Riscos psicossociais nas residências em medicina de família e comunidade do Distrito Federal

Abstract

Introduction: Medical residency, recognized as the gold standard for specialized training in Brazil, is a setting for work-based learning, but also one marked by intense clinical, pedagogical, and subjective demands. In the field of Family and Community Medicine, the expansion of Network Residency Programs, especially within the Federal District State Health Secretariat, increased the number of positions and training settings while also revealing challenges related to working conditions, institutional organization, and the mental health of residents and preceptors. Exposure to psychosocial risk factors, such as overload, harassment, violence, imbalance between personal and professional life, emotional distress, and use of psychoactive substances, may affect training, professional performance, and the quality of health care. Objective: To analyze the psychosocial risks and work context of residents and preceptors in the Family and Community Medicine Residency Program who use training settings linked to the Federal District State Health Secretariat. Method: This was a descriptive, field-based, quantitative, exploratory cross-sectional study conducted with 109 participants, including 37 preceptors, 36 first-year residents, and 36 second-year residents. Data were collected using a structured, validated, and adapted electronic questionnaire administered through the REDCap® platform. Sociodemographic variables, working conditions, satisfaction with the specialty, work environment, exposure to harassment and violence, anxiety and depressive symptoms, psychosomatic complaints, suicidal ideation, professional activities outside residency, and use of psychoactive substances were investigated. The analysis included descriptive and inferential statistical procedures, with a 5% significance level. Results: A total of 109 participants took part in the study, with a predominance of women and heterosexual individuals. Differences were observed between groups regarding marital status and living arrangements, with a higher proportion of single residents and married or cohabiting preceptors. Compared with preceptors, residents reported greater dissatisfaction with the specialty, higher daily emotional exhaustion, anxiety symptoms, difficulty controlling worries, depressive feelings, and greater imbalance between professional and personal life. Physical aggression was more frequent among second-year residents, particularly when perpetrated by patients or accompanying persons. Consumption of energy drinks was higher among residents. Although no statistically significant differences were observed regarding suicidal ideation, its presence was identified in all groups. Psychosomatic complaints were high and similarly distributed among residents and preceptors. Conclusion: Residency in Family and Community Medicine in training settings linked to SES-DF is associated with important psychosocial risk factors, with greater vulnerability among residents, especially regarding emotional distress, dissatisfaction with the specialty, imbalance between work and personal life, and exposure to situations of violence. The findings indicate the need for ongoing institutional strategies to promote mental health, prevent violence, strengthen supervision, and expand psychosocial support, in order to improve the training and work environment, protect residents and preceptors, and contribute to safer, more ethical, and more humanized care within the Brazilian Unified Health System.