Estrés ocupacional y engagement en trabajadores de atención primaria a la salud

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.

Descriptores:
Atención Primaria de Salud; Estrategia de Salud Familiar; Personal de Salud; Estrés Laboral; Compromiso Laboral

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