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.

Occupational stress and work engagement among primary healthcare physicians: a cross-sectional study.

BACKGROUND: Brazil's Family Health Strategy is based on a primary healthcare model, which is considered to have case resolution capacity, with physicians at its center. OBJECTIVES: To evaluate the levels of occupational stress and work engagement among primary healthcare physicians. DESIGN AND SETTING: Cross-sectional study conducted in 2017, in São José do Rio Preto, São Paulo, Brazil. METHODS: A non-probability sample including 32 physicians from family health teams was used. Three self-applied instruments were used: a scale developed by the researchers seeking sociodemographic and professional variables, the Work Stress Scale and the Utrecht Work Engagement Scale. RESULTS: Female professionals (59.4%), permanent employees (56.3%), workload of 40 hours per week (59.4%) and 3-10 years of acting in primary care (68.8%) were more prevalent. Six professionals (19.4%) exhibited significant stress (score ≥ 2.5). The main stressors were lack of prospects for career growth (2.9 ± 1.3), form of task distribution (2.7 ± 1.0), poor training (2.7 ± 1.2) and insufficient time to perform the job (2.6 ± 1.2). Levels of work engagement ranged from 4.3 to 4.6 and were rated as high in all dimensions. Physicians with occupational stress had average levels of work engagement, whereas those without occupational stress had high levels of work commitment. CONCLUSIONS: A notable percentage of the physicians were experiencing occupational stress. The physicians had high levels of work engagement. Occupational stress was negatively correlated with work engagement, and it significantly compromised physicians' levels of work engagement and interfered with their positive relationship with the work environment.

Career commitment and career entrenchment among Primary Health Care workers.

OBJECTIVE: Assess levels of career commitment and career entrenchment among Primary Health Care workers. METHODS: This Cross-sectional study addressed 393 workers using the Brazilian versions of the Career Commitment Measure (CCM) and Career Entrenchment Measure (CEM). RESULTS: Levels of Career commitment [75.5-77.5] were higher (p<0.001) than Career Entrenchment [66.7-69.2]. Identity levels [82.7-85.5] were higher (p<0.001) than Investment levels [60.4-65.0]. Career resilience levels [75.1-79.2] were higher (p<0.001) than Emotional costs [69.0-72.1]. Planning levels [64.2-67.1] were lower (p<0.001) than levels of limitedness of career alternatives [68.1-71.0]. CONCLUSION: The highest scores were obtained in Career commitment, showing the workers' identification and positive relationship with their careers, that is, these workers remain in Primary Health Care services because they identify themselves with their professions.

Career commitment and entrenchment among Primary Care nurses.

OBJECTIVE: To assess career commitment and entrenchment among Primary Care nurses. METHOD: This is a cross-sectional study, carried out in 2018, with primary care nurses from two cities in the state of São Paulo. The Career Commitment and Entrenchment Scales, validated in Brazil, and consisting of 12 items each, were used, and assess: identity, resilience, and planning, related to commitment; emotional costs, investments, and limitation of career alternatives, related to entrenchment. RESULTS: The mean score of career commitment (61.4 points) was higher than that of career entrenchment (57.8 points); the identity factor had a high level (70.9 points); resilience and career planning obtained medium levels (62.5 and 50.8 points, respectively). Career entrenchment (57.8 points) and its respective factors reached medium levels (investments: 57.7 points; limitation of alternatives: 58.8 points; emotional costs: 57.0 points). CONCLUSION: The nurses showed a predominance of the career commitment relationship, as they showed a greater link of identification and positive relationship than of career stagnation.

Laboratory diagnosis of leprosy: Two staining methods from bacilloscopy and rapid ml flow test.

