Entre o prazer e o sofrimento : saúde mental e vivências de trabalhadores da atenção primária à saúde no interior do Tocantins.

Abstract

This study investigated the experiences of pleasure and suffering among primary health care (PHC) workers in a municipality in the interior of Tocantins, aiming to promote reflection on mental health at work. The research stemmed from the observation that, despite the strategic importance of these workers in the Brazilian Unified Health System (SUS), their working conditions are frequently marked by overload, precarious employment, and lack of institutional care, factors that have worsened with the Covid-19 pandemic. A Psicodinâmica do Trabalho (PDT) foi adotada como referencial teórico e metodológico para compreender os impactos subjetivos do trabalho na saúde mental desses trabalhadores. Utilizando uma abordagem qualiquantitativa, a pesquisa foi conduzida por meio de uma pesquisa-intervenção, com a aplicação de duas escalas validadas: a Escala de Indicadores de Prazer e Sofrimento e o Self Report Questionnaire, além da realização de grupos focais com trabalhadores da APS. The analysis of the information combined the use of the IRAMUTEQ software (quantitative) with the analysis proposed by Dejours, from the perspective of PDT (qualitative), allowing the identification of subjective aspects related to pleasure and psychic suffering, as well as individual and collective strategies for mediating the work context (defensive, coping, and resistance). The results revealed an ambivalence in professional experiences: on the one hand, the pleasure linked to recognition, the bond with users, and the social meaning of the work; on the other hand, the suffering related to the scarcity of resources, the accumulation of functions, the absence of institutional recognition, and the lack of support from users regarding the emotional demands of the workers themselves. As for mediation strategies, these were observed as attempts to maintain psychological balance in the face of adversity. Based on the intervention research, a technical product in the form of a card game was developed, with a pedagogical and playful function, aimed at stimulating reflections on mental health at work among primary health care workers. Finally, the work highlights the importance of recognizing psychological suffering in the context of primary health care as a collective and institutional phenomenon, and not only an individual one. Although this occurs, there are also moments of pleasure and recognition of the work, especially on the part of colleagues and users of the Brazilian Unified Health System (SUS). Furthermore, promoting the mental health of workers requires the creation of spaces for listening, recognition, and sharing, articulating theory, practice, and intervention. By valuing the experience of these workers and proposing a technical product for worker health care, this research contributes to strengthening public policies and more humanized institutional practices within the SUS (Brazilian Unified Health System), starting from the care for the mental health of these workers.