Ergonomic and psychosocial risks related to musculoskeletal problems among Brazilian labor judges in telework during the COVID-19 pandemic.

Objectives. The aim of this study was to evaluate the ergonomic and psychosocial risks in telework and their relationship with musculoskeletal problems in Brazilian labor judges during the COVID-19 pandemic. Methods. A cross-sectional study was conducted with 119 participants. Data were collected through a sociodemographic and occupational questionnaire, from the Brazilian versions of the revised Maastricht upper extremity questionnaire (MUEQ-Br revised), the rapid office strain assessment (ROSA-Br) and the Nordic musculoskeletal questionnaire (NMQ), added to a numerical pain scale. Results. According to the ROSA-Br, 47.06% of the participants showed an outcome where it is considered that there is a need for immediate intervention in the workplace. Results of the ROSA-Br and the MUEQ-Br revised presented a significant correlation with the intensity of complaints in the neck and shoulders in the last 12 months and in the last 7 days. The total score of MUEQ-Br revised presented more important correlations with problems in these body regions and with the intensity of complaints in the upper back, wrists/hands and lower back in both periods. Conclusions. Companies should propose ways to assess the ergonomic and psychosocial risks among their employees in telework as a way to prevent the occurrence of musculoskeletal problems.

Psychosocial factors, musculoskeletal symptoms, and presenteeism among labor judges.

Introduction: Labor judges are subjected to productivity goals associated with a workload that does not take into consideration the complexity of their work. Objectives: To evaluate the relationship between psychosocial factors, musculoskeletal problems, and presenteeism among labor judges. Methods: A cross-sectional study was conducted with 151 judges who answered a sociodemographic and occupational characterization questionnaire and the Brazilian versions of the Nordic Musculoskeletal Questionnaire, Health and Safety Executive - Indicator Tool, and Stanford Presenteeism Scale. The results underwent a descriptive analysis and Spearman correlation coefficients were calculated. Results: The psychosocial dimension of demands presented a higher risk of occupational stress, while role had a lower risk. Musculoskeletal problems in the neck, upper back, shoulders, and lower back were more common and affected almost 70% of the participants. Presenteeism was more affected by the avoiding distractions dimension. Almost all psychosocial dimensions had a significant correlation with musculoskeletal symptoms (p < 0.05), especially demands, which also was correlated with total presenteeism and the avoiding distractions dimension. Conclusions: The work overload observed among labor judges was related to the occurrence of musculoskeletal problems and to a high prevalence of presenteeism.

Introdução: Os magistrados trabalhistas estão sujeitos a metas de produtividade associadas a uma carga de trabalho que não contempla a complexidade do seu trabalho. Objetivos: Avaliar a relação entre fatores psicossociais, problemas osteomusculares e presenteísmo em magistrados trabalhistas. Métodos: Foi realizado um estudo transversal com 151 magistrados, que responderam a um questionário de caracterização sociodemográfica e ocupacional e às versões brasileiras do Questionário Nórdico de Sintomas Osteomusculares, do Health and Safety Executive ­ Indicator Tool e do Stanford Presenteeism Scale. Foram utilizadas análises descritivas e teste de correlação de Spearman. Resultados: A dimensão psicossocial de demandas apresentou um risco mais elevado de estresse ocupacional, enquanto o cargo apresentou um risco mais baixo. Problemas osteomusculares em pescoço, parte superior das costas, ombros e parte inferior das costas foram mais comuns e afetaram quase 70% dos participantes. O presenteísmo foi mais afetado pela dimensão de concentração mantida. Quase todas as dimensões psicossociais apresentaram correlação significativa com os sintomas osteomusculares (p < 0,05), principalmente demandas, que também apresentou correlação com o presenteísmo total e a dimensão de concentração mantida. Conclusões: A sobrecarga de trabalho observada entre os magistrados trabalhistas foi relacionada à ocorrência de problemas osteomusculares e à elevada prevalência de presenteísmo.

Assessment instrument of risk factors for exposure to SARS-CoV-2 among health care workers with suspected COVID-19.

