Autoeficacia académica y ansiedad, como incidente crítico, en mujeres y hombres universitarios / Academic Self-efficacy and Anxiety, as a Critical Incident in Female and Male University Students

Resumen Con el objetivo de explorar las relaciones entre la autoeficacia académica y la ansiedad, como inciden te crítico, el presente estudio descriptivo-correlacional incluyó una muestra de 310 estudiantes (183 mujeres y 127 hombres), quienes respondieron a la Escala de Autoeficacia en Conductas Académicas (EACA), la Escala de Ansiedad ZUNG y el Inventario de Ansiedad Estado-Rasgo (IDARE). La prueba de Pearson indicó una correlación positiva significativa entre las puntuaciones de autoeficacia percibida, deseable y alcanzable en EACA, pero una correlación negativa con el índice de mejora de la misma prueba; es decir, los puntajes de autoeficacia percibida, deseable y alcanzable se com portan de manera similar; pero, a medida en que los puntajes de estos tres indicadores disminuyen, la puntuación del índice de mejora es mayor. Por lo tanto, la autoeficacia percibida se tomó como el principal indicador de EACA, la cual se correlacionó inversamente con los puntajes de las escalas de ZUNG e IDARE; es decir, cuanto menor es la autoeficacia percibida mayor es el nivel de ansie dad. En un segundo análisis, un criterio arbitrario permitió definir tres rangos de puntuaciones en autoeficacia percibida: baja (puntuación 1-7.4), intermedia (puntuación 7.5-8.9) y alta (puntuación 9.0-10.0). Un ANOVA de dos vías indicó que los estudiantes, con niveles de autoeficacia percibida baja, obtuvieron los niveles de ansiedad más altos con la conocida tendencia del género femenino a desarrollar mayores puntajes de ansiedad. En conclusión, los estudiantes con baja autoeficacia perci bida manifiestan ansiedad en el momento de la prueba. Permanece pendiente la exploración de una relación causa-efecto.

Abstract: With the aim of exploring relationships between academic self-efficacy and anxiety, as critical incidents, this des criptive study included a sample of 310 students (183 women and 127 men). Volunteers responded to the Self-efficacy in Academic Behavior Scale (EACA), ZUNG anxiety scale and State-Trait Anxiety Inventory (STAI). A correlation analysis was performed between the different levels of perceived, desirable, achievable self-efficacy and an improvement index with anxiety indicators. A Pearson analysis indicated a moderate but significant positive correlation among perceived, desirable, and attainable self-efficacy scores in the EACA test, but a negative corre lation among these three indicators and the same test's improvement index. In other words, perceived, desirable, and attainable self-efficacy scores tabulated similarly, but as the scores of these three indicators rose, the score of the improvement index declined. Therefore, the perceived self-efficacy was taken as main indicator of EACA. The perceived self-efficacy correlated inversely with the scores obtained on ZUNG and STAI scales, i.e., as lower the perceived self-efficacy, the higher the level of anxiety. In second analyses, an arbitrary criterion allowed the esta blishment of three ranges of perceived self-efficacy scores into low (score 1-7.4), intermediate (score 7.5-8.9) and high (score 9.0-10.0). A two-way ANOVA indicated that students in the low range of perceived self-efficacy also scored the highest anxiety levels, with the well-known trend of feminine gender to express high levels of anxiety. In conclusion, students with low perceived self-efficacy are also anxious at the moment of the test, leaving for the future an exploration of a cause and effect relationship.

Errores de medicamentos LASA en anestesiología en Uruguay / LASA medication errors in anesthesiology in Uruguay

