Stress and Occupational Coping among Brazilian Nurses in Critical Care Units during the COVID-19 Pandemic.

OBJECTIVE: To investigate the effects of sociodemographic and working condition variables, as well as the coping strategies used by nurses, on their occupational stress during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted with 104 nurses who worked in intensive and emergency care at a public hospital in the state of São Paulo, Brazil. Data collection was performed in person and online using a questionnaire assessing sociodemographic and occupational characteristics, the Nursing Stress Inventory, and the Occupational Coping Scale. RESULTS: The participants had a high level of stress (median = 132), especially in the 'interpersonal relations' domain (median = 63), and made little use of occupational coping strategies (median = 87). Income (p = 0.027), work shift (p = 0.028), being on leave from work (p = 0.020), number of hospitals with employment ties (p = 0.001), and relationship with management were independently associated with the levels of stress among the nurses. CONCLUSION: In the present study, the high levels of stress among nurses were influenced by financial and work-related factors as well as interpersonal relationships. No significant association was found between stress among the nurses and the use of occupational coping strategies.

Comparative Study of the Quality of Life and Coping Strategies in Oncology Patients.

BACKGROUND: Despite the current data on morbidity and mortality, a growing number of patients with a diagnosis of cancer survive due to an early diagnosis and advances in treatment modalities. This study aimed to compare the quality of life and coping strategies in three groups of patients with cancer and identify associated clinical and sociodemographic characteristics. METHODS: A comparative study was conducted with outpatients at a public hospital in the state of São Paulo, Brazil. The 300 participants were assigned to three groups: patients in palliative care (Group A), patients in post-treatment follow-up with no evidence of disease (Group B), and patients undergoing treatment for cancer (Group C). Data collection involved the use of the McGill Quality of Life Questionnaire and the Ways of Coping Questionnaire. No generic quality-of-life assessment tool was utilized, as it would not be able to appropriately evaluate the impact of the disease on the specific group of patients receiving palliative care. RESULTS: Coping strategies were underused. Participants in the palliative care group had poorer quality of life, particularly in the psychological well-being and physical symptom domains. Age, currently undergoing treatment, and level of education were significantly associated with coping scores. Age, gender, income, and the absence of pharmacological pain control were independently associated with quality-of-life scores. Moreover, a positive association was found between coping and quality of life. CONCLUSION: Cancer patients in palliative care generally report a lower quality of life. However, male patients, those who did not rely on pharmacological pain control, and those with higher coping scores reported a better perception of their quality of life. This perception tended to decrease with age and income level. Patients currently undergoing treatment for the disease were more likely to use coping strategies. Patients with higher education and quality-of-life scores also had better coping scores. However, the use of coping strategies decreased with age.

Dificuldades enfrentadas pelos profissionais de saúde no atendimento de emergências em unidades básicas de saúde no Brasil / Difficulties faced by health professionals in emergency care in primary health care units in Brazil / Dificultades enfrentadas por los profesionales de salud en la atención de emergencias en unidades básicas de salud en Brasil

Objetivos: compreender as dificuldades enfrentadas pelos profissionais de saúde para o atendimento de casos de urgências/emergências em unidades básica de saúde e identificar as proposições de resolubilidade. Métodos: Pesquisa qualitativa, realizada com dez profissionais de saúde, em uma unidade básica de saúde do interior paulista. As entrevistas foram transcritas e analisadas utilizando-se a estratégia metodológica do Discurso do Sujeito Coletivo. Resultados: As dificuldades foram atreladas a fatores como despreparo da equipe, falta de infraestrutura, insumos e equipamentos, carência de profissional médico, pouca aproximação das unidades básicas de saúde com o setor de emergência hospitalar e escasso investimento do município para realização desses atendimentos. As proposições de melhorias destacaram a necessidade de capacitação dos profissionais de saúde, investimentos em recursos materiais e equipamentos, permanência de médico em período integral no serviço, implantação de protocolos de atendimento e empenho dos gestores. Conclusão: Os discursos evidenciaram que o serviço não tem condições de atender casos de urgência/emergência, em virtude do despreparo da equipe e da falta de recursos humanos e materiais. Além disso, não é prioridade do município oferecer condições mínimas para a realização deste atendimento nas unidades básicas de saúde, para que sejam integrantes da rede de atenção de Atenção às Urgências no Sistema Único de Saúde.

