Mental health problems among nurses in paediatric cardiac intensive care.

At present, there are growing rates of psychiatric symptoms among some occupational categories, with emphasis on health professionals who work in hospitals. This study aimed to identify the occurrence of mental health problems (anxiety and depression) among 92 nursing workers in a paediatric cardiac intensive care unit. This is an exploratory, cross-sectional study, with a quantitative approach. The research was conducted in a public university hospital specialising in cardiology, pneumology, and thoracic and cardiac surgery. The data were collected between June and July of 2012 through socio-demographic and Self-Reporting Questionnaire (SRQ-20) instruments. The analysis of the results revealed the occurrence of mental health problems in 45% (41) of the workers. There was the prevalence of tension, nervousness and worry symptoms, followed by headache. Findings highlight the need for protective measures towards the mental health of workers who assist children with serious heart disease.

[Workloads and strain process in Community Health Agents]. / Cargas de trabalho e processo de desgaste em Agentes Comunitários de Saúde.

OBJECTIVE: To identify the workloads present in the work activities of community health agents (CHAs) and the resulting strain processes. METHOD: A descriptive, exploratory, cross-sectional and quantitative study conducted with 137 CHAs. Data were collected through a questionnaire and interview guided by the health surveillance software called SIMOSTE (Health Monitoring System of Nursing Workers), following the ethical codes of the current law. RESULTS: In total, were identified 140 workloads involved in 122 strain processes, represented by the occurrence of health problems of the CHAs. The mechanical (55.00%) and biological (16.43%) loads stood out. The most common strain processes were the external causes of morbidity and mortality (62.31%) and diseases of the musculoskeletal system and connective tissue (10.66%). CONCLUSION: From the identified overloads, it became evident that all workloads are present in the work process of CHAs, highlighting the mechanical load, represented mainly by external causes of morbidity and mortality that are related to occupational accidents.

Exposure of nursing workers to workloads and their consequences. / Exposição dos trabalhadores de enfermagem às cargas de trabalho e suas consequências.

Objective Measure the exposure of nursing workers to workloads and strain processes and their consequences, by means of indicators. Method Epidemiological, descriptive, cross-sectional quantitative study, conducted in 12 units of three teaching hospitals in the city of Sao Paulo. The study population consisted of 452 nursing workers and the data was collected from hospital medical records using the software System for Monitoring the Health of Nursing Workers (SIMOSTE). The data was analyzed on the basis of indicators that provided information about organizational dynamics, occupational health problems and their consequences. Results The health problem indicators revealed 879 exposures to worloads and 1,355 strain processes. The consequences indicators showed 2,709 lost days per year. Conclusions Exposure to different workloads subjects workers to numerous strain processes, which should be monitored in order to implement preventive measures.

Nursing workers health and patient safety: the look of nurse managers. / Saúde dos trabalhadores de enfermagem e a segurança do paciente: o olhar de gerentes de enfermagem.

Objective To understand the perception of nurse managers about the relationship between nursing workers health and patient safety. Method A qualitative survey was conducted using the social phenomenology approach of Alfred Schütz, accomplished through individual interviews with nine nurse managers from five Brazilian university hospitals. Results Nurse managers' perception of the relationship between nursing workers health and patient safety was evidenced in the following categories: "The suffering to balance workers health and patient safety" and "Interventions in everyday work life". Conclusion Managers' experience showed an everyday work life marked by suffering and concern, due to high rates of absenteeism and presenteeism resulting from illness and incapability of workers, and the need to ensure patient safety through qualified nursing care.

[Health problems of nursing workers in a public educational institution]. / Agravos à saúde dos trabalhadores de enfermagem em uma instituição pública de ensino.

OBJECTIVE: To identify the issues occurred with nursing workers through a Health Monitoring System for Nursing Workers (SIMOSTE) and to describe the consequences of those problems. METHOD: This is a quantitative, exploratory and descriptive study realized in a teaching hospital in the west region of the city of São Paulo. RESULTS: From the SIMOSTE, 1.847 occurrences were registered in a six month period. Within the main occurrences, medical licenses, work related accidents with and without removals; psychiatric consultations and psychotherapy were highlighted. CONCLUSION: The data points out to the need for the development of new health vigilance actions to notify accidents and illness related to work, besides the prevention of issues.

