Poor physical and mental health were prevalent among Brazilian health workers employed in the public sector during the COVID-19 pandemic, according to a study by researchers at the Federal University of São Carlos (UFSCar) in the state of São Paulo. , Brazil. The study showed that 86% reported burnout and 81% suffered from stress. They slept poorly, experienced depression, and complained of aches and pains. On the other hand, most said they were happy to provide meaningful services to society.
The study is still in progress. An analysis of the initial findings is reported in an article published In the diary Health care. The initiative as a whole is supported by FAPESP and is now in the final stage of data collection and analysis.
“The document offers a snapshot of the situation, and we cannot blame the pandemic for all the problems we found, but we believe that the particularly severe effects of COVID-19 in Brazil contributed to these very negative results,” he said. Tatiana de Oliveira Satoprofessor of physiotherapy at the Faculty of Biological and Health Sciences (CCBS) of UFSCar.
“Overwork, difficult decisions, and dramatic experiences have intensified due to the pandemic, affecting all healthcare workers, but especially those on the front lines,” Sato said. Brazil has had more health professional deaths from COVID-19 than any other country, according to the article.
“The original idea for the survey came just before the pandemic. Even outside of the context of the pandemic, healthcare workers have to deal with heavy schedules and a burden of responsibility. We wanted to assess the effects of all this on their physical and mental health. However, when the pandemic hit, we decided to measure the impact of the public health emergency on the well-being of these workers,” Sato said.
The researchers initially planned to interview volunteers at work. All would be health workers from SUS, Brazil’s public health service, in São Carlos. However, the procedures necessary to prepare for the survey (permits, questionnaires, etc.) became irrelevant between the end of 2020 and the beginning of 2021, when the pandemic was ravaging Brazil and the implementation of the vaccine was still in its infancy.
“Instead, we created an online form and expanded the search for respondents across the country,” Sato explained. “The inclusion criteria were working for the SUS, being over 18 years of age, and being directly involved in patient care.”
The form was publicized through social networks, emails and newspapers. It contained five questionnaires, each designed to quantify an aspect of the respondent’s life. They included the Copenhagen Psychosocial Questionnaire, the Pittsburgh Sleep Quality Index, the Nordic Musculoskeletal Questionnaire, and the Beck Depression Inventory.
The form had 10 pages. “We estimate that it took 20 to 30 minutes to answer all the questions. Questionnaires were only included in the analysis if they were fully completed,” Sato said. Local respondents also used equipment to measure the amount of physical activity for inclusion in the survey.
Finally, 125 health workers participated in the study. The first stage of data collection lasted from June 2021 to April 2022. The data published so far constitutes a baseline and does not yet cover physical activity, but the project requires four more steps to be carried out three, six, nine and 12 months later. the first collection.
“We call this cohort HEROES. We put a lot of thought into the name because we didn’t want it to be interpreted as saying that healthcare workers are superhuman and never get tired or discouraged. The name is intended as a tribute. We also wanted to draw attention to the need to value healthcare workers, who have been disproportionately affected by the pandemic,” Sato said. Some 60 respondents participated in all stages.
The data presented in the article show a high prevalence of musculoskeletal symptoms: 64% reported neck pain, 62% shoulder pain, 58% upper back pain, and 61% lower back pain. lower back.
For Sato, all of this was no doubt due in large part to the long hours, being on his feet most of the time, lifting patients, and working at full steam. “But mental stress can also trigger this type of pain because of the stress it creates on the body,” she noted.
The frequency of psychosocial problems is striking, according to the authors, with 81% stress affecting the participants and 86% burnout. Symptoms of mild depression were detected in 22%, moderate depression in 16%, and severe depression in 8%. In addition, 74.4% said they slept badly.
However, it is still necessary to analyze the evolution of the indicators over time. According to Sato, prevalence levels tend to be lower in studies of other populations. For example, five meta-analyses mentioned in the article found burnout rates ranging from 25% to 37%, while nine of those studies found that between 17% and 57% of the respective samples suffered from stress. These proportions are much lower than those reported in the study by the UFSCar researchers.
Other psychosocial factors were assessed through the Copenhagen questionnaire, with the vast majority of respondents giving negative scores to the emotional demands of their job (75%), its pace and intensity (61%), and its unpredictability (47%). These were the worst valued psychosocial factors in the survey.
The proportions reporting offensive behavior were also surprisingly high: 15% said they had been the subject of unwanted sexual attention or harassment, while 26% had been threatened, 17% intimidated and 9% physically assaulted.
“This is deplorable. All these numbers must be zero. Such occurrences in any workplace are unacceptable,” Sato said. Sexual harassment was reported more by young women, she noted. Threats of violence came mainly from patients and their families, while coworkers were more harassing than supervisory.
On the plus side, more than 90% said they believed their work was very meaningful, and about 80% said they were committed to their work despite the stress.
Limitations and implications
For Sato, the relatively small number of respondents in the first form (125) and the even smaller number (around 60) that remained in the last stage of the survey were a limitation because they prevented extrapolation and analysis of data for other regions. . “However, the survey was valuable because of its depth,” he said.
The information obtained, he added, is enough to put pressure on the SUS senior management and the authorities for improvements in working conditions. Professionals with physical and mental problems cannot always provide the best patient care.
“This has to lead to more staffing, better pay, fewer grueling hours and proper training,” Sato said. Simple issues, such as training staff on the best ways to lift and transport patients without injury, could lead to significant improvements in musculoskeletal terms. Similarly, the creation of support networks would help nursing and other staff to cope with the emotional impact. “Health care workers need a lot of support. They are people too,” she said.
About the São Paulo Research Foundation (FAPESP)
The São Paulo Research Foundation (FAPESP) is a public institution whose mission is to support scientific research in all fields of knowledge by granting scholarships, grants and grants to researchers linked to State higher education and research institutions. from Sao Paulo, Brazil. FAPESP is aware that the best research can only be done by working with the best international researchers. Therefore, it has established partnerships with funding agencies, higher education, private companies, and research organizations in other countries known for the quality of their research and has been encouraging scientists funded by its grants to further develop their international collaboration. You can obtain more information about FAPESP at www.fapesp.br/en and visit FAPESP’s news agency at www.agencia.fapesp.br/en to stay up to date with the latest scientific advances that FAPESP helps to achieve through of its numerous programs, awards and research centers. You can also subscribe to the FAPESP news agency at http://agencia.fapesp.br/subscribe
Poor health conditions among Brazilian health workers: study design and baseline characteristics of the HEROES cohort
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