Working conditions in nursing in the face of Covid-19 from the perspective of precariousness.

OBJECTIVE: To investigate working conditions in nursing when facing the Covid-19 pandemic, in light of aspects of precarious work. METHODS: Cross-sectional study, with 131 nursing workers who worked against Covid-19 in hospitals in Alagoas State, Northeast Brazil. Data were collected online, using a workers' health assessment questionnaire. The Chi -Square or Fisher's Exact test and logistic regression were used. RESULTS: among nursing workers, 71% had precarious contracts, 33.6% reported extended working hours and 23.7% were union members. In the multivariable analysis, having little hospital experience was a predictor for poor employment (OR= 2.408; 95%CI= 1.051-5.518). The predictor variables for lengthening the working day were being a nurse (OR= 3.824; 95%CI= 1.274-11.483); overtime (OR= 3.668; 95%CI= 1.009-13.333) and inadequate number of workers (OR= 10.872; 95%CI= 3.409-34.675). Being a nursing technician was a predictor of being a union member (OR= 8.967; 95%CI=2.560-31.410). CONCLUSIONS: The pandemic has accentuated the precariousness of working conditions in nursing professionals, especially among nurses.

Working conditions in nursing in the face of Covid-19 from the perspective of precariousness / Condiciones de trabajo de la enfermería en el afrontamiento del Covid-19 bajo el prisma de la precarización / Condições de trabalho em enfermagem no enfrentamento da Covid-19 sob o prisma da precarização

ABSTRACT Objective: To investigate working conditions in nursing when facing the Covid-19 pandemic, in light of aspects of precarious work. Methods: Cross-sectional study, with 131 nursing workers who worked against Covid-19 in hospitals in Alagoas State, Northeast Brazil. Data were collected online, using a workers' health assessment questionnaire. The Chi -Square or Fisher's Exact test and logistic regression were used. Results: among nursing workers, 71% had precarious contracts, 33.6% reported extended working hours and 23.7% were union members. In the multivariable analysis, having little hospital experience was a predictor for poor employment (OR= 2.408; 95%CI= 1.051-5.518). The predictor variables for lengthening the working day were being a nurse (OR= 3.824; 95%CI= 1.274-11.483); overtime (OR= 3.668; 95%CI= 1.009-13.333) and inadequate number of workers (OR= 10.872; 95%CI= 3.409-34.675). Being a nursing technician was a predictor of being a union member (OR= 8.967; 95%CI=2.560-31.410). Conclusions: The pandemic has accentuated the precariousness of working conditions in nursing professionals, especially among nurses.

RESUMEN Objetivo: Investigar las condiciones de trabajo de la enfermería para el afrontamiento del Covid-19, según la visión de la precarización del trabajo. Métodos: Es un estudio transversal realizado entre 131 trabajadoras(es) de enfermería que actuaron contra el Covid-19 en hospitales de Alagoas, Brasil. Los datos se recogieron online mediante un cuestionario de la salud de los trabajadores, con la Prueba X2 o Exacto de Fisher y regresión logística. Resultados: El 71% tenía contratos precarios, 33,6% declaró jornadas laborales prolongadas y 23,7% estaba sindicado. En el análisis multivariado, tener poca experiencia hospitalaria fue un factor predictivo del empleo precario (OR= 2,408; IC95%= 1,051-5,518). Las variables predictoras de jornadas laborales extendidas fueron: ser enfermera(o) (OR= 3,824; IC95%=1,274-11,483); horas extraordinarias (OR= 3,668; IC95%= 1,009-13,333) y número inadecuado de trabajadores (OR= 10,872; IC95% =3,409-34,675). Ser técnica(o) de enfermería fue un factor predictivo de estar sindicado (OR= 8,967; IC 95%= 2,560-31,410). Conclusiones: La pandemia acentuó la precarización de las condiciones de trabajo en la enfermería, principalmente entre las(os) enfermeras(os).

