Associações de Mindfulness, estresse percebido e bem estar subjetivo entre profissionais da atenção primária a Saúde
Data
2013
Autores
Atanes, Ana Cristina Melo 
Orientadores
Demarzo, Marcelo Marcos Piva
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: há evidências de que profissionais da atenção primária à saúde (APS) apresentam níveis elevados de estresse percebido e sintomas de exaustão profissional (burnout) em relação à população em geral. O constructo de mindfulness se refere ao estado psicológico que emerge quando se auto regula a atenção para a experiência direta do momento presente, numa atitude não-crítica ou julgadora, e parece ser um fator moderador para a influência de níveis elevados de estresse para o desenvolvimento de exaustão emocional neste tipo de profissional. Objetivo: verificar a associação de mindfulness,
estresse percebido (EP) e bem estar subjetivo (BES) em profissionais da APS brasileiros. Método: estudo de corte transversal com abordagem quantitativa, que investiga profissionais de APS trabalhando na equipe mínima (médicos,
enfermeiros, auxiliares de enfermagem, e agentes comunitários de saúde - ACS) da estratégia da saúde da família (ESF) do bairro de Sapopemba em São Paulo-SP, por meio de instrumentos de auto relato: versão brasileira da Mindful Attention Awareness Scale (MAAS), Escala de Estresse Percebido (EEP)
e Escala de Bem Estar Subjetivo (EBES) com sub escalas de Afeto Positivo (EBES_AP), Afeto Negativo (EBES_AN) e Satisfação com a Vida (EBES_SV). Conduziu-se análise de variância multivariada (MANOVA), através de coeficiente de regressão (β) em relação às categorias profissionais e tempo de
serviço e verificou-se as correlações de Pearson entre as variáveis dependentes (ajustando-se por categoria profissional e tempo de serviço). Ainda, verificouse as propriedades da MAAS junto aos profissionais de APS em estudo: consistência interna através do coeficiente alfa de Cronbach (α) e correlação total excluindo um item; análise fatorial exploratória (EFA) e análise fatorial confirmatória (CFA). A qualidade do ajuste da estrutura foi calculada através de índice comparativo de ajustamento (CFI), raiz do erro quadrático médio (RMSEA), qui-quadrado (X²), índice normativo (NFI) e índice não normatizado (NNFI). Resultados: A MAAS apresentou qualidades psicométricas adequadas para a população estudada. Dentre os profissionais avaliados (N=450) 94% eram do sexo feminino e 83.1% trabalhavam na ESF há mais de 1 ano. Observou-se diferenças em relação à categoria profissional e ao tempo de serviço, quanto aos níveis de mindfulness, EP e BES. Médicos e enfermeiros apresentaram menores níveis de mindfulness e maiores níveis de EP em comparação às outras categorias profissionais. Maiores níveis em afeto negativo foram encontrados em enfermeiros, que junto com os ACSs apresentaram menor nível de afeto positivo. ACSs apresentaram ainda menores níveis de satisfação com a vida. Estar no mesmo serviço mais de 1 ano, associou-se a níveis elevados de EP e afeto negativo e diminuídos de BES afeto positivo e satisfação com a vida, mas não se correlacionou com
mindfulness. Conclusão: este estudo verifica associações entre mindfulness, EP e BES junto a profissionais da atenção primária à saúde do Brasil. Correlação negativa forte entre mindfulness e EP, evidenciaram que as categorias com menor nível de mindfulness foram respectivamente médicos e enfermeiros,
sendo estes também os mais estressados entre os profissionais de ESF. Tempo de serviço superior a um ano, demonstrou clara influência nos níveis de EP e BES independentemente da categoria profissional. Sugestões foram feitas na aplicação do instrumento MAAS para esta população.
