Stresse nos enfermeiros de urgência na abordagem à pessoa em situação crítica / Stress among emergency nurses when dealing with people in critical condition

Os enfermeiros são um grupo profissional particularmente suscetível de experienciar com o stresse, pela natureza das suas funções. A exposição permanente ao contacto humano com doentes e familiares, a gestão de situações de emergência, em que um pequeno erro pode comprometer a sobrevivência ou o prognóstico do doente, a interação com outros profissionais de saúde, o trabalho por turnos e a disrupção de ritmos circadianos, a morte de doentes, de entre outros fatores, criam uma conjuntura em que o enfermeiro experiencie níveis elevados de stresse no seu dia-a-dia. Objetivos: Caracterizar o perfil sociodemográfico e profissional dos enfermeiros do Serviço de Urgência de um Centro Hospitalar da região norte de Portugal; Identificar os principais fatores indutores de stresse nos enfermeiros do Serviço de Urgência de um Centro Hospitalar da região norte de Portugal; Avaliar a relação entre os fatores indutores de stresse e as variáveis sociodemográficas e profissionais. Métodos: Foi realizado um estudo descritivo, transversal correlacional, avaliando os níveis de stresse numa amostra de 54 enfermeiros de um serviço de urgência de um hospital da região do norte de Portugal através da aplicação da Escala de Stresse Profissional dos Enfermeiros e de um questionário para fazer o levantamento de aspetos sociodemográficos e profissionais. Resultados: Os participantes no estudo (n=54) eram maioritariamente do sexo feminino (68,5%). A classe etária dominante (63%) foi a dos 31-40 anos. O estado civil dos enfermeiros dividiu-se quase equitativamente entre os que estão sozinhos e aqueles casados ou união de facto. Quarenta enfermeiros (74,1%) eram licenciados, e os restantes 25,9% mestres. Trinta e três eram enfermeiros (61.1%), os restantes eram especialistas (38,9%). O tempo de serviço mais frequente (46,3%) foi 11 a 20 anos, e 2 a 10 anos no Serviço de Urgência. O contrato sem termo foi a modalidade de vínculo mais frequente (74,1%). Só 35,2% dos enfermeiros indicou acumular funções noutra instituição. O valor médio observado para o conjunto de profissionais que constituíram a amostra foi de 80,94±11,95. Considerando que o ponto médio da escala é de 85 pontos, pode considerar-se que os enfermeiros do SU apresentam, em média, níveis medianos de stresse. Das várias componentes da escala, a "carga de trabalho" integrada na componente "ambiente físico" foi um domínio onde foram registados níveis de stresse elevados. Na componente de "ambiente psicológico" a morte do doente e a incerteza quanto aos tratamentos representaram maior stresse para os enfermeiros. No "ambiente social" a relação com os médicos mostrou-se como um fator importante na perceção de stresse pelos enfermeiros. Atendendo aos resultados da relação das variáveis sociodemográficas na perceção do stresse percecionado pelos enfermeiros, avaliado com a ESPE, os enfermeiros do sexo masculino e aqueles que têm a habilitação de mestre apontam para níveis mais elevados de perceção de stresse. Também ao nível do estado civil verifica-se que os enfermeiros casados percecionarem níveis mais elevados de stresse. Pelo contrário, a idade dos enfermeiros, avaliada em classes de 10 anos, não evidenciou ter influência na perceção de stresse. Não se observou uma relação entre as variáveis profissionais e a perceção do stresse pelos enfermeiros, avaliado pela pontuação total da ESPE. Há, porém, diferenças pontuais em fatores da escala que apontam para os enfermeiros que trabalham há pouco tempo no SU e aqueles que aí trabalham entre 11 e 20 anos percecionarem mais stresse associado ao conflito com outros profissionais, assim como uma tendência para os profissionais com contrato a termo certo sentirem percecionarem mais stresse Conclusão: O enfermeiro que trabalha num serviço de urgência está sujeito a inúmeros stressores. Há aspetos técnicos, relacionais e emocionais que potencial o agravamento do stresse nos enfermeiros. Tratando-se de um serviço que lida permanentemente com a vida ou morte do doente, particularmente na área do doente crítico, o stresse do enfermeiro deve ser olhado com atenção, pois as implicações cognitivas do stresse crónico podem fazer o profissional ter uma prestação de menor qualidade. Particularmente na área dedicada a doentes críticos, todas as capacidades cognitivas do enfermeiro são valiosas, pelo que é determinante que se consiga criar um ambiente de reduzido stresse para que os cuidados prestados sejam de elevada qualidade, como se espera e exige que aconteça.

