RESUMO Objetivo Analisar os indicadores de prazer e sofrimento no trabalho associados a depressão e ansiedade entre agentes comunitários de saúde (ACSs). Métodos Estudo transversal, no qual variáveis dependentes foram a presença de sintomas de ansiedade e depressão, avaliadas com o Patient Health Questionnaire (PHQ-9) e com o Inventário de Ansiedade de Traço-Estado (IDATE). As variáveis independentes foram avaliadas com um questionário sociodemográfico e a Escala de Indicadores de Prazer e Sofrimento no Trabalho (EIPST) do Inventário do Trabalho e Riscos de Adoecimento (ITRA). As associações entre as variáveis foram testadas com o uso de regressão logística multinominal. Resultados Participaram do estudo 675 ACSs, sendo a maioria mulheres (83,7%), com até 40 anos (51,3%). As chances de apresentar sintomas de ansiedade foram maiores entre ACSs efetivos (1,61 [1,10-2,36]), e avaliações críticas ou graves nos fatores realização (Crítica 1,87 [1,30-2,68]; Grave 4,16 [2,06-8,40]) e esgotamento profissional (Crítica 2,60 [1,78-3,80]; Grave 3,97 [2,53-6,21]). Sexo feminino (2,12 [1,03-4,40]), idade de até 40 anos (1,741 [1,05-2,89]), tempo de serviço superior a cinco anos (1,88 [1,18-2,99]), avaliações crítica ou grave nos fatores realização (Crítica 2,53 [1,55-4,10]; Grave 6,07 [2,76-13,38]), esgotamento profissional (Crítica 5,21 [2,30-11,80]; Grave 15,64 [6,53-37,44]) e falta de reconhecimento (Crítica 1,93 [1,13-3,28]) estiveram associados a maiores chances de sintomas depressivos. Conclusões Apesar de se tratar de estudo transversal, que não permite inferir causalidade, os achados sugerem importante associação entre aspectos laborais dos ACS e os sintomas de ansiedade e depressão. Sexo feminino e possuir 40 anos ou menos também mostraram relação com o aumento dos sintomas de depressão. ACSs. . (ACSs) transversal PHQ9 PHQ 9 (PHQ-9 TraçoEstado Traço Estado IDATE. IDATE (IDATE) EIPST (EIPST ITRA. ITRA (ITRA) multinominal 67 83,7%, 837 83,7% , 83 7 (83,7%) 4 51,3%. 513 51,3% 51 3 (51,3%) 1,61 161 1 61 (1,6 1,102,36, 110236 1,10 2,36 10 2 36 [1,10-2,36]) Crítica 187 87 1,8 1,302,68 130268 1,30 2,68 30 68 [1,30-2,68] 416 16 4,1 2,068,40 206840 2,06 8,40 06 8 [2,06-8,40] 260 60 2,6 1,783,80 178380 1,78 3,80 78 80 [1,78-3,80] 397 97 3,9 2,536,21. 253621 6,21 53 6 21 [2,53-6,21]) 2,12 212 12 (2,1 1,034,40, 103440 1,03 4,40 03 [1,03-4,40]) 1,741 1741 741 (1,74 1,052,89, 105289 1,05 2,89 05 89 [1,05-2,89]) 1,88 188 88 (1,8 1,182,99, 118299 1,18 2,99 18 99 [1,18-2,99]) 253 2,5 1,554,10 155410 1,55 4,10 55 [1,55-4,10] 607 07 6,0 2,7613,38, 2761338 2,76 13,38 76 13 38 [2,76-13,38]) 521 5 5,2 2,3011,80 2301180 2,30 11,80 11 [2,30-11,80] 1564 15 64 15,6 6,5337,44 6533744 6,53 37,44 37 44 [6,53-37,44] 193 93 1,9 1,133,28 113328 1,13 3,28 28 [1,13-3,28] depressivos causalidade (ACSs (PHQ- (IDATE (ITRA 83,7 (83,7% 51,3 (51,3% 1,6 (1, 102 1,102,36 11023 110 1,1 236 2,3 [1,10-2,36] 1, 302 1,302,6 13026 130 1,3 268 [1,30-2,68 41 4, 068 2,068,4 20684 206 2,0 840 8,4 0 [2,06-8,40 26 2, 783 1,783,8 17838 178 1,7 380 3,8 [1,78-3,80 39 3, 536 2,536,21 25362 621 6,2 [2,53-6,21] 2,1 (2, 034 1,034,40 10344 103 1,0 440 4,4 [1,03-4,40] 1,74 174 74 (1,7 052 1,052,89 10528 105 289 2,8 [1,05-2,89] 182 1,182,99 11829 118 299 2,9 [1,18-2,99] 25 554 1,554,1 15541 155 1,5 410 [1,55-4,10 6, 7613 2,7613,38 276133 276 2,7 1338 13,3 [2,76-13,38] 52 5, 3011 2,3011,8 230118 230 1180 11,8 [2,30-11,80 156 15, 5337 6,5337,4 653374 653 6,5 3744 37,4 [6,53-37,44 19 133 1,133,2 11332 113 328 3,2 [1,13-3,28 (PHQ 83, (83,7 51, (51,3 (1 1,102,3 1102 23 [1,10-2,36 1,302, 1302 [1,30-2,6 2,068, 2068 20 84 8, [2,06-8,4 1,783, 1783 17 [1,78-3,8 2,536,2 2536 62 [2,53-6,21 (2 1,034,4 1034 [1,03-4,40 1,052,8 1052 [1,05-2,89 1,182,9 1182 29 [1,18-2,99 1,554, 1554 [1,55-4,1 761 2,7613,3 27613 27 13, [2,76-13,38 301 2,3011, 23011 11, [2,30-11,8 533 6,5337, 65337 65 374 37, [6,53-37,4 1,133, 1133 32 [1,13-3,2 (83, (51, ( 1,102, [1,10-2,3 1,302 [1,30-2, 2,068 [2,06-8, 1,783 [1,78-3, 2,536, [2,53-6,2 1,034, [1,03-4,4 1,052, [1,05-2,8 1,182, [1,18-2,9 1,554 [1,55-4, 2,7613, 2761 [2,76-13,3 2,3011 2301 [2,30-11, 6,5337 6533 [6,53-37, 1,133 [1,13-3, (83 (51 1,102 [1,10-2, [1,30-2 [2,06-8 [1,78-3 2,536 [2,53-6, 1,034 [1,03-4, 1,052 [1,05-2, 1,182 [1,18-2, [1,55-4 2,7613 [2,76-13, 2,301 [2,30-11 6,533 [6,53-37 [1,13-3 (8 (5 [1,10-2 [1,30- [2,06- [1,78- [2,53-6 [1,03-4 [1,05-2 [1,18-2 [1,55- 2,761 [2,76-13 [2,30-1 [6,53-3 [1,13- [1,10- [1,30 [2,06 [1,78 [2,53- [1,03- [1,05- [1,18- [1,55 [2,76-1 [2,30- [6,53- [1,13 [1,10 [1,3 [2,0 [1,7 [2,53 [1,03 [1,05 [1,18 [1,5 [2,76- [2,30 [6,53 [1,1 [1, [2, [2,5 [1,0 [2,76 [2,3 [6,5 [1 [2 [2,7 [6, [ [6
ABSTRACT Objective To analyze indicators of pleasure and suffering at work associated with depression and anxiety among community health workers (CHW). Methods Crosssectional study in which the dependent variables were the presence of anxiety and depression symptoms, assessed using the Patient Health Questionnaire (PHQ-9) and State-Trait Anxiety Inventory (STAI). The independent variables were evaluated using the Scale of Indicators of Pleasure and Suffering at Work (EIPST) of the Inventory of Work and Risks of Illness (ITRA). Associations between dependent and independent variables were tested using multinomial logistic regression. Results 675 CHW participated in the study, the majority being women (83.7%), aged up to 40 years (51.3%). The chances of presenting anxiety symptoms were higher among effective CHW (OR=1.61; 95%CI: 1.10-2.36), and critical or severe assessments in the achievement factors (Critical OR=1.87; 95%CI: 1.30-2.68; Severe OR=4.16; 95%CI: 2.06-8.40) and professional exhaustion (Critical OR=2.60; 95%CI: 1.78-3.80; Severe OR=3.97; 95% CI: 2.53-6.21). Female gender (OR=2.12; 95%CI: 1.03-4.40), age up to 40 years (OR=1.74; 95%CI: 1.05-2.89), length of service greater than five years (OR=1.88; 95%CI: 1.18-2.99), critical or severe ratings on achievement factors (Critical OR=2.53; 95%CI: 1.55-4.10; Severe OR= 6.07; 95%CI: 2.76-13.38), professional exhaustion (Critical OR=5.21; 95%CI: 2.30-11.80; Severe OR=15.64; 95%CI: 6.53 -37.44) and lack of recognition (Critical OR=1.93; 95%CI: 1.13-3.28) were