Factors associated with musculoskeletal pain among teachers: sociodemographics aspects, general health and well-being at work

Albanita Gomes da Costa de Ceballos Gustavo Barreto Santos About the authors

Abstracts

INTRODUCTION:

Musculoskeletal pain is one of the most frequent complaints among teachers, compromising their health and quality of life.

OBJECTIVE:

To estimate the prevalence of musculoskeletal pain among teachers, assessing their occurrence according to sociodemographic characteristics, general health and well-being at work.

METHODS:

An exploratory cross-sectional study conducted with 525 teachers. During activities of continuing education, the teachers completed a self-administered questionnaire containing questions about sociodemographic factors, general health, well-being at work and musculoskeletal pain.

RESULTS:

The overall prevalence of musculoskeletal pain was equal to 73.5%. The most common musculoskeletal pains were localized in the shoulders (31.6%), upper back (27.8%), neck (27.2%) and ankles and/or feet (24.0%). Circulatory and respiratory problems and Common Mental Disorders were associated with pain in the shoulders, upper back, neck and ankles and/or feet. Well- being at work is associated with pain in the shoulders, neck and ankles and/or feet.

CONCLUSION:

It is necessary to deepen the knowledge about musculoskeletal pain among teachers, exploring the biological, ergonomic, occupational and psychosocial mechanisms of teaching, as well as invest in practices that improve the relationship of coexistence between workers and activities that enhance the comfort and reduce referred pain.

Work; Occupational health; Musculoskeletal system; Musculoskeletal pain; Teaching; Faculty


INTRODUCTION

Work has been widely described as a determinant of quality of life. In addition to providing material resources, it helps to define the identity of subjects and their role in society, providing opportunity for personal control, use of skills, building goals and social contact that influence health and well-being1Warr PB. Work, happiness and unhappiness. New Jersey: Lawrence Erlbaum Associates; 2007..

As in other professional activities, health impairment of teachers may be associated with their working conditions. The main causes of illnesses and absence from work are linked to the occurrence of mental and behavioral disorders, respiratory diseases and musculoskeletal pain (MSP)2Vedovato TG, Monteiro MI. Perfil sociodemográfico e condições de saúde e trabalho dos professores de nove escolas estaduais paulistas. Rev Esc Enferm USP 2008; 42(2): 290-7. , 3Gasparini SM, Barreto SM, Assunção AA. O professor, as condições de trabalho e os efeitos sobre sua saúde. Educação e Pesquisa. 2005; 31(2): 189-99.. The latter is referred to as one of the most common problems among teachers, with correlation of occurrence related to low quality of life4Cardoso JP, Araújo TM, Carvalho FM, Oliveira NF, Reis EJFB. Aspectos psicossociais do trabalho docente e dor musculoesquelética. Cad Saúde Pública, 2011; 27(8): 1498-506.

Fernandes MH, Rocha VM; Fagundes AAR. Impacto da sintomatologia osteomuscular na qualidade de vida de professores. Rev Bras Epidemiol 2011; 14(2): 276-84.
- 6Carvalho AJFP, Alexandre NMC. Sintomas osteomusculares em professores do ensino fundamental. Rev Bras Fisioter 2006; 10(1): 35-41..

Studies conducted with elementary school teachers show high prevalence of MSP complaints, being more common in the lumbar, thoracic and cervical regions, shoulders, wrists and hands6Carvalho AJFP, Alexandre NMC. Sintomas osteomusculares em professores do ensino fundamental. Rev Bras Fisioter 2006; 10(1): 35-41. , 7Delcor NS, Araújo TM, Reis EJFB, Porto LA, Carvalho FM, Silva MO, et al. Condições de trabalho e saúde dos professores da rede particular de ensino de Vitória da Conquista, Bahia, Brasil. Cad Saúde Publica 2004; 20(1): 187-96..

