Accessibility to the treatment of hypertension in the family health strategy. / Acessibilidade ao tratamento da hipertensão arterial na estratégia saúde da família.

OBJECTIVE: To analyze the satisfaction about the accessibility to the treatment of people with hypertension accompanied by the Family Health Strategy. METHOD: Cross-sectional study, conducted with 417 people living in a city in the state of Paraná, Brazil. The data collection was performed between February and June of 2016, using a satisfaction instrument regarding the services provided by the Primary Health Care, using issues related to treatment accessibility. A descriptive and inferential analysis to treat the variables was adopted. RESULTS: 417 people participated in the study, from which 62.4% were elderly, 67.8% were female and 55.2% were retired/pensioners. The economic accessibility was the best evaluated indicator. The regular evaluation of the services characteristic of the geographical and organizational accessibility was significantly associated to the inadequate monitoring of these users in the Family Health Strategy. CONCLUSION: The services offered to people with arterial hypertension were evaluated as regular, presenting the main barriers related to geographical and organizational aspects.

Foot ulceration in patients with diabetes: a risk analysis.

The study reported in this article aimed to analyse factors associated with the risk of ulceration in the feet of patients with diabetes using a conceptual hierarchic model. It was a cross-sectional study carried out with 1515 people with diabetes mellitus aged 40 years and older. The risk of foot ulceration was of higher significance in male patients with diabetes (adjusted odds ratio (OR)=1.39 (95% confidence interval (CI) 1.11 to 1.73); p=0.020), who did not practise a regular physical activity (adjusted OR=1.58 (95% CI 1.15 to 2.15); p=0.013), with time since diagnosis over 10 years (adjusted OR=1.42 (95% CI 1.10 to 1.86); p=0.011), who used insulin (adjusted OR=1.40 (95% CI 1.09 to 1.84); p=0.012), with retinopathy (adjusted OR=1.84 (95% CI 1.38 to 2.45); p=0.001) and who had had a previous stroke (adjusted OR=1.47 (95% CI 1.09 to 2.04); p=0.018). Mycosis on the nails and the interdigital spaces of the feet was statistically associated with ulceration risk independent of other variables of the model (adjusted OR=2.48 (95%CI 1.70 to 3.63); p=0.001). Finding the factors associated with ulceration contributes to the provision of quality care by nurses.

The effects of organisational culture on nurses' perceptions of their work.

This study aimed to analyse the relationship between the organisational culture and feelings of pleasure and suffering among working nursing professionals. This was a cross-sectional correlational study conducted in a tertiary hospital with 214 nursing staff over 3 months using three instruments: professional characterisation, the Brazilian Instrument for Assessment of Organisational Culture, and the Scale of Pleasure and Suffering at Work. The analysis included descriptive statistics and the Spearman correlation test. The external integration practice was the domain most frequently found in the organisational culture and the feeling of pleasure-gratification predominated among the workers. Values of cooperative professionalism and wellbeing, and practices of external integration and relationship promotion, were related to increased pleasure and decreased suffering at work. These aspects depend on the organisational culture of the institution. Investigating organisational culture facilitates the understanding of potential collective coping strategies and the organisational changes that favour good mental health in nurses.

Quality of life of workers who underwent work adjustments and adaptations in a public state university. / Qualidade de vida dos trabalhadores readequados e readaptados de uma universidade estadual pública.

OBJECTIVE: Assess the quality of life of workers who underwent work adjustments and adaptations in a public state university. METHODS: This was a cross-sectional study carried out with 92 employees from a public state university. Data were collected from November 2012 to May 2013 using a population characterization questionnaire and the Medical Outcome Study 36-item Short Form, and then underwent a univariate and bivariate analysis through the Mann-Whitney test. RESULTS: The two domains that obtained the best scores were social function and emotional performance, whereas the ones with the worst scores were physical performance and body pain. Most workers did not note changes in their health status in the last year. CONCLUSIONS: The quality of life scores, in general, were not high, especially in physical aspects. Therefore, measures need to be implemented to evaluate the effectiveness of work adjustments and adaptations, in order to improve occupational health.

Factors associated with foot ulceration of people with diabetes mellitus living in rural areas. / Fatores associados à ulceração nos pés de pessoas com diabetes mellitus residentes em área rural.

