ABSTRACT:

Introduction:

Social support at work - related to the interaction between co-workers and supervisors in cooperation toward work achievement - can contribute to reducing the strain on workers and health risks. Therefore, the present study aimed to analyze the social support at work and associated factors among the technical-administrative staff in education from a public university.

Methods:

This is a cohort study with 328 active civil servants, who answered a questionnaire providing information about the social support at work and the independent sociodemographic variables related to work and health. We used Student’s t-test, the χ² test, and logistic regression to analyze the prevalence of and factors associated with social support at work.

Results:

The workers were predominantly males, with a mean age of 47 years, married, with children, had higher education and beyond, showed good working conditions, health status, and high social support at work (85.7%). Factors associated with social support at work included work shift, depression, and work ability.

Conclusion:

The factors associated with social support should be properly analyzed in order to maintain this positive interaction in the work environment.

Keywords:
Occupational health; Social support; Work; Government employees; Cohort studies

INTRODUCTION

Humans, unlike most other living creatures, are inherently social beings living in a community/society, with which they interact, establishing the most diverse relationships¹1. Guareschi PA. Ética e relações sociais entre o existente e o possível. In: Jacques MGC, Nunes MLT, Bernardes NMG, Guareschi PA. editores. Relações sociais e ética. Rio de Janeiro: Centro Edelstein de Pesquisas Sociais; 2008. p. 6-11.. Due to this social character of human beings, for many years, some authors have suggested that the rupture of social ties affects the body defense system, making the individual more susceptible to diseases and influencing the health maintenance, in addition to hindering adaptive behaviors in stress situations²2. Cassel J. An epidemiological perspective of psychosocial factors in disease etiology. Am J Public Health 1974; 64(11): 1040-3.^,33. Cobb S. Social support as a moderator of life stress. Psychosom Med 1976; 38(5): 300-14. https://psycnet.apa.org/doi/10.1097/00006842-197609000-00003
https://psycnet.apa.org/doi/10.1097/0000... . Other authors⁴4. Griep RH, Chor D, Faerstein E, Werneck GL, Lopes CS. Validade de constructo de escala de apoio social do Medical Outcomes Study adaptada para o português no Estudo Pró-Saúde. Cad Saúde Pública 2005; 21(3): 703-14. http://dx.doi.org/10.1590/S0102-311X2005000300004
http://dx.doi.org/10.1590/S0102-311X2005... , when investigating the influence of social ties on the risk of falling ill and dying, found that being part of a social network and receiving help from individuals who belong to it can, in fact, benefit the health and well-being.

Considering the above, social network and support are significant in maintaining the health of individuals. Social network relates to the group of people with whom the individual can keep contact or some kind of social bond, while social support concerns the resources that other people, such as friends and family, can provide in situations of need⁵5. Due P, Holstein B, Lund R, Modvig J, Avlund K. Social relations: network, support and relational strain. Soc Sci Med 1999; 48(5): 661-73. https://doi.org/10.1016/s0277-9536(98)00381-5
https://doi.org/10.1016/s0277-9536(98)00... . Thus, we can assume that work integrates with the social network of individuals, particularly when taking into account that people spend most of their day at work⁶6. Carvalho JF, Martins EPT, Lúcio L, Papandréa PJ. Qualidade de vida no trabalho e fatores motivacionais dos colaboradores nas organizações. Educação Foco 2013; 7: 21-31..

However, when labor activities are developed under inadequate environmental, organizational, and physiological conditions, health damage can be accelerated or exacerbated as a result of these activities⁷7. Pereira DAM. Work ability index and thermal and acoustic conditions of municipal schools’ teachers. In: Arezes P, et al. (Eds.). Occupational Safety and Hygiene. Florida: Taylor & Francis Group; 2013. p. 205-10.. Therefore, it is necessary to evaluate the social relationships established in the work environment as a factor that can also affect the health of individuals, especially when analyzed together with other work-related aspects.