Considering MSP as a multifactorial condition, and sociodemographic features, individual characteristics, lifestyle and working conditions as factors that may contribute to the onset or worsening of pain8Barros ENC, Alexandre NMC. Cross-cultural adaptation of Nordic musculoskeletal questionnaire. Int Nurs Rev 2003; 50(2): 101-8. , 9Lemos LC, Marqueze EC, Moreno CRC. Prevalência de dores musculoesqueléticas em motoristas de caminhão e fatores associados. Rev Bras Saúde Ocup 2014; 39(129): 26-34., this study aimed to estimate the prevalence of musculoskeletal pain in teachers, assessing occurrences according to sociodemographic aspects, overall health and well-being at work.

METHODS

This study is part of a broader one entitled Working conditions and health of teachers. This is an exploratory cross-sectional study conducted between August and October 2011 with teachers of the kindergarten and elementary grades of the municipal network Guararapes Jaboatão. The municipality comprises the metropolitan area of Recife, capital of Pernambuco State, with approximately 259,000 km2, 645,000 inhabitants, and Municipal Human Development Index (MHDI) of 0.7171010 IBGE Cidades. Disponível emhttp://www.ibge.gov.br/cidadesat/xtras/perfil.php?codmun=260790 (Acesso em09 agosto de 2013).
http://www.ibge.gov.br/cidadesat/xtras/p...
.

Data collection was made during the mandatory continuing education activities promoted by the municipal secretary of education for all school teachers. All teachers were invited to participate. After the presentation of the research group, the teachers who agreed to participate completed a self-administered questionnaire on sociodemographic data, working conditions, general health, mental disorders and well-being at work.

Sample size was calculated using Statcalc Epi Info software (version 6.04) and took into account the 55% prevalence of musculoskeletal pain4Cardoso JP, Araújo TM, Carvalho FM, Oliveira NF, Reis EJFB. Aspectos psicossociais do trabalho docente e dor musculoesquelética. Cad Saúde Pública, 2011; 27(8): 1498-506., and maximum error of 5% for a 95% significance level. A 10% addition in values was made to compensate for any loss or incomplete questionnaires, resulting in a minimum sample size of 356 subjects. However, due to the great increase in the study, the final sample was composed of 525 teachers.

To build the variable well-being at work (WBW), an adaptation of the Well-being at Work Scale (WBWS) validated by Paschoal and Tamayo1111 Paschoal T, Tamayo A. Construção e validação da escala de bem estar no trabalho. Aval Psicol 2008; 7(1): 11-22.was used. This assessment tool considers the affective dimensions (positive and negative) and satisfaction/expression to assess well-being at work. However, taking as a basis that the affective dimension is central to building this concept1212 Daniels K. Measures of five aspects of affective well-being at work. Hum Relat 2000; 53(2): 275-94.

13 Horn JE, Taris TW, Schaufeli WB, Schreurs PJG. The structure of occupational well-being: a study among Dutch teachers. J Occup Organ Psychol 2004; 77: 365-75.
- 1414 Paschoal T, Torres CV, Porto JB. Felicidade no trabalho: relações com suporte organizacional e suporte social. Rev Adm Contemp 2010; 14(6): 1054-72., our study considered only the positive and negative affect dimensions of the scale to compose the variable WBW. The values of 9 positive and 12 negative items were summed, being considered the tertiles to compose low and moderate/high WBW.

MSP was self-reported by teachers through the following question: "In the last seven days, in which parts of the body did you feel pain?". Respondents could mark one or more options among the listed: no pain, neck, shoulders, upper back, elbows, wrists and/or hands, lower back, hips and/or thigh, knees, ankles, and/or feet, another part of the body. Teachers were considered without MSP when the option "No pain" was signaled, and with MSP when at least one of the other options was marked.

