Mental workload and social support in primary health care workers / Carga de trabajo mental y apoyo social en trabajadores de atención primaria de salud / Carga mental de trabalho e o apoio social em trabalhadores da atenção primária à saúde

ABSTRACT Objective: To analyze the relationship between mental workload and social support in Primary Health Care workers. Method: This is a quantitative cross-sectional survey with healthcare professionals from Primary Health Care in Rio Grande do Sul, Brazil. Data were collected online between July 2021 and April 2022, using the questionnaire with sociodemographic, employment and healthcare profile information; Job Stress Scale; and Subjective Mental Workload Scale. Data were analyzed with descriptive statistics, Spearman's correlation, chi-square or Fischer's exact test (with statistical significance established at p<0.05) and internal consistency using Cronbach's alpha coefficient. Results: The largest group of workers had an adequate mental workload (48.7%) and there was a prevalence of low social support (57.6%). Mental load had a significant association with having time for leisure (p<0.001) and satisfaction with work (p=0.028). Furthermore, satisfaction with work had a significant relationship with social support (p<0.001). Furthermore, social support had negative and significant correlations with mental load in the health consequences (r=-0.377; p<0.001) and work characteristics (r=-0.192; p=0.008) dimensions. Conclusion: Workers with a high mental workload have a lower perception of social support, which may have an impact on their health, considering work characteristics. Furthermore, aspects of satisfaction and leisure activities should be promoted as a way of promoting quality of life at work.

RESUMEN Objetivo: Analizar la relación entre carga de trabajo mental y apoyo social en trabajadores de atención primaria de salud. Método: Se trata de una encuesta cuantitativa transversal con profesionales de la salud de la Atención Primaria de Salud de Rio Grande do Sul, Brasil. Los datos se recopilaron en línea entre julio de 2021 y abril de 2022 a través de un cuestionario con información del perfil sociodemográfico, laboral y de salud, Job Stress Scale y Escala de Carga Mental Subjetiva en el Trabajo. Los datos fueron analizados con estadística descriptiva, correlación de Spearman, chi-cuadrado o prueba exacta de Fischer (con significación estadística establecida en p<0,05) y consistencia interna mediante el coeficiente alfa de Cronbach. Resultados: Un grupo mayor de trabajadores tenía una carga de trabajo mental adecuada (48,7%) y prevalecía un bajo apoyo social (57,6%). La carga mental tuvo asociación significativa con tener tiempo para ocio (p<0,001) y satisfacción con el trabajo (p=0,028). Además, la satisfacción con el trabajo tuvo una relación significativa con el apoyo social (p<0,001). Además, el apoyo social tuvo correlaciones negativas y significativas con la carga mental en las dimensiones consecuencias para la salud (r=-0,377; p<0,001) y características laborales (r=-0,192; p=0,008). Conclusión: Los trabajadores con alta carga mental de trabajo tienen una menor percepción de apoyo social, lo que puede repercutir en su salud, considerando las características del trabajo. Además, se deben potenciar aspectos de satisfacción y actividades de ocio como forma de promover la calidad de vida en el trabajo.

RESUMO Objetivo: analisar a relação entre a carga mental de trabalho e o apoio social em trabalhadores da atenção primária à saúde. Método: trata-se da pesquisa transversal quantitativa com profissionais de saúde da Atenção Primária à Saúde do Rio Grande do Sul, Brasil. Os dados foram coletados online entre julho de 2021 e abril de 2022, por meio dos seguintes instrumentos: questionário com informações sociodemográficas, laborais e perfil de saúde; Job Stress Scale; e Escala Subjetiva de Carga Mental no Trabalho. Analisaram-se os dados com estatística descritiva, correlação de Spearman, teste Qui-Quadrado ou Exato de Fischer (com significância estatística estabelecida em p<0,05) e consistência interna usando o coeficiente Alpha de Cronbach. Resultados: maior contigente de trabalhadores apresentou carga mental de trabalho adequada (48,7%) e houve prevalência de baixo apoio social (57,6%). A carga mental teve associação significativa com o ter tempo para lazer (p<0,001) e satisfação com o trabalho (p=0,028). Ainda, satisfação com o trabalho obteve relação significativa com apoio social (p<0,001). Ademais, apoio social teve correlações negativas e significativas com a carga mental nas dimensões consequências para a saúde (r=-0,377; p<0,001) e as características do trabalho (r=-0,192; p=0,008). Conclusão: os trabalhadores com alta carga mental têm menor percepção de apoio social, o que pode repercutir na saúde, considerando as características do trabalho. Ainda, os aspectos da satisfação e as atividades de lazer deveriam ser promovidos como forma de promoção de qualidade de vida no trabalho.

Creation and content validity of 5r-medsafe: assessing adherence to the safe drug administration "five rights" / Elaboración y validez de contenido del instrumento 5r-medsafe: evaluación de la adhesión a los "cinco correctos" de la administración segura de medicamentos / Construção e validade de conteúdo do 5r-medsafe: avaliação da adesão aos cinco certos da administração segura de medicamentos

ABSTRACT Objective: to present the creation and content validity stages of a questionnaire to assess the determinants of adherence to the safe drug administration five "rights" "x", based on the Theory of Planned Behavior integrative model. Method: a methodological study to create and validate a self-reported measuring instrument for psychosocial variables. It took place in two public university teaching hospitals: one located in the South and the other in the Southeast of Brazil. Results: the results were organized according to each stage of the 5R-MEDSAFE content validation process. Conclusion: the results obtained in this creation and content validation study of the 5R-MEDSAFE indicated that the tool presented diverse content validity evidence. Its application can be useful in different contexts as a way of assessing adherence to these behaviors among Nursing workers. This will make it possible to identify which elements of the behaviors are amenable to intervention, as well as to implement the most appropriate intervention, according to the Theory of Planned Behavior constructs.

