Estresse ocupacional, padrão alimentar e composição corporal de trabalhadores de hospital

Abstract

Introduction: Occupational stress is a reality in hospitals and a global public health problem, being aggravated by precarious working conditions. Among the stages of occupational stress on workers' health, negative impacts on body composition are observed. Aim: To evaluate associations between occupational stress, dietary patterns and body composition in hospital workers. Methods: Two methodological approaches were adopted. The first was a systematic review (PROSPERO: CRD42022331846), where the search was carried out in seven databases, gray literature, manual search and contact with experts. The selection of studies occurred independently by two evaluators following the pre-established inclusion criteria. Risk of bias was assessed using the Joanna Briggs Institute checklist and certainty of evidence presented by the Recommendation Assessment, Development and Evaluation Classification. In the primary study, 218 workers from a private hospital in Santo Antônio de Jesus - Bahia, were included in the sample. Sociodemographic, occupational, lifestyle data, body composition (by bioelectrical impedance and anthropometry), food consumption and occupational stress were eliminated before and during the COVID-19 pandemic. After evaluating the normality of the data, parametric and/or non-parametric tests were used according to relevance. Furthermore, for article II, we performed Exploratory Factor Analysis to identify the dietary pattern and Structural Equation Modeling to test the desired model. In article III, in addition to descriptive and bivariate statistics, we also carried out Mixed Effects Modeling. Results: In article I, which dealt with a systematic review, we identified that 10 of the 12 studies were carried out only with health professionals. Even so, a relationship was observed between occupational stress and changes in Body Mass Index (BMI) in these workers. However, most studies presented moderate or high risk to life and low quality of evidence. In article II, we observed that three dietary patterns had a direct effect on the latent variable “occupational stressors” and, only in Pattern A (b= -0.133; p=0.185) this effect was negative. In Pattern B (b= 0.225; p=0.023) and Pattern C (b= 0.144; p=0.278) there was a direct and positive effect on the latent variable, with Pattern B being the only statistically significant one. Even so, the latent variable exerted a direct and positive mediating effect on the variables BMI (b=0.478; p<0.001), waist variations (b=0.395; p=0.001), Fat Free Mass (FFM) (b =0.440; p=0.001) and Fat Mass (FM) (b= -0.104; p=0.292). Finally, in article III, the results indicate that high demand and low control at work are risk factors for changes in BMI (p=0.023; p=0.008), MG (p=0.044; p=0.015) and FFM (p =0.054) in hospital workers over time. Conclusion: Both general occupational stress and high demand and low control at work, dimensions of the instruments evaluated separately, are risk factors for changes in BMI, MG and FFM of hospital workers. Even so, a dietary pattern with calorie-dense foods favors changes in the body composition of these workers, with occupational stressors mediating this relationship.