[Work context, job satisfaction and suffering in primary health care]. / Contexto de trabalho, prazer e sofrimento na atenção básica em saúde.

OBJECTIVE: To evaluate the work context, job satisfaction and suffering from the perspective of workers in primary health care. METHOD: This cross-sectional study was conducted with 242 employees of a municipality of Rio Grande do Sul, Brazil, from May to July 2012. The adopted instruments were the Work Context Assessment Scale (EACT) and the Job Satisfaction and Suffering Indicators Scale (EIPST). Research also included descriptive and inferential statistical analysis. RESULTS: Organization (91.3%) and work conditions (64%) received the worst scores in terms of context. The indicators of job satisfaction were related to professional achievement (55.8%), freedom of expression (62.4%) and recognition (59.9%). However, 64.5% presented professional exhaustion, which had an inverse association with age and years in the institution (p<0.05). CONCLUSION: The workers evaluated their work context as inappropriate and complained of exhaustion, although they claimed their work affords some satisfaction.

[Violence, Burnout and Minor Psychiatric Disorders in Hospital Work]. / Violência, burnout e transtornos psíquicos menores no trabalho hospitalar.

OBJECTIVE: Identifying the violence suffered by the health team workers and their association with Burnout and minor psychiatric disorders. METHODS: Cross-sectional study with 269 health team professionals of a public hospital in southern Brazil. Data were collected through the use of the Survey Questionnaire: Workplace Violence in the Health Sector, Maslach Inventory Burnout and Self-Report Questionnaire. RESULTS: Workplace violence struck 63.2% of workers, prevailing mostly in women (p = 0.001), among nursing auxiliaries/technicians (p=0.014) and was associated with minor psychiatric disorders (p<0.05), as exposure to different forms of violence increased the chances of these disorders by 60% (CI 95%: 1.2-2.1). The three Burnout dimensions were also associated to violence at work (p<0.05). CONCLUSION: Health workers experience violence in the workplace and this exposure is associated with Burnout symptoms and minor psychiatric disorders.

[Nursing care for patients undergoing pharmacological stress echocardiography: implications for clinical practice]. / A enfermeira no cuidado aos pacientes submetidos ao eco-stress farmacológico: implicacções para a prática clínica.

The study aim was both to identify signs and symptoms previous to and during the pharmacological stress echocardiography test and to describe the nurse's role and nursing care principles for this exam. This is a descriptive study, carried out in cardiac care unit in a University Hospital in Porto Alegre, RS. Two hundred forty-six records of patients submitted to stress echocardiography were retrospectively reviewed, according to four different pharmacological schedules. The statistical comparison showed that signs and symptoms were related to the type of drug used during the exam, namely: typical angina, precordial ache, tiredness, headache and premature complexes. These results enabled a better understanding of pharmacological stress echocardiography and the instrumentalization of nurses in order to plan individualized and qualified nursing care assistance. Aside from helping develop nursing practices for the pharmacological stress echocardiography test this knowledge could also be used by nurses who carry out their activities in institutions that use this diagnostic method.

[Influence of work shift and chronotype on the quality of life of nursing professionals]. / Influência do turno de trabalho e cronotipo na qualidade de vida dos trabalhadores de enfermagem.

The purpose of this study was to investigate the influence of shift work and chronotype on the quality of life of nursing staff at a university hospital in the state of Rio Grande do Sul, Brazil. It is an analytical and cross-sectional study, developed with a sample of 101 nursing professionals working in clinical and surgical units for adult inpatients. Chronotype and quality of life were evaluated using the Horne and Ostberg Morningness-Eveningness Questionnaire (MEQ) and the WHOQOL-Brief None of the WHOQOL-Brief domains demonstrated any association with shift work (p > 0.05). It was observed however, that individuals with a certain chronotype agreeing with the shift in which they work (67.01 +/- 10.8) showed higher means than those disagreeing (59.16 +/- 14.67) on the WHOQOL field that assesses the environment (p = 0.03). Thus, it is suggested that agreement with the chronobiological shift might be a factor determining quality of life for the nursing staff

[Quality of life and voluntary work among the elderly]. / Qualidade de vida e trabalho voluntário em idosos.