The variable Common Mental Disorders (CMD) was composed using the Self-Reporting Questionnaire (SRQ20)1515 Goldberg D, Huxley P. Commom mental disorders: a bio-social model. London: Tavistock; 1992.. Positive responses were summed, being used the 6/7 cut-off point, that is, 0-6 = not suspected, and 7 or more = suspected.

Body Mass Index (BMI) was calculated by dividing the weight by the square of the height. Measurements of weight and height were self-reported by respondents. Continuous variables such as age and length of professional experience as a teacher were categorized.

Data analysis was performed using the Statistical Package for Social Sciences (SPSS, v 9.0.). Initially, the frequencies of variables were described. The most common types of musculoskeletal pain (p > 20%) were selected for the bivariate analysis. To assess the association between musculoskeletal pain and other variables, the prevalence ratio and 95%confidence intervals (95%CI) were calculated.

Participants signed the informed consent in which the research objectives and the information required were explained, with the guarantee of confidentiality of information obtained. The research protocol was approved by the Ethics Committee of the Health Sciences Center, Universidade Federal de Pernambuco (UFPE) (protocol 008/2011).

RESULTS

Among 525 teachers who participated in the study, most were female (86.1%) and refers dark brown or black skin (72.2%). Age of teachers was greater than or equal to 40 years (57.0%), and they had been acting as teachers for up to 10 years (58.3%). The predominant education level was graduate studies (53.5%), with mentions of specialization (51.0%) and master's/doctorate degrees (2.5%). When we considered the sum of their family monthly income and the amount of people who depended on this income, per capita income of teachers' households was up to R$ 1,000.00 (79.6%) (Table 1).

Table 1.
Description of the study population according to sociodemographic and work-related variables.

The five health problems most frequently reported were voice problems (49.9%), allergies (47.5%), common mental disorders (37.1%), circulatory (36.0%) and digestive problems (32.0%). Overweight or pre-obesity was present in 25.7% of the sample. Most subjects reported not consuming alcohol (62.5%) and being non-smokers (90.1%). The WBW was considered moderate or high by 61.3% of respondents (Table 2).

Table 2.
Description of the study population according to variables related to health and well-being at work.

The prevalence of musculoskeletal pain was 73.5% (386 teachers). Out of these, 152 (29.0%) had only one complaint, 151 (28.8%) had two or three complaints, and 83 (15.9%) had more than three complaints. The spots of the most common musculoskeletal pain were shoulders (31.6%), upper back (27.8%), neck (27.2%), ankle and/or feet (24.0%) (Table 3).

Table 3.
Description of the study population according to self-reported musculoskeletal pain.

Shoulder pain was statistically associated with allergies (prevalence ratio - PR = 1.27), digestive problems (PR = 1.38), circulatory problems (PR = 1.24), vocal problems (PR = 1, 34), breathing problems (PR = 1.29), CMD (PR = 1.42) and WBW (PR = 1.53). Pain in the upper back was statistically associated with gender (PR = 1.98), race (PR = 1.14), allergies (PR = 1.17), digestive problems (PR = 1.19), circulatory problems (PR = 1.24), vocal problems (PR = 1.36), respiratory problems (PR = 1.20), CMD (PR = 1.23), BMI (PR = 1.15) and smoking habit (PR = 1.37) (Tables 4 and 5).

Table 4.
Association between demographic and work-related variables and self-reported musculoskeletal pain in the shoulder, upper back, neck and ankles and/or feet.

Neck pain was statistically associated with gender (PR = 1.76), race (PR = 1.10), allergies (PR = 1.29), digestive problems (PR = 1.30), circulatory problems (PR = 1.30), vocal problems (PR = 1.31), respiratory problems (PR = 1.32), CMD (PR = 1.58) and WBW (PR = 1.44). Pain in the ankles and/or feet was associated with length of professional experience as a teacher (PR = 1.10), circulatory problems (PR = 1.37), respiratory problems (PR = 1.30), CMD (PR = 1, 23), and WBW (PR = 1.86) (Tables 4 and 5).

