Work-family conflict and time use: psychometric assessment of an instrument in ELSA-Brazil

Gender, work-family conflict, and weight gain: four-year follow-up of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

This study sought to analyze the effect of work-to-family conflict (demands from work that affect one's family/personal life), family-to-work conflict (demands from family/personal life that affect work), and lack of time for self-care and leisure due to professional and domestic demands on the incidence of weight gain and increase in waist circumference by gender in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Our study included 9,159 ELSA-Brasil participants (4,413 men and 4,746 women) who attended baseline (2008-2010) and the first follow-up visit (2012-2014). Weight gain and increase in waist circumference were defined as an annual increase ≥ 75th percentile, i.e., ≥ 1.21kg/year and ≥ 1.75cm/year, respectively for women; and ≥ 0.96kg/year and ≥ 1.41cm/year respectively for men. Associations were estimated by Poisson regression applying robust variance with the R software. Analyses were stratified by gender and adjusted for socioeconomic variables. Adjusted models showed a higher risk of weight gain among women who reported family-to-work conflict frequently and sometimes (relative risk - RR = 1.37 and RR = 1.15, respectively) and among those who reported frequent lack of time for self-care and leisure (RR = 1.13). Among men, time-based work-to-family conflict (RR = 1.17) and strain-based work-to-family conflict (RR = 1.24) were associated with weight gain. No associations were observed between work-family conflict domains and increase in waist circumference. These findings suggest that occupational and social health promotion programs are essential to help workers balance work and family life to reduce weight gain.

Is work-family conflict a pathway between job strain components and binge eating? A cross-sectional analysis from the ELSA-Brasil study

BACKGROUND

Job strain has been reported as a trigger for binge eating, yet the underlying mechanisms have been unclear. The aim of this study was to evaluate whether work-family conflict is a pathway in the association between job strain and binge eating, considering the possible effect-modifying influence of body mass index (BMI).

METHODS

This cross-sectional analysis included 12,084 active civil servants from the multicenter Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Job strain was assessed using the Demand-Control-Support Questionnaire. Work-family conflict was considered as a latent variable comprising three items. Binge eating was defined as eating a large amount of food in less than 2 h at least twice a week in the last six months with a sense of lack of control over what and how much was eaten. Structural equation modelling was used to test the role of work-family conflict in the association between job strain and binge eating, stratifying for BMI.

RESULTS

For individuals of normal weight, positive associations were found between skill discretion and binge eating (standardized coefficient [SC] = 0.209, 95%CI = 0.022-0.396), and between psychological job demands and work-family conflict (SC = 0.571, 95%CI = 0.520-0.622), but no statistically significant indirect effect was found. In overweight individuals, psychological job demands, skill discretion, and work-family conflict were positively associated with binge eating (SC = 0.099, 95%CI = 0.005-0.193; SC = 0.175, 95%CI = 0.062-0.288; and SC = 0.141, 95%CI = 0.077-0.206, respectively). Also, work-family conflict was observed to be a pathway on the associations of psychological job demands and decision authority with binge eating (SC = 0.084, 95%CI = 0.045-0.122; and SC =  - 0.008, 95%CI =  - 0.015- - 0.001, respectively).

CONCLUSIONS

Work-family conflict partly explains effects of high levels of psychological job demands and low levels of decision authority on binge eating among overweight individuals. Moreover, skill discretion is positively associated with binge eating, regardless of BMI category.

Gender Differences in the Quality of Life of Formal Workers

BACKGROUND

This study aimed to assess the quality of life associated with gender inequalities in formal workers and to determine the effect of sociodemographic, clinical, and behavioral factors on the quality of life (QOL).

METHODS

This cross-sectional study involved 1270 workers. Quality of life was measured using the EUROHIS-QOL 8-Item and assessed in terms of psychological, environmental, social, and physical domains, while demographic, socioeconomic, behavioral, and clinical variables served as explanatory variables. Analyses were performed using an ordinal logistic regression model whose significance level was 5%.

