Estresse ocupacional, engagement e estratégias de enfrentamento em agentes comunitários de saúde

Abstract

Community Health Workers (CHW) comprise the family health teams as a health care professional. By acquiring technical knowledge, they will be able to provide information on health promotion and prevention and, also as a resident of the community in question; they carry with them the culture, customs and popular knowledge of the place; so that this proximity can create the intended links with the health care service. Objective: This study aimed at evaluating the levels of occupational stress, work engagement and coping strategies among CHWs of a large municipality in the interior of São Paulo state. Method: This is a quantitative, descriptive, cross-sectional study carried out among the Community Health Care Workers from primary health care units in the municipality of São José do Rio Preto, São Paulo, in the year 2017. Four self-applicable instruments were used: one containing sociodemographic and professional variables of the CHWs, the Work Stress Scale (WSS), the Brazilian version of the Utrecht Work Engagement Scale (UWES) and the "Problem Facing Modes" Scale - PFMS. Data of the scales were analyzed according to the calculation of the scores, suitable for the analysis of the instruments and underwent appropriate statistical treatment, considering a 95%- level of significance. There were 133 CHWs; 105 (78.9%) female; 71 (53.3%) in the age group between 31 and 50 years; 78 (58.6%) married; 102 (76.7%) with high school; 124 (93.2%) officially admitted ; 105 (78.9%) with family income from two to five minimum wages; 85 (63.9%) not practicing physical activity; 98 (73.7%) with six to eight hours sleep daily; 82 (61.7%) satisfied with the profession, 76 (57.01%) that already thought about giving up the profession and 84 (63.2%) with professional performance time longer than one and less or equal to five years. Results: Seventy-five CWHs (56.4%) presented scores compatible with occupational stress (≥2,5). The mean stress level of the sample was 2.7 (dp = ±0.7; 95% CI = 2.6 - 2.8). In relation to the coping mode, the strategies of Problem-Focused Coping (3.9;±0.6) and Facing based on religious practices and fanciful thinking (3.4;±0.7) were outstanding. Conclusion: It is concluded that most CWHs have presented important levels of stress, however with good levels of engagement being higher in the dedication and strength dimensions. The study highlights the importance and the need for CHW to work under low levels of occupational stress, with good levels of engagement and coping strategies that allow them to overcome adversities, contributing to the expansion of the coverage of the Family Health Strategy and the effective increase population access to basic health services. Engagement proves to be beneficial for the health and well-being of CHW, constituting an advantage for institutions and the health care system.