TESTING THE MULTIDIMENSIONAL MODEL OF WORK ABILITY IN A COHORT OF HOSPITAL WORKERS IN BRAZIL - 2009-2011
The multidimensional work ability house model considers work ability structured on 4 levels (floors) of determination: health/functional capacity, professional competence, values and job characteristics. This study aims to test this theoretical model, verifying the proposed hierarchy of levels among a group of Brazilian hospital workers.
METHODS:
A 3-year cohort study (2009-2011) was conducted in a 300-bed hospital of São Paulo, Brazil. Hospital workers answered a comprehensive questionnaire including sociodemographics, lifestyles, working conditions, psychosocial factors at work, and the work ability index. The number of participants during the 3 years totalized 599 workers. The outcome variable was obtained from the difference (delta) between initial and follow-up work ability index (WAI).
RESULTS:
Females were 76.2 % of participants; 27.5 % of participants were 40 years old and plus. The means of initial and final WAIs were 44.0 (SD=4.0) and 43.0 points (SD= 4.7) respectively. The mean delta was -0.5 points (SD= 4.6). Hierarchical analysis showed that effects on work ability were: (a) health/functional capacity floor: reports of work injuries (p =0.033); (b ) professional competence floor: low education (p = 0.002); ( c ) values (attitudes/motivation) floor: overcommitment (p < 0.001) and (d) work floor: effort-reward imbalance (p = 0.016).
CONCLUSIONS:
A mild WAI impairment was observed during the 3 years of follow-up. Variables of each hierarchical level contributed to WAI pointing to the validity of the theoretical model “Work Ability House”. Managers should be attentive to the combined effects of the 4 floors of work ability in order to prevent negative outcomes among hospital workers.