Abstract BACKGROUND: Brazil’s Family Health Strategy is based on a primary healthcare model, which is considered to have case resolution capacity, with physicians at its center. OBJECTIVES: To evaluate the levels of occupational stress and work engagement among primary healthcare physicians. DESIGN AND SETTING: Cross-sectional study conducted in 2017, in São José do Rio Preto, São Paulo, Brazil. METHODS: A non-probability sample including 32 physicians from family health teams was used. Three self-applied instruments were used: a scale developed by the researchers seeking sociodemographic and professional variables, the Work Stress Scale and the Utrecht Work Engagement Scale. RESULTS: Female professionals (59.4%), permanent employees (56.3%), workload of 40 hours per week (59.4%) and 3-10 years of acting in primary care (68.8%) were more prevalent. Six professionals (19.4%) exhibited significant stress (score ≥ 2.5). The main stressors were lack of prospects for career growth (2.9 ± 1.3), form of task distribution (2.7 ± 1.0), poor training (2.7 ± 1.2) and insufficient time to perform the job (2.6 ± 1.2). Levels of work engagement ranged from 4.3 to 4.6 and were rated as high in all dimensions. Physicians with occupational stress had average levels of work engagement, whereas those without occupational stress had high levels of work commitment. CONCLUSIONS: A notable percentage of the physicians were experiencing occupational stress. The physicians had high levels of work engagement. Occupational stress was negatively correlated with work engagement, and it significantly compromised physicians’ levels of work engagement and interfered with their positive relationship with the work environment.

Abstract BACKGROUND: Brazil’s Family Health Strategy is based on a primary healthcare model, which is considered to have case resolution capacity, with physicians at its center. OBJECTIVES: To evaluate the levels of occupational stress and work engagement among primary healthcare physicians. DESIGN AND SETTING: Cross-sectional study conducted in 2017, in São José do Rio Preto, São Paulo, Brazil. METHODS: A non-probability sample including 32 physicians from family health teams was used. Three self-applied instruments were used: a scale developed by the researchers seeking sociodemographic and professional variables, the Work Stress Scale and the Utrecht Work Engagement Scale. RESULTS: Female professionals (59.4%), permanent employees (56.3%), workload of 40 hours per week (59.4%) and 3-10 years of acting in primary care (68.8%) were more prevalent. Six professionals (19.4%) exhibited significant stress (score ≥ 2.5). The main stressors were lack of prospects for career growth (2.9 ± 1.3), form of task distribution (2.7 ± 1.0), poor training (2.7 ± 1.2) and insufficient time to perform the job (2.6 ± 1.2). Levels of work engagement ranged from 4.3 to 4.6 and were rated as high in all dimensions. Physicians with occupational stress had average levels of work engagement, whereas those without occupational stress had high levels of work commitment. CONCLUSIONS: A notable percentage of the physicians were experiencing occupational stress. The physicians had high levels of work engagement. Occupational stress was negatively correlated with work engagement, and it significantly compromised physicians’ levels of work engagement and interfered with their positive relationship with the work environment.

RESUMO Objetivo: Avaliar o comprometimento e o entrincheiramento com a carreira entre enfermeiros de serviços da Atenção Primária à Saúde. Método: Trata-se de um estudo transversal, realizado em 2018, com enfermeiros da atenção primária de dois municípios paulistas. Foram utilizadas as Escalas de Comprometimento e de Entrincheiramento com a Carreira, validadas no Brasil, e composta por 12 itens cada, que avaliam: identidade, resiliência e planejamento, relacionados ao comprometimento; custos emocionais, investimentos e limitação de alternativas na carreira, referentes ao entrincheiramento. Resultados: O escore médio do comprometimento (61,4 pontos) foi maior do que o de entrincheiramento com a carreira (57,8 pontos); o fator identidade obteve nível alto (70,9 pontos); resiliência e planejamento na carreira obtiveram níveis médios (62,5 e 50,8 pontos, respectivamente). O entrincheiramento com a carreira (57,8 pontos) e seus respectivos fatores atingiram níveis médios (investimentos: 57,7 pontos; limitação de alternativas: 58,8 pontos; custos emocionais: 57,0 pontos). Conclusão: Os enfermeiros apresentaram predomínio do vínculo de comprometimento com a carreira, pois apresentaram maior vínculo de identificação e relação positiva do que de estagnação com a carreira.

ABSTRACT Objective: To assess career commitment and entrenchment among Primary Care nurses. Method: This is a cross-sectional study, carried out in 2018, with primary care nurses from two cities in the state of São Paulo. The Career Commitment and Entrenchment Scales, validated in Brazil, and consisting of 12 items each, were used, and assess: identity, resilience, and planning, related to commitment; emotional costs, investments, and limitation of career alternatives, related to entrenchment. Results: The mean score of career commitment (61.4 points) was higher than that of career entrenchment (57.8 points); the identity factor had a high level (70.9 points); resilience and career planning obtained medium levels (62.5 and 50.8 points, respectively). Career entrenchment (57.8 points) and its respective factors reached medium levels (investments: 57.7 points; limitation of alternatives: 58.8 points; emotional costs: 57.0 points). Conclusion: The nurses showed a predominance of the career commitment relationship, as they showed a greater link of identification and positive relationship than of career stagnation.

RESUMEN Objetivo: Evaluar el compromiso y el atrincheramiento con la carrera entre enfermeros de cuidados de la Atención Primaria a la Salud. Método: Ha sido realizado un estudio transversal en 2018, con enfermeros de la atención primaria de dos ciudades paulistas. Se utilizaron las Escalas de Compromiso y de Atrincheramiento con la Carrera, convalidadas en Brasil, y compuesta por 12 temas cada, que evalúan: identidad, resiliencia y planificación, relacionados al compromiso; costos emocionales, inversiones y limitación de alternativas en la carrera, referentes al atrincheramiento. Resultados: El score promedio del compromiso (61,4 puntos) fue mayor del que el de atrincheramiento con la carrera (57,8 puntos); el factor identidad obtuvo nivel alto (70,9 puntos); resiliencia y planificación en la carrera obtuvieron niveles medios (62,5 y 50,8 puntos, respectivamente). El atrincheramiento con la carrera (57,8 puntos) y sus respectivos factores obtuvieron niveles medios (inversiones: 57,7 puntos; limitación de alternativas: 58,8 puntos; costos emocionales: 57,0 puntos). Conclusión: Los enfermeros presentaron en mayor proporción gran vínculo de compromiso con la carrera, una vez que presentaron mayor vínculo de identificación y relación positiva, más que de estagnación con la carrera.