Work and illness risks in Territorial Psychosocial Care: implications for mental health care management

Lima, Israel Coutinho Sampaio; Sampaio, José Jackson Coelho; Ferreira Júnior, Antonio Rodrigues

doi:10.1590/0103-1104202313911I

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLE • Saúde debate 47 (139) • Oct-Dec 2023 • https://doi.org/10.1590/0103-1104202313911I copy

Work and illness risks in Territorial Psychosocial Care: implications for mental health care management

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The study aims to analyze precarious work due to working conditions that influence the management of mental health care and occupational health. This single case mixed study was conducted in six Psychosocial Care Centers (CAPS) in a Decentralized Health Sector. The Work and Illness Risks Inventory was applied to a total purposeful sample of 35 workers, 15 of whom participated in the projective interview. Data were processed in SPSS 26.0.0.0 as measures of central tendency and dispersion. The interviews were categorized based on the evaluation axes proposed by the inventory, contextualized, and discussed from Edgar Morin’s Complex Thought. The result is critical for most predictors that evaluated the context, human cost, pleasure, distress, and harm related to work in the CAPS. Data illustrated by the workers’ narratives describe the precarious work conditions. Local Unified Health System managers quickly incorporated neoliberalism’s productivist principles, perpetuating substandard work conditions. Mental health care management processes, funding, and legal occupational and contractual conditions must be reviewed to align with Territorial Psychosocial Care (APT).

KEYWORDS
Working conditions; Occupational health; Mental health services

Scale	Description	Values	Results
Work Context Assessment Scale (EACT)	It comprises three factors: work organization, working conditions, and socio-professional relationships.	1 = never 2 = rarely 3 = sometimes 4 = often 5 = always	≥ 3,7= severe 2,3-3,69 = critical ≤ 2,29 = satisfactory
Work Human Cost Scale (ECHT)	It comprises three factors: physical cost, cognitive cost, and affective cost.	1 = not demanding 2 = little demanding 3 = more or less demanding 4 = quite demanding 5 = totally demanding	≥ 3.7 = severe 2.3-3.69 = critical ≤ 2.29 = satisfactory
Work Pleasure and Distress Indicators Scale (EIPST)	It comprises four factors: professional achievement, freedom of speech, lack of recognition, and lack of freedom of speech.	0 = never 1 = once 2 = twice 3 = three times 4 = four times 5 = five times 6 = six times or more	a) Pleasure experience: ≥ 4.0 = satisfactory 2.1-3.9 = critical ≤ 2.0 = severe b) Distress experience ≥ 2.0 = satisfactory 2.1-3.9 = critical ≤ 4.0 = severe
Work-Related Harm Assessment Scale (EADRT)	It comprises three factors: physical harm, psychological harm, and social harm.	0 = never 1 = once 3 = three times 4 = four times 5 = five times 6 = six times or more	≥ 4.1 = presence of occupational diseases 3.1-4.0 = severe 2.0-3.0 = critical ≤ 1.9 = bearable

Scales	Factors	Items	Mean	Standard Deviation	Classification
Work Context Assessment Scale (EACT)	Work Organization	The work pace is excessive	3,26	0,95	critical
		Tasks are completed under pressure of deadlines	2,86	1,22	critical
		There is strong pressure for results	2,97	1,2	critical
		The rules for performing tasks are strict	2,66	1,14	critical
		Performance is monitored	2,74	1,24	critical
		Expected results are unrealistic	2,43	1,14	critical
		Tasks are repetitive	3,23	1,21	critical
		The tasks performed are disrupted	2,86	1,33	critical
	Socio-professional relationships	There is a fine line between the planners and implementers	2,89	1,35	critical
		There are professional disputes in the workplace	2,4	1,58	critical
		Communication between staff is unsatisfactory	2,46	1,29	critical
		Tasks are not clearly defined	2,37	1,35	critical
	Work conditions	The number of people is insufficient to perform the tasks	2,91	1,31	critical
		Lack of time to take rest breaks at work	2,89	1,39	critical
		Working conditions are substandard	2,63	1,24	critical
		The physical environment is uncomfortable	2,43	1,22	critical
		There is a lot of noise in the work environment	2,51	1,09	critical
	Work conditions	The existing furniture in the workplace is inadequate	2,6	1,31	critical
		Work tools are insufficient to perform tasks	2,94	1,06	critical
		The equipment required to perform the tasks is precarious	2,43	1,24	critical
		The physical space to perform the work is inadequate	2,4	1,22	critical
		Consumables are insufficient	2,57	1,12	critical