Table 5.
Association between health-related variables and well-being at work with self-reported musculoskeletal pain in the shoulder, upper back, neck and ankles and/or feet.

DISCUSSION

Studies with elementary and high school teachers in Brazil showed results on sociodemographic and work data (gender, ethnicity, age, income and time of professional experience) Yesilar to those reported in this study (Table 1)2Vedovato TG, Monteiro MI. Perfil sociodemográfico e condições de saúde e trabalho dos professores de nove escolas estaduais paulistas. Rev Esc Enferm USP 2008; 42(2): 290-7. , 5Fernandes MH, Rocha VM; Fagundes AAR. Impacto da sintomatologia osteomuscular na qualidade de vida de professores. Rev Bras Epidemiol 2011; 14(2): 276-84. , 1616 Araujo TM, Carvalho FM. Condições de trabalho docente e saúde na Bahia: estudos epidemiológicos. Educ Soc 2009; 30(107): 427-49.

17 Ceballos AGC, Carvalho FM, Araújo TM, Reis EJFBD. Auditory vocal analysis and factors associated with voice disorders among teachers. Rev Bras Epidemiol 2011; 14(2): 285-95.
- 1818 Santos MN, Marques AC. Condições de saúde, estilo de vida e características de trabalho de professores de uma cidade do sul do Brasil. Ciênc Saúde Coletiva 2013; 18(3): 837-46..

As for education level, it is noteworthy that over half of the teachers were postgraduates. Unlike earlier reports and studies showing low schooling of Brazilian teachers, the percentage of post-graduate teachers has increased: 15.12Vedovato TG, Monteiro MI. Perfil sociodemográfico e condições de saúde e trabalho dos professores de nove escolas estaduais paulistas. Rev Esc Enferm USP 2008; 42(2): 290-7., 30.41919 Araújo TM, Reis EJFB, Carvalho FM, Porto LA, Reis IC, Andrade JM. Fatores associados a alterações vocais em professores. Cad Saúde Pública 2008; 24(6): 1229-38., 42.45Fernandes MH, Rocha VM; Fagundes AAR. Impacto da sintomatologia osteomuscular na qualidade de vida de professores. Rev Bras Epidemiol 2011; 14(2): 276-84. and 59.0%1818 Santos MN, Marques AC. Condições de saúde, estilo de vida e características de trabalho de professores de uma cidade do sul do Brasil. Ciênc Saúde Coletiva 2013; 18(3): 837-46.. As to the study population, we can infer that a law enacted in the city in 20022020 Jaboatão dos Guararapes.Lei Municipal n.° 178, de 22 de outubro de 2002. Disponível em: http://legis.jaboatao.pe.gov.br/lei-ordinaria/2002/00178/(Acesso em 12 de março de 2013).
http://legis.jaboatao.pe.gov.br/lei-ordi...
, establishing job, career and remuneration planning for professionals in the teaching occupational group, has encouraged them to pursue postgraduate courses due to career progression and consequent increase in salaries.

As for morbidity, main complaints reported were vocal problems, mental and behavioral disorders, diseases of the respiratory, circulatory and digestive systems. These results corroborate those of other studies, reinforcing the Yesilarities involving teaching activities and the health status of these professionals in various areas of the country2Vedovato TG, Monteiro MI. Perfil sociodemográfico e condições de saúde e trabalho dos professores de nove escolas estaduais paulistas. Rev Esc Enferm USP 2008; 42(2): 290-7. , 5Fernandes MH, Rocha VM; Fagundes AAR. Impacto da sintomatologia osteomuscular na qualidade de vida de professores. Rev Bras Epidemiol 2011; 14(2): 276-84. , 1616 Araujo TM, Carvalho FM. Condições de trabalho docente e saúde na Bahia: estudos epidemiológicos. Educ Soc 2009; 30(107): 427-49. , 1717 Ceballos AGC, Carvalho FM, Araújo TM, Reis EJFBD. Auditory vocal analysis and factors associated with voice disorders among teachers. Rev Bras Epidemiol 2011; 14(2): 285-95..

