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MENTAL HEALTH IN PRIMARY HEALTH CARE: AN EXPERIENCE
REPORT ON OCCUPATIONAL STRESSORS IN A BASIC HEALTH UNIT
Elines Santos Rocha Novaes1
Maria Clara Jorge Cavalcante2
Gabriel Correia Maciel3
Maria Eduarda Chaves Silva4
Maria Janaína do Nascimento5
Vitor Juan Nogueira Alencar6
Flaelma Almeida da Silva7
Diana de Lima8
Abstract: This experience report originates from a university extension project developed between
August and December 2024, aimed at analyzing occupational stress and stressors experienced by
healthcare professionals at the Dr. José Ramos Neto Basic Health Unit, in Eunápolis, Bahia, Brazil.
The extension activity involved students and professors in the health eld, integrating education,
service, and community through investigative actions with a quantitative and qualitative approach.
Data collection included the application of the Lipp Stress Symptom Inventory for Adults (ISSL),
as well as a questionnaire on occupational stressors. Fourteen health professionals participated in
the study, and the responses revealed that biological risk was the main stressor identied (34.6%),
1 Master in Nursing, CETSC Professor at the Pitágoras Faculty of Medicine in Eunápolis.
2 Student of the Medicine Course at the Pitágoras Faculty of Medicine in Eunápolis.
3 Student of the Medicine Course at the Pitágoras Faculty of Medicine in Eunápolis.
4 Student of the Medicine Course at the Pitágoras Faculty of Medicine in Eunápolis.
5 Student of the Medicine Course at the Pitágoras Faculty of Medicine in Eunápolis.
6 Student of the Medicine Course at the Pitágoras Faculty of Medicine in Eunápolis.
7 Master in Education, CETSC Professor at the Pitágoras Faculty of Medicine in Eunápolis.
8 PhD in Environmental Engineering Sciences, CETSC Professor at the Pitágoras Faculty of
Medicine in Eunápolis.
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followed by the physical structure of the unit (23%). The data also indicated that 28.57% of the
participants experienced some level of stress, with the resistance phase being the most prevalent. The
extension experience provided a critical reection on the mental health of professionals in Primary
Health Care, highlighting the need for institutional interventions aimed at preventing occupational
illness and reinforcing the role of extension activities in promoting social awareness, professional
training, and humanized care.
Keywords: Occupational Stress. Primary Health Care. Extension Project. Mental Health. Stressors.
Introduction
Primary Health Care (PHC) is characterized as the main gateway to the health services of
the Unied Health System (SUS), encompassing a set of actions aimed at health protection, disease
prevention, diagnosis and treatment. In this context, there is a constant ow of care in these health
networks, covering low and medium complexity procedures, which makes it essential to discuss
the work processes and the relationship between the work environment and the mental health of
professionals working in this area (Brasil, 2012).
In the health area, the complexity involved in the responsibility of dealing with lives,
combined with the growing demand for care and the need to increase the workload, can cause physical
and emotional exhaustion among professionals (Ferreira et al., 2016).
The individual characteristics of the worker, especially his emotional dimension, play a
signicant role in occupational stress among health professionals. In addition, these professionals still
face the stigmatization associated with seeking help for mental health issues in the workplace, which
aggravates the confrontation of the problem (Lima et al., 2024).
Occupational stress is a condition characterized by mental and physical exhaustion reactions
related to professional practice. Among the main causes, exposure to stressors resulting from work
activities stands out, which negatively affect both the psychological and physical aspects of workers.
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These situations can be aggravated by inadequate working conditions, such as poor infrastructure and
exhausting routines (Damasceno et al., 2023).
In view of this scenario, the high exposure of Primary Health Care professionals to physical,
emotional and organizational stressors emerges as a central problem, aggravated by the insufciency
of institutional support and the invisibility of psychological suffering in the work context. Thus, this
study aims to analyze the levels of occupational stress and stressors present in the daily lives of
workers at the Dr. José Ramos Neto Basic Health Unit, located in the municipality of Eunápolis,
Bahia. The investigation is based, above all, on the contributions of Lima et al. (2024), who address
the stigmatization of the search for mental health care; by Damasceno et al. (2023), when discussing
working conditions and the prevalence of stress in PHC teams; de Faria et al. (2021), when dealing with
the emotional vulnerability of community health agents; and Lourenção et al. (2022), who explore the
relationship between stress and engagement in primary care medical professionals. Based on these
theoretical bases and the extension experience, it is proposed to reect on the impact of the work
environment on the mental health of professionals and the urgency of institutional coping strategies.