This cross-sectional, comparative study was performed with the objective to evaluate the quality of life of elderly individuals who perform volunteer work, compared to those who do not. The WHO Quality of Life questionnaire was applies in a group of 166 elderly individuals who performed volunteer work and to another 33 who did not. Results show most are women, single and with high-level education. Compared to No statistically significant difference was found between the groups for the quality of life scores in the physical and environmental domains (p>0.05). In the psychological and social relations domains, and in the global evaluation, it was observed that volunteers had higher scores (p<0.05). In the linear regression model, performing volunteer work appeared as a determinant for better quality of life in the psychological domain and global evaluation. It is suggested that volunteer work is a mechanism to promote quality of life among the elderly, and can be encouraged by health professionals.

[Work capacity of nurses in a university hospital]. / Capacidade para o trabalho de enfermeiros de um hospital universitário.

This is a cross-sectional study that evaluated the work ability index (WAI) and the sociodemographic and work-related aspects of 93 nurses in a university hospital. The data were analyzed using descriptive and analytical statistics. The sample was predominantly female (98.9%), with 41.7 (SD = 9.0) years old 63.4% have a partner, sleep 6.9 (SD = 1.3) hours daily, 8.6% smoked and 37.6% performed regular physical activity The WAI score was 40.1 (SD = 3.7), indicating a good work capacity. There were correlations between WAI and age (r = -0.22, p = 0.0394), duration of work (r = -0.23, p = - 0.0295), and sleep (r = 0.26, p = 0.0162). Nurses who live alone and non-smokers had higher average than those with a partner and who smoked (41.3 and 39.6; 40.4 and 37.8; p = 0.0476). Thus, healthy life habits such as sleeping 7 hours or more and not smoking were positively associated with work capacity.

[Syndrome of burnout among the workers of the strategy of health of the family]. / Sindrome de burnout entre os trabalhadores da estratégia de saúde da familia.

This descriptive study was developed with sixteen Family Health Strategy teams from Santa Maria (Rio Grande do Sul), with the objective to identify works with the Burnout syndrome and the variables associated with this disorder. The sample consisted of 86 workers, representing 86.3% of professionals (physicians, nurses, nursing technicians, dentists and dental office assistants) and 30.2% of community health agents, who answered the Maslach Burnout Inventory. The average age of the group was 36.94 +/- 9.3 years, with a predominance of females (84.9%). Most participants had a partner (68.2%), children (69.4%), have worked in the team for, in average, 3.38 +/- 1.9 years and do not exercise regularly (62.8%). Six workers (6.9%) presented the Burnout Syndrome, which has a statistically significant association (p = 0.034) with the young age variable. Younger subjects obtained higher scores on the subscales for emotional distress and depersonalitation on the Burnout Inventory.

[The sense of self-efficacy in maintaining health promoting behaviors in older adults]. / O senso de auto-eficácia na manutenção de comportamentos promotores de saúude de idosos.

This descriptive study used a qualitative approach and was developed with older adults who were members of a recreational center in Porto Alegre (Brazil). The objective was to understand the influence of the sense of self-efficacy on maintaining health-promoting behaviors among the participants. Interviews were performed with eleven older adults who obtained scores on the WHOQOL-brief questionnaire with standard deviation equal or above the group mean (> or = 85.18). Content analysis of the interviews revealed four categories: positive personal attitudes and attributes; expectation to enjoy a higher quality of life; expectation to live longer; and other aspects that make behavior maintenance easier. The study found evidence that these individuals sustain health-promoting behaviors similar to what is recommended by health professionals and organizations. It appears that they maintain those behaviors due to their positive sense of self-efficacy.

[Voluntary work, demographic, social and economic features and health self-perception by elderly people from Porto Alegre (Brazil)]. / Trabalho voluntário, características demográficas, socioeconômicas e autopercepção da saúde de idosos de Porto Alegre.

The objective of this cross-sectional, comparative study was to describe the demographic, socioeconomic and health characteristics of elderly voluntary workers of a Non-governmental organization of Porto Alegre, and investigate the influence of voluntary work and the referred characteristics on the subjects' self-perception of health, compared to a paired group of elderly individuals who did not perform any voluntary work. Through interviews it was found that 87.4% of the elderly voluntary workers were women, with complete secondary education, had their own income and followed a religion and a healthy lifestyle. The comparison of data from both groups showed that self-perception of great health was more common among voluntary workers (30.5% compared to 6.1%, p = 0.054). Multivariate analysis revealed that performing voluntary work and having fewer diseases influenced the individuals' having a positive self-perception of their health (p < 0.05). Study results support the hypothesis that voluntary work may be a mechanism of health promotion among the elderly.