Background: There are evidences that primary healthcare professionals (PHP) are known for displaying high levels of stress and burnout symptoms in relation to the general population. Mindfulness construct refers to the psychological state that emerges from self-regulated attention of direct experience of the present moment, in a non-critical or judgmental attitude, and it appears to be a moderate factor in the relation between high levels of stress and burnout development among this type of professional. Objective: to assess the associations of mindfulness, perceived stress (PS) and subject well-being (SW) across Brazilian PHP. Method: cross sectional quantitative study on all PHP (Assistant Nurses, Registered Nurses, Medical Personnel and Community Health Worker – CHW) working in the Family Health Program (FHP) on the area of Sapompemba, in São Paulo-SP, using self-report instruments: The Brazilian version of the Mindful Attention Awareness Scale (MAAS), Perceived Stress Scale (PSS) and Subjective Wellbeing Scale (SWS) with subscales: positive affect (SWS_PA), negative affect (SWS_NA) and satisfaction with life (SWS_SL). We performed a multivariate analysis of variance (MANOVA) through regression coefficient (β) in relation to the professional category, as well as, length of time in the job and verified Person´s correlations between the dependent variables (controlling by professional category and length of time in the job). We analyzed MAAS psychometric properties on the studied population: internal consistency with Cronbach´s alpha (α) and total correlation excluding one item; exploratory factorial analysis (EFA) and confirmatory factor analysis (CFA). Fit index was calculated by comparative fit index (CFI), root mean square error approximation (RMEA), chi-square (X²), normed fit index (NFI) and non-normed fit index (NNFI). Results: MAAS showed good psychometric properties for the related population. Amongst the participants (N=450) 94% were female and 83.1% had work period over 1 year. Differences were observed across professional categories and length of time in the job, in relation to mindfulness, PS and SW. Medical personnel and registered nurses demonstrated the lowest MAAS, and highest PS in relation to the other professional categories. Higher levels of negative affect were found in registered nurses, who showed with CHW, the lower positive affect. CHW also demonstrated the lower level of satisfaction with life. Being at work for 1 year or longer was associated to higher levels of PS and negative affect and lower levels of SW positive affect and satisfaction with life, but not with mindfulness. Conclusion: this study verifies associations between mindfulness PS and SW on PHP of Brazil. Strong negative correlation of mindfulness and PS evidenced that professional categories with the lowest level of mindfulness were medical personnel and registered nurses respectively, also showing the highest levels of PS amongst FHP. Time in the job longer than one year had a clear influence on PS and SW levels independently of professional category. Suggestions have been made on the applicability of MAAS.
Background: There are evidences that primary healthcare professionals (PHP) are known for displaying high levels of stress and burnout symptoms in relation to the general population. Mindfulness construct refers to the psychological state that emerges from self-regulated attention of direct experience of the present moment, in a non-critical or judgmental attitude, and it appears to be a moderate factor in the relation between high levels of stress and burnout development among this type of professional. Objective: to assess the associations of mindfulness, perceived stress (PS) and subject well-being (SW) across Brazilian PHP. Method: cross sectional quantitative study on all PHP (Assistant Nurses, Registered Nurses, Medical Personnel and Community Health Worker – CHW) working in the Family Health Program (FHP) on the area of Sapompemba, in São Paulo-SP, using self-report instruments: The Brazilian version of the Mindful Attention Awareness Scale (MAAS), Perceived Stress Scale (PSS) and Subjective Wellbeing Scale (SWS) with subscales: positive affect (SWS_PA), negative affect (SWS_NA) and satisfaction with life (SWS_SL). We performed a multivariate analysis of variance (MANOVA) through regression coefficient (β) in relation to the professional category, as well as, length of time in the job and verified Person´s correlations between the dependent variables (controlling by professional category and length of time in the job). We analyzed MAAS psychometric properties on the studied population: internal consistency with Cronbach´s alpha (α) and total correlation excluding one item; exploratory factorial analysis (EFA) and confirmatory factor analysis (CFA). Fit index was calculated by comparative fit index (CFI), root mean square error approximation (RMEA), chi-square (X²), normed fit index (NFI) and non-normed fit index (NNFI). Results: MAAS showed good psychometric properties for the related population. Amongst the participants (N=450) 94% were female and 83.1% had work period over 1 year. Differences were observed across professional categories and length of time in the job, in relation to mindfulness, PS and SW. Medical personnel and registered nurses demonstrated the lowest MAAS, and highest PS in relation to the other professional categories. Higher levels of negative affect were found in registered nurses, who showed with CHW, the lower positive affect. CHW also demonstrated the lower level of satisfaction with life. Being at work for 1 year or longer was associated to higher levels of PS and negative affect and lower levels of SW positive affect and satisfaction with life, but not with mindfulness. Conclusion: this study verifies associations between mindfulness PS and SW on PHP of Brazil. Strong negative correlation of mindfulness and PS evidenced that professional categories with the lowest level of mindfulness were medical personnel and registered nurses respectively, also showing the highest levels of PS amongst FHP. Time in the job longer than one year had a clear influence on PS and SW levels independently of professional category. Suggestions have been made on the applicability of MAAS.
Descrição
Citação
Atanes, Ana Cristina Melo. Associações de Mindfulness, estresse percebido e bem estar subjetivo entre profissionais da atenção primária a Saúde. Dissertação (Mestrado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2013.