RESUMO Objetivo: Investigar as condições de trabalho em enfermagem no enfrentamento da pandemia de Covid-19, à luz de aspectos da precarização do trabalho. Métodos: Estudo transversal, com 131 trabalhadoras(es) da enfermagem que atuaram contra a Covid-19 em hospitais alagoanos, no Nordeste brasileiro. Os dados foram coletados online, por questionário de avaliação da saúde dos trabalhadores. Utilizaram-se o teste do Qui-Quadrado ou Exato de Fisher e a regressão logística. Resultados: Entre as(os) trabalhadoras(es), 71% tiveram contratos precários, 33,6% referiram ao prolongamento da jornada e 23,7% eram sindicalizadas(os). Na análise multivariável, ter pouca experiência hospitalar foi preditor para o vínculo precário (OR= 2,408; IC95%= 1,051-5,518). As variáveis preditoras para o prolongamento da jornada foram: ser enfermeira(o) (OR= 3,824; IC95%= 1,274-11,483), horas extras (OR= 3,668; IC95%=1,009-13,333) e número inadequado de trabalhadoras(es) (OR= 10,872; IC95%= 3,409-34,675). Ser técnica(o) de enfermagem foi preditor para ser sindicalizada(o) (OR= 8,967; IC95%=2,560-31,410). Conclusões: A pandemia acentuou a precarização das condições de trabalho em enfermagem, principalmente entre as(os) enfermeiras(os).

Desgaste laboral en personal prehospitalario en México durante la pandemia de 2020 / Burnout in prehospital staff in Mexico during the 2020 pandemic

El burnout (desgate emocional) es una problemática que tiene consecuencias en las y los trabajadores expuestos a determinados riesgos y exigencias. Durante la pandemia por COVID-19 en México aumentó la carga laboral del personal de salud, por lo que esta investigación tiene como propósito explorar la relación entre los datos sociodemográficos, de salud, de las condiciones laborales y burnout entre los profesionales de salud de atención prehospitalaria a inicios de la pandemia en México. Materiales y Métodos: Estudio cuantitativo y descriptivo, se realizó una encuesta en línea en la que participaron 80 trabajadores/as del área prehospitalaria de un universo de aproximadamente 21 mil personas para indagar sus condiciones laborales y la exposición a factores estresantes, así como la prevalencia de la despersonalización, el agotamiento emocional y la realización personal, dimensiones emocionales que definen el burnout. Resultados: El 11.25% de la muestra presenta burnout de acuerdo con el instrumento; en el resto de la muestra destaca que un porcentaje alto de participantes, no tienen burnout, refieren niveles elevados de despersonalización y agotamiento emocional, lo que indica un síndrome en proceso, por lo que es importante dar seguimiento para evitar el avance del burnout en el personal de salud en general y el prehospitalario en particular. Conclusiones: El personal prehospitalario reconoce su trabajo como actividad de riesgo, no obstante, también destacan que su labor favorece la realización personal y la ayuda a otros, que funcionan como factores protectores(AU)

Burnout (emotional exhaustion) is a problem that has consequences for workers, exposed to certain risks and demands. During the COVID-19 pandemic in Mexico, the workload of health workers increased, so this research aims to explore the relationship between sociodemographic, health, working conditions and burnout syndrome data between prehospital care health professionals at the beginning of the pandemic in Mexico. Materials and Methods: Quantitative and descriptive study, an online survey was carried out in which 80 workers from the pre-hospital area participated to investigate their working conditions and exposure to stressors, as well as the prevalence of depersonalization, exhaustion emotional and personal fulfillment, which are the emotional dimensions that define burnout. Results: 11.25% of the sample presents burnout according to the instrument; In the rest of the sample, it stands out that a high percentage of participants, who do not have burnout, report high levels of depersonalization and emotional exhaustion, which indicates a syndrome in process, so it is important to follow up to avoid the progression of burnout in health personnel in general and pre-hospital personnel in particular. Conclusions: The prehospital staff recognize their work as a risky activity; however, they also emphasize that their work favors personal fulfillment and helps others, which function as protective factors(AU)

Sintomatología asociada al estrés y condiciones laborales de operarios de taxi de un sitio de la Ciudad de México / Stress-related symptoms and working conditions among Mexico City taxi drivers

