Discharge Planning After Myocardial Revascularization: Differences in Opinions From Patients and Health Experts.

BACKGROUND: In-hospital education and discharge planning contribute to recovery after coronary artery bypass graft surgery (CABG). OBJECTIVE: The objective of this study was to identify differences in perception of the importance of discharge instructions between a sample of adult patients after CABG and health experts responsible for their care. METHODS: Thirty-five first-time CABG adult patients and 8 multidisciplinary experts rated a 46-item questionnaire of discharge education themes on a 3-point scale. Items were classified as most important if rated as "very important" by more than 85% of the participants in each group. RESULTS: Of the 31 items considered most important (reaching the 85% approval criteria), agreement between groups was reached for 15 (48%), whereas 11 (35%) items were selected only by the patients and 5 (16%) were selected only by the experts. CONCLUSIONS: The authors of this study demonstrate a difference in perception between patients and health experts regarding the importance of various discharge instructions. Better understanding areas of patient concern may improve discharge routines.

Stress, coping and burnout among Intensive Care Unit nursing staff: associated factors. / Estresse, coping e burnout da Equipe de Enfermagem de Unidades de Terapia Intensiva: fatores associados.

Objective To investigate emotional stress, coping and burnout among nursing staff and their association with biosocial factors and characteristics of work in Intensive Care Units (ICU). Method This was a cross-sectional study, conducted in eight ICUs at a teaching hospital in the city of São Paulo, Brazil, in October 2012. Biosocial data and information about the professionals' work was gathered, and they were given the Scale of Occupational Stress, Scale of Occupational Coping, List of Signs and Symptoms of Stress and the Maslach Burnout Inventory. Results The study sample consisted of 287 subjects, predominately women, with partners and children. Most professionals presented moderate stress levels and control as a coping strategy (74.47% and 79.93%, respectively), and burnout was present among 12.54%. Factors associated with stress were related to working conditions. The most prevalent protective factors were having a partner, working in the clinical ICU and liking work, while adequate amount of sleep was a protective factor for burnout. Conclusion Control of the working environment and adequate sleep are decisive and protective factors in dealing with situations of occupational stress.

Hardy personality and burnout syndrome among nursing students in three Brazilian universities-an analytic study.

BACKGROUND: Nursing students may exhibit the characteristics of resistance to stress, such as hardiness, which can reduce the risk of burnout. However, we found only one published study about these phenomena among nursing students. Thus, we investigated the association between hardiness and burnout in such students. METHODS: An analytic, cross-sectional study was conducted among 570 nursing students from three Brazilian universities. Data were collected relating to sociodemographic characteristics, hardiness, and burnout, which we analyzed using inferential statistics. RESULTS: We observed that 64.04% of nursing students in the sample had a high level of emotional exhaustion, 35.79% had a high level of cynicism, and 87.72% had a low level of professional efficacy: these are dimensions of burnout. We also found that 48.77% had a high level of control, 61.40% a high level of commitment, and 35.44% a high level of challenge: these are dimensions of hardiness. Only 24.74% of the students experienced burnout, and 21.93% met the criteria for a hardy personality. There was a statistically significant difference between the frequency of hardiness and burnout (p = 0.033), with 68.00% of hardy students not exhibiting burnout. CONCLUSIONS: Although nursing students live with educational stressors, burnout was not preponderant in our sample students; this may be linked to hardiness. Thus, given its benefits to student life and health, we recommend the development of strategies to promote hardiness among nursing students.

[Influence of stress factors and socio-demographic characteristics on the sleep quality of nursing students]. / Influencia de los factores de estrés y de las características sociodemograficas en la calidad del sueño de estudiantes de enfermería.

OBJECTIVE: To analyze the influence of stress factors and socio-demographic characteristics on the sleep quality of nursing students. METHOD: An analytical cross-sectional and quantitative study, conducted with 151 nursing students in São Paulo between March and April of 2012. A form for socio-demographic characteristics, the Instrument to Evaluate Stress in Nursing Students and the Pittsburgh Sleep Index were applied. RESULTS: High levels of stress was predominant for Time Management (27.8%) and Professional Training (30.5%) and low sleep quality (78.8%). The Professional Communication, Professional Training and Theoretical Activity are positively correlated to sleep quality. Work activity, academic year and time for daily studies contributed to a low quality of sleep. CONCLUSION: Few stress factors from the academic environment and some socio-demographic characteristics contributed to the reduction of sleep quality in students.