associated with greater chances of depressive symptoms. Conclusions Despite being a cross-sectional study, which does not allow inferring causality, the findings suggest an important association between the work aspects of the CHW and the symptoms of anxiety and depression. Female gender and being 40 years old or younger also showed a relationship with increased symptoms of depression. CHW. . (CHW) PHQ9 PHQ 9 (PHQ-9 StateTrait State Trait STAI. STAI (STAI) EIPST (EIPST ITRA. ITRA (ITRA) regression 67 83.7%, 837 83.7% , 83 7 (83.7%) 4 51.3%. 513 51.3% 51 3 (51.3%) OR=1.61 OR161 OR 1 61 (OR=1.61 95%CI 95CI CI 95 1.102.36, 110236 1.10 2.36 10 2 36 1.10-2.36) Critical OR=1.87 OR187 87 1.302.68 130268 1.30 2.68 30 68 1.30-2.68 OR=4.16 OR416 16 2.068.40 206840 2.06 8.40 06 8 2.06-8.40 OR=2.60 OR260 60 1.783.80 178380 1.78 3.80 78 80 1.78-3.80 OR=3.97 OR397 97 2.536.21. 253621 2.53 6.21 53 6 21 2.53-6.21) OR=2.12 OR212 12 (OR=2.12 1.034.40, 103440 1.03 4.40 03 1.03-4.40) OR=1.74 OR174 74 (OR=1.74 1.052.89, 105289 1.05 2.89 05 89 1.05-2.89) OR=1.88 OR188 88 (OR=1.88 1.182.99, 118299 1.18 2.99 18 99 1.18-2.99) OR=2.53 OR253 1.554.10 155410 1.55 4.10 55 1.55-4.10 6.07 607 07 2.7613.38, 2761338 2.76 13.38 76 13 38 2.76-13.38) OR=5.21 OR521 5 2.3011.80 2301180 2.30 11.80 11 2.30-11.80 OR=15.64 OR1564 15 64 653 6.5 37.44 3744 37 44 -37.44 OR=1.93 OR193 93 1.133.28 113328 1.13 3.28 28 1.13-3.28 crosssectional cross sectional causality (CHW (PHQ- (STAI (ITRA 83.7 (83.7% 51.3 (51.3% OR=1.6 OR16 (OR=1.6 102 1.102.36 11023 110 1.1 236 2.3 1.10-2.36 OR=1.8 OR18 302 1.302.6 13026 130 1.3 268 2.6 1.30-2.6 OR=4.1 OR41 068 2.068.4 20684 206 2.0 840 8.4 0 2.06-8.4 OR=2.6 OR26 783 1.783.8 17838 178 1.7 380 3.8 1.78-3.8 OR=3.9 OR39 536 2.536.21 25362 253 2.5 621 6.2 2.53-6.21 OR=2.1 OR21 (OR=2.1 034 1.034.40 10344 103 1.0 440 4.4 1.03-4.40 OR=1.7 OR17 (OR=1.7 052 1.052.89 10528 105 289 2.8 1.05-2.89 (OR=1.8 182 1.182.99 11829 118 299 2.9 1.18-2.99 OR=2.5 OR25 554 1.554.1 15541 155 1.5 410 4.1 1.55-4.1 6.0 7613 2.7613.38 276133 276 2.7 1338 13.3 2.76-13.38 OR=5.2 OR52 3011 2.3011.8 230118 230 1180 11.8 2.30-11.8 OR=15.6 OR156 65 6. 37.4 374 -37.4 OR=1.9 OR19 133 1.133.2 11332 113 328 3.2 1.13-3.2 (PHQ 83. (83.7 51. (51.3 OR=1. OR1 (OR=1. 1.102.3 1102 1. 23 2. 1.10-2.3 1.302. 1302 26 1.30-2. OR=4. OR4 2.068. 2068 20 84 8. 2.06-8. OR=2. OR2 1.783. 1783 17 3. 1.78-3. OR=3. OR3 2.536.2 2536 25 62 2.53-6.2 (OR=2. 1.034.4 1034 4. 1.03-4.4 1.052.8 1052 1.05-2.8 1.182.9 1182 29 1.18-2.9 1.554. 1554 41 1.55-4. 761 2.7613.3 27613 27 13. 2.76-13.3 OR=5. OR5 301 2.3011. 23011 11. 2.30-11. OR=15. OR15 37. -37. 1.133. 1133 32 1.13-3. (83. (51. OR=1 (OR=1 1.102. 1.10-2. 1.302 1.30-2 OR=4 2.068 2.06-8 OR=2 1.783 1.78-3 OR=3 2.536. 2.53-6. (OR=2 1.034. 1.03-4. 1.052. 1.05-2. 1.182. 1.18-2. 1.554 1.55-4 2.7613. 2761 2.76-13. OR=5 2.3011 2301 2.30-11 OR=15 -37 1.133 1.13-3 (83 (51 (OR= 1.102 1.10-2 1.30- 2.06- 1.78- 2.536 2.53-6 1.034 1.03-4 1.052 1.05-2 1.182 1.18-2 1.55- 2.7613 2.76-13 2.301 2.30-1 -3 1.13- (8 (5 (OR 1.10- 2.53- 1.03- 1.05- 1.18- 2.761 2.76-1 2.30- - ( 2.76-