Relationship between work-related psychosocial factors and self-leadership in advanced nurse practitioners: A cross-sectional study.

AIM: The aim of this study was to investigate the relationship between advanced nurse practitioners' self-leadership and commitment to the workplace, work engagement and influence at work. BACKGROUND: The concept of self-leadership is particularly suited to ANPs, who are required to take responsibility for their work roles. An optimum balance between the ANPs' psychosocial work environment and self-leadership may positively impact work ability in this group and can be compromised by interactions between and among these variables. DESIGN: A cross-sectional correlational study was conducted from July 2020 to August 2020 on 153 ANPs across a national health service. METHODS: The survey was distributed to respondents online. The revised self-leadership questionnaire was used to measure self-leadership, and three scales from the Copenhagen Psychosocial Questionnaire were used to measure commitment to the workplace, work engagement and influence at work. Multiple linear regression was used to examine the association between self-leadership and the psychosocial variables. RESULTS: ANPs with high levels of self-leadership reported high levels of work engagement and commitment to the workplace. No relationship was found between self-leadership and influence at work. CONCLUSION: Improving self-leadership among ANPs by involving them in strategic leadership activities at an organizational level could be an effective strategy for optimizing the role and facilitating ANPs to contribute at an organizational level beyond the clinical interface. However, organizational support is required to ensure that ANPs practise to the full potential of their training and capability. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. IMPACT: This study provided new evidence of a relationship between ANPs' self-leadership and psychosocial factors. This study found that ANPs with high levels of self-leadership reported high levels of work engagement and commitment to the workplace. Policymakers and organizational leaders can optimize the ANP role and facilitate ANPs to contribute strategically to improve care systems. This study identifies a relationship between ANPs' self-leadership and specific psychosocial variables.

"I had become fed up": A qualitative study of Black nurse practitioners' experiences fighting against health inequity, racism, and burnout.

BACKGROUND: Increasing diversity in the nurse practitioner (NP) workforce is key to improving outcomes among patients who experience health inequities. However, few studies to date have examined the specific mechanisms by which NPs from diverse backgrounds address inequities in care delivery. PURPOSE: To explore Black NPs' efforts in addressing inequities, and the facilitators and barriers they face in doing so. METHODOLOGY: We conducted focus groups and interviews of Black NPs ( N = 16) in the greater Philadelphia area in early 2022, just following the height of the COVID-19 pandemic and the social unrest of the early 2020s. Data were analyzed using thematic analysis. RESULTS: Emergent themes included: Strategies Utilized to Address Health Inequities ; Burnout & the Minority Tax ; Risks & Rewards of Taking a Stance ; and Uneven Promises of Organizational Engagement . Nurse practitioners prioritized patient-centered, culturally congruent care, taking additional time to explore community resources and learn about patients' lives to facilitate care planning. Participants advocated to administrators for resources to address inequities while simultaneously navigating organizational dynamics, microaggressions, and racism. Finally, NPs identified organizational-level barriers, leading to emotional exhaustion and several participants' intent to leave their roles. CONCLUSIONS: Black NPs use a myriad of strategies to improve equity, yet frequently face substantial barriers and emotional exhaustion in doing so with little change to the inequities in care. IMPLICATIONS: The NP workforce has a critical role to play in reducing health inequities. The strategies outlined by Black NPs in this study offer a roadmap for all clinicians and health care organizations to prioritize equity in care delivery.

Barriers and facilitators to becoming an alcohol and other drug nurse practitioner in Australia: A mixed methods study.

Alcohol and other drug (AOD) nurse practitioners have an advanced scope of practice that allows them to diagnose, prescribe pharmacological treatments for alcohol and other substance use disorders, and monitor physical and mental health. The Behaviour Change Wheel (BCW) is used to understand barriers and facilitators to implementation by applying three conditions of behaviour change (capability, opportunity, and motivation-the COM-B framework). The aim of this paper is to describe the current AOD nurse practitioner workforce, and to explore barriers and facilitators to AOD nurse practitioner uptake in Australia. A mixed method approach was used in this study: a survey to determine the current state of the AOD nurse practitioner workforce (n = 41) and qualitative interviews with 14 participants to determine barriers to endorsement and ongoing work as a nurse practitioner. Interview transcripts were analysed using thematic analysis and mapped to the COM-B framework. The AOD nurse practitioner is a highly specialized provider of holistic care to people who use alcohol and other drugs, with AOD nurse practitioners performing advanced roles such as prescribing and medication management. However, there are several barriers to the further uptake of AOD nurse practitioners in Australia, including varied organizational support, a lack of support for the higher study required to become a nurse practitioner and a lack of available positions. Arguably, nurse practitioners are key to addressing prescriber shortages inherent in AOD treatment settings. In addition, they are equipped to provide true holistic care. We recommend that barriers are addressed to expand the AOD nurse practitioner workforce in Australia.