[Subjective memory complain in healthy elderly: influence of depressive symptoms, perceived stress and self-esteem]. / Queixa subjetiva de comprometimento da memória em idosos saudáveis: influência de sintomas depressivos, percepção de estresse e autoestima.

The current study analyzed the relationship between perceived stress, depressive symptoms and self-esteem in elderly with and without subjective memory complain. Two-hundred four elderly were included (104 without and 100 with subjective memory complain) assesse using the Memory Assessment Complain Questionnaire (MAC-Q). The study protocol was composed by the Perceived Stress Scale (PSS), the Geriatric Depression Scale (GDS) and the Self-Esteem Scale of Rosenberg (SES). The elderly with subjective memory complain showed higher PSS and GDS scores (p < 0.001) and lower SES scores (p = 0.045). Negative correlation was observed between MAC-Q and PSS (p < 0.001) and GDS (p = 0.01). Multiple regression analysis showed predictor effect of perceived stress in the subjective memory complain. These findings suggest that the perceived stress and depressive symptoms are associated with subjective memory complain in elderly.

[Victims of traffic occurrence submitted to surgery procedures: characteristics and perioperative complications]. / Vítimas de ocorrência de trânsito submetidas a procedimentos cirúrgicos: características e intercorrências transoperatórias.

This study aimed to characterize the victims of traffic occurrence submitted to anesthetic-surgical procedures according to demographics and clinical data and identify the predictors of complications during the perioperative period (hemorrhagic shock and death). A cross-longitudinal analysis developed from the consultations of patients´ records submitted to surgery at a hospital in São Paulo city. There was predominance of young, male, and motorcycle/cyclist accident victims who received prehospital support in 69 analyzed patients. The abdomen as the most severely injured region, Injury Severity Score, general and orthopedic surgeries variables showed statistically significant association with shock and death. Age was only associated with shock. In the final model, the Injury Severity Score was predictor for shock and death, and general surgery only for shock. Orthopedic surgery was a protection factor for death. These findings subsidize the surgical team in strategic planning that aims to decrease undesirable outcomes.

[Education in operating room nursing: transformation of the discipline at University of São Paulo School of Nursing (Brazil)]. / Ensino de enfermagem em centro cirúrgico: transformações da disciplina na Escola de Enfermagem da USP (Brasil).

The objectives of this paper are to present a summary of the evolution of the content of perioperative nursing at the University of São Paulo School of Nursing (EEUSP) and reflect on the National Curriculum Directives (NCD) for the nursing course. The study was developed from a brief history of the practice of perioperative nursing and the inclusion of this topic in the nursing curriculum at EEUSP. The National Curriculum Directives are important because they permit undergraduate schools to determine the amount of teaching time for each course that will comprise their curriculum, but the competencies and skills proposed are nonspecific. We believe that the general nurse should have theoretical and practical learning opportunities to work in every area and level of healthcare.

Health alterations in nursing students after a year from admission to the undergraduate course.

OBJECTIVE: To identify health alterations in nursing students after a year from admission to a nursing undergraduate course. METHOD: A longitudinal prospective study with a quantitative approach was carried out in 2016 with first-year nursing students from two universities in the state of São Paulo. The following instruments were applied at the beginning and the end of the first school year: an instrument for Assessment of Stress in Nursing Students, the Center for Epidemiologic Studies Depression Scale, and the Pittsburgh Sleep Quality Index. The ANOVA test for mixed models was used for analysis. RESULTS: The sample was made up of 117 students in March and 100 students in December. A significant increase in stress in all dimensions of the instrument, a reduction in the duration and subjective quality of sleep, and an increase in general stress and depressive symptoms were observed. CONCLUSION: The nursing academic environment presents the potential for students to become ill. Institutions should rethink their curricular elements, promote resilience, and create spaces to promote students' health.

Comparison of stress in freshman and senior nursing students.

