Trayectorias de estrés familiar y laboral y su asociación con accidentes cerebrovasculares

Autores/as

DOI:

https://doi.org/10.11606/s1518-8787.20210550033253

Palabras clave:

Accidente Cerebrovascular, Factores de Riesgo, Estrés Financiero, Agotamiento Profesional, Factores Socioeconómicos

Resumen

OBJETIVOS: Reconstruir tipos de trayectorias de estrés simultáneo en el dominio familiar y laboral en diferentes etapas de la vida y estimar su asociación con accidentes cerebrovasculares (ACV) en la vejez. MÉTODOS: Se utilizó una encuesta retrospectiva, cara a cara, y representativa de personas de 65 a 75 años en la ciudad de Santiago de Chile (n = 802). Se empleó un análisis de secuencias multicanal para reconstruir tipos de trayectorias de estrés familiar y laboral en diversas etapas de la vida y luego se utilizaron modelos de regresión logística para estimar la asociación de estos tipos de trayectoria con ACV en la vejez, controlado por factores tradicionales de riesgo cardiovascular. RESULTADOS: Se identificaron cuatro tipos representativos de trayectorias de estrés familiar y laboral: (1) Ausencia de estrés familiar y laboral, (2) Ausencia de estrés familiar, estrés laboral persistente, (3) Ausencia de estrés familiar, fuera de mercado laboral, y (4) Estrés familiar persistente, ausencia de estrés laboral. El 61,7% de la muestra siguió trayectorias marcadas por la presencia permanente de estrés familiar y/o laboral. Asimismo, el 18,3% tuvo una trayectoria caracterizada por la ausencia prolongada del mercado del trabajo. Las personas con trayectorias de estrés familiar o laboral persistente, así como aquellas con períodos extensos de inactividad, tienen más riesgo de desarrollar ACV. CONCLUSIONES: El estrés es un factor de riesgo de enfermedades cardiovasculares que experimenta de manera prolongada muchas personas en distintas etapas y dominios de la vida. En consecuencia, los sistemas de prevención de este tipo de enfermedades crónicas deben enfatizar los efectos altamente nocivos de enfrentar cotidiana y acumulativamente experiencias de vida estresantes. Esto a su vez podría mitigar las múltiples consecuencias sanitarias y financieras asociadas al ACV.

Referencias

Melo-Silva AM, Mambrini JVM, Souza Junior PRB, Andrade FB, Lima-Costa MF. Hospitalizations among older adults: results from ELSI-Brazil. Rev Saude Publica. 2018;52 Suppl 2:3s. https://doi.org/10.11606/S1518-8787.2018052000639

GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1736-88. https://doi.org/10.1016/S0140-6736(18)32203-7

Campbell BCV, Khatri P. Stroke. Lancet. 2020;396(10244):129-42. https://doi.org/10.1016/S0140-6736(20)31179-X

Joseph P, Leong D, McKee M, Anand SS, Schwalm JD, Teo K, et al. Reducing the Global Burden of Cardiovascular Disease, Part 1: the epidemiology and risk factors. Circ Res. 2017;121(6):677-94. https://doi.org/10.1161/CIRCRESAHA.117.308903

Surkan PJ, Sakyi KS, Hu A, Olinto MT, Gonçalves H, Horta BL, et al. Impact of stressful life events on central adiposity in the Pelotas Birth Cohort. Rev Saude Publica. 2018;52:61. https://doi.org/10.11606/s1518-8787.2018052000161

Máximo RO, Lopes IC, Brigola AG, Luchesi BM, Gratão ACM, Inouye K, et al. Pre-frailty, frailty and associated factors in older caregivers of older adults. Rev Saude Publica. 2020;54:17. https://doi.org/10.11606/s1518-8787.2020054001655

Lightbody CE, Clegg A, Patel K, Lucas JC, Storey H, Hackett ML, et al. Systematic review and meta-analysis of psychosocial risk factors for stroke. Semin Neurol. 2017;37(3):294-306. https://doi.org/10.1055/s-0037-1603758

Kivimäki M, Steptoe A. Effects of stress on the development and progression of cardiovascular disease. Nat Rev Cardiol. 2018;15(4):215-29. https://doi.org/10.1038/nrcardio.2017.189

Kotlęga D, Gołąb-Janowska M, Masztalewicz M, Ciećwież S, Nowacki P. The emotional stress and risk of ischemic stroke. Neurol Neurochir Pol. 2016;50(4):265-70. https://doi.org/10.1016/j.pjnns.2016.03.006

Blanco M. El enfoque del curso de vida: orígenes y desarrollo. Rev Lat Am Población.2011;5(1):5-31. https://doi.org/10.31406/relap2011.v5.i1.n8.1

Kuh D, Schlomo YB, Ezzra S. A life course approach to chronic disease epidemiology. Oxford (UK): Oxford University Press; 2004.