Background: The diagnosis of leprosy is based on the characteristic signs and symptoms of the disease, subsidized by laboratory tests. When positive, the bacilloscopy closes the diagnosis for leprosy. Phenolic glycolipid-I, or PGL-I, is a molecule in the bacillus cell wall that confers a greater immune response. The ML Flow test is an immunochromatographic test for the detection of anti-PGL-I IgM in human blood or serum. Methods: A prospective study with data collection and biological materials in patients with suspected leprosy from August 2020 to May 2021. For microscopy, intradermal smears were stained with Auramine O, and after reading under a fluorescence microscope, reviewed by Ziehl-Neelsen. The ML flow test was performed according to the Bührer-Sékula protocol. To assess the agreement between the methods, the Kappa index was estimated. Results: Of the 94 suspected leprosy patients, 31 (32.9%) were diagnosed with leprosy. There was moderate agreement between the results of the ML Flow and Auramine O tests (Kappa = 0.58) and substantial agreement between the ML Flow and Ziehl-Neelsen microscopy (Kappa = 0.72). In paucibacillary cases, serology was positive in 100% of patients. Conclusions: This study concluded that the Ziehl-Neelsen technique remains the best option for standard leprosy staining, and the ML flow test is more positive among the three techniques evaluated and can be an effective tool in the early diagnosis of leprosy cases.

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.

The epidemiological dimension of TB/HIV co-infection.

This study aimed to analyze the epidemiological indicators of TB/HIV co-infection in São José do Rio Preto, São Paulo, Brazil from 1998 to 2006. Data of new TB cases that initiated treatment between January 1998 and December 2006 were obtained from the TB Notification System (EPI-TB) and 306 cases were reported. The incidence rate was 5.1/100,000 inhabitants in 2006. Most cases were men (72.5%) with ages ranging between 20 and 59 years (96.4 %). The majority (51%) had incomplete primary education. Pulmonary TB was the most common type (52.9%) and 46.1% of the patients received supervised treatment. In 2006, the cure rate was 33.3%, 14.3% death rate and no patient abandoned the treatment. Diagnosis occurred at the hospital in 60% of the cases. Results show the need of improved coordination between the city's Tuberculosis Control Program and the Sexually Transmitted Diseases and HIV Program.

Engagement of multi-professional residents in health.

OBJECTIVE: To evaluate the levels of engagement of multi-professional health residents of a higher education institution in the northwest of São Paulo. METHOD: A cross-sectional census study in which the Utrecht Work Engagement Scale was used to identify the level of relationship with work (Total score) through 17 questions distributed in the Vigor, Dedication and Absorption dimensions. RESULTS: Participation of 50 professionals, of which 92.0% were female, median age of 24 years, 88.0% were single; 82.0% were satisfied with the program, and 56.0% had thought of giving up. Professionals satisfied with the program had high levels for Total Score (4.0) and Dedication (4.5), and average levels for Absorption (3.9) and Vigor (3.8). Those who reported dissatisfaction had average levels in all dimensions (Vigor: 3.2, Absorption: 3.5, Dedication: 3.5) and in the Total score (3.2), which are considered positive results. CONCLUSION: Professionals presented good levels of engagement in spite of dissatisfactions with the program. The results showed a good relationship between professionals and preceptors and supervisors, which reinforces that support and recognition of professional performance are important for strengthening the engagement, especially at the beginning of the career.

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.

Tuberculosis contact control in Brazil: a literature review (1984-2004).

This study aims to review plans for tuberculosis control through the analysis of measures for tuberculosis contact tracing in Brazil from 1984 to 2004. This article presents a literature review on tuberculosis control published in manuals of the Ministry of Health and the State Department of Health of Sao Paulo, and in Medline and Lilacs databases. There was a gap in the standardization of control measures in the decade from 1984 to 1994. It was concluded that health professionals need to incorporate TB control and prevention actions from the perspective of health surveillance and systematic monitoring.

[Access to diagnosis of tuberculosis in Brazilian medium-sized municipality]. / Acesso ao diagnóstico da tuberculose em município brasileiro de médio porte.

OBJETIVO: Evaluating access to tuberculosis diagnosis, from the perspective of patients. METHODS: Cross-sectional study with 108 tuberculosis patients. Data were collected using the brazilian instrument Primary Care Assessment Tool - PCAT-Brazil, adapted for attention to tuberculosis, including socio-economic and demographic indicators, location of diagnosis and diagnostic access tuberculosis. The analysis of the data was of frequency, average, standard deviation, confidence interval and Chi-square test. RESULTS: Most cases were diagnosed in hospitals (52.8%). The patient sought the Health Unit on average three times until receiving medical care. The indicators of difficulty of displacement, expenditure on motorized transport and consultation within 24 hours to discover the disease were not satisfactory and regular. The chi-square test showed a statistical association between diagnosis location and seeking the nearest health unit from home. CONCLUSIONS: There are weaknesses in the early diagnosis of tuberculosis in primary care. There are many challenges to be faced to strengthen this level of health care, with organizational capacity to overcome the shortcomings related to the patient and the service that make it difficult to access the diagnosis of the disease.