Objective To analyze the factors associated with the risk of ulceration in the feet of people with diabetes mellitus living in rural areas. Methods This is a cross-sectional study conducted with 293 individuals with diabetes mellitus, aged 40 years or older, living in the south of Brazil, in 2014. We analyzed socioeconomic variables, clinical conditions and foot self-care. We used the Poisson multiple regression model and the Prevalence Ratio (PR) and p-value<0.05 as a measure of association. Results 43.7% of the sample presented risk of foot ulceration. The highest prevalence of foot ulceration risk was associated with people with lower purchasing power (PRadjusted=1.62/IC95%:1.52-2.22), with retinopathy (PRadjusted=1.30/IC95%:1.12-1.68) and alteration in foot moisture (PRadjusted=1.57/IC95%:1.22-2.01). We identified low education level (64.2%), high prevalence of arterial hypertension (86.3%) and onychomycosis in the feet (72%). Conclusions Diabetic patients need an assessment of the risk of foot ulceration, especially those with longer diagnosis, chronic complications and low socio-educational level.

Promoting mental health in the workplace: web software development and validation.

OBJECTIVE: to develop and validate the content and technical aspects of a web software program for promoting mental health in the workplace. METHOD: applied methodological study and technological development, carried out in three stages: 1) Umbrella review development; 2) Web software development; 3) Content and technical validation carried out by 14 judges. The data was submitted to descriptive statistical analysis and calculation of the content validity index. RESULTS: based on the guidelines' recommendations, information was defined and extracted in order to develop the web software consisting of the following dimensions: mental health education, support among coworkers, promotion strategies and mental health self-assessment. For the technical development, the objectives, general functions and technological infrastructure were defined. After development and functional testing, the version was made available for content and technical validation by judges. The overall content validity index was 0.98 and for the technical aspects it was 0.97. CONCLUSION: the agreement between the judges in relation to the content and technical aspects, as well as the suggestions incorporated, demonstrated the potential for using web software to promote mental health in the workplace.

Factors associated with work activity of technical-administrative staff from state universities retired due to disability.

OBJECTIVE: To verify the factors associated with the type of work activity performed by university technical-administrative staff retired due to disability. METHOD: Cross-sectional research with 68 workers, conducted using an electronic questionnaire between November 2019 and September 2020. Data were collected on sociodemographic, occupational characterization and causes of disability. Data were analyzed descriptively and by multiple logistic regressions. RESULTS: Health professionals were more likely to have mental and behavioral disorders, associated with females and regardless of age. The chances of the nervous system diseases were higher in workers who performed administrative work, being associated with higher education. Operational employees were more likely to have musculoskeletal diseases associated with primary and secondary education and were male, regardless of age. CONCLUSION: There was an association between work activity performed before retirement and the diseases responsible for disability, with differences between gender, age, and educational levels.

Prenatal assessment of high-risk pregnancies in primary and specialized outpatient care: a mixed study.

OBJECTIVES: to assess high-risk prenatal care and identify strategies for improving care. METHODS: a mixed study of a prospective cohort, with 319 mothers in a public maternity hospital, from October 2016 to August 2017, using a semi-structured instrument and interview. Analysis was performed using the chi-square test (p≤0.05). The qualitative approach was carried out through interviews with guiding questions to 13 managers, at their workplace, between January and March 2020, analyzed under social phenomenology. RESULTS: higher rates of inadequacy were identified for all criteria. However, when care was shared, there was a higher rate for performing tests (p=0.023), consultations (p=0.002), risk stratification (p=0.013) and emergency information (≤0.000). Weaknesses in the record evidenced impairment in communication and continuity of care. FINAL CONSIDERATIONS: shared care is a strategy for improving care, however there is a need to strengthen effective referral and counter-referral to care continuity.

Educational intervention in social skills for Primary Care nurses.

OBJECTIVE: to assess an educational intervention on social skills for nurses who work in Primary Health Care. METHOD: a qualitative research-intervention study, carried out in the municipalities covered by the 17th Health Regional of Paraná. It was developed in three interrelated stages: exploratory, where meetings were held with the managers to define the groups and logistics for running the course; intermediate, developed in meetings with different groups of nurses, addressing selected topics; assessment, in which the nurses developed a personal plan to improve their social skills. RESULTS: participants were 57 nurses who acted as coordinators of Primary Care. They considered the educational intervention in social skills fundamental for positive changes in their professional performance. FINAL CONSIDERATIONS: the educational intervention in social skills was assessed as an important strategy to strengthen the development of nurses' managerial and care skills.

