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. 2021 Dec 8:55:101.
doi: 10.11606/s1518-8787.20210550033253. eCollection 2021.

Trajectories of family and employment stress associated with cerebrovascular accidents

[Article in English, Spanish]
María Pilar Jerez  1 , Ignacio Madero-Cabib  2   3
Affiliations

Trajectories of family and employment stress associated with cerebrovascular accidents

[Article in English, Spanish]
María Pilar Jerez et al. Rev Saude Publica. .

Abstract
in English, Spanish

Objectives: Reconstruct types of simultaneous stress trajectories in the family and employment domain at different stages of life and estimate their association with cerebrovascular accident (CVA) in old age.

Methods: We used a retrospective, face-to-face, representative survey of people aged 65 to 75 years in the city of Santiago, Chile, (n = 802). We performed a multichannel sequence analysis to reconstruct family and employment stress trajectory types at various life stages and then used logistic regression models to estimate the association of these trajectory types with CVA in old age, controlled for traditional cardiovascular risk factors.

Results: Four representative types of family and employment stress trajectories were identified: (1) Absence of family and employment stress, (2) Absence of family stress, persistent employment stress, (3) Absence of family stress, out of the labor market, and (4) Persistent family stress, absence of employment stress. The 61.7% of the sample followed trajectories marked by the permanent presence of family and/or employment stress. Likewise, 18.3% had a trajectory characterized by prolonged absence from the labor market. Individuals with persistent family or employment stress trajectories, as well as those with extended periods of inactivity, are more at risk of developing CVA.

Conclusions: Stress is a risk factor for cardiovascular disease experienced by many people at different stages and domains of life on a prolonged basis. Consequently, prevention systems for this type of chronic diseases should emphasize the highly harmful effects of daily and cumulatively stressful life experiences. This could mitigate the multiple health and financial consequences associated with CVA.

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.

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Conflict of interest statement

Conflict of Interest: The authors declare no conflict of interest.

Figures

Figure 1
Figure 1. Life course calendar used in this study.
Figure 2
Figure 2. Cluster selection criteria.
Figure 3
Figure 3. Chronogram graphs of the four types of family and employment stress trajectories.
Figure 4
Figure 4. Graphs of individual sequences of the four types of family and employment stress trajectories.
Figura 1
Figura 1. Calendario de curso de vida utilizado en este estudio.
Figura 2
Figura 2. Criterios de selección de conglomerados.
Figura 3
Figura 3. Gráficos de cronogramas de los cuatro tipos de trayectorias de estrés familiar y laboral.
Figura 4
Figura 4. Gráficos de secuencias individuales de los cuatro tipos de trayectorias de estrés familiar y laboral.
See this image and copyright information in PMC

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