[Description of workloads and fatigue experienced among health workers in a teaching hospital]. / Cargas e desgastes de trabalho vivenciados entre trabalhadores de saúde em um hospital de ensino.

This is an exploratory, descriptive and quantitative study, based on the following categories: work process, workloads and fatigue in a teaching hospital in Curitiba in the southern region of Brazil. The article characterizes the load and stress experienced in a university hospital, based on a previous study entitled "System for monitoring the health of nursing workers" (SIMOSTE). The results show that females were the most affected (85.9%) and the most affected professionals were nursing assistants (53.1%). The highest number of sick leaves was due to diseases of the osteoarticular system (25.2%) and the most significant loads were mechanical and physiological with 33.06% each. These results may support intervention strategies in the policies directed toward the workers' health to ensure a better quality of life and consequently improve the quality of care provided to the user.

Organizational climate, job satisfaction, and burnout in nursing workers.

Introduction: Characterized by high levels of emotional exhaustion and depersonalization and reduced professional accomplishment, burnout syndrome has been a major cause of psychic illness in nursing workers, with a serious impact on the quality of services and on patient safety. Objectives: To analyze the correlation between organizational climate, job satisfaction, and burnout in nursing workers. Methods: This is a cross-sectional study with a sample of 534 Brazilian nursing workers. We used the Organizational Climate Scale for Health Organizations, the Job Satisfaction Questionnaire (S20/23), and the Maslach Burnout Inventory. An analytical descriptive analysis of the data was performed using relative and absolute frequencies, mean, standard deviation, minimum, maximum, and correlation test between the variables. Results: Organizational climate and job satisfaction were evaluated as regular. With regard to burnout, moderate levels of emotional exhaustion, low levels of depersonalization, and high levels of professional accomplishment were observed. A strong positive correlation was found between job satisfaction and organizational climate; in addition to a moderate negative correlation between emotional exhaustion and both organizational climate and job satisfaction, and a moderate negative correlation between depersonalization and job satisfaction. Conclusions: Organizational climate and job satisfaction had a negative correlation with burnout dimensions, representing possible protective factors.

Introdução: Caracterizada por elevados níveis de exaustão emocional, despersonalização e diminuição da realização profissional, a síndrome de burnout tem sido uma grande causa de adoecimento psíquico em trabalhadores de enfermagem, com sérios impactos na qualidade dos serviços e na segurança do paciente. Objetivos: Analisar a correlação entre clima organizacional, satisfação no trabalho e burnout em trabalhadores de enfermagem. Métodos: Trata-se de um estudo transversal, realizado com uma amostra de 534 trabalhadores de enfermagem brasileiros. Utilizou-se a Escala de Clima Organizacional para Organizações de Saúde, o Questionário de Satisfação no Trabalho (S20/23) e o Inventário de Burnout de Maslach. Foi realizada uma análise analítica e descritiva dos dados por meio de frequências relativas e absolutas, média, desvio padrão, mínimo, máximo e teste de correlação entre as variáveis. Resultados: O clima organizacional e a satisfação no trabalho foram avaliados como regulares. Quanto ao burnout, observou-se moderada exaustão emocional, baixa despersonalização e elevada realização profissional. Verificou-se correlação positiva forte entre satisfação no trabalho e clima organizacional; correlação negativa moderada entre exaustão emocional e clima organizacional; correlação negativa moderada entre exaustão emocional e satisfação no trabalho; e correlação negativa moderada entre despersonalização e satisfação no Trabalho. Conclusões: Clima organizacional e satisfação no trabalho apresentaram correlação negativa com as dimensões de burnout, constituindo-se em possíveis fatores de proteção.

[Nursing workers' perceptions regarding the handling of hazardous chemical waste]. / A percepção dos trabalhadores de enfermagem sobre o manejo dos resíduos químicos perigosos.