RESUMEN Objetivo: presentar las etapas de creación y validez de contenido correspondientes a un cuestionario para evaluar los determinantes del nivel de adhesión a los "Cinco correctos" de la administración segura de medicamentos - "5R-MEDSAFE", sobre la base del modelo integrador de la Teoría del Comportamiento Planificado. Método: estudio metodológico para crear y validar un instrumento de medición autoinformado de variables psicosociales. Se desarrolló en dos hospitales-escuela universitarios y públicos: uno situado en la región Sur y el otro en la región Sudeste de Brasil. Resultados: los resultados se organizaron conforme a cada etapa de la validación de contenido de 5R-MEDSAFE. Conclusión: los resultados obtenidos en este estudio de creación y validación del contenido del instrumento 5R-MEDSAFE indicaron que la herramienta presentó diversa evidencia de validez de contenido. Su aplicación puede resultar útil en diferentes contextos como una forma de evaluar el nivel de adhesión a estas conductas entre trabajadores de Enfermería. Eso permitirá identificar los elementos de los comportamiento que son pasibles de intervención, al igual que implementar la intervención más adecuada, conforme a los constructos de la Teoría del Comportamiento Planificado.

RESUMO Objetivo: apresentar as etapas de construção e validade de conteúdo de um questionário para avaliação dos determinantes da adesão aos cinco certos da administração segura de medicamentos - 5R-MEDSAFE, baseado no modelo integrador da Teoria do Comportamento Planejado. Método: estudo metodológico de construção e validação de instrumento de medida autorrelatada de variáveis psicossociais. Desenvolveu-se em dois hospitais-escola universitários, públicos, um localizado na região Sul e outro na região Sudeste do Brasil. Resultados: os resultados foram organizados conforme cada etapa da validação de conteúdo do 5R-MEDSAFE. Conclusão: os resultados obtidos neste estudo de construção e validação de conteúdo do instrumento 5R-MEDSAFE indicaram que o instrumento apresentou evidências de validade de conteúdo. Sua aplicação pode ser útil em contextos distintos como forma de avaliar a adesão a esse comportamento entre trabalhadores de enfermagem. Isso permitirá identificar qual elemento do comportamento é passível de intervenção, bem como implementar a intervenção mais adequada, conforme os construtos da Teoria do Comportamento Planejado.

Burnout, ethical climate and work organization in covid-19 intensive care units: mixed method study.

OBJECTIVES: to analyze the association between burnout and the perception of the ethical climate in nursing professionals in the covid-19 Intensive Care Unit and the relationship with the organization of work from the perspective of managers of these units. METHODS: mixed method study conducted in three university hospitals in southern Brazil from December 2021 to March 2022. A cross-sectional study was developed with 110 nursing professionals, followed by an exploratory-descriptive study through semi-structured interviews with six managers. Descriptive and analytical statistics and discursive textual analysis were used. RESULTS: the prevalence of burnout was 10% and the perception of negative ethical climate was 24.5%. The association between burnout and ethical climate revealed overload and fatigue during working hours, related to tension, fear, and stress that emerged from the consequences of the organization and relations of work in the covid-19 Intensive Care Unit. CONCLUSIONS: there was an association between burnout and ethical climate and elements of the work organization.

Estratégias para promoção do clima ético positivo sob a perspectiva de enfermeiros hospitalares / Strategies to promote a positive ethical climate from the perspective of hospital nurses / Estrategias para promover un clima ético positivo desde la perspectiva de los enfermeros hospitalarios

Objetivo: analisar as estratégias de promoção do clima ético positivo sob a perspectiva de enfermeiros hospitalares. Método: estudo qualitativo e descritivo exploratório, realizado com 182 enfermeiros de um hospital universitário do sul do Brasil. A coleta dos dados ocorreu por meio de um questionário sociodemográfico, laboral e uma pergunta aberta sobre estratégias de promoção do clima ético positivo. A organização dos dados ocorreu no software Atlas TI 8.0, versão 2019, e aplicou-se análise temática dos dados. Recebeu aprovação do Comitê de Ética em Pesquisa da instituição envolvida. Resultados: a macro categoria "Organização do trabalho" elencou itens sobre as relações na equipe, gestão, educação permanente e condições de trabalho. A macro categoria "Dimensão ética do trabalho" se referiu a exigências, valores pessoais e profissionais, expressão e sensibilidade moral. Conclusão: as estratégias de melhores condições de trabalho e organização, bem como o tratamento das questões éticas e relações interpessoais promovem o clima ético positivo(AU)

Objective: to analyze strategies for promoting a positive ethical climate from the perspective of hospital nurses. Method: qualitative and descriptive exploratory study, carried out with 182 nurses from a university hospital in southern Brazil. Data collection occurred through a sociodemographic and employment questionnaire and an open question about strategies for promoting a positive ethical climate. The data was organized using the Atlas TI 8.0 software, version 2019, and thematic analysis of the data was applied. It received approval from the Research Ethics Committee of the institution involved. Results: the macro category "Work organization" listed items on team relationships, management, continuing education and working conditions. The macro category "Ethical dimension of work" referred to demands, personal and professional values, expression and moral sensitivity. Conclusion: strategies for better working conditions and organization, as well as the treatment of ethical issues and interpersonal relationships promote a positive ethical climate(AU)

