Occupational stress and musculoskeletal symptoms in Community Health Workers

To evaluate the presence of occupational stress and musculoskeletal symptoms in community health workers, and compare the levels of occupational stress, according to sociodemographic characteristics.

Method

Cross-sectional study, conducted in 2017, in a municipality in the interior of São Paulo state. The Work Stress Scale and the Nordic Musculoskeletal Questionnaire were used.

Results

Forty-four CHWs participated, 70.5% were female, 47.7% were 40 years old or older, 79.5% had no other paid activity and 50.0% had three to 10 years of professional experience. Twenty-one (47.7%) professionals presented important levels of occupational stress (>2.5). The main stressors were: deficiency in disclosure of information about organizational decisions (3.3;±1.1); deficiency in training (3.4;±1.6); little appreciation (3.2;±1.4); few prospects for career growth (3.2;±1.6); discrimination/favoritism in the work environment (3.1;±1.5); lack of understanding about job responsibilities (3.0; ±1.5); type of control (2.9;±1.1); how tasks are distributed (2.8;±1.4); performing tasks that are beyond one's capacity (2.8;±1.2); lack of autonomy in performing the work (2.7;±1.3); receiving contradictory orders from the superior (2.7;±1.4); insufficient time to perform the work (2.7;±1.3). In the last year, 65.9% of CHWs reported musculoskeletal pain in the lower back, 61.4% in the neck, 47.7% in the shoulders, and 43.2% in the knees.

Conclusion

Occupational stress and musculoskeletal symptoms are problems present in the CHWs' work practice, showing that organizations need to increase labor resources to prevent psychosocial risks and enhance the quality of work of these professionals.

Keywords:
Primary Health Care; Community Health Workers; Occupational Health; Cumulative Trauma Disorders

Variables	n	%
Gender
Male	12	27.3
Female	31	70.4
No answer	01	2.3
Age group
From 18 to 28 years old	5	11.4
From 29 to 39 years old	13	29.5
From 40 years old or more	21	47.7
No answer	5	11.4
Education level
High school	18	40.9
Incomplete Higher Education	16	36.4
Graduation	9	20.4
No answer	1	2.3
Marital status
Married	21	47.7
Single	22	50.0
Separated	1	2.3
Family income ^* * Minimum Wage for the Study Period: R$937,00.
Up to 1 Minimum Wage	8	18.2
From 2 to 5 Minimum Wage	33	75.0
From 6 to 10 Minimum Wage	3	6.8
Othe Paid Activities
Yes	9	20.5
No	35	79.5
Daily hours of sleep
Less than 6 hours	7	15.9
From 6 to 8 hours	37	84.1
Time Acting at PHC
Up to 2 years	15	34.1
From 3 to 10 years	22	50.0
More than 10 years	6	13.6
No answer	1	2.3

WSS items	Mean (±SD)
Q1 - The way tasks are distributed in my area has made me nervous	2.8 (±1.4)
Q2 - The kind of control that exists in my work annoys me.	2.9 (±1.1)
Q3 - The lack of autonomy in the execution of my work has been exhausting.	2.7 (±1.3)
Q4 - I have been uncomfortable with my superior's lack of confidence in my work.	2.4 (±1.3)
Q5 - I am irritated by the lack of disclosure of information about organizational decisions.	3.3 (±1.1)
Q6 - I feel uncomfortable with the lack of information about my tasks at work.	2.6 (±1.2)
Q7 - The lack of communication between me and my co-workers makes me angry.	2.1 (±1.4)
Q8 - I feel annoyed that my superior treats me badly in front of co-workers	1.8 (±1.1)
Q9 - I feel uncomfortable having to perform tasks that are beyond my capacity	2.8 (±1.2)
Q10 - I get in a bad mood for having to work for many hours at a time	2.1 (±1.2)
Q11 - I feel uncomfortable with the communication between me and my superior	2.0 (±1.2)
Q12 - I get irritated by discrimination/favoritism in my work environment.	3.1 (±1.5)
Q13 - I have been uncomfortable with the deficiency in training for professional training.	3.4 (±1.6)
Q14 - I get in a bad mood because I feel isolated in the organization.	2.0 (±1.1)
Q15 - I get annoyed at being undervalued by my superiors	3.2 (±1.4)
Q16 - The few prospects for career growth have left me anguished	3.2 (±1.6)
Q17 - I have been uncomfortable working on tasks below my skill level.	2.3 (±1.4)
Q18 - The competition in my work environment has put me in a bad mood.	2.3 (±1.1)
Q19 - The lack of understanding of what my responsibilities are in this work upsets me.	3.0 (±1.5)
Q20 - I've been nervous about my superior giving me contradictory orders	2.7 (±1.4)
Q21 - I feel irritated that my superior is covering up my job well done in front of other people.	2.1 (±1.3)
Q22 - Insufficient time to carry out my workload makes me nervous	2.7 (±1.3)
Q23 - It bothers me that my superior avoids taking on important responsibilities.	1.8 (±1.1)

Universidade Federal de São Carlos, Departamento de Terapia Ocupacional Rodovia Washington Luis, Km 235, Caixa Postal 676, CEP: , 13565-905, São Carlos, SP - Brasil, Tel.: 55-16-3361-8749 - São Carlos - SP - Brazil
E-mail: cadto@ufscar.br

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[1] Author´s Contributions

Luciano Garcia Lourenção: He contributed to the project design, analysis, and interpretation of data and writing of the article. Maria Cristina Oliveira Santos Miyazaki: She contributed to the relevant critical review of the intellectual content and final approval of the version to be published. Eduardo Henrique Tadashi Suyama, Dezolina Franciele Cardin Cordioli, and João Roberto Cordioli Junior: They contributed to the collection, analysis, and interpretation of data and writing of the article. All authors approved the final version of the text.