OBJECTIVE: To compare stress levels in freshman and senior nursing students. METHOD: A cross-sectional study was carried out in a public federal university of the state of Bahia, with students who answered questionnaires about sociodemographic variables, academic life, and a scale for assessing stress in nursing students. Chi-square and Fisher's exact tests were applied to analyze the relationship between variables. To assess proportional trends between ordinal variables and groups, a chi-square test for linear trend was applied. The significance level was 5%. RESULTS: One hundred and fifty-four students participated in the study. There was a tendency to higher stress levels among students in the last year compared to those in the first year, in four out of six domains: Performance of Practical Activities (p=0.00), Professional Communication (p=0.00), Environment (p=0.00) and Professional Education (p=0.00). CONCLUSION: High levels of stress were observed in students taking the last year. There is a need for broader research that includes other years of the course, an institutional reflection on stress factors and the adoption of an institutional policy that favors a better confrontation of stress factors.

Relationship between cortisol reactivity to psychosocial stress and declarative memory decline during aging: Impact of age and sex.

AIM: To analyze the relationship between memory performance and the neuroendocrine and cardiovascular response to acute psychosocial stress in healthy older people, and the sex and age impact in this relationship. METHODS: We randomly selected 100 literate older adults, without cognitive or functional impairment. The neuroendocrine stress response was evaluated by measuring the concentration of salivary cortisol, whereas cardiovascular reactions were determined based on blood pressure and heart rate measures taken before, during and after participant exposure to an acute psychosocial stressor (the Trier social stress test [TSST]). Memory performance was evaluated by applying the word pairs test before and after the TSST. RESULTS: A significant reduction in the word pair test scores was observed after the TSST, and a negative correlation between cortisol concentration and immediate and delayed recall of the word pair. Cortisol concentration associated with age, sex and education explained memory performance variability before and after the TSST. CONCLUSIONS: The results showed that the influence of acute stress on memory performance during aging might vary according to age and sex, highlighting potential differences in the vulnerability of older individuals to the neurotoxic effects of stress exposure on memory and consequently on the development of cognitive disorders. Geriatr Gerontol Int 2018; 18: 169-176.

Short version of the "instrument for assessment of stress in nursing students" in the Brazilian reality.

GOAL: validate a short version of the Instrument for assessment of stress in nursing students in the Brazilian reality. METHOD: Methodological study conducted with 1047 nursing students from five Brazilian institutions, who answered the 30 items initially distributed in eight domains. Data were analyzed in the R Statistical Package and in the latent variable analysis, using exploratory and confirmatory factor analyses, Cronbach's alpha and item-total correlation. RESULTS: The short version of the instrument had 19 items distributed into four domains: Environment, Professional Training, Theoretical Activities and Performance of Practical Activities. The confirmatory analysis showed absolute and parsimony fit to the proposed model with satisfactory residual levels. Alpha values ​​per factor ranged from 0.736 (Environment) to 0.842 (Performance of Practical Activities). CONCLUSION: The short version of the instrument has construct validity and reliability for application to Brazilian nursing undergraduates at any stage of the course.

Non-pharmacological interventions to promote the sleep of patients after cardiac surgery: a systematic review.