Introduction: Health professionals are at high or very high risk of being infected with COVID-19, making it essential to adopt control and protection measures. The World Health Organization developed a risk assessment instrument to identify possible protection failures and to guide corrective actions. Objectives: To test an adapted version of this instrument among health care workers with a suspected case of COVID-19. Methods: The World Health Organization instrument was translated and adapted with the participation of health care workers. The adapted version was inserted into Google Forms® and applied to 211 health care workers with a suspected case of COVID-19 in three public hospitals. Results: Fifty-five percent of workers were nursing professionals. The main risk factors for exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were failures in training, in donning and doffing, and in the use and maintenance of personal and collective protective equipment; problems in cleaning rooms and equipment; and changes in work organization. The assessment instrument fulfilled its purpose of assessing risk factors for exposure to SARS-CoV-2 and helped adopt the corrective and preventive measures required to prevent COVID-19 among health care workers. Conclusions: The adapted instrument proved to be an important support tool to improve risk management and protection of these workers.

Shoulder arthralgia: case study of the Occupational Medicine clinic of Universidade Estadual de Campinas (Unicamp).

Introduction: Shoulder pain is ranked as the third most common musculoskeletal complaint in clinical practice. It is estimated that 65 to 70% of these occurrences are due to rotator cuff injuries. A significant number of rotator cuff syndrome cases are work related. Objectives: To evaluate the success or failure of therapeutic and administrative procedures for workers treated at an occupational medicine outpatient clinic. Methods: This study analyzed the medical reports of 142 workers treated for shoulder pain between January 2015 and December 2019. To homogenize the information, medical record review was necessary in some cases. Results: Rotator cuff syndrome was diagnosed in 84% of the cases after imaging exams. Conservative treatment was recommended for 88% of these patients and 58% required subsequent surgical treatment. Regarding rehabilitation, 51% of the patients were able to return to work and 49% returned to the same job function. Conclusions: Diagnosing rotator cuff syndrome requires clinical and occupational history assessment, as well as imaging examinations, and the sensitivity and specificity of ultrasound were similar to magnetic resonance imaging. Removal from work and its risks must be an integral part of treatment. Upon returning to work, the rehabilitation and reintegration process should involve activities that will not worsen the injury.

Introdução: De acordo com a literatura médica, as dores nos ombros são a terceira queixa musculoesquelética mais comum observada na prática clínica. Calcula-se que 65 a 70% dessas ocorrências sejam causadas por lesões do manguito rotador. Um número significativo de casos da síndrome do manguito rotador está relacionado ao trabalho. Objetivos: Avaliar os diagnósticos dessa síndrome e os fatores de sucesso e insucesso nas condutas terapêuticas e administrativas de trabalhadores atendidos em um ambulatório de Medicina do Trabalho. Métodos: Este estudo analisou 142 relatórios médicos de trabalhadores com queixa de dores nos ombros atendidos no ambulatório de Medicina do Trabalho, de janeiro de 2015 a dezembro de 2019. Para homogeneizar as informações, em alguns casos, foi necessária a revisão do prontuário médico. Resultados: Após a realização de exames de imagem, 84% dos casos tiveram diagnóstico confirmado de síndrome do manguito rotador. Em 88% dos casos, foi indicado tratamento conservador, e parte destes (58%) evoluiu para tratamento cirúrgico. No processo de reabilitação, 51% dos pacientes foram reinseridos em atividade compatíveis e/ou readaptados ao trabalho e 49% não tiveram mudança de função. Conclusões: Além da história clínica e ocupacional, o exame de ultrassonografia teve sensibilidade e especificidade semelhantes à ressonância magnética para o diagnóstico de síndrome do manguito rotador. O afastamento do trabalho e dos fatores de risco ergonômicos devem ser parte integrante do tratamento da síndrome do manguito rotador. No retorno ao trabalho, o processo de reinserção e reabilitação precisa considerar a atividade compatível para não haver agravamentos das lesões.

Musculoskeletal symptoms, psychosocial factors and work ability in Brazilian labor justice workers.

BACKGROUND: The implementation of the electronic judicial process (PJe) in recent years is associated with an increase in workload and stricter control through productivity targets in the Brazilian labor judiciary. OBJECTIVES: To evaluate the relations between musculoskeletal symptoms, psychosocial factors and work ability in civil servants of a labor justice body in the context of the PJe. METHODS: A cross-sectional exploratory study with a quantitative approach involving 449 workers. Sociodemographic, occupational and related data were collected through questionnaires validated in the Brazilian context. Data analysis was conducted by descriptive and inferential statistics: Mann-Whitney test, Spearman's correlation coefficient and multiple linear regression. RESULTS: There was a correlation between musculoskeletal symptoms and psychosocial factors (p < 0.05), as well as between both musculoskeletal symptoms and psychosocial factors with reduced work ability (p < 0.05). The multiple linear regression model pointed to the female gender and the dimensions "demands", "control" and "peer support" as related to the musculoskeletal symptoms. CONCLUSION: We highlight the importance of a broader approach, involving psychosocial factors in preventive actions related to musculoskeletal disorders considering the important relationship with work ability.