Introducción: Los estilos de vida no saludables se relacionan con hábitos y conductas que deterioran los órganos y sus funciones generando envejecimiento prematuro y enfermedades crónicodegenerativas, estas condiciones se ven agravadas por las desigualdades sociales en ciertos grupos laborales, tal es el caso de los conductores de taxis, los cuales presentan riesgos ambientales, físicos, químicos, bioquímicos, así como exigencias laborales como son extensión de jornada, bajos salarios, las formas de organización y la falta de apoyo sindical. Estudiar el proceso salud/enfermedad de estos trabajadores, permite identificar el desgaste laboral y la integridad mental determinada por la cantidad e intensidad de trabajo y proponer medidas de prevención. Método: Se diseñó un estudio transversal, observacional y descriptivo, se aplicó una encuesta, valoración antropométrica, análisis bioquímicos, cuyos resultados tuvieron un procesamiento para identificar asociaciones y significancia estadística. Resultados: el 32.5% de la muestra conduce más de 9 horas. al día sin descansos, el 21.8% presentó supervisión estricta y 48.7% son obligados a cubrir cuotas diarias. Más de la mitad de la muestra se encuentra con exposición constante a condiciones adversas tanto en la unidad como en el lugar de trabajo. Se encontró asociación de estas condiciones con la prevalencia de enfermedades crónico degenerativas como diabetes mellitus, hipertrigliceridemia e hipercolesterolemia, más altas con las reportadas a nivel nacional. Conclusiones: las condiciones de los conductores de taxis tanto laborales como de salud mental y física se encuentran deterioradas de manera extrema por lo cual se necesitan estrategias multidisciplinarias para su disminución(AU)

Introduction: Unhealthy lifestyles are related to habits and behaviors that can contribute to the deterioration and function of organ systems, leading to premature aging and degenerative chronic diseases. These conditions are aggravated due to the social inequality in certain occupations. Such is the case of taxi drivers, who experience environmental, physical, chemical, and biochemical risks, as well as high work demands such as long work days, low pay and little union support. By studying the health / disease process of these workers we can identify occupational burnout and mental integrity determined by the amount and intensity of the work, and propose preventive measures. Methods: A cross-sectional, observational and descriptive study was designed. We obtained data via a survey, anthropometric measurements, and laboratory testing. We examined associations and tested them for statistical significance. Results: Of the overall respondents, 32.5% reported driving more than 9 hours a day without breaks; 21.8% mentioned strict supervision and 48.7% reported being required to meet daily fee quotas. More than half the sample was continuously exposed to adverse conditions in the cab and the workplace. We found associations between these working conditions and the prevalence of chronic degenerative diseases, including diabetes, hypertriglyceridemia and hypercholesterolemia, higher than national average prevalence figures. Conclusion: occupational, physical and psychological working conditions among taxi drivers are very poor, and multidisciplinary strategies are needed to diminish them(AU)

Life, health and work conditions of taxi drivers in Mexico City / Condiciones de vida, salud y trabajo en conductores de taxi en la Ciudad de México

Background: In informal work, unfavorable working conditions derived from labor flexibility, employment insecurity and reduction of purchasing power have more impact in marginal population. For taxi drivers, informal work may be detrimental to their working conditions, and to their life and health as well. Objective: To analyze the relationship between the living and working conditions of taxi drivers from the Milpa Alta precinct and their health conditions from March to July, 2016. Methods: A complete medical record was performed on 44 male taxi drivers, aged 21 to 73 years, from a Milpa Alta taxi stand in Mexico City. Two questionnaires were administered, one on material life conditions and another on labor conditions. Anthropometric measures were taken as well as the lipid levels and glucose through capillary samples. The diagnosis of metabolic syndrome (MS) was made with ATPIII criteria. Based on the results, the pathological profile was defined and the relationship between working and health conditions, the frequencies of the symptomatology by devices and systems, as well as the prevalence of the diagnoses of degenerative disease were analyzed. Results: It was found that 93% of the participants presented some component of MS; 34% presented three or more components. The nosological entities with highest frequencies were dyslipidemia (86%), obesity (52%), type 2 diabetes mellitus (18%) and hypertension (25%). Conclusions: The symptoms with higher frequencies were those related to the work process instead of the material conditions of life.