OBJECTIVE:: to analyze evidence available in the literature concerning non-pharmacological interventions that are effective to treat altered sleep patterns among patients who underwent cardiac surgery. METHOD:: systematic review conducted in the National Library of Medicine-National Institutes of Health, Cochrane Central Register of Controlled Trials, Latin American and Caribbean Health Sciences Literature, Scopus, Embase, Cumulative Index to Nursing and Allied Health Literature and PsycINFO databases, and also grey literature. RESULTS:: ten controlled, randomized clinical trials were included in this review. Non-pharmacological interventions were grouped into three main categories, namely: relaxation techniques, devices or equipment to minimize sleep interruptions and/or induce sleep, and educational strategies. Significant improvement was found in the scores assessing sleep quality among studies testing interventions such as earplugs, sleeping masks, muscle relaxation, posture and relaxation training, white noise, and educational strategies. In regard to the studies' methodological quality, high quality studies as established by Jadad scoring were not found. CONCLUSION:: significant improvement was found among the scores assessing sleep in the studies testing interventions such as earplugs, sleeping masks, muscle relaxation, posture and relaxation training, white noise and music, and educational strategies. OBJETIVO:: analisar as evidências disponíveis, na literatura, sobre as intervenções não farmacológicas, efetivas para o tratamento da alteração do padrão do sono em pacientes submetidos à cirurgia cardíaca. MÉTODO:: revisão sistemática realizada por meio de busca nas bases de dados National Library of Medicine National Institutes of Health, Cochrane Central Register of Controlled Trials, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Scopus, Embase, Cumulative Index to Nursing and Allied Health Literature e PsycINFO, e na literatura cinzenta. RESULTADOS:: dez ensaios clínicos controlados e randomizados foram incluídos na revisão. Constatou-se que as intervenções não farmacológicas agruparam-se em três categorias principais, a saber: técnicas de relaxamento, dispositivos ou equipamentos para minimizar a interrupção do sono e/ou induzir o sono e estratégias educacionais. Houve melhoria significativa nos escores de avaliação do sono entre os estudos que testaram intervenções como tampões de ouvidos, máscara de olhos, relaxamento muscular, treinamento de postura e relaxamento, produção sonora e estratégia educacional. Em relação à qualidade metodológica dos estudos, não foram encontrados estudos considerados de alta qualidade pelo escore de Jadad. CONCLUSÃO:: houve melhora significativa nos escores de avaliação do sono em estudos que avaliaram intervenções como tampões de ouvidos, máscara de olhos, relaxamento muscular, treinamento de postura e relaxamento, produção sonora e estratégia educacional. OBJETIVO:: analizar las evidencias disponibles en la literatura sobre las intervenciones no farmacológicas, eficientes para el tratamiento de la alteración del patrón del sueño en pacientes sometidos a una cirugía cardíaca. MÉTODO:: revisión sistemática realizada mediante búsqueda en las bases de datos de la Librería Nacional de Medicina (National Library of Medicine), de los Institutos Nacionales de la Salud (National Institutes of Health), del Registro Central Cochrane de Ensayos Controlados (Cochrane Central Register of Controlled Trials), de la literatura latinoamericana y del Caribe, en Ciencias de la Salud, Scopus, Embase, Índice Acumulado de Enfermería y Literatura en Ciencias de la Salud, CINAHL (Cumulative Index to Nursing and Allied Health Literature) y PsycINFO, y en la literatura gris. RESULTADOS:: se incluyeron en la revisión diez ensayos clínicos controlados y aleatorizados. Se constató que las intervenciones no farmacológicas se agruparon en tres categorías principales: técnicas de relajación, dispositivos o equipos para minimizar la interrupción del sueño y/o inducirlo, y estrategias educativas. Hubo una mejora significativa en las puntuaciones de la evaluación del sueño entre los estudios que probaron las intervenciones como tapón de oídos, máscara de ojos, relajación muscular, entrenamiento de postura y relajación, producción sonora y estrategia educacional. Con respecto a la calidad metodológica de los estudios, no se hallaron los considerados de alta calidad mediante la puntuación de Jadad. CONCLUSIÓN:: hubo una mejora significativa en las puntuaciones de la evaluación del sueño en los estudios que evaluaron intervenciones como tapones de oídos, máscara de ojos, relajación muscular, entrenamiento de postura y relajación, producción sonora y estrategia educacional.

Social Support Is a Predictor of Lower Stress and Higher Quality of Life and Resilience in Brazilian Patients With Colorectal Cancer.

BACKGROUND: The well-being of patients undergoing chemotherapy treatment for colorectal cancer (CRC) is affected by psychological effects associated with cancer treatment. However, little is known about the impact of these psychological factors in Brazilian patients with CRC. OBJECTIVE: The aim of this study was to determine whether perceived stress, social support, and resilience are associated with quality of life in urban Brazilian patients receiving chemotherapy treatment for CRC. METHODS: This was a cross-sectional study conducted with 144 Brazilian CRC patients in an ambulatory oncology clinic. The participants completed 5 questionnaires: Demographics, Perceived Stress Scale 14, Social Support Satisfaction Scale, Resilience Scale, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (C30 and CR29). Confirmatory factor analysis modeling and Cronbach's α were used to examine construct validity and internal consistency. We used the MPlus 3.0 to construct and validate the structural model. RESULTS: There was a moderate and positive effect of resilience on the physical, social, and emotional aspects of quality of life. Social support had a strong and positive direct effect on quality of life (ie, social, physical, social, and emotional). Social support had a negative effect on stress perception. Resilience was also negatively related to stress perception. CONCLUSIONS: Family support and professional social support are important factors for Brazilian CRC patients. Resilience is an important ally for patients. It is important for nurses to consider this when developing educational and psychological interventional strategies to reduce stress and ultimately improve quality of life in this population. IMPLICATION FOR PRACTICE: Psychological factors that improve quality of life should be evaluated in patients undergoing treatment for cancer.