Nurses are a professional group particularly susceptible to experiencing stress due to the nature of their work. The constant exposure to human contact with patients and their families, the management of emergency situations where a small error can compromise the patient's survival or prognosis, interaction with other healthcare professionals, shift work and disruption of circadian rhythms, and the death of patients, among other factors, create a situation in which nurses experience high levels of stress in their daily lives. Objectives: Characterize the sociodemographic and professional profile of nurses in the Emergency Service of a Hospital Center in the north of Portugal; Identify the main factors that induce stress in nurses in the Emergency Department of a Hospital Center in the north of Portugal; Assess the relationship between stress-inducing factors and sociodemographic and professional variables. Methods: A descriptive, cross-sectional correlational study was conducted, evaluating stress levels in a sample of 54 nurses from an emergency department in a hospital in the northern region of Portugal. This was done through the application of the Nurses' Professional Stress Scale and a questionnaire to collect sociodemographic and professional information. Results: The study participants (n=54) were predominantly female (68.5%). The dominant age group (63%) was between 31 and 40 years old. The marital status of the nurses was almost equally divided between those who are single and those who are married or in a domestic partnership. Forty nurses (74.1%) had a bachelor's degree, and the remaining 25.9% had a master's degree. Thirty-three were general nurses (61.1%), while the remaining were specialists (38.9%). The most frequent length of service was 11 to 20 years (46.3%), both overall and in the Emergency Department. Permanent contracts were the most common employment type (74.1%). Only 35.2% of nurses indicated that they held additional positions in another institution. The average observed value for the professionals in the sample was 80.94±11.95. Considering that the midpoint of the scale is 85 points, it can be considered that nurses in the Emergency Department have, on average, moderate to high levels of stress. Among the various components of the scale, "workload" within the "physical environment" domain was an area where high levels of stress were reported. In the "psychological environment" component, the death of patients and uncertainty about treatments were identified as major sources of stress for nurses. In the "social environment," the relationship with doctors was found to be an important factor in nurses' perception of stress. Regarding the relationship between sociodemographic variables and the perceived stress reported by nurses, as evaluated by the Nurses' Professional Stress Scale, male nurses and those with a master's degree reported higher levels of perceived stress. Additionally, married nurses indicated higher levels of stress. On the other hand, the age of nurses, assessed in 10-year intervals, did not show any influence on the perception of stress. There was no significant relationship between professional variables and nurses' perception of stress, as measured by the total score of the Nurses' Professional Stress Scale. However, there were some isolated differences in scale factors indicating that nurses who had recently started working in the Emergency Department and those who had been working there for 11 to 20 years perceived more stress related to conflicts with other professionals. There was also a tendency for professionals with fixed-term contracts to report higher levels of perceived stress. Conclusion: Nurses working in an emergency department are exposed to numerous stressors. Technical, relational, and emotional aspects contribute to the exacerbation of stress in nurses. Considering that this department deals constantly with life or death situations, particularly in critical care, nurses' stress should be closely monitored, as the cognitive implications of chronic stress can impair their performance. In the field dedicated to critical patients, all cognitive abilities of the nurse are valuable, so it is crucial to create a low-stress environment to ensure the provision of high-quality care, as expected and demanded.

Sentimentos de tristeza e desesperança em jovens portugueses / Sadness and hopelessness feelings in Portuguese youngers

Introduction: Sadness as a basic of the human being emotion. It can be associated with the intrinsic of the younger's characteristics and their context. It may manifest as discouragement, unwillingness to perform routine and social activities, low self-esteem or aloneness. Hopelessness arises when there is no sight of possibilities, confi-dence in others or future, enthusiasm for life being. That can inhibit the set goals and energy mobilization. These feelings may be signs of more complex problems, such as depressive disorders when associated with loss of interest or pleasure, changes in appetite, sleep and concentration and suicidal ideation thoughts. Aims: To identify the sadness and hopelessness feelings perceived by the younger ́s and the associations between these feelings and demographic, educational and family characteristics. Method: Descriptive correlational study with 1377 Portuguese younger ́s, which go into high school, aged 14-21 years, average age 17 years and mostly female. Was used the survey "Comportamentos de saúde, comportamentos de risco e envolvimento dos jovens com a escola e a família". Results: Sadness and hopelessness were not noticed by most younger ́s. However, there is a higher risk in younger's with negative school performance, who relate good relationship with colleagues, have never felt threatened by their colleagues, when they become involved with school and family and even if they are perceived the family as functional. Conclusions: Health professionals should identify early, value feelings of sadness and hopelessness in younger ́s and have a transdisciplinary and inclusive practice in health education, in school and family contexts

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Consumo de sustancias adictivas, tabaco, alcohol y marihuana, en los estudiantes del Norte de Portugal / Consumo de substâncias aditivas, tabaco, álcool y marijuana, em estudantes do Norte de Portugal / Consumption of addictive substances, tobacco, alcohol and marijuana by students of North Portugal