Objetivo: analizar las estrategias para promover un clima ético positivo desde la perspectiva de los enfermeros hospitalarios. Método: estudio cualitativo y descriptivo exploratorio, realizado junto a 182 enfermeros de un hospital universitario del sur de Brasil. La recolección de datos tuvo lugar mediante un cuestionario sociodemográfico y laboral y una pregunta abierta sobre estrategias para promover un clima ético positivo. Los datos se organizaron por medio del software Atlas TI 8.0, versión 2019, y se aplicó análisis temático de los datos. Recibió la aprobación del Comité de Ética en Investigación de la institución involucrada. Resultados: la macro categoría "Organización del trabajo" enumeró ítems sobre las relaciones en el equipo, la gestión, la educación continua y las condiciones de trabajo. La macro categoría "Dimensión ética del trabajo" hacía referencia a exigencias, valores personales y profesionales, expresión y sensibilidad moral. Conclusión: las estrategias para mejores condiciones de trabajo y organización, así como el tratamiento de las cuestiones éticas y las relaciones interpersonales promueven un clima ético positivo(AU)

Association between Moral Distress and Burnout Syndrome in university-hospital nurses / Associação do Sofrimento Moral e Síndrome de Burnout em enfermeiros de hospital universitário / Asociación del Sufrimiento Moral y Síndrome de Burnout en enfermeros de un hospital universitario

Abstract Objective: to analyze the association between moral distress and Burnout Syndrome among nurses in a university hospital. Method: descriptive, analytical study conducted with 269 nurses working in a university hospital located in Rio Grande do Sul, Brazil. Data were collected in person in 2019 by previously trained collectors. A sociodemographic and employment questionnaire, the Brazilian Scale of Moral Distress in Nurses and the Maslach Burnout Inventory were applied. Descriptive and analytical statistical analysis was used. Results: an association was identified between moral distress intensity and frequency and its dimensions with Burnout Syndrome and its dimensions. Nurses with low professional achievement and high emotional exhaustion showed a higher prevalence of moral distress. Conclusion: an association between moral distress and Burnout Syndrome, as well as between their dimensions, was evidenced. The results suggest the need to investigate urgent interventions to mitigate the situations and manifestations of moral distress and Burnout Syndrome by developing strategies for workers' health.

Resumo Objetivo: analisar a associação entre sofrimento moral e síndrome de Burnout em enfermeiros de hospital universitário. Método: estudo descritivo-analítico, realizado com 269 enfermeiros atuantes em um hospital universitário localizado no Rio Grande do Sul, Brasil. A coleta de dados ocorreu de maneira presencial no ano de 2019 por coletadores previamente capacitados. Aplicaram-se questionário sociodemográfico e laboral, Escala Brasileira de Distresse Moral em Enfermeiros e o Inventário Maslach de Burnout. Empregou-se análise estatística descritiva e analítica. Resultados: identificou-se associação entre intensidade e frequência de sofrimento moral e suas dimensões com a síndrome de Burnout e suas dimensões. Enfermeiros em baixa realização profissional e alta exaustão emocional apresentaram prevalências mais elevadas para sofrimento moral. Conclusão: evidenciou-se a associação entre sofrimento moral e síndrome de Burnout bem como entre suas dimensões. Os resultados sinalizam a necessidade de investigar intervenções urgentes para amenizar as situações e as manifestações do sofrimento moral e a síndrome de Burnout, elaborando estratégias para a saúde dos trabalhadores.

Resumen Objetivo: analizar la asociación entre sufrimiento moral y síndrome de Burnout en enfermeros de un hospital universitario. Método: estudio descriptivo y analítico, realizado en 269 enfermeros que actuaban en un hospital universitario localizado en el estado de Rio Grande del Sur, en Brasil. La recogida de datos se realizó de manera presencial en el año de 2019 por colectores previamente capacitados. Se aplicaron el cuestionario sociodemográfico y laboral, la Escala Brasileña de Estrés Moral en Enfermeros y el Inventario Maslach de Burnout. Se empleó el análisis estadístico descriptivo y analítico. Resultados: se identificó asociación entre intensidad y frecuencia de sufrimiento moral y sus dimensiones con el síndrome de Burnout y sus dimensiones. Los enfermeros que tuvieron baja realización profesional y alta extenuación emocional, presentaron prevalencias más elevadas para el sufrimiento moral. Conclusión: se evidenció asociación entre sufrimiento moral y síndrome de Burnout así como entre sus dimensiones. Los resultados señalan la necesidad urgente de investigar intervenciones para amenizar las situaciones y las manifestaciones del sufrimiento moral y el síndrome de Burnout, elaborando estrategias para la salud de los trabajadores.

Nurses' assessment of the ethical climate of a university hospital in the South of Brazil.

Background: Ethical climate can be defined as the healthcare professionals' perceptions of the ethical treatment of healthcare issues and human interactions in their work environment. A number of studies on ethical climate are being carried out in several countries. In Brazil, however, research on the matter is still incipient, especially among hospital nurses. Aim: To assess nurses' perception of the ethical climate in a university hospital in the South of Brazil. Methods: Cross-sectional study carried out with 269 nurses from a university hospital, using a sociodemographic and occupational profiling survey and the Hospital Ethical Climate Survey - Brazilian version. Data analysis was done through descriptive statistics. Results: The nurses' perception of the ethical climate was positive (3.68 ± 0.55). Among the five assessment factors, 'peers' had the highest score (4.07 ± 0.57), whereas 'physicians' had the lowest score (3.26 ± 0.70) for ethical climate. Conclusion: In general, the ethical climate was perceived as positive, with small variations between the factors of the instrument. Ethical climate could be enhanced through strategies that encourage interpersonal relationships. This study shows the importance of a positive ethical climate based on good relationships between healthcare professionals for ensuring better care.

Association between Moral Distress and Burnout Syndrome in university-hospital nurses.