Workaholism and burnout among stricto sensu graduate professors.

OBJECTIVE: To analyze the association of excessive work and compulsive work with the dimensions of the burnout syndrome in masters and doctoral professors of Languages, Literature, and Linguistics in Brazil. METHODS: Cross-sectional study carried out with 585 permanent professors of stricto sensu graduate studies in Languages, Literature, and Linguistics in Brazil. Data collection took place between February and August 2019, by an online questionnaire. The outcomes of this study were the compulsive work and excessive work dimensions of the Dutch Work Addiction Scale, the Maslach Burnout Inventory TM dimensions and their associated factors, identified by multiple logistic regression models. RESULTS: Professors with a high level of excessive work (29.40%) had 2.75 times the chance of high emotional exhaustion and 2.08 times the chance of high depersonalization. Regarding professors with a high level of compulsive work (8.03%), they had 4.88 times the chance of high emotional exhaustion and 2.97 times the chance of high depersonalization. No association of excessive work and compulsive work with low professional fulfillment was identified. CONCLUSION: The results showed a statistically significant association of excessive work and compulsive work with high emotional exhaustion and high depersonalization, allowing managers and professors to reflect the criteria that guide their work processes, to adopt management models, institutional regulatory policies, and strategies to improve the working conditions and health of professors.

Factors associated with quality of life in retirement: a systematic review.

The purpose of this review was to determine the effects of retirement on quality of life and associated factors among older adults. This integrative review addressed the following question: what factors are associated with the health and quality of life of retired older adults? Biblioteca Virtual em Saúde and PubMed databases were searched using the following terms: retirement, quality of life, and health. Searches were conducted between June and December 2020. A total of 22 studies were included in the sample, categorized as follows: financial situation, social life, health conditions, and retirement preparation programs. The results indicate that quality of life among retirees is influenced by socioeconomic conditions, and the factors associated with this phenomenon differ according to culture, education, income, and professional category.

Conhecer os efeitos da aposentadoria na qualidade de vida de idosos aposentados e os fatores associados a esse fenômeno. Trata-se de revisão integrativa, com o seguinte questionamento: quais são os fatores associados à saúde e qualidade de vida do idoso aposentado? A busca foi realizada nas bases de dados Biblioteca Virtual em Saúde e Biblioteca Nacional de Medicina dos Estados Unidos utilizando os seguintes descritores: aposentadoria, qualidade de vida e saúde. As buscas foram realizadas no período de junho a dezembro de 2020. A amostra foi composta por 21 estudos, verificando-se quatro categorias: condições financeiras, convívio social, condições de saúde e programas de preparação para a aposentadoria. Os aposentados têm a qualidade de vida influenciada pelas condições socioeconômicas, sendo os fatores associados a esse fenômeno diferentes conforme a cultura, o ensino, a renda e as categorias profissionais.

Internal Regulation Center in hospitals: Repercussions of its implementation on the health services' indicators. / Núcleo Interno de Regulação hospitalar: repercussões da implantação nos indicadores dos serviços de saúde.

OBJECTIVE: To evaluate the hospital indicators and their repercussions on the number of monthly admissions to a public university hospital, before and after implementing the Internal Regulation Center. METHOD: An evaluative research study, of the Case Study type, developed in a public university hospital. A total of 28 indicators related to structure, production, productivity and quality were measured, which are part of internal Benchmarking. The data were analyzed by means of descriptive statistics and multiple regression to identify the independent factors and those associated with the number of monthly hospitalizations with 95% confidence intervals. RESULTS: Implementation of the Center significantly increased (p<0.001) the number of discharges, the bed utilization factor and the bed renewal rate, emergency hospitalization, bed occupancy percentage, surgical procedures performed and the patient-day mean value (p=0.027). There was a reduction (p<0.001) in the number of visits to the medical, obstetric and orthopedic emergency room, in the rates of in-hospital infection and infant mortality, as well as a mean reduction of 0.81/day, approximately one day less of hospitalization per patient, or a gain of 40 available beds per month. CONCLUSION: Although the number of available beds was lower in the post-implementation period, the bed replacement interval was reduced, representing an increase of 40 more beds per month due to the reduction in the patients' length of stay in the institution.

