Transtorno de ansiedade generalizada e representações sociais dos trabalhadores da saúde com suspeita da Covid-19

Abstract

The aim of this research was to describe the protocol for monitoring health workers from the Bahia State Health Department with suspected or confirmed COVID-19; to understand the social representations (SR) of COVID-19 among health workers with suspected infection; to identify the presence of generalized anxiety disorder (GAD) among these workers and associated factors; and to compare the social representations (SR) of workers with suspected COVID-19 with and without GAD. This was a mixed-method, qualitative and quantitative study carried out at the COVID-19 Testing Center, between February and August 2022, with 152 health professionals. Data collection used sociodemographic and occupational characterization instruments, the TAG Questionnaire (GAD-7) and the Free Word Association Technique. The quantitative analysis used descriptive statistics, Pearson's chi-square test or Fisher's exact test, the odds ratio and the logistic regression model. Statistical significance was set at 5%. The SRs were analyzed by prototypical analysis of the evocations that gave rise to the four-house table and by the similarity tree and descending hierarchical classification. The results showed that structuring the theoretical content and operationalizing the health worker monitoring protocol included training the team, organizing physical spaces, flows, protocols and drawing up thematic scripts. The workers highlighted the ease of access to testing and diagnosis, the support they received and the quality of care. Regarding the SRs of COVID-19, the words evoked that made up the central nucleus were more negative in their SRs about COVID-19. In the first and second peripheries and in the contrast elements, the evoked words supported the central core. The descending hierarchical classification generated four classes called: Protective measures to prevent COVID-19, Negative experiences while working during the pandemic, Negative feelings about working during the pandemic and Uncertainties while working during the pandemic. The tree of similarity was structured around two cores: fear and isolation. GAD was identified in 26.3% of professionals. For the group with GAD, the SRs maintained the same negative character, but differed in the expressions that show greater suffering represented by the terms fear, death and sadness. In the final logistic regression model, professionals who considered the care adopted to be unsatisfactory or not satisfactory were 2.62 times more likely to have GAD (95% CI: 1.16-5.93). It was concluded that the protocol for monitoring workers strengthened the implementation strategy of the Testing Center, helping to support them and control infection. The social representations of health workers had negative elements expressed by fear, isolation, pandemic, disease, care and contamination. Regardless of whether or not they had GAD, the central core was negative, centered on fear, which highlighted psychological suffering. However, for workers with GAD, the salience of the terms was different, showing that the community of words between the two groups suggests greater suffering for the group with GAD. GAD was associated with occupational variables, especially the unsatisfactory care adopted in the service to prevent COVID-19.