ABSTRACT
Objective: The study aims to analyze the mental health of employees at a federal higher education institution (IFES) during the COVID-19 pandemic.
Theoretical Framework: With the worsening of COVID-19, some factors contribute to the increase in illness in the general population, including: social isolation, excess information, grief and/or fear of losing loved ones, among other economic, social and work factors (Nabuco, Oliveira, & Afonso, 2020).
Method: In addition to simple descriptive statistics to identify the prevalence of mental suffering, the Chi-square test was also carried out to detect whether there is a significant association between the prevalence of CMD and the variables relating to gender, age and education of employees
Research implications: The findings in this study invite the reader to reflect on three complex phenomena: pandemic, public service and mental health.
Originality/Value: This work, in addition to addressing mental health issues in public service, provides an overview of mental illness at this pandemic time.
Keywords: Common Mental Disorders, mental illness, Covid-19, public servants.
RESUMO
Objetivo: О estudo tem como objetivo analisar a saúde mental dos servidores de uma instituição federal de ensino superior (IFES) durante a pandemia da COVID-19.
Referencial Teórico: Com о agravamento da COVID-19 alguns fatores corroboram para о aumento do adoecimento da população em geral, são eles: isolamento social, excesso de informações, luto e/ou medo de perder entes queridos, dentre outros fatores económicos, sociais e laborais (Nabuco, Oliveira, & Afonso, 2020).
Método: Além da estatística descritiva simples para identificação da prevalência do sofrimento mental, se o Teste do Qui-quadrado para detectar se existe uma associação significativa entre a prevalência de TMC e as variáveis referente ao género, idade e escolaridade dos servidores.
Resultados e Discussão: Os resultados indicam que o percentual de servidores acometidos de TMC, equivalente а 29,0%, é anterior ао momento pandémico e reforçam os índices de adoecimento entre servidores. Ademais, corroboram com outros estudos empíricos de que as causas desse adoecimento sáo referentes aos elementos constitutivos do ambiente laboral do serviço público. Contudo, esse momento atual contribuiu para agravar o seu sofrimento mental desses servidores. Ademais, observa-se a existência de uma relação significativa entre o género e a prevaléncia de sofrimento mental.
Implicações da pesquisa: Os achados neste estudo convidam o leitor a refletir sobre três fenómenos complexos: pandemia, servico público e saúde mental.
Originalidade/Valor: Este trabalho além abordar questões de saúde mental no funcionalismo público, traz um panorama do adoecimento psíquico neste momento pandémico.
Palavras-chave: Transtornos Mentais Comuns, adoecimento mental, Covid-19, servidores públicos.
RESUMEN
Objetivo: El estudio tiene como objetivo analizar la salud mental de los empleados de una institución federal de educación superior (IFES) durante la pandemia de COVID-19. Marco
Marco Teórico: Con el agravamiento de la COVID-19, algunos factores contribuyen al aumento de enfermedades en la población general, entre ellos: aislamiento social, exceso de información, duelo y/o miedo a perder a seres queridos, entre otros factores económicos, sociales y laborales (Nabuco, Oliveira, & Afonso, 2020).
Método: Además de la estadística descriptiva simple para identificar la prevalencia del sufrimiento mental, también se realizó la prueba de Chi-cuadrado para detectar si existe una asociación significativa entre la prevalencia de TMC y las variables relacionadas con el sexo, la edad y la educación de los empleados.
Resultados y Discusión: Los resultados indican que el porcentaje de empleados que padecen TMC, equivalente al 29,0%, es previo a la pandemia y refuerza los índices de enfermedad entre los empleados. Además, corroboran otros estudios empíricos que las causas de esta enfermedad se refieren a los elementos constitutivos del ambiente laboral del servicio público. Sin embargo, este momento actual contribuyó a agravar el sufrimiento mental de estos empleados. Además, existe una relación significativa entre el género y la prevalencia del sufrimiento mental.
Implicaciones de la investigación: Los hallazgos de este estudio invitan al lector a reflexionar sobre tres fenómenos complejos: pandemia, servicio público y salud mental.
Originalidad/Valor: Este trabajo, además de abordar problemas de salud mental en el servicio público, proporciona una visión general de las enfermedades mentales en este momento de pandemia.
Palabras clave: Trastornos Mentales Comunes, enfermedad mental, Covid-19, servidores públicos.
1 INTRODUCTION
The new Coronavirus (SARS-CoV-2) called Coronavirus Disease 2019 (COVID-19) was first identified in Wuhan, Hubei Province , China (LI et al., 2020), and spread rapidly around the world, reaching high numbers of confirmed cases of infection and deaths. As a result, on March 11, 2020, the World Health Organization (WHO) declared the disease a public health emergency of international concern, with unprecedented social and economic consequences. This unexpected and devastating scenario has affected the mental health of people around the world ( Ornell , Schuch , Sordi , & Kessler , 2020) and created new challenges for those who already suffer from mental disorders ( Valdés-Florido ег al ., 2020).
In recent years, mental disorders have become a field of study of increasing interest due to concerns about global health ( Kessler et al ., 2009; Stratton et al ., 2013; Steel et al ., 2014), specifically because of its association with a high risk of mortality (Walker, McGee , & Druss , 2015). Gongalves, Stein, and Kapczinski (2008) state that mental disorders account for 13% of the burden of disease worldwide; however, less than 1% of the resources spent on health in countries are allocated to the treatment of mental illnesses (Mota, Silva, & Amorim, 2020). According to the WHO (2015), in countries considered to be developing, more than 75% of the population have mental disorders, but they do not receive any treatment.