El error en la administración de fármacos es una causa frecuente de incidentes críticos en el perioperatorio. Se definen como medicamentos LASA (del inglés, look alike, sound alike) a aquellos medicamentos que se parecen físicamente o que sus nombres suenan parecido. Objetivo: conocer la situación de probable riesgo a la que se exponen los pacientes en Uruguay durante las cirugías con anestesia a causa de errores de medicación LASA (subgrupo LA). Material y método: se documentaron fotográficamente las ampollas involucradas en las confusiones con medicamentos LASA de uso anestésico que causaron o pudieron causar la muerte del paciente al inyectarse accidentalmente. La identificación de las ampollas confundidas se realizó mediante una encuesta anónima a una muestra representativa de los anestesiólogos de Uruguay (n=70). Se analizaron dos tipos de confusiones: las casi inyecciones y las inyecciones accidentales. Resultados: el atracurio es el fármaco que se confunde con mayor frecuencia; los 10 fármacos más confundidos (27,0% de los 37 analizados) están implicados en 80,6% de las confusiones y en 88,4% de las inyecciones accidentales. Se fotografiaron las ampollas LASA para esos 10 fármacos y 48 de los 56 pares de fármacos confundidos. Conclusión: en Uruguay existen ampollas LASA de uso anestésico que generan riesgo potencial y real de confusiones, dado su aspecto similar, al 86,2% de los anestesiólogos. El 88,4% de esos accidentes podrían disminuirse si se identifican claramente las ampollas de 10 fármacos.

Medication errors are a frequent cause of critical incidents in the preoperative and postoperative stages. LASA drugs (look alike, sound alike) are defined as those which physically resemble others, or whose names sound similar. Objective: to learn about the probable risk Uruguayan patients are exposed to when undergoing surgeries with anesthesia, due to LASA medication errors (LA subgroup). Method: pictures of ampoules involved in LASA medication errors for anesthetic use that cause or could have caused the patients' death when accidentally injected were taken. Identification of the confused ampoules was made by means of an anonymous survey in a representative sample of Uruguayan anesthesiologists (n=70). Two kinds of confusions were analysed: accidental injections and cases where injections were almost given. Results: atracurio is the most frequently confused drug; the 10 most regularly confused drugs (27.0% out of the 37 analysed) are involved in 80.6% of confusions and in 88.4% of accidental injections. Pictures were taken of LASA ampoules for these 10 drugs and 48 of the 56 pairs of drugs confused. Conclusion: there are LASA ampoules for anesthetic purposes in Uruguay that represent a potential and real risk of being confused, due to their being similar to others, by 86.2% of anesthesiologists. 88,4% of these accidents could be reduced if the ampoules of these 10 drugs were clearly identified.

O erro na administração de fármacos é uma causa frequente de acidentes críticos no período peri operatório. Os medicamentos chamados LASA (abreviatura em inglês, Look Alike, Sound Alike) são aqueles cujo aspecto, nome fonético ou ortográfico são semelhantes. Objetivo: conhecer a situação de provável risco a que estão expostos os pacientes durante as cirurgias com anestesia devido a erros por medicamentos LASA (subgrupo LA) no Uruguai. Material e método: fez-se um registro fotográfico das ampolas que foram usadas nos episódios de confusão com medicamentos LASA de uso anestésico que causaram ou puderam causar a morte do paciente por ser injetados acidentalmente. A identificação das ampolas confundidas foi feita através de um questionário anónimo submetido a uma amostra representativa de anestesistas no Uruguai (n=70). Foram analisados dois tipos de erros: as quase injeções e as injeções acidentais. Resultados: o atracúrio é o fármaco que é confundido com mais frequência; os 10 fármacos mais confundidos (27,0% dos 37 analisados) estão presentes em 80,6% das confusões e em 88,4% das injeções acidentais. As ampolas LASA desses 10 fármacos e 48 dos 56 pares de fármacos confundidos foram fotografados. Conclusão: no Uruguai existem ampolas LASA de uso anestésico que geram risco potencial e real de confusões, devido ao aspecto similar, para 86,2% dos anestesistas. 88,4% desses acidentes poderiam ser reduzidos se as ampolas desses 10 fármacos fossem claramente identificadas.

Inserting epidural patient controlled analgesia into a peripheral venous line. / Colocación de analgesia controlada por el paciente epidural por vía venosa periférica.

A case is reported from the Safety Reporting System in Anaesthesia and Resuscitation database. The event occurred in a patient undergoing abdominal surgery in whom an epidural catheter was inserted for analgesia. After the intervention, the patient was transferred to the recovery unit where the patient controlled analgesia (PCA) is programmed. Due to an error, the PCA was connected to a peripheral venous line, which was detected early without harm to the patient. Communication and analysis of this incident served to introduce a new drug delivery protocol through PCA pumps, including the obligation to prescribe the PCA in the electronic system, a dual computerised check immediately before connecting PCA, labelling the medication bag as well as the proximal and distal lines, standardisation of daily visits to patients, and monthly monitoring of results.

