Depressão e estresse psicossocial de Agentes Comunitários de Saúde: condições de vida e de trabalho

Abstract

Community Health Workers (CHWs) play an important role in relation to the organization of the Unified Health System (SUS), being considered fundamental in the articulation of health policies and indispensable for SUS. Previous studies have shown illness and suffering of these workers due to the activities developed at work, justifying the development of research. The aim of this study was to analyze the association between the prevalence of symptoms of depression and psychosocial stress of Community Health Workers in the city of Juiz de Fora (MG) with living and working conditions. A cross-sectional study was conducted with the CHWs population, totaling 400 participants. The dependent variables of this study were: psychosocial stress at work through the Demand-Control Model (MDC) and the prevalence of symptoms of depression using the Patient Health Questionnaire scale. The independent variables were: socioeconomic and demographic profile; self-perception of health; physical activity assessed by the International Physical Activity Questionnaire (IPAQ-short); characteristics and working conditions; social support at work; work capacity through the Work Ability Index (ICT); quality of life through the World Health Organization Quality of Life group instrument - WHOQOL-Bref. Data were processed using the Statistical Package for Social Sciences (SPSS® Software) version 15. Data analysis was performed using descriptive, bivariate and multivariate statistics. The results showed that the population of this study was predominantly composed of women, with a mean age of 46 years, of non white color/race and who had two or more children. Most of the participants had completed high school, were married or lived in a stable union and belonged to economic classes B2 and C1. There was a predominance among CHWs of very good or good health self-perception and high level of physical activity. Most of the participants had only one job, worked up to 40 hours per week, had no work accident in the last 12 months, worked in Primary Health Care for over ten years, had no night work, had high social support at work and were rated with good or great work ability. The prevalence of depressive symptoms among the CHWs was 20.6% and was associated with multivariate analysis with low/moderate work ability, low social support, economic classes C, D and E and the psychological domain of quality of life. In the MDC, there was a predominance of high demand work (32.5%), which is the exposure group for psychosocial stress at work. After multivariate analysis, high demand work was associated with low/moderate work ability and low social support. By identifying the prevalence of depression and psychosocial stress at work of CHWs and the associated factors, it becomes possible to direct strategies to improve health conditions and work processes, as well as highlighting the importance of addressing mental health issues.