Methodology
The present study was derived from a university extension project developed from August
to December 2024, with a basic, descriptive nature and quantitative-qualitative approach. Descriptive
research aims to study the characteristics of a group or phenomenon, such as the distribution of a
population by age, physical and mental health status, among other aspects (Gil, 2008).
The activity was carried out at the Dr. José Ramos Neto Basic Health Unit, located in the
municipality of Eunápolis, Bahia. This municipality is located between the federal highways BR-101
and BR-367 and has an estimated population of 113,710 inhabitants (IBGE, 2022).
The sample consisted of 26 professionals from the unit, according to the following inclusion
criteria: being a professional who had been working at the UBS for more than six months, performing
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the functions of nurse, physician, dentist, nursing technician, community health agent or administrative
support, and having agreed to participate in the research by signing the Informed Consent Form
(ICF). Professionals who refused to answer the collection instruments were excluded. All participants
were guaranteed the reading of the ICF, as well as the condentiality and anonymity of the data and
identities involved.
The objective of the extension action was to identify and analyze the presence and/or level
of stress, in addition to the main stressors that affect the mental health of professionals working
at the UBS. For data collection, three instruments were used: a sociodemographic questionnaire
to characterize the participants; the Lipp Adult Stress Symptom Inventory (ISSL), used to assess
stress levels; and a third instrument composed of questions about the stressors perceived in the work
environment. The forms were made available through the Google Forms platform, with the aim of
expanding adherence and facilitating access for professionals.
The Lipp Inventory is an instrument validated in Brazil and was developed by Marilda Lipp
in 1994. It consists of 52 items that must be marked by the participants, in order to identify physical
and psychological symptoms associated with stress. The instrument classies individuals into three
phases of stress: in the alert phase, seven or more symptoms are reported in the last 24 hours; in the
resistance phase, four or more symptoms that occurred in the last month; and, in the exhaustion phase,
nine or more symptoms identied in the last three months (Rossetti et al., 2024).
The collected data were submitted to descriptive analysis, being organized in spreadsheets
and presented in absolute numbers and percentages. This systematization allowed a quantitative
reading of stress levels, as well as the qualitative categorization of the main stressors reported by the
participants.
Analysis and Discussion of Results
Mental health is an inseparable component of human health and an indispensable element in
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preserving the integral health of workers (Esperidião et al., 2020). It takes on a meaning related to the
“healthy socius”, which involves job satisfaction, an expressive daily life, social participation, leisure,
equity, in short, quality of life (Filho et al., 1999).
In this sense, the World Health Organization defends the idea that mental health goes beyond
the mere absence of any mental disorder, encompassing the broad state of health and can be determined
by socioeconomic, biological, and environmental factors (WHO, 2016).
A healthy work environment has a positive inuence on the health and well-being of workers,
and is a fundamental right of every citizen (article 6, caput, CF/88). This right must be ensured not
only by the State, but also by the employing and managing institutions. However, the labor universe
sustains conditions that often lead to the weakening of workers’ mental health, such as social exclusion,
competitiveness, and authoritarian relationships (Lourenção et al., 2022).
Primary Health Care (PHC) is responsible for a set of strategies and actions at the individual
and collective levels, which covers health promotion and prevention. Within this network, the Basic
Health Units (UBS) and the Family Health Strategy (ESF) are the primary care centers and carry out
less complex procedures, such as regular consultations, administration of medications and vaccines,
as well as health education activities (Brasil, 2019).
Despite its importance, PHC presents challenges ranging from the low problem-solving
capacity of services to chronic underfunding of health, situations that occupy a prominent position
among the obstacles to compliance with public policy (Geremia, 2020). In addition, there is fragility
in the health care actions of PHC workers and the lack of awareness of these professionals about the
importance of occupational health (Silva et al., 2018).