The prevalence of musculoskeletal pain in this study (73.5%) reached an intermediate values compared to that found in other studies (55.04Cardoso JP, Araújo TM, Carvalho FM, Oliveira NF, Reis EJFB. Aspectos psicossociais do trabalho docente e dor musculoesquelética. Cad Saúde Pública, 2011; 27(8): 1498-506., 63.25Fernandes MH, Rocha VM; Fagundes AAR. Impacto da sintomatologia osteomuscular na qualidade de vida de professores. Rev Bras Epidemiol 2011; 14(2): 276-84. and 90.4%6Carvalho AJFP, Alexandre NMC. Sintomas osteomusculares em professores do ensino fundamental. Rev Bras Fisioter 2006; 10(1): 35-41.), demonstrating the relevance of pain in teaching practice. However, considering the study named "healthy worker effect" as a limitation, musculoskeletal pain complaints are likely to be underestimated. That is, the ones complaining the most may be relieved of their work activities, absent or licensed for health reasons.

Another factor to consider in the study of pain prevalence is the measurement of the variable itself, because, even though there are some measurement scales of general use (verbal, numerical, face scales) and clinical use (McGill multidimensional2121 Pimenta CAM, Teixeira MJ. Questionário da dor McGill: proposta de adaptação para a língua portuguesa. Rev Esc Enferm USP 1996; 30(3): 473-83. and WHO analgesia2222 Rabelo ML, Borella, MLL. Papel do farmacêutico no seguimento farmacoterapêutico para o controle da dor de origem oncológica. Rev Dor 2013; 14(1): 58-60.), the pain is always self-reported and, therefore, its measurement can be influenced by subjective aspects of participants, which maximizes or minimizes their perception.

The body parts of higher MSP incidence in this study were Yesilar to that of previous studies5Fernandes MH, Rocha VM; Fagundes AAR. Impacto da sintomatologia osteomuscular na qualidade de vida de professores. Rev Bras Epidemiol 2011; 14(2): 276-84.

Carvalho AJFP, Alexandre NMC. Sintomas osteomusculares em professores do ensino fundamental. Rev Bras Fisioter 2006; 10(1): 35-41.
- 7Delcor NS, Araújo TM, Reis EJFB, Porto LA, Carvalho FM, Silva MO, et al. Condições de trabalho e saúde dos professores da rede particular de ensino de Vitória da Conquista, Bahia, Brasil. Cad Saúde Publica 2004; 20(1): 187-96.. Although the relationship between MSP and working conditions of teachers has not been the object of this work, other studies claim that working conditions are determinants of health impairment among teachers. The prevalence of MSP is related to variables of teaching activities, including working time, number of students per class, weekly schedule, physical exertion, heat, furniture, high demand and low decision-making capacity4Cardoso JP, Araújo TM, Carvalho FM, Oliveira NF, Reis EJFB. Aspectos psicossociais do trabalho docente e dor musculoesquelética. Cad Saúde Pública, 2011; 27(8): 1498-506. , 2323 Cardoso JP, Ribeiro IQB, Araújo TM, Carvalho FM, Reis EJFB. Prevalência de dor musculoesquelética em professores. Rev Bras Epidemiol 2009; 12(4): 604-14.

The conditions under which the work is performed by educators can be a source of personal wear with consequent impairment of perception of well-being at work2424 Souza AN, Leite MP. Condições de trabalho e suas repercussões na saúde dos professores da educação básica no Brasil. Educ Soc 2011; 32(117): 1105-21.