Hardiness em profissionais de primeira resposta: uma revisão sistemática / Hardiness in first responders: a systematic revision

Esta revisão sistemática da literatura trata do construto teórico de hardiness dirigido a profissionais de primeira resposta, detectando sua aplicabilidade em contextos de exposição regular a incidentes críticos. Consultou-se bases de dados (EBSCO, Web of Science e PsycINFO) no período de abril a junho de 2013, restringindo-se a artigos em português, inglês e espanhol publicados entre 2003 e 2013. Assim, 10 artigos compuseram esta revisão, sendo estes agrupados em um bloco temático – hardiness como agente amortecedor dos efeitos nocivos do estresse. Bombeiros, profissionais de enfermagem, médicos, paramédicos, militares e policiais compuseram os profissionais estudados. Hardiness mostrou estar negativamente relacionado ao mal-estar psíquico, ao desenvolvimento de quadros de adoecimento emocional e exercer influência negativa no uso de mecanismos desadaptativos e de risco, considerando as amostras elencadas nas pesquisas. Também mostrou relação positiva com bem estar psicológico e com a capacidade de enfretamento eficiente, útil e saudável em ambientes altamente estressantes(AU)

This article provides a systematic revision in the literature regarding the hardiness construct, aimed to first responders, checking its applicability on scenarios where there is a regular exposure to critical incidents. From April to June, 2013, the EBSCO, Web of Science and PsycINFO databaseswere searched, looking for articles in Portuguese, English and Spanish, published between 2003 and 2013. After applying the inclusion and exclusion criteria, 10 articles ended up being included in this revision. They were then grouped, based on their goals and identified associations, in a single thematic block – hardiness as a weakening agent from the harmful effects of stress. The professionals studied comprised firemen, nurses, doctors, paramedics, military and policemen. From the studies analysis it is concluded that hardiness was shown to be negatively related to psychological distress, development of emotional illness and negatively influence the use of maladaptive and risky mechanisms, considering the samples listed in researches. Likewise, it showed a positive relationship with psychological well-being and the ability of efficient, helpful and healthful coping in highly stressful environments(AU)

Hardiness em profissionais de primeira resposta: uma revisão sistemática / Hardiness in first responders: a systematic revision

Esta revisão sistemática da literatura trata do construto teórico de hardiness dirigido a profissionais de primeira resposta, detectando sua aplicabilidade em contextos de exposição regular a incidentes críticos. Consultou-se bases de dados (EBSCO, Web of Science e PsycINFO) no período de abril a junho de 2013, restringindo-se a artigos em português, inglês e espanhol publicados entre 2003 e 2013. Assim, 10 artigos compuseram esta revisão, sendo estes agrupados em um bloco temático ­ hardiness como agente amortecedor dos efeitos nocivos do estresse. Bombeiros, profissionais de enfermagem, médicos, paramédicos, militares e policiais compuseram os profissionais estudados. Hardiness mostrou estar negativamente relacionado ao mal-estar psíquico, ao desenvolvimento de quadros de adoecimento emocional e exercer influência negativa no uso de mecanismos desadaptativos e de risco, considerando as amostras elencadas nas pesquisas. Também mostrou relação positiva com bem estar psicológico e com a capacidade de enfretamento eficiente, útil e saudável em ambientes altamente estressantes.(AU)

This article provides a systematic revision in the literature regarding the hardiness construct, aimed to first responders, checking its applicability on scenarios where there is a regular exposure to critical incidents. From April to June, 2013, the EBSCO, Web of Science and PsycINFO databases were searched, looking for articles in Portuguese, English and Spanish, published between 2003 and 2013. After applying the inclusion and exclusion criteria, 10 articles ended up being included in this revision. They were then grouped, based on their goals and identified associations, in a single thematic block ­ hardiness as a weakening agent from the harmful effects of stress. The professionals studied comprised firemen, nurses, doctors, paramedics, military and policemen. From the studies analysis it is concluded that hardiness was shown to be negatively related to psychological distress, development of emotional illness and negatively influence the use of maladaptive and risky mechanisms, considering the samples listed in researches. Likewise, it showed a positive relationship with psychological well-being and the ability of efficient, helpful and healthful coping in highly stressful environments.(AU)