Workplace violence in the Psychosocial Care Centers of a city in the state of São Paulo.

INTRODUCTION: Workplace violence against health care professionals is a highly prevalent problem and is considered a public health concern by the World Health Organization. Yet most studies on the topic focus on its negative impact on the mental health of workers rather than the causes of these incidents. OBJECTIVES: To describe the frequency of workplace violence and its impact on professionals working in Psychosocial Care Centers (Centros de Atenção Psicossocial [CAPS]) in a large city in the state of São Paulo. METHODS: A quantitative cross-sectional study was conducted on a non-probabilistic sample of 193 health care workers across 11 Psychosocial Care Centers. Participants completed two self-administered instruments: a biosocial questionnaire and the Survey Questionnaire on Workplace Violence. RESULTS: The results showed that 42.4% of respondents had suffered physical violence; 64.8% had experienced psychological violence; and 29.5% had been victims of bullying/mobbing. In most cases, the victims responded to these incidents by taking no action, asking the perpetrator to stop, or speaking of the incident to a colleague or superior. A verbal warning was issued to perpetrators in only 21% of cases of physical violence. Mobbing had the greatest negative impact on respondents, followed by psychological and physical violence. CONCLUSIONS: Workplace violence is a part of everyday work in Psychosocial Care Centers. Though this violence is often naturalized and considered a collective defense against suffering, it did not prevent participants from reporting high levels of job satisfaction, reflecting the degree to which professionals at Psychosocial Care Centers are committed to their colleagues and to service users, as well as their search for professional recognition.

Occupational risk perceived by pregnant workers: proposal for an assessment tool for health professionals.

INTRODUCTION: The risk factors and agents present in the work environment may represent a risk to the health of pregnant women, the developing infants, and breast-feeding mothers; however, tools to assess occupational exposure of these workers are not available. OBJECTIVE: To develop an instrument for the qualitative assessment of occupational exposure of pregnant workers based on their perceptions. METHOD: We conducted a data survey from the National Institute for Occupational Safety and Health and the Brazilian Regulatory Standard 15. Next, a comparative analysis was performed, according to the scientific literature available, followed by a preliminary version of the instrument, a pilot test with 15 pregnant women, and preparation of the final version. RESULTS: A tool was developed consisting of 28 questions, divided into 7 categories: 1) pregnant or lactating woman; 2) habits and behaviors; 3) information about work; 4) risk factors identified by the worker in the work environment divided into chemical, physical, biological, ergonomic, and accidents; 5) difficulties faced at work; 6) need for antenatal leave; and 7) open question so that the worker can inform something she considers necessary. CONCLUSIONS: The study of work-related risk factors and/or agents relevant to the health of pregnant women and/or the fetus is essential to conduct adequate prenatal care and to protect the health of these workers. The use of this tool can be of great value for health professionals, especially for physicians. The practical application can bring possible improvements that were not identified by the authors during the study.

Os fatores psicossociais no trabalho e estresse entre os profissionais de enfermagem de uma Central de Materiais Esterilizados / Psychosocial factors at work and stress among the nursing staff of a central sterile services department

| Introdução: A literatura internacional aponta a associação entre estresse e os fatores psicossociais no trabalho (FPT), que podem acometer diversas profissões. Na área da saúde, a assistência direta aos pacientes pode ser gratificante ou ter impacto no desencadeamento de estresse. Nos serviços hospitalares, a Central de Materiais Esterilizados (CME) tem importância relevante no suporte à assistência. Objetivo: Identificar os FPT com potencial de desencadear estresse ocupacional nos profissionais de enfermagem da CME de um hospital universitário. Método: Estudo quantiqualitativo de amostra não probabilística de 63 profissionais que responderam aos questionários sociodemográfico e balanço esforço-recompensa (ERI) sobre os fatores psicossociais no trabalho. Após essa etapa, foram entrevistadas 51 pessoas. As entrevistas, gravadas, transcritas e analisadas em seu conteúdo, foram organizadas em matrizes temáticas dos FPT e respectivas categorias. Resultados: A amostra identificou predominância de mulheres (92%), com idade média de 45 anos. Constatou-se desequilíbrio no ERI em 16% dos participantes. Condições de trabalho, equipamentos e materiais, relacionamentos entre colegas e suporte da gestão foram elencados como fatores de satisfação e insatisfação no trabalho. A falta de reconhecimento do trabalho pelos colegas de outros setores foi apontada como principal fator de insatisfação e estresse. Conclusão: Os profissionais da CME sentem-se estigmatizados e desprestigiados pelos colegas dos setores assistenciais e pela própria Instituição. O reconhecimento do trabalho realizado é de fundamental importância na satisfação no trabalho, proteção e preservação da saúde.