According to the WHO (2017), the total number of people suffering from depression in the world is 332 million, and the number of people suffering from anxiety disorders is 264 million, representing 4.4% and 3.6% of the world population, respectively. Furthermore, according to the WHO (2020), it is estimated that in 2016 alone, there were around 800,000 deaths by suicide; and this number becomes even greater when the total number of unsuccessful attempts is included . In this scenario, suicide accounted for around 1.4% of all deaths worldwide, and was considered one of the 18 leading causes of death in that same year.
Furthermore, it is estimated that one in four people suffer from some type of mental disorder during their lifetime, whether considered mild or not. Currently, around 450 million people suffer from mental disorders, considered mild ( Engidaw , Abdu , & Hinani , 2020). Mild mental disorders, also known as Common Mental Disorders (CMD), include signs and symptoms such as anxiety, depression, insomnia, fatigue, irritability, memory loss, and poor concentration ( Ludermir & Lewis, 2005). Such signs and symptoms can make it difficult or even incapacitating for workers to perform their work functions; which can be costly for organizations, in addition to increasing the demand on health services ( Guirado & Pereira, 2016). Thus, affecting not only individuals, but also work organizations, societies, and countries around the world (Goncalves, Stein, & Kapczinski , 2008).
In view of this, in the last decade, several studies on CMD have been carried out with different occupational groups; Among which we can mention: employees of a metallurgical industry ( Guirado & Pereira, 2016), health professionals ( Cabana, Ludermir , Silva, Ferreira, & Pinto, 2007; Rodrigues, Rodrigues, Oliveira, Laudano , & Sobrinho, 2014); Nascimento, Santos, Meira, Pierin , & Souza -Talarico , 2019; Li et al ., 2020), public school teachers ( Baldaçara , Silva, Castro, & Santos, 2015; Lima; Coêlho , & Ceballos , 2017; Santos, Espinosa, & Macon, 2020), bus drivers (Lima et al ., 2020), waterway workers (Silva et al ., 2020). However, studies with public servants are scarce. In addition, no studies with this population were found during the outbreak of the new Coronavirus , making this a research gap. In view of this, this study aims to analyze the mental health of employees of a federal higher education institution (IFES) during the COVID-19 pandemic.
2 THEORETICAL FRAMEWORK
2.1 MENTAL ILLNESS IN TIMES OF PANDEMIC
On January 30, 2020, the World Health Organization (WHO) declared that the outbreak of the disease caused by the new Coronavirus constitutes a Public Health Emergency of International Concern - the Organization's highest level of alert, as provided for in the International Health Regulations. On March 11, 2020, COVID-19 was characterized by the WHO as a pandemic (Pan American Health Organization, 2020).
Given the seriousness of the health problem that is taking hold in almost the entire world, with the realization of vulnerability to illness and the eventual risk of contagion, the COVID-19 crisis has triggered intense repercussions on social functioning and has the potential to severely impact the mental health of society ( Coronavirus Resource Center, 2020). Concern for the mental health of the population intensifies during a serious social crisis. The COVID-19 pandemic can be described as one of these crises, which has been characterized as one of the greatest international public health problems in recent decades, having affected practically the entire planet (World Health Organization , 2020).
In this context, the fear of contracting the disease, COVID-19, has caused a feeling of insecurity in all aspects of life, from the collective to the individual perspective, from the daily functioning of society to changes in interpersonal relationships (Lima et al ., 2020; Ozili & Arun , 2020). This, in turn, has increased concerns related to the population's mental health, as well as the need to investigate and act on issues related to mental health throughout the crisis; since the ability to achieve a state of healthy psychological adjustment is challenged, day after day, by numerous adversities unusual in this period (Brooks et al ., 2020; Ho, Chee , & Ho, 2020; Lima et al ., 2020; Ozili & Arun, 2020).
Some international studies have already revealed that teachers are becoming ill due to uncertainty, stress, anxiety, and depression, leading to burnout syndrome, as it was one of the professions that most needed to reinvent itself in the current context, having to work from home and having to learn to use technologies to ensure the continuity of teaching ( Araújo, Lima, Cidade, Nobre, 8 Neto, 2020). A Chinese study reveals numerous teachers who became mentally ill due to COVID-19, diagnosed with mild depressive disorder, bipolar affective disorder, generalized anxiety, adjustment disorder, and burnout syndrome or burnout syndrome (Wang & Wang, 2020).
A study conducted in Brazil, based on international research, proves that the COVID19 pandemic worsens not only people's physical health, but also their mental health and wellbeing. In fact, it is suspected that the psychological impacts may be longer lasting than the pandemic itself, due to the incalculable economic and psychosocial implications. Some factors arising from the pandemic contribute to the increase in illness among the general population, such as: physical isolation, which reduces access to work, school, leisure, family and friends; excess information that is not always reliable; mourning. In addition, in the Brazilian context, the political-institutional crisis is also evident, increasing the population's anxiety and insecurity (Nabuco, Oliveira, & Afonso, 2020).
2.2 INCIDENCE OF COMMON MENTAL DISORDERS IN THE PUBLIC SERVICE
Empirical studies show that CMDs have been the main cause of the increase in the number of absences from work and long-term leave among employees (Oliveira, Baldacara , & Maia, 2015; Bastos, Junior, Domingos, Araújo, & Santos, 2018). Pathologies resulting from the work environment lead employees to adopt defense mechanisms to cope with adverse work conditions, reduce suffering, and avoid illness. However, defensive strategies alter people's psychological functioning, triggering new risks. These mechanisms arise when there is difficulty in negotiating between the individual and organizational interests (Barros & Honorio, 2015). Even so, the influence that the social context has on individual behavior cannot be ignored (Pereira & Vieira, 2011).