RESULTS

Of the participants, 80.2% were men, and 19.8% were women; the mean age was 34 (standard deviation: ±10) and 32 (±9) years, respectively. In all prediction scenarios, men were more likely to have a higher quality of life, especially in the physical (odds ratio: 2.16; 95% confidence interval: 1.60-2.93) and psychological (odds ratio: 2.09; 95% confidence interval: 1.51-2.91) domains.

CONCLUSIONS

Men and women had significantly different levels of quality of life, and sociodemographic, clinical, and behavioral variables partially clarified these differences, which were possibly established by a socio-historical process of construction of the work role determined by gender issues.

Implications of Lifestyle and Occupational Factors on the Risk of Breast Cancer in Shiftwork Nurses

Shift work that involves circadian disruption has been highlighted as a likely carcinogenic factor for breast cancer in humans. Also, unhealthy lifestyle habits observed in night work nurses could be causally related to an increase in the incidence of estrogen-positive breast tumours in this population. Assessing baseline risk of breast cancer in nurses is essential. The objective of this study was to analyze the risk of breast cancer that nurses had in relation to their lifestyle and labour factors related to shift work. A cross-sectional descriptive study through a questionnaire about sociodemographic variables, self-perception of health, and working life was designed. The sample consisted of 966 nurses. The relationship between variables was tested. A binary logistic regression and a classification and regression tree were performed. The most significant labour variables in relation to the risk of breast cancer were the number of years worked (more than 16 years; p < 0.01; OR = 8.733, 95% CI = 2.811, 27.134) and the total years performing more than 3 nights per month (10 or more years; p < 0.05; OR = 2.294, 95% CI = 1.008, 5.220). Also, the nights worked throughout life (over 500; OR = 4.190, 95% CI = 2.118, 8.287) were significant in the analysis. Nurses who had or ever had breast cancer valued their self-perceived health more negatively (p < 0.001) and referred a lower quality of sleep (p < 0.001) than the non-cases nurses. The occupational factors derived from night work could have several impacts on nurses' health and their family-work balance. Promoting healthy lifestyles, informing about shift work risks, and adjusting shift work schedules are critical methods to decrease the possible effects of circadian disruption in nurses.

Impact of Work-Family Conflict on Sleep Complaints: Results From the Longitudinal Study of Adult Health (ELSA-Brasil)

Background: Balancing work and family demands is often a challenge. Family and job responsibilities may affect many aspects of health, and sleep is an important issue. Work-family conflict (WFC) refers to situations where it is difficult to reconcile family and professional demands. WFC can act in two directions: work-to-family conflicts occur when job demands interfere in family life; family-to-work conflicts arise when family demands interfere with job performance. This study evaluated whether dimensions of WFC-time- and strain-related, work-to-family conflict; family-to-work conflict; and lack of time for self-care and leisure due to work and family demands-were cross-sectionally and longitudinally associated with sleep complaints, by gender. Methods: The sample comprised 9,704 active workers (5,057 women and 4,647 men) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Standardized questionnaires were used to collect data. WFC was measured at baseline (2008-2010), and sleep complaints were measured at baseline and approximately 4 years after the first visit (2012-2014). To test the association between the four WFC dimensions and sleep complaints, crude and multiple logistic regressions were conducted to estimate odds ratios and 95% confidence intervals. The adjusted model included age, education, marital status, hours worked and work schedule. Results: Mean age at baseline was 48.2 years. Most participants were educated to University degree level (54.5%), married (68.2%) and worked ≤ 40 h/week (66.1%). At baseline, 48.3% of women and 41.1% of men reported sleep complaints. Frequent WFC was reported by women and men, respectively, as follows: time-related work-to-family conflict (32.6 and 26.1%), strain-related work-to-family conflict (25.3 and 16.0%), family-to-work conflict (6.6 and 7.6%) and lack of time for self-care (35.2 and 24.7%). For both women and men, time- and strain-related work-to-family conflicts and conflicts for lack of time for self-care were cross-sectionally and longitudinally associated with sleep complaints. The findings also suggest a weaker and non-significant association between family-to-work conflict and sleep complaints. Conclusions: The statistically significant associations observed here underline the importance of reducing WFC. In the modern world, both WFC and sleep problems are increasingly recognized as frequent problems that often lead to ill health, thus posing a public health challenge.

