Violence at work and depressive symptoms in primary health care teams: a cross-sectional study in Brazil

Author(s)

Correia da Silva, Andrea Tenorio ^{[1, 2]} ; Tourinho Peres, Maria Fernanda ^[1] ; Lopes, Claudia de Souza ^[3] ; Schraiber, Lilia Blima ^[1] ; Susser, Ezra ^{[4, 5]} ; Menezes, Paulo Rossi ^{[1, 2]}

Affiliation

^[1] Univ Sao Paulo, Sch Med, Dept Prevent Med, BR-01246903 Sao Paulo, SP - Brazil

^[2] NAPSaMP, Ctr Res Populat Mental Hlth, BR-01246903 Sao Paulo, SP - Brazil

^[3] Univ Estado Rio De Janeiro, Inst Social Med, Dept Epidemiol, BR-20559900 Rio De Janeiro, RJ - Brazil

^[4] Columbia Univ, Mailman Sch Publ Hlth, Dept Epidemiol, New York, NY 10032 - USA

^[5] New York State Psychiat Inst & Hosp, New York, NY 10032 - USA

• Document type: Journal article
• Source: Social Psychiatry and Psychiatric Epidemiology; v. 50, n. 9, p. 1347-1355, SEP 2015.
• Web of Science Citations: 16

Abstract

Implementation of primary care has long been a priority in low- and middle-income countries. Violence at work may hamper progress in this field. Hence, we examined the associations between violence at work and depressive symptoms/major depression in primary care teams (physicians, nurses, nursing assistants, and community health workers). A cross-sectional study was undertaken in the city of Sao Paulo, Brazil. We assessed a random sample of Family Health Program teams. We investigated depressive symptoms and major depression using the nine-item Patient Health Questionnaire (PHQ-9), and exposure to violence at work in the previous 12 months using a standardized questionnaire. Associations between exposure to violence and depressive symptoms/major depression were analyzed using multinomial logistic regression. Of 3141 eligible workers, 2940 (93 %) completed the interview. Of these, 36.3 % (95 % CI 34.6-38.1) presented intermediate depressive symptoms, and 16 % (95 % CI 14.6-17.2), probable major depression. The frequencies of exposure to the different types of violence at work were: insults (44.9 %), threats (24.8 %), physical aggression (2.3 %), and witnessing violence (29.5 %). These exposures were strongly and progressively associated with depressive symptoms (adjusted odds ratio 1.67 for exposure to one type of violence; and 5.10 for all four types), and probable major depression (adjusted odds ratio 1.84 for one type; and 14.34 for all four types). Primary care workers presenting depressive symptoms and those who have experienced violence at work should be assisted. Policy makers should prioritize strategies to prevent these problems, since they can threaten primary care sustainability. (AU)

• FAPESP's process: 10/07180-6 - Burnout and depression among health professionals from the family health strategy in the city of São Paulo
• Grantee: Paulo Rossi Menezes
• Support Opportunities: Regular Research Grants