Violence in the neighborhood and mental health of community health workers in a Brazilian metropolis

Detalhes bibliográficos
Autor(a) principal: Anya Pimentel Gomes Fernandes Vieira-Meyer
Data de Publicação: 2023
Outros Autores: Ana Patrícia Pereira Morais, Helena Paula Guerra dos Santos, Aisha Khizar Yousafzai, Isabella Lima Barbosa Campelo, José Maria Ximenes Guimarães
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Cadernos de Saúde Pública
Texto Completo: https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8102
Resumo: Violence is a major social problem in Brazil, with severe repercussions on the health care sector. Primary health care professionals, especially community health workers (CHWs), are at high risk of violence at facilities and in the socially vulnerable area where they work. This study analyzed the relationships between adverse working conditions and dimensions of localized violence on the prevalence of common mental disorders (CMD) among CHWs in Fortaleza, a state capital in Northeastern Brazil. Information was collected with a self-report questionnaire containing items on sociodemographic data, work-related violence, psychoemotional signs and symptoms (Self-Reporting Questionnaire-20), mental health care, and absence from work due to general or mental health issues. Based on the responses of 1,437 CHWs, the prevalence of CMD (32.75%) was associated with perceived, witnessed, or suffered violence in the work area. In the hierarchical analysis, CMD were associated with age, sex, religious identity, years of experience as a CHW with the Family Health Strategy (FHS), work neighborhood, activities in the community, considering the lack of bonding with families as an obstacle, having suffered domestic violence, use of medication for emotional dysregulation, identifying the neighborhood as violent, considering violence a physical or mental health determinant, and identifying impunity as a cause of violence. Thus, the work and mental health of CHWs were significantly affected by violence dimensions. Our findings are relevant to the adoption of strategies to mitigate the effects of violence on the work and mental health of CHWs.
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spelling Violence in the neighborhood and mental health of community health workers in a Brazilian metropolisViolenceExposure to ViolenceMental HealthCommunity Health WorkersPrimary Health CareViolence is a major social problem in Brazil, with severe repercussions on the health care sector. Primary health care professionals, especially community health workers (CHWs), are at high risk of violence at facilities and in the socially vulnerable area where they work. This study analyzed the relationships between adverse working conditions and dimensions of localized violence on the prevalence of common mental disorders (CMD) among CHWs in Fortaleza, a state capital in Northeastern Brazil. Information was collected with a self-report questionnaire containing items on sociodemographic data, work-related violence, psychoemotional signs and symptoms (Self-Reporting Questionnaire-20), mental health care, and absence from work due to general or mental health issues. Based on the responses of 1,437 CHWs, the prevalence of CMD (32.75%) was associated with perceived, witnessed, or suffered violence in the work area. In the hierarchical analysis, CMD were associated with age, sex, religious identity, years of experience as a CHW with the Family Health Strategy (FHS), work neighborhood, activities in the community, considering the lack of bonding with families as an obstacle, having suffered domestic violence, use of medication for emotional dysregulation, identifying the neighborhood as violent, considering violence a physical or mental health determinant, and identifying impunity as a cause of violence. Thus, the work and mental health of CHWs were significantly affected by violence dimensions. Our findings are relevant to the adoption of strategies to mitigate the effects of violence on the work and mental health of CHWs.La violencia es un problema social importante en Brasil, con graves impactos en el sector de la salud. Los profesionales de la atención primaria de salud, en especial los agentes comunitarios de salud (ACS), se encuentran en alto riesgo de violencia en los establecimientos y en el área de vulnerabilidad social donde actúan. Este estudio analizó la relación entre las condiciones laborales adversas y las dimensiones de la violencia localizada en la prevalencia de los trastornos mentales comunes (TMC) entre los ACS de Fortaleza, una capital en la Región Nordeste de Brasil. Para recabar la información, se aplicó un cuestionario de autoinforme (Self-Reporting Questionnaire-20) que constaba de ítems sobre datos sociodemográficos, violencia laboral, signos y síntomas psicoemocionales, cuidados en salud mental y ausencia al trabajo por problemas generales o de salud mental. De las respuestas de 1.437 ACS, se constató que la prevalencia de TMC (32,75%) estuvo asociada con la violencia percibida, que se presenció o sufrió en el lugar de trabajo. En el análisis jerárquico, los TMC se asociaron con la edad, el sexo, la identidad religiosa, los años de experiencia como ACS en la Estrategia de Salud Familiar (ESF), el barrio donde actúan, las actividades en la comunidad, considerando como obstáculo la falta de vínculo con las familias, haber sufrido violencia intrafamiliar, uso de medicamentos para la desregulación emocional, la identificación del barrio como violento, considerar la violencia como determinante de la salud física o mental e identificar la impunidad como causa de la violencia. Por lo tanto, el trabajo y la salud mental de los ACS se vieron significativamente afectados por las dimensiones de la violencia. Estos hallazgos son relevantes para aplicar estrategias de mitigación de los efectos de la violencia en el trabajo y en la salud mental de los ACS.A violência é um grande problema social no Brasil, com graves repercussões no setor de saúde. Profissionais da atenção primária à saúde, principalmente os agentes comunitários de saúde (ACS), apresentam alto risco de violência nas instalações e na área de vulnerabilidade social onde atuam. Este estudo analisou as relações entre condições adversas de trabalho e as dimensões da violência no território na prevalência de transtornos mentais comuns (TMC) entre ACS de Fortaleza, uma