Prevalência de fadiga por compaixão e sua associação com a exposição ocupacional à violência e o risco de adoecimento psíquico entre policiais da perícia forense do Ceará

Abstract

Occupational exposure to violence represents a risk factor for mental illness among public safety professionals, especially in the context of forensic science. Continuous work with trauma victims can cause mental disorders, notably compassion fatigue (CF), a phenomenon composed of Burnout (BO) and Secondary Traumatic Stress (STS). This condition can be mitigated by Compassion Satisfaction (CS), which arises when the professional feels fulfilled by helping others, and is associated with self-compassion and emotional regulation. This study analyzed the prevalence of CF and its association with exposure to violence and the risk of mental illness among police officers of the Forensic Science Department of Ceará (PEFOCE). This is a cross-sectional, analytical study, a subset of the research project "Experienced Violence, Health Conditions and Illness among Civil and Military Police Officers in the State of Ceará," conducted with police officers from PEFOCE. A structured online questionnaire was used, encompassing the FC (outcome) and sociodemographic variables, work characteristics, lifestyle habits, exposure to violence, common mental disorders (CMD), suicidal ideation, and substance use disorder (SUD). Absolute and relative frequencies were obtained; the prevalence ratio (PR) was calculated to analyze the association between exposures and the outcome; multivariate analysis of factors associated with FC was performed; and Spearman's correlation test was used between the BO, ETS, and SC scales. The analysis was performed taking into account the sampling design, using SPSS 21.0 software, considering a 95% confidence interval. The results indicated a predominance of men (67.1%), Black/mixed-race individuals (56.0%), an average age of 39.4 years, religious beliefs (84.1%), and postgraduate education (66.8%). The majority worked in Fortaleza (53.5%), on shift work (88.1%), with more than six years of service (55.3%). Almost half had another job and intended to change jobs (45.3%). Despite a relatively healthy lifestyle (fruit consumption: 82%; physical activity: 79.5%), 39.8% engaged in excessive screen time during their free time. The work environment was marked by high exposure to violence (93.1%), mainly in assisting victims and their families (75.3%). The prevalence of chronic violence was 58.9%, predominantly influenced by police reports (moderate level in 55.2%). Social security showed a favorable profile (only 3% with a low level), acting as a moderating factor. There was a moderate negative correlation between BO and SC (-0.38), and a moderate positive correlation between BO and ETS (0.36). In the bivariate analysis, factors such as living with up to two people and the absence of chemical dependency were protective; while poor financial health, intention to rotate jobs, harmful use of screens, lack of mental health activities, police victimization, risk of injury/death, victim care, mental distress, and suicide risk were risk factors. In the multivariate analysis, the risk factors for CF were: attending to victims of violence (PR=1.407), harmful use of screens (PR=1.326), activities with high cognitive and psychosocial demands (PR=1.504), mental distress (PR=1.672), and intention to rotate jobs (PR=1.280). It is concluded that compassion fatigue is an important health problem among forensic experts, directly associated with occupational exposure to violence and the risk of other mental disorders. The findings reinforce the urgent need to implement institutional strategies focused on prevention, monitoring, and mental health care for this vulnerable population.