological symptoms in professionals of public hospitals in the Metropo- litan Region and their association with current working conditions. Material and Methods : A questionnaire of quality of working life was applied to a sample of 80 physicians and 110 nurses. The questionnaire considers scales and open questions. Results : Nurses had a higher level of discomfort than physicians (p < 0.01) and had signifi cantly higher scores for emotional distress, physical fatigue, digestive disorders, headache, insomnia, back pain and muscle tension (p < 0.01). There were statistically signifi cant negative correlations between psychophysiological distress and working conditions (r = -0.418), social climate (r = -0.395), satisfaction with the organization (r = -0.337) and psychosocial well-being (r = -0.267). A regression model showed that 21% of the variance in psychophysiological distress was explained by working conditions, psychosocial well-be ing and adaptation to the organization. Conclusions: There is a relationship between the high prevalence of psychophysiological symptoms and bad working conditions of public health professionals

Sintomas depresivos y distres laboral en trabajadores chilenos: condiciones diferenciales para hombres y mujeres

This article assessed depressive symptoms associated with work-related psychosocial risk factors according to gender in Chile, using the demand-control model (Karasek) and effort-reward imbalance (Siegrist). A cross-sectional study was conducted in a random sample of 3,010 workers (35% female and 65% male) from the country. Data analysis determined prevalence and associations through various statistical techniques (χ2, logistic regression). Exposure to psychosocial risk factors at work and prevalence of depressive symptoms were higher in women than men (15% vs. 5%). The adjusted analysis highlighted that female workers exposed to Isostrain (OR = 2.34; 95%CI: 1.42-3.85) and low rewards (OR = 2.13; 95%CI: 1.41-3.21) and male workers exposed to psychological demands (OR = 3.04; 95%CI: 1.94-4.76) and effort-reward imbalance (OR = 2.19; 95%CI: 1.39-3.46) had increased risk of depressive symptoms. Exposure to work-related psychosocial risk factors was associated with depressive symptoms in Chilean workers. Effective prevention in key aspects of work organization is thus needed.O objetivo foi avaliar os sintomas depressivos associados com fatores de risco ocupacionais psicossociais, por sexo, no Chile, por meio do modelo demanda-controle (Karasek) e desequilibrio esforco-recompensa (Siegrist). O estudo foi transversal, com uma amostra aleatoria de 3.010 empregados (35% mulheres e 65% homens) em todo o pais. Prevalencia e associacoes foram determinados por diversas tecnicas estatisticas (eg. χ 2 ; regressao logistica). A exposicao ao fatores de risco ocupacionais psicossociais e prevalencia de sintomas depressivos e maior em mulheres do que em homens (15% vs. 5%). Analise ajustada salienta que as mulheres expostas a Isostrain (OR = 2,34; IC95%: 1,42-3,85) e baixa recompensa (OR = 2,13; IC95%: 1,41-3,21) e homens expostos a demandas psicologicas (OR = 3,04; IC95%: 1,94-4,76) e desequilibrio esforco-recompensa (OR = 2,19; IC95%: 1,39-3,46) tem chance maior de sintomas depressivos quando comparado com o nao exposto. A exposicao a fatores de risco ocupacionais psicossociais foi associada com sintomas depressivos em trabalhadores chilenos. A geracao de cuidados preventivos em aspectos de organizacao do trabalho e fundamental.

Indicadores de salud mental asociados a riesgo psicosocial laboral en un hospital público

BACKGROUND Health care workers are exposed to high stress levels and psychosocial risks. The imbalance between the invested efforts and received rewards acquires special importance in this setting. AIM To assess the psychosocial risk level and its relationship with depression, distress and psychotropic drug use among health care workers. MATERIAL AND METHODS Seven hundred eighty two workers (602 females; 180 males) answered self-administered questionnaires to measure psychosocial risk and mental health. RESULTS Twenty five percent of respondents used psychotropic drugs, 34% had a high level of distress and 23% had depressive symptoms. They also reported a low level of decisional latitude (48%), high emotional demands (47%), low social support (41%) and a significant effort-reward imbalance (67%). Those exposed to job strain (high demands and low decisional latitude), iso-strain (job strain plus low social support), and effort-reward imbalance were twice as likely to suffer symptoms of depression and elevated distress compared to non-exposed subjects. CONCLUSIONS There are high levels of psychosocial stress among health care workers.Background: Health care workers are exposed to high stress levels and psychosocial risks. The imbalance between the invested efforts and received rewards acquires special importance in this setting. Aim: To assess the psychosocial risk level and its relationship with depression, distress and psychotropic drug use among health care workers. Material and methods: Seven hundred eighty two workers (602 females; 180 males) answered self-administered questionnaires to measure psychosocial risk and mental health. Results: Twenty five percent of respondents used psychotropic drugs, 34% had a high level of distress and 23% had depressive symptoms. They also reported a low level of decisional latitude (48%), high emotional demands (47%), low social support (41%) and a significant effort-reward imbalance (67%). Those exposed to job strain (high demands and low decisional latitude), iso-strain (job strain plus low social support), and effort-reward imbalance were twice as likely to suffer symptoms of depression and elevated distress compared to non-exposed subjects. Conclusions: There are high levels of psychosocial stress among health care workers.

