Scientific evidence indicates that workers in the health sector are commonly exposed to work-related musculoskeletal pain. Objectives: We aimed to identify the relationship between the presence and intensity of musculoskeletal pain in the neck and lumbar regions reported by Primary Health Care (PHC) workers with workloads and occupational risks, analyze musculoskeletal pain in the presence and absence of self-reported mental disorders based on a medical diagnosis, and identify workers’ strategies to manage pain. Method: This cross-sectional study addressed 338 health professionals working in PHC outpatient services in the extreme South of Brazil. One questionnaire addressed sociodemographic questions concerning occupation, occupational risks, and mental disorders. The Nordic Musculoskeletal Questionnaire was used to assess self-reported musculoskeletal pain. The National Aeronautics and Space Administration Task Load Index (NASA-TLX) measured the workload. A descriptive and inferential analysis was performed using SPSS version 21.0. Results: Most (55.3%) participants reported neck and (64.5%) lower back pain in the previous 12 months, and 22.5% and 30.5% reported intense neck and lower back pain, respectively, in the previous 12 months. The results showed different independent associations with increased musculoskeletal pain among health workers. Dentists presented the highest prevalence of neck pain, while female workers presented the highest prevalence of lower back pain. Furthermore, the perception of ergonomic risk and virtually all self-reported mental disorders (except panic syndrome for neck pain) were associated with pain in the neck and lower back regions and a higher frustration level (mental demand). Additionally, professionals with graduate degrees, nurses, and professionals working the longest in PHC services reported seeking complementary therapies more frequently, while physicians and those with self-reported mental disorders self-medicated more frequently.
Various studies indicate that workload metrics can be used to assess inequities in the division of labor according to gender and in the mental health of health care professionals. In most studies, the workload is portrayed in a way that does not integrate the different fields of work, that is, work in health services and unpaid domestic work. The objective was to determine the effects of the workload domains of health work and unpaid domestic work according to the gender division of health professionals working in primary health care (PHC), and to analyze the workload as an inducer of anxiety disorders and episodes of depression. This cross-sectional study consisted of 342 health care professionals recruited for interview at primary health care units in the extreme south of Rio Grande do Sul, Brazil. Sociodemographic and occupational variables, workload in PHC and unpaid domestic work, and dichotomies of anxiety disorders and episodes of depression were considered. Poisson and multivariate linear regression models were used for data analysis. Cohen’s standardized effect size was used to assess the magnitude of the difference between women and men in terms of workload. The female professionals presented higher scores in terms of PHC work and unpaid domestic work and higher proportions of episodes of depression and anxiety disorders compared to males. The male professionals showed that anxiety disorders presented a medium standardized effect size on domestic workload and the level of frustration with family involvement was higher in those with episodes of depression. The results illustrate that the workload metric is an important indicator of female vulnerability to working conditions in PHC and in the family environment.
Resumo Objetivo: Conhecer a percepção de enfermeiros docentes sobre a relação saúde e ambiente e como se dá a abordagem da temática na formação profissional em enfermagem. Métodos: Pesquisa qualitativa, exploratória e descritiva, com dezessete enfermeiros docentes de cinco cursos de graduação em enfermagem. Dados coletados por meio de entrevista semiestruturada e analisados por análise de conteúdo. Resultados: A interface saúde e ambiente é percebida a partir de duas perspectivas: causa-efeito, entendendo ambiente como causador de doenças, e coletiva-ética-complexa, integrando relações sociais e o comportamento humano com o meio. Quanto à abordagem na formação profissional, verificou-se que embora haja, ainda é superficial, demonstrando-se como lacuna. Considerações finais: Evidenciou-se a fragilidade da abordagem do tema na formação, assim como a descontinuidade naqueles espaços onde o mesmo é presente, carecendo de base teórica que contemple a complexidade envolvida
1 December 2009 in Revista Latino-Americana de Enfermagem
This analytical and qualitative study aimed to identify how workers in the Family Health Strategy perceive the risks they are exposed to at work. Thematic analysis and the reference framework of the work process were used to examine the contents of interviews with 48 subjects (community health agents, nurses, nursing auxiliaries and physicians). The workers noticed the following risks: physical and moral violence, typical work accident, emotional exhaustion, lack of problem-solving ability and occupational disease. The results predominantly show the connection with the object / subject of the work and the social environmental characteristics of the related communities. The study adds to the body of knowledge and can systemize collective and individual technological processes for occupational health risk management in primary health care.
Well-being at work is one of the factors determining healthy work conditions and is perceived by workers as a positive psychological state. In this study, the concept of well-being at work was used together with occupational functionality (i.e., current health state, current work environment, and barriers/facilitators to implementing well-being at work), occupational risk perception, and proactivity/negotiations held by workers to improve working conditions. In this context, the objectives were to identify the socio-demographic and occupational characteristics independently associated with levels of well-being at work of the multidisciplinary PHC health team; detect barriers or facilitators resulting from the attitudes of colleagues, community members, and managers that influence the well-being at work of the multidisciplinary health team; and identify with whom and what reasons led health workers to become proactive and negotiate improved working conditions. This cross-sectional study addressed 338 health workers from the multidisciplinary teams of PHC outpatient services in the extreme south of Brazil. Multivariate linear regression models were adopted to analyze data. The results show various independent associations with levels of well-being at work. Nursing workers (technicians and nurses) more frequently expressed job commitment and job satisfaction. Difficulties in solving problems and performing work routines, and co-workers’ attitudes directly influence the well-being of the PHC team members. Risk perception (physical and chemical) also influences well-being. Negotiations in which PHC managers engaged to improve working conditions appeared as a significant predictor of job commitment, job satisfaction, and job involvement. The results reveal that well-being at work is an important indicator of the potential of workers’ proactivity in negotiating improved working conditions.
This study’s aim was to analyse the relationship between musculoskeletal disorders (low back pain and dorsalgia) and sociodemographic characteristics, workload and occupational hazards among casual dockworkers. This cross-sectional study addressed casual dockworkers from the state of Rio Grande do Sul, Brazil. The convenience sample was composed of 232 casual dockworkers. Data were collected using a structured interview and observation. Poisson regression analysis was used. Association between low back pain and physiological occupational risk (p = 0.006), total exertion levels (p = 0.014) and frustration (p = 0.020) remained statistically significant, while the use of illicit drugs (p = 0.023), being a quayside worker (p = 0.021) and physiological occupational risk (p = 0.040) remained associated with dorsalgia. Decreasing these variables in the workplace may also reduce the prevalence of musculoskeletal disorders such as low back pain and dorsalgia.