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.

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.

Estresse ocupacional e engajamento em profissionais de saúde bucal / Occupational stress and engagement in oral health professionals / Estrés laboral y compromiso de profesionales de salud bucal

Objetivo: Avaliar os níveis de estresse ocupacional e engajamento em profissionais de saúde bucal de unidades da Atenção Primária à Saúde. Métodos: Estudo quantitativo, descritivo, correlacional e transversal, realizado com profissionais da saúde bucal das unidades de Atenção Primária à Saúde do município de São José do Rio Preto, São Paulo, em 2017. Utilizaram-se três instrumentos autoaplicáveis: um elaborado pelos pesquisadores, contendo variáveis sociodemográficas e profissionais, a Escala de Estresse no Trabalho e a Utrecht Work Engagement Scale. Os níveis de estresse ocupacional e engajamento foram calculados segundo modelo estatístico proposto pelos instrumentos e, para a análise, utilizou-se teste de correlação de Pearson, considerando significância de 95%. Resultados: Participaram 31 profissionais, sendo 20 (64,5%) cirurgiões-dentistas e 11 (35,5%) auxiliares de saúde bucal. Houve prevalência do sexo feminino (n=21; 67,7%), faixa etária de 40 anos ou mais (n=14; 45,2%), casados (n=26; 83,9%), concursados/estatutários (n=16; 51,6%), com carga horária semanal de 40 horas (n=23; 74,2%), sem outra atividade remunerada (n=19; 61,3%), três a dez anos de atuação na Atenção Primária à Saúde (n=13; 41,9%) e satisfeitos com a profissão (n=28; 90,3%). A amostra não apresentou níveis importantes de estresse, mas nove (29,0%) profissionais obtiveram escores compatíveis com estresse importante (>2,5). Os profissionais apresentaram níveis altos de engajamento em todas as dimensões. Estresse ocupacional e engajamento se correlacionam negativamente. Conclusão: Os trabalhadores apresentaram altos níveis de engajamento. Estresse ocupacional e engajamento tendem a ser inversamente proporcionais.

Objective: To evaluate the levels of occupational stress and engagement in oral health professionals from Primary Health Care units. Methods: It is a quantitative, descriptive, correlational and cross-sectional study conducted with oral health professionals from Primary Health Care units in the city of São José do Rio Preto, São Paulo, in 2017. We used three self-applied instruments: one developed by the researchers, containing sociodemographic and professional variables, the Stress at Work Scale, and the Utrecht Work Engagement Scale. Occupational stress and engagement levels were calculated according to the statistical model proposed by the instruments and, for the analysis, Pearson's correlation test was used, considering the significance of 95%. Results: 31 professionals participated, being 20 (64.5%) dental surgeons and 11 (35.5%) oral health auxiliaries. There was a prevalence of females (n = 21; 67.7%), aged 40 years or older (n = 14; 45.2%), married (n = 26; 83.9%), hired / statutory ( n = 16; 51.6%), with a weekly workload of 40 hours (n = 23; 74.2%), without any other paid activity (n = 19; 61.3%), three to ten years of experience in the Primary Health Care (n = 13; 41.9%) and satisfied with the profession (n = 28; 90.3%). The sample did not show significant stress levels, but nine (29.0%) professionals obtained scores compatible with significant stress (> 2.5). Professionals had high levels of engagement in all dimensions. Occupational stress and engagement correlate negatively. Conclusion: Workers had high levels of engagement. Occupational stress and engagement tend to be inversely proportional.

Objetivo: Evaluar los niveles de estrés laboral y compromiso de profesionales de salud bucal de unidades de la Atención Primaria de Salud. Métodos: Estudio cuantitativo, descriptivo, de correlación y transversal realizado con profesionales de salud bucal de las unidades de Atención Primaria de Salud del municipio de São José do Rio Preto, São Paulo, en 2017. Se ha utilizado tres instrumentos auto aplicables: uno de ellos ha sido elaborado por los investigadores con variables sociodemográficas y profesionales, la Escala de Estrés en el Trabajo y la Utrecht Work Engagement Scale. Los niveles del estrés laboral y del compromiso han sido calculados según el modelo estadístico propuesto por los instrumentos y para el análisis se utilizó la prueba de correlación de Pearson con significancia del 95%. Resultados: Participaron 31 profesionales siendo 20 (64,5%) cirujanos-dentistas y 11 (35,5%) auxiliares de salud bucal. Hubo prevalencia para el sexo femenino (n=21; 67,7%), la franja de edad de 40 años o más (n=14; 45,2%), casados (n=26; 83,9%), concursantes/estatutarios (n=16; 51,6%), con 40 horas semanales de trabajo (n=23; 74,2%), sin otra actividad remunerada (n=19; 61,3%), entre tres y diez años de actuación en la Atención Primaria de Salud (n=13; 41,9%) y satisfechos con la profesión (n=28; 90,3%). La muestra no ha presentado niveles importantes de estrés pero nueve (29,0%) profesionales tuvieron puntuaciones compatibles con el estrés importante (>2,5). Los profesionales presentaron niveles altos de compromiso para todas las dimensiones investigadas. El estrés laboral y el compromiso se han correlacionado de manera negativa.