Normative Instruction DC/INSS No. 98 of 2003 defines the organizational and psychosocial factors linked to work, the reason for which originates from the subjective perceptions that the worker has of the factors of work organization (Brazil, 2003). As examples, the following stand out: considerations related to career, workload and pace, and the social and technical environment of the work. The psychological "perception" that the individual has of the demands of the work is the result of a combination of the physical and mental characteristics of the workload, the individual's personality, previous experiences, and the social situation of the work.
Serafim, Campos, Cruz and Rabuske ( 2012) corroborate the concept that the conditions, organization and social relations of work provide indications that play a fundamental role in the health of workers, contributing to the occurrence of well-being or discomfort among employees and the risk of illness, which can cause psychological damage.
Based on the concept of Pereira, Souza, Lucca , & Iguti , (2020), that nowadays the goal of management models is to produce more and more with less, and in a short period of time; the way in which institutions are organized ends up reinforcing individualism among coworkers; increasing physical and mental fatigue, constituting a center of production of damage to the mental health of workers.
From the above, it can be seen that mental illnesses can arise from a series of factors common to work processes and work organization models, not only in private organizations, but also in public organizations. Such as low professional satisfaction and fulfillment; feelings of organizational injustice; inadequate remuneration; authoritarianism and excessive control by managers ( Guirado & Pereira, 2016).
In Brazil, although civil servants hold a permanent position that guarantees them job stability, they also face work contexts that affect their mental health. Issues such as the degradation of their working conditions and their image in society; accountability for imperfections in services; instability caused by the transition of political managers; service stoppages; and the accumulation of functions can significantly affect the health of these workers (Fonseca Carlotto , 2011; Oliveira, Baldacara , & Maia, 2015).
A study carried out in Brazil by Mota, Silva and Amorim (2020), with technical administrative staff of a federal education institute located in the Brazilian Northeast, presented a CMD rate of 37%, indicating that of the 434 employees studied, 160 have some type of mental disorder; of these, 60 have already been removed from work. It is noteworthy in this study that there 15 a prevalence of CMD of 66.7% in females; 61.7% in those over 34 years of age; 80% in people who have worked for more than four years in the institution; 55% in workers who work 40 hours a week; 55% in employees who do not have other paid activities; 60% in married people or in a stable union; and 45% in people who have some academic specialization.
Among the main somatic symptoms reported in the results of this study, the following stood out: headache, insomnia, digestive problems, hand tremors and lack of appetite. In addition, with regard to symptoms of depressive-anxious mood, 60.6% said they felt nervous, tense or worried; 34.56% said they felt sad; 26.73% claimed they were easily frightened; and 16.82% cried more than usual. With regard to symptoms of vital energy, 86% of workers felt tired; 37% had difficulty making decisions, as well as dissatisfaction in the work environment; 28% had difficulty thinking clearly; and 17.51% suffered to some extent when performing tasks related to their work. Furthermore, with regard to symptoms of depressive thoughts, 30% said they had lost interest in things; 11% felt useless; 8% feel unable to carry out any useful activity in life; and 7.37% have had suicidal thoughts (Mota, Silva, & Amorim, 2020).
Another study conducted by Rodrigues, Freitas, Assuncáo, Bassi and Medeiros (2013), with the objective of analyzing the profile of municipal employees with regard to absenteeism due to illness over a period of one year, showed that 51.1% feel nervous, tense and worried; 41.1% have frequent headaches; 37.88% experience suffering at work; 36.7% experience stomach pain; 31.1% have indigestion; 27.8% say they have difficulty finding satisfaction in their tasks; and 22.2% feel unable to play a useful role in their lives. Furthermore, it was possible to observe that the prevalence of absenteeism due to illness was higher among female employees; but it decreased with increasing age groups. However, the prevalence of CMD was observed in employees of all levels of education, including secondary, technical, higher or postgraduate education, which demonstrates that CMD is independent of the level of education. In addition, it was also found that CMD predominated in employees who had worked for less than ten years in the institution, with lower rates in those who had worked for more than twenty years.
Furthermore, a study carried out by Lima and Dimenstein (2019) with the aim of investigating the incidence of common mental disorders among prison officers linked to prison institutions in the State of Rio Grande do Norte showed that the prevalence of CMD is higher among employees who have worked in the system for between 10 and 15 years (48.42%); are between 30 and 45 years of age (71.58%); are married (62.11%); have one or two children (62.11%); are Catholic (50%); have completed higher education (45.26%); have another paid activity (30.53%); take on another occupation in the security sector (31.03%); have doubled shifts in the last month (33.68%); and have never sought medical help to treat any type of mental illness before (62.11%).
Regarding the symptoms of CMD that stood out most in the research, it was possible to conclude that at least half of the agents reported sleeping poorly (40%), work causes suffering (40%), nervousness, tension and worry (43%), covering the main symptoms related to depressive-anxious mood (59.55%), such as headache, insomnia, stomach discomfort, indigestion, lack of appetite and hand tremors; and somatic symptoms (53.35%), nervousness, being easily startled, sadness and crying more frequently. Overall, the results indicate a prevalence of 23.57% of CMD among prison agents (Lima & Dimenstein, 2019).
Finally, a study conducted by Alarcon and Guimaraes (2016) with employees of a public university in Mato Grosso do Sul showed that the prevalence of CMD among employees was 18.4%. Among the results found, 48.5% of the interviewees had health problems arising from work; this was more common among women, with a prevalence of 26.3% compared to 10.8% among men. Another aspect addressed in this study was academic qualifications, which showed that the transition from a master's degree to a doctorate increases the chance of CMD by 31.4%. It was also possible to prove that the younger the age group, the higher the level of CMD; therefore, age can be a protective factor for occupational health, with employees over 56 years of age being less likely to develop mental disorders.
