Estresse ocupacional e sintomas osteomusculares em Agentes Comunitários de Saúde / Occupational stress and musculoskeletal symptoms in Community Health Workers

Resumo Introdução Os Agentes Comunitários de Saúde (ACS) trabalham em condições de riscos ocupacionais e sobrecarga que podem causar adoecimento. Objetivos Avaliar a presença de estresse ocupacional e sintomas osteomusculares em Agentes Comunitários de Saúde e comparar os níveis de estresse ocupacional, segundo as características sociodemográficas. Método Estudo transversal, realizado em 2017, em um município do interior paulista. Foram utilizadas a Escala de Estresse no Trabalho e o Questionário Nórdico de Sintomas Osteomusculares. Resultados Participaram 44 ACS, sendo 70,5% do sexo feminino, 47,7% com 40 anos ou mais, 79,5% não exerciam outra atividade remunerada e 50,0% tinham de três a 10 anos de atuação profissional. Vinte e um (47,7%) profissionais apresentaram níveis importantes de estresse ocupacional (>2,5). Os principais fatores estressores foram: deficiência na divulgação de informações sobre decisões organizacionais (3,3;±1,1); deficiência nos treinamentos (3,4;±1,6); pouca valorização (3,2;±1,4); poucas perspectivas de crescimento na carreira (3,2;±1,6); discriminação/favoritismo no ambiente de trabalho (3,1;±1,5); falta de compreensão sobre as responsabilidades no trabalho (3,0;±1,5); tipo de controle (2,9;±1,1); forma como as tarefas são distribuídas (2,8;±1,4); realizar tarefas que estão além da capacidade (2,8;±1,2); falta de autonomia na execução do trabalho (2,7;±1,3); receber ordens contraditórias do superior (2,7;±1,4); tempo insuficiente para realizar o trabalho (2,7;±1,3). No último ano, 65,9% dos ACS referiram dor osteomuscular nas regiões lombar, 61,4% no pescoço, 47,7% nos ombros e 43,2% nos joelhos. Conclusão O estresse ocupacional e os sintomas osteomusculares são problemas presentes na prática laboral dos ACS, evidenciando que as organizações precisam incrementar recursos laborais para prevenir riscos psicossociais e amplificar a qualidade do trabalho destes profissionais.

Abstract Introduction Community health workers (CHWs) work under conditions of occupational risks and overload that can cause illness. Objectives To evaluate the presence of occupational stress and musculoskeletal symptoms in community health workers, and compare the levels of occupational stress, according to sociodemographic characteristics. Method Cross-sectional study, conducted in 2017, in a municipality in the interior of São Paulo state. The Work Stress Scale and the Nordic Musculoskeletal Questionnaire were used. Results Forty-four CHWs participated, 70.5% were female, 47.7% were 40 years old or older, 79.5% had no other paid activity and 50.0% had three to 10 years of professional experience. Twenty-one (47.7%) professionals presented important levels of occupational stress (>2.5). The main stressors were: deficiency in disclosure of information about organizational decisions (3.3;±1.1); deficiency in training (3.4;±1.6); little appreciation (3.2;±1.4); few prospects for career growth (3.2;±1.6); discrimination/favoritism in the work environment (3.1;±1.5); lack of understanding about job responsibilities (3.0; ±1.5); type of control (2.9;±1.1); how tasks are distributed (2.8;±1.4); performing tasks that are beyond one's capacity (2.8;±1.2); lack of autonomy in performing the work (2.7;±1.3); receiving contradictory orders from the superior (2.7;±1.4); insufficient time to perform the work (2.7;±1.3). In the last year, 65.9% of CHWs reported musculoskeletal pain in the lower back, 61.4% in the neck, 47.7% in the shoulders, and 43.2% in the knees. Conclusion Occupational stress and musculoskeletal symptoms are problems present in the CHWs' work practice, showing that organizations need to increase labor resources to prevent psychosocial risks and enhance the quality of work of these professionals.

Quality of life and osteomuscular symptoms in workers of primary health care.

OBJECTIVES: to evaluate the quality of life and musculoskeletal symptoms in primary care workers. METHODS: descriptive, correlational and cross-sectional study with 85 workers using the WHOQOL-Bref and Nordic Osteomuscular Symptoms Questionnaire. RESULTS: lower quality of life for the Environment domain and higher for Social Relationships. Workers reported pain in lower back, neck, shoulders, wrists/hands/fingers and knees. Neck pain influenced Physical (p=0.015) and Psychological (p=0.030) domains; shoulder pain (p=0.004) and dorsal region (p=0.013) influenced the Physical domain; pain in knees influenced Physical (p=0.000) and Environment (p=0.032) domains; pain in the ankles/feet influenced Physical (p=0.000), Psychological (p=0.032) and Environment (p=0.007) domains; pain in the dorsal region influenced the Physical domain (p=0.013). CONCLUSIONS: workers evaluated their quality of life as good or very good and reported to be satisfied or very satisfied with their health. They also reported pains in lower back, neck, shoulders, wrists/hands/fingers and knees. Pain has influenced the quality of life.