An Integrative Review of Postoperative Accelerated Recovery Protocols.

We undertook an integrative literature review of articles pertaining to perioperative nursing care provided to patients using postoperative accelerated recovery protocols. To select the articles, we searched the MEDLINE, PubMed, Cumulative Index to Nursing and Allied Health Literature, and LiteraturaLatino-Americana e do Caribe em Ciências da Saúde databases. We identified 329 studies, 13 of which met our inclusion criteria and described perioperative nursing care activities. Nursing activities noted in these articles were hypothermia prevention and maintenance of normothermia, restriction of IV fluids, assessment of vital signs, management of symptoms and pain, support of early ambulation, care for tubes and drains, oral administration of carbohydrate-rich foods, assessment of ability to tolerate diet, and encouragement to resume activities of daily living. There was a lack of research on this topic by nursing professionals; additional research by nursing professionals is needed regarding nurses' roles in providing this care.

Association between perceived psychological stress and cognitive decline in aging: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this review is to identify, appraise and synthesize the best available evidence on the association between perceived psychological stress and cognitive decline in aging.

Estresse, má qualidade do sono e desfechos negativos a saúde em estudantes de enfermagem / Stress, poor sleep quality and negative health outcomes in nursing students / Estrés, mala calidad del sueño y resultados negativos de salud en estudiantes de enfermería

RESUMO Objetivo: analisar o perfil biossocial-acadêmico, nível de estresse e qualidade de sono em estudantes de enfermagem no primeiro ano do curso. Método: pesquisa longitudinal, prospectiva e quantitativa, realizada em 2016 junto a estudantes de enfermagem do primeiro ano de duas universidades de São Paulo. Ao início das aulas e ao final do ano letivo, aplicaram-se um formulário biossocial-acadêmico, instrumento para avaliação do estresse em estudantes de enfermagem e índice de qualidade de sono de Pittsburgh. Utilizaram-se os testes de Qui-quadrado e exato de Fischer para comparar o estresse e a qualidade do sono. Resultados: O total de 117 estudantes compuseram a amostra em março e 100 em dezembro de 2016. Evidenciou-se aumento no percentual de estudantes com muito e alto estresse, a duração do sono reduziu significativamente de 6,0 para 5,4 horas em média, por noite, e apresentaram dificuldades no gerenciamento do tempo, formação profissional para seguir o curso e atividades teóricas.Conclusão: o ambiente acadêmico apresenta potencial para o adoecimento do estudante, com alto estresse, má qualidade do sono e desfechos negativos à saúde.

ABSTRACT Objective: to analyze the biosocial-academic profile, level of stress and quality of sleep in nursing students during the first year of the course. Method: longitudinal, prospective and quantitativeresearch, carried out in 2016 with first-year nursing students from two universities in São Paulo. At the beginning of classes and at the end of the school year, the following were applied a biosocial-academic \form, an instrument to assess stress in nursing students and a Pittsburgh sleep quality index. Chi-square and Fisher's exact tests were used to compare stress and sleep quality. Results:117 students comprised the sample in March and 100 in December 2016. There was an increase in the percentage of students with high and high stress, sleep duration significantly reduced from 6.0 to 5.4 hours on average, per night, and had difficulties in time management, professional training to follow the course and theoretical activities.Conclusion:theacademic environment has the potential for the student's illness, with high stress, poor sleep quality and its negative health outcomes.