capital do Nordeste do Brasil. As informações foram coletadas por meio de um questionário de autorrelato (Self-Reporting Questionnaire-20) com itens sobre dados sociodemográficos, violência relacionada ao trabalho, sinais e sintomas psicoemocionais, cuidados em saúde mental e ausência ao trabalho por problemas gerais ou de saúde mental. Com base nas respostas de 1.437 ACS, a prevalência de TMC (32,75%) foi associada à violência percebida, testemunhada ou sofrida na área de trabalho. Na análise hierárquica, os TMC estavam associados a idade, sexo, identidade religiosa, anos de experiência como ACS na Estratégia Saúde da Família (ESF), bairro onde trabalha, atividades na comunidade, considerando a falta de vínculo com as famílias como obstáculo, ter sofrido violência doméstica, uso de medicação para desregulação emocional, identificar o bairro como violento, considerar violência um determinante da saúde física ou mental e identificar a impunidade como causa de violência. Assim, o trabalho e a saúde mental dos ACS foram significativamente afetados pelas dimensões da violência. Nossos achados são relevantes para a adoção de estratégias para mitigar os efeitos da violência no trabalho e na saúde mental dos ACS.Reports in Public HealthCadernos de Saúde Pública2023-01-13info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8102Reports in Public Health; Vol. 38 No. 12 (2022): DecemberCadernos de Saúde Pública; v. 38 n. 12 (2022): Dezembro1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZenghttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8102/18164https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8102/18165Anya Pimentel Gomes Fernandes Vieira-MeyerAna Patrícia Pereira MoraisHelena Paula Guerra dos SantosAisha Khizar YousafzaiIsabella Lima Barbosa CampeloJosé Maria Ximenes Guimarãesinfo:eu-repo/semantics/openAccess2024-03-06T15:30:23Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/8102Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:09:17.602116Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true
dc.title.none.fl_str_mv Violence in the neighborhood and mental health of community health workers in a Brazilian metropolis
title Violence in the neighborhood and mental health of community health workers in a Brazilian metropolis
spellingShingle Violence in the neighborhood and mental health of community health workers in a Brazilian metropolis
Anya Pimentel Gomes Fernandes Vieira-Meyer
Violence
Exposure to Violence
Mental Health
Community Health Workers
Primary Health Care
title_short Violence in the neighborhood and mental health of community health workers in a Brazilian metropolis
title_full Violence in the neighborhood and mental health of community health workers in a Brazilian metropolis
title_fullStr Violence in the neighborhood and mental health of community health workers in a Brazilian metropolis
title_full_unstemmed Violence in the neighborhood and mental health of community health workers in a Brazilian metropolis
title_sort Violence in the neighborhood and mental health of community health workers in a Brazilian metropolis
author Anya Pimentel Gomes Fernandes Vieira-Meyer
author_facet Anya Pimentel Gomes Fernandes Vieira-Meyer
Ana Patrícia Pereira Morais
Helena Paula Guerra dos Santos
Aisha Khizar Yousafzai
Isabella Lima Barbosa Campelo
José Maria Ximenes Guimarães
author_role author
author2 Ana Patrícia Pereira Morais
Helena Paula Guerra dos Santos
Aisha Khizar Yousafzai
Isabella Lima Barbosa Campelo
José Maria Ximenes Guimarães
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Anya Pimentel Gomes Fernandes Vieira-Meyer
Ana Patrícia Pereira Morais
Helena Paula Guerra dos Santos
Aisha Khizar Yousafzai
Isabella Lima Barbosa Campelo
José Maria Ximenes Guimarães
dc.subject.por.fl_str_mv Violence
Exposure to Violence
Mental Health
Community Health Workers
Primary Health Care
topic Violence
Exposure to Violence
Mental Health
Community Health Workers
Primary Health Care
description Violence is a major social problem in Brazil, with severe repercussions on the health care sector. Primary health care professionals, especially community health workers (CHWs), are at high risk of violence at facilities and in the socially vulnerable area where they work. This study analyzed the relationships between adverse working conditions and dimensions of localized violence on the prevalence of common mental disorders (CMD) among CHWs in Fortaleza, a state capital in Northeastern Brazil. Information was collected with a self-report questionnaire containing items on sociodemographic data, work-related violence, psychoemotional signs and symptoms (Self-Reporting Questionnaire-20), mental health care, and absence from work due to general or mental health issues. Based on the responses of 1,437 CHWs, the prevalence of CMD (32.75%) was associated with perceived, witnessed, or suffered violence in the work area. In the hierarchical analysis, CMD were associated with age, sex, religious identity, years of experience as a CHW with the Family Health Strategy (FHS), work neighborhood, activities in the community, considering the lack of bonding with families as an obstacle, having suffered domestic violence, use of medication for emotional dysregulation, identifying the neighborhood as violent, considering violence a physical or mental health determinant, and identifying impunity as a cause of violence. Thus, the work and mental health of CHWs were significantly affected by violence dimensions. Our findings are relevant to the adoption of strategies to mitigate the effects of violence on the work and mental health of CHWs.
publishDate 2023
dc.date.none.fl_str_mv 2023-01-13
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dc.identifier.uri.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8102
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8102/18164
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dc.publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
dc.source.none.fl_str_mv Reports in Public Health; Vol. 38 No. 12 (2022): December
Cadernos de Saúde Pública; v. 38 n. 12 (2022): Dezembro
1678-4464
0102-311X
reponame:Cadernos de Saúde Pública
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Cadernos de Saúde Pública
collection Cadernos de Saúde Pública
repository.name.fl_str_mv Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br
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