Measures
Self-administered questionnaires were used which included
sections on socio-demographic characteristics, occupational
and medical history, self-reported health, psychosocial
and lifestyle factors, social network and support, job
strain, and psychological distress. Diverse methods to
improve the quality of the information gathered were
applied, including pilot studies, validation of scales and
reliability testing.
Psychological distress
Psychological distress was evaluated using the Brazilian
version of the General Health Questionnaire-12 items
(GHQ-12) [14, 28]. Scores for individual items were coded
as absent or present (0 or 1) and then added and those
whose total scores were 3 or more (out of 12) were classified
as cases [15]. In Brazil, the GHQ-12 was validated
against a structured psychiatric interview and a similar cutoff
point of 3 or more for cases of psychological distress
was identified with a sensitivity of 85% and a specificity of
79% [28]. More recently, a study conducted among a
community sample of Chinese living in Brazil, found that
this cut-off point (3 or more) yield a sensitivity of 75% and
specificity of 71% [49].
Job strain and other work characteristics
Job strain was assessed using the short version—17 questions—
of the Karasek and Theorell Job Content Questionnaire
[21, 46]. This instrument has three sub-scales,
namely ‘‘job demands’’, ‘‘job control’’, and ‘‘support from
colleagues and supervisors at work’’. The section on
demand includes four questions measuring time and speed
for performing tasks, and one question assessing conflicts
between different demands. The section on control includes
four questions related to the use and development of abilities,
and two related to decision latitude in relation to the
work process. The section on social support at work
includes six questions measuring feedback and support
from colleagues and supervisors.
Our translation and adaptation of this scale to Portuguese
showed good test-retest reliability, with intraclass
correlation coefficients for the demand, control and social
support at work dimensions of the scale estimated at 0.88,
0.87, and 0.85, respectively. Internal consistency (Cronbach’s
alpha) estimates for these dimensions were 0.79,
0.67, and 0.85, respectively [4].
With respect to shift work, the subjects were asked to
answer whether they were engaged in night shift work [41].
Occupational status was determined through five questions
involving type of work, level of responsibility, and
Measures
Self-administered questionnaires were used which included
sections on socio-demographic characteristics, occupational
and medical history, self-reported health, psychosocial
and lifestyle factors, social network and support, job
strain, and psychological distress. Diverse methods to
improve the quality of the information gathered were
applied, including pilot studies, validation of scales and
reliability testing.
Psychological distress
Psychological distress was evaluated using the Brazilian
version of the General Health Questionnaire-12 items
(GHQ-12) [14, 28]. Scores for individual items were coded
as absent or present (0 or 1) and then added and those
whose total scores were 3 or more (out of 12) were classified
as cases [15]. In Brazil, the GHQ-12 was validated
against a structured psychiatric interview and a similar cutoff
point of 3 or more for cases of psychological distress
was identified with a sensitivity of 85% and a specificity of
79% [28]. More recently, a study conducted among a
community sample of Chinese living in Brazil, found that
this cut-off point (3 or more) yield a sensitivity of 75% and
specificity of 71% [49].
Job strain and other work characteristics
Job strain was assessed using the short version—17 questions—
of the Karasek and Theorell Job Content Questionnaire
[21, 46]. This instrument has three sub-scales,
namely ‘‘job demands’’, ‘‘job control’’, and ‘‘support from
colleagues and supervisors at work’’. The section on
demand includes four questions measuring time and speed
for performing tasks, and one question assessing conflicts
between different demands. The section on control includes
four questions related to the use and development of abilities,
and two related to decision latitude in relation to the
work process. The section on social support at work
includes six questions measuring feedback and support
from colleagues and supervisors.
Our translation and adaptation of this scale to Portuguese
showed good test-retest reliability, with intraclass
correlation coefficients for the demand, control and social
support at work dimensions of the scale estimated at 0.88,
0.87, and 0.85, respectively. Internal consistency (Cronbach’s
alpha) estimates for these dimensions were 0.79,
0.67, and 0.85, respectively [4].
With respect to shift work, the subjects were asked to
answer whether they were engaged in night shift work [41].
Occupational status was determined through five questions
involving type of work, level of responsibility, and
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