Objective: understand the difficulties health professionals face in urgency/emergency care at primary health care units and identify the propositions of problem-solving ability. Methods: Qualitative research, conducted with ten health professionals at a primary health care unit in the interior of São Paulo. The interviews were transcribed and analyzed using the methodological strategy of the collective subject discourse. Results: The difficulties were linked to factors such as unpreparedness of the team, lack of infrastructure, supplies and equipment, lack of medical professional, little cooperation between the primary health care units and the hospital emergency sector and scarce investment of the municipality to carry out these services. The proposals for improvements highlighted the need for training of health professionals, investments in material resources and equipment, full-time presence of physician at the service, implementation of care protocols and commitment of managers. Conclusion: The discourse showed that the service is not able to attend urgency/emergency cases, due to the unpreparedness of the team and the lack of human and material resources. In addition, the municipality does not prioritize the supply of minimum conditions for this care in primary health care units to make them part of the emergency care network in the Unified Health System.

Objetivo: comprender las dificultades enfrentadas por los profesionales de salud para la atención de casos de Urgencias/Emergencias en unidades básicas de salud e identificar las proposiciones de resolubilidad. Métodos: Investigación cualitativa, desarrollada con diez profesionales de salud, en una unidad básica de salud del interior paulista. Las entrevistas fueron transcritas y analizadas utilizando la estrategia metodológica del Discurso del Sujeto Colectivo. Resultados: Las dificultades fueron ligadas a factores como la falta de preparación del equipo, falta de infraestructura, insumos y equipamientos, carencia de profesional médico, poca aproximación de las unidades básicas de salud con el sector de emergencia hospitalaria y escasa inversión del municipio para realizar esas atenciones. Las propuestas de mejorías destacaron la necesidad de capacitación de los profesionales de salud, inversiones en recursos materiales y equipamientos, permanencia de médico a tiempo completo en el servicio, implantación de protocolos de atención y empeño de los gestores. Conclusión: Los discursos evidenciaron que el servicio no tiene condiciones de atender casos de urgencia/emergencia, en virtud de la falta de preparación del equipo y de la falta de recursos humanos y materiales. Además, no es prioridad del municipio ofrecer condiciones mínimas para la realización de esta atención en las unidades básicas de salud, para que sean integrantes de la red de atención de atención a las urgencias en el Sistema Único de Salud.

Determining factors of service priority in the risk classification of patients with chest pain.

OBJECTIVE: To verify the determining factors of high priority in the risk classification and the outcomes of the care provided to adult patients with chest pain. METHOD: Retrospective study, conducted at an emergency referral service of a public hospital in the interior of São Paulo State, analyzing the records of care performed in the risk classification in 181 medical records of patients with the symptom of chest pain, between August and November 2020. RESULTS: Individuals were most males 98 (54.1%), with moderate pain 133 (73.5), high priority for care 135 (74.5%) and who sought the service spontaneously 139 (76.8%). Of those classified as high priority, 47 (34.8%) were referred to the emergency room and, of these, 27 (17.0%) remained hospitalized. Female gender (p=0.0198; OR=0.40; CI=0.189-0.866) was independently associated with high priority of care. CONCLUSION: Despite the priority classification, few participants were referred to the emergency room and required hospitalization. Female gender was a protective factor in the risk classification as high priority.

Spiritual/religious coping strategies and religiosity of patients living with cancer in palliative care.