Multiprofessional round with checklist: association with the improvement in patient safety in intensive care.

OBJECTIVE: To verify the association between a multiprofessional round with the use of checklists and patient safety practices by health professionals in an intensive care unit. METHOD: Mixed-method study, delineated by the sequential explanatory approach, conducted in a hospital in southern Brazil. Quantitative data were analyzed using Poisson regression, and qualitative data, using content analysis. The integrated analysis was performed through the explained/connected combination. RESULTS: In the post-implementation period of the rounds with systematic use of the checklist, there was a significant improvement in the prophylaxis of venous thromboembolism, light sedation, reduction in the days of use of mechanical ventilation, central venous catheter and indwelling urinary catheter. CONCLUSION: The multiprofessional round with the systematic use of checklist, associated with the improvement in patient safety practices, was considered as a strategy that ensures better care in intensive care and favors job satisfaction.

Care for women in situations of violence: construction of a model of permanent health education.

OBJECTIVE: To propose a Permanent Health Education Model with strategies linked to the Five Disciplines framework for the development of competencies of professionals who work in direct care for women in situations of violence. METHOD: A qualitative research carried out by the focus group technique, with professionals who are part of an intersectoral network in Curitiba-PR, from August to October 2019. Data analyzed by content analysis in the thematic modality, in the light of the theoretical framework of the Five Disciplines: personal mastery; mental model; shared vision; team learning and systems thinking. RESULTS: The Five Disciplines were evidenced in the categories, as well as strategies to be used for competence development. A diagrammatic representation was used to be covered during the learning process. CONCLUSION: The strategies suggested by professionals who work in the care for women in situations of violence supported the proposition of a Permanent Health Education Model based on the adopted theoretical framework.

Construction and validation of clinical scenarios for training informal caregivers of dependent persons.

OBJECTIVE: To construct and validate three clinical scenarios for training dependent persons' informal caregivers. METHODS: Methodological study, conducted between January and August 2021, in a municipality in the northwest of the state of Paraná. It was developed in two stages: construction of scenarios; and content validation by experts (n = 12). To estimate the degree of agreement between the experts, the content validity index was used, and 80% was considered an acceptable rate of agreement. RESULTS: The simulation scenarios proved appropriate, obtaining an average value of 91.6%. However, some adjustments were made in their organization pertaining clarity in the wording of guidelines, as suggested by the expert validators. CONCLUSIONS: The construction and validation of the clinical scenarios proved to be adequate and relevant for use in the training of informal caregivers of dependent persons.

Effects of multidisciplinary rounds and checklist in an Intensive Care Unit: a mixed methods study.

OBJECTIVES: to analyze the implementation of multidisciplinary checklist-directed rounds before health indicators and multidisciplinary team perception of an Intensive Care Unit. METHODS: a mixed methods study, with an explanatory sequential design, carried out at a hospital in southern Brazil, from September 2020 to August 2021. The integration of quantitative and qualitative data was combined by connection. RESULTS: after the implementation of checklist-directed rounds, there was a significant reduction in hospital stay from ventilator-associated pneumonia, urinary tract infection and daily invasive device use. The investigated practice is essential for comprehensive care, harm reduction, effective work and critical patient safety. CONCLUSIONS: the multidisciplinary rounds with checklist use reduced data on health indicators of critically ill patients and was considered a vital practice in the intensive care setting.

Effectiveness of the interventions against workplace violence suffered by health and support professionals: A meta-analysis. / Efetividade das intervenções contra violência no trabalho sofrida por profissionais de saúde e apoio: metanálise.

OBJECTIVE: to assess the effectiveness of the interventions targeted at preventing and reducing the workplace violence suffered by health and support professionals. METHOD: a systematic review with meta-analysis conducted in eight databases and in the gray literature. Risk of bias was assessed by means of the Cochrane tools and certainty of the evidence, through Grading of Recommendations Assessment, Development and Evaluation. The analysis was performed in a descriptive manner and through the meta-analysis, including a heterogeneity assessment. RESULTS: a total of 11 randomized and quasi-randomized studies were eligible, of which six (54.5%) implemented individual skills, four used a multiple approach (36.4%) and one (9.1%) resorted to governmental actions. Four studies (36.4%) exerted a positive and significant effect on reducing violence. Risk of bias was classified as high or uncertain. The meta-analysis was performed with two studies that tested individual skill (intervention group) versus individual skill (comparator group), although there was no scientific evidence (95% CI: -0.41 - 0.25, p=0.64) for the violence prevention/reduction outcome. CONCLUSION: this review did not obtain a high level of evidence in the prevention or reduction of workplace violence. The reduced number of randomized trials, the lack of studies with low risk of bias and the high consistency may have been factors that hindered recommending effective interventions.