RESUMEN Objetivo: analizar el perfil biosocial y académico, nivel de estrés y calidad del sueño en estudiantes de enfermería durante el primer año del curso. Método: investigación longitudinal, prospectiva y cuantitativa, realizada en 2016 con estudiantes de primer año de enfermeríade dos universidades de São Paulo. Al inicio de las clases y al final del año lectivo se aplicaron un formulario biosocial y académico, un instrumento para evaluar el estrés en estudiantes de enfermería y un índice de calidad del sueño de Pittsburgh. Paracomparar el estrés y la calidad del sueño se utilizaron las pruebas de chi-cuadrado y exacta de Fisher. Resultados:El total de 117 estudiantes conformaron la muestra en marzo y 100 en diciembre de 2016. Hubo un aumento en el porcentaje de estudiantes conmucho y alto estrés, la duración del sueño se redujo significativamente de 6.0 a 5.4 horas en promedio, por noche, y tuvieron dificultades en la gestión del tiempo. formación profesional para seguir el curso y actividades teóricas. Conclusión:el entorno académico tiene el potencial de que el estudiante se enferme, con alto estrés, mala calidad del sueño y sus resultados negativos para la salud.

Estresse e resiliência em discentes de enfermagem de duas universidades públicas paulistas / Estrés y resiliencia en estudiantes de enfermería de dos universidades publicas paulistas / Stress and resilience in nursing students from two public universities in sao paulo

Objetivo: verificar a relação entre estresse e resiliência em discentes de enfermagem de duas universidades públicas do Estado de São Paulo. Método: trata-se de um estudo transversal realizado em março de 2016 junto a 117 discentes de enfermagem. Aplicaram-se um Formulário para caracterização acadêmica e demográfica, o Instrumento para Avaliação do Estresse em Discentes de Enfermagem e a Escala de Resiliência de Wagnilde Young. Analisaram-se os dados no Statistical Package for Social Sciences, versão 10.0. Resultados: observou-se predomínio de discentes com médio nível de estresse. O gerenciamento do tempo e as atividades teóricas representaram alto nível de estresse para 23,9% e 20,5% da população. 11,1% apresentaram muito alto estresse relacionado ao Ambiente. Os níveis de resiliência foram reduzidos (51%). Não houve correlação significativa entre estresse e resiliência. Conclusão: o ambiente de formação em enfermagem apresenta potencial para o adoecimento dos discentes, embora parte deles já apresente resiliência moderada.

Aim: to verify the relation between stress and resilience in nursing students from two public universities in the State of São Paulo. Method: this is a cross-sectional study conducted in March 2016 with 117 nursing students. We applied academic and sociodemographic forms, the instrument for nursing students stress assessment, and the Wagnild and Young´s resilience scale. Data were analyzed in Statistical Package for Social Sciences, version 10.0. Results: we found a predominance of moderately stressed students. Time management and theoretical activities meant high stress level for 23,9% and 20,5% of the sample. Also, 11,1% showed a very high stress level related to the work environment. Levels of resilience were low (51%). There was not a significant correlation between stress and resilience. Conclusion: nursing education setting shows potential for students ́ illness, although part of them already show moderate resilience.

Objetivo: verificar la relación entre estrés y resiliencia en discentes de enfermería de dos universidades públicas del Estado de São Paulo. Método: se trata de un estudio transversal realizado en marzo de 2016 con 117 discentes de enfermería. Se aplicó un formulario para caracterización académica y demográfica, el Instrumento para Evaluación de Estrés en discentes de enfermería y la escala de resiliencia de Wagnild y Young. Los datos fueron evaluados en el Statistical Package for Social Sciences, versión 10.0. Resultados: se observó el predominio de discentes con nivel medio de estrés. El gerenciamiento del tiempo y las actividades teóricas representaron alto nivel de estrés para 23,9% y 20,5% de la población. 11,1% presentaron muy alto el nivel de estrés relacionado al Ambiente. Los niveles de resiliencia fueron bajos (51%). No hubo correlación significativa entre estrés y resiliencia. Conclusión: el ambiente de formación en enfermería presenta potencial para el padecimiento de los discentes, aunque parte de ellos ya presente moderada resiliencia.

