Fatores de proteção e risco para ideação suicida em trabalhadores de hospitais públicos no Chile: dimensões organizacionais e liderança destrutiva
DOI:
https://doi.org/10.17533/udea.rfnsp.e358993Palavras-chave:
liderança, saúde mental, suicídio, profissionais de saúde, violência no local de trabalhoResumo
Objetivo: Identificar fatores de proteção e risco na relação entre liderança destrutiva, dimensões organizacionais e ideação suicida em profissionais de saúde pública no Chile.
Métodos: Estudo seccional. Foi realizada uma pesquisa entre 1.855 trabalhadores de hospitais públicos em três regiões do Chile entre janeiro e maio de 2023. A amostragem foi probabilística, estratificada por sexo e classe social. Utilizando modelos de regressão logística segmentados por sexo, foi analisada a associação entre estilos de liderança (laissez-faire, tirânico e construtivo), saúde mental (ideação suicida) e dimensões organizacionais (assédio moral no local de trabalho, exigências emocionais, conflito de papéis, vulnerabilidade no trabalho e clima de gerenciamento de conflitos).
Resultados: 6,42% da amostra apresentou ideação suicida; 32.94% relataram liderança laissez-faire; 13,42% liderança tirânica e 85,93% liderança construtiva. Os modelos ajustados nos mostraram que homens expostos à liderança laissez-faire [aOR = 2,52 (IC 95%: 1,34-5,76)] e à liderança tirânica [aOR = 2,80 (IC 95%: 1,33-5,87)] têm quase três vezes mais chances de apresentar ideação suicida do que aqueles não expostos. Um clima favorável à gestão de conflitos é um fator de proteção para ideação suicida para a amostra total de trabalhadores [aOR = 0,58 (IC 95%: 0,34-0,98)].
Conclusão: Liderança destrutiva é um fator de risco para ideação suicida em homens. Assédio no local de trabalho e exigências emocionais também atuam como fatores de risco para ideação suicida em homens e mulheres, e a vulnerabilidade no trabalho é um fator de risco apenas em mulheres. Um clima favorável à gestão de conflitos é um fator de proteção à saúde mental nas organizações e uma possível via de intervenção.
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Referências
1. Ociel Moya M, Albala C, Cea-Nettig X. Envejecimiento y vejez: el permanente desafío sociosanitario. Rev. Méd. Chile. 2023;151(5):665-66. DOI: http://dx.doi.org/10.4067/s0034-98872023000500665
2. Peiró JM. El sistema de trabajo y sus implicaciones para la prevención de los riesgos psicosociales en el trabajo. Universitas Psychologica [internet]. 2004 [citado 2025 may. 10]; 3(2):179-86. Disponible en: https://www.integraorg.com/wp-content/docs/El%20sistema%20de%20trabajo%20y%20sus%20implicaciones.pdf
3. Merhy EE, Macruz Feuerwerker LC, Burg Ceccim R. Educación permanente en salud: una estrategia para intervenir en la micropolítica del trabajo en salud. Salud Colectiva [internet]. 2006 [citado 2025 may. 10]; 2(2):147-60. Disponible en: https://www.scielosp.org/pdf/scol/2006.v2n2/147-160/es
4. Palma A. Dimensiones organizacionales, violencia laboral e indicadores de problemas de salud mental atendiendo a las desigualdades de género: un estudio en tres hospitales chilenos de alta complejidad [tesis doctoral]. [Santiago, Chile]: Universidad Diego Portales; 2019.
