COVID-19 CONTAMINATION, CHANGES IN WORK ROUTINE, AND THE IMPACTS ON THE MENTAL HEALTH OF PRIMARY CARE PROFESSIONALS IN SALVADOR-BA, BRAZIL, 2022
Main Article Content
Abstract
The COVID-19 pandemic was a public health emergency between 2020 and 2022 with a direct impact on the lives of health professionals. The objective of the study was to identify the prevalence of contamination of the disease in primary care professionals in Salvador-Ba, Brazil, work activities changed by the pandemic, and the impacts on the mental health of these professionals. A cross-sectional study was carried out, and the reference population was the universe of professionals with higher and secondary education (N=1675) who worked in the network. An electronic form was applied from December 2021 to April 2022, including socioeconomic and demographic issues, health history and comorbidities, routine and working hours, contamination by COVID-19, and evaluation of the emotional aspects of these professionals through the application of the Anxiety Scale (GAD-7) and Burnout Syndrome (Maslach Burnout Inventory) questionnaire. A descriptive analysis of the variables of interest was performed using central tendency and dispersion measures and absolute and relative frequencies. 321 workers participated in the study, 97.20% with a workload of 40 hours per week. The female gender was the majority - 83.18%, married marital status with 57.94% and having a postgraduate degree was the most present level of education (48.50%). Among the comorbidities, hypertension had the highest occurrence (10.59%). 80.7% of health professionals revealed that they participated in the screening team (reception) of patients with or suspected of COVID-19 and in the organization of vaccination. Contamination by COVID-19 was 64.79%, and 41.83% attributed it to work activity. Of the total, 67.28% of workers had some type of anxiety intensity. Regarding the Burnout indices, it was observed that 47.06% had a high level of emotional exhaustion, 68.84% had a high level of depersonalization, and 99.06% considered their professional fulfillment to be low.
Article Details
How to Cite
D´AGOSTINO, Erica Santana et al.
COVID-19 CONTAMINATION, CHANGES IN WORK ROUTINE, AND THE IMPACTS ON THE MENTAL HEALTH OF PRIMARY CARE PROFESSIONALS IN SALVADOR-BA, BRAZIL, 2022.
Medical Research Archives, [S.l.], v. 13, n. 5, may 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6515>. Date accessed: 23 june 2025.
doi: https://doi.org/10.18103/mra.v13i5.6515.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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10. Ziani JS, Harter J, Zuge BL, Pellegrini DCP, Busanelo J, Herrera KHS. Infection and the use of personal protective equipment among Primary Health Care workers during the COVID-19 pandemic. Rev Lat Am Enfermagem. 2024;32:e4290. https://doi.org/10.1590/1518-8345.6870.4290
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15. Aragones E, Cura-Gonzales ID, Hernandez-Rivas L, Polentinos-Castro E, San-Martín MIF, López-Rodriguez JA et al. Psychological impact of the COVID-19 pandemic on primary care workers: a cross-sectional study. Br J Gen Pract. 2022;72(720):e501–e510. https://doi.org/ 10.3399/BJGP.2021.0691.