25 Oliveira ESG. O "mal estar docente" como fenômeno da modernidade: os professores no país das maravilhas. Ciência & Cognição 2006; 7: 27-41.
- 2626  26. SantosGB.. Bem estar e condições de trabalho de professores do Centro de Ciências da Saúde da Universidade Federal de Pernambuco dissertação Recife: Universidade Federal de Pernambuco; 2013 . . In this investigation, more than a third of teachers had low levels of WBW. Pain in the neck, shoulders, ankles/feet showed positive association with low WBW, Yesilarly to other findings which show that pain in the neck, shoulders, hands/wrists and lower back are significantly lower in individuals with high levels of well-being compared to those with low levels7Delcor NS, Araújo TM, Reis EJFB, Porto LA, Carvalho FM, Silva MO, et al. Condições de trabalho e saúde dos professores da rede particular de ensino de Vitória da Conquista, Bahia, Brasil. Cad Saúde Publica 2004; 20(1): 187-96..

Another study assessing WBW among educators in primary and secondary education found that the three symptoms most commonly cited were pain in the neck and shoulders, lower back, and headache. Teachers aging 48 - 55 years had a tendency to higher levels of emotional exhaustion at work, with negative results on well-being2828 Santavirta N, Kovero C, Solovieva S. Psychosocial work environment, well being and emotional exhaustion. A study comparing five age groups of female workers within the human sector. International Congress Series 2005; 1280: 130-35..

Although the biological mechanisms linking emotions and moods to health conditions are not fully known, studies have shown increasing evidence that affective statuses can affect health through changes in the functioning of the central nervous system, as well as immune, endocrine and cardiovascular systems2929 Steptoe A, O'Donnell K, Badrick E, Kumari M, Marmot M. Neuroendocrine and In?ammatory Factors Associated with Positive Affect in Healthy Men and Women. Am J Epidemiol 2008; 167: 96-102.

30 Kiecolt-Glaser JK, McGuire L, Robles TF, Glaser R. Emotions, Morbidity, and Mortality: New Perspectives from Psychoneuroimmunology. Annu Rev Psychol 2002; 53: 83-107.
- 3131 Steptoe A, Wardle J, Marmot M. Positive affect and health-related neuroendocrine, cardiovascular, and inflammatory processes. PNAS 2005; 102(18): 6508-12.. In this sense, common mental disorders were associated with all four types of pain surveyed in this study. One can also infer that people with depression and anxiety may have sensitivity to pain increased and more health complaints.

When considering the association of WBW and CMD with musculoskeletal pain, studies have shown that negative emotions arising from depressive states, anxiety, anger and hostility increase the risk of heart attack, bone mineral loss and loss of muscle strength, increased levels cortisol and increased cytokines secretion3030 Kiecolt-Glaser JK, McGuire L, Robles TF, Glaser R. Emotions, Morbidity, and Mortality: New Perspectives from Psychoneuroimmunology. Annu Rev Psychol 2002; 53: 83-107., while positive emotions reflect in lower levels of cortisol, lower heart rate, lower psychological stress and depression, and lower secretion of inflammatory markers2929 Steptoe A, O'Donnell K, Badrick E, Kumari M, Marmot M. Neuroendocrine and In?ammatory Factors Associated with Positive Affect in Healthy Men and Women. Am J Epidemiol 2008; 167: 96-102. , 3131 Steptoe A, Wardle J, Marmot M. Positive affect and health-related neuroendocrine, cardiovascular, and inflammatory processes. PNAS 2005; 102(18): 6508-12., which could explain the relationship between variables .

Although this study agree with the statements of the previous paragraph, due to the limitation inherent to the cross-sectional design, it is not possible to draw a time sequence showing the development of musculoskeletal pain as well-being is changed, which requires further studies to further deepening the problem.