5. Bidegain Ponte N, Güezmes A, Scuro Somma, L. Igualdad de género y sociedad del cuidado. Rev Cepal [internet]; 2023 [citado 2025 may. 10]; (141):179-92. Disponible en: https://www.cepal.org/es/publicaciones/69119-igualdad-genero-sociedad-cuidado
6. Palma A, Ansoleaga E. Demandas emocionales, violencia laboral y salud mental según género en trabajadores de hospitales públicos chilenos. Psicoperspectivas. 2022;21(2):55-66. DOI: http://dx.doi.org/10.5027/psicoperspectivas-vol21-issue2-fulltext-2258
7. Aymerich C, Pedruzo B, Pérez JL, et al. COVID-19 pandemic effects on health worker’s mental health: Systematic review and meta-analysis. Eur Psychiatry. 2022;65(1):e10. DOI: http://dx.doi.org/10.1192/j.eurpsy.2022.1
8. Vindegaard N, Benros ME. COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain Behav Immun. 2020;89:531-42. DOI: http://dx.doi.org/10.1016/j.bbi.2020.05.048
9. Younès N, Rivière M, Plancke L, et al. Work intensity in men and work-related emotional demands in women are associated with increased suicidality among persons attending primary care. J Affect Disord. 2018; 235:565-73. DOI: https://doi.org/10.1016/j.jad.2018.04.075
10. Yoshimasu K, Kiyohara C, Miyashita K, The Stress Research Group of the Japanese Society for Hygiene. Suicidal risk factors and completed suicide: Meta-analyses based on psychological autopsy studies. Environ Health Prev Med. 2008;13(5):243-56. DOI: http://dx.doi.org/10.1007/s12199-008-0037-x
11. Favril L, Yu R, Uyar A, et al. Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies. Evid Based Ment Health. 2022;25(4):148-55. DOI: http://dx.doi.org/10.1136/ebmental-2022-300549
12. Greiner BA, Arensman E. The role of work in suicidal behavior – uncovering priorities for research and prevention. Scand J Work Environ Health. 2022;48(6):419-24. DOI: http://dx.doi.org/10.5271/sjweh.4051
13. Crosby AE, Ortega L, Melanson C. Self-directed violence surveillance: Uniform definitions and recommended data elements (Version 1.0). Atlanta, GA: CDC, National Center for Injury Prevention and Control (U.S.). Division of Violence Prevention [internet]; 2011 [citado 2025 may. 10]. Disponible en: https://stacks.cdc.gov/view/cdc/11997
14. Gunn V, Kreshpaj B, Matilla-Santander N, et al. Initiatives addressing precarious employment and its effects on workers’ health and well-being: A systematic review. Int J Environ Res Public Health. 2022;19(4):2232. DOI: http://dx.doi.org/10.3390/ijerph19042232
15. Howard MC, Follmer KB, Smith MB, et al. Work and suicide: An interdisciplinary systematic literature review. J Organ Behav. 2022;43(2):260-85. DOI: http://dx.doi.org/10.1002/job.2519
16. Wang Y, Xu M, et al. Associations between workplace violence and suicidal ideation among Chinese medical staff: A propensity score matching analysis. Psychol Health Med. 2024;29(5):1020-34. DOI: http://dx.doi.org/10.1080/13548506.2023.2254037
17. Kim SM, Kim HR, Min KJ, et al. Resilience as a protective factor for suicidal ideation among Korean workers. Psychiatry Investig. 2020;17(2):147-56. DOI: http://dx.doi.org/10.30773/pi.2019.0072
18. Milner A, Witt K, et al. Psychosocial job stressors and suicidality: A meta-analysis and systematic review. Occup Environ Med. 2018;75(4):245-53. DOI: https://doi.org/10.1136/oemed-2017-104531
19. Leach LS, Poyser C, Butterworth P. Workplace bullying and the association with suicidal ideation/thoughts and behaviour: a systematic review. Occup Environ Med. 2017;74(1):72-9. DOI: https://doi.org/10.1136/oemed-2016-103726