OBJECTIVE: to analyze the association between moral distress and Burnout Syndrome among nurses in a university hospital. METHOD: descriptive, analytical study conducted with 269 nurses working in a university hospital located in Rio Grande do Sul, Brazil. Data were collected in person in 2019 by previously trained collectors. A sociodemographic and employment questionnaire, the Brazilian Scale of Moral Distress in Nurses and the Maslach Burnout Inventory were applied. Descriptive and analytical statistical analysis was used. RESULTS: an association was identified between moral distress intensity and frequency and its dimensions with Burnout Syndrome and its dimensions. Nurses with low professional achievement and high emotional exhaustion showed a higher prevalence of moral distress. CONCLUSION: an association between moral distress and Burnout Syndrome, as well as between their dimensions, was evidenced. The results suggest the need to investigate urgent interventions to mitigate the situations and manifestations of moral distress and Burnout Syndrome by developing strategies for workers' health.

Burnout, ethical climate and work organization in covid-19 intensive care units: mixed method study / Agotamiento profesional, clima ético y organización del trabajo en unidades de cuidados intensivos de covid-19: estudio de método mixto / Burnout, clima ético e organização do trabalho em unidade de terapia intensiva covid-19: estudo misto

ABSTRACT Objectives: to analyze the association between burnout and the perception of the ethical climate in nursing professionals in the covid-19 Intensive Care Unit and the relationship with the organization of work from the perspective of managers of these units. Methods: mixed method study conducted in three university hospitals in southern Brazil from December 2021 to March 2022. A cross-sectional study was developed with 110 nursing professionals, followed by an exploratory-descriptive study through semi-structured interviews with six managers. Descriptive and analytical statistics and discursive textual analysis were used. Results: the prevalence of burnout was 10% and the perception of negative ethical climate was 24.5%. The association between burnout and ethical climate revealed overload and fatigue during working hours, related to tension, fear, and stress that emerged from the consequences of the organization and relations of work in the covid-19 Intensive Care Unit. Conclusions: there was an association between burnout and ethical climate and elements of the work organization.

RESUMEN Objetivos: analizar la asociación entre el agotamiento profesional y la percepción del clima ético en profesionales de enfermería de la Unidad de Cuidados Intensivos covid-19 y la relación con la organización del trabajo desde la perspectiva de los directivos de estas unidades. Métodos: estudio de método mixto realizado en tres hospitales universitarios del sur de Brasil entre diciembre de 2021 y marzo de 2022. Se desarrolló un estudio transversal con 110 profesionales de enfermería, seguido de un estudio exploratorio-descriptivo mediante entrevistas semiestructuradas con seis gestores. Se utilizó estadística descriptiva, analítica y análisis textual discursivo. Resultados: hubo un 10% de prevalencia de agotamiento profesional y un 24,5% de percepción de clima ético negativo. La asociación entre el agotamiento profesional y el clima ético reveló sobrecarga y fatiga durante la jornada laboral, relacionadas con la tensión, el miedo y el estrés que surgieron de las consecuencias de la organización y las relaciones laborales en la Unidad de Cuidados Intensivos covid-19. Conclusiones: hubo asociación entre agotamiento profesional y clima ético y elementos de la organización del trabajo.

RESUMO Objetivos: analisar a associação entre burnout e percepção do clima ético em profissionais de enfermagem de Unidade de Terapia Intensiva covid-19 e a relação com a organização do trabalho na perspectiva dos gestores dessas unidades. Métodos: estudo misto realizado em três hospitais universitários no Sul do Brasil, de dezembro de 2021 a março de 2022. Empregou-se estudo transversal com 110 profissionais de enfermagem, seguido de estudo exploratório-descritivo por meio de entrevistas semiestruturadas com seis gestores. Utilizou-se estatística descritiva e analítica, e análise textual discursiva. Resultados: evidenciou-se 10% de prevalência de burnout e 24,5% de percepção do clima ético negativo. A associação entre burnout e clima ético revelou sobrecarga e cansaço nas jornadas de trabalho, relacionados à tensão, medo, e estresse, que emergiram das consequências da organização e das relações do trabalho nas UTI covid-19. Conclusões: verificou-se a associação entre burnout e clima ético e elementos da organização do trabalho.

Patient safety culture and incidents recorded during nursing shift changes in intensive care units. / Cultura de segurança do paciente e incidentes registrados durante as passagens de plantão de enfermagem em unidades de terapia intensiva.

OBJECTIVE: To analyze the association of patient safety culture perceived by nursing professionals with incidents recorded during nursing shifts in intensive care units. METHODS: This was a cross-sectional study that investigated patient safety culture measured by the Hospital Survey on Patient Safety Culture instrument. Descriptive statistics, chi-square tests, Student's t-test and multiple linear regression models were analyzed considering a significance level of 5%. RESULTS: The study reported a mean of 3.1 (standard deviation of 0.4) for the culture of patient safety in the perception of nursing professionals and 480 incidents with and without damage recorded during the nursing shifts. The variables patient safety culture with a difference between means of 0.543 (95%CI 0.022 - 1.065; p < 0.05) and nursing assistants with a difference between means of -0.133 (95%CI -0.192 - -0.074; p < 0.05) were associated with the incidents recorded during the nursing shifts. Further, nursing assistants had a lower tendency to record incidents than did the nurses. CONCLUSION: The strengthening of the patient safety culture and the aspects tangential to the nursing professionals represent a possible target for interventions to encourage the recording of incidents during the nursing shift shifts and improve patient safety.