Scales	Factors	Items	Mean	Standard Deviation	Classification
Work Human Cost Scale (ECHT)	Affective cost	Keeping emotions under control	3,46	1,24	Critical
		Dealing with contradictory instructions	2,37	1,21	Critical
		Having emotional costs	2,8	1,28	Critical
		Being forced to deal with the aggressiveness of others	2,54	1,4	Critical
		Disguising own feelings	2,8	1,45	Critical
		Having to be nice to others	2,37	1,52	Critical
	Cognitive cost	Having to solve problems	3,46	1,4	Critical
		Being forced to deal with unforeseen events	3,17	1,2	Critical
		Predicting events	2,37	1,19	Critical
		Using the memory	3,4	1,35	Critical
		Having intellectual challenges	3,03	1,38	Critical
		Making mental effort	3,2	1,51	Critical
		Having mental concentration	3,57	1,42	Critical
		Using creativity	3,74	1,15	Critical
	Physical cost	Using vision continuously	3,03	1,44	Critical

Scales	Factors		Items	Mean	Standard Deviation	Classification
Work Pleasure and Distress Indicators Scale (EIPST)	Work pleasure	Freedom	Freedom with management to negotiate my needs	4,26	1,85	Satisfactory
			Freedom to talk about my work with colleagues	4,51	1,69	Satisfactory
			Solidarity among peers	4,89	1,39	Satisfactory
			Trust among peers	4,2	1,78	Satisfactory
			Freedom to express my opinions in the workplace	4,69	1,32	Satisfactory
			Freedom to use my creativity	5,09	1,15	Satisfactory
			Freedom to talk about my work with the bosses	4,49	1,6	Satisfactory
			Cooperation among peers	4,66	1,28	Satisfactory
Work Pleasure and Distress Indicators Scale (EIPST)	Work pleasure	Professional achievement	Satisfaction	4,77	1,4	Satisfactory
			Motivation	4,37	1,63	Satisfactory
			Proud of what I do	5,34	1,21	Satisfactory
			Well-being	4,4	1,58	Satisfactory
			Professional achievement	4,74	1,34	Satisfatório
			Appreciation	3,69	1,83	Critical
			Recognition	3,46	2,06	Critical
	Work distress	Professional burnout	Emotional exhaustion	3,49	2,13	Critical
			Stress	3,63	2,07	Critical
			Unsatisfaction	2,37	1,88	Critical
			Overload	3,4	2,19	Critical
			Frustration	2,83	2,04	Critical
			Insecurity	2,54	2,13	Critical
			Fear	2,14	1,99	Critical
		Lack of recognition	Lack of recognition of my effort	2,31	2,15	Critical
			Lack of recognition of my performance	2,17	2,04	Critical
			Depreciation	2,26	1,95	Critical
			Outrage	2,29	1,9	Critical

Scales	Factors	Items	Mean	Standard Deviation	Classification
Work-Related Harm Assessment Scale (EADRT)	Physical harm	Body pain	2,66	2,07	Critical
		Headache	3,17	2,16	Severe
		Back pain	3	2,01	Critical
		Sleeping disorders	2,94	2,22	Critical
	Social harm	Willingness to be alone	2	2,34	Critical
	Psychological harm	Sadness	2,11	2,05	Critical

Centro Brasileiro de Estudos de Saúde Av. Brasil, 4036, sala 802, 21040-361 Rio de Janeiro - RJ Brasil, Tel. 55 21-3882-9140, Fax.55 21-2260-3782 - Rio de Janeiro - RJ - Brazil
E-mail: revista@saudeemdebate.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Conflict of interests: non-existent