From this perspective, it is valid to recognize that the care activities developed by professionals
working in PHC are permeated by challenges, uncertainties, and anguish, which makes them more
susceptible to psychological distress and psychological distress (Esperidião et al., 2020). In the
analysis of Leite et al. (2014), these professionals face, in their daily lives, specic challenges that can
generate stress and overload, negatively impacting their quality of life at work (QWL). Among these
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conditions, the lack of understanding on the part of the teams about the objectives of the health policy,
the high workload and the lack of preparation to work in the context of the FHS stand out. In addition,
the absence of institutional support is also a factor that compromises QWL.
Tenório-Correia et al. (2024) show that PHC professionals, especially those subjected to
intense working hours, pressure for goals and limited resources, are often affected by work-related
psychological problems. In contexts of prolonged burnout, there is an increased probability of leaves
and risk of exclusion from the labor market, which amplies the social and institutional impact of
these conditions.
In accordance with the objectives of the study, a sociodemographic prole of the research
participants was drawn (Table 1), with the aim of identifying aspects that could be related to the
development of stress.
Of a total of 26 people approached during the survey, 16 responded to the form made available
online. In this scenario, one person did not sign the mandatory consent form for the continuation of
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the research and another did not agree to answer the questionnaire on stress symptoms presented.
Thus, 14 people agreed to participate in the research, resulting in an adherence rate of approximately
53.84%.
From the sociodemographic survey of the 14 professionals working at the Dr. José Ramos
Neto Basic Health Unit, there is a predominance of individuals in the 46 to 55 age group. Next, 35.7%
are in the age group of 36 to 45 years, while only 7.1% are between 26 and 35 years old.
This prole reects a group mostly composed of professionals at a more advanced stage of
their work trajectory and possibly with previous experiences of insertion in the labor market. This
maturity may be associated with greater exposure to risk factors, which may amplify the impact of
adverse conditions over time. Studies show that prolonged and continuous exposure to stressors at
work can determine an insidious process of occupational stress (Costa et al., 2003), and that length
of service and professional experience interfere with the way each person copes with stressors
(Tamborini et al., 2023).
As for gender, the survey revealed a predominance of women (64.3%). This data is compatible
with the scenario observed in many public health services, in which care functions are mostly occupied
by women (Martins et al., 1996).
Several studies relate the gender category to the development of stress. Sadir et al. (2010) cite
research by Levi (1999) that found that the combination of being a woman, being overworked, and
living in an unfavorable economic situation constitutes an increased risk factor for the development
of stress.
In this sense, the World Health Organization (WHO) reveals that, both in emerging and
developed countries, women in the workplace generally present greater stress compared to men
(WHO, 2007).
Among the participants, there was a predominance of community health agents (50%),
followed by nursing technicians (14.3%), administrative professionals (14.3%), nurses (7.1%), physicians
(7.1%) and dentists (7.1%). This distribution reects the multiprofessional structure characteristic of
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the UBS’s, highlighting the role of the community health agents (CHA).
The ACS’s play a crucial role in the consolidation of the SUS, due to their continuous and
permanent performance. Its actions prioritize strengthening the bond between team members and the
community, promoting initiatives aimed at health. In addition, they carry out activities such as home
visits, welcoming, and community actions, and are often engaged in group and community practices
(Faria et al., 2021).
Regarding the employment relationship, only 21.4% of the participants reported having some
external relationship to the one provided at the Dr. José Ramos Neto UBS, and only 7.1% stated
that they felt overloaded with the workload at the UBS. These data contrast with those described in
literature studies, which point to high levels of stress related to overload and high workload among
primary care professionals (Fernandes et al., 2019).
Another relevant aspect identied was the great variation in the weekly workload of the
participants, which ranged between 8 and 70 hours per week. About 85% of professionals reported
working up to 40 hours a week, while 15% exceeded this limit. According to Lopes (2018), the
exhaustive workload can contribute signicantly to work overload, culminating in the emergence of
occupational stress.
Stress is characterized as the organic reaction to situations that require intense emotional
effort; when these situations become constant, physical and psychological changes are triggered that
can manifest themselves in headache, malaise, cardiovascular changes and, in chronic cases, burnout
syndrome (Damasceno et al., 2023). Occupational stress, on the other hand, refers specically to
psychological tension linked to work; occurs when the individual perceives certain work demands as
stressors and, when activating coping mechanisms, experiences negative reactions that compromise
their well-being (Paschoal and Tamayo, 2004).