Current epidemiological aspects of tuberculosis and the impact of the DOTS strategy in disease control.

This article aims to present the current situation of tuberculosis and how the DOTS (Directly Observed Treatment Short Course) strategy has impacted national tuberculosis control programs worldwide, in Latin America and in Brazil. Data reveal a tendency towards a slow decline in disease rates (1%) around the world in 2003. In Brazil, data indicate a constant downward tendency of approximately 3% a year in incidence levels. The DOTS strategy has been recommended to all countries. Brazil needs to improve its tuberculosis surveillance efforts, particularly in terms of confirming negative sputum smear results at the end of treatment.

Poverty: socioeconomic characterization at tuberculosis.

This study aimed to evaluate the epidemiological status of Tuberculosis regarding to the socioeconomic characteristics of São José do Rio Preto between 1998 and 2004. Indexes estimated for 432 urban census tracts from the demographic census of 2000, sorted systematically according to the values of socioeconomic factors and grouped into quartiles were taken into account. The socioeconomic characterization was outlined based on Schooling, Income, and Number of Residents. The incidence rates were considered for 1998, 1999, 2003, and 2004. The socioeconomic factor accounted for 87% of the total variation. The disease prevalence is higher in the poorest areas. The incidence rate and the risk of being infected by TB in the poorest areas declined in 2003 and 2004. The results confirm that TB is determined by the population's living conditions in the city studied. It strengthens the relevance of understanding the TB conditional social factors to transform the worrisome scenario in which this population is inserted.

Prevalência de ansiedade e depressão em trabalhadores da Atenção Primária à Saúde / Prevalence of anxiety and depression in Brazilian Primary Health Care workers

Resumo Introdução A atualização da Política Nacional de Atenção Básica em Saúde, em 2017, trouxe importantes retrocessos para o sistema de saúde brasileiro, dificultando a atuação profissional e favorecendo o adoecimento psíquico dos trabalhadores. Objetivo Avaliar a prevalência de ansiedade e depressão em trabalhadores da atenção primária à saúde. Método Estudo transversal, realizado em 2017, em um município de grande porte do interior paulista. Foram avaliados 173 profissionais das equipes da Atenção Primária à Saúde, utilizando um questionário com variáveis sociodemográficas e profissionais; o Inventário de Ansiedade de Beck (BAI); e o Inventário de Depressão de Beck (BDI-II). Resultados A ansiedade esteve presente em 45,3% dos profissionais, sendo 25,0% com ansiedade leve, 9,9% com ansiedade moderada e 10,5% com ansiedade grave. A depressão esteve presente 41,0% dos profissionais, sendo 28,9% com depressão leve e 12,1% com depressão moderada. Houve maior prevalência de ansiedade (17,3%) e de depressão (28,3%) entre Agentes Comunitários de Saúde e menor prevalência de ansiedade (1,2%) e de depressão (0,6%) entre médicos. Conclusão Há uma prevalência elevada de ansiedade e depressão em profissionais da Atenção Primária em Saúde, especialmente em agentes comunitários de saúde. Os gestores municipais devem implementar medidas de atenção à saúde dos trabalhadores, bem como garantir condições de trabalho favoráveis, para evitar o adoecimento dos profissionais.

Abstract Introduction The update of the National Primary Health Care in 2017 brought important setbacks to the Brazilian health system, hindering professional performance and favoring the psychological illness of workers. Objective To evaluate the prevalence of anxiety and depression in primary health care workers. Method This is a cross-sectional study conducted in 2017 in a large city in the interior of the state of São Paulo. We evaluated 173 professionals from Primary Health Care teams, using a questionnaire with sociodemographic and professional variables; the Beck Anxiety Inventory (BAI); and the Beck Depression Inventory (BDI-II). Results Anxiety was present in 45.3% of the professionals, with 25.0% having mild anxiety, 9.9% having moderate anxiety, and 10.5% having severe anxiety. Depression was present in 41.0% of professionals, 28.9% with mild depression, and 12.1% with moderate depression. There was a higher prevalence of anxiety (17.3%) and depression (28.3%) among community health workers and a lower prevalence of anxiety (1.2%) and depression (0.6%) among doctors. Conclusion There is a high prevalence of anxiety and depression in Primary Health Care professionals, especially in community health workers. Municipal managers should implement measures to care for workers' health, as well as ensure favorable working conditions, to prevent the professionals from becoming ill.