OBJETIVO: Analisar a associação da cultura de segurança do paciente na percepção dos profissionais de enfermagem com os incidentes registrados durante as passagens de plantão de enfermagem nas unidades de terapia intensiva. MÉTODOS: Estudo transversal que investigou a cultura de segurança do paciente medida pelo instrumento Hospital Survey on Patient Safety Culture. Estatísticas descritivas, teste do qui-quadrado, teste t de Student e modelo de regressão linear múltiplo foram analisados considerando o nível de significância de 5%. RESULTADOS: O estudo relatou média de 3,1 (desvio-padrão de 0,4) para a cultura de segurança do paciente na percepção dos profissionais de enfermagem e 480 incidentes com e sem danos registrados nas passagens de plantão de enfermagem. As variáveis cultura de segurança do paciente com diferença entre médias de 0,543 (IC95% 0,022 - 1,065; p < 0,05) e técnicos de enfermagem com diferença entre médias de -0,133 (IC95% -0,192 - -0,074; p < 0,05) foram associadas aos incidentes registrados nas passagens de plantão de enfermagem, considerando ainda que os técnicos de enfermagem apresentaram menor tendência de registro que os enfermeiros. CONCLUSÃO: O fortalecimento da cultura de segurança do paciente e dos aspectos tangentes aos profissionais de enfermagem representam uma possibilidade real de intervenção para favorecer os incidentes registrados durante as passagens de plantão de enfermagem nas unidades de terapia intensiva deste estudo.

Cultura de segurança do paciente e incidentes registrados durante as passagens de plantão de enfermagem em unidades de terapia intensiva / Patient safety culture and incidents recorded during nursing shift changes in intensive care units

RESUMO Objetivo: Analisar a associação da cultura de segurança do paciente na percepção dos profissionais de enfermagem com os incidentes registrados durante as passagens de plantão de enfermagem nas unidades de terapia intensiva. Métodos: Estudo transversal que investigou a cultura de segurança do paciente medida pelo instrumento Hospital Survey on Patient Safety Culture. Estatísticas descritivas, teste do qui-quadrado, teste t de Student e modelo de regressão linear múltiplo foram analisados considerando o nível de significância de 5%. Resultados: O estudo relatou média de 3,1 (desvio-padrão de 0,4) para a cultura de segurança do paciente na percepção dos profissionais de enfermagem e 480 incidentes com e sem danos registrados nas passagens de plantão de enfermagem. As variáveis cultura de segurança do paciente com diferença entre médias de 0,543 (IC95% 0,022 - 1,065; p < 0,05) e técnicos de enfermagem com diferença entre médias de -0,133 (IC95% -0,192 - -0,074; p < 0,05) foram associadas aos incidentes registrados nas passagens de plantão de enfermagem, considerando ainda que os técnicos de enfermagem apresentaram menor tendência de registro que os enfermeiros. Conclusão: O fortalecimento da cultura de segurança do paciente e dos aspectos tangentes aos profissionais de enfermagem representam uma possibilidade real de intervenção para favorecer os incidentes registrados durante as passagens de plantão de enfermagem nas unidades de terapia intensiva deste estudo.

ABSTRACT Objective: To analyze the association of patient safety culture perceived by nursing professionals with incidents recorded during nursing shifts in intensive care units. Methods: This was a cross-sectional study that investigated patient safety culture measured by the Hospital Survey on Patient Safety Culture instrument. Descriptive statistics, chi-square tests, Student's t-test and multiple linear regression models were analyzed considering a significance level of 5%. Results: The study reported a mean of 3.1 (standard deviation of 0.4) for the culture of patient safety in the perception of nursing professionals and 480 incidents with and without damage recorded during the nursing shifts. The variables patient safety culture with a difference between means of 0.543 (95%CI 0.022 - 1.065; p < 0.05) and nursing assistants with a difference between means of -0.133 (95%CI -0.192 - -0.074; p < 0.05) were associated with the incidents recorded during the nursing shifts. Further, nursing assistants had a lower tendency to record incidents than did the nurses. Conclusion: The strengthening of the patient safety culture and the aspects tangential to the nursing professionals represent a possible target for interventions to encourage the recording of incidents during the nursing shift shifts and improve patient safety.

Estresse e burnout em trabalhadores de enfermagem de Unidade de Cirurgia Geral / Estrés y burnout en los trabajadores de enfermería de una unidad de cirugía general / Stress and burnout in nursing workers at a General Surgery Unit

Objetivo: avaliar os níveis de estresse e burnout dos trabalhadores de enfermagem de clínica cirúrgica antes e após a participação em grupo de apoio. Materiais e método: estudo quase-experimental, realizado em um hospital público com 16 trabalhadores. Os dados foram coletados entre maio e junho de 2015, e no mesmo período em 2016, por meio de instrumento de características biossociais e laborais, da Escala de Estresse no Trabalho e do Inventário Maslach de Burnout. Resultados: antes da participação no grupo de apoio em 2015, houve predomínio de médio nível de estresse (50 %). Quanto ao burnout, evidenciaram-se níveis de baixo desgaste emocional (43,8 %), baixa despersonalização (56,3 %), baixa realização profissional (43,8 %) e nenhum caso de burnout. Em 2016, após a participação no grupo de apoio, o nível médio de estresse manteve-se prevalente (56,6 %). Para o burnout, houve aumento dos níveis de desgaste emocional e despersonalização, e diminuição da realização profissional. Apesar disso, também não foram identificados casos da síndrome. Conclusões: a participação no grupo de apoio mobilizou o aumento do alto nível de estresse, apesar da manutenção da prevalência de nível médio. Quanto ao burnout, notaram-se piora na avaliação do desgaste emocional, despersonalização e, consequentemente, diminuição da realização profissional. Situação que sinaliza atenção, pois mostra condição favorável para o surgimento de casos da síndrome. Contudo, ainda são necessárias intervenções com foco no enfrentamento desses estressores ocupacionais.