In the present study, the application of Lipp’s Stress Symptom Inventory for Adults revealed
that 28.47% of the professionals had some level of stress; The resistance phase was the most prevalent,
while only one participant was in the exhaustion phase, and none was in the alert phase. Although most
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of them were classied as stress-free, the presence of a signicant set of symptoms was found that
approached the cutoff points of the instrument, which demands attention, as these workers constitute
a risk group for the evolution of occupational stress.
The symptoms reported by the participants revealed important aspects of occupational
health. In the last 24 hours (alert phase), the majority (57.1%) reported muscle pain or tension, followed
by stomach pain (28.6%) and other stress-related symptoms (Table 2). This stage occurs when the
individual comes into contact with the stressor and is marked by the prevalence of physical symptoms
to the detriment of psychological ones (Cordíoli et al., 2019).
The items that make up the questionnaire follow an order of symptom intensity, as it is
common for the initial signs of the alert phase to appear mildly and sporadically, disappear and later
reappear with greater intensity (Sadir et al., 2010). At this stage, it is essential to identify, minimize
or eliminate the stressors present in the work environment, in order to prevent the progression of
symptoms. Health promotion actions in the workplace can act as an effective strategy in the prevention
and control of occupational stress.
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When extending the time horizon, it is observed that, in the last month (resistance or struggle
phase), the most frequent problems were memory difculties (57.1%) and excessive irritability
(35.7%). The development of the resistance phase is associated with the persistence of the action of the
aggressive stimulus (Table 3). In this sense, when stressful stimuli become repetitive and chronic, the
body response tends to decrease in intensity, being anticipated on a recurring basis. This anticipation,
however, can trigger more serious pathologies, such as anxiety. In this phase, the most recurrent
symptoms become predominantly psychological (Cordíoli et al., 2019).
Finally, in the last three months (exhaustion phase), excessive tiredness was reported by half
of the participants (50%), followed by irritability without a dened cause (35.7%) and the desire to “run
away from everything” (35.7%) (Table 4). In this stage, the symptoms are triggered by a condition of
chronic anxiety resulting from the resistance phase and are characterized by the exhaustion generated
by adaptive failure in the face of continuous emotional efforts to overcome a persistent stressful
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situation. From this perspective, the third phase of stress presents more intense symptoms and can
lead to the development of serious diseases, such as cardiovascular pathologies, which, in extreme
cases, can result in the death of the worker (Tenório-Correia et al., 2024).
The survey also revealed that, in relation to the care offered in the territory, 57.1% of the
professionals reported that they considered that the UBS where they work does not have sufcient
structural, logistical and human resources conditions to meet the demand. This data indicates
that structural precariousness and work overload are perceived as sources of stress for the unit’s
professionals, which requires attention from the municipal management regarding the working
conditions offered in the daily routine of primary care.
Regarding the team’s reception with the health worker, most of the research participants
(64.3%) reported that there was no active listening and moments of care aimed at the professionals who
work in the unit. This perception reveals the absence of institutional strategies to welcome workers
and, at the same time, the fragility of interpersonal relationships within the team.
When asked about what caused stress in the unit’s daily life, the main answers reported were:
“overloaded and unmotivated”, “working beyond hours”, “exhausting work”, “moral harassment and
overload”, “devaluation”, “overloaded with accumulation of functions”, “being constantly charged
and being treated with ignorance”. All these answers reveal important aspects of psychic suffering,
and its repetition among the professionals of the unit is an alert for health management.
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Participatory management presupposes qualied listening, horizontality in work relationships
and valuing the knowledge of all team members. When there is asymmetry in decision-making power,
vertical imposition of goals and absence of dialogue, work tends to become sicker. Suffering, in these
cases, ceases to be a temporary condition and starts to crystallize as ethical-political suffering, as the
worker is prevented from performing a dignied job, which brings him meaning and recognition.
Qualied listening should be understood as an intentional and humanized process, in which
the worker not only reports his complaints, but is welcomed in its entirety, considering the multiple
aspects that cross his subjectivity and his performance. Promoting spaces for listening and care among
professionals from the same team can contribute to the collective coping with suffering, being a tool
for strengthening the team and preventing occupational stress.
The absence of listening spaces is also related to the symbolic devaluation of SUS workers.