Kornerup H, Osler M, Boysen G, Barefoot J, Schnohr P, et al. Major life events increase the risk of stroke but not of myocardial infarction: results from the Copenhagen City Heart Study. Eur J Cardiovasc Prev Rehabil. 2010;17(1):113-8. https://doi.org/10.1097/HJR.0b013e3283359c18

Ripoll Gallardo A, Pacelli B, Alesina M, Serrone D, Iacutone G, Faggiano F, et al. Medium- and long-term health effects of earthquakes in high-income countries: a systematic review and meta-analysis. Int J Epidemiol. 2018;47(4):1317-32. https://doi.org/10.1093/ije/dyy130

Engström G, Khan FA, Zia E, Jerntorp I, Pessah-Rasmussen H, Norrving B, et al. Marital dissolution is followed by an increased incidence of stroke. Cerebrovasc Dis (Base). 2004;18(4):318-24. https://doi.org/10.1159/000080770

Li J, Loerbroks A, Bosma H, Angerer P. Work stress and cardiovascular disease: a life course perspective. J Occup Health. 2016;58(2):216-9. https://doi.org/10.1539/joh.15-0326-OP

American Association for Public Opinion Research. Standard definitions. Final dispositions of case codes and outcome rates for surveys. Washington, DC: AAPOR; 2016 [citado 15 Abr 2016]. Disponible en: https://www.aapor.org/Standards-Ethics/Standard-Definitions-(1).aspx

Morselli D, Dasoki N, Gabriel R, Gauthier JA, Henke J, Le Goff JM. Using life history calendars to survey vulnerability. In: Oris M, Roberts C, Joye D, Ernst Stähli M, editors. Surveying human vulnerabilities across the life course. Cham (CH): Springer; 2016. p.177-201. (Life Course Research and Social Policies; nº 3).

Morselli D, Le Goff JM, Gauthier JA. Self-administered event history calendars: a possibility for surveys? Contemp Soc Sci. 2019;14(3-4):423-46. https://doi.org/10.1080/21582041.2017.1418528

Gauthier JA, Widmer ED, Bucher P, Notredame C. Multichannel sequence analysis applied to social science data. Sociol Methodol. 2010;40(1):1-38. https://www.jstor.org/stable/41336881

Madero-Cabib I, Fasang AE. Gendered work–family life courses and financial well-being in retirement. Adv Life Course Res. 2016;27:43-60. https://doi.org/10.1016/j.alcr.2015.11.003

Madero-Cabib I, Gauthier JA, Le Goff JM. The influence of interlocked employment–family trajectories on retirement timing. Work Aging Retire. 2016:2(1):38-53. https://doi.org/10.1093/workar/wav023

Gabadinho A, Ritschard G, Mueller NS, Studer M. Analyzing and visualizing state sequences in R with TraMineR. J Stat Softw. 2011;40(4):1-37. https://doi.org/10.18637/jss.v040.i04

Ward JH Jr. Hierarchical grouping to optimize an objective function. J Am Stat Assoc. 1963;58(301):236-44. https://doi.org/10.1080/01621459.1963.10500845

Studer M. WeightedCluster library manual: a practical guide to creating typologies of trajectories in the social sciences with R. Lives Working Papers. 2013;2013(24):1-32. https://doi.org/10.12682/lives.2296-1658.2013.24

R Development Core Team. R: a language and environment for statistical computing. Vienna, AT: R Foundation for Statistical Computing; 2019.

Lumley T. Complex surveys: a guide to analysis using R. Hoboken, NJ: John Wiley & Sons; 2011.

Kang MY, Kim, HR. Association between voluntary/involuntary job loss and the development of stroke or cardiovascular disease: a prospective study of middle-aged to older workers in a rapidly developing Asian country. PloS One. 2014;9(11):e113495. https://doi.org/10.1371/journal.pone.0113495

Booth J, Connelly L, Lawrence M, Chalmers C, Joice S, Becker C, et al. Evidence of perceived psychosocial stress as a risk factor for stroke in adults: a meta-analysis. BMC Neurol. 2015;15:233. https://doi.org/10.1186/s12883-015-0456-4

Egido JA, Castillo O, Roig B, Sanz I, Herrero MR, Garay MT, et al. Is psycho-physical stress a risk factor for stroke? A case-control study.J Neurol Neurosurg Psychiatry. 2012;83(11):1104-10. https://doi.org/10.1136/jnnp-2012-302420

Gallo WT, Teng HM, Falba TA., Kasl SV, Krumholz HM, Bradley EH. The impact of late career job loss on myocardial infarction and stroke: a 10 year follow up using the health and retirement survey. Occup Environ Med. 2006;63(10):683-7. https://doi.org/10.1136/oem.2006.02682

Dupre ME, George LK, Liu G, Peterson ED. The cumulative effect of unemployment on risks for acute myocardial infarction. Arch Intern Med. 2012;172(22):1731-7. https://doi.org/10.1001/2013.jamainternmed.447

Sposato LA, Ioli P, Povedano G, Esnaola y Rojas MM, Saposnik G; Argentinean Neurological Society; ReNACer Investigators. Unemployment: a social risk factor associated with early ischemic stroke mortality? Results from the Argentinean National Stroke Registry (ReNACer). J Stroke Cerebrovasc Dis. 2012;21(8):679-83. https://doi.org/10.1016/j.jstrokecerebrovasdis.2011.02.018

Madero-Cabib I, Biehl A, Sehnbruch K, Calvo E, Bertranou F. Private pension systems built on precarious foundations: a cohort study of labor-force trajectories in Chile. Res Aging. 2019;41(10):961-87. https://doi.org/10.1177/0164027519874687

Madero-Cabib I, Undurraga R, Valenzuela C. How have women’s employment patterns during young adulthood changed in Chile? A cohort study. Longit Life Course Stud. 2019;10(3):375-97. https://doi.org/10.1332/175795919X15628474680736

Madero-Cabib I, Corna L, Baumann I. Aging in different welfare contexts: a comparative perspective on later-life employment and health. J Gerontol B Psychol Sci Soc Sci. 2020;75(7):1515-26. https://doi.org/10.1093/geronb/gbz037

Publicado

2021-12-08

Número

Sección

Original Articles

Cómo citar

Jerez Ríos, M. P., & Madero-Cabib, I. (2021). Trayectorias de estrés familiar y laboral y su asociación con accidentes cerebrovasculares. Revista De Saúde Pública, 55, 101. https://doi.org/10.11606/s1518-8787.20210550033253

Datos de los fondos