Psychosocial Risk at Work and Hazardous Alcohol Consumption Among Chile’s Working Adults

ObjectivesKarasek’s demand-control model and Siegrist’s effort-reward imbalance model have accumulated solid evidence regarding the associations between exposure to psychosocial risk at work (PSRW) and mental health of workers. However, there is scarce such evidence with regard to its associations with alcohol consumption. This study proposed to estimate the associations between exposure to PSRW and hazardous alcohol consumption (HAC) in Chile’s working adult population.MethodThe study was cross-sectional and a nationally representative survey was applied to 3,010 workers (65% male and 35% female, ages 20 to 65). The analysis included prevalences and logistic regression controlling for covariables.ResultsThe adjusted analyses show that male workers exposed to low social support (OR=1.47; 95% CI:1.14–1.89), low reward (OR=1.38; 95% CI:1.07–1.78) and effort-reward imbalance (OR=1.34; 95% CI:1.04–1.73) have a higher chance of presenting with HAC compared to those who are not exposed. Female workers exposed to effort-reward imbalance (OR=2.34; 95% CI:1.10–5.58) have twice the risk of HAC compared with their reference group.ConclusionThis study shows evidence of the associations between HAC and exposure to a set of psychosocial risk factors from the Karasek and Siegrist models. For future research, it is recommended that HAC and PSRW factors be examined in a longitudinal study in order to control for possible confounding effects on these associations.RésuméObjectifsLe modèle ªDemande-Latitude« de Karasek et le modèle ªDéséquilibre Efforts/Reconnaissance« de Siegrist accumulent des preuves solides sur les associations entre l’exposition aux risques psychosociaux au travail (RPT) et la santé mentale des travailleurs. Cependant, il existe peu de preuves de la sorte en ce qui a trait aux associations entre les RPT et la consommation d’alcool. Nous avons voulu estimer les associations entre l’exposition aux RPT et la consommation dangereuse d’alcool (CDA) dans la population active d’âge adulte du Chili.MéthodeUne enquête représentative nationale transversale a été menée auprès de 3 010 travailleurs (65% d’hommes et 35% de femmes, 20 à 65 ans). L’analyse a inclus le calcul des prévalences et de la régression logistique après ajustement pour tenir compte des effets des covariables.RésultatsLes analyses ajustées montrent que les travailleurs masculins exposés à un faible soutien social (RC=1,47; IC de 95%: 1,14–1,89), à une faible reconnaissance (RC=1,38; IC de 95%: 1,07-1,78) et à un déséquilibre efforts/reconnaissance (RC=1,34; IC de 95%: 1,04–1,73) ont une probabilité supérieure de présenter une CDA comparativement aux travailleurs non exposés. Les travailleuses exposées à un déséquilibre efforts/reconnaissance (RC=2,34; IC de 95%: 1,10–5,58) ont un risque deux fois supérieur de présenter une CDA comparativement à leur groupe témoin.ConclusionCette étude prouve qu’il existe des associations entre la CDA et l’exposition à un ensemble de facteurs de risque psychosociaux tirés des modèles de Karasek et de Siegrist. Pour pousser la recherche, il est recommandé d’examiner les facteurs de la CDA et des RPT dans une étude longitudinale afin de tenir compte des effets de facteurs de confusion possibles sur ces associations.

Facilitadores del reintegro laboral en trabajadores con patología mental de origen laboral: una revisión sistemática

Background: There is growing interest in the treatment and return-to-work of workers with labor related mental illnesses. Aim: To perform a systematic review of practices and interventions that improve return to work. Material and methods: Systematic literature review. Thirty articles were selected for in- depth analysis. Results: Self efficacy perception, work motivation, a lower age and a better socioeconomic status were identified as worker-related return to work facilitators. Among work environment facilitators, good communication practices, supervisor support, a good assessment and modification of work load, adjustment of expectations, a good relationship between employers and employees and positive work experiences were identified. Treatment may improve return to work using a multidisciplinary approach, reducing stress and identifying psychosocial determinants of mental problems rather than symptoms and providing a timely health care. Conclusions: Return to work of workers with labor related mental illnesses requires a constant sharing of information between health care workers, employers and employees to identify common therapeutic objectives.BACKGROUND There is growing interest in the treatment and return-to-work of workers with labor related mental illnesses. AIM To perform a systematic review of practices and interventions that improve return to work. MATERIAL AND METHODS Systematic literature review. Thirty articles were selected for in- depth analysis. RESULTS Self efficacy perception, work motivation, a lower age and a better socioeconomic status were identified as worker-related return to work facilitators. Among work environment facilitators, good communication practices, supervisor support, a good assessment and modification of work load, adjustment of expectations, a good relationship between employers and employees and positive work experiences were identified. Treatment may improve return to work using a multidisciplinary approach, reducing stress and identifying psychosocial determinants of mental problems rather than symptoms and providing a timely health care. CONCLUSIONS Return to work of workers with labor related mental illnesses requires a constant sharing of information between health care workers, employers and employees to identify common therapeutic objectives.