The objectives of this study were to identify the perceptions of nursing workers regarding the handling of hazardous chemical waste at the University of São Paulo University Hospital (HU-USP), and develop a proposal to improve safety measures. This study used a qualitative approach and a convenience sample consisting of eighteen nursing workers. Data collection was performed through focal groups. Thematic analysis revealed four categories that gave evidence of training deficiencies in terms of the stages of handling waste. Difficulties that emerged included a lack of knowledge regarding exposure and its impact, the utilization of personal protective equipment versus collective protection, and suggestions regarding measures to be taken by the institution and workers for the safe handling of hazardous chemical waste. The present data allowed for recommending proposals regarding the safe management of hazardous chemical waste by the nursing staff.

The second victim experience: cross-cultural adaptation of an instrument for the Brazilian context.

OBJECTIVE: To cross-culturally adapt and analyze the evidence of content validity of the Second Victim Experience and Support Tool for the Portuguese language spoken in Brazil. METHOD: Psychometric study of cross-cultural adaptation following the steps of the Patient-Reported Outcome Measurement Information System. Semantic, idiomatic, experimental, and conceptual equivalences were evaluated. The content validity was verified using the Content Validity Ratio. 31 health professionals from the city of São Paulo participated in the pre-test. RESULTS: The equivalence analysis showed an agreement rate was 88.7%. The content validity presented 86% of the items with Content Validity Ratio values ​​above the stipulated. In the pre-test, the participants reported that they understood the items of the instrument and only 10% of the participants reported difficulty in understanding any item. CONCLUSION: The Brazilian version of the Second Victim Experience and Support Tool presented a good translation quality and good evidence of content validity.

Distress and pleasure indicators in health care workers on the COVID-19 front line. / Indicadores de sofrimento e prazer em trabalhadores de saúde na linha de frente da COVID-19.

OBJECTIVE: to evaluate distress and pleasure indicators in health care workers on the front line of care for suspected or confirmed COVID-19 cases. METHOD: an exploratory, analytical and cross-sectional study with a quantitative approach. The studied sample consisted of 437 health professionals invited by electronic means, who answered the questionnaire on sociodemographic information, occupational aspects and clinical conditions. Distress and pleasure at work were considered as outcomes, which were analyzed with multinomial logistic regression regarding the associated independent variables. RESULTS: Most of the participants were female (71.0%), nurses (55.6%), with a weekly working shift of 40 hours or more (75.8%); 61.6% of the participants suffered from mental distress. The psychosocial characteristics of high-strain work and low social support were reported by 23.8% and 52.9% of the participants, respectively. In the multiple analysis, distress and lack of pleasure at work were associated with high job strain, low support from co-workers and mental distress. The profession is also associated with distress at work. CONCLUSION: distress and lack of pleasure at work are associated with occupational characteristics and mental strain among health care workers in the COVID-19 scenario.

Relationship between team climate and satisfaction at work in the Family Health Strategy.

OBJECTIVE: To analyze the association between team climate, team characteristics and satisfaction at work in teams of the Estratégia Saúde da Família com Saúde Bucal (Family Health Strategy with Oral Health) (ESF with SB). METHODS: Cross-sectional correlational study with ESF teams with SB in the municipality of São Paulo. Universe of 1,328 teams and random sample of 124 teams with 1,231 professionals. Applied questionnaire with data teams' characterization, team climate scale, and satisfaction at work. Analysis of validity, of climate and satisfaction scores through mean among professionals in each team, cluster analysis, association between variables by Pearson's correlation and Chi-square, and tested linear regression model for the two factors of satisfaction at work. RESULTS: There was a directly proportional association between team climate and satisfaction at work. The better the climate with regard to team goals, the greater the intrinsic satisfaction at work and with the physical environment. The better the climate with regard to team goals and task orientation, the greater the satisfaction with hierarchical relations. The group with best team climate reported higher percentage of teams ranked with better satisfaction at work, and in the group with the worst team climate there was higher percentage of teams with the lowest satisfaction at work. CONCLUSIONS: The study provides consistent although moderate evidence of association between favorable teamwork climate and job satisfaction in ESF with SB. It emphasizes the dimensions of climate, common goals and task orientation, and may serve as subsidy for management and permanent education of teams, aiming at the quality of care to the health needs of users, family and community in APS.