The ideal of user-centered care often disregards the health of those who provide care, which, in
addition to being incoherent, compromises the quality of care and the permanence of professionals in
the territories. Caring for those who care is, therefore, an ethical and strategic responsibility for the
sustainability of the SUS.
During the data collection stage, signs of discomfort were observed on the part of some
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participants when addressing the topic of occupational stress. Although the condentiality of the
answers was ensured, some professionals reported insecurity in answering with total frankness,
motivated by the fear of possible retaliation in the work environment. This perception points to the
presence of manifestations of non-verbalized psychic suffering, suggesting institutional weaknesses
in the reception of demands related to the mental health of workers.
It was observed that approximately 93% of the professionals working at the Dr. José Ramos
Neto Basic Health Unit reported the absence of institutional psychological support. Psychological
support is an essential resource for the identication of stressors and for the development of coping
strategies in the work context. It is also noteworthy that 100% of the professionals who presented
some level of stress, according to the Lipp Inventory, are part of the group that declared that they did
not have any type of psychological support.
This nding corroborates evidence in the literature that indicates the low perception of
institutional support in the workplace as an aggravating factor for occupational stress among primary
health care professionals. In a study conducted by Tamborini et al. (2023), which assessed the risk
of exposure to occupational stress in this group, it was observed that 46.6% of the participants
reported not having psychological support at their place of work. These data reinforce the relevance of
implementing institutional policies aimed at the mental health of workers, with permanent strategies
of care, listening and psychosocial support in the daily lives of the teams.
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Final Thoughts
The results of the present report showed the signicant presence of symptoms of occupational
stress among health professionals working at the Dr. José Ramos Neto Basic Health Unit. Although
most participants did not t into the most critical phases of stress according to the Lipp Inventory,
a signicant frequency of physical and psychological signs was observed, such as muscle pain,
irritability, excessive tiredness and memory difculties, which indicate a high risk of progression to
more severe conditions. The phases of resistance and exhaustion were especially marked, revealing
the persistence of stressors in the work environment.
The research also highlighted structural and subjective aspects that contribute to the illness
of workers, such as the overload of functions, lack of motivation, the absence of active listening and
institutional fragility in the promotion of care for those who care. The lack of institutional psychological
support, reported by more than 90% of the participants, associated with the perception of professional
devaluation, reinforces the need for strategic actions aimed at mental health in the context of primary
care. The scientic literature consulted reinforces that the absence of psychosocial support is recurrent
in this eld, which can aggravate the ethical-political suffering of health professionals.
Thus, the ndings of this study reveal not only a situational diagnosis of occupational
stress in a family health team, but also the urgency of public and institutional policies that ensure
decent working conditions, qualied listening, and interventions that favor the comprehensive care of
professionals. Taking care of the mental health of workers is an ethical imperative for the qualication
of health practices and for the sustainability of the Unied Health System in the territories.
References
BALLONE, G. J. Stress, anxiety and exhaustion. Brain & Mind, Campinas, n: 11, Oct./Dec. 2000.
Brain Diseases Section. Available at: https://www.cerebromente.org.br/n11/doencas/estresse.htm.
240
ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025
Accessed on: 20 out. 2024.
BRAZIL. National Association of Occupational Medicine. Understand the main differences between
burnout, stress and depression. 2007 Available at: https://www.anamt.org.br/portal/2019/06/07/
entenda-diferencas-entre-burnout-estresse-e-depressao/. Accessed on: 16 out. 2024.
BRAZIL. Ministry of Health. Stress. Virtual Health Library. Brasília, Ed. Ministério da Saúde, 2012.
Available at: https://bvsms.saude.gov.br/bvs/dicas/253_estresse.html.
BRAZIL. Ministry of Health. Ordinance No. 2,539, of September 26, 2019. Available at: https://
bvsms.saude.gov.br/bvs/saudelegis/gm/2019/prt2539_27_09_2019.html.
CARREIRO, G.S.P. et al. The process of mental illness of workers in the Family Health Strategy. Rev
Eletr Enf. 2013; 15(1):146-55. Available at: https://doi.org/10.5216/ree.v15i1.14084. Accessed on: 20 out.
2024.
COR DIOLI, D. F. C. et al. Occupational st ress and engagement among prim ar y health care workers. Braz ilian
Journal of Nursing, v. 72, n. 6, p. 1580–1587, 2019. A national study with community agents, assistants
and nurses highlights stressors such as insufcient training, harassment, and lack of time. Available
at: https://www.scielo.br/j/reben/a/QgSbVvnzfWFtbgVX3FGSXdK/?format=pdf&lang=en&utm_
source. Accessed on: 12 jul. 2024.