Considering the presence of CMD as related to sociodemographic and work-related variables for the areas of the body, this study showed an association between age and pain in the neck and ankle and/or foot, the latter being also associated with length of work time greater than 10 years. Another study found that MSP on the back, upper limbs and lower limbs were positively associated with length of work time greater than 5 years2323 Cardoso JP, Ribeiro IQB, Araújo TM, Carvalho FM, Reis EJFB. Prevalência de dor musculoesquelética em professores. Rev Bras Epidemiol 2009; 12(4): 604-14; thus, it is possible to think that aging and consequent increase in time of work as a teacher lead to the accumulation of wear situations that can contribute, over time, with the onset of musculoskeletal symptoms, causing more pain to teachers.

Musculoskeletal pain can be traumatic, inflammatory, ischemic, related to tumors or functional overload, and it is aggravated or mitigated by emotional factors. Thus, several discussion points can be highlighted in order to explain the association between MSP in teachers and factors such as allergies, circulatory, respiratory, digestive and vocal problems, overweight/obesity and smoking.

Although this research has been presented to teachers as a study on overall health, not specifically about musculoskeletal pain or well being at work, and has included all the teachers of the public schools in the placed searched, with only 4 refusals registered, we cannot rule completely the possibility of bias in the selection of respondents. Thus, it is necessary to explore other analytical study models that can bring more evidence on the relation between teaching and physical pain.

CONCLUSION

Musculoskeletal pain is often reported by teachers, with emphasis to shoulder, upper back, neck and ankles and/or feet pain, as the most common complaints, all of them being associated with sociodemographic factors, physical and mental health, and well being at work.

We must deepen the knowledge about musculoskeletal pain in teachers, exploring the biological, ergonomic, occupational and psychosocial mechanisms of teaching, as well as invest in practices that improve the coexistence relationship between workers and activities that increase comfort in the working environment to reduce the referred pain.

ACKNOWLEDGMENTS

CNPq (protocol 475848/2010-1), for the financing of the research, and to the Municipal Education Secretariat of Jaboatão dos Guararapes for the support.