3 METHODOLOGY
To achieve the proposed objective, in August, a Google Forms link was made available via email to all active employees of the federal higher education institution, whether technicaladministrative or teaching staff; from the Self Report Questionnaire (SRQ-20) developed by the World Health Organization (WHO, 2001), already evaluated and validated for Brazilian implementation (Gonçalves, Stein, & Kapczinski , 2008; lacoponi & Mari, 1988; Santos, Carvalho, & Araujo, 2016).
The SRQ-20 aims to assess the level of mental distress in general. As described in its name, the questionnaire consists of 20 yes/no items, and the respondent must inform which of the signs and symptoms described applies to him/her in the last 30 days. If the sign or symptom described in the question applies to the respondent, he/she should choose the "yes" option; otherwise, the option "no" (Gonçalves, Stein, & Kapezinski , 2008; Santos, Carvalho, & Araújo, 2016). Questions were added to this instrument to enable identification of the employee in terms of age, gender and education and the implications of the pandemic on the emergence or worsening of these signs and symptoms.
The data extracted from this instrument provide indications of the level of non-psychotic mental distress of the employees participating in the research; or, in other words, the prevalence of CMD. Each affirmative answer, "yes", was scored with the value 1 to compose the final score through the sum of these values. The scores obtained are related to the probability of the presence of a non-psychotic disorder, ranging from 0 (no probability) to 20 (extreme probability). The SRQ-20 cut-off score considered for this study was 7/8. Thus, when the result was > 7 (greater than or equal to seven "yes" answers), it received an indication of mental distress (Goncalves, Stein, & Kapczinski , 2008; Santos, Carvalho, & Araújo, 2016). Furthermore, according to the classification by lacoponi and Mari (1988), signs and symptoms can be grouped by their nature into four categories, namely: depressive-anxious mood, somatic symptoms, decreased vital energy and depressive thoughts.
Of the 1,240 active servers in August 2020, 345 responded to the survey. This number corresponds statistically to a representative sample number, with a significance level of 95% and an estimation error of 5% (Richardson, 2017).
Data analysis was performed with the aid of IBM Statistical software Package for the Social Sciences (IBM SPSS), version 24.0. In addition to simple descriptive statistics to identify the prevalence of mental distress, the Chi -square test was also performed to detect whether there 1s a significant association between two categorical and dichotomous variables. The statistics extracted from this test make it possible to test whether two variables are dependent. If the significance value is small enough (less than 0.05), the hypothesis that the variables are independent is rejected and the hypothesis that they are somehow related is accepted (Field, 2020).
4 ANALYSIS AND DISCUSSION OF RESULTS
4.1 PROFILE OF SERVERS PARTICIPATING IN THE SURVEY
The sample of this study had an almost equal representation in relation to gender, with a small evidence of males (51.3%). Regarding age, the instrument was answered by civil servants aged 19 to 70 years. This variable was divided into two age groups, following, with adaptations, the conceptual orientation of Erikson (1976ab): young adults (19 to 39 years) and middle-aged and elderly adults (40 years or older); and a dominance of civil servants considered young adults was observed (64.6%). Regarding the level of education, as expected, considering that the target audience of this study are civil servants of a federal higher education institution; there was a preponderance of participants with a strictu postgraduate level. sensu ; master's, doctorate and post-doctorate (65.2%). For analysis purposes, this variable was divided into three groups: without strictu sensu postgraduate studies , With master's, with doctorate and/or post-doctorate.
4.2 ANALYSIS OF THE PREVALENCE OF MENTAL DISTRESS AMONG SERVANTS PARTICIPATING IN THE RESEARCH
According to the frequency of affirmative responses, that 1s, the number of signs and symptoms perceived by the institution's employees, the data were separated into two groups: those who received an indication of mental suffering (Y es) and those who did not receive the indication (No). The data in Table 1 reveal that 29.0% of the employees presented indications of CMD, according to the SRQ-20 cut-off score considered to be 7/8.
This percentage of sick employees is within an expected margin, when considering the results of other similar studies that measured the level of CMD among employees (Mota, Silva and Amorim, 2020; Rodrigues et al ., 2013; Lima and Dimenstein, 2019; Alarcon and Guimaraes, 2016).
Regarding the symptoms presented; overall, a total of 1656 statements or indications of signs and symptoms were found. The three most indicated signs and symptoms, by more than 40% of the employees, were: nervousness, tension or worry. These findings confirm those already mentioned by Rodrigues et al. (2013) and Mota, Silva and Amorim (2020);
in addition to a bad night's sleep and sadness, also corroborating the studies carried out by Lima and Dimenstein (2019). See Table 2.
In order to better understand the nature of these signs and symptoms, they were grouped into their respective categories (according to the classification by Iacoponi & Mari, 1988). When grouping the signs and symptoms into these categories, it can be observed, from the data presented in Table 3, that the signs and symptoms related to the categories: decreases in vital energy, somatic symptoms and depressive-anxious mood are equivalent to an approximate percentage of 30%. However, the signs and symptoms related to depressive thoughts were shown to be infrequent, for only 8% of the participants in this research.
Regarding the category of decreases in vital energy, the results confirm the findings of other studies carried out by Rodrigues et al . (2013) and Mota, Silva, and Amorim (2020). However, they contrast with the literature by demonstrating that the category of depressive thoughts is the one that presents the least dominance among the most frequent symptoms (Rodrigues et al ., 2013; Lima & Dimenstein, 2019; Mota, Silva, & Amorim, 2020).