Engagement in primary health care nurses: A cross-sectional study in a Brazilian city.

OBJECTIVE: Professional engagement is an indicator of the relationship between a nurse and the work environment and is an important factor in performance and productivity. The goal of this study was to evaluate levels of engagement among nurses in primary health care units. METHODS: Cross-sectional study in a city of São Paulo state, Brazil, in 2017, using an instrument containing sociodemographic variables and the Utrecht Work Engagement Scale (UWES). RESULTS: In the sample of 75 nurses, the majority were female (94.7%), aged between 29 and 39 (52.0%), specialists (81.3%), married (57.3%), permanent employees (68.0%), working 40 hr per week (98.7%), and working in primary health care for 3-10 years (42.7%). Engagement levels were classified as high in all dimensions. Nurses who worked as managers presented a very high level of dedication; professionals aged 40 years or older presented very high levels in all dimensions (Dedication: 5.2; Absorption: 5.0; Vigor: 5.3; and Overall score: 5.1); and professionals with more than 10 years of experience in primary health care had very high levels in all dimensions (Dedication: 5.0; Absorption: 5.0; Vigor: 5.0; and Overall score: 5.0). CONCLUSIONS: Nurses working in Brazil's primary health care system have high engagement and ability to act; they enhance team performance and quality and effectiveness of care provided.

Quality of life and osteomuscular symptoms in workers of primary health care / Calidad de vida y síntomas osteomusculares en trabajadores de la atención primaria / Qualidade de vida e sintomas osteomusculares em trabalhadores da atenção primária

ABSTRACT Objectives: to evaluate the quality of life and musculoskeletal symptoms in primary care workers. Methods: descriptive, correlational and cross-sectional study with 85 workers using the WHOQOL-Bref and Nordic Osteomuscular Symptoms Questionnaire. Results: lower quality of life for the Environment domain and higher for Social Relationships. Workers reported pain in lower back, neck, shoulders, wrists/hands/fingers and knees. Neck pain influenced Physical (p=0.015) and Psychological (p=0.030) domains; shoulder pain (p=0.004) and dorsal region (p=0.013) influenced the Physical domain; pain in knees influenced Physical (p=0.000) and Environment (p=0.032) domains; pain in the ankles/feet influenced Physical (p=0.000), Psychological (p=0.032) and Environment (p=0.007) domains; pain in the dorsal region influenced the Physical domain (p=0.013). Conclusions: workers evaluated their quality of life as good or very good and reported to be satisfied or very satisfied with their health. They also reported pains in lower back, neck, shoulders, wrists/hands/fingers and knees. Pain has influenced the quality of life.

RESUMEN Objetivos: evaluar la calidad de vida y síntomas osteomusculares en trabajadores de atención primaria. Métodos: investigación descriptiva, correlacional y transversal con 85 trabajadores, utilizando el WHOQOL-Bref y el Cuestionario Nórdico de Síntomas Osteomusculares. Resultados: menor calidad de vida para dominio Medio Ambiente y mayor para Relaciones Sociales. Trabajadores indicaron dolor en región lumbar, cuello, hombros, puños/manos/dedos y rodillas. El dolor en cuello influenció los dominios Físicos (p=0,015) y Psicológico (p=0,030); dolor en hombros (p=0,004) y región dorsal (p=0,013) influenció el dominio Físico; dolor en rodillas influenció los dominios Físicos (p=0,000) y Medio Ambiente (p = 0,032); dolor en tobillos/pies influenció los dominios Físicos (p=0,000), Psicológico (p=0,032) y Medio Ambiente (p=0,007); dolor en región dorsal influenció el dominio Físico (p=0,013). Conclusiones: trabajadores evaluaron calidad de vida como buena o muy buena y se refirieron satisfechos o muy satisfechos con salud. También indicaron dolor en región lumbar, cuello, hombros, puños/manos/dedos y rodillas. El dolor influenció la calidad de vida.

RESUMO Objetivos: avaliar qualidade de vida e sintomas osteomusculares em trabalhadores da atenção primária. Métodos: estudo descritivo, correlacional e transversal com 85 trabalhadores, utilizando o WHOQOL-Bref e Questionário Nórdico de Sintomas Osteomusculares. Resultados: menor qualidade de vida para domínio Meio Ambiente e maior, para Relações Sociais. Trabalhadores referiram dores na lombar, pescoço, ombros, punhos/mãos/dedos e joelhos. Dor no pescoço influenciou domínios Físico (p=0,015) e Psicológico (p=0,030); dor nos ombros (p=0,004) e região dorsal (p=0,013) influenciaram domínio Físico; dor nos joelhos influenciou domínios Físico (p=0,000) e Meio Ambiente (p=0,032); dor nos tornozelos/pés influenciou domínios Físico (p=0,000), Psicológico (p=0,032) e Meio Ambiente (p=0,007); dor na região dorsal influenciou domínio Físico (p=0,013). Conclusões: trabalhadores avaliaram qualidade de vida como boa ou muito boa e referiram-se satisfeitos ou muito satisfeitos com a saúde; referiram dores na região lombar, pescoço, ombros, punhos/mãos/dedos e joelhos. A dor influenciou a qualidade de vida.

