Condições de trabalho e saúde mental de enfermeiros da Estratégia Saúde da Família de uma região serrana do Ceará pós pandemia da covid-19

Abstract

Primary Health Care (PHC) constitutes the gateway for users to the Unified Health System (SUS) and is responsible for organizing health care networks. To ensure compliance with the principles and guidelines established by SUS, PHC relies on a team of professionals within the Family Health Strategy (FHS), including nurses. The work environment can be considered a risk factor for distress and, consequently, for the illness of health professionals. Psychosocial risks can influence nursing practices, as the relationship between mental health and work is deeply interconnected. Discussions on health work processes have become essential to understand the structure of health care delivery, especially when assessing the production of subjectivities arising from power relations, which are crucial to the analysis of care provision and training in the health field. This study aimed to evaluate the working conditions of Family Health Strategy nurses in a mountainous region of Ceará, Brazil, after the Covid-19 pandemic, and their relationship with mental health, also considering sociodemographic characteristics and labor market insertion. A mixed-methods study with a sequential explanatory design was conducted in two phases: quantitative and qualitative. Data collection instruments included a sociodemographic and professional questionnaire, the Work and Illness Risk Inventory (ITRA), and the Depression, Anxiety and Stress Scale (DASS-21), applied to 28 nurses in the first phase. In the second phase, semi-structured interviews were conducted with 12 nurses until theoretical data saturation was reached. Data were collected between May and August 2025. Quantitative results were consolidated into tables using descriptive statistics and Spearman’s correlation, while qualitative results were analyzed through Bardin’s content analysis. The study was approved by the Research Ethics Committee of Vale do Acaraú State University (UVA), under approval number 7.449.295/2025 and CAAE 86725625.4.0000.5053. The findings reveal a lack of investment in the nurses’ work environment, which affects work organization and interpersonal relationships. Levels of anxiety, stress, and depression remained within normal ranges. It is concluded that the lack of institutional investment in workers’ quality of life negatively impacts work performance. Moreover, nurses tend to adopt individual rather than collective coping strategies to deal with work-related distress. The few experiences of satisfaction reported by these professionals stem from community recognition of their work.