Desequilíbrio esforço-recompensa e comprometimento excessivo entre trabalhadores da saúde na linha de frente ao combate à pandemia da COVID-19

Abstract

The Coronavirus Disease 2019 (COVID-19) pandemic was declared by the World Health Organization in January 2020, since then COVID-19 morbidity and mortality figures have progressed rapidly and aggressively across all countries. In this context, health professionals who worked in the care of patients with COVID-19 faced physical and psychological exhaustion in their work environment, lack of resources and equipment and lack of access to mental health services. This study aims to: estimate the prevalence of effort-reward imbalance and excessive commitment in health workers who provided care to patients with suspected and diagnosed COVID-19; and to estimate the magnitude of the association between the effort-reward imbalance and overcommitment with the sociodemographic characteristics, occupational profile and lifestyle of these workers. This is a cross-sectional epidemiological survey, of the websurvey type, entitled “Occupational Health among Health Workers in times of COVID-19” carried out in a medium-sized municipality in the north of the state of Minas Gerais. A total of 378 health workers participated in this study, these being doctors, nurses and dentists, who performed their duties in Basic Health Units. For data collection, which took place between October 2020 and July 2021, a self-administered questionnaire was used through the WhatsApp application and e-mail, with questions regarding sociodemographic characteristics, occupational profile, lifestyle and the Effort Reward Imbalance (ERI) scale. The variables were described through their absolute and relative frequencies. The prevalences were estimated, with a 95% confidence interval, of high effort, low reward, effort-reward imbalance and overcommitment. The chi-square test was used to verify the association between effort-reward imbalance and overcommitment with sociodemographic characteristics, occupational profile and workers' lifestyle. The multiple Poisson regression model was adopted, with robust variance, to estimate the magnitude of the associations. Prevalence of high effort was estimated at 67.5%, low reward at 84.7%, effort-reward imbalance at 74.9% and overcommitment at 81.5%. Through multiple analysis, a significant association of effort-reward imbalance with marital status with partner, medical or nurse profession, negative self-perception of health and fear of COVID-19 was verified; and association of excessive commitment to the medical profession, daily working hours of more than 8 hours and fear of COVID-19. This study points out the need to make changes in the scope of work of health professionals in times of pandemic, aiming to reduce occupational stress, discontent and illness of health workers. Such changes may provide an improvement in the quality of life of these professionals and, consequently, an improvement in the care provided to patients.