Enfermeiros novatos e os fatores que influenciam a adaptação ao trabalho após a incorporação ao mundo laboral / Enfermeros novatos y factores que influyen en la adaptación laboral tras la incorporación al mundo laboral / Novice nurses and factors that influence job adaptation after incorporation into the world of work

Resumo Objetivo Analisar os fatores que influenciam a adaptação ao trabalho da enfermagem hospitalar durante o período de transição dos egressos como força de trabalho em saúde em sua nova etapa. Método Estudo exploratório, transversal, que envolveu 100 enfermeiros graduados como força de trabalho de unidades hospitalares. A coleta foi realizada com um questionário na plataforma web no período de novembro de 2020 a agosto de 2021. A análise foi realizada por meio de estatística descritiva. Resultados Houve predomínio de mulheres, solteiras, com idade entre 23 e 32 anos, licenciadas e operacionais, trabalhando entre 19 meses e 2 anos. Em relação aos fatores, foram identificados três mais influentes: Autonomia; Psicológico; Funcionários. Conclusões e implicações para a prática A adaptação da equipe de enfermagem no hospital apresenta dificuldades no período de transição; os fatores internos do profissional, sejam adquiridos por meio de práticas ou desenvolvidos ao longo da vida, e a formação dos empregadores influenciam. Para melhoria, seria fundamental que os protocolos de indução garantissem a adaptação do novato e que os programas de treinamento de funcionários avaliassem a efetividade da equipe de enfermagem no hospital, até a realização da adaptação da enfermagem ao hospital.

Resumen Objetivo Analizar los factores que influyen en la adaptación laboral de enfermería en hospital, durante el período de transición de graduados como fuerza laboral en salud en su nueva etapa. Método Estudio exploratorio, transversal, participaron 100 enfermeras/os graduados como fuerza de trabajo de unidades hospitalarias. La recolección se realizó con un cuestionario en plataforma web en el período noviembre 2020 - agosto 2021. El análisis se realizó mediante estadística descriptiva. Resultados Se encontró predominancia de mujeres, solteras, de edades entre 23 y 32, licenciadas y operativas, trabajando entre 19 meses a 2 años. Respecto a los factores, se identificaron tres más influyentes, correspondientes a: Autonomía; Psicológico; Personal. Conclusiones e implicaciones para la práctica La adaptación del personal de enfermería en hospital se presenta con dificultades en el período de transición, los factores internos del profesional ya sean adquiridos mediante las prácticas como desarrollados durante la vida, y la formación de los empleadores influyen. Para la mejora, sería fundamental que los protocolos de inducción garantizarán la adaptación del novato y los programas de formación de empleados evalúen la efectividad del personal de enfermería en el hospital, hasta el logro de la adaptación de enfermería al hospital.

Abstract Objective To analyze the factors that influence the job adaptation of hospital nursing, during the transition period of graduates as a health workforce in their new stage. Method An exploratory, cross-sectional study, involving 100 graduate nurses as a workforce of hospital units. The collection was carried out with a questionnaire on the web platform in the period November 2020 - August 2021. The analysis was carried out using descriptive statistics. Results There was a predominance of women, single, aged between 23 and 32, licensed and operational, working between 19 months and 2 years. Regarding the factors, three most influential were identified, corresponding to: Autonomy; Psychological; Staff. Conclusions and implications for practice The adaptation of nursing staff in the hospital presents difficulties in the transition period; the internal factors of the professional, whether acquired through practices or developed during life, and the training of employers have influence. For improvement, it would be essential that the induction protocols guarantee the adaptation of the novice and that the employee training programs evaluate the effectiveness of the nursing staff in the hospital, until the achievement of the adaptation of nursing to the hospital.

First-year experience of transitioning from registered nurse to nurse practitioner.