Introducción: El consumo de sustancias causantes de dependencia es un problema de salud pública y potencia otros comportamientos de riesgo, entre los cuales, la agresión física, en los jóvenes. Objetivo: Evaluar el consumo de sustancias adictivas (tabaco, alcohol y marihuana) en una población estudiantil de una ciudad del Norte de Portugal.Métodos: Estudio cuantitativo, descriptivo y transversal. La muestra estuvo compuesta por 1.066 adolescentes, de una región del norte de Portugal, que estudiaban en nueve centros de enseñanza secundaria y universitaria de esa región y con una edad media de 17 años. Los participantes respondieron a un cuestionario tipo test en soporte papel y digital. Resultados: Se deduce que el consumo de sustancias que causan dependencia tiene lugar a edades precoces de la adolescencia, que el consumo actual de bebidas alcohólicas se ha elevado y que el consumo de tabaco, alcohol y marihuana se potencian entre sí. Conclusiones: Como el consumo de estas sustancias tiene como base factores individuales y de contexto, y afecta a los resultados de esta investigación, se considera que la intervención con los jóvenes debe incluir una estrategia concertada de políticas sociales, educativas y de salud y que simultáneamente apelen a la adhesión de los jóvenes estudiantes

Introdução: O consumo de substâncias aditivas é um problema de saúde pública e potencia outros comportamentos de risco, entre os quais o envolvimento em agressões físicas, nos jovens. Objetivo: Avaliar o consumo de substâncias aditivas (tabaco, álcool y marijuana) numa população estudantil de uma cidade do Norte de Portugal.Métodos: Estudo quantitativo, descritivo e transversal. O estudo envolveu 1.066 jovens, de uma cidade da região Norte de Portugal, que estudavam em nove instituições de ensino secundário e uma de ensino superior e idade média de 17 anos. Utilizou-se um questionário, de auto preenchimento e fornecido em suporte papel e digital. Resultados: Verificou-se que o consumo de substâncias aditivas se iniciou em idades precoces da adolescência, que o consumo atual de bebidas alcoólicas é elevado e o consumo de tabaco, álcool e marijuana se potenciam entre si. Conclusões: O consumo de substâncias aditivas tem como base fatores individuais e contextuais que influenciam os resultados desta investigação, considerando-se importante que a intervenção com jovens deve incluir uma estratégia de aproximação concertada de políticas sociais, educativas e de saúde apelativas da adesão pelos jovens estudantes

Introduction: The consumption of addictive substances is a public health problem likely to precipitate other risk behaviours in youngsters, including physical aggression. Aim: To evaluate the consumption of tobacco, alcohol and marijuana in a student population of a city in the north of Portugal.Methods: A quantitative study, descriptive and cross-sectional. The study involved 1.066 young students, from a city in the north of Portugal, enrolled in nine high school and higher education institutions, with an average age of seventeen years. A self-administered questionnaire was applied in paper and digital format. Results: Results showed that the consumption of addictive substances began in early adolescence, that the current consumption of alcoholic beverages is high and the consumption of tobacco, alcohol and marijuana is often interrelated. Conclusions: The consumption of addictive substances is influenced by individual and contextual factors affecting these research results. Thus, it is crucial to plan an intervention strategy encompassing social, educational and health policies appealing for young students' adherence

Security and violence - young people's risk behaviours profile

Introduction: The risk behaviours, safety and violence of young people have been a major concern for societies. Health promotion focused on the importance of a safe environment and the implications that come from incorrect behaviours at this stage of life in which building autonomy is critical. Objectives: To identify individual health measures adopted by adolescents/youngsters in this case and violence situations to which they are commonly exposed; to determine the level of the risk behaviour; to explore the connections between risk behaviours, school year, and gender. Method: A quantitative, correlational and transversal study was conducted. A selfadministered questionnaire it was deliver to participants. The sample comprised 1614 young people, of the municipality of Vila Nova de Famalicão, and attending the academic year of 2013/2014. Results: The average age of respondents was 17 years old and the majority were female, attended the secondary school and perceived their family as highly functional. The use of a protection helmet was more frequent when riding a motorcycle than riding a bicycle. The majority of participants reported the regular use of the seatbelt and did not drive nor accompanied a person driving under the influence of alcohol. Most of the respondents have not been involved in situations of violence. The majority showed low levels of risk behaviours. Conclusion: These study participants reported a positive image of the risk beha-viours. Notwithstanding, young people would still highly benefit from the development of multidisciplinary and innovative interventions leading to the acquisition of a healthy and responsible lifestyle

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