4.3 ANALYSIS OF THE PREVALENCE OF MENTAL DISTRESS AMONG SERVERS PARTICIPATING IN THE RESEARCH REGARDING THE PANDEMIC TIME
The additional questions in the instrument allowed an analysis of the presence and worsening of these signs and symptoms at this time of the pandemic. Based on the above, it can be observed, through the data presented in Table 4, that many of the signs and symptoms were already perceived by 53.0% of the employees before this moment. On the other hand, 47.0% of the employees reported that they only noticed the presence of these signs and symptoms in the context of the pandemic.
Regarding the result of Pearson's Chi -square test, used for dichotomous data, a significant association was observed between those who already perceived the presence of these signs and symptoms before the pandemic and the prevalence of mental distress, y2 (1) = 50.735, (p < 0.001). Furthermore, the count of affirmative responses in both variables was higher than the expected count (83 - 53). This means that, based on the relative risk, the prevalence of mental distress 1s 7.08 times more likely to be prior to the pandemic. In other words, the data suggest that this moment of pandemic did not trigger the appearance of signs and symptoms in the employees participating in the research, at least not for those who were without signs and symptoms prior to the pandemic.
These results indicate that the percentage of civil servants affected by CMD, equivalent to 29.0%, predates the pandemic and reinforces the rates of illness among civil servants (Bastos et al ., 2018; Mota, Silva & Amorim, 2020, Rodrigues et al ., 2013; Lima & Dimenstein, 2019) . Furthermore, they corroborate empirical studies that the causes of this illness are related to the elements that constitute the work context of the public service (Fonseca Carlotto , 2011; Oliveira, Baldacara , & Maia, 2015, Bastos et al ., 2018).
Although 63.3% of the employees did not associate these signs and symptoms with worsening in this context, Pearson's Chi -square test reveals an interesting fact. The data presented in Table 5 indicate a strong association between those who perceived worsening of signs and symptoms during the pandemic and those who presented indications of mental distress, y2 (1) = 38.441, (р < 0.001). As in the previous analysis, the count of "yes" for both variables was well above the expected (63 - 37.7). This seems to represent the fact that, based on the relative risk, mental distress is 4.52 times more likely to have worsened during the pandemic. In other words, especially for those who felt affected by CMD before the pandemic, this current moment contributed to worsening their mental distress.
This finding reinforces discussions about the effects of this pandemic scenario on people's mental health, especially for those who already suffered from mental disorders ( Ornell et al. 2020, V aldés- Florida et al ., 2020).
Mental health is currently being affected by COVID-19, due to the fact that, during a pandemic, a high burden of negative experiences and emotions is likely to be experienced, raising the need for constant psychological care from the initial period of the problem (Ho, Chee , & Ho, 2020; Li et al ., 2020). Thus, there is a need to investigate and act on issues related to mental health throughout the crisis, since the ability to achieve a state of healthy psychological adjustment is challenged, day after day, by numerous unusual adversities during this period (Brooks et al ., 2020; Ho, Chee , & Ho, 2020; Lima et al ., 2020; Ozili & Arun, 2020).
4.4 ANALYSIS OF THE MAIN SIGNS AND SYMPTOMS IDENTIFIED BY SERVERS PARTICIPATING IN THE SURVEY DURING THE PANDEMIC
As already emphasized, concern for the population's mental health intensifies during a serious social crisis. A crisis of this magnitude, involving social isolation and disruption of routine, ends up causing mental health problems, thus hindering the ability of society as a whole to cope with the disease. COVID-19 has caused a feeling of insecurity in all aspects of life, from the collective to the individual perspective, from the daily functioning of society to changes in interpersonal relationships (Lima et al ., 2020; Ozili & Arun, 2020). These feelings, when they persist, can manifest themselves through signs and symptoms. Therefore, participants who indicated that signs and symptoms appeared or worsened during the pandemic were encouraged to respond freely about which signs and symptoms these were.
The signs and symptoms that emerged during the pandemic according to the participating employees are: worry; anxiety; nervousness; and fatigue, especially mental fatigue; in addition to insomnia and pain, headaches/migraines, in the shoulders, spine and/or lower back; as well as digestive and gastric problems. As represented in Figure 1.
4.5 COMPARATIVE ANALYSIS OF THE PREVALENCE OF MENTAL DISTRESS IN RELATION TO GENDER, AGE AND EDUCATION OF SERVANTS PARTICIPATING IN THE RESEARCH
In order to verify whether the prevalence of signs and symptoms perceived by the participating employees is related to any of their personal characteristics, the Chi -square test was performed for the variables gender, age and education and the indication of mental suffering.
Regarding gender, Table 6 shows that, based on the prevalence percentage, female employees have a higher rate of mental distress than male employees, 34.5% versus 23.7%. Furthermore, the result of Pearson's Chi -square test reinforces the existence of a significant relationship between gender and the prevalence of mental distress, y2 (1) = 4.880, (р < 0.05). These findings corroborate the studies by Rodrigues et al . (2013), Alarcon and Guimaraes (2016), Lima and Dimenstein (2019) and Mota, Silva and Amorim (2020), showing a higher prevalence of CMD in women.
Furthermore, in the cross-tabulation, it can be seen that the number of women who received the indication of mental suffering was higher than the expected number. This data shows that, based on relative risk, females (Women) are 1.96 times more likely to present mental suffering than males (men).