In this regard, Johnson and Hall created a way to assess social support at work, including this dimension in an already existing scale, developed by Robert Karasek at the end of the 1970s and early 1980s, focused on researching the causes of work-related stress and their effects on health. With the introduction of the social support dimension, the scale was renamed to Swedish Demand-Control-Support Questionnaire (DCSQ), in which the social support at work is related to the interaction between co-workers and supervisors in cooperation toward work achievement and can contribute to reducing the strain on workers and health risks⁸8. Johnson JV, Hall EM. Job strain, work place social support, and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population. Am J of Public Health 1988; 78(10): 1336-42.^,99. Karasek R, Theorell T. Healthy work: stress, productivity and reconstruction of working life. Nova York: Basic Books; 1990.^,1010. Alves MGM, Chor D, Faerstein E, Lopes CS, Werneck GL. Short version of the “job stress scale”: a Portuguese-language adaptation. Rev Saúde Pública 2004; 38(2): 164-71. https://doi.org/10.1590/s0034-89102004000200003
https://doi.org/10.1590/s0034-8910200400... ^,1111. Griep RH, Rotenberg L, Landsbergis P, Vasconcellos-Silva PR. Uso combinado de modelos de estresse no trabalho e a saúde auto-referida na enfermagem. Rev Saúde Pública 2011; 45(1): 145-52. http://dx.doi.org/10.1590/S0034-89102011000100017
http://dx.doi.org/10.1590/S0034-89102011... .

Negeliskii and Lautert¹²12. Negeliskii C, Lautert L. Estresse laboral e capacidade para o trabalho de enfermeiros de um grupo hospitalar. Rev Latino-Am Enfermagem 2011; 19(3): 606-13. http://dx.doi.org/10.1590/S0104-11692011000300021
http://dx.doi.org/10.1590/S0104-11692011... consider that social support should be the basis of work relationships and a social organization strategy in institutions, as it can decrease or even prevent occupational stress. These authors further highlighted that valuing work relationships and environment benefits the health and ability of workers¹²12. Negeliskii C, Lautert L. Estresse laboral e capacidade para o trabalho de enfermeiros de um grupo hospitalar. Rev Latino-Am Enfermagem 2011; 19(3): 606-13. http://dx.doi.org/10.1590/S0104-11692011000300021
http://dx.doi.org/10.1590/S0104-11692011... .

Studies on social support at work relating to different aspects of labor activities have been carried out with workers from numerous areas and sectors; among them, we underline the workers who act on the public sector, particularly on universities¹³13. Fonseca IS, Araújo TM, Bernardes KO, Amado N. Apoio social e satisfação no trabalho em funcionários de uma empresa de petróleo. Psicol Am Lat 2013; 25: 43-56.^,1414. Costa ÉSM, Hyeda A, Maluf EMCP. A relação entre o suporte organizacional no trabalho e o risco para doenças crônicas não transmissíveis em um serviço de saúde. Rev Bras Med Trab 2017; 15(2): 134-41. http://dx.doi.org/10.5327/Z1679443520176046
http://dx.doi.org/10.5327/Z1679443520176... ^,1515. Mattos AIS, Araújo TM, Almeida MMG. Interaction between demand-control and social support in the occurrence of common mental disorders. Rev Saúde Pública 2017; 51(0): 48. https://doi.org/10.1590/S1518-8787.2017051006446
https://doi.org/10.1590/S1518-8787.20170... . Nevertheless, in Brazil, workers from the public sector are stereotyped as inefficient and costly, and, for this reason, derogatory names are associated with both the institutions and the civil servants¹⁶16. Ribeiro CVS, Mancebo D. O servidor público no mundo do trabalho do século XXI. Psicol Ciênc Prof 2013; 33(1): 192-207. http://dx.doi.org/10.1590/S1414-98932013000100015
http://dx.doi.org/10.1590/S1414-98932013... .

Integrating the group of university workers is the technical-administrative staff in education (técnico-administrativos em educação - TAEs), who stand out for encompassing a variety of roles within different training/working areas, covering positions that require schooling levels ranging from elementary to higher education¹⁷17. Godinho MR, Greco RM, Teixeira MTB, Teixeira LR, Guerra MR, Chaoubah A. Work ability and associated factors of Brazilian technical-administrative workers in education. BMC Res Notes 2016: 9: 1-10. https://dx.doi.org/10.1186%2Fs13104-015-1837-x
https://dx.doi.org/10.1186%2Fs13104-015-... , representing the heterogeneity of the population, and being of great scientific importance to the field of worker’s health.

In 2012, a study carried out with TAEs from a public university in Minas Gerais found an increased prevalence of civil servants with high social support at work¹⁷17. Godinho MR, Greco RM, Teixeira MTB, Teixeira LR, Guerra MR, Chaoubah A. Work ability and associated factors of Brazilian technical-administrative workers in education. BMC Res Notes 2016: 9: 1-10. https://dx.doi.org/10.1186%2Fs13104-015-1837-x
https://dx.doi.org/10.1186%2Fs13104-015-... . Thus, the present study aimed to analyze the social support at work and its associated factors among TAE civil servants from a public university to give continuity to the research mentioned above.