Background: The international literature points out an association between stress and psychosocial factors at work (PFW) in different occupational groups. Among health care workers, providing direct patient care might be rewarding or contribute to cause stress, and central sterile services departments (CSSD) provide relevant support to in-hospital care. Objective: To investigate PFW liable to cause stress among the nursing staff of a university hospital CSSD. Methods: Quantitative and qualitative study of a non-probabilistic sample of 63 workers who responded a sociodemographic questionnaire and the Effort-Reward Imbalance (ERI) scale. Fifty-one participants were also subjected to individual interviews, which were recorded, transcribed and subjected to content analysis, resulting in thematic matrices and categories. Results: The sample mainly comprised women (92%) and was aged 45 years old, on average. Effort-reward imbalance was found for 16% of the participants. Working conditions, equipment and materials, relationship among coworkers, and management support were listed as factors related to job satisfaction or dissatisfaction. Lack of peer recognition was described as the main factor associated with dissatisfaction and stress. Conclusion: CSSD workers feel they are stigmatized and underestimated by their coworkers involved in direct patient care and the institution as a whole. Recognition of the work done is fundamental for job satisfaction and health protection and preservation.

Estresse e enfrentamento de trabalhadores de centro de atenção psicossocial em uma cidade do interior do Estado de São Paulo / Stress and coping among workers at psychosocial care centers in the interior of the state of Sao Paulo

INTRODUÇÃO: Os Centros de Atenção Psicossocial (CAPS) são serviços comunitários que foram concebidos como modelo substitutivo que rompe com o modelo de atenção manicomial, alinhado aos princípios do Sistema Único de Saúde (SUS), promovendo uma clínica centrada no sujeito. OBJETIVO: Identificar a prevalência de estresse e suas associações com as características biossociais e as estratégias de enfrentamento relacionadas ao processo de trabalho dos profissionais da saúde que trabalham nos CAPS de uma cidade do interior de São Paulo. MÉTODO: Estudo transversal quantitativo utilizando três questionários de autopreenchimento: um biossocial, a Escala de Estresse no Trabalho (EET) e um com estratégias de enfrentamento do estresse (coping). A investigação foi desenvolvida com 193 profissionais de saúde de 11 CAPS. RESULTADOS: Houve predominância de sexo feminino, 35 anos, sem filhos e solteiros. O estresse foi considerado alto, com 50,2% de prevalência. As principais associações dizem respeito às questões subjetivas relacionadas à forma como o trabalhador avalia e sente seu trabalho. As estratégias de enfrentamento mais utilizadas foram resolução de problemas e suporte social. CONCLUSÃO: Observou-se elevado grau de estresse na população estudada e, principalmente, suas associações com características biossociais.

BACKGROUND: Psychosocial Care Centers (CAPS) are community-based facilities designed as a substitutive model to break with asylum-based care and aligned to the principles underlying the Unified Health System (Sistema Único de Saúde­SUS); thus they promote patient-centered care. OBJECTIVE: To establish the prevalence of stress and its association with biosocial characteristics and coping strategies within the work process of healthcare providers at CAPS in a city in the interior of the state of Sao Paulo, Brazil. METHOD: Cross-sectional quantitative study involving administration of three questionnaires: biosocial, Work Stress Scale and a checklist of coping strategies. The sample comprised 193 healthcare providers from 11 different CAPS. RESULTS: Most participants were female, with average age 35 years old, single and without children. The levels of stress were rated high, with prevalence of 50.2%. The main associations found concern the participants' subjective appraisal of their job, particularly personal recognition and satisfaction. The coping strategies most frequently cited were problem-solving and social support. CONCLUSION: We found high levels of stress in the analyzed population and association of stress mainly with biosocial characteristics.

Psychosocial factors at work and stress among the nursing staff of a central sterile services department.