16. Denning M, Goh ET, Tan B, Kanneganti A, Almonte M, Scott A, Martin G et al. Determinants of burnout and other aspects of psychological well-being in healthcare workers during the COVID-19 pandemic: a multinational cross-sectional study. PLoS One. 2021;16(4):e0238666. https://doi.org/10.1371/journal.pone.0238666
17. Cohen M, Cruz LN, Cardoso RB, Albuquerque MFPM, Montarroyos UR, Souza WV et al. Impact of the COVID-19 pandemic on the mental health of frontline healthcare workers in a highly affected region in Brazil. BMC Psychiatry. 2023;23(255). https://doi.org/10.1186/s12888-023-04702-2
18. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–1097. https://doi.org/10.1001/archinte.166.10.1092
19. Maslach C, Jackson SE. The measurement of experienced burnout. J Organ Behav. 1981;2(2):99–113. https://doi.org/10.1002/job.4030020205
20. Garcia-Sierra RMG, Perich EB, Dominguez JMM, Milalan NM, Cintas VS, Martínez MR et al. Descriptive study of the health services of a primary care department confined by COVID-19. Rev Esp Salud Publica. 2020;94:e202009106. PMID: 32880381
21. Algado-Selles N, Gras-Valenti P, Chico-Sanchez P, Mora-Muriel JG, Soler-Molina VM, Maldonado MH et al. Frequency, associated risk factors, and characteristics of COVID-19 among healthcare personnel in a Spanish Health Department. Am J Prev Med. 2020;59(6):e221–e229. https://doi.org/10.1016/j.amepre.2020.07.014
22. Gallasch CH, Silva RFA, Faria MGA, Lourenção DCA, Pires MP, Almeida MCS et al. Prevalence of COVID-19 testing among health workers providing care for suspected and confirmed cases. Rev Bras Med Trab. 2021;19(2):209–213. https://doi.org/10.47626/1679-4435-2020-722
23. Ferreira ARB, Neves JV, Lucas VM, et al. Prevalência da Síndrome de Burnout em profissionais da Atenção Primária durante a pandemia do Covid-19. Rev Bras Qual Vida. 2022;14:e14995. https://doi.org/10.3895/rbqv.v14n0.14995
24. Krist AH, Devoe JE, Cheng A, Ehrlich T, Jones SM. Redesigning primary care to address the COVID-19 pandemic amid pandemic. Ann Fam Med. 2020;18(4):349–354. https://doi.org/10.1370/afm.2557
25. Oliveira LMS, Gomes NP, Oliveira ES, Santos AA, Pedreira LC. Estratégia de enfrentamento para Covid-19 na atenção primária à saúde: relato de experiência em Salvador-BA. Rev Gaúcha Enferm. 2021;42:e20200138. https://doi.org/10.1590/1983-1447.2021.20200138
26. Sarti TD, Lazarini WS, Fontenelle LF, Almeida APSC. What is the role of Primary Health Care in the COVID-19 pandemic? Epidemiol Serv Saude. 2020;29(2):e2020166. https://doi.org/10.5123/s1679-49742020000200024
27. Silva BRG, Correa APV, Uehara SCDSA. Primary health care organization in the COVID-19 pandemic: scoping review. Rev Saude Publica. 2022;56:94. https://doi.org/10.11606/s1518-8787.2022056004374
28. Lourenço GM, Stefanello S, Kawanishi JY, Da Luz JAB, Silva GQ, Neto PP. A experiência de telemonitoramento por equipes de saúde da família em uma Unidade Básica de Saúde: breve relato. J Manag Prim Health Care. 2021;13:e019. https://doi.org/10.14295/jmphc.v13.1168
29. Brazil. Medida Provisória nº 970, de 22 de março de 2020. Accessed April 2025. http://planalto.gov.br/ccivil_03/_ato2019-2022/mpv/mpv927.htm
30. Shi LSB, Xu RH, Xia Y, Chen DX, Wang D. The impact of COVID-19-related work stress on the mental health of primary healthcare workers: the mediating effects of social support and resilience. Front Psychol. 2022;12:800183.