Occupational stress and work engagement among primary healthcare physicians: a cross-sectional study

Abstract BACKGROUND: Brazil's Family Health Strategy is based on a primary healthcare model, which is considered to have case resolution capacity, with physicians at its center. OBJECTIVES: To evaluate the levels of occupational stress and work engagement among primary healthcare physicians. DESIGN AND SETTING: Cross-sectional study conducted in 2017, in São José do Rio Preto, São Paulo, Brazil. METHODS: A non-probability sample including 32 physicians from family health teams was used. Three self-applied instruments were used: a scale developed by the researchers seeking sociodemographic and professional variables, the Work Stress Scale and the Utrecht Work Engagement Scale. RESULTS: Female professionals (59.4%), permanent employees (56.3%), workload of 40 hours per week (59.4%) and 3-10 years of acting in primary care (68.8%) were more prevalent. Six professionals (19.4%) exhibited significant stress (score ≥ 2.5). The main stressors were lack of prospects for career growth (2.9 ± 1.3), form of task distribution (2.7 ± 1.0), poor training (2.7 ± 1.2) and insufficient time to perform the job (2.6 ± 1.2). Levels of work engagement ranged from 4.3 to 4.6 and were rated as high in all dimensions. Physicians with occupational stress had average levels of work engagement, whereas those without occupational stress had high levels of work commitment. CONCLUSIONS: A notable percentage of the physicians were experiencing occupational stress. The physicians had high levels of work engagement. Occupational stress was negatively correlated with work engagement, and it significantly compromised physicians' levels of work engagement and interfered with their positive relationship with the work environment.

Career commitment and career entrenchment among Primary Health Care workers / Compromiso y afianzamiento con la carrera del personal de la Atención Primaria de Salud / Comprometimento e entrincheiramento com a carreira em trabalhadores da Atenção Primária à Saúde

ABSTRACT Objective: Assess levels of career commitment and career entrenchment among Primary Health Care workers. Methods: This Cross-sectional study addressed 393 workers using the Brazilian versions of the Career Commitment Measure (CCM) and Career Entrenchment Measure (CEM). Results: Levels of Career commitment [75.5-77.5] were higher (p<0.001) than Career Entrenchment [66.7-69.2]. Identity levels [82.7-85.5] were higher (p<0.001) than Investment levels [60.4-65.0]. Career resilience levels [75.1-79.2] were higher (p<0.001) than Emotional costs [69.0-72.1]. Planning levels [64.2-67.1] were lower (p<0.001) than levels of limitedness of career alternatives [68.1-71.0]. Conclusion: The highest scores were obtained in Career commitment, showing the workers' identification and positive relationship with their careers, that is, these workers remain in Primary Health Care services because they identify themselves with their professions.

RESUMEN Objetivo: Evaluar los niveles de compromiso y afianzamiento con la carrera del personal de la Atención Primaria de Salud. Métodos: Se trata de un estudio transversal, realizado entre 393 trabajadores, en el que se utilizaron las versiones brasileras de las Escalas de Compromiso con la Carrera (ECC) y de Afianzamiento con la Carrera (EEC). Resultados: Los niveles de Compromiso [75,5 - 77,5] eran superiores (p<0,001) a los de Afianzamiento [66,7 - 69,2]. Los niveles de Identidad [82,7 - 85,5] eran superiores (p<0,001) a los de Inversión [60,4 - 65,0]. Los niveles de Resiliencia con la carrera [75,1 - 79,2] eran superiores (p<0,001) a los de Costo emocional [69,0 - 72,1]. Los niveles de Planificación [64,2 - 67,1] eran inferiores (p<0,001) a los de Limitación de alternativas [68,1 - 71,0]. Conclusión: Predominó el vínculo de compromiso con la carrera, lo que demuestra una identificación y relación positiva de los trabajadores con la misma y permanecen en la Atención Primaria de Salud porque se identifican con la profesión.

