Occupational stress and engagement in primary health care workers

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.

Descriptors:
Primary Health Care; Family Health Strategy; Health Personnel; Occupational Stress; Work Engagement

Variables	Mean (±sd)	p value
Professional Category
Physician	1.5 (±0.4)	<0.001
Dentist	2.4 (±0.6)
Nurse	1.9 (±0.7)
Auxiliary/Nursing Technician	2.1 (±0.7)
Community Health Agent	2.4 (±0.5)
Vector control agent	2.9 (±1.0)
Age Group
From 18 to 28 years old	2.3 (±0.4)	0.917
From 29 to 39 years old	2.3 (±0.7)
40 years old or more	2.3 (±0.9)
Level of education
High school	2.3 (±0. 7)	0.311
Incomplete Higher Education	2.6 (±0.8)
Complete higher education	2.4 (±0.9)
Graduation (Specialization)	2.1 (±0.7)
Master's Degree	1.9(^ Variable with only one worker; standard deviation absent. )
Marital Status
Married	2.3 (±0.8)	0.879
Single	2.4 (±0.7)
Divorced	2.1 (±1.1)
Widowed	2.4 (±0.6)
Family Income^* * Minimum Wage Value: R$ 937.00;
Up to 1 Minimum Wage	2.5 (±0.8)	0.506
From 2 to 5 Minimum Wages	2.3 (±0.86)
From 6 to 10 Minimum Wages	2.0 (±0.3)
More than 10 minimum wages	2.3 (±1.0)
Time of experience PHC
Up to 2 years	2.5 (±0.8)	0.363
From 3 to 10 years	2.3 (±0.8)
Above 10 years	2.2 (±0.8)
Satisfied with the Profession/Occupation
Yes	2.2 (±0.7)	<0.001
No	3.0 (±0.8)	<0.001
Thought about giving up the Profession/Occupation
Yes	2.6 (±0.8)	0.024
No	2.2 (±0.7)	0.024

UWES Dimensions	Cronbach's Alpha	Min	Max	Md	Mean±sd	CI (95%)	Interpretation
Vigor	0.808	0.4	6.0	4.0	4.4±1.4	4.0 – 4.5	High
Dedication	0.857	0.8	6.0	4.6	4.1±1.2	4.1 – 4.7	High
Absorption	0.754	1.0	6.0	4.2	4.3±1.1	3.8 – 4.3	High
Overall Score	0.924	0.8	6.0	4.2	4.3±1.1	4.0 – 4.5	High