El análisis de incidentes críticos como método de estudio de los conflictos interculturales / Critical Incident Analysis As a Method for Studying Intercultural Conflicts

En la actualidad, la globalización económica y el consecuente aumento de la desigual en la distribución de recursos entre el hemisferio norte y sur inciden en el incremento y transformación de los flujos migratorios que modelan las sociedades modernas. El estudio que presentamos pone de relieve la validez del análisis de incidentes críticos -AIC- (Flanagan, 1954; cohen-Emerique, 1999; Arthur, 2001) como herramienta de estudio de los elementos estructurales de los conflictos interculturales. Esta técnica permite profundizar en las culturas que interactúan, facilitando la adquisición de competencia cultural (Maya-Jariego, 2002). Fueron analizados 95 incidentes críticos tomados en dos contextos de formación diferenciados. Los resultados apuntan a la importancia de determinadas áreas de fricción cultural como detonantes del conflicto. Entre las más destacadas se señalan: a. los procesos de comunicación intercultural (Gudykunst & Nishida, 2001; Gudykunst, Nishida & chua, 1986), b. los roles de género (Best, 2001; Best & Williams, 2001), c. el cumplimiento de preceptos mágico-religiosos en el ámbito público y d. la influencia de los prejuicios y estereotipos (Leyens, Yzerbit & Schandron, 1994) en la génesis y desenlace del conflicto. Finalmente, se indican algunas lecciones aprendidas sobre el abordaje del estudio de los conflictos interculturales.

At this moment economic globalization and the increase of inequal distribution of resources in the society, provoke the speed up of the evolution and change of the migration flows that shape modern society. The study presented stands out the validity of the Critical Incident Method -CIM (Flanagan, 1954, Cohen-Emerique, 1999; Arthur, 2001) as a study tool of structural elements of intercultural conflicts. This method allows in depth knowledge of cultures that interact to facilitate the acquisition of cultural competence (Maya-Jariego, 2002). A total of 95 critical incidents collected in two different formation contexts were analized. The results point to the importance of certain areas of cultural friction as triggers of conflict. The most important areas of cultural friction have been: a) the intercultural communication barriers (Gudykunst & Nishida, 2001; Gudykunst, Nishida & Chua, 1986), b) gender roles (Best, 2001; Best & Williams, 2001), c) the expression of magical-religious precepts in public and d) the influence of prejudice and stereotypes (Leyens, Yzerbit & Schandron, 1994) in the genesis and outcome of the conflict. Finally, some learnt lessons about study of intercultural conflicts are exposed.

La técnica de incidentes críticos: una herramienta clásica y vigente en enfermería / The critical incidents technique: a classic and effective tool in nursing

Este artículo tiene como objetivo presentar una visión actualizada de la técnica de incidentes críticos, destacando que es una valiosa técnica de investigación cualitativa, flexible, relativamente fácil de aplicar, que permite comprender la interacción de las acciones de los trabajadores en el complejo contexto de la salud y es ampliamente utilizada en salud y en enfermería. En esta revisión se describe su origen, sus principales características, luego se explica cada una de las etapas básicas de su aplicación y también se analiza sus ventajas y desventajas. Finalmente, se discute su contribución a la investigación y su empleo en enfermería para evaluar acciones de intervención en centros de salud.

This paper present an up-to-date vision of the critical incidents technique, highlighting that it is a valuable technique for qualitative investigation, flexible, of relative easy application and broadly used in nursing contexts. This technique also allows understanding the interaction between the actions of people in complex area of health context. In this review, its origin and main characteristics are described. Then a step-by-step explanation is given regarding the use of the technique, and also its advantages and disadvantages are analyzed. Finally, a discussion is presented of how it can contribute to research activities and to the assessment of intervention actions in health organizations.