BACKGROUND: Transitioning to advanced practice, novice nurse practitioners need to take on new roles, learn new practice areas, and develop new skills. This process requires breaking old practices and work habits and facing new challenges. PURPOSE: To explore the nature of nurse practitioners' work experiences during the first year of transition from registered nurse to nurse practitioner. METHODS: This qualitative study was based on Husserl's phenomenological methodology. A purposive sample of 16 first-year nurse practitioners was recruited. Data were collected through in-depth interviews and analyzed by thematic content analysis. The approaches of Lincoln & Guba were applied to improve the validity of the study. RESULTS: Results showed that the first-year experience of transitioning from registered nurse to nurse practitioner fell into two overarching themes: challenge and adjustment. The challenge consists of five subthemes: "facing the expectation-reality gap," "managing others' expectations," "striving to acquire professional skills," "handling situational variability," and "bearing emotional burdens" subthemes. The adjustment includes five subthemes: "finding resources," "gaining experiences," "building relationships," "relieving stress," and "overcoming obstacles." IMPLICATIONS FOR PRACTICE: Novice nurse practitioners face many challenges as they adjust to a new role during their first year on the job. New nurse practitioners develop coping strategies to help themselves adjust to their work. They also gradually gain new resources and experiences to help them stay positive in stressful situations and restore work-life balance. The challenges of transitioning from a registered nurse to a nurse practitioner cannot be overlooked. Novice nurse practitioners need appropriate support measures to adapt to advanced practice roles.

Neonatal nurse practitioner job satisfaction, workforce environment, and mental well-being.

BACKGROUND: Increased demand for nurse practitioners emphasizes the importance of consistent and ongoing collection of data to provide a better understanding of the NNP workforce and to promote retention and recruitment of NNPs. PURPOSE: To understand how work environment and work hours influence job or career satisfaction. METHODOLOGY: The National Association of Neonatal Nurse Practitioners in collaboration with the National Certification Corporation emailed an online survey to all 6,558 certified neonatal nurse practitioners (NNPs) in 2020 with 845 (12.8%) responding. Subjects included those with responsibilities in direct patient care, transport NPs, faculty/directors, and advanced practice registered nurse coordinators/managers/administrators. RESULTS: Satisfaction with career choice as an NNP was reported as very satisfied by 58% (n = 493) and mostly satisfied by 37% (n = 310). Satisfaction with current job as an NNP was reported as very satisfied for 30% (n = 252), with 51% being mostly satisfied (n = 435). Age influenced satisfaction scores, with NNPs aged 61 years or older having a higher mean score than NNPs aged 31-40 years ( p = .041). The majority of NNPs did not use all of their available paid time off (72%; n = 609) and respondents worked an additional 248 extra hours per year. NNPs experience bullying (58%) and/or lateral violence (32%). Seventeen percent have called in sick for mental health reasons (n = 147). CONCLUSIONS: Neonatal nurse practitioners' satisfaction is multifactorial. Those who reported taking time off for self-prescribed mental health indicated less job satisfaction, more work hours, poor work/life balance, and a less-than-optimum work environment. IMPLICATIONS: Overall, NNPs are satisfied with their career choice but are less satisfied with their job choice. Understanding factors that influence mental well-being and job satisfaction will improve recruitment and retention of nurse practitioners.

Nurse practitioner experiences providing nutrition counseling to adult patients in primary care.

BACKGROUND: Poor nutrition is one of the leading risk factors for preventable chronic diseases in the United States. Nutrition counseling has been shown to improve clinical outcomes in the adult primary care setting. Nurse practitioners (NPs) can help fill the critical need for nutrition counseling, yet little is known about their role providing nutrition counseling. PURPOSE: To describe the primary care NP's experience in providing nutrition counseling to adult patients in primary care practice. METHODS: Qualitative descriptive study design. Data were collected through virtual semi-structured interviews with 18 board-certified primary care NPs. Interviews were audio-recorded, de-identified, transcribed verbatim, and analyzed. Data collection and analysis took place concurrently and continued until data saturation was achieved. RESULTS: Five themes emerged from NPs' descriptions of their experiences in providing nutrition counseling to adult patients in primary care practice: (1) role of nutrition counseling in NP primary care practice; (2) developing NP self-efficacy in nutrition counseling; (3) nutrition counseling is more than the provision of information; (4) emotional aspect of nutrition; and (5) barriers to behavior change. CONCLUSIONS: Findings suggest that although NPs understand the importance of nutrition counseling in primary care practice and provide it in some capacity, its continuance is limited by multiple barriers. Future research should evaluate ways to enhance NPs' preparedness to provide nutrition counseling, assess specific resources and tools to aid in nutrition counseling, and determine best practices for communication when delivering nutrition counseling. IMPLICATIONS FOR PRACTICE: Future interventions have the potential to positively affect patients' dietary practices and improve clinical outcomes.