Objetivo: evaluar los niveles de estrés y burnout de los trabajadores de enfermería de una clínica quirúrgica antes y después de participar en un grupo de apoyo. Materiales y método: estudio cuasiexperimental realizado en un hospital público sobre una muestra de 16 trabajadores. Los datos fueron recopilados entre mayo y junio de 2015, y durante el mismo periodo de 2016, a través de un instrumento de características biosociales y laborales, la Escala de Estrés Laboral y el Inventario de Burnout de Maslach. Resultados: antes de la participación en el grupo de apoyo, en 2015, los participantes reportaron un nivel medio de estrés (50 %). En cuanto al burnout, se evidenciaron niveles de baja angustia emocional (43,8 %), baja despersonalización (56,3 %), baja realización profesional (43,8 %) y ningún caso específico de burnout. En 2016, tras la participación en el grupo de apoyo, el nivel medio de estrés siguió siendo prevalente (56,6 %). En el caso del burnout, se observó un aumento de los niveles de malestar emocional y despersonalización, así como una disminución de los logros profesionales. A pesar de eso, tampoco fueron identificados casos del síndrome. Conclusiones: la participación en el grupo de apoyo generó un aumento del nivel alto de estrés, a pesar de que se mantuvo la prevalencia del nivel medio. En cuanto al burnout, se evidenció un incremento en la evaluación del malestar emocional, la despersonalización y, en consecuencia, una disminución en la realización profesional. Esta situación llama la atención, puesto que muestra una condición favorable para la aparición de casos del síndrome. Por lo anterior, las intervenciones centradas en el afrontamiento de estos factores de estrés laboral continúan siendo necesarias.

Objective: To evaluate the levels of stress and burnout among nursing workers at a surgical clinic before and after their participation in a support group. Materials and method: Quasi-experimental study conducted in a public hospital over a sample of 16 workers. Data were collected between May and June 2015 and in the same period of 2016, through a biosocial and work characteristics instrument, the Work Stress Scale, and the Maslach Burnout Inventory. Results: Prior to participation in the support group, in 2015, there was a predominance of medium level of stress (50 %). As for burnout, low emotional distress (43.8 %), low depersonalization (56.3 %), low professional fulfillment (43.8 %), and no cases of burnout were observed. In 2016, after participating in the support group, the average level of stress among individuals remained stable (56.6 %). Regarding burnout, there was an increase in the levels of emotional distress and depersonalization, as well as decreased professional achievement. Despite this, no cases of the burnout syndrome were identified. Conclusions: Participating in the support group mobilized an increase in the high level of stress, despite the steady prevalence of the medium level. As for burnout, we noticed a worsening in the evaluation of emotional distress, depersonalization, and, consequently, a decrease in professional fulfillment. This situation is particularly important, since it shows favorable conditions for the emergence of cases of the syndrome. Therefore, interventions focused on coping with these occupational stressors are still necessary.

Estresse e depressão em estudantes universitários da saúde / Stress and depression in university health students

RESUMO Objetivo analisar a associação entre o estresse e depressão em estudantes universitários da saúde. Métodos estudo transversal realizado com 792 estudantes universitários da saúde. O instrumento de pesquisa consistiu: caracterização dos estudantes; Inventário de Depressão de Beck versão II e Escala de Estresse Percebido. Empregaram-se análise de frequência absoluta e relativa, média, desvio-padrão, mediana, intervalo interquartil, e estatística analítica. Resultados observou-se associação entre a depressão e o estresse (p<0,001) bem como correlação forte entre eles (r=0,731; p<0,001). Em alto nível de estresse encontraram-se 9,5% dos estudantes e, em moderada a grave intensidade de sintomas comuns de depressão, 23,6% dos mesmos. Conclusão percebeu-se diferença nas médias entre os níveis de depressão e estresse, em que quanto maior o nível de depressão maior a média do estresse. Contribuições para a prática: o estresse está relacionado com a depressão em estudantes universitários da saúde, os quais, após a conclusão da graduação, podem entrar no mercado de trabalho já adoecidos, o que traz implicações para as relações interpessoais, saúde do trabalhador e segurança do paciente. Isso possibilita às instituições de ensino superior uma reflexão acerca da organização de práticas e políticas de intervenções para a redução do estresse e depressão entre os estudantes.

ABSTRACT Objective to analyze the association between stress and depression in university health students. Methods cross-sectional study conducted with 792 university health students. The research instrument consisted of characterization of the students, Beck Depression Inventory version II and the Perceived Stress Scale. Absolute and relative frequency analysis, mean, standard deviation, median, interquartile range, and analytical statistics were used. Results an association between depression and stress was observed (p<0.001) as well as a strong correlation between them (r=0.731; p<0.001). In high level of stress 9.5% of the students were found and in moderate to severe intensity of common symptoms of depression, 23.6% of them. Conclusion a difference was noticed in the averages between the levels of depression and stress, in that the higher the level of depression, the higher the average stress. Contributions to practice: stress is related to depression in university health students, who, after graduation, may enter the labor market already sick, which brings implications for interpersonal relationships, worker health and patient safety. This enables higher education institutions to reflect on the organization of practices and intervention policies for the reduction of stress and depression among students.

Patient safety culture in critical and non-critical areas: a comparative study.

OBJECTIVE: to compare the perception of patient safety culture among health workers from critical and non-critical areas. METHOD: cross-sectional study with health workers from critical and non-critical areas of a large hospital. Data collection used a characterization instrument and the Safety Attitudes Questionnaire. The analysis was performed in the Predictive Analytics Software Statistic®. RESULTS: a total of 393 workers participated, predominantly women, over 43 years old, nursing technicians, with a partner, and children. Results indicated that the areas have a negative perception of patient safety (66.5%, ±12.7 critical; 63.5%, ±14.4 non-critical). Only job satisfaction had a positive score (83.0%, ±15.9 critical; 80.1%, ±17.5 non-critical). There was a relationship between being a worker in critical areas and having a positive perception of the unit's management (p = 0.041). CONCLUSION: both areas have a negative perception of the safety culture. Although critical areas have obtained more positive evaluations, the results did not show statistical significance when compared to non-critical areas.