La maternidad y el trabajo en Chile: Discursos actuales de actores sociales

La relacion entre maternidad y trabajo ha sido materia de politicas publicas desde comienzos del siglo XX, pero en las ultimas decadas ha adquirido nuevas connotaciones por el aumento de la participacion laboral femenina. Ello no ha conducido a una eliminacion de las discriminaciones que enfrentan las trabajadoras por su condicion (real o potencial) de madres, ni a una organizacion del mercado de trabajo que permita articular demandas laborales y familiares, ni una redistribucion del trabajo reproductivo. Para analizar como actores involucrados en la formulacion de politicas relacionadas con esta tematica concebian la relacion entre trabajo y maternidad y las tensiones que derivaban de ella, se entrevisto a un grupo de actores sociales provenientes de tres ambitos. Dos ideas caracterizan sus concepciones: las normas de proteccion a la maternidad en el trabajo afectan negativamente la empleabilidad femenina y la relacion maternidad trabajo es dificil porque la organizacion del mercado de trabajo dificulta la articulacion de responsabilidades laborales y familiares. Respecto de las tensiones, se constataron en diferentes dimensiones: economica, demografica, ejercicio de derechos y sociocultural.

Asociaciones entre distrés, riesgos psicosociales y calidad del empleo en trabajadores/as asalariados/as en Chile: una perspectiva de género

El estudio estimo la prevalencia de distres laboral en Chile y sus asociaciones con exposicion a riesgo psicosocial laboral y calidad del empleo, considerando diferencias de genero. El estudio transversal considero una muestra probabilistica representativa a nivel nacional de 3.010 asalariados/as en Chile (1.486 mujeres y 1.524 hombres). Un 18% reporta distres (23,8% mujeres versus 14,8% hombres). Los expuestos a riesgos psicosociales tienen mayor chance de experimentar distres que los no expuestos, y las mujeres presentan una chance de sufrir distres mayor que los hombres. Hombres y mujeres en empleos precarios tienen una chance mayor de presentar distres al compararse con quienes tienen menos precariedad laboral. No obstante, mujeres en empleos precarios tienen mayor chance de sufrir distres que los hombres en empleos similares. Se concluye que las mujeres ocupan empleos precarios en mayor proporcion, estan mas expuestas a riesgos psicosociales y presentan mayor distres, evidenciando la existencia de una doble discriminacion-social y de genero-en el mercado laboral en Chile.This study aimed to estimate the prevalence of work-related stress in Chile and its association with exposure to workplace psychosocial risks and quality of employment, considering gender differences. The cross-sectional study included a representative probabilistic national sample of 3,010 salaried workers (1,486 women and 1,524 men). Eighteen percent reported work-related stress (23.8% of women and 14.8% of men). People exposed to psychosocial risks had a higher probability of experiencing stress, and women were more likely to suffer stress than men. Women and men in precarious work showed increased likelihood of distress, compared to workers with less precarious jobs. However, women in precarious jobs were more likely to suffer stress than men in the same situation. The study concluded that women had more precarious jobs, experienced greater exposure to psychosocial risks, and suffered more stress than men. This is evidence of double discrimination (social and gender-based) in the Chilean labor market.

Associação entre estresse, riscos psicossociais e qualidade do emprego de trabalhadores assalariados chilenos: uma perspectiva de gênero