20. Liu Y, Zhang J, Hennessy DA, et al. Psychological strains, depressive symptoms, and suicidal ideation among medical and non-medical staff in urban china. J Affect Disord. 2019;245:22-27. DOI: http://dx.doi.org/10.1016/j.jad.2018.10.111
21. Liu J, Gan Y, Jiang H, et al. Prevalence of workplace violence against healthcare workers: A systematic review and meta-analysis. Occup Environ Med. 2019;76(12):927-37. DOI: http://dx.doi.org/10.1136/oemed-2019-105849
22. Schyns B, Schilling J. How bad are the effects of bad leaders? A meta-analysis of destructive leadership and its outcomes. Leadersh Q. 2013;24(1):138-58. DOI: http://dx.doi.org/10.1016/j.leaqua.2012.09.001
23. Liu Y, Gul H, Zhang J, et al. Abusive supervision and suicidal ideation: The potential role of meaning in life. Deviant Behav. 2021;42(12):1513-24. DOI: http://dx.doi.org/10.1080/01639625.2020.1757195
24. Einarsen S, Aasland MS, Skogstad A. Destructive leadership behaviour: A definition and conceptual model. Leadersh Q. 2007;18(3):207-16. DOI: http://dx.doi.org/10.1016/j.leaqua.2007.03.002
25. Mackey JD, Parker Ellen B III, et al. The dark side of leadership: A systematic literature review and meta-analysis of destructive leadership research. J Bus Res. 2021; 132:705-18. DOI: http://dx.doi.org/10.1016/j.jbusres.2020.10.037
26. STROBE. Strengthening the reporting of observational studies in epidemiology [internet]. s. f. [citado 2025 may. 10]. Disponible en: https://www.strobe-statement.org/
27. Von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344-9. DOI: https://doi.org/10.1016/j.jclinepi.2007.11.008
28. Aasland MS, Skogstad A, Notelaers G, et al. The prevalence of destructive leadership behaviour. Br J Manag. 2010;21(2):438-52. DOI: http://dx.doi.org/10.1111/j.1467-8551.2009.00672.x
29. Einarsen S, Hoel H, Notelaers G. Measuring exposure to bullying and harassment at work: Validity, factor structure and psychometric properties of the Negative Acts Questionnaire-Revised. Work Stress. 2009;23(1):24-44. DOI: http://dx.doi.org/10.1080/02678370902815673
30. González-Santa Cruz A, Ansoleaga E. Validación de la Escala de Liderazgo Destructivo y del Cuestionario de Conductas Negativas-Revisado en Chile. Psykhe. 2023;32(2):1-24. DOI: http://dx.doi.org/10.7764/psykhe.2020.27999
31. Nielsen MB, Nielsen GH, et al. Workplace bullying and suicidal ideation: A 3-wave longitudinal Norwegian study. Am J Public Health. 2015;105(11):e23-e28. DOI: http://dx.doi.org/10.2105/ajph.2015.302855
32. Candia M, Pérez Franco JT, González D. Manual del método del cuestionario SUSESO/ISTAS21. Superintendencia de Seguridad Social [internet]. 2020 [citado 2025 may. 10]. Disponible en: https://www.suseso.cl/606/articles-19640_archivo_01.pdf
33. Katz D, Kahn RL. The social psychology of organizations. 2.a ed. Nashville, TN: John Wiley & Sons [internet]; 1978 [citado 2025 may. 10]. Disponible en: https://ia601401.us.archive.org/34/items/in.ernet.dli.2015.139013/2015.139013.The-Social-Psychology-Of-Organizations.pdf
34. Bowling NA, Khazon S, Alarcon GM, et al. Building better measures of role ambiguity and role conflict: The validation of new role stressor scales. Work Stress. 2017;31(1):1-23. DOI: http://dx.doi.org/10.1080/02678373.2017.1292563
35. Greenhalgh L, Rosenblatt Z. Job insecurity: Toward conceptual clarity. Acad Manage Rev. 1984;9(3):438-48. DOI: http://dx.doi.org/10.5465/amr.1984.4279673