Educational actions on first aid for early childhood education teachers: a quasi-experimental study.

OBJECTIVE: To assess the early childhood education teachers' knowledge about first aid before and after the participation in an educational action. METHOD: Quantitative research with a quasi-experimental pre- and post-test design, carried out with 45 teachers from four early childhood education schools. For data collection, an instrument with questions regarding the characterization of the participants and knowledge about first aid was used. Data were analyzed through statistical techniques, using the Shapiro Wilk and Wilcoxon tests. RESULTS: There was an increase in the number of correct answers to the questions and improvement regarding grades, with an increase in the score from pre- to post-test by 5.17 points and with a significant comparison of sums. CONCLUSION: Carrying out educational actions on first aid increases the knowledge of early childhood education teachers on the subject and the nurses' role as health educators is highlighted.

Salivary cortisol concentrations in hematogy/oncology nurses on working days and days off.

OBJECTIVE: to assess salivary cortisol concentrations in hematology/oncology nurses on working days and days off. METHODS: a cross-sectional study carried out with 28 nurses from a university hospital. A sociodemographic, employment and health profile questionnaire was applied. For saliva collection, Salivette® tubes were used. Descriptive and analytical analysis was used. RESULTS: there was no significant difference in cortisol concentrations between working days and days off (p>0.05). The high cortisol concentration was associated with not having children (0.621±0.340; p=0.046), not using medication (0.623±0.133; p=0.017) and birth control pills (0.556 ± 0.228; p=0.047) and intention to leave work (0.951±0.154; p=0.001). A positive correlation was identified between cortisol and absence from work due to health issues (0.72; p=0.05) and weight gain (0.935; p=0.02). CONCLUSION: in general, cortisol concentration is within the reference parameters, with no significant difference in its secretion on working days and days off.

Caring ability of urban and rural family caregivers: association with overburden, stress and coping.

OBJECTIVE: To correlate caring ability with overburden, stress and coping of urban and rural family caregivers of patients undergoing cancer treatment. METHOD: Cross-sectional study, carried out in a referral hospital for cancer treatment, with urban and rural caregivers who responded the following instruments: questionnaire of sociodemographic characterization of the caregiver and the care provided, Perceived Stress scale, Burden Interview scale and Brief COPE. Pearson's correlation test was used for statistical analysis, with a significance level ≤5%. RESULTS: A total of 163 urban caregivers and 59 rural caregivers participated in the study. Between the caring ability and stress, a negative and moderate correlation was found in rural caregivers. In the relationship between the caring ability and the overburden, there was a statistically significant correlation in urban caregivers in the interpersonal relationship and perception of self-efficacy factor. Between coping and the caring ability, a positive and moderate correlation was identified in coping focused on the problem in the knowledge dimension in urban caregivers. CONCLUSION: Urban caregivers had greater intensity of overburden and coping focused on the problem in relation to the caring ability.

Presenteeism and safety culture: evaluation of health workers in a teaching hospital.

OBJECTIVES: to verify associations between presenteeism and safety culture among health workers. METHODS: a descriptive, cross-sectional study with health workers from a teaching hospital in Rio Grande do Sul. Data collection took place through instruments of sample characterization, the Brazilian version of the Stanford Presenteeism Scale and the Safety Attitudes Questionnaire were analyzed using descriptive statistics and chi-square tests. RESULTS: a total of 758 (48%) professionals participated; 330 (43.5%) presenteeism were identified, who evaluated the safety culture more negatively compared to non- presenteeism. The safety culture had a mean less than 75; associations between presenteeism and general safety culture were observed, and with the domains of teamwork climate, safety climate, stress recognition and working conditions. CONCLUSIONS: presenteeism was associated with a safety culture, which requires investment by hospital management, with consideration to the health of workers.

Occupational stress, burnout and patient safety culture among workers from critical care and non critical care units in a hospital in Brazil.

OBJECTIVES: To evaluate the relationship among occupational stress, burnout and the perception of patient safety culture in health workers in critical care compared to non critical care units. RESEARCH METHODOLOGY: A cross-sectional study with health workers in the critical care and non critical care units of a university public hospital in Brazil. Data were collected using the Demographic and Labour Profile Questionnaire, Safety Attitudes Questionnaire, Job Stress Scale and the Maslach Burnout Inventory. An analysis of descriptive and inferential statistics was performed in PASW Statistics® software. RESULTS: A total of 393 health workers participated in the study, with 58.3% from critical care units and 41.7% from non critical care units. There was a prevalence of workers in high demand in non critical care units and 13.4% were experiencing burnout; there was a predominance of active work in the reviews and 8.3% were experiencing burnout. The patient safety culture perception was negative in both. The multivariate analysis pointed out that the variables such as high demand and burnout increased the prevalence of negatively assessing the safety culture. CONCLUSION: Workers from non critical care units were more affected by occupational stress and burnout and seemed to evaluate the safety culture more negatively, which can interfere in the quality of care provided.

Presenteeism and safety culture: evaluation of health workers in a teaching hospital / Presentismo y cultura de seguridad: evaluación de los trabajadores de la salud en un hospital universitario / Presenteísmo e cultura de segurança: avaliação dos trabalhadores de saúde de um hospital universitário

ABSTRACT Objectives: to verify associations between presenteeism and safety culture among health workers. Methods: a descriptive, cross-sectional study with health workers from a teaching hospital in Rio Grande do Sul. Data collection took place through instruments of sample characterization, the Brazilian version of the Stanford Presenteeism Scale and the Safety Attitudes Questionnaire were analyzed using descriptive statistics and chi-square tests. Results: a total of 758 (48%) professionals participated; 330 (43.5%) presenteeism were identified, who evaluated the safety culture more negatively compared to non- presenteeism. The safety culture had a mean less than 75; associations between presenteeism and general safety culture were observed, and with the domains of teamwork climate, safety climate, stress recognition and working conditions. Conclusions: presenteeism was associated with a safety culture, which requires investment by hospital management, with consideration to the health of workers.