BACKGROUND: The palliative care provided to cancer patients should also contemplate the psychological and spiritual dimensions of care. AIMS: This study aimed to compare religiosity and spiritual/religious coping (SRC) of cancer patients in palliative care with a group of healthy volunteers and determine whether sociodemographic characteristics affected this association. METHODS: This was a case-control study conducted with 86 patients living with cancer from an outpatient palliative care clinic of the São Paulo State University (UNESP) medical school, Botucatu, Brazil and 86 healthy volunteers. The brief Spiritual/Religious Coping Scale (SRCOPE) and the Duke University Religion (DUREL) Index were used as a brief measure of 'religiosity'. RESULTS: All 172 participants reported to be religious and, overall, made very little use of SRC strategies. DUREL scores were negatively associated with religious practice (P<0.01) and positive SRC (P<0.01). Age was associated with non-organisational religious activities and intrinsic religiosity (P<0.01); and income was associated with intrinsic religiosity (P<0.04). Positive SRC was negatively associated with the palliative group (P=0.03) and DUREL index (P<0.01). Negative SRC was positively associated with the palliative group (P=0.04) and negatively associated with education level (P=0.03) and practice of religion (P<0.01). CONCLUSION: All participants reported to be religious; however, their use of SRC strategies was very low. Positive religious coping was the most prevalent score. Negative religious coping was more common in the palliative care group compared to healthy volunteers. There is an association between religious coping and religiosity in palliative cancer care patients.

Determining factors of service priority in the risk classification of patients with chest pain / Factores determinantes de la prioridad de servicios en la clasificación de riesgo de pacientes con dolor torácico / Fatores determinantes de prioridade de atendimento na classificação de risco a pacientes com dor torácica

ABSTRACT Objective: To verify the determining factors of high priority in the risk classification and the outcomes of the care provided to adult patients with chest pain. Method: Retrospective study, conducted at an emergency referral service of a public hospital in the interior of São Paulo State, analyzing the records of care performed in the risk classification in 181 medical records of patients with the symptom of chest pain, between August and November 2020. Results: Individuals were most males 98 (54.1%), with moderate pain 133 (73.5), high priority for care 135 (74.5%) and who sought the service spontaneously 139 (76.8%). Of those classified as high priority, 47 (34.8%) were referred to the emergency room and, of these, 27 (17.0%) remained hospitalized. Female gender (p=0.0198; OR=0.40; CI=0.189-0.866) was independently associated with high priority of care. Conclusion: Despite the priority classification, few participants were referred to the emergency room and required hospitalization. Female gender was a protective factor in the risk classification as high priority.

RESUMEN Objetivo: Verificar los factores determinantes de prioridad en la clasificación de riesgo y los resultados de las atenciones realizadas a pacientes adultos con dolor torácico. Método: Estudio retrospectivo realizado en urgencias referidas, del hospital público del interior de Sao Paulo, analizando los registros de las atenciones realizadas en la clasificación de riesgo en 181 prontuarios de pacientes con el síntoma dolor torácico, en el período de agosto a noviembre de 2020. Resultados: Los principales hallazgos del estudio deben presentarse de manera concisa y clara, sin excesivos detalles. Los resultados deben estar alineados con la sección de resultados del artículo completo, proporcionando información más detallada sobre los análisis estadísticos realizados y los principales resultados encontrados. Conclusión: A pesar de la clasificación prioritaria, pocos participantes fueron remitidos a la sala de emergencias y evolucionaron con necesidad de ingreso hospitalario. El sexo femenino fue un factor protector en la clasificación de riesgo como alta prioridad.

RESUMO Objetivo: Verificar os fatores determinantes de alta prioridade na classificação de risco e os desfechos deste atendimento realizado a pacientes adultos com dor torácica. Método: Estudo retrospectivo, realizado em pronto-socorro referenciado, de hospital público do interior de São Paulo, analisando-se os registros dos atendimentos realizados na classificação de risco em181 prontuários de pacientes com o sintoma dor torácica, no período de agosto a novembro de 2020. Resultados: Prevaleceram indivíduos do sexo masculino 98 (54,1%), com dor moderada 133 (73,5%), alta prioridade de atendimento 135(74,5%,) e que procuraram o serviço espontaneamente 139 (76,8%). Dos classificados em alta prioridade, 47 (34,8%) foram encaminhados para sala de emergência, e destes 27(17,0%) permaneceram internados. Sexo feminino (p=0,0198; OR=0,40; IC=0,189-0866) associou-se ao atendimento prioritário. Conclusão: Apesar da classificação prioritária, poucos participantes foram encaminhados à sala de emergência e evoluíram com necessidade de internação hospitalar. Sexo feminino foi fator protetor para classificação em alta prioridade de atendimento.