RESUMO Objetivo: Avaliar os níveis de comprometimento e entrincheiramento com a carreira de trabalhadores da Atenção Primária à Saúde. Métodos: Estudo transversal com 393 trabalhadores, utilizando as versões brasileiras das Escalas de Comprometimento com a Carreira (ECC) e de Entrincheiramento na Carreira (EEC). Resultados: Os níveis de Comprometimento [75,5 - 77,5] foram superiores (p<0,001) aos de Entrincheiramento [66,7 - 69,2]. Os níveis de Identidade [82,7 - 85,5] foram superiores (p<0,001) aos níveis de Investimentos [60,4 - 65,0]. Os níveis de Resiliência com a carreira [75,1 - 79,2] foram superiores (p<0,001) aos níveis de Custos emocionais com a carreira [69,0 - 72,1]. Os níveis de Planejamento [64,2 - 67,1] foram inferiores (p<0,001) aos níveis de Limitação de alternativas [68,1 - 71,0]. Conclusão: Predominou o vínculo de comprometimento com a carreira, evidenciando identificação e relação positiva dos trabalhadores com a carreira, os quais permanecem na Atenção Primária à Saúde porque se identificam com a profissão.

Estresse ocupacional, work engagement e estratégias de enfrentamento em Agentes Comunitários de Saúde / Occupational stress, work engagement and coping strategies in Community Health Workers

RESUMO Objetivo avaliar os níveis de estresse ocupacional, work engagement e estratégias de enfrentamento em agentes comunitários de saúde. Métodos estudo transversal com 133 Agentes Comunitários de Saúde. Foram utilizados um questionário com variáveis socioeconômicas e profissionais, a Escala de Estresse no Trabalho, a Utrecht Work Engagement Scale e a Escala Modos de Enfrentamento de Problemas. Resultados o escore médio do estresse ocupacional foi 2,7. Os níveis de work engagement foram altos para dedicação (4,0), vigor (4,3) e escore geral (4,0). Destacaram-se os modos de enfrentamento Focalizados no Problema (3,9;±0,6) e Baseados na busca de práticas religiosas e pensamento fantasioso (3,4;±0,7). Conclusão há um percentual elevado de profissionais com estresse ocupacional importante. Os níveis de work engagement foram médios para a absorção e altos para dedicação, vigor e escore geral. As estratégias de enfrentamento estão voltadas para a focalização na resolução do problema, práticas religiosas e pensamentos fantasiosos de caráter positivo.

ABSTRACT Objectives to evaluate the levels of occupational stress, work engagement, and coping strategies among community health workers. Methods cross-sectional study with 133 Community Health Workers. We used a questionnaire with socioeconomic and professional variables, the Work Stress Scale, the Utrecht Work Engagement Scale, and the Coping Modes Scale. Results The mean occupational stress score was 2.7. Work engagement levels were high for dedication (4.0), vigor (4.3), and overall score (4.0). Problem-focused coping modes (3.9; ±0.6) and based on religious practices and fantasy thinking (3.4; ±0.7) stood out. Conclusion there is a high percentage of professionals with significant occupational stress. The levels of work engagement were medium for absorption and high for dedication, vigor, and overall score. The coping strategies are focused on problem solving, religious practices and fanciful thoughts of positive character.

Ansiedade, depressão e work engagement em profissionais de enfermagem da Atenção Primária à Saúde / Anxiety, depression, and work engagement in Primary Health Care nursing professionals

RESUMO Objetivo analisar os níveis de ansiedade, depressão e work engagement em profissionais de enfermagem da Atenção Primária à Saúde. Métodos estudo transversal, descritivo e correlacional com profissionais de enfermagem das Unidades de Saúde da Família. Utilizaram-se o Inventário de Ansiedade de Beck; o Inventário de Depressão de Beck; e a Utrecht Work Engagement Scale . Resultados observaram-se destaques para ansiedade moderada entre enfermeiros e ansiedade leve para auxiliares/técnicos de enfermagem; e para depressão leve entre enfermeiros e auxiliares/técnicos de enfermagem. Ansiedade e depressão se correlacionaram positiva e moderadamente (r:0,562; p=0,000). Os profissionais apresentaram níveis altos de work engagement . Conclusão evidenciaram-se níveis importantes de ansiedade e depressão presentes entre profissionais com indicação de avanço para níveis que comprometem a saúde e a qualidade de vida. Apesar do comprometimento na saúde mental, os profissionais se mostram dispostos para o trabalho e com importante capacidade de resiliência.