Night Work and Breast Cancer Risk in Nurses: Multifactorial Risk Analysis

Night work has been highlighted by the International Agency for Research on Cancer (IARC) as a likely carcinogenic factor for humans, associated with breast cancer and professions that require continuity of work. Knowing the impact that short and long-term night work has on the nurses' collective seems a priority, therefore, this study aims to analyse the relationship between night work and the development of breast cancer risk factors in nurses. For this, a cross-sectional study through an online questionnaire on breast cancer risk variables and working life was designed. The study was conducted in Spain and the sample consisted of 966 nurses, of whom 502 were healthy participants and 56 were breast cancer patients. These two groups were compared in the analyses. A descriptive analysis was performed, and the relationship was tested using χ2 independence test and OR calculation. The CHAID (Chi Square Automatic Interaction Detection) data mining method allowed for the creation of a segmentation tree for the main risk variables. The most significant risk variables related to working life have been the number of years worked, nights worked throughout life, and years working more than 3 nights per month. Exceeding 16 years of work has been significant for women and men. When the time worked is less than 16 years, the number of cases increases if there is a family history of cancer and if there have been more than 500 nights of work. High-intensity night work seems more harmful at an early age. The accumulation of years and nights worked increase the risk of breast cancer when factors such as sleep disturbance, physical stress, or family responsibilities come together.

Prevalence of overweight and obesity and associated factors among women of childbearing age in Brazil

OBJECTIVE

To assess the factors associated with overweight and obesity among women of childbearing age in Brazil.

DESIGN

Cross-sectional study.

SETTING

Using the National Health Survey (PNS) database, from the year 2013. The socio-economic and demographic factors analysed were age, race/skin colour, region, marital status, education level, employment and family income. Concerning health history, diagnoses of hypertension, diabetes mellitus, high cholesterol, heart attack, stroke, chronic kidney disease, menarche, parity and depression were evaluated. For lifestyle information, health status, alcoholic beverage consumption, smoking and physical activity were included. The outcomes were obesity and overweight. The association of excess weight with socio-economic and demographic factors, health history and lifestyle characteristics was investigated according to the appropriate theoretical-conceptual model for the topic.

PARTICIPANTS

The sample size was 17 109 women aged 18-49 years.

RESULTS

The prevalence of women with excess weight was 55·20 %, with 33·26 % being overweight and 21·94 % with obesity. The factors associated with excess weight were age, non-white skin colour, having a partner, family income of up to two minimum wages, menarche before the age of 12, multiparity, diabetes mellitus, depression, hypertension, high cholesterol, stroke and heart attack.

CONCLUSION

The results showed an association between excess weight and socio-demographic factors, both determinants of general and reproductive health history. Implementation of effective public health policies is necessary to prevent unfavourable outcomes related to the health of women of childbearing age with excess weight.

Work-Family Conflict and Ideal Cardiovascular Health Score in the ELSA-Brasil Baseline Assessment

Background

There are few data about the association between work‐related stress and the American Heart Association ideal cardiovascular health (CVH) metrics. We studied the association between work‐family conflict (WFC) and ideal CVH scores in the ELSA‐Brasil (Brazilian Longitudinal Study of Adult Health) baseline study.

