The Working Environment in Primary Healthcare Outpatient Facilities: Assessment of Physical Factors and Health Professionals' Perceptions of Working Environment Conditions

初级卫生保健门诊机构的工作环境:对物理因素和卫生专业人员对工作环境条件的看法的评估

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作者:Marta Regina Cezar-Vaz, Clarice Alves Bonow, Joana Cezar Vaz, Carlos Henrique Cardona Nery, Mara Regina Santos da Silva, Daniela Menezes Galvão, Aline Soares Alves, Flávia Santana Freitas Sousa, Joice Simionato Vettorello, Jociel Lima de Souza, Joaquim Vaz

Abstract

The objectives of this study were to assess the adequacy of physical parameters/factors (temperature, relative humidity, noise, and illuminance levels) of the work environment in PHC facilities, to evaluate the association between the adequacy of these measured physical parameters and the physical characteristics of the PHC facilities and their surroundings and to assess the association between health professionals' perceptions about exposure to physical risks in the PHC work environment and the adequacy of physical parameters measured in the same facilities. The study monitored 23 PHC facilities in southern Brazil and interviewed 210 health professionals. Data analysis involved Pearson's chi-square, Fisher's exact test, Spearman's correlation, and multivariate linear regression analysis was used to control for confounding factors. The significance level was set at 5% (p ≤ 0.05). The combination of temperature and relative humidity presented thermal comfort levels outside the adopted criteria for adequacy in consultation (outdoor relative humidity, p = 0.013) and procedure rooms (front door open, p = 0.034). Inadequate sound comfort (noise) levels in the morning shift were found in the vaccination (front door open, p = 0.021) and consultation rooms (movement of people, p = 0.016). In PHC facilities where reception rooms had insufficient lighting, internal curtains were opened less frequently (p = 0.047). The analysis of health professionals' perceptions of physical factors demonstrated that physicians more frequently perceive the physical risk of temperature and humidity (p = 0.044). The higher the number of nurses (p = 0.004) and oral health technicians in the PHC facilities (p = 0.031), the greater the general percentage of adequacy of monitored physical parameters. It was also confirmed that the higher the perception of moderate or severe physical risk among health professionals, the lower the general percentage of the adequacy of the physical parameters of the work environment of the PHC facilities evaluated (rs = -0.450, p = 0.031). This study's evidence contributes to a better understanding of physical conditions and future occupational interventions to ensure the comfort, safety, and well-being of PHC workers.

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