ABSTRACT Objective to analyze the levels of anxiety, depression, and work engagement among nursing professionals in Primary Health Care. Methods cross-sectional, descriptive, and correlational study with nursing professionals from Family Health Units. We used: the Beck Anxiety Inventory; the Beck Depression Inventory; and the Utrecht Work Engagement Scale. Results we observed moderate anxiety among nurses and mild anxiety among nursing assistants/technicians; and mild depression among nurses and nursing assistants/technicians. Anxiety and depression were positively and moderately correlated (r:0.562; p=0.000). The professionals presented elevated levels of work engagement. Conclusion important levels of anxiety and depression were evidenced among professionals, indicating progress to levels that compromise health and quality of life. Despite the compromised mental health, the professionals showed willingness to work and an important resilience capacity.

Análise do engajamento no trabalho em agentes comunitários de saúde no período pré-pandêmico / Analysis of work engagement in community health agents in the pre-pandemic period / Análisis del compromiso laboral entre los trabajadores de salud comunitarios en el período prepandémico

RESUMO Objetivo: avaliar os níveis de engajamento no trabalho em agentes comunitários de saúde, no período pré-pandêmico. Método:estudo transversal, realizado em 2017, com 85 agentes comunitários de saúde, utilizando-se a Utrecht Work Engagement Scale (UWES), composta por dezessete itens de autoavaliação e três dimensões: vigor, dedicação e absorção. Os escores foram calculados conforme modelo estatístico proposto no Manual Preliminar UWES. Resultados: os níveis de engajamento no trabalho variaramde 3,3 a 3,5, classificados como médios. Profissionais que nunca pensaram em desistir da profissão e aqueles que se referiram satisfeitos com a profissão apresentaram escores altos nas dimensões Vigor (4,6±1,1 e 4,1±1,3) e Dedicação (4,2±1,2 e 4,1±1,2). Conclusão:os resultados evidenciaram a presença de situações de risco que podem interferir no desempenho laboral dos agentes comunitários de saúde. Ao quantificar os níveis de vigor, dedicação e absorção, o engajamento no trabalho torna-se um constructo importante para a avaliação das relações laborais dos profissionais com o trabalho, reforçando a necessidade e a importância de implementação de ações de valorização profissional.

ABSTRACT Objective: to evaluate the levels of work engagement among community health workers in the pre-pandemic period.Method: cross-sectional study conducted in 2017 with 85 community health workers, using the Utrecht Work Engagement Scale (UWES), composed of seventeen self-assessment items and three dimensions: vigor, dedication, and absorption. The scores were calculated according to the statistical model proposed in the UWES Preliminary Manual.Results: the levels of work engagement ranged from 3.3 to 3.5, classified as average. Professionals who never thought of giving up their profession and those who reported being satisfied with their profession showed high scores in the dimensions Vigor (4.6±1.1 and 4.1±1.3) and Dedication (4.2±1.2 and 4.1±1.2). Conclusion: the results showed the presence of risk situations that can interfere with the work performance of community health agents. By quantifying the levels of vigor, dedication, and absorption, work engagement becomes an important construct for the evaluation of the professionals' labor relations with work, reinforcing the need and importance of implementing professional valorization actions.

RESUMEN Objetivo:avaliar los niveles de compromiso laboral de los trabajadores de salud comunitarios en el período prepandémico. Método:estudio transversal, realizado en 2017, con 85 trabajadores de salud comunitarios, utilizando la Escala de Compromiso Laboral de Utrecht (UWES), que consta de diecisiete ítems de autoevaluación y tres dimensiones: vigor, dedicación y absorción. Los puntajes se calcularon de acuerdo con el modelo estadístico propuesto en el Manual Preliminar de UWES. Resultados:los niveles de engagement en el trabajo oscilaron entre 3,3 y 3,5, clasificado como medio. Los profesionales que nunca pensaron en dejar la profesión y los que informaron estar satisfechos con la profesión obtuvieron puntuaciones altas en las dimensiones Vigor (4,6 ± 1,1 y 4,1 ±1,3) y Dedicación (4,2 ± 1,2 y 4,1 ± 1,2). Conclusión:los resultados mostraron la presencia de situaciones de riesgo que pueden interferir con el desempeño laboral de los trabajadores comunitarios de salud. Al cuantificar los niveles de vigor, dedicacióny absorción, el engagement en el trabajo se convierte en un constructo importante para la valoración de las relaciones laborales del profesional con el trabajo, reforzando la necesidad e importancia de implementar acciones de desarrollo profesional.