BACKGROUND: The international literature points out an association between stress and psychosocial factors at work (PFW) in different occupational groups. Among health care workers, providing direct patient care might be rewarding or contribute to cause stress, and central sterile services departments (CSSD) provide relevant support to in-hospital care. OBJECTIVE: To investigate PFW liable to cause stress among the nursing staff of a university hospital CSSD. METHODS: Quantitative and qualitative study of a non-probabilistic sample of 63 workers who responded a sociodemographic questionnaire and the Effort-Reward Imbalance (ERI) scale. Fifty-one participants were also subjected to individual interviews, which were recorded, transcribed and subjected to content analysis, resulting in thematic matrices and categories. RESULTS: The sample mainly comprised women (92%) and was aged 45 years old, on average. Effort-reward imbalance was found for 16% of the participants. Working conditions, equipment and materials, relationship among coworkers, and management support were listed as factors related to job satisfaction or dissatisfaction. Lack of peer recognition was described as the main factor associated with dissatisfaction and stress. CONCLUSION: CSSD workers feel they are stigmatized and underestimated by their coworkers involved in direct patient care and the institution as a whole. Recognition of the work done is fundamental for job satisfaction and health protection and preservation.

INTRODUÇÃO: A literatura internacional aponta a associação entre estresse e os fatores psicossociais no trabalho (FPT), que podem acometer diversas profissões. Na área da saúde, a assistência direta aos pacientes pode ser gratificante ou ter impacto no desencadeamento de estresse. Nos serviços hospitalares, a Central de Materiais Esterilizados (CME) tem importância relevante no suporte à assistência. OBJETIVO: Identificar os FPT com potencial de desencadear estresse ocupacional nos profissionais de enfermagem da CME de um hospital universitário. MÉTODO: Estudo quantiqualitativo de amostra não probabilística de 63 profissionais que responderam aos questionários sociodemográfico e balanço esforço-recompensa (ERI) sobre os fatores psicossociais no trabalho. Após essa etapa, foram entrevistadas 51 pessoas. As entrevistas, gravadas, transcritas e analisadas em seu conteúdo, foram organizadas em matrizes temáticas dos FPT e respectivas categorias. RESULTADOS: A amostra identificou predominância de mulheres (92%), com idade média de 45 anos. Constatou-se desequilíbrio no ERI em 16% dos participantes. Condições de trabalho, equipamentos e materiais, relacionamentos entre colegas e suporte da gestão foram elencados como fatores de satisfação e insatisfação no trabalho. A falta de reconhecimento do trabalho pelos colegas de outros setores foi apontada como principal fator de insatisfação e estresse. CONCLUSÃO: Os profissionais da CME sentem-se estigmatizados e desprestigiados pelos colegas dos setores assistenciais e pela própria Instituição. O reconhecimento do trabalho realizado é de fundamental importância na satisfação no trabalho, proteção e preservação da saúde.

Stress and coping among workers at psychosocial care centers in the interior of the state of Sao Paulo.

BACKGROUND: Psychosocial Care Centers (CAPS) are community-based facilities designed as a substitutive model to break with asylum-based care and aligned to the principles underlying the Unified Health System (Sistema Único de Saúde-SUS); thus they promote patient-centered care. OBJECTIVE: To establish the prevalence of stress and its association with biosocial characteristics and coping strategies within the work process of healthcare providers at CAPS in a city in the interior of the state of Sao Paulo, Brazil. METHOD: Cross-sectional quantitative study involving administration of three questionnaires: biosocial, Work Stress Scale and a checklist of coping strategies. The sample comprised 193 healthcare providers from 11 different CAPS. RESULTS: Most participants were female, with average age 35 years old, single and without children. The levels of stress were rated high, with prevalence of 50.2%. The main associations found concern the participants' subjective appraisal of their job, particularly personal recognition and satisfaction. The coping strategies most frequently cited were problem-solving and social support. CONCLUSION: We found high levels of stress in the analyzed population and association of stress mainly with biosocial characteristics.

INTRODUÇÃO: Os Centros de Atenção Psicossocial (CAPS) são serviços comunitários que foram concebidos como modelo substitutivo que rompe com o modelo de atenção manicomial, alinhado aos princípios do Sistema Único de Saúde (SUS), promovendo uma clínica centrada no sujeito. OBJETIVO: Identificar a prevalência de estresse e suas associações com as características biossociais e as estratégias de enfrentamento relacionadas ao processo de trabalho dos profissionais da saúde que trabalham nos CAPS de uma cidade do interior de São Paulo. MÉTODO: Estudo transversal quantitativo utilizando três questionários de autopreenchimento: um biossocial, a Escala de Estresse no Trabalho (EET) e um com estratégias de enfrentamento do estresse (coping). A investigação foi desenvolvida com 193 profissionais de saúde de 11 CAPS. RESULTADOS: Houve predominância de sexo feminino, 35 anos, sem filhos e solteiros. O estresse foi considerado alto, com 50,2% de prevalência. As principais associações dizem respeito às questões subjetivas relacionadas à forma como o trabalhador avalia e sente seu trabalho. As estratégias de enfrentamento mais utilizadas foram resolução de problemas e suporte social. CONCLUSÃO: Observou-se elevado grau de estresse na população estudada e, principalmente, suas associações com características biossociais.