Using technological innovation as a tool to monitor nursing workers' health. / A inovação tecnológica como ferramenta para monitoramento da saúde dos trabalhadores de enfermagem.

The objective of the present study is to describe the development of the "Monitoring System for Nursing Workers' Health" software, a technological innovation designed to identify the health hazards caused to nursing workers' and their determinants, i.e., strain and/or strength potentials, monitoring their health using indicators. The software development comprises the phases of defining the objective, chosing the thoeoretical framework, organizing the content, and developing the system's architecture. It is important to socialize this process with researchers, managers, and workers interested in this subject, because monitoring the health of nursing workers is indispensible when planning strategies to minimize the occurrence of accidents and occupational illnesses, promoting better working conditions and improving their quality of life.

Occupational psychosocial stressors and mental distress among healthcare workers during COVID-19 pandemic.

OBJECTIVE: To analyze the factors associated with mental distress among health workers who cared for patients with a suspected or confirmed diagnosis of coronavirus disease 2019 (COVID-19). METHODS: A cross-sectional analytical study of national scope, carried out between in the second quarter of 2020. A total of 437 health professionals, who filled out an electronic form about sociodemographic data, occupational aspects, psychosocial characteristics of work and mental distress. Multiple logistic regression was performed to analyze the covariables associated with mental distress. RESULTS: There was a predominance of workers on the nursing team (65.0%), female (71.0%), from Southeastern region of the country (68.6%) and with no morbidities (36.2%). The prevalence of mental distress was 61.6%. Job strain was reported by 24% of participants, and the perception of low support from coworkers was described by 52.9%. The final multiple regression model showed that mental distress was associated with females (odds ratio - OR: 1.93; 95%CI: 1.22-3.07), age up to 40 years (OR: 1.64; 95%CI: 1.07-2.52), weekly working hours equal or over 60 hours (OR: 1.87; 95%CI: 1.15-3.11), job strain (OR: 2.45; 95%CI: 1.41-4.40) and low support from co-workers (OR: 3.47; 95%CI: 2.26-5.38). CONCLUSION: Six out of ten participants presented mental distress, which was associated to both individual characteristics and factors related to the work carried out during the pandemic. There is an urgent need to map services that have such characteristics, to outline actions to promote mental health and prevent emotional distress at different levels of health care.

Prevalence of COVID-19 testing among health workers providing care for suspected and confirmed cases.

OBJECTIVES: To describe the prevalence of testing among health workers providing care for suspected and confirmed cases of COVID-19. METHODS: This quantitative, cross-sectional study was conducted from April to June 2020, using a convenience sample. An online questionnaire was used for collecting sociodemographic, occupational, and clinical data, which were analyzed descriptively. RESULTS: In total, 437 health workers participated in the study, with a predominance of nursing workers (58.68%), women (70.3%), age between 30 and 49 years (54.2%), individuals living in the Southeast region of Brazil (60.54%), working in the public care system (69.11%), and focused on primary care (30.89%). Among the participants, 36% reported comorbidities, 21.1% had symptoms suggestive of COVID-19, and only 27% had undergone some type of COVID-19 testing. CONCLUSIONS: Despite the existence of risk comorbidities and symptoms suggestive of contamination, the frequency of testing was below one third among respondents. The lack of action compromises health surveillance and protection strategies for workers providing care for the population and may favor the contamination of new patients and the community.

Burnout among nurses: a multicentric comparative study.