Considering the result of the Chi -square test for the gender variable in relation to the indication of mental suffering, the same test was carried out to verify the presence and/or worsening of these signs and symptoms at the time of the pandemic.
The data in Table 7 show a strong association between those who already perceived the presence of these signs and symptoms before the pandemic and gender, y2 (1) = 7.736, (р < 0.008). Based on the above, based on relative risk, females (women) are 1.83 times more likely to suffer from signs and symptoms before the pandemic than males (men). The findings of Silva et al . (2012) reveal that there is a significant predominance of females in absences, compared to men, especially during the reproductive period, when women are more vulnerable to anxious and depressive signs and symptoms.
Similarly, the data in Table 8 indicate a significant association between those who perceived worsening of signs and symptoms during the pandemic and gender, y2 (1) = 4.645, (p <0.05). This result, based on the relative risk, shows that the female gender (women) is 1.62 times more likely to have their mental suffering worsened due to the pandemic than the male gender (men).
Regarding the presence of mental suffering according to gender, as in the present study, a higher prevalence in women, in relation to men, was found not only in this research but also in several others. Araújo and Carvalho (2009) suggested the overload of domestic work as one of the possible factors that increased women's vulnerability to mental suffering.
Regarding the age variable, as previously specified, the data were divided into two age groups: the first from 19 to 39 years old and the second from 40 to 70 years old. The results of the cross-tabulation and Pearson's chi -square test shown in Table 9 show that there was no significant relationship between the age group and the prevalence of mental distress, x2 (1) = 114, (р > 0.05). In addition, the count identified in each quadrant is very close to the expected count. This may indicate that the prevalence of mild distress is independent of the age group.
However, these results are contradicted by the findings of Mota, Silva and Amorim (2020), in which civil servants over 34 years of age presented a high rate of mental disorders (61.7%); which can be compared with the studies of Lima and Dimenstein (2019), who demonstrated that civil servants between 30 and 45 years of age have higher levels of mental disorders. Similarly, the studies carried out by Rodrigues et al. (2013) and Alarcon and Guimaraes (2016) confirmed that there is a higher prevalence of CMD in older civil servants.
One possible explanation for the fact that the results of this study contradict other studies already conducted with public servants comes from the current situation. These studies, although current, were conducted before the WHO declaration on March 11, 2020 (Pan American Health Organization, 2020). This issue suggests that the effects of the pandemic affect everyone regardless of age group.
stricto sensu postgraduate studies : high school, higher education and specialization; with a master's degree; and with a doctorate.
Before grouping, although the number is much lower than that of other levels, it was noteworthy that civil servants with only a high school education were those who had the highest prevalence of CMD. Of the six civil servants who participated in the survey with this level of education, four received an indication of mental distress, i.e., 66.7%; as for the other levels of education, the percentages were around 26% to 36%.
After grouping, as can be seen in Table 10, it was observed that the Chi -Square test for association and linear trend; option for more than two response categories, as is the case here; did not show a significant association between education and the prevalence of mental suffering, y2 (1) = .003, (р > 0.05). Furthermore, the count identified in each quadrant is very close to the expected count.
This result indicates that the prevalence of mental suffering is independent of education level, and confirms the percentage of illness by level of education, corroborating the findings of Rodrigues et al . (2013), who showed a predominance of CMD both in employees with high school education and in employees with complete higher education and postgraduate studies.
However, they contradict other studies that indicated the prevalence of CMD in civil servants with complete higher education (Lima & Dimenstein, 2019), academic specialization (Mota, Silva, & Amorim, 2020), with a higher risk of developing CMD in the transition from master's to doctorate ( Alarcon & Guimaraes). The same explanation for the age variable applies to the education variable.
5 CONCLUSION
The main objective of this article was to analyze the mental health of public servants at a higher education institution during the COVID-19 pandemic. Given the situation, which suddenly took hold worldwide and resulted in social isolation, this study sought to understand how the safety measures requested by the WHO were affecting the mental health of public servants at a university in the interior of Rio Grande do Norte.
The findings of this study indicate that the percentage of civil servants suffering from CMDs predates the pandemic; and confirm other empirical studies that the causes of this illness are related to the elements that constitute the work context of public agencies. However, they also reinforce the concern about the effects of this pandemic scenario on people's mental health, especially for those who already suffered from mental disorders. Furthermore, they reveal the existence of a significant relationship between gender and the prevalence of mental suffering.
As contributions, the research stands out for being a pioneer in the analysis of the mental health of federal public servants in this pandemic context. Despite its contributions, the research has limitations regarding the selection of participating subjects, since the study evaluated civil servants in the general context, without separating administrative technicians from teachers. Furthermore, there is no way to carry out comparative studies to prove that some civil servants already presented signs and symptoms of CMD before the pandemic.
For future research, it is suggested that the study be replicated at a time after the COVID19 pandemic, in order to make a comparison, both in relation to the number of signs and symptoms, during and after, and in relation to the category of the server, whether technicaladministrative or teaching. Furthermore, it is recommended that this study be replicated in private organizations, or even in other public organizations not related to education.
REFERENCES
Araújo, Е. J. O, de Lima, L. $. A., Cidade, P. I. M., Nobre, С. B., € Neto, M. L. К. (2020). Impact of Sars-Cov-2 And its reverberation in global higher education and mental health. Psychiatry Research, 288, 112977.
Araújo, T. M., & Carvalho, Е. М. (2009). Condições de trabalho docente e saúde na Bahia: estudos epidemiológicos. Educação & Sociedade, 30(107), 427-449.
Alarcon, A. D. С. R. S., & Guimaraes, L. A. М. (2016). Prevalência de transtornos mentais em trabalhadores de uma universidade pública do Estado de Mato Grosso do Sul, Brasil. Revista Sul Americana de Psicologia, 4(1), 46-68.
