Contexto, exigências, sentido e efeitos do trabalho entre Agentes Comunitários de Saúde em Montes Claros (MG)

Abstract

This thesis is composed of three products, which aimed to analyze representations relating to the context, requirements, meaning and effects of work among Community Health Workers (CHW), being an excerpt from the project “Working Conditions and Health of CHWs in the North of Minas Gerais". This is a census study, descriptive, analytical with a quantitative approach. 675 CHAs working in Family Health Strategy (ESF) units in the city of Montes Claros - Minas Gerais participated in the study. For the analyzes described in this work, the Work and Illness Risk Inventory (ITRA), the sociodemographic questionnaire, the nine-item Patient Health Questionnaire (Patient Health Questionnare - PHQ-9) and the reduced form of the State-Trait Anxiety Inventory (IDATE-6), the latter two of which assess depression and anxiety, respectively. There was a predominance of women, mixed race, aged between 26 and 40 years old, married or in a stable union and with complete secondary education. Regarding labor aspects, the majority were hired, with a length of service of less than 5 years. The first product evaluated the context and human cost of work, with critical results being found in all factors analyzed. Age, length of service and employment relationship were the variables associated with all factors that evaluated the work context. Length of service remained associated with all scores that assessed the human cost of work. The second product aimed to analyze the global perception of the work context, human cost, indicators of pleasure and suffering, risks and damages at work, identifying differences in scores according to sociodemographic and work variables. It was found that most of the factors presented a critical classification, with the exception of the pleasure factors and the factors that assessed harm at work, which presented positive classifications. Activities inherent to the role of CHWs, referring to their work process and resulting from working conditions were the items that most contributed to the negative scores. On the other hand, items such as pride in what you do and solidarity among colleagues were those that most influenced positive evaluations. Length of service of more than 10 years and permanent employment were associated with the worst scores in all aspects analyzed. The third product analyzed indicators of pleasure and suffering at work associated with depression and anxiety. High scores in the suffering factors “Professional burnout” and “Lack of Recognition” represented an increased chance of developing symptoms of depression. Low scores on the pleasure factor “Professional Fulfillment” were associated with increased chances of anxiety symptoms. The data observed reflects a critical perception of the context and demands of work among CHWs and highlights relevant aspects in relation to the meaning and effects of work on the part of these professionals. These results should serve as input for the construction of strategies that alleviate the aspects that cause the most suffering and that aim to increase well-being at work for CHWs.