Methods and Results

We analyzed data of active workers (5424 men and 5967 women), aged 35 to 74 years, from 2008 to 2010. Ideal CVH scores were calculated based on the lifestyle and health metrics proposed by the American Heart Association, using data from questionnaires and clinical and laboratory examinations from the ELSA‐Brasil study baseline. The WFC questionnaire was based on the Frone model, validated for Brazilian Portuguese. WFC domains (time and strain‐based work interference with family, family interference with work, and lack of time for personal care and leisure) and frequency (never to rarely, sometimes, or frequently) were self‐reported. Main models were adjusted for age, sex, race, educational level, income, and study site. Positive relative predicted score differences (rPSDs) indicate higher predicted scores. We found lower lifestyle ideal CVH scores among men (rPSD, −5.7%; P=0.002) and women (rPSD, −10.2%; P<0.001) with frequent lack of time for personal care and leisure. We found lower lifestyle ideal CVH scores among women with frequent strain‐based work interference with family (rPSD, −5.1%; P=0.002), and family interference with work (rPSD, −8.6%; P=0.001). We found higher health ideal CVH scores among men with frequent WFC, which may be attributable to reverse causation.

Conclusions

We found significant associations between WFC and ideal CVH scores. These associations were heterogeneous according to sex.

Mental health of public health workers in Bento Gonçalves, Rio Grande do Sul, Brazil

Background

Work-related mental disorders are an acknowledged global health problem.

Objective

The aim of the present study was to investigate the prevalence of and factors associated with common mental disorders and suicidal ideation among public health workers.

Methods

We conducted a cross-sectional study with municipal healthcare workers. We collected sociodemographic and occupational data including employment relationship, job area, professional category, length of work in current job and interpersonal conflict in the workplace (ICW). The analyzed mental health indicators were common mental disorders (CMD) and suicidal ideation by means of the Self Reporting Questionnaire (SRQ-20). Statistical analysis included the χ² test and Poisson regression.

Results

The prevalence of CMD and suicidal ideation was 20.3% and 11.6%, respectively, among the 597 participants. Permanent and younger employees exhibited higher CMD rates, while suicidal ideation predominated among the participants with higher educational level and the widowed/separated/divorced. Physicians, administrative employees, cleaning personnel and community health agents exhibited the highest rates of CMD. In turn, there was no association between professional category and suicidal ideation on multivariate analysis. ICW was associated with poorer mental health indicators, the association being stronger when conflict involved supervisors and coworkers.

Conclusion

Both analyzed indicators (CMD and suicidal ideation) point to a worrisome situation as concerns the mental health of professionals charged of collective health care. The possible limitations of the questionnaire applied notwithstanding, ICW was the main factor associated with poorer mental health indicators. These findings point to the need to develop specific approaches to improve the psychosocial work environment.

Gender, time use and overweight and obesity in adults: Results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Perceived time constraints have been highlighted in sociological studies as representing a core issue in determining quality of life. The objective of this study was to test the hypothesis that gender inequalities regarding insufficiency of time play a role in the development of overweight and obesity in adults. The study used baseline data (2008–2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), which monitors a cohort of 15,105 civil servants of 35 to 74 years of age. Insufficient time for personal care and leisure due to professional and domestic duties, as detailed in a structured questionnaire, comprised the main exposure variable. The outcome variable was overweight/obesity measured according to body mass index. Prevalence ratios were calculated using multinomial logistic regression. A greater proportion of women compared to men reported insufficient time for personal care and leisure (34.5% versus 23.8%, respectively). The prevalence of overweight was greater in men, while obesity was more common in women. Insufficient time for personal care and leisure was associated with overweight (PR = 1.29; 95% CI: 1.04–1.61) and obesity (PR = 1.65; 95% CI: 1.28–2.12) only in women working over 40 hours/week. No significant association was found for males. These results suggest that the length of the working week influences factors underlying weight gain, possibly issues linked to behavior and/or stress mechanisms. The fact that such an association was restricted to women suggests that the results originate from gender inequalities involving relationships between time and health. The findings of this study provide data on which to base public policies aimed at encouraging the redistribution of domestic responsibilities in the direction of gender equity, as well as macrosocial policies such as providing public schools for workers’ children.