Burnout e a organização do trabalho na Enfermagem / Burnout and work organization in Nursing

Introdução: A síndrome de burnout (SB) é um conjunto de sintomas que surgem da resposta a estressores interpessoais crônicos no trabalho e envolvem a percepção que a pessoa tem de si própria e do ambiente em que realiza seu trabalho. Objetivo: Identificar os fatores de risco psicossociais e da organização do trabalho preditores de sofrimento mental, bem como estimar a prevalência da SB em uma população de profissionais de Enfermagem de um hospital público do interior do Estado de São Paulo. Métodos: Pesquisa mista, combinando as abordagens quantitativa e qualitativa, desenvolvida em um hospital público universitário. Foram utilizados o Maslach Burnout Inventory-Human Services Survey (MBI-HSS), para estimar a prevalência de SB, e a análise de conteúdo em grupos focais (GFs), para identificar fatores psicossociais de risco no trabalho (FPRT). Resultados: A prevalência de SB na instituição estudada (5,7%) foi compatível com a literatura internacional. A análise das falas emergentes dos GFs revelou a existência de FPRT atuando como estressores na organização do trabalho. Conclusão: Esta pesquisa apontou ainda a necessidade de um olhar mais amplo sobre as causas da SB, sendo de grande importância a inclusão, nos trabalhos, do estudo da singularidade dos fatores psicossociais e da organização do trabalho por meio da voz dos profissionais que têm como foco de trabalho o cuidado ao ser humano.

Background: Burnout syndrome (BS) consists of a set of symptoms that appear in response to chronic interpersonal stressors at work and involve the perceptions individuals have of themselves and their work environment. Objectives: To identify psychosocial risk and work organization factors able to predict mental suffering, and to estimate the prevalence of BS in a sample of nursing professionals from a public hospital in the state of São Paulo, Brazil. Methods: Mixed methods research combining quantitative and qualitative approaches conducted at a public university hospital. Maslach Burnout Inventory-Human Services Survey (MBIHSS) was used to estimate the prevalence of BS. Thematic content analysis of narratives gathered in focus groups was performed to identify psychosocial risk factors at work (PRFW). Results: The prevalence of BS at the investigated institution (5.7%) is consistent with the rates reported in the international literature. Analysis of the narratives gathered in focus groups revealed stressors in the organization of work. Conclusion: The present study also points to the need for a broader look into the causes of BS, in which consideration of singular psychosocial risk and work organization factors from the perspective of workers devoted to proving care to human beings has paramount importance.

Burnout and workorganization in Nursing.

BACKGROUND: Burnout syndrome (BS) consists of a set of symptoms that appear in response to chronic interpersonal stressors at work and involve the perceptions individuals have of themselves and their work environment. OBJECTIVES: To identify psychosocial risk and work organization factors able to predict mental suffering, and to estimate the prevalence of BS in a sample of nursing professionals from a public hospital in the state of São Paulo, Brazil. METHODS: Mixed methods research combining quantitative and qualitative approaches conducted at a public university hospital. Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to estimate the prevalence of BS. Thematic content analysis of narratives gathered in focus groups was performed to identify psychosocial risk factors at work (PRFW). RESULTS: The prevalence of BS at the investigated institution (5.7%) is consistent with the rates reported in the international literature. Analysis of the narratives gathered in focus groups revealed stressors in the organization of work. CONCLUSION: The present study also points to the need for a broader look into the causes of BS, in which consideration of singular psychosocial risk and work organization factors from the perspective of workers devoted to proving care to human beings has paramount importance.