Creation and content validity of a scale for assessing adherence to good practices for COVID-19.

OBJECTIVE: to create a scale for assessing the adherence of healthcare providers to good practices for COVID-19 in the hospital setting and determine its content and face validity. METHODS: A methodological study was developed in three sequential phases: creation of items and domains based on a literature review and administration of the questionnaire to 16 nursing professionals; assessment of content and face validity by experts; and semantic analysis. RESULTS: The 51-item scale was submitted to the evaluation of seven experts. Items with a content validity index ≥ 0.83 were maintained. During the semantic analysis performed by the administration of the scale to 37 healthcare providers, no suggestions for changes were made and the comprehension rate was 87%. CONCLUSIONS: the 47-item instrument with three dimensions (personal, organizational, and psychosocial) achieved satisfactory content and face validity, meeting the parameters established in the literature.

Creation and content validity of a scale for assessing adherence to good practices for COVID-19 / Construcción y validación de contenido de escala para evaluar adherencia a buenas prácticas para COVID-19 / Construção e validação de conteúdo de escala para avaliar a adesão às boas práticas para COVID-19

ABSTRACT Objective: to create a scale for assessing the adherence of healthcare providers to good practices for COVID-19 in the hospital setting and determine its content and face validity. Methods: A methodological study was developed in three sequential phases: creation of items and domains based on a literature review and administration of the questionnaire to 16 nursing professionals; assessment of content and face validity by experts; and semantic analysis. Results: The 51-item scale was submitted to the evaluation of seven experts. Items with a content validity index ≥ 0.83 were maintained. During the semantic analysis performed by the administration of the scale to 37 healthcare providers, no suggestions for changes were made and the comprehension rate was 87%. Conclusions: the 47-item instrument with three dimensions (personal, organizational, and psychosocial) achieved satisfactory content and face validity, meeting the parameters established in the literature.

RESUMEN Objetivo: construir y validar una escala para evaluar la adherencia de los profesionales de la salud a las buenas prácticas para el COVID-19 en el hospital y determinar su contenido y validez aparente. Métodos: estudio metodológico, desarrollado en tres fases secuenciales: creación de ítems y dominios a partir de revisión bibliográfica y aplicación de cuestionario a 16 profesionales de enfermería; evaluación de contenido y validez aparente por especialistas; y análisis semántico. Resultados: la escala de 51 ítems fue sometida a evaluación por siete expertos. Se mantuvieron los ítems con índice de validez de contenido ≥ 0,83. Durante el análisis semántico realizado por la administración de la escala a 37 proveedores de salud, no se hicieron sugerencias de cambios y la tasa de comprensión fue del 87%. Conclusiones: el instrumento con 47 ítems y tres dimensiones (personal, organizacional y psicosocial) alcanzó la validez de contenido y apariencia con un estándar satisfactorio, además de alcanzar los parámetros recomendados por la literatura.

RESUMO Objetivo: Construir e validar conteúdo e face de escala para avaliar a adesão dos profissionais de saúde às boas práticas para COVID-19, no âmbito hospitalar. Métodos: Estudo metodológico, desenvolvido em três fases sequenciais: construção dos itens e dimensões a partir de revisão de literatura e aplicação de questionário a 16 profissionais de enfermagem; validação de conteúdo e de face por especialistas e análise semântica. Resultados: A escala com 51 itens foi submetida à avaliação de sete especialistas e foram mantidos os itens que apresentaram o índice de validade de conteúdo ≥0,83. Na análise semântica, realizada mediante aplicação da escala a 35 profissionais de saúde, não houve sugestão de modificação e o percentual de compreensão foi de 0,87%. Conclusões: O instrumento com 47 itens e três dimensões (pessoal, organizacional e psicossocial), alcançou a validade de conteúdo e de face com padrão satisfatório, além de atingir os parâmetros preconizados pela literatura.