Career commitment and entrenchment among Primary Care nurses / Compromiso y atrincheramiento con la carrera entre enfermeros de la Atención Primaria / Comprometimento e entrincheiramento com a carreira entre enfermeiros da Atenção Primária

ABSTRACT Objective: To assess career commitment and entrenchment among Primary Care nurses. Method: This is a cross-sectional study, carried out in 2018, with primary care nurses from two cities in the state of São Paulo. The Career Commitment and Entrenchment Scales, validated in Brazil, and consisting of 12 items each, were used, and assess: identity, resilience, and planning, related to commitment; emotional costs, investments, and limitation of career alternatives, related to entrenchment. Results: The mean score of career commitment (61.4 points) was higher than that of career entrenchment (57.8 points); the identity factor had a high level (70.9 points); resilience and career planning obtained medium levels (62.5 and 50.8 points, respectively). Career entrenchment (57.8 points) and its respective factors reached medium levels (investments: 57.7 points; limitation of alternatives: 58.8 points; emotional costs: 57.0 points). Conclusion: The nurses showed a predominance of the career commitment relationship, as they showed a greater link of identification and positive relationship than of career stagnation.

RESUMEN Objetivo: Evaluar el compromiso y el atrincheramiento con la carrera entre enfermeros de cuidados de la Atención Primaria a la Salud. Método: Ha sido realizado un estudio transversal en 2018, con enfermeros de la atención primaria de dos ciudades paulistas. Se utilizaron las Escalas de Compromiso y de Atrincheramiento con la Carrera, convalidadas en Brasil, y compuesta por 12 temas cada, que evalúan: identidad, resiliencia y planificación, relacionados al compromiso; costos emocionales, inversiones y limitación de alternativas en la carrera, referentes al atrincheramiento. Resultados: El score promedio del compromiso (61,4 puntos) fue mayor del que el de atrincheramiento con la carrera (57,8 puntos); el factor identidad obtuvo nivel alto (70,9 puntos); resiliencia y planificación en la carrera obtuvieron niveles medios (62,5 y 50,8 puntos, respectivamente). El atrincheramiento con la carrera (57,8 puntos) y sus respectivos factores obtuvieron niveles medios (inversiones: 57,7 puntos; limitación de alternativas: 58,8 puntos; costos emocionales: 57,0 puntos). Conclusión: Los enfermeros presentaron en mayor proporción gran vínculo de compromiso con la carrera, una vez que presentaron mayor vínculo de identificación y relación positiva, más que de estagnación con la carrera.

RESUMO Objetivo: Avaliar o comprometimento e o entrincheiramento com a carreira entre enfermeiros de serviços da Atenção Primária à Saúde. Método: Trata-se de um estudo transversal, realizado em 2018, com enfermeiros da atenção primária de dois municípios paulistas. Foram utilizadas as Escalas de Comprometimento e de Entrincheiramento com a Carreira, validadas no Brasil, e composta por 12 itens cada, que avaliam: identidade, resiliência e planejamento, relacionados ao comprometimento; custos emocionais, investimentos e limitação de alternativas na carreira, referentes ao entrincheiramento. Resultados: O escore médio do comprometimento (61,4 pontos) foi maior do que o de entrincheiramento com a carreira (57,8 pontos); o fator identidade obteve nível alto (70,9 pontos); resiliência e planejamento na carreira obtiveram níveis médios (62,5 e 50,8 pontos, respectivamente). O entrincheiramento com a carreira (57,8 pontos) e seus respectivos fatores atingiram níveis médios (investimentos: 57,7 pontos; limitação de alternativas: 58,8 pontos; custos emocionais: 57,0 pontos). Conclusão: Os enfermeiros apresentaram predomínio do vínculo de comprometimento com a carreira, pois apresentaram maior vínculo de identificação e relação positiva do que de estagnação com a carreira.