COSTA J.R.A; LIMA, J.V; ALMEIDA, P.C. Stress in the nurse’s work. Rev Esc Enfermagem USP.
2003; 37(3): 63-71. Available at: https://doi.org/10.1590/S0080-62342003000300008. Accessed on: 7
out. 2024.
DAMASCENO, K. S. M. et al. Prevalence of occupational stress in health professionals during the
COVID-19 pandemic: a cross-sectional study. Brazilian Journal of Occupational Medicine, v. 21,
n. 4, e2022957, 2023. Available at: https://cdn.publisher.gn1.link/rbmt.org.br/pdf/en-v21n4aop957.
pdf?utm_source. Accessed on: 12 out. 2024
ESPERIDIÃO, E.; SAIDEL, M. G. B.; RODRIGUES, J. Mental health: focus on health
professionals. Brazilian Journal of Nursing, v. 73, 2020. Available at: https://www.scielo.br/j/reben/a/
Pb9ydVgY43nrP36qNW9wKGh/?format=pdf&lang=pt. Accessed on: 15 out. 2024.
241
ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025
FARIA, F. R. C. et al. Occupational stress, work engagement and coping strategies in community health
agents. Rene Magazine, v. 22, e70815, 2021. Includes coping strategies and stress/engagement levels in
CHAs. Available at: https://pdfs.semanticscholar.org/6e64/803c729ba07510e0d7e43007d3b3b3f7ab52.
pdf?utm_source. Accessed on: June 20, 2024.
FERNANDES, J. M. et al. Psychological stress in relation to the female and male sex in Brazil:
a narrative review of the literature. e-HUMANIT@S. 2019; v.6. Available at: https://unisalesiano.
com.br/aracatuba/wp-content/uploads/2020/12/Artigo-O-estresse-psicologico-em-relacao-ao-sexo-
feminino-e-masculino-no-Brasil-uma-revisao-narrativa-da-literatura-Pronto.pdf. Accessed on: 1
nov. 2024.
FERREIRA, C. A. V. et al. The Context of Occupational Stress in Health Workers: A Bibliometric
Study. Journal of Management in Health Systems, v. 5, n. 2, p. 84–99, 2016. Available at: https://
periodicos.uninove.br/revistargss/article/view/12761. Accessed on 7 Oct. 2024.
GEREMIA, D. S. Primary Health Care on alert: challenges of the continuity of the asymptitial model.
Physis: Revista de Saúde Coletiva, Rio de Janeiro v. 30, n. 1, e300100, 2020. Available at: https://www.
scielo.br/j/physis/a/bfHzYdb3tyCcyGKYPz5KdNJ/#. Accessed on: 1 nov. 2024.
GIL, Antonio Carlos. How to develop research projects. 4. ed. São Paulo: Atlas, 2008.
IBGE – BRAZILIAN INSTITUTE OF GEOGRAPHY AND STATISTICS. 2022 Census Eunápolis.
Rio de Janeiro: IBGE, 2022. Available at: https://www.ibge.gov.br/cidades-e-estados/ba/eunapolis.
html. Accessed on: 21 out. 2024.
LEITE, Denise Fernandes et al. Quality of life at work of NASF professionals in the city of São Paulo.
SciELO, 2014. Available at: https://doi.org/10.1590/S0103-73312014000200010. Accessed on: 02 Dec.
2024.
LEVI, L.; SAUTER, S.L.; SHIMOMITSU, T. (1999). Work-related stress is time to take action.
Journal of Occupational Health Psychology, 4 (4), 394-396. Translated by Use of Articial Intelligence.
Available at: https://doi.org/10.1037/1076-8998.4.4.394. Accessed on: 2 out. 2024.
LIPP, M. E. N; MALAGRIS, L. E. N. Stress management. In B. Rangé (Ed.). Behavioral and cognitive
psychotherapy: research, practice, application, and problems (pp. 279-92). Campinas: Psy II, 1995.
242
ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025
LIMA, et al. Impacts of occupational stress on the mental health of health professionals: a qualitative
study. Contribuciones a Las Ciencias Sociales, São José dos Pinhais, v.17, n.1, p. 7708-7720, 2024.