Bastos, М. L. A., Junior, С. В. D. S., Domingos, E.T. C., Araújo, К. М. O. D., & Santos, A. L. D. (2018). Afastamentos do trabalho por transtornos mentais: um estudo de caso com servidores públicos em uma instituição de ensino no Ceará, Brasil. Revista Brasileira de Medicina do Trabalho, 16(1), 53-59.
Baldacara, L., Silva, A. F., Castro, J. G. D., & Santos, G. D. C. A. (2015). Sintomas psiquiátricos comuns em professores das escolas públicas de Palmas, Tocantins, Brasil. Um estudo observacional transversal. São Paulo Medical Journal, 133(5), 435-438.
Barros, М. М. С. C., & Honório, L. С. (2015). Riscos de adoecimento no trabalho de médicos e enfermeiros em um hospital regional mato-grossense. REGE-Revista de Gestão, 22(1), 21-39.
Brasil. Instrução Normativa DC/INSS n 98, de 5 de dezembro de 2003. Aprova Norma Técnica sobre Lesões por Esforços Repetitivos - LER ou Distúrbios Osteomusculares Relacionados ao Trabalho - DORT. Diario Oficial da Unido. 10 dez 2003.
Brooks, S. K., Webster, К. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet, 395(102227), 912-920.
Cabana, М. С. F., Ludermir, A. B., Silva, É. R., Ferreira, М. L. L., & Pinto, М. Е. КВ. (2007). Transtornos mentais comuns em médicos e seu cotidiano de trabalho. Jornal Brasileiro de Psiquiatria, 56(1), 33-40.
Coronavirus Resource Center. (2020). Coronavirus COVID-19 global cases by the Center for Systems Science and Engineering (CSSE). Baltimore: Johns Hopkins University. Retrieved from http://coronavirus.jhu.edu/map.html
Engidaw, М. A., Abdu, Z., & Chinani, 1. (2020). Prevalence and associated factors of common mental disorders among residents of Ши Ababore zone, southwest Ethiopia: a crosssectional study. International Journal of Mental Health Systems, 14(1), 1-8.
Erikson, E. H. Identidade: Juventude e crise. 2 ed. Rio de Janeiro: Zahar, 1976a. Erikson, Е. H. Infáncia e sociedade. 2 ed. Rio de Janeiro: Zahar, 1976b.
Field. A. Descobrindo a estatistica usando о SPSS [recurso eletrónico]. 5 ed. Porto Alegre: Penso, 2020.
Fonseca, К. М. C., & Carlotto, М. $. (2011). Saúde mental e afastamento do trabalho em servidores do Judiciário do Estado do Rio Grande do Sul. Revista Psicologia ет Pesquisa, 5(2), 1-9.
Gonçalves, D. M., Stein, A. T., & Kapczinski, Е. (2008). Avaliação de desempenho do SelfReporting Questionnaire como instrumento de rastreamento psiquiátrico: um estudo comparativo com o Structured Clinical Interview for DSM-IV-TR. Cadernos de Saúde Pública, 24(2), 380-390.
Но, С. S., Chee, С. Y., & Но, К. С. (2020). Mental health strategies to combat the psychological impact of COVID-19 beyond paranoia and panic. Ann Acad Med Singapore, 491), 1-6.
lacoponi, E., & de Jesus Mari, J. (1989). Reliability and factor structure of the Portuguese version of Self-Reporting Questionnaire. International Journal of Social Psychiatry, 35(3), 213-222.
Kessler, R. C., Aguilar-Gaxiola, S., Alonso, J., Chatterji, S., Lee, S., Ormel, J., & Wang, Р. $. (2009). The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiologia e psichiatria sociale, 18(1), 23.
Li, X., Yu, H., Bian, G., Hu, Z., Liu, X., Zhou, Q., ... & Zhou, D. (2020). Prevalence, risk factors, and clinical correlates of insomnia in volunteer and at home medical staff during the COVID-19. Brain, behavior, and immunity.
Lima, С. К. T., Carvalho, P. M. M., Lima, I. A. S., Nunes, J. A. У. O., Saraiva, J. S., Souza, К. I., Silva, С. С. L., Rolim Neto, М. L. (2020). The emotional impact of coronavirus 2019Ncov (new Coronavirus Disease). Psychiatry Research, 287, 112915.
Lima, A. L, & Dimenstein, М. (2019). Transtornos Mentais Comuns entre Trabalhadores do Sistema Prisional. Revista Psicologia em Pesquisa, 13(1), 53-63.
Ludermir, A. B., & Lewis, С. (2005). Investigating the effect of demographic and socioeconomic variables on misclassification by the SRQ-20 compared with a psychiatric interview. Social psychiatry and psychiatric epidemiology, 40(1), 36-41.
Nabuco, G., de Oliveira, M. H. P. P., & Afonso, M. P. D. (2020). O impacto da pandemia pela COVID-19 na saúde mental. Revista Brasileira de Medicina de Familia e Comunidade, 15(42), 2532-2532.
Nascimento, J. O. V., Santos, J. D., Meira, K. C., Pierin, A. M. G., & Souza-Talarico, J. N. (2019). Trabalho em turnos de profissionais de enfermagem e a pressáo arterial, burnout e transtornos mentais comuns. Revista da Escola de Enfermagem da USP, 53, 1-9.
Ornell, F., Schuch, J. B., Sordi, A. O., & Kessler, Е. H. P. (2020). "Pandemic fear" and COVID19: mental health burden and strategies. Brazilian Journal of Psychiatry, 42(3), 232-235.