Fatores de estresse associados à sintomatologia depressiva e qualidade do sono de acadêmicos de enfermagem / Stress factors associated with depressive symptoms and sleep quality in nursing students / Factores de estrés asociados a síntomas depresivos y calidad del sueño en estudiantes de enfermería

Objetivo: Analisar os fatores estressores associados à sintomatologia depressiva, qualidade de sono de acadêmicos de enfermagem. Método: Trata-se de uma pesquisa transversal, analítica e de abordagem quantitativa, realizada em março de 2016 junto a 159 discentes da área de saúde de uma instituição pública do estado de São Paulo por meio de instrumentos validados. Os dados foram analisados no Statistical Package for Social Sciences, versão 25.0, por meio de regressão linear. Valores de p<0,05 foram considerados significativos. Resultados: Observou-se, predomínio de alto estresse (50,9%), seguido por médio estresse (46,5%), bem como baixa qualidade do sono (99,4%) e presença de sintomas depressivos (100%) entre os discentes de enfermagem avaliados. Os fatores de estresse Gerenciamento do Tempo e ao Ambiente contribuíram significativamente para a redução na qualidade do sono. Já os fatores Gerenciamento do Tempo e a Realização de Atividades Práticas levaram ao aumento da sintomatologia depressiva entre os discentes. Conclusão: Os fatores de estresse estão significativamente associados à sintomatologia depressiva e à qualidade de sono de acadêmicos de enfermagem, que justifica a necessidade de uma revisão nas ações voltadas ao manejo de tais fatores durante a formação acadêmica.

Objective: To analyze the stressors associated with depressive symptoms, sleep quality of nursing students. Method: This is a cross-sectional, analytical and quantitative study, carried out in March 2016 with 159 students from the health area of a public institution in the state of São Paulo using validated instruments. The data were analyzed in the Statistical Package for Social Sciences, version 25.0, using linear regression. Values of p <0.05 were considered significant. Results: There was a predominance of high stress (50.9%), followed by medium stress (46.5%), as well as low quality of sleep (99.4%) and presence of depressive symptoms (100%) among the nursing students evaluated. The stress factors Time Management and the Environment contributed significantly to the reduction in sleep quality. The factors Time Management and Practical Activities led to an increase in depressive symptoms among students. Conclusion: Stress factors are associated with depressive symptoms and the quality of academic nursing sleep, which justifies the need for a review of actions aimed at treating these factors during academic training.

Objetivo: Analizar los factores estresantes asociados a síntomas depresivos, calidad del sueño de estudiantes de enfermería. Método: Se trata de un estudio transversal, analítico y cuantitativo, realizado en marzo de 2016 con 159 estudiantes del área de salud de una institución pública del estado de São Paulo utilizando instrumentos validados. Los datos se analizaron en el paquete estadístico de ciencias sociales, versión 25.0, mediante regresión lineal. Se consideraron significativos valores de p <0,05. Resultados: predominó el estrés alto (50,9%), seguido del estrés medio (46,5%), así como la baja calidad del sueño (99,4%) y la presencia de síntomas depresivos (100%) entre los estudiantes de enfermería evaluados. Los factores de estrés Gestión del tiempo y el medio ambiente contribuyeron significativamente a la reducción de la calidad del sueño. Los factores Gestión del tiempo y Actividades prácticas llevaron a un aumento de los síntomas depresivos entre los estudiantes. Conclusión: Los factores de estrés están asociados a los síntomas depresivos y la calidad del sueño de enfermería académica, lo que justifica la necesidad de una revisión de las acciones dirigidas a tratar estos factores durante la formación académica.

Nível de tolerância nas relações de amizade em profissionais de saúde durante a pandemia da COVID-19 / Tolerance level in friendly relationships among health professionals during the COVID-19 pandemic / Nivel de tolerancia en las relaciones amistosas entre profesionales de la salud durante la pandemia del COVID-19

Objetivo: Analisar o nível de tolerância nas relações de amizade em profissionais de saúde durante a pandemia da COVID-19. Método: Trata-se de um estudo transversal e descritivo, realizado com 979 profissionais de saúde das cinco macrorregiões brasileiras entre junho e julho de 2020. Aplicaram-se via online um questionário sociodemográfico; um questionário semi-estruturado e o Instrumento de Avaliação da tolerância nas relações de amizade. Utilizou-se a estatística descritiva para a análise dos dados que ocorreu no Statistical Package for Social Science, versão 25,0. Resultados: A tolerância de amizade no ambiente domiciliar é considerada satisfatória (92,2%); os amigos ajudaram a superar as tensões vivenciadas durante a quarentena (84,5%); e houve mudança nas relações de amizade desde o início da quarentena (72,5%). Verifica-se predomínio de alta tolerância nas relações de amizade (90,3%) entre os profissionais de saúde. Os profissionais são mais tolerantes nas seguintes situações: "aceitar os defeitos dos amigos; compreender amizade como aceitar a outra pessoa do jeito que ela é; esforçar-se para encontrar algo bom nas pessoas; entender e manter amizades demanda dedicação extrema; e os amigos considerarem o respondente como flexível e tolerante. Conclusão: A tolerância nas relações de amizade entre os profissionais de saúde durante a pandemia de COVID-19 é considerada alta, mesmo frente as mudanças trazidas por ela

