Title:	Effects of working in vulnerable contexts on the mental health of primary healthcare professionals during the COVID-19 pandemic : a mixed-methods study
Authors:	Miranda, Kleverson Gomes de Silva, Izabel Cristina Rodrigues da Fonseca, Rafaela Maria Alves Martins Gallassi, Andrea Donatti
metadata.dc.identifier.orcid:	https://orcid.org/0000-0003-0510-2471 https://orcid.org/0000-0003-1852-485X
metadata.dc.contributor.affiliation:	Universidade de Brasilia, Programa de Pós-Graduação em Ciências e Tecnologias em Saúde Universidade de Brasilia, Programa de Pós-Graduação em Ciências e Tecnologias em Saúde Universidade de Brasilia, Programa de Pós-Graduação em Ciências e Tecnologias em Saúde Universidade de Brasilia, Programa de Pós-Graduação em Ciências e Tecnologias em Saúde Universidade de Brasilia, Centro de Referência sobre Drogas e Vulnerabilidades Associadas
Assunto::	Saúde mental Profissionais da saúde Covid-19
Issue Date:	Nov-2023
Publisher:	BMJ
Citation:	MIRANDA, Kleverson Gomes et al. Effects of working in vulnerable contexts on the mental health of primary healthcare professionals during the COVID-19 pandemic: a mixed-methods study. DOI: https://doi.org/10.1136/bmjopen-2023-073472. Disponível em: https://bmjopen.bmj.com/content/13/11/e073472. Acesso em: 24 ago. 2026.
Abstract:	Objective The objective of this study is to analyse the relationship and psychosocial issues between working during the COVID-19 pandemic in primary healthcare (PHC) facilities located in the most vulnerable health region (HR) of the Federal District of Brazil (FDB) compared with a lesser region. Design Mixed-method study data. The questionnaire was based on the World Health Survey and the Convid Behavioural Survey. Quantitative data were described in absolute and relative frequency. Pearson’s χ 2 test verified differences according to the region (significance level <5%). A margin of error of 8% with 95% CI defined the sample. The content analysis (by Bardin) analysed the qualitative data. Setting A representative sample of PHC professionals working at the Western HR and Central HR of the FDB. Participants 111 women and 27 male PHC professionals, aged ≥ 18 years. Outcome measures Psychosocial variables—personal emotions towards the clients, social relationships and use of psychoactive substances (PAS). Intervention An online questionnaire (27 questions) and 1 open-ended question. Results The sample comprised 138 PHC professionals; 80.40% were female aged between 40 and 49 years old (27.3%); declared themselves as black/pardo (58.7%); were married (53.60%), and worked in family healthcare teams (47.80%). No association between working in the most vulnerable HR compared with the least one and presenting psychosocial issues, except for anger towards clients (p=0.043). 55.10% worked much more than usual, 60.80% reported being depressed, 78.20% anxious, 76.80% stressed, 77.50% had no empathy and 78.30% felt isolated from family/friends. Towards the clients, 59.40% reported empathy and 72.5% no affection/care. The consume of psychotropic medications was reported by 34.80%, and 14.50% increased alcohol/PAS use. Qualitative data leverage quantitative findings: work overload, the indifference of the Federal Government and distance from family/friends. Conclusion Working in the most vulnerable region and in the least one affects the psychosocial aspects of the PHC professionals equally.
metadata.dc.description.unidade:	Faculdade de Ciências e Tecnologias em Saúde (FCTS) – Campus UnB Ceilândia
metadata.dc.description.ppg:	Programa de Pós-Graduação em Ciências e Tecnologias em Saúde
Licença::	This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
DOI:	https://doi.org/10.1136/bmjopen-2023-073472
Appears in Collections:	Artigos publicados em periódicos e afins UnB - Covid-19

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