METHODS

This prospective cohort study, with a quantitative approach, is the second stage of the base-study “Work ability and associated factors of Brazilian technical-administrative workers in education.” The present study was carried out at the Universidade Federal de Juiz de Fora (UFJF), located in the city of Juiz de Fora, state of Minas Gerais, and the population of this study consisted of permanent TAE workers from this university. The workers were invited to participate in the research through direct contact (in-person at the workplace), telephone, or e-mail, when both parts agreed to meet in a place that ensured the privacy of the interviewee, where they would receive and sign the Informed Consent Form and be interviewed.

The present investigation considered as inclusion criteria: having participated in the base-study between January 2012 and April 2013. The exclusion criteria were: having filled the questionnaire of the base-study incorrectly or incompletely; being off-work due to sick leave, maternity leave, or leave of absence granted by the National Institute of Social Security; having leave to accompany a spouse; or having been transferred to another institution.

Civil servants who were not found after three attempts, who retired for the length of service, age, or disability, those dismissed, or who died were regarded as losses. We also respected the individual’s right not to continue participating in the study, and these cases were considered refusals.

Data were collected through interviews conducted by trained researchers or self-administered questionnaires between August 1, 2016 and April 28, 2017, that is, 4 years after the conclusion of the base-study.

We characterized the profile of civil servants by analyzing variables related to sociodemographic characteristics (age, gender, marital status, ethnicity, schooling, number of children), work aspects (age at first job, number of jobs, weekly workload, total length of service, length of service at UFJF, night shift, psychosocial stress at work, social support at work), and health status (signs and symptoms of depression, physical activity, and work ability)¹⁸18. Matsudo S, Araújo T, Matsudo V, Andrade D, Andrade E, Oliveira LC, et al. Questionário Internacional de Atividade Física (IPAQ): estudo de validade e reprodutibilidade no Brasil. Rev Bras Ativ Fís Saúde 2001; 6(2): 5-18. https://doi.org/10.12820/rbafs.v.6n2p5-18
https://doi.org/10.12820/rbafs.v.6n2p5-1... ^,1919. Santos IS, Tavares BF, Munhoz TN, Almeida LSP, Silva NTB, Tams BD, et al. Sensibilidade e especificidade do Patient Health Questionnaire-9 (PHQ-9) entre adultos da população geral. Cad Saúde Pública 2013; 29(8): 1533-43. http://dx.doi.org/10.1590/0102-311X00144612
http://dx.doi.org/10.1590/0102-311X00144... .

Work conditions were analyzed through issues concerning the occupational history and by using the DCSQ, a reduced scale that addresses stress and social support at work adapted to Portuguese¹⁰10. Alves MGM, Chor D, Faerstein E, Lopes CS, Werneck GL. Short version of the “job stress scale”: a Portuguese-language adaptation. Rev Saúde Pública 2004; 38(2): 164-71. https://doi.org/10.1590/s0034-89102004000200003
https://doi.org/10.1590/s0034-8910200400... . The Demand-Control Model covers four specific work situations: high-strain job; passive job, active job; and low-strain job. Social support at work has two possible classifications - low or high support⁹9. Karasek R, Theorell T. Healthy work: stress, productivity and reconstruction of working life. Nova York: Basic Books; 1990.^,2020. Urbanetto JS, Silva PC, Hoffmeister E, Negri BS, Bartira Costa EP, Figueiredo CEP. Workplace stress in nursing workers from an emergency hospital: Job Stress Scale analysis. Rev Latino-Am Enfermagem 2011; 19(5): 1122-31. https://doi.org/10.1590/s0104-11692011000500009
https://doi.org/10.1590/s0104-1169201100... ^,2121. Alves MGM, Hökerberg YHM, Faerstein E. Tendências e diversidade na utilização empírica do Modelo Demanda-Controle de Karasek (estresse no trabalho): uma revisão sistemática. Rev Bras Epidemiol 2013; 16(1): 125-36. http://dx.doi.org/10.1590/S1415-790X2013000100012
http://dx.doi.org/10.1590/S1415-790X2013... .

Information about health status was collected using the following instruments:

The independent variables were sociodemographic characteristics, work aspects, and health status, and we evaluated their association with the outcome - social support at work. Chart 1 presents the variables studied and their categories.

We analyzed the data with the software Statistical Package for the Social Sciences, based on descriptive statistics, using measures of central tendency and dispersion for continuous variables, and frequency distributions for categorical variables. We verified the presence of statistically significant differences among the study groups using Student’s t-test and the χ² test and selected the variables associated with the outcome with a p-value ≤ 0.20 for the logistic regression. After the multivariate analysis, variables with a p-value ≤ 0.05 were considered statistically relevant to explain the social support at work.