Available at: https://ojs.revistacontribuciones.com/ojs/index.php/clcs/article/view/4754. Accessed on:
20 jul. 2024.
LOPES, S. V.; SILVA, M. C. da. Occupational stress and associated factors in public servants of a
federal university in southern Brazil. Ciência & Saúde Coletiva, v. 23, n. 11, p. 3869–3880, nov. 2018.
Available at: https://www.scielo.br/j/csc/a/qGMVYspNVbZVgBWtcckFrZG/?format=pdf&lang=pt.
Accessed on: 18 out. 2024.
LOURENÇÃO, L. G., SODRÉ, P. C., GAZETTA, C. E., SILVA, A. G. D., CASTRO, J. R.; MANIGLIA,
J. V. (2022). Occupational stress and work engagement among primary health care physicians: a cross-
sectional study. São Paulo. Medical Journal Revista Paulista de Medicina, 140(6), 747–754. Available
at: https://doi.org/10.1590/1516-3180.2021.0644.R1.10012022. Accessed on: 5 out. 2024.
MARTINS C. L. et al. Community agents in public health services: elements for a discussion. Saúde
Debate Magazine. 51:38-43. 1996. Available at: https://pesquisa.bvsalud.org/portal/resource/pt/lil-
201593. Accessed on: 3 out. 2024.
MUNIZ, Adriano Dos Santos. Et al. Stress levels and related factors in primary care health professionals:
an integrative review. Rev Cienc Saude. 2023; 13(1):26-34. Available at: https://portalrcs.hcitajuba.org.
br/index.php/rcsfmit_zero/article/download/1369/868/10873?. Accessed on: 25 out. 2024.
WORLD HEALTH ORGANIZATION. Mental health depends on physical and social well-being,
says WHO on World Day. 2016. Available at: https://brasil.un.org/pt-br/74566-saúde-mental-depende-
de-bem-estar-físico-e-social-diz-oms-em-dia-mundial. Accessed on: 15 out. 2024.
WORLD HEALTH ORGANIZATION. Doing what matters/what’s important in times of stress: An
illustrated guide. Geneva, 2007.
PASCHOAL, T; TAMAYO, A. Impact of labor values and family-work interference on occupational
stress. Psychology: Theory and Research, 21, 173-180. 2004. Available at: https://www.scielo.br/j/
ptp/a/8M7sGNdwy3XJRmTDdrf9ZMv/. Accessed on: 10 out. 2024.
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ISSN: 2763-5724 / Vol. 05 - n 03 - ano 2025
ROSSETTI, M. O. et al. The Inventory of Stress Symptoms for Adults of Lipp (ISSL) in
Ederal Police Servers of São Paulo. Brazilian Journal of Cognitive Therapies, v. 4, n. 2, p. 108–
120, 2024. Available at: https://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1808-
56872008000200008#:~:text=Os%20resultados%20dessa%20pesquisa%20indicaram,4%25%20
na%20fase%20de%20exaustão. Accessed on: 16 out. 2024.
SADIR, M. A.; BIGNOTTO, M. M.; LIPP, M. E. N. Stress and quality of life: inuence of some
personal variables. Paideia, Ribeirão Preto, v. 20, n. 45, p. 73–81, 2010. Available at: https://www.
scielo.br/j/paideia/a/ctxdtbWNVN6FFJCFfvtGKXJ/?format=pdf&lang=pt. Accessed on: 18 out.
2024.
SILVA, V. S; PRAZERES, T.A; LIMA, M.A.G. Congurations of home work in the territory of
the Family Health Strategy. Rev Enferm Contemp. 2017. Jun 12]; 6(Suppl-1):77. Available at: https://
www5.bahiana.edu.br/index.php/enfermagem/issue/viewIssue/103/13. Accessed on: 3 out. 2024.
TENÓRIOCORREIA, A. et al. Professional burnout among primary health care workers in Brazil:
results of a multilevel analysis. Healthcare, v. 12, n. 6, 2024. Available at: https://www.researchgate.
net/publication/351999174_Burnout_among_primary_health_care_workers_in_Brazil_results_
of_a_multilevel_analysis?utm_source=chatgpt.com . Accessed on: 4 apr. 2024.