REFERENCES

  • 1
    Warr PB. Work, happiness and unhappiness. New Jersey: Lawrence Erlbaum Associates; 2007.
  • 2
    Vedovato TG, Monteiro MI. Perfil sociodemográfico e condições de saúde e trabalho dos professores de nove escolas estaduais paulistas. Rev Esc Enferm USP 2008; 42(2): 290-7.
  • 3
    Gasparini SM, Barreto SM, Assunção AA. O professor, as condições de trabalho e os efeitos sobre sua saúde. Educação e Pesquisa. 2005; 31(2): 189-99.
  • 4
    Cardoso JP, Araújo TM, Carvalho FM, Oliveira NF, Reis EJFB. Aspectos psicossociais do trabalho docente e dor musculoesquelética. Cad Saúde Pública, 2011; 27(8): 1498-506.
  • 5
    Fernandes MH, Rocha VM; Fagundes AAR. Impacto da sintomatologia osteomuscular na qualidade de vida de professores. Rev Bras Epidemiol 2011; 14(2): 276-84.
  • 6
    Carvalho AJFP, Alexandre NMC. Sintomas osteomusculares em professores do ensino fundamental. Rev Bras Fisioter 2006; 10(1): 35-41.
  • 7
    Delcor NS, Araújo TM, Reis EJFB, Porto LA, Carvalho FM, Silva MO, et al. Condições de trabalho e saúde dos professores da rede particular de ensino de Vitória da Conquista, Bahia, Brasil. Cad Saúde Publica 2004; 20(1): 187-96.
  • 8
    Barros ENC, Alexandre NMC. Cross-cultural adaptation of Nordic musculoskeletal questionnaire. Int Nurs Rev 2003; 50(2): 101-8.
  • 9
    Lemos LC, Marqueze EC, Moreno CRC. Prevalência de dores musculoesqueléticas em motoristas de caminhão e fatores associados. Rev Bras Saúde Ocup 2014; 39(129): 26-34.
  • 10
    IBGE Cidades. Disponível emhttp://www.ibge.gov.br/cidadesat/xtras/perfil.php?codmun=260790 (Acesso em09 agosto de 2013).
    » http://www.ibge.gov.br/cidadesat/xtras/perfil.php?codmun=260790
  • 11
    Paschoal T, Tamayo A. Construção e validação da escala de bem estar no trabalho. Aval Psicol 2008; 7(1): 11-22.
  • 12
    Daniels K. Measures of five aspects of affective well-being at work. Hum Relat 2000; 53(2): 275-94.
  • 13
    Horn JE, Taris TW, Schaufeli WB, Schreurs PJG. The structure of occupational well-being: a study among Dutch teachers. J Occup Organ Psychol 2004; 77: 365-75.
  • 14
    Paschoal T, Torres CV, Porto JB. Felicidade no trabalho: relações com suporte organizacional e suporte social. Rev Adm Contemp 2010; 14(6): 1054-72.
  • 15
    Goldberg D, Huxley P. Commom mental disorders: a bio-social model. London: Tavistock; 1992.
  • 16
    Araujo TM, Carvalho FM. Condições de trabalho docente e saúde na Bahia: estudos epidemiológicos. Educ Soc 2009; 30(107): 427-49.
  • 17
    Ceballos AGC, Carvalho FM, Araújo TM, Reis EJFBD. Auditory vocal analysis and factors associated with voice disorders among teachers. Rev Bras Epidemiol 2011; 14(2): 285-95.
  • 18
    Santos MN, Marques AC. Condições de saúde, estilo de vida e características de trabalho de professores de uma cidade do sul do Brasil. Ciênc Saúde Coletiva 2013; 18(3): 837-46.
  • 19
    Araújo TM, Reis EJFB, Carvalho FM, Porto LA, Reis IC, Andrade JM. Fatores associados a alterações vocais em professores. Cad Saúde Pública 2008; 24(6): 1229-38.
  • 20
    Jaboatão dos Guararapes.Lei Municipal n.° 178, de 22 de outubro de 2002. Disponível em: http://legis.jaboatao.pe.gov.br/lei-ordinaria/2002/00178/(Acesso em 12 de março de 2013).
    » http://legis.jaboatao.pe.gov.br/lei-ordinaria/2002/00178/
  • 21
    Pimenta CAM, Teixeira MJ. Questionário da dor McGill: proposta de adaptação para a língua portuguesa. Rev Esc Enferm USP 1996; 30(3): 473-83.
  • 22
    Rabelo ML, Borella, MLL. Papel do farmacêutico no seguimento farmacoterapêutico para o controle da dor de origem oncológica. Rev Dor 2013; 14(1): 58-60.
  • 23
    Cardoso JP, Ribeiro IQB, Araújo TM, Carvalho FM, Reis EJFB. Prevalência de dor musculoesquelética em professores. Rev Bras Epidemiol 2009; 12(4): 604-14
  • 24
    Souza AN, Leite MP. Condições de trabalho e suas repercussões na saúde dos professores da educação básica no Brasil. Educ Soc 2011; 32(117): 1105-21.
  • 25
    Oliveira ESG. O "mal estar docente" como fenômeno da modernidade: os professores no país das maravilhas. Ciência & Cognição 2006; 7: 27-41.
  • 26
    26. SantosGB.. Bem estar e condições de trabalho de professores do Centro de Ciências da Saúde da Universidade Federal de Pernambuco dissertação Recife: Universidade Federal de Pernambuco; 2013 .
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  • Financial support: CNPq (Universal Notice 2010, process 475848/2010-1).

Publication Dates

  • Publication in this collection
    Jul-Sep 2015

History

  • Received
    01 Oct 2013
  • Reviewed
    15 Dec 2015
  • Accepted
    26 Dec 2014
Associação Brasileira de Pós -Graduação em Saúde Coletiva São Paulo - SP - Brazil
E-mail: revbrepi@usp.br