Ansiedade e depressão em profissionais de enfermagem de uma maternidade durante a pandemia de COVID-19 / Anxiety and depression in nursing professionals of a maternity during the COVID-19 pandemic / Ansiedad y depresión en profesionales de enfermería de una maternidad durante la pandemia de COVID-19

Objetivo: Estimar a prevalência de sintomas de ansiedade e depressão e seus fatores relacionados, entre os profissionais de enfermagem de uma maternidade, durante a pandemia de COVID-19. Método: Estudo observacional, descritivo e transversal, realizado com 189 profissionais de enfermagem de uma maternidade de referência, em Fortaleza-Ceará. A coleta de dados ocorreu durante três meses − de agosto a outubro de 2020 −, e utilizou-se Formulário Sociodemográfico e Clínico e Escala Hospitalar de Ansiedade e Depressão. Os fatores relacionados para depressão ou ansiedade foram determinados pela análise bivariada, por meio do teste qui-quadrado (nominais) e Wilcoxon (numéricas), com significância de p<0,05. Resultados: Estimou-se a prevalência de sintomatologia ansiosa e depressiva em 58,3% e 29,6% dos participantes, respectivamente. Cerca de 53,5% foram afastados por suspeita de COVID-19 e 58%, infectados pelo vírus. Observou-se que os profissionais que atuavam na emergência, clínica obstétrica e Unidade de Terapia Intensiva materna foram os mais expostos ao risco de ter depressão (p=0,01055). Conclusão e implicações para a prática: Alta prevalência de sintomas de ansiedade e depressão entre os participantes, independentemente de estarem na linha de frente da pandemia ou não. A situação requer acolhimento às demandas da saúde mental

Objective: To estimate the prevalence of anxiety and depression symptoms and their related factors among nursing professionals in a maternity hospital during the COVID-19 pandemic. Method: Observational, descriptive and cross-sectional study carried out with 189 nursing professionals from a reference maternity hospital in Fortaleza-Ceará. Data collection took place over three months, from August to October 2020, using the Sociodemographic and Clinical Form and the Hospital Anxiety and Depression Scale. Factors related to depression or anxiety were determined by bivariate analysis using the chi-square (nominal) and Wilcoxon (numerical) tests, with a significance of p<0.05. Results: The prevalence of anxious and depressive symptoms was estimated in 58.3% and 29.6% of the participants, respectively. About 53.5% were removed due to suspected COVID-19 and 58% were infected with the virus. It was observed that professionals who worked in the emergency, obstetric clinic and maternal Intensive Care Unit were the most exposed to the risk of having depression (p=0.01055). Conclusion and implications for practice: High prevalence of anxiety and depression symptoms among participants, regardless of whether they are on the front lines of the pandemic or not. The situation requires meeting the demands of mental health.

Objetivo: Estimar la prevalencia de síntomas de ansiedad y depresión y sus factores relacionados entre profesionales de enfermería en una maternidad durante la pandemia de COVID-19. Método: Estudio observacional, descriptivo y transversal realizado con 189 profesionales de enfermería de una maternidad de referencia en Fortaleza-Ceará. La recolección de datos ocurrió durante tres meses, de agosto a octubre de 2020, utilizando el Formulario Sociodemográfico y Clínico y la Escala Hospitalaria de Ansiedad y Depresión. Los factores relacionados con la depresión o la ansiedad se determinaron mediante análisis bivariado mediante las pruebas de chi-cuadrado (nominal) y Wilcoxon (numérica), con una significancia de p<0,05. Resultados: La prevalencia de síntomas ansiosos y depresivos se estimó en 58,3% y 29,6% de los participantes, respectivamente. Alrededor del 53,5% fueron retirados por sospecha de COVID-19 y el 58% estaban infectados con el virus. Se observó que los profesionales que actuaban en emergencia, clínica obstétrica y Unidad de Terapia Intensiva materna eran los más expuestos al riesgo de tener depresión (p=0,01055). Conclusión e implicaciones para la práctica: Alta prevalencia de síntomas de ansiedad y depresión entre los participantes, independientemente de si están en la primera línea de la pandemia o no. La situación requiere atender las demandas de salud mental.

Qualidade de vida relacionada à saúde de profissionais de enfermagem na Bahia na pandemia da COVID-19 / Health-related quality of life of nursing professionals in Bahia, Brazil, in the COVID-19 pandemic / Calidad de vida de los profesionales de enfermería en Bahía, Brasil, en la pandemia COVID-19

Objetivo: Identificar fatores associados à qualidade de vida relacionada à saúde de profissionais de enfermagem da Bahia durante