Coping mechanisms used by non-burned out and burned out workers in the family health strategy.

This study aimed to investigate stress coping mechanisms used by workers of 16 Family Health Strategy (FHS) teams in Santa Maria, RS, Brazil. Six workers with scores compatible with the Burnout Syndrome, identified through the Maslach Burnout Inventory, and six workers without the syndrome were interviewed in January and February 2007. In the reports' content analysis, we identified that burned out workers predominantly used individual mechanisms to cope with occupational problems, while non-burned out workers sought collective mechanisms. These findings indicate the importance of interpersonal relationships among FHS team members to cope with occupational stress and the need to develop collective strategies to prevent stress and maintain workers' health.

[Accidents with biological materials among nurses in a training hospital: case-control study]. / Acidente com material biológico no trabalhador de enfermagem em um hospital de ensino: estudo caso-controle.

This case-control study aimed at analyzing the association between occupational stress and disagreement between chronotype and the work shift of nurses who suffered accidents with biological materials in a hospital of Porto Alegre, Rio Grande do Sul, Brazil. A number of 99 workers who suffered accidents (cases) and 232 that had not suffered accidents (controls) were interviewed. Data were collected through the Job Stress Scale according to Karasek's model and the Horne-Ostberg scale The occurrence of accident was not statistically associated with high work requirement scores (p = 0.317), with a chronobiological profile discordant with work shift (p = 0.563), or with other labor variables associated to accidents--overtime, having two jobs (p = 1.000). In addition, there was no significant difference (chi2 Pearson; p = 1.00) among the scores of professionals with high work requirements who work in shifts discordant with their chronotype, both in the case group and in the control group as well.

Work under urgency and emergency and its relation with the health of nursing professionals.

The study aimed at understanding work under urgent and emergency conditions and its connection with the health of nursing professionals, who work at an urgency and emergency state service. Descriptive qualitative case study carried out at a state service in Porto Alegre, RS. The collection of data included the analysis of documents from the Institution, the observation of the work dynamics, and the performance of semi-structured interviews with the nursing professionals. The data were submitted to content analysis. One could understand that the health of the nursing professionals is constituted from a working dynamics which is sometimes harmful because it results from an organizational context that carries marks of a state health system with many gaps, however, that allows the meaning of work to be an essential element for the ability to keep the balance and not getting sick in view of the work demands.

Vancomycin administration: mistakes made by nursing staff.

AIM: To identify the number and types of errors made by assistant and technical nurses when administering intravenous (IV) vancomycin. METHOD: Preparation and IV administration of 143 doses of vancomycin by 55 assistant and technical nurses were observed in four acute wards (three adult and one paediatric) in a public university hospital in Brazil. Non-participant observers completed a structured checklist for each dose. RESULTS: A total of 27 (19%) doses were administered correctly and 116 (81%) incorrectly. There were 268 errors of four types: (i) incorrect dose; (ii) improper preparation of a dose; (iii) inadequate administration technique; and (iv) infusion at an incorrect rate. For 13 of 143 (9%) doses, errors occurred in all four aspects of administration. Errors were observed on all four wards. CONCLUSION: The high incidence of suboptimal administration of vancomycin observed is a cause for concern. Focused education and safety measures have been introduced and their impact is being evaluated.

[Voluntary work: an alternative to promote health for the elderly]. / Trabalho voluntário: uma alternativa para a promoção da saúde de idosos.

This article is a thematic reflection. It aims at presenting volunteer work as an alternative for promoting health for elders in Brazil. Having as a starting point the definition of volunteer work, this study contextualizes this type of activity in Brazilian society, explaining it also as an instrument that makes possible for people to experience an active and healthy aging process. The text presents international studies with elders who volunteer and, as a result, have found a relationship between volunteering and satisfaction with their lives and have had less symptoms of depression and a more positive evaluation of life when compared to elderly who do not volunteer. The conclusion emphasizes the importance for health professionals to stimulate and facilitate the access of elders to volunteer work, considering this posture a creative and innovative challenge for the promotion of health for the elderly.

[The effect of shift work on the health of workers: a systematic review]. / Efeitos do trabalho em turnos na saúde do trabalhador: revisão sistemática.

