Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-19T06:45:23.108Z Has data issue: false hasContentIssue false
  • English
  • Français

Stress, depression, quality of life and salivary cortisol levels in community health agents

Published online by Cambridge University Press:  02 November 2015

Berenice Scaletzky Knuth ,
Rafaela Abreu Cocco ,
Vinicius Augusto Radtke ,
João Ricardo Carvalho Medeiros ,
Jean Pierre Oses ,
Carolina David Wiener  and
Karen Jansen
Berenice Scaletzky Knuth
Affiliation:
Coordinator of Health and Quality of Life, Federal University of Pelotas, Brazil
Rafaela Abreu Cocco
Affiliation:
Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Brazil (Universidade Católica de Pelotas)
Vinicius Augusto Radtke
Affiliation:
Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Brazil (Universidade Católica de Pelotas)
João Ricardo Carvalho Medeiros
Affiliation:
Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Brazil (Universidade Católica de Pelotas)
Jean Pierre Oses
Affiliation:
Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Brazil (Universidade Católica de Pelotas)
Carolina David Wiener*
Affiliation:
Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Brazil (Universidade Católica de Pelotas)
Karen Jansen
Affiliation:
Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Brazil (Universidade Católica de Pelotas)
*
Carolina Wiener, Rua Gonçalves Chaves, Pelotas, RS, Brazil. Tel: +55 53 2128 8404; Fax: +55 53 21288298; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To determine the prevalence of and factors associated with depression and stress with perceived quality of life and the salivary cortisol levels in Community Health Agent (CHA).

Materials and Methods

Cross-sectional descriptive study of CHAs in Pelotas-RS, Brazil. Data collection, including sociodemographic information and factors related to work and health. Beck Depression Inventory (BDI) II was used to assess depressive symptoms, Inventory of Stress Symptoms Lipp (ISSL) was used for the analysis of stress and the WHOQOL-BREF was used to investigate quality of life. Salivary cortisol was quantified via ELISA test.

Results

The assessments showed that 71.0% are in a state of stress resistance, 30.5% were in the alert state of stress and 32.8% were in the stress state of exhaustion. Depressive episodes (BDI≥12) were observed in 28.2%. The environmental domain had the lowest score for quality of life. We observed significantly higher salivary cortisol levels in CHAs with less than 1 year of service and with the lowest quality of life scores in the environmental subsection.

Conclusion

A high prevalence of stress and depression was observed in this sample of CHAs. In addition, the worst levels of quality of life were identified in the environmental subsection. Cortisol levels corroborate these findings regarding quality of life within the environmental domain and began working less than a year previously.

