Mudanças estruturais, condições de trabalho e riscos psicossociais em um hospital público universitário

Abstract

The main objective of this work was to identify and evaluate the psychosocial effects of structural changes management model and legal framework in a huge University Hospitals. Work conditions and workers stress perception were also evaluated. The methodology used was the triangulation method, with documental analysis, interviews and structured questionnaire. The Brazilian government management restructuration, with emphasis in efficiency, cost reduction and resources allocated for production affected University Hospitals. The lack of contests resulted in a revenue impairment due to outsourced workforce payments. To guarantee its viability and maintain its relevant hole in the society, the studied hospital prioritized assistance and productivity increase, impairing work conditions. Workers were submitted to work overload, under dimensioned job posts and precarious employment bonds. In 2012, as a crisis response, Brazilian Federal Government created a public company with private nature (Ebserh) and have made University Hospitals financial viability conditioned to Ebserh joining. In 2013, the studied hospital joined the company and passed through structural changes that led to psychosocial impacts. The factorial analysis of the Work Condition Questionnaire confirmed three second order factors, named: Demands, Contradictions and Material Conditions; Communication, Challenge and Participation; and Support and Planning. Factors score showed the difference among sociodemographic variables and contractual and legal aspects. The stress perception questionnaire used (Effort-Reward Balance Model) presented results that demonstrate work stress situation. The positive relation between factors allows the conclusion that inadequate work conditions perceived by the workforce represent psychosocial risk factors, being predictive factors of work stress and its consequences, sickness, turnover and engagement on personal and organizational development.