Organização Mundial da Saúde. 2001. Relatório sobre a saúde no mundo 2011: Saúde Mental: nova concepção, nova esperança. Disponível em: https://www.who.int/whr/2001/en/whr01_djmessage po.pdf. Acesso em 17 de Set. 2020.
Oliveira, L. A., Baldaçara, L. R., & Maia, M. Z. B. (2015). Afastamentos por transtornos mentais entre servidores públicos federais no Tocantins. Revista Brasileira de Saúde Ocupacional, 40(132), 156-169.
Ozili, P., & Arun, T. (2020). Spillover of COVID-19: impact on the global economy. SSRN Preprints.
Pereira, А. С. L., Souza, H. A., Lucca, $. К. D., & Iguti, A. M. (2020). Fatores de riscos psicossociais no trabalho: limitações para uma abordagem integral da saúde mental relacionada ao trabalho. Revista Brasileira de Saude Ocupacional, 45, 1-9.
Rodrigues, E. P., Rodrigues, U. S., Oliveira, L. D. M. M., Laudano, К. С. S., & Sobrinho, С. L. N. (2014). Prevaléncia de transtornos mentais comuns em trabalhadores de enfermagem em um hospital da Bahia. Revista Brasileira de Enfermagem, 67(2), 296-301.
Pereira, С. У. M., & Vieira, A. (2011). O sofrimento humano nas organizacdes: Estratégias de enfrentamento adotadas em uma empresa de logistica. Rio de Janeiro: Anpad.
Richardson, К. J. Pesquisa social: métodos e técnicas. 4 ed. São Paulo: Atlas, 2017.
Rodrigues, С. D. S., Freitas, К. М. D., Assunção, A. A., Bassi, 1. B., & Medeiros, A. М. D. (2013). Absenteismo-doenca segundo autorrelato de servidores publicos municipais em Belo Horizonte. Revista Brasileira de Estudos de População, 30, S135-S154.
Santos, Е. C., Espinosa, M. M., & Marcon, $. К. (2020). Qualidade de vida, saúde e trabalho de professores do ensino fundamental. Acta Paulista de Enfermagem, 33, 1-8.
Santos, K. O. B., Carvalho, F. M., & Araujo, T. M. D. (2016). Consisténcia interna do selfreporting questionnaire-20 em grupos ocupacionais. Revista de Saude Publica, 50(6), 110.
Serafim, A. D. C., Campos, I. С. M., Cruz, К. M., & Rabuske, М. М. (2012). Riscos psicossociais е incapacidade do servidor publico: um estudo de caso. Psicologia: Ciéncia e profissão, 32(3), 686-705.
Silva, J. L. L., Acco, A. H., Almeida, С. L., Silva Soares, R., Lima, У. F., & Brezolin, С. A, ... & da Silva Correio, К. Р. (2020). Aspectos psicossociais e relação com sedentarismo entre trabalhadores hidroviários/Psychosocial aspects and its relation with sedentarism among waterway workers. Brazilian Journal of Development, 6(6), 33252-33263.
Steel, Z., Marnane, C., Iranpour, C., Chey, T., Jackson, J. W., Patel, V., & Silove, D. (2014). The global prevalence of common mental disorders: a systematic review and meta-analysis 1980-2013. International journal of epidemiology, 43(2), 476-493.
Stratton, K. J., Aggen, S. H., Richardson, L. K., Acierno, R., Kilpatrick, D. G., Gaboury, M. T., ... & Ha, T. T. (2013). Evaluation of the psychometric properties of the Self-Reporting Questionnaire (SRQ-20) in a sample of Vietnamese adults. Comprehensive psychiatry, 54(4), 398-405.
Valdés-Florido, M. J., López-Díaz, À, Palermo-Zeballos, Е. J., Martinez-Molina, I, MartinGil, V. E., Crespo-Facorro, B., & Ruiz-Veguilla, M. (2020). Reactive psychoses in the context of the COVID-19 pandemic: clinical perspectives from a case series. Revista de psiquiatria y salud mental, 20(13), 90-94.
Walker, E. R., McGee, R. E., & Druss, B. G. (2015). Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA psychiatry, 72(4), 334-341.
World Health Organization - WHO. 2017. Depression and other Common Mental Disorders. Global Health Estimates. Disponivel em: eng.pdf?sequence=1. Acesso em 18 de Setembro de 2020
World Health Organization -WHO. Suicide Data. Disponível em:<https://www.who.int/mental health/prevention/suicide/suicideprevent/en/>. Acesso em 10 de Novembro de 2020.
Wang, J., & Wang, Z. (2020). Strengths, weaknesses, opportunities and threats (Swot) analysis of china's prevention and control strategy for the covid-19 epidemic. International Journal of Environmental Research and Public Health, 17(7), 2235.
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Abstract
Objective: The study aims to analyze the mental health of employees at a federal higher education institution (IFES) during the COVID-19 pandemic. Theoretical Framework: With the worsening of COVID-19, some factors contribute to the increase in illness in the general population, including: social isolation, excess information, grief and/or fear of losing loved ones, among other economic, social and work factors (Nabuco, Oliveira, & Afonso, 2020). Method: In addition to simple descriptive statistics to identify the prevalence of mental suffering, the Chi-square test was also carried out to detect whether there is a significant association between the prevalence of CMD and the variables relating to gender, age and education of employees Research implications: The findings in this study invite the reader to reflect on three complex phenomena: pandemic, public service and mental health. Originality/Value: This work, in addition to addressing mental health issues in public service, provides an overview of mental illness at this pandemic time.