The Research Ethics Committees of the Escola Nacional de Saúde Pública (REC/ENSP) and UFJF approved this study under the reports no. 1,574,457 and 1,673,735, respectively.

RESULTS

Among all TAEs who participated in the base-study, 328 comprised the cohort of this study, as shown in Figure 1.

When comparing the participant and non-participant population, the statistical analysis showed that the two groups did not differ with respect to most sociodemographic, health, and work variables investigated in the present study, except for age, ethnicity, and schooling.

The sociodemographic profile of TAEs, presented in Table 1, indicates that they are predominantly male, with a mean age of 47 years (ranging from 25 to 67 years), a higher incidence in the age group 41 to 59 years, white, married, with children, and have higher education or beyond.

Regarding the work- and health-related characteristics of TAEs, we found that most of them had only one job, with fixed working hours, weekly workload that did not exceed 40 hours, did not work at night, had up to 15 years working at UFJF, had another job before starting to work at the university, and were older than 18 years at their first job. Most TAEs did not show any signs and symptoms of depression, were classified as active or very active concerning their level of physical activity, had passive work and high social support at work.

In the follow-up period (2012/2013 to 2016/2017), some variables have changed, as many individuals got married, had children, and improved their level of schooling. Concerning work-related aspects, more civil servants started working fixed hours and up to 40 hours per week, and the percentage of workers with high social support at work increased. On the other hand, the percentage of individuals who did not work at night decreased, and two civil servants no longer have just one job.

As to health status, one TAE no longer had signs and symptoms of depression, and the number of workers with good WAI increased. In contrast, relating to the level of physical activity, the number of individuals classified as active or very active dropped.

When performing bivariate and regression analyses of independent variables with the outcome - social support at work -, we identified that, in the bivariate analysis, the variables type of work schedule, night shift, signs and symptoms of depression, level of physical activity (active/very active versus sedentary), demand control, and WAI had some influence on social support at work, with a p-value ≤ 0.20, as shown in Table 2.

After the multivariate analysis, the variables night shift, signs and symptoms of depression, and WAI remained associated with the outcome, and the data indicated that the probability of the worker having low social support at work is approximately 3.2 times higher if he or she works the night shift; five times higher if the individual presents signs and symptoms of depression; and three times higher when the worker has his or her work ability impaired.

DISCUSSION

The first aspect to be discussed in the present study concerns the comparison between participants and non-participants, and it is important to emphasize that both groups differed only in relation to ethnicity, schooling, and age. The difference is justified by the fact that the mean age of the non-participant group, which included workers who had retired, was superior to that of the participant group, influencing the distinction between the groups, since the mean age of non-white individuals and those with a lower level of schooling was higher. We underline that, over the cohort follow-up period, 88 individuals retired, and the mean age of these retirees was 58 years.

With respect to the results of the cohort participants, the profile of these civil servants was similar to that found by other authors who also conducted studies with Brazilian workers and identified that most of the study population had high social support at work¹⁵15. Mattos AIS, Araújo TM, Almeida MMG. Interaction between demand-control and social support in the occurrence of common mental disorders. Rev Saúde Pública 2017; 51(0): 48. https://doi.org/10.1590/S1518-8787.2017051006446
https://doi.org/10.1590/S1518-8787.20170... ^,2727. Augusto VG, Sampaio RF, Ferreira FR, Kirkwood RN, César CC. Factors associated with inadequate work ability among women in the clothing industry. Work 2015; 50(2): 275-83. https://doi.org/10.3233/WOR-131801
https://doi.org/10.3233/WOR-131801... .

In the multivariate analysis, the variables night shift, signs and symptoms of depression, and WAI remained associated with social support at work. We found that individuals who work at night have 3.2 times more chance of presenting low social support at work. Thus, we emphasize that working the night shift causes health damage to the worker, including interference in the circadian rhythm, incompatibility of schedules with family and friends, social isolation, and physical and mental strain²⁸28. Zarpelão RZN, Martino MMF. A qualidade do sono e os trabalhadores de turno: revisão integrativa. Rev Enferm UFPE On Line 2014; 8(6): 1782-90..

Another variable associated with social support at work was signs and symptoms of depression, as the data showed that individuals who presented these signs and symptoms were more likely to have low social support at work. The Whitehall II study, conducted with British civil servants, demonstrated that repetitive occupational stress and low social support at work increased the risk of major depressive disorder (MDD), indicating the relevance of social support at work²⁹29. Stansfeld SA, Shipley MJ, Head J, Fuhrer R. Repeated job strain and the risk of depression: longitudinal analyses from the Whitehall II study. Am J Public Health 2012; 102(12): 2360-6. https://doi.org/10.2105/AJPH.2011.300589
https://doi.org/10.2105/AJPH.2011.300589... .