INTRODUÇÃO: A síndrome deburnout (SB) éum conjunto de sintomas que surgem da resposta a estressores interpessoais crônicos no trabalho e envolvem a percepção que a pessoa tem de si própria e do ambiente em que realiza seu trabalho. OBJETIVO: Identificar os fatores de risco psicossociais e da organização do trabalho preditores de sofrimento mental, bem como estimar a prevalência da SB em uma população de profissionais de Enfermagem de um hospital público do interior do Estado de São Paulo. MÉTODOS: Pesquisa mista, combinando as abordagens quantitativa e qualitativa, desenvolvida em um hospital público universitário. Foram utilizados o Maslach Burnout Inventory-Human Services Survey (MBI-HSS), para estimar a prevalência de SB, e a análise de conteúdo em grupos focais (GFs), para identificar fatores psicossociais de risco no trabalho (FPRT). RESULTADOS: A prevalência de SB na instituição estudada (5,7%) foi compatível com a literatura internacional. A análise das falas emergentes dos GFs revelou a existência de FPRT atuando como estressores na organização do trabalho. CONCLUSÃO: Esta pesquisa apontou ainda a necessidade de um olhar mais amplo sobre as causas da SB, sendo de grande importância a inclusão, nos trabalhos, do estudo da singularidade dos fatores psicossociais e da organização do trabalho por meio da voz dos profissionais que têm como foco de trabalho o cuidado ao ser humano.

Assessment of a physical activity program on the medical-hospital costs of a healthcare company.

BACKGROUND: The protective effect of regular physical activity against risk of development of noncommunicable diseases and reduction of medical-hospital costs are well established in the literature. However, no study investigated the financial impact of workplace physical activity promotion programs in Brazil. OBJECTIVE: To investigate the financial impact of a workplace physical activity promotion program on the medical-hospital costs of a private healthcare company. METHODS: The average healthcare cost per capita was monitored along one year and compared between employees who performed physical activity with sufficient frequency and the ones who did not adhere to the program. Employees were matched per age, sex and length of work at the company. RESULTS: From 3,744 employees offered participation in the program, only 80 performed physical activity 2 or more times per week. The average medical-hospital cost per capita/year was BRL 2,874.00 (SD=5.259), being BRL 125.00 higher, on average, for the employees who did not adhere to the program. The average medical-hospital cost per capita/year was BRL 1,901.00 lower, on average, for the employees who performed physical activity 3 or more times per week (n=3) compared to the ones who did not (p=0.34). CONCLUSIONS: The results of the present study do not allow asserting that the medical-hospital costs of employees who adhered to the program decreased. Longer follow-up and adjustments in the program design are needed to assess its actual impact.

INTRODUÇÃO: O efeito protetor da prática regular de atividade física na redução do risco de doenças crônicas não transmissíveis e dos custos médico-hospitalares é bem estabelecido na literatura. No entanto, o Brasil carece de estudos que avaliem os impactos financeiros de programas que incentivem a prática de atividade física no trabalho. OBJETIVOS: Avaliar o impacto financeiro de um programa de incentivo à prática regular de atividade física sobre os custos médico-hospitalares de uma empresa privada de serviços de saúde. MÉTODOS: Os custos médios per capita com o plano de saúde da empresa foram acompanhados por um ano e comparados no que diz respeito aos trabalhadores que praticaram atividade física com frequência suficiente e os que não aderiram ao programa. Os pares de comparação foram homogeneizados de acordo com a idade, o sexo e o tempo de empresa. RESULTADOS: Dos 3.744 trabalhadores com acesso ao programa, apenas 80 praticaram atividade física 2 vezes por semana ou mais. O custo médio per capita foi R$ 2.874 (DP=5.259) em 1 ano, R$ 125,00 a mais do que para os que não praticaram (p=0,88). Aqueles que praticaram atividade física 3 vezes ou mais por semana (n=32) apresentaram custo médio per capita de R$ 3.635 (DP=6.994) em 1 ano, R$ 1.901 a menos do que os pares que não praticaram (p=0,34). CONCLUSÕES: O estudo não permite afirmar que houve redução dos custos médico-hospitalares dos participantes do programa. Maior tempo de seguimento e ajustes no desenho do projeto são necessários para avaliar seu impacto.

Prevalence of presenteeism among workers of an industrial company.

BACKGROUND: Attending work when sick for fear of losing the job is common among workers. Presenteeism is a rising problem, which has called the attention of researchers from different fields; being difficult to notice, it also raised concerns among managers. OBJECTIVE: To establish the prevalence of presenteeism at a food industrial company. METHOD: Cross-sectional epidemiological study conducted with 1,224 workers, with application of Stanford Presenteeism Scale (SPS-6) as method to investigate presenteeism. RESULTS: Presenteeism was adopted by 30.6% of the analyzed workers along the previous 12 months. The prevalence of presenteeism detected through SPS-6 was 50.9% for the full sample. Significant association was found between presenteeism and sedentarism, overweight and some self-reported symptoms. CONCLUSION: The detected high prevalence of presenteeism and its association with sedentary lifestyle and musculoskeletal symptoms confirm the relevance of presenteeism and its negative impact on the health of workers.