El estudio estimo la prevalencia de distres laboral en Chile y sus asociaciones con exposicion a riesgo psicosocial laboral y calidad del empleo, considerando diferencias de genero. El estudio transversal considero una muestra probabilistica representativa a nivel nacional de 3.010 asalariados/as en Chile (1.486 mujeres y 1.524 hombres). Un 18% reporta distres (23,8% mujeres versus 14,8% hombres). Los expuestos a riesgos psicosociales tienen mayor chance de experimentar distres que los no expuestos, y las mujeres presentan una chance de sufrir distres mayor que los hombres. Hombres y mujeres en empleos precarios tienen una chance mayor de presentar distres al compararse con quienes tienen menos precariedad laboral. No obstante, mujeres en empleos precarios tienen mayor chance de sufrir distres que los hombres en empleos similares. Se concluye que las mujeres ocupan empleos precarios en mayor proporcion, estan mas expuestas a riesgos psicosociales y presentan mayor distres, evidenciando la existencia de una doble discriminacion-social y de genero-en el mercado laboral en Chile.This study aimed to estimate the prevalence of work-related stress in Chile and its association with exposure to workplace psychosocial risks and quality of employment, considering gender differences. The cross-sectional study included a representative probabilistic national sample of 3,010 salaried workers (1,486 women and 1,524 men). Eighteen percent reported work-related stress (23.8% of women and 14.8% of men). People exposed to psychosocial risks had a higher probability of experiencing stress, and women were more likely to suffer stress than men. Women and men in precarious work showed increased likelihood of distress, compared to workers with less precarious jobs. However, women in precarious jobs were more likely to suffer stress than men in the same situation. The study concluded that women had more precarious jobs, experienced greater exposure to psychosocial risks, and suffered more stress than men. This is evidence of double discrimination (social and gender-based) in the Chilean labor market.

Psychosocial risks, quality of employment, and workplace stress in Chilean wage-earning workers: a gender perspective

El estudio estimo la prevalencia de distres laboral en Chile y sus asociaciones con exposicion a riesgo psicosocial laboral y calidad del empleo, considerando diferencias de genero. El estudio transversal considero una muestra probabilistica representativa a nivel nacional de 3.010 asalariados/as en Chile (1.486 mujeres y 1.524 hombres). Un 18% reporta distres (23,8% mujeres versus 14,8% hombres). Los expuestos a riesgos psicosociales tienen mayor chance de experimentar distres que los no expuestos, y las mujeres presentan una chance de sufrir distres mayor que los hombres. Hombres y mujeres en empleos precarios tienen una chance mayor de presentar distres al compararse con quienes tienen menos precariedad laboral. No obstante, mujeres en empleos precarios tienen mayor chance de sufrir distres que los hombres en empleos similares. Se concluye que las mujeres ocupan empleos precarios en mayor proporcion, estan mas expuestas a riesgos psicosociales y presentan mayor distres, evidenciando la existencia de una doble discriminacion-social y de genero-en el mercado laboral en Chile.This study aimed to estimate the prevalence of work-related stress in Chile and its association with exposure to workplace psychosocial risks and quality of employment, considering gender differences. The cross-sectional study included a representative probabilistic national sample of 3,010 salaried workers (1,486 women and 1,524 men). Eighteen percent reported work-related stress (23.8% of women and 14.8% of men). People exposed to psychosocial risks had a higher probability of experiencing stress, and women were more likely to suffer stress than men. Women and men in precarious work showed increased likelihood of distress, compared to workers with less precarious jobs. However, women in precarious jobs were more likely to suffer stress than men in the same situation. The study concluded that women had more precarious jobs, experienced greater exposure to psychosocial risks, and suffered more stress than men. This is evidence of double discrimination (social and gender-based) in the Chilean labor market.

Reintegro Laboral en Trabajadores con Problemas de Salud Mental: La Perspectiva de los Tratantes

Antecedentes: En los ultimos anos se ha observado un aumento en la prevalencia de problemas mentales de origen laboral, incrementando significativamente el promedio anual de dias de trabajo perdidos por reposo. Con respecto al posterior reintegro, la evidencia es categorica en afirmar la importancia de que este sea un proceso exitoso para la prevencion de recaidas del trabajador. Asimismo, se constata que a nivel latinoamericano es casi inexistente la literatura e investigacion en torno a intervenciones para el retorno laboral. Objetivo: Estudiar las condiciones de diagnostico, intervencion y retorno al trabajo que han mostrado efectividad desde la perspectiva y experiencias de tratantes de una mutualidad respecto de la intervencion para el reintegro al trabajo en individuos con problemas de salud mental de origen laboral. Metodo: Se diseno una investigacion exploratoria-descriptiva, empleando metodologia cualitativa. Se utilizaron grupos focales y entrevistas a seis psicologos, tres psiquiatras y cuatro terapeutas ocupacionales que ejercen sus labores profesionales en una mutual en Chile. Resultados: A partir de un analisis descriptivo, empleando el procedimiento de codificacion abierta propuesto por el modelo de Teoria Fundamentada, emergieron cinco categorias centrales y dos fenomenos transversales: La comunicacion tripartita y el proceso orientado al reintegro laboral. Ambos hacen referencia tanto al proceso de intervencion para el retorno al trabajo como a los actores involucrados en este, ya sea de la mutualidad como tambien del contexto laboral inmediato de los trabajadores.