OBJETIVO: to identify and compare burnout levels between Portuguese, Spanish and Brazilian nurses. METHOD: quantitative, descriptive, correlational, comparative and cross-sectional study conducted using a sample of 1,052 nurses working in hospitals and primary care centers. A sociodemographic questionnaire and the Maslach Burnout Inventory were applied to nurses in Porto, Portugal (n=306), Oviedo, Spain (n=269) and S. Paulo, Brazil (n=477). Data analysis was performed using descriptive, inferential and multivariate analysis. RESULTS: approximately 42% of the nurses showed moderate/high levels of burnout, with no differences found between countries (Portugal and Brazil 42%, Spain 43%). Only depersonalization showed differences between countries, presenting Spain the highest level and Portugal the lowest one. Comparative analysis showed higher burnout levels in young nurses and those working by shifts. Considering job schedules, burnout was associated to shift work in Portugal, while in Spain and Brazil it was associated with fixed schedules. CONCLUSION: these results suggest that this syndrome among nurses is a global phenomenon. The daily stressors and higher demands of the nursing profession are crucial in the preparation of nurses to deal with complex situations, to avoid burnout, and to reduce the negative impact on nurses' health and on the quality of care they provide.

Translation, adaptation and validation of the "Cultural and Psychosocial Influences on Disability (CUPID) Questionnaire" for use in Brazil.

The paper describes the adaptation and testing of the Cultural and Psychosocial Influences on Disability Questionnaire for use in Portuguese. The cross-cultural adaptation followed the steps of translation, back-translation, evaluation of the translations by a committee of judges, and then piloting of the pre-final version. This was performed in a sample of 40 nursing staff from the Hospital at the University of São Paulo. Adjustments were made after review of the translations by the committee of judges (CVI ≤ 80%). The pilot study was used to test whether questions could be satisfactorily understood and completed (≥ 85% of subjects). The Brazilian version of the Questionnaire is an adequate instrument for the ascertainment of occupational activities, psychosocial aspects of work, musculoskeletal symptoms and associated disabilities in nursing staff.

Resilience factors in nursing workers in the hospital context.

OBJECTIVE: To investigate the level and factors related to resilience in nursing workers in the hospital context. METHOD: A cross-sectional study conducted with nursing workers of a university hospital in the city of São Paulo. Data were collected through a questionnaire containing sociodemographic and labor variables and the Resilience Scale. RESULTS: It was found that 45.3% of the 375 nursing workers investigated had a moderately low/moderate level of resilience, followed by a moderately high/high level (39.5%), and then a low level of resilience (15.2%). Age, working time in the institution, and working time in the profession showed a statistically significant correlation with resilience. The model showed that there is an increase of 0.289 points on the Resilience Scale for each year of age, regardless of the other variables. CONCLUSION: The resilience level of nursing workers is moderate to high. Age was determinant in resilience, as well as working time in the profession and institution.

Burnout syndrome in Brazilian and Spanish nursing workers.

OBJECTIVE: to analyze the burnout dimensions scores in Brazilian and Spanish nursing workers. METHOD: quantitative, cross-sectional and comparative study conducted with 589 Nursing workers who answered the Sociodemographic and Professional Characterization Questionnaire and the Maslach Burnout Inventory. Descriptive and analytical analysis of the data was performed. RESULTS: Spanish Nursing workers presented higher averages in the Depersonalization dimension (p = 0.004) and Brazilians, higher scores in the Professional Achievement dimension (p = 0.031). In both Spain and Brazil, nursing assistants / technicians were found to have higher Emotional Exhaustion than nurses; In Brazil, Depersonalization is higher in nurses and in Spain it is higher in Nursing assistants / technicians. Statistically significant results were found in the association of burnout dimensions with sociodemographic and work characteristics: age; professional category; workplace; work regime; work shift; time of professional experience; working time in the same workplace and consider stressful work. CONCLUSION: Although Brazilian and Spanish nursing workers score low levels of Depersonalization and high Professional Achievement, there are average levels of Emotional Exhaustion, indicating an important preventive factor to be worked on, since Emotional Exhaustion is considered the first stage of burnout.

Compassion fatigue among nurses working on an adult emergency and urgent care unit. / Fadiga por compaixão em enfermeiros de urgência e emergência hospitalar de adultos.

