Estresse ocupacional e engajamento no trabalho em médicos da atenção primária à saúde

Abstract

In Brazil, Family Health Strategy represents the model of Primary Health Care, considered as a higher resolution and the physician as an important member of the team. However, the changes incorporated by the National Basic Care Policy of 2017 have produced fragilities for the management of Primary Care in Brazil, especially, in relation to workers. Factors associated with work, such as overload, precarious bonds and work conditions, lack of autonomy and pressure to achieve proper goal can trigger occupational stress and compromise work engagement. Objective: To assess levels of occupational stress and work engagement in Primary Health Care physicians. Methods: Quantitative, descriptive, correlational and cross-sectional study, carried out in São José do Rio Preto, São Paulo, in 2017, with a non-probabilistic, convenience sample with 32 physicians from Primary Health Care units. Three self-applicable instruments were used: one developed by the researchers, including sociodemographic and professional variables; Work Stress Scale and Utrecht Workplace Engagement Scale. For occupational stress analysis, a general mean score and mean score were calculated for each item on the scale, identifying the most frequent stressors. To calculate the work engagement, a statistical model proposed in the Preliminary Manual UWES was used. Mean values were compared with T test or analysis of variance (ANOVA), with a significance level of 95%. Pearson's correlation test was used to analyze the correlation between occupational stress and work engagement. Results: Prevalence of female professionals (59.4%), married (62.5%), public servant (56.3%), 40 hours a week (59.4%) and working in Primary Care for three to 10 years (68.8%). Six professionals (19.4%) had significant stress (scores ≥2.5). Stressors were considered: lack of prospects for career growth (2.9; ± 1.3); distribution of tasks (2.7; ± 1.0); training deficiency (2.7; ± 1.2); insufficient time to carry out work (2.6; ± 1.2); control type (2.5; ± 1.0); and lack of autonomy in carrying out work (2.5; ± 1.2). Work engagement levels ranged from 4.3 to 4.6 and were classified as high in all dimensions. Physicians who experienced occupational stress have achieved average levels of engagement across all dimensions of UWES, while those who did not experience occupational stress have achieved high levels on work engagement. Conclusions: There is a high rate of doctors with occupational stress. Doctors have high levels of work engagement. Occupational stress and work engagement are negatively correlated and occupational stress significantly impairs physicians' levels of work engagement, interfering in their positive relationship with the work environment.