CONTEXTO: Comparecer ao trabalho doente com medo de perder o emprego é um comportamento frequentemente adotado pelos trabalhadores. O presenteísmo é um problema emergente, cujas repercussões socioeconômicas têm despertado a atenção de pesquisadores em diversas áreas e a preocupação de gestores por ser difícil de ser percebido. OBJETIVO: Determinar a prevalência de presenteísmo entre os trabalhadores em uma indústria do setor alimentício. MÉTODOS: Estudo epidemiológico, de corte transversal, com população de 1.224 trabalhadores, com aplicação da Stanford Presenteeism Scale (SPS-6) como método de investigação do presenteísmo. RESULTADOS: A avaliação do presenteísmo apontou que 30,6% da amostra teve um comportamento presenteísta nos últimos 12 meses e o SPS-6 identificou que 50,9% desses trabalhadores são presenteístas. Observou-se uma associação significativa do presenteísmo entre os trabalhadores sedentários, com excesso de peso, e alguns sintomas autorreferidos. CONCLUSÃO: Os resultados da elevada prevalência de presenteísmo e a associação entre sedentarismo e sintomas osteomusculares confirmam a relevância do tema e o impacto negativo para a saúde dos trabalhadores.

Negative self-rated health in the elderly in cities with different levels of economic well-being: data from FIBRA.

This comparative, cross-sectional study analyzed negative self-rated health in elderly people, according to sociodemographic and health variables, use of public or private health services, functional performance, frailty and depressive symptoms. The participants lived in Belém (n = 571) and Campinas (n = 676), cities with different socioeconomic conditions, and the research formed part of a multicentric study on frailty (Fibra Study, Unicamp). Multivariate regression analysis showed that in both cities, negative self-rated health was associated with low education, three or more chronic diseases and sight deficiencies. In Belem, additional observations included associations with fatigue, three or more signs and symptoms and use of public health services; in Campinas, negative self-rated health was also associated with depressive symptoms. The associations suggest that poor health in old age is the result of an accumulation of deficits for lack of socioeconomic resources throughout life and that deficits are not sufficiently compensated for health services in old age.

Burnout syndrome in nursing assistants of a public hospital in the state of São Paulo.

INTRODUCTION: The burnout syndrome is a psychosocial phenomenon that arises as a response to chronic interpersonal stressors present at work. There are many aspects that make nursing assistants vulnerable to chronic stress situations that may lead to burnout, highlighting the low degree of autonomy in the healthcare staff and spending more in direct contact with patients. OBJECTIVES: To assess the prevalence of the burnout syndrome in nursing assistants in a public hospital, as well as its association with socio-demographic and professional variables. METHODS: A socio-demographic and professional questionnaire and the Maslach Burnout Inventory (MBI-SS) were applied to 534 nursing assistants. RESULTS: The prevalence of burnout syndrome among nursing assistants was 5.9%. High emotional exhaustion was observed in 23.6%, 21.9% showed high depersonalization, and 29.9% low professional achievement. It was found statistically significant associations between emotional exhaustion, job sector and marital status; depersonalization, having children and health problems; low professional achievement and job sector and number of jobs. There was association between job satisfaction and the three dimensions. CONCLUSISON: Professionals working in the health area must pay intense and extended attention to people who are dependent upon others. The intimate contact of the nursing assistants with hard-to-handle patients, as well as being afraid to make mistakes in healthcare are additional chronic stress factors and burnout syndrome cases related in this study.

[Risk perception related to work in a rural community of Rio de Janeiro State, Brazil: pesticides, health, and environment]. / Percepção de riscos no trabalho rural em uma região agrícola do Estado do Rio de Janeiro, Brasil: agrotóxicos, saúde e ambiente.

The present study applies the risk perception analytical methodology based on rapid surveys. It took place in the micro-basin of the São Lourenço Creek in Nova Friburgo, Rio de Janeiro State, Brazil. The methodological approach was based on participatory observation, semi-structured interviews with 24 key informants selected among local farmers (N = 120), and evaluation of local work processes. Field data analysis revealed some issues related to the risk perception profile in the study population, including the development of defensive strategies to deal with work hazards, the importance of communication in developing workers' risk perceptions, the subjective responses to potentially hazardous situations, and the role of individual risk perception as a determinant of human exposure to pesticides. The results evoked the importance of systematically incorporating risk perception analyses into intervention strategies, especially in educational risk communication campaigns.