Variables	Dedication	Absorption	Vigor	Overall score
Variables	Mean (±sd)	Mean (±sd)	Mean (±sd)	Mean (±sd)
Professional Category
Physician	5.4 (±0.5)^c c Very high score.	4.5 (±0.7)^b b High score;	4.5 (±0.9)^b b High score;	4.8 (±0.6)^b b High score;
Dentist	4.6 (±1.1)^b b High score;	4.4 (±1.2)^b b High score;	4.8 (±0.9)^b b High score;	4.6 (±1.1)^b b High score;
Nurse	5.1 (±0.9)^c c Very high score.	4.8 (±1.1)^b b High score;	4.7 (±1.2)^b b High score;	4.8 (±1.0)^b b High score;
Auxiliary/Nursing Technician	4.7 (±1.2)^b b High score;	4.2 (±1.4)^b b High score;	4.6 (±1.2)^b b High score;	4.5 (±1.2)^b b High score;
Community Health Agent	4.1 (±1.2)^b b High score;	3.8 (±1.0)^a a Mean score;	4.1 (±0.9)^b b High score;	4.0 (±0.9)^b b High score;
Vector control agent	3.3 (±1.3)^a a Mean score;	3.4 (±1.3)^a a Mean score;	3.7 (±1.4)^a a Mean score;	3.5 (±1.4)^a a Mean score;
p value	0.001	0.025	0.102	0.008
Age Group
From 18 to 28 years old	3.9 (±1.5)^a a Mean score;	3.4 (±1.0)^a a Mean score;	3.9 (±1.1)^a a Mean score;	3.7 (±1.2)^a a Mean score;
From 29 to 39 years old	4.3 (±1.5)^b b High score;	4.0 (±1.3)^b b High score;	4.2 (±1.1)^b b High score;	4.2 (±1.2)^b b High score;
40 years old or more	4.5 (±1.3)^b b High score;	4.2 (±1.1)^b b High score;	4.3 (±1.2)^b b High score;	4.3 (±1.1)^b b High score;
p value	0.541	0.291	0.736	0.468
Level of education
High school	4.5 (±1.2)^b b High score;	4.1 (±1.2)^b b High score;	4.5 (±1.1)^b b High score;	4.4 (±1.0)^b b High score;
Incomplete Higher Education	4.2 (±1.2)^b b High score;	3.9 (±0.8)^a a Mean score;	4.0 (±0.8)^b b High score;	4.0 (±0.8)^b b High score;
Complete higher education	3.7 (±2.0)^a a Mean score;	3.6 (±1.5)^a a Mean score;	4.0 (±1.4)^b b High score;	3.8 (±1.5)^a a Mean score;
Graduation (Specialization)	5.1 (±0.8)^c c Very high score.	4.8 (±0.9)^b b High score;	4.6 (±1.1)^b b High score;	4.8 (±0.9)^b b High score;
Master's Degree	3.0 (^ Variable with only one worker; standard deviation absent. )^a a Mean score;	2.3 (^ Variable with only one worker; standard deviation absent. )^a a Mean score;	3.3 (^ Variable with only one worker; standard deviation absent. )^a a Mean score;	2.9 (^ Variable with only one worker; standard deviation absent. )^a a Mean score;
p value	0.024	0.009	0.206	0.029
Marital Status
Married	4.6 (±1.2)^b b High score;	4.3 (±1.2)^b b High score;	4.6 (±1.1)^b b High score;	4.5 (±1.1)^b b High score;
Single	3.8 (±1.5)^a a Mean score;	3.6 (±1.2)^a a Mean score;	3.8 (±1.0)^a a Mean score;	3.7 (±1.1)^a a Mean score;
Divorced	5.7 (±0.3)^c c Very high score.	4.6 (±0.6)^b b High score;	4.2 (±0.8)^b b High score;	4.8 (±0.2)^b b High score;
Widowed	4.5 (±1.6)^b b High score;	4.4 (±1.1)^b b High score;	3.6 (±2.0)	4.2 (±1.5)^b b High score;
p value	0.031	0.054	0.045	0.036
Family income^* * Minimum Wage Value: R$ 937.00;
Up to 1 Minimum Wage	4.1 (±1.2)^b b High score;	3.9 (±0.8)^a a Mean score;	4.3 (±0.9)^b b High score;	4.1 (±0.9)^b b High score;
From 2 to 5 Minimum Wages	4.4 (±1.4)^b b High score;	4.1 (±1.2)^b b High score;	4.3 (±1.2)^b b High score;	4.3 (±1.2)^b b High score;
From 6 to 10 Minimum Wages	4.3 (±1.8)^b b High score;	3.8 (±1.5)^a a Mean score;	4.3 (±1.3)^b b High score;	4.1 (±1.5)^b b High score;
More than 10 minimum wages	5.0 (±0.9)^c c Very high score.	4.7 (±0.8)^b b High score;	4.6 (±1.3)^b b High score;	4.7 (±1.0)^b b High score;
p value	0.626	0.523	0.953	0.706
Time of experience PH^c c Very high score.
Up to 2 years	4.3 (±1.7)^b b High score;	3.9 (±1.2)^a a Mean score;	4.3 (±1.1)^b b High score;	4.2 (±1.2)^b b High score;
From 3 to 10 years	4.3 (±1.4)^b b High score;	4.0 (±1.2)^b b High score;	4.1 (±1.1)^b b High score;	4.1 (±1.2)^b b High score;
Above 10 years	4.7 (±1.0)^b b High score;	4.4 (±1.1)^b b High score;	4.6 (±1.0)^b b High score;	4.5 (±1.0)^b b High score;
p value	0.553	0.458	0.271	0.401
Satisfied with the Profession/Occupation
Yes	4.8 (±1.0)^b b High score;	4.4 (±1.0)^b b High score;	4.5 (±1.0)^b b High score;	4.5 (±0.9)^b b High score;
No	2.3 (±1.4)^a a Mean score;	2.8 (±1.3)^a a Mean score;	3.3 (±1.2)^a a Mean score;	2.9 (±1.2)^a a Mean score;
p value	<0.001	<0.001	<0.001	<0.001
Thought about giving up the Profession/Occupation
Yes	3.6 (±1.6)^a a Mean score;	3.4 (±1.2)^a a Mean score;	3.7 (±1.1)^a a Mean score;	3.6 (±1.2)^a a Mean score;
No	5.0 (±0.9)^c c Very high score.	4.5 (±1.0)^b b High score;	4.7 (±1.0)^b b High score;	4.7 (±0.8)^b b High score;
p value	<0.001	<0.001	<0.001	<0.001

	EET	p value
Dedication	-0.416^ p <0.01.	<0.001
Absorption	-0.292^ p <0.01.	0.008
Vigor	-0.224^* * p <0.05;	0.042
Overall score	-0.333^ p <0.01.	0.002

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[1] Corresponding Author: Luciano Garcia Lourenção. E-mail: luciano.famerp@gmail.com