Introducción: Las inadecuadas condiciones de trabajo generadas por la flexibilidad laboral, la inseguridad del empleo y la disminución del poder adquisitivo en el trabajo informal tienen más impacto en la población marginal. Para los operadores de taxi, la informalidad puede afectar sus condiciones de trabajo, de vida y de salud. Objetivo: Analizar la relación entre las condiciones de vida y trabajo de varones operarios de taxi de la delegación Milpa Alta y sus condiciones de salud en el periodo de marzo a julio de 2016. Métodos: Se realizó una historia clínica completa a 44 operadores de taxi del sexo masculino de 21 a 73 años, de un sitio de taxis de Milpa Alta, Ciudad de México. Se aplicaron dos cuestionarios, uno sobre condiciones materiales de vida y otro sobre condiciones laborales. Se hicieron mediciones de lípidos y glucosa en muestras capilares y medidas antropométricas. El diagnóstico de síndrome metabólico (SM) se estableció con los criterios del ATPIII. A partir de los resultados se definió el perfil patológico y se analizaron las relaciones entre las condiciones de trabajo y de salud, las frecuencias de la sintomatología por aparatos y sistemas, así como la prevalencia diagnósticos de enfermedad crónico-degenerativa. Resultados: El 93% de los participantes presentó algún componente del SM; 34% cumplió con tres o más criterios. Las entidades nosológicas con mayor prevalencia fueron las dislipidemias (86%), la obesidad (52%), la diabetes mellitus tipo 2 (18%) y la hipertensión arterial (25%). Conclusiones: Los síntomas más frecuentes fueron aquellos que se relacionan con el proceso de trabajo más que con las condiciones materiales de vida.

[Adolescense pregnancy in a marginalized rural community in Mexico]. / Embarazo en adolescentes de una comunidad rural de alta marginalidad. Un estudio mixto de caso.

OBJECTIVE:: To identify objective and subjective conditions in the lives of pregnant teens within a highly-marginalized community in the state of Puebla, Mexico. MATERIALS AND METHODS:: Objective and subjective conditions of pregnant teens were evaluated through a mixed methodology (surveys, observation guides and a structured interview guide). RESULTS:: The main family characteristic is the absence of a father due to migration, no desire to study or work and the new meaning of pregnancy: the initial social stigma for engaging in a sexual activity and then, the stigma for being a young mother. CONCLUSIONS:: Objective conditions show family disintegration, lack of access to education at the community, high school and college level as well as unemployment as processes linked to teen pregnancy; thus, making it practically impossible to develop life goals. Subjective conditions center around the reproduction of gender stereotypes related to maternity.

Embarazo en adolescentes de una comunidad rural de alta marginalidad. Un estudio mixto de caso / Adolescense pregnancy in a marginalized rural community in Mexico

Resumen: Objetivo: Identificar condiciones de vida y asociaciones subjetivas en el embarazo en adolescentes de una comunidad rural marginal en Puebla, México. Material y métodos: Con metodología cualicuantitativa, que incluyó una encuesta, guías de observación y una entrevista semiestructurada, caracterizando el contexto, identificando condiciones materiales de vida y obteniendo narrativas del plan de vida en adolescentes embarazadas entre 2013 y 2014. Resultados: Se observó migración y desintegración familiar, limitados servicios educativos, de salud y escasas opciones de trabajo. Destacan condiciones como ausencia parental, baja escolaridad e ingreso, malas condiciones de vivienda y saneamiento básico deficiente, que buscan superarse mediante estudio y empleo. Se narran estereotipos tradicionales de género y modelos familiares que se repiten generacionalmente. Conclusión: Tanto las condiciones objetivas como el aprendizaje subjetivo limitan las oportunidades para realizar el plan de vida y determinan la incidencia del embarazo entre adolescentes.

Abstract: Objective: To identify objective and subjective conditions in the lives of pregnant teens within a highly-marginalized community in the state of Puebla, Mexico. Materials and methods: Objective and subjective conditions of pregnant teens were evaluated through a mixed methodology (surveys, observation guides and a structured interview guide). Results: The main family characteristic is the absence of a father due to migration, no desire to study or work and the new meaning of pregnancy: the initial social stigma for engaging in a sexual activity and then, the stigma for being a young mother. Conclusions: Objective conditions show family disintegration, lack of access to education at the community, high school and college level as well as unemployment as processes linked to teen pregnancy; thus, making it practically impossible to develop life goals. Subjective conditions center around the reproduction of gender stereotypes related to maternity.