This study conducted a systematic review of the literature with the objective of describing the effect of working in shifts on workers' health. The descriptors used were: "occupational risk", "occupational health", and "shift work", all of which were provided by on-line publications from 2000 to 2007. MEDLINE and SciELO publications were selected associating Shift Work and Occupational Risk--and the former to Occupational Health--using single descriptors. Among the one hundred and seventeen papers reviewed thirty seven were chosen. 91.7% were in English, 70.3% were transversal studies, 18.9% were cutoff and 10.8% were control cases. The research focused on cardiovascular changes (24.4%), quality of sleep and alertness (17.7%), metabolic changes (13.3), among others. Some papers did not identify a connection between changes in the workers' health and shift work.

[Virtual discussion groups: a proposal for nursing teaching]. / Grupos de discussão virtual: uma proposta para o ensino em enfermagem.

This paper describes a teaching experience aimed at providing interactivity to the technique of field diary by using a virtual learning environment. The educational proposal derives from the Federal University of Rio Grande do Sul (UFRGS)'s Teaching Training Program of the Stricto Sensu Post-Graduation Program in Nursing, in which the author, a Master's degree candidate, oriented by her advisor, proposed forming virtual discussion groups in order to write the field diary for an undergraduate discipline in Nursing, with the aim of providing an opportunity for a joint discussion of academic experiences in the realm of practice. The instructors of the discipline in which the proposal was developed also participated in the activities. The virtual technology gave new dynamism to the technique of field diary, making possible an exchange of experiences among the students, the instructor and the author, as well as moments of reflection and discussion regarding the themes faced in the Nursing practice.

[Workloads in communitarian health agents]. / Cargas de trabalho entre os agentes comunitários de saúde.

A convergent-assistance research study with Community Health Agents of the Family Health Strategy was developed with the objective of identifying workloads they were submitted to and to promote actions to stimulate their self-care. A weekly group meeting was carried out with five workers, as well as a collective interview. Physical, chemical, organic, mechanical, and particularly psychic loads, for which there are difficulties to find measures of protection and self-care were identified. By creating awareness on the workloads to which the workers were submitted and on the potential health hazards generated by them, we believe self-care was stimulated in these groups.

Relationship between psychosocial stress dimensions and salivary cortisol in military police officers.

OBJECTIVE: to analyze the relationship between psychosocial stress dimensions and salivary cortisol in military police officers. METHOD: cross-sectional and analytical study with 134 military police officers. The Effort-Reward Imbalance (ERI) Model scale has been used to assess psychosocial stress. Salivary cortisol was collected in three samples. The following tests were used: Student's t-test, Mann-Whitney, ANOVA, Bonferroni, Kruskal-Wallis and Dunn. Pearson and Spearman correlation methods were used, as well as multiple linear regression. Cortisol at night showed an ascending statistical association with the psychosocial reward (p=0.004) and a descending association with the effort-impairment scores (p=0.017). Being part of the Special Tactical Operations Group (GATE) and the diastolic blood pressure explained 13.5% of the variation in cortisol levels on waking up. The sectors GATE, Special Patrol of the Elite Squad of the Military Police and Motorcyclists explained 21.9% of the variation in cortisol levels 30-minute after awakening. The variables GATE sector and Effort Dimension explained 27.7% of the variation in cortisol levels at night. CONCLUSION: it was evidenced that salivary cortisol variation was influenced by individual, labor and psychosocial variables.

Errors committed by nursing technicians and assistants in administering antibiotics.

BACKGROUND: Success in any antibiotic treatment depends on many factors, including the associated preparation procedures and the nursing care management. OBJECTIVE: The aim of this research was to analyze errors in nursing procedures in the use of cefepime. METHODS: A survey was performed in the adult patients' wing of a university hospital in Brazil, and a direct observation technique was used to process variation errors. Errors were classified by type. RESULTS: Thirty-three nursing assistants were observed and interviewed as they prepared and administered cefepime on 99 occasions. From our sample, 20 (20%) applications were performed correctly but 126 errors were observed in 79 cases (80%). The majority (62%) of errors detected were time (scheduled and rate) related. Trained personnel executed the procedure for diluting the solution better than nontrained personnel, but no other statistically significant effect related to the knowledge level of the personnel was detected. This study concluded that errors occurred during care of patients because lack of specific procedures, such as adequate planned rate of infusion and schedule time. They were classified in an American Society of Health-System Pharmacists scheme. It is recommended that corrective practice and safety measures be introduced.