OBJECTIVE: to assess compassion fatigue levels among nurses and its variation according socio-demographic and professional characteristics. METHOD: quantitative, descriptive and cross-sectional study, with 87 nurses from an emergency and urgent care unit for adults from a university hospital. A socio-demographic and professional questionnaire, along with the Professional Quality of Life Scale 5 were used. Data analysis was performed using descriptive and inferential statistics. RESULTS: compassion satisfaction presents the highest means, followed by burnout and secondary traumatic stress. Among the participants, 51% presented a high level of compassion satisfaction, 54% a high level of burnout, and 59% a high level of secondary traumatic stress. Older participants presented higher score of compassion satisfaction, and younger nurses, women, nurses having less job experience and nurses without leisure activities showed higher means of secondary traumatic stress. CONCLUSION: we found compassion fatigue, expressed in the large percentage of nurses with high levels of burnout and secondary traumatic stress. Fatigue is related to individual factors such as age, gender, job experience and leisure activities. Doing research and understanding this phenomenon allow the development of health promotion strategies at work.

Factors associated with use of personal proactive equipment among community health agents in a coastal municipality in northern São Paulo, Brazil.

BACKGROUND: Community health agents (CHAs) are a part of Family Health Strategy multidisciplinary teams, and their function is to develop individual and collective health promotion, recovery and preventive actions, including household visits. Their work exposes CHAs to hazards in the work environment, therefore, using personal protective equipment (PPE) is essential. AIMS: To draw the sociodemographic and occupational profile of CHAs and investigate associations with use of PPE. METHODS: Cross-sectional quantitative study performed with 137 CHAs in a coastal municipality in the north of the state of São Paulo, Brazil. We applied a questionnaire for sociodemographic and occupational data. The data were subjected to descriptive and inferential analysis, with significance level of 5%. RESULTS: 94.16% of the participants were female, and their average age 34.80 years old. Their average time in the job was 3.18 years. The means of transport most often used to commute was bicycles. 94.16% of the participants reported daily use of some type of PPE, which included: sunscreen (88.32%), closed footwear (53.28%), hats (8.0%), sunglasses (6.57%) and raincoats (3.65%). We found significant association between use of PPE and longer time in the job, and between wearing closed footwear and older age and longer time in the job. CONCLUSION: The results point to the need of interventions to promote use of PPE.

INTRODUÇÃO: O agente comunitário de saúde (ACS) integra uma equipe multiprofissional na Estratégia Saúde da Família (ESF) e tem por função o desenvolvimento de ações individuais e coletivas de promoção, prevenção e recuperação da saúde, incluindo visitas domiciliares. O trabalho do ACS o expõe a riscos presentes no ambiente laboral; nesse contexto, o uso de equipamentos de proteção individual (EPI) é fundamental. OBJETIVOS: Identificar o perfil sociodemográfico e de trabalho de ACS e verificar associações com a utilização de EPI. MÉTODOS: Estudo transversal, quantitativo, realizado com 137 ACS de um município do litoral norte de São Paulo, Brasil, por meio de um questionário contendo dados sociodemográficos e relacionados ao trabalho. A análise foi realizada estabelecendo-se as análises descritivas e inferenciais, considerando estatisticamente significativos os resultados com p=0,05. RESULTADOS: 94,16% dos ACS são mulheres, com idade média de 34,80 anos. O tempo médio de atuação profissional foi de 3,18 anos; o tipo de transporte mais utilizado entre a UBS e a residência e para exercer o trabalho na microárea foi a bicicleta; 94,16% dos ACS referiu utilizar algum tipo de EPI diariamente. Os tipos de EPI relatados foram: protetor solar (88,32%), sapato fechado (53,28%), boné (8,03%), óculos de sol (6,57%) e capa de chuva (3,65%). Verificou-se associação significativa entre utilização de EPI e maior tempo de profissão, entre uso de sapato fechado e maior idade e maior tempo de profissão. CONCLUSÃO: Os resultados evidenciam necessidade de intervenções para favorecer o uso desses equipamentos.