Keywords

community health workersdepressionoccupational stressquality of lifesalivary cortisol
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 28 , Issue 3 , June 2016 , pp. 165 - 172
Check for updates
Copyright
© Scandinavian College of Neuropsychopharmacology 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Mendes, EV. The historical development of primary health care in Brazil, Primary Health Care in the SUS. Escola de Saúde Pública do Ceará 2002;23–29.Google Scholar
2. Lavor, ACH, Lavor, MC, LAVOR, IC. Community health agent: a new professional that the health needs. Sanare Rev Políticas Públicas 2004;1:121–128.Google Scholar
3. Brasil. Ministério da Saúde. Secretaria de políticas de saúde: the work of the community health agent. Ministério Saúde 2000;1–43.Google Scholar
4. Martines, WRV, Chaves, EL. Vulnerabilities and suffering in the work of the community health agent program family health. Rev Esc Enfermagem 41(Suppl. 3):426–433.Google Scholar
5. Fernandez, JM, Gascón, G, García-Olalla, CM, González, MIC, Peña, MCC, Sánchez, SG. Measurement of the evaluative capacity of the CVP-35 questionnaire for perceiving the quality of profession life. Aten Primaria 2008;40:327–334.Google Scholar
6. Wang, LL, Patten, SB. Perceived work stress and major depression in the Canadian employed population, 20-49 years old. J Occup Health Psychol 2001;6:283–289.Google Scholar
7. Lipp, MEN. The four phases stress model. In: Pearson Brasil, editor. Mechanisms of stress: theory and clinical applications. São Paulo: Casa do Psicólogo, 2003:17–22.Google Scholar
8. Goulart, EG Junior, Lipp, MEN. Stress among elementary school teachers in public schools. Psicol Estud 2008;13:847–857.Google Scholar
9. Kristenson, M, Garvin, P, Lundberg, U, eds. The Role of Saliva Cortisol Measurement in Health and Disease. Bentham Science Publishers, 2011. p. 3–16.Google Scholar
10. Dallman, MF. Stress update. Adaptation of the hypothalamic-pituitary-adrenal axis to chronic stress. Trends Endocrinol Metab 1993;4:62–69.Google Scholar
11. Backe, EM, Seidler, A, Latza, U, Rossnagel, K, Schumann, B. The role of psychosocial stress at work for the development of cardiovascular diseases: a systematic review. Int Arch Occup Environ Health 2012;85:67–79.Google Scholar
12. Myers, B, McKlveen, JM, Herman, JP. Glucocorticoid actions on synapses, circuits, and behavior: implications for the energetics of stress. Front Neuroendocrinol 2014;35:180–196.Google Scholar
13. Goodyer, IM, Herbert, J, Altham, PM. Adrenal steroid secretion and major depression in 8- to 16-year olds, III. Influence of cortisol/DHEA ratio at presentation on subsequent rates ofdisappointing life events and persistent major depression. Psychol Med 1998;28:265–273.Google Scholar
14. Weibel, L. Methodological guidelines for the use of salivary cortisol as biological marker of stress. La Presse Médicale 2003;32:845–851.Google Scholar
15. Hellhammer, D, Wust, S, Kudielka, B. Salivary cortisol as a biomarker in stress research. Psychoneuroendocrinology 2009;34:163–171.Google Scholar
16. Kirschbaum, C, Hellhammer, D. Salivary cortisol. In: Fink G, editor. Encyclopedia of stress. San Diego: Academic, 2000:379–383.Google Scholar
17. Brazilian Association of Research Companies. Data based on the Socio Economic Survey 2012. Available at http://www.ibge.gov.br, accessed May 2012.Google Scholar
18. Gomes-Oliveira, MH, Gorenstein, C, Lotufo, NF, Andrade, LH, Wang, YP. Validation of the Brazilian Portuguese version of the Beck Depression Inventory-II in a community sample. Rev Bras Psiquiatr 2012;34:389–394.Google Scholar
19. Lipp, MEN. Inventory Symptoms of Stress Manual for Adults Lipp (ISSL). São Paulo: Casa do Psicólogo, 2000.Google Scholar
20. Fleck, MPA, Leal, OF, Louzada, S et al. Application of the Portuguese version of the abbreviated instrument of quality life WHOQOL-bref. Rev Saúde Pública 2000;34:178–183.Google Scholar
21. Casals, G, Foj, L, Osaba, MJ. Day-to-day variation of late-night salivary cortisol in healthy voluntaries. Clin Biochem 2011;44:665–668.Google Scholar
22. Dean, AG, Dean, JÁ, Coulombier, D et al. Epi-info version 6,04d: a word processing database, and statistics program for epidemiology on microcomputers. Atlanta, Georgia, USA: Center of Disease Control and Prevention, 1994.Google Scholar
23. IBM Corp. IBM: SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp. Released, 2012.Google Scholar
24. Lipp, MEN. Centro Psicológico de Controle do Stress. Rio de Janeiro. Papirus Editora, 1996.Google Scholar
25. Rocha, LE, Debert-Ribeiro, M. Work and health: a gender study on systems analysts. Rev Saúde Públ 2001;35:539–547.Google Scholar
26. Lipp, MEN, Malagris, LEN, Novais, LE. Stress lifelong. São Paulo: Editora Ícone, 2007.Google Scholar
27. William, ES, Manwell, LB, Konrad, TR, Linzer, M. The relationship of organizational culture, estress, satisfaction, and burnout with physician-reported error as suboptimal patient care-Results form the MEMO study. Health Care Manage Rev 2007; 32:203–212.Google Scholar
28. Ramminger, T. The mental health worker in mental health: a study of workers in a psychiatric hospital. Boletim Saúde 2002;16:111–124.Google Scholar
29. Mendes, R. From Psychopathology and mental health in work. In: Editora Atheneu, editor. Pathology of the work 2013. Volume 2. 3rd edn. São Paulo, 2013:32(1054-1095).Google Scholar
30. Gessner, CLS. Quality of life in a team of Family Health Strategy in Timbó-SC. PhD thesis, Universidade Vale do Itajaí 2006.Google Scholar
31. Kluthcovsky, ACGC. Quality of life in Community Health Agent in Paraná. PhD thesis, Universidade de São Paulo 2005.Google Scholar
32. Mendonça, MHM. Community health agent. Cad Saúde Publica 2004;20:1433–1434.Google Scholar
33. Bernardes, KAG. Quality of life in Community Health Agent in western region of the state of São Paulo. PhD thesis, Universidade de São Paulo 2008.Google Scholar
34. Neves, SF. Teacher work and Quality of life in the public schools of Pelotas. PhD thesis, Universidade Católica de Pelotas 2008.Google Scholar
35. Karlson, B, Lindfors, P, Riva, R, Mellner, C, Theorell, T, Lundberg, U. Psychosocial work stressors and salivary cortisol. The Role of Saliva Cortisol Measurement in Health and Disease 2011:43–66.Google Scholar
36. Camelo, SHH, Angerami, ELS. Stress symptoms in workers in family health centers. Rev Lat Enfermagem 2004;12:14–21.Google Scholar