Research carried out with workers in Bahia¹⁵15. Mattos AIS, Araújo TM, Almeida MMG. Interaction between demand-control and social support in the occurrence of common mental disorders. Rev Saúde Pública 2017; 51(0): 48. https://doi.org/10.1590/S1518-8787.2017051006446
https://doi.org/10.1590/S1518-8787.20170... revealed that individuals exposed to a high-strain job and low social support at work showed a prevalence of common mental disorders, evidencing that low social support can negatively impact their health. In this scenario, some authors argue that social support behaves as a beneficial factor, as it contributes to minimizing the perception of a threat and works as a fundamental element in the process of facing adverse situations¹⁵15. Mattos AIS, Araújo TM, Almeida MMG. Interaction between demand-control and social support in the occurrence of common mental disorders. Rev Saúde Pública 2017; 51(0): 48. https://doi.org/10.1590/S1518-8787.2017051006446
https://doi.org/10.1590/S1518-8787.20170... .

When analyzing the influence of health status on the outcome, we could identify that impaired work ability showed a statistically significant association with low social support in this study. The analyses showed that individuals with impaired work ability were approximately three times more likely to present low social support at work.

Other researchers³⁰30. Martinez MC, Latorre MRDO, Fischer FM. Estressores afetando a capacidade para o trabalho em diferentes grupos etários na Enfermagem: seguimento de 2 anos. Ciênc Saúde Coletiva 2017; 22(5): 1589-600. http://dx.doi.org/10.1590/1413-81232017225.09682015
http://dx.doi.org/10.1590/1413-812320172... found a similar result when evaluating whether different stressors affect the work ability of young and aging nursing professionals. Their findings revealed that the work ability of younger professionals was influenced by several of the stressors analyzed, including the worsening in social support³⁰30. Martinez MC, Latorre MRDO, Fischer FM. Estressores afetando a capacidade para o trabalho em diferentes grupos etários na Enfermagem: seguimento de 2 anos. Ciênc Saúde Coletiva 2017; 22(5): 1589-600. http://dx.doi.org/10.1590/1413-81232017225.09682015
http://dx.doi.org/10.1590/1413-812320172... .

Some authors argue that improvement in the work ability is strongly associated with a better relationship with the supervisor and the organizational process at work. Therefore, social support should be the basis of work relationships and a social organization strategy in institutions, as it can decrease or even prevent occupational stress. Valuing work relationships and environment can benefit the workers’ health and ability¹²12. Negeliskii C, Lautert L. Estresse laboral e capacidade para o trabalho de enfermeiros de um grupo hospitalar. Rev Latino-Am Enfermagem 2011; 19(3): 606-13. http://dx.doi.org/10.1590/S0104-11692011000300021
http://dx.doi.org/10.1590/S0104-11692011... ^,1717. Godinho MR, Greco RM, Teixeira MTB, Teixeira LR, Guerra MR, Chaoubah A. Work ability and associated factors of Brazilian technical-administrative workers in education. BMC Res Notes 2016: 9: 1-10. https://dx.doi.org/10.1186%2Fs13104-015-1837-x
https://dx.doi.org/10.1186%2Fs13104-015-... .

Despite the lack of significant differences between participants and non-participants, we cannot refrain from considering the size of the study population as a limitation. Also, extrapolating data to the general population requires caution, given that TAEs from the university have health and working conditions that might not reflect the reality of the general Brazilian population. Nonetheless, our results can contribute to designing intervention strategies that could to promote social support, prevent occupational stress and illnesses in workers with characteristics similar to those of the sample of this study.

CONCLUSION

We concluded that it is crucial to implement actions aimed at controlling risk factors associated with low social support at work and measures that promote a balanced work environment focused on existing social relationships, both among co-workers and between employees and supervisors. These actions can help to prevent diseases among workers, which often leads to a leave of absence, a situation that can happen early in some cases.

Thus, it is essential to have an ongoing multidisciplinary support program for civil servants from the university who presented low social support at work and health deficiencies, paying special attention to psychological support and the maintenance of functional capacity. For this multidisciplinary support program for civil servants, we suggest that the university includes its student body under the supervision of faculty members, integrating the TAEs in the process so that they can maintain an active and healthy life inside and outside the work environment.

ACKNOWLEDGMENTS

We want to thank the technical-administrative staff in education, without whom this study would not have been possible.

References

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History