Occupational stress and engagement in primary health care workers / Estrés ocupacional y engagement en trabajadores de atención primaria a la salud / Estresse ocupacional e engagement em trabalhadores da atenção primária à saúde

ABSTRACT Objective: To evaluate levels of occupational stress and work engagement among primary health care workers. Method: A descriptive, correlational and transversal study was carried out in a small municipality in the countryside of São Paulo, with a non-probabilistic sample of convenience, with 85 workers. Three self-applied instruments were used: one developed by researchers, containing sociodemographic variables; Work Stress Scale (WSS) and Utrech Work Engagement Scale (UWES). Results: Prevalence of women (72.6%), 40 years old or more (45.9%), 4 years and 4 months of mean working time in primary care. Thirty-one workers (36.5%) presented significant stress (scores ≥2.5). Work engagement showed a mean of 4.1 (±1.2) to 4.4 (±1.4), classified as high in all dimensions. Occupational stress and work engagement correlated negatively. Conclusion: Workers presented high levels of work engagement; more than one-third had significant occupational stress. Workers with high levels of occupational stress tend to have lower work engagement.

RESUMEN Objetivo: Evaluar niveles de estrés ocupacional y engagement en trabajadores de la atención primaria de salud. Método: Estudio descriptivo, correlacional y transversal, en municipio de pequeño porte del interior paulista, con muestra no probabilística, de conveniencia, con 85 trabajadores. Se utilizaron tres instrumentos auto aplicables: uno elaborado por los investigadores, conteniendo variables sociodemográficas; Escala de Estrés en el trabajo (EET) y Utrech Work Engagement Scale (UWES). Resultados: Prevalencia del sexo femenino (72,6%), 40 años o más (45,9%), tiempo mediano de actuación en la atención primaria de 4 años y 4 meses. Treinta y un trabajadores (36,5%) presentaron estrés importante (puntuaciones ≥2,5). Engagement presentó promedios de 4,1 (±1,2) a 4,4 (±1,4), clasificado como alto en todas las dimensiones. El estrés ocupacional y el engagement se correlacionaron negativamente. Conclusión: Los trabajadores presentaron altos niveles de engagement; más de un tercio presentó estrés ocupacional importante. Los trabajadores con altos niveles de estrés ocupacional tienden a tener engagement más bajo.

RESUMO Objetivo: Avaliar níveis de estresse ocupacional e engagement em trabalhadores da atenção primária à saúde. Método: Estudo descritivo, correlacional e transversal, em município de pequeno porte do interior paulista, com amostra não probabilística, de conveniência, com 85 trabalhadores. Foram utilizados três instrumentos autoaplicáveis: um elaborado pelos pesquisadores, contendo variáveis sociodemográficas; Escala de Estresse no Trabalho (EET); e Utrech Work Engagement Scale (UWES). Resultados: Prevalência do sexo feminino (72,6%), 40 anos ou mais (45,9%), tempo mediano de atuação na atenção primária de 4 anos e 4 meses. Trinta e um trabalhadores (36,5%) apresentaram estresse importante (escores ≥2,5). Engagement apresentou médias de 4,1 (±1,2) a 4,4 (±1,4), classificado como alto em todas as dimensões. Estresse ocupacional e engagement se correlacionaram negativamente. Conclusão: Os trabalhadores apresentaram altos níveis de engagement; mais de um terço apresentou estresse ocupacional importante. Trabalhadores com elevados níveis de estresse ocupacional tendem a ter engagement mais baixo.

Occupational stress and engagement in primary health care workers.

OBJECTIVE: To evaluate levels of occupational stress and work engagement among primary health care workers. METHOD: A descriptive, correlational and transversal study was carried out in a small municipality in the countryside of São Paulo, with a non-probabilistic sample of convenience, with 85 workers. Three self-applied instruments were used: one developed by researchers, containing sociodemographic variables; Work Stress Scale (WSS) and Utrech Work Engagement Scale (UWES). RESULTS: Prevalence of women (72.6%), 40 years old or more (45.9%), 4 years and 4 months of mean working time in primary care. Thirty-one workers (36.5%) presented significant stress (scores ≥2.5). Work engagement showed a mean of 4.1 (±1.2) to 4.4 (±1.4), classified as high in all dimensions. Occupational stress and work engagement correlated negatively. CONCLUSION: Workers presented high levels of work engagement; more than one-third had significant occupational stress. Workers with high levels of occupational stress tend to have lower work engagement.