RESUMEN Objetivos: verificar asociaciones entre el presentismo y la cultura de seguridad entre trabajadores de la salud. Métodos: estudio descriptivo, transversal con trabajadores de la salud de un hospital universitario de Rio Grande do Sul. Se analizaron los datos recolectados mediante instrumentos para la caracterización de la muestra, la versión brasileña de la Escala de Presentismo Stanford-6 y el Cuestionario de Actitudes de Seguridad, mediante la estadística descriptiva y la prueba de chi-cuadrado. Resultados: participaron 758 (48%) profesionales; se identificó el presentismo en 330 (43,5%), quienes evaluaron la cultura de seguridad de manera más negativa en comparación con los no presentistas. La cultura de seguridad promedió menos de 75 y hubo asociaciones entre el presentismo y la cultura de seguridad general, y con los dominios de trabajo en equipo, el clima de seguridad, percepción del estrés y las condiciones de trabajo. Conclusiones: el presentismo se asoció a la cultura de seguridad, que requiere inversión por parte de la dirección hospitalaria, con atención a la salud de los trabajadores.

RESUMO Objetivos: verificar associações entre presenteísmo e cultura de segurança entre trabalhadores de saúde. Métodos: estudo descritivo, transversal, com trabalhadores de saúde de um hospital universitário do Rio Grande do Sul. Os dados coletados por meio de instrumentos de caracterização da amostra, a versão brasileira da Stanford Presenteeism Scale e o Questionário de Atitudes de Segurança, foram analisados por estatística descritiva e teste do qui-quadrado. Resultados: participaram 758 (48%) profissionais; identificaram-se 330 (43,5%) presenteístas, os quais avaliaram a cultura de segurança mais negativamente comparados aos não presenteístas. A cultura de segurança obteve média inferior a 75; observaram-se associações entre presenteísmo e cultura de segurança geral, e com os domínios clima de trabalho em equipe, clima de segurança, reconhecimento do estresse e condições de trabalho. Conclusões: o presenteísmo esteve associado à cultura de segurança, a qual necessita de investimento por parte da gerência hospitalar, com atenção à saúde dos trabalhadores.

Estresse ocupacional, cortisol salivar e dor musculoesquelética em enfermeiros de hemato-oncologia / Estrés laboral, cortisol salival y dolor musculoesquelético en enfermeras de hemato-oncología / Occupational stress, salivary cortisol and musculoskeletal pain in hemato-oncology nurses

RESUMO Objetivo: verificar a correlação entre estresse ocupacional, concentração de cortisol salivar e dor musculoesquelética, em enfermeiros de hemato-oncologia. Método: estudo transversal com 28 enfermeiros de hemato-oncologia de uma instituição do sul do Brasil. Utilizou-se para coleta a Job Stress Scale e o Questionário Nórdico de Sintomas Osteomusculares, e tubos Salivette® para coleta de saliva e análise do cortisol salivar em três momentos num dia de trabalho, e em dois momentos em um dia de folga. Empregou-se estatística descritiva e teste de Correlação de Spearman. Resultados: houve correlação significativa e positiva entre cortisol de início da folga com controle. Os valores de cortisol com o estresse ocupacional e com a dor musculoesquelética não foram significativos. Conclusão: os resultados contribuem para a compreensão do processo saúde-doença dos enfermeiros de hemato-oncologia, destacando a necessidade de avaliações fisiológicas e psíquicas concomitantes para melhor avaliação e definição de estratégias.

RESUMEN Objetivo: verificar la correlación entre el estrés laboral, la concentración de cortisol salival y el dolor musculoesquelético en enfermeras de hemato-oncología. Método: estudio transversal con 28 enfermeras de hemato-oncología de una institución del sur de Brasil. Para la recogida de datos se utilizaron la Escala de Estrés Laboral y el Cuestionario Nórdico de Síntomas Musculoesqueléticos, así como tubos Salivette® para la recogida de saliva y el análisis de cortisol salival en tres momentos de un día de trabajo, y en dos momentos de un día de descanso. Se utilizaron estadísticas descriptivas y la prueba de correlación de Spearman. Resultados: hubo una correlación significativa y positiva entre el cortisol del inicio del día libre con el control. Los valores de cortisol con el estrés laboral y el dolor musculoesquelético no fueron significativos. Conclusión: los resultados contribuyen a la comprensión del proceso salud-enfermedad de las enfermeras de hemato-oncología, destacando la necesidad de evaluaciones fisiológicas y psíquicas concomitantes para una mejor evaluación y definición de estrategias.

ABSTRACT Objective: to verify the correlation between occupational stress, salivary cortisol concentration and musculoskeletal pain in hematology-oncology nurses. Method: cross-sectional study with 28 hematology-oncology nurses from an institution in southern Brazil. The Job Stress Scale and the Nordic Musculoskeletal Symptoms Questionnaire were used for data collection, and Salivette® tubes were used for saliva collection and salivary cortisol analysis on three moments during a workday, and on two moments during a day off. Descriptive statistics and Spearman's Correlation test were used. Results: there was a significant and positive correlation between cortisol at the beginning of the day off with control. Cortisol values with occupational stress and musculoskeletal pain were not significant. Conclusion: the results contribute to the understanding of the health-disease process of hematology-oncology nurses, highlighting the need for concomitant physiological and psychological assessments for better evaluation and definition of strategies.