Associated factors of professional burnout among faculty members of graduate stricto sensu programs in language teaching and linguistics: a cross-sectional study.

BACKGROUND: The burnout syndrome can be avoided and/or have its signs and symptoms reduced by knowing the five associated factors that help identify the health and working conditions of the professors of graduate programs. OBJECTIVE: To analyze the factors associated with burnout among faculty members of graduate stricto sensu programs. DESIGN AND SETTING: A cross-sectional study was conducted among 585 faculty members of Graduate Programs in Language Teaching and Linguistics in Brazil. METHODS: Data were collected through an online questionnaire. The outcomes were the dimensions of burnout and its related factors identified through multiple templates of logistic regression. RESULTS: Faculty members with increased chances of emotional exhaustion and depersonalization mentioned the use of medications due to labor activities. The negative influence of pace and intensity of work, thoughts about quitting the program, and having to produce three or more scientific articles were associated with higher chances of emotional exhaustion, while having to achieve nine hours per week in undergraduate programs was related to reduced personal accomplishment. Having a conjugal relationship, satisfaction with health and work, post-doctoral degree, autonomy, and good interpersonal relationships with faculty members of the program reduced the chances of emotional exhaustion. Reduced chances of depersonalization occurred among those who were satisfied with work, had good interpersonal relationships with advisees and faculty members, and received productivity funding. CONCLUSION: Sociodemographic, health, and occupational factors related to the dimensions of burnout were identified.

Innovative actions developed by nurses in primary health care.

OBJECTIVES: to understand the work process dimensions related to innovative actions developed by nurses in Primary Health Care. METHODS: qualitative, descriptive study, developed in Primary Health Care in a city in the Southern Region of Brazil. Seventy-six nurses, who worked in management and assistance, participated in this study through semi-structured interviews. After data processing by IRAMUTEQ software, the textual analysis occurred by descending hierarchical classification. RESULTS: forty-two innovative actions, considered by the participants as new ways of working, were identified. There was a predominance of innovative actions related to the Management and Assist dimensions; we noticed the fragility of the actions to contemplate all the nurse's work process dimensions. FINAL CONSIDERATIONS: the predominance of innovative actions was related to users' assistance and better conditions in the teamwork process, besides highlighting the role of nurses in the perspective of a new way of working in health services.

Workaholism and quality of life: an integrative literature review.

This study aimed to analyze the scientific evidence available in the literature that addresses the relationship between workaholism-workaholic and quality of life. This was an integrative review, whose search was conducted on the following databases: MEDLINE, Latin American and Caribbean Literature in Health Sciences, Web of Science, and Scopus. The survey found 10 primary articles published from 2011 to 2018, of which eight were published in English and two in Portuguese. Only 20% of the investigations included health care professionals in the hospital setting, of which one was conducted in Korea and the other in Brazil. It was concluded that workaholism was associated with workers' quality of life in all studies, consolidating the fact that the workaholism phenomenon has negative consequences to workers' quality of life.

Este estudo teve como objetivo analisar as evidências científicas disponíveis na literatura que abordem a relação workaholism-workaholic com qualidade de vida. Tratou-se de uma revisão integrativa, por meio de consulta às bases de dados MEDLINE, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Web of Science e Scopus. Encontraram-se 10 artigos primários publicados entre 2011 e 2018, dos quais oito foram publicados em inglês e dois, em português. Apenas 20% das pesquisas incluídas foram conduzidas com trabalhadores de saúde no ambiente hospitalar, sendo uma delas na Coreia e a outra, no Brasil. Conclui-se que o workaholism associou-se à qualidade de vida dos trabalhadores em todos os estudos, consolidando que o fenômeno workaholism acarreta consequências negativas à qualidade de vida dos trabalhadores.