Objective: To analyze the level of tolerance in friendship relationships among health professionals during the COVID-19 pandemic. Method: This is a cross-sectional and descriptive study, carried out with 979 health professionals from the five Brazilian macro-regions between June and July 2020. A sociodemographic questionnaire was applied online; a semi-structured questionnaire and the Tolerance Assessment Tool in friendship relationships. Descriptive statistics were used to analyze the data that occurred in the Statistical Package for Social Science, version 25.0. Results: The tolerance of friendship in the home environment is considered satisfactory (92.2%); friends helped to overcome the tensions experienced during the quarantine (84.5%); and there was a change in friendship relations since the beginning of the quarantine (72.5%). There is a predominance of high tolerance in friendship relationships (90.3%) among health professionals. Professionals are more tolerant in the following situations: "accepting the defects of friends; understand friendship how to accept the other person as they are; strive to find something good in people; understanding and maintaining friendships requires extreme dedication; and friends consider the respondent to be flexible and tolerant. Conclusion: Tolerance in friendly relationships among health professionals during the COVID-19 pandemic is considered high despite the changes brought about by it.

Objetivo: Analizar el nivel de tolerancia en las relaciones de amistad entre profesionales de la salud durante la pandemia de COVID-19. Método: Se trata de un estudio transversal y descriptivo, realizado con 979 profesionales de la salud de las cinco macrorregiones brasileñas entre junio y julio de 2020. Se aplicó un cuestionario sociodemográfico en línea; un cuestionario semiestructurado y la Herramienta de Evaluación de la Tolerancia en las relaciones de amistad. Se utilizaron estadísticas descriptivas para analizar los datos que ocurrieron en el Statistical Package for Social Science, versión 25.0. Resultados: La tolerancia de la amistad en el ámbito familiar se considera satisfactoria (92,2%); los amigos ayudaron a superar las tensiones vividas durante la cuarentena (84,5%); y hubo un cambio en las relaciones de amistad desde el inicio de la cuarentena (72,5%). Se verifica un predominio de alta tolerancia en las relaciones de amistad (90,3%) entre los profesionales de la salud. Los profesionales son más tolerantes en las siguientes situaciones: "aceptar los defectos de los amigos; entender la amistad cómo aceptar a la otra persona tal como es; esforzarse por encontrar algo bueno en las personas; comprender y mantener las amistades requiere una dedicación extrema; y los amigos consideran que el encuestado es flexible y tolerante. Conclusión: La tolerancia en las relaciones amistosas entre los profesionales de la salud durante la pandemia de COVID-19 se considera alta, a pesar de los cambios provocados por ella.

Pre-hospital delay in acute myocardial infarction: judgement of symptoms and resistance to pain.

OBJECTIVE: To estimate the time of decision (TD) to look for medical care and the time of arrival (TA) at the health service for men (M) and women (W) suffering from acute myocardial infarction and to analyze the influence of the interpretation of pain and pain resistance behaviors during these times. METHODS: This is an exploratory research, performed at the university hospital in Salvador/Bahia. 43 W and 54 M were interviewed. To study the dependence among sociodemographic and gender variables, the Fisher Exact Test was used. To analyze times, a geometric mean (GM) was used. In order to verify the association between the GM of TD and TA and the judgment of pain, and between the GM of TD and TA and the behavior of resistance to pain, as well as to test the time of interaction between the gender variable and other variables of interest, the robust regression model was used. The statistical significance adopted was 5%. RESULTS: The GM of the TD for M was 1.13 h; for W, 0.74 h. The GM of the TA was 1.74 h for M and 1.47 h for W. Those who did not recognize the symptoms of AMI and presented behavior of resistance to pain had higher TD and TA, being the associations significant. Gender did not change the associations of interest. CONCLUSION: The findings demonstrate the importance of health education aiming at the benefits of early treatment.