36. Casas Becerra L. The effectiveness of sexual harassment law in Chile: From theory to practice [tesis doctoral]. Ottawa: University of Ottawa [internet]; 2016 [citado 2025 may. 10]. Disponible en: https://scispace.com/pdf/the-effectiveness-of-sexual-harassment-law-in-chile-from-1p80ra2oy8.pdf
37. Vives-Vergara A, González-López F, Solar O, et al. Precarious employment in Chile: Psychometric properties of the Chilean version of Employment Precariousness Scale in private sector workers. Cad Saúde Pública. 2017;33(3):e00156215. DOI: http://dx.doi.org/10.1590/0102-311x00156215
38. Rivlin JN. Conflict management climate related to employment litigation [tesis doctoral]. [Atlanta: Georgia]: Institute of Technology [internet]; 2001 [citado 2025 may. 10]. Disponible en: https://repository.gatech.edu/entities/publication/78634d8a-84be-4267-b4d6-df667e8eabcf
39. Einarsen S, Skogstad A, Rørvik E, et al. Climate for conflict management, exposure to workplace bullying and work engagement: A moderated mediation analysis. Int J Hum Resour Manag. 2018;29(3):549-70. DOI: http://dx.doi.org/10.1080/09585192.2016.1164216
40. Vézina, M., Cloutier, E., Stock, S., et al. Québec survey on working and employment conditions and occupational health and safety (EQCOTESST): Summary (Sommaire de rapport n° RR-707). INSPQ; ISQ; IRSST. Québec: l’Institut de Recherche Robert-Sauvé en santé et en sécurité du travail (IRSST) [internet]; 2011 [[citado 2025 may. 10]. Disponible en: en: https://pharesst.irsst.qc.ca/cgi/viewcontent.cgi?article=1336&context=rapports-scientifique
41. StataCorp. Stata Statistical Software: Release 17 [internet]. StataCorp, College Station, TX: StataCorp [internet]; 2021 [citado 2025 may. 10]. Disponible en: https://www.stata.com/manuals17/i.pdf
42. Trachik B, Tucker RP, Ganulin ML, et al. Leader provided purpose: Military leadership behavior and its association with suicidal ideation. Psychiatry Res. 2020;285:112722. DOI: http://dx.doi.org/10.1016/j.psychres.2019.112722
43. Ansoleaga E. Indicadores de salud mental asociados a riesgo psicosocial laboral en un hospital público. Rev Med Chil. 2015;143(1):47-55. DOI: http://dx.doi.org/10.4067/s0034-98872015000100006
44. Messing K, Punnett L, Bond M, et al. Be the fairest of them all: Challenges and recommendations for the treatment of gender in occupational health research. Am J Ind Med. 2003;43(6):618-29. DOI: http://dx.doi.org/10.1002/ajim.10225
45. Magnusson Hanson LL, Pentti J, Nordentoft M, et al. Association of workplace violence and bullying with later suicide risk: A multicohort study and meta-analysis of published data. Lancet Public Health. 2023;8(7):e494-e503. DOI: http://dx.doi.org/10.1016/s2468-2667(23)00096-8
46. Ansoleaga E, Ahumada M, González-Santa Cruz A. Association of workplace bullying and workplace vulnerability in the psychological distress of Chilean workers. Int J Environ Res Public Health. 2019;16(20):4039. DOI: http://dx.doi.org/10.3390/ijerph16204039
47. O’Brien S, Galavan E, O’Shea D. Developing a competency framework for managers to address suicide risk in the workplace. Hum Resour Dev Q. 2022;33(2):157-78. DOI: https://doi.org/10.1002/hrdq.21437
48. Raschke N, Mohsenpour A, Aschentrup L, et al. Socioeconomic factors associated with suicidal behaviors in South Korea: Systematic review on the current state of evidence. BMC Public Health. 2022;22(1):129. DOI: http://dx.doi.org/10.1186/s12889-022-12498-1
49. Krieger N. Epidemiology and the web of causation: Has anyone seen the spider? Soc Sci Med. 1994;39(7):887-903. DOI: http://dx.doi.org/10.1016/0277-9536(94)90202-x
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