31. Lobo BLV, Almeida PC, Cabral M. COVID-19 e a saúde mental de médicos residentes na atenção primária: medo, ansiedade e depressão. Rev Bras Med Fam Comunidade. 2022;17(44):e3163. https://doi.org/10.5712/rbmfc17(44)3163
32. Maroto MAM. Resilience as a predictor of the negative impact (depression, anxiety, and stress) of COVID-19 in primary care physicians. Med Fam Semergen. 2022;48(7):e101813. https://doi.org/10.1016/j.semerg.2022.101813
33. Pedrosa AN, Bitencourt L, Fróes ACF, Cazumbá MLB, Campos RGB, Brito SBCS, Silva ACS. Emotional, behavioral, and psychological impact of the COVID-19 pandemic. Front Psychol. 2020;11:566212. https://doi.org/10.3389/fpsyg.2020.566212
34. Santos HMM, Fontes CJF, Lima DS. Síndrome de Burnout e qualidade de vida dos profissionais da atenção primária à saúde durante a pandemia de COVID-19, em município da Amazônia Brasileira. Debates em Psiquiatria. 2022;12:1-19. https://doi.org/10.25118/2763-9037.2022.v12.410
35. Baptista S, Teixeira A, Castro L, Cunha M, Serrão C, Rodrigues A et al. Physician burnout in primary care during the COVID-19 pandemic: a cross-sectional study in Portugal. J Prim Care Community Health. 2021;12:1-9. https://doi.org/10.1177/21501327211008437
36. Lasalvia A, Rigon G, Rugiu C, Negri C, Del Zotti F, Amaddeo, Bonetto C. The psychological impact of COVID-19 among primary care physicians in the province of Verona, Italy: a cross-sectional study during the first pandemic wave. Fam Pract. 2022;39(1):65-73. https://doi.org/10.1093/fampra/cmab080
37. Apaydin EA, Rose DE, Yano EM, Shekelle PG, McGowan MG, Antonini TL et al. Burnout among primary care healthcare workers during the COVID-19 pandemic. J Occup Environ Med. 2021;63(8):642-645. doi:10.1097/JOM.0000000000002220
2. Botacin GW, Gonçalves DM. Estratégia de Saúde da Família: atuação e desafios frente ao cenário de COVID-19. Cad Ibero-Am Dir Sanit. 2022;11(4):67–85. https://doi.org/10.17566/ciads.v11i4.872
3. Kozhekenova N, Moiynbayeva S, Jeremic D, Dinic M, Semenov P, Nurgaliyeva Z et al. The burden of COVID-19 in primary care of Almaty, Kazakhstan, 2021-2022. Sci Rep. 2025;15(1):5186. https://doi.org/10.1038/s41598-025-89707-5
4. Guimarães FG, Carvalho TML, Bernardes RM, Pinto J. A organização da atenção Primária à Saúde de Belo Horizonte no enfrentamento da Pandemia Covid-19: relato de experiência. APS Rev. 2020;2(2):74–82. https://doi.org/10.14295/aps.v2i2.128
5. Ares-Blanco S, Guisado-Clavero M, Del Rio LR, Larrondo IG, Fitzgerald L, Adler L et al. Clinical pathway of COVID-19 patients in primary health care in 30 European countries: Eurodata study. Eur J Gen Pract. 2023;29(2):2182879. https://doi.org/10.1080/13814788.2023.2182879
6. Fernandez M, Fernandes LDAMM, Massuda A. A atenção Primária à Saúde na pandemia da COVID-19: uma análise dos planos de resposta à crise sanitária no Brasil. Rev Bras Med Fam Comunidade. 2022;17(44):3336. https://doi.org/10.5712/rbmfc17(44)3336
7. Centers for Disease Control and Prevention. Interim US guidance for risk assessment and public health management of healthcare personnel with potential exposure in a healthcare setting to patients with coronavirus disease (COVID-19). Published March 7, 2020. Accessed April 2025. https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html
8. World Health Organization. Operational considerations for case management of COVID-19 in a health facility and community: interim guidance. Published March 19, 2020. Accessed April 2025. http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid19/technical-guidance/2020/operational-considerations-for-case-managementof-covid-19-in-health-facility-and-community-interim-guidance,-19-march-2020
9. Santos RPO, Nunes JA, Dias NG, Lisboa AS, AntunesVH, Pereira EV et al. Condições de trabalho na atenção primária à saúde na pandemia de COVID-19: um panorama sobre Brasil e Portugal. Cienc Saude Colet. 2023;28(10):2979–2992. https://doi.org/10.1590/1413-812320232810.10002023
10. Ziani JS, Harter J, Zuge BL, Pellegrini DCP, Busanelo J, Herrera KHS. Infection and the use of personal protective equipment among Primary Health Care workers during the COVID-19 pandemic. Rev Lat Am Enfermagem. 2024;32:e4290. https://doi.org/10.1590/1518-8345.6870.4290
11. Ran L, Chen X, Wang Y, Wu W, Zhang L, Tan X. Risk factors of healthcare workers with coronavirus disease 2019: a retrospective cohort study in a designated hospital of Wuhan in China. Clin Infect Dis. 2020;71(16):ciaa287. https://doi.org/10.1093/cid/ciaa287
12. Fio Cruz. Pinto F. COVID-19: Estudo avalia condições de trabalho na Saúde. Accessed April 2025. https://www.fiocruzbrasilia.fiocruz.br/covid-19-estudo-avalia-condicoes-de-trabalho-na-saude/
13. Correia RF, Da Costa ACC, Moore DCBC, Gomes Junior SC, Oliveira MPC, Zuma MCC, Galvani RG et al. SARS-CoV-2 seroprevalence and social inequalities in different subgroups of healthcare workers in Rio de Janeiro, Brazil. Lancet Reg Health Am. 2022;7:e100170. https://doi.org/10.1016/j.lana.2021.100170
14. Boucher VG, Dahl M, Lee J, Faulkner G, Beauchamp MR, Puterman E. An umbrella review and meta-analysis of 87 meta-analyses examining healthcare workers’ mental health during the COVID-19 pandemic. J Affect Disord. 2025;375:423–436. https://doi.org/10.1016/j.jad.2025.01.109
15. Aragones E, Cura-Gonzales ID, Hernandez-Rivas L, Polentinos-Castro E, San-Martín MIF, López-Rodriguez JA et al. Psychological impact of the COVID-19 pandemic on primary care workers: a cross-sectional study. Br J Gen Pract. 2022;72(720):e501–e510. https://doi.org/ 10.3399/BJGP.2021.0691.
16. Denning M, Goh ET, Tan B, Kanneganti A, Almonte M, Scott A, Martin G et al. Determinants of burnout and other aspects of psychological well-being in healthcare workers during the COVID-19 pandemic: a multinational cross-sectional study. PLoS One. 2021;16(4):e0238666. https://doi.org/10.1371/journal.pone.0238666
17. Cohen M, Cruz LN, Cardoso RB, Albuquerque MFPM, Montarroyos UR, Souza WV et al. Impact of the COVID-19 pandemic on the mental health of frontline healthcare workers in a highly affected region in Brazil. BMC Psychiatry. 2023;23(255). https://doi.org/10.1186/s12888-023-04702-2
18. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–1097. https://doi.org/10.1001/archinte.166.10.1092
19. Maslach C, Jackson SE. The measurement of experienced burnout. J Organ Behav. 1981;2(2):99–113. https://doi.org/10.1002/job.4030020205
20. Garcia-Sierra RMG, Perich EB, Dominguez JMM, Milalan NM, Cintas VS, Martínez MR et al. Descriptive study of the health services of a primary care department confined by COVID-19. Rev Esp Salud Publica. 2020;94:e202009106. PMID: 32880381
21. Algado-Selles N, Gras-Valenti P, Chico-Sanchez P, Mora-Muriel JG, Soler-Molina VM, Maldonado MH et al. Frequency, associated risk factors, and characteristics of COVID-19 among healthcare personnel in a Spanish Health Department. Am J Prev Med. 2020;59(6):e221–e229. https://doi.org/10.1016/j.amepre.2020.07.014
22. Gallasch CH, Silva RFA, Faria MGA, Lourenção DCA, Pires MP, Almeida MCS et al. Prevalence of COVID-19 testing among health workers providing care for suspected and confirmed cases. Rev Bras Med Trab. 2021;19(2):209–213. https://doi.org/10.47626/1679-4435-2020-722
23. Ferreira ARB, Neves JV, Lucas VM, et al. Prevalência da Síndrome de Burnout em profissionais da Atenção Primária durante a pandemia do Covid-19. Rev Bras Qual Vida. 2022;14:e14995. https://doi.org/10.3895/rbqv.v14n0.14995
24. Krist AH, Devoe JE, Cheng A, Ehrlich T, Jones SM. Redesigning primary care to address the COVID-19 pandemic amid pandemic. Ann Fam Med. 2020;18(4):349–354. https://doi.org/10.1370/afm.2557
25. Oliveira LMS, Gomes NP, Oliveira ES, Santos AA, Pedreira LC. Estratégia de enfrentamento para Covid-19 na atenção primária à saúde: relato de experiência em Salvador-BA. Rev Gaúcha Enferm. 2021;42:e20200138. https://doi.org/10.1590/1983-1447.2021.20200138
26. Sarti TD, Lazarini WS, Fontenelle LF, Almeida APSC. What is the role of Primary Health Care in the COVID-19 pandemic? Epidemiol Serv Saude. 2020;29(2):e2020166. https://doi.org/10.5123/s1679-49742020000200024
27. Silva BRG, Correa APV, Uehara SCDSA. Primary health care organization in the COVID-19 pandemic: scoping review. Rev Saude Publica. 2022;56:94. https://doi.org/10.11606/s1518-8787.2022056004374
28. Lourenço GM, Stefanello S, Kawanishi JY, Da Luz JAB, Silva GQ, Neto PP. A experiência de telemonitoramento por equipes de saúde da família em uma Unidade Básica de Saúde: breve relato. J Manag Prim Health Care. 2021;13:e019. https://doi.org/10.14295/jmphc.v13.1168
29. Brazil. Medida Provisória nº 970, de 22 de março de 2020. Accessed April 2025. http://planalto.gov.br/ccivil_03/_ato2019-2022/mpv/mpv927.htm
30. Shi LSB, Xu RH, Xia Y, Chen DX, Wang D. The impact of COVID-19-related work stress on the mental health of primary healthcare workers: the mediating effects of social support and resilience. Front Psychol. 2022;12:800183.
31. Lobo BLV, Almeida PC, Cabral M. COVID-19 e a saúde mental de médicos residentes na atenção primária: medo, ansiedade e depressão. Rev Bras Med Fam Comunidade. 2022;17(44):e3163. https://doi.org/10.5712/rbmfc17(44)3163
32. Maroto MAM. Resilience as a predictor of the negative impact (depression, anxiety, and stress) of COVID-19 in primary care physicians. Med Fam Semergen. 2022;48(7):e101813. https://doi.org/10.1016/j.semerg.2022.101813
33. Pedrosa AN, Bitencourt L, Fróes ACF, Cazumbá MLB, Campos RGB, Brito SBCS, Silva ACS. Emotional, behavioral, and psychological impact of the COVID-19 pandemic. Front Psychol. 2020;11:566212. https://doi.org/10.3389/fpsyg.2020.566212
34. Santos HMM, Fontes CJF, Lima DS. Síndrome de Burnout e qualidade de vida dos profissionais da atenção primária à saúde durante a pandemia de COVID-19, em município da Amazônia Brasileira. Debates em Psiquiatria. 2022;12:1-19. https://doi.org/10.25118/2763-9037.2022.v12.410
35. Baptista S, Teixeira A, Castro L, Cunha M, Serrão C, Rodrigues A et al. Physician burnout in primary care during the COVID-19 pandemic: a cross-sectional study in Portugal. J Prim Care Community Health. 2021;12:1-9. https://doi.org/10.1177/21501327211008437
36. Lasalvia A, Rigon G, Rugiu C, Negri C, Del Zotti F, Amaddeo, Bonetto C. The psychological impact of COVID-19 among primary care physicians in the province of Verona, Italy: a cross-sectional study during the first pandemic wave. Fam Pract. 2022;39(1):65-73. https://doi.org/10.1093/fampra/cmab080
37. Apaydin EA, Rose DE, Yano EM, Shekelle PG, McGowan MG, Antonini TL et al. Burnout among primary care healthcare workers during the COVID-19 pandemic. J Occup Environ Med. 2021;63(8):642-645. doi:10.1097/JOM.0000000000002220