Fatores de risco psicossocial e estresse no trabalho de enfermagem em hospital universitário: modelo desequilíbrio esforço - recompensa

Abstract

The present study has as its theme the “factors of psychosocial risk and stress in nursing workers in hospital clinical unit of a university hospital”. In my empirical observations in the hospital that served as a field for this study, I identified that part of the institution’s workers accumulated double employment bond, worked extensive shifts and felt worn out physically and mentally due to the requirements of the work itself in terms of physical, cognitive and psychomotor efforts. Added to the problem is the outsourcing of part of the nursing service, whose staff was being composed of workers with unstable employment bonds. From the above, the objectives of the study are: check the efforts and rewards from the effort-reward imbalance (ERI) model in a sample of nursing workers; discuss the relationship between ERI and the sociodemographic and occupational characteristics in a sample of nursing workers; analyze the stress resulting from the absence of reciprocity between effort and rewards of clinical work in a sample of hospital nursing workers. Cross-sectional, quantitative and descriptive study, whose fields were the clinical hospitalization units of a public university hospital situated in the city of Rio de Janeiro. Recruitment of participants was conducted through data survey, being elected as participants to the study the employees who met the following inclusion criteria: nursing workers (nurses, technicians and nursing assistants) with statutory or temporary employment bonds who exercised their activities as of 6 months in the service. Workers with less than 6 months in service, on leave for treatment of health problems, other medical leaves and sector managers were excluded. The instruments used for data collection were the Effort Reward Imbalance Questionnaire (SIEGRIST, 1996), validated for use in Brazil by Chor (2008), and a tool for the characterization of sociodemographic, health and occupational data of the sample. The data collection was performed at the institution itself, after the authorization of the study by the Board of Ethics in Research (BER) and signature of the Informed Consent Form (ICF). Results: from a population of 160 employees, the sample consisted of 110 participants, mostly female (87%), older than 45 years (48%), secondary education level (51%), married (50%) statutory employment bond (64%), civil employment bond (36%) and household income of 3 to 5 minimum wages. About the efforts and rewards at work, the application of the ERI scale verified that from the total sample, 88 (80%) workers were “not exposed” (balance) and the remaining 22 (20%) were “exposed” (unbalance), therefore with psychosocial stress risk. Only the family income and the type of labor bond have been associated with the ERI (p < 0.005). It is concluded that further investigations are needed in view of the current productive restructuring being a psychosocial risk factor for occupational stress. A proper evaluation of psychosocial risks in hospital nursing work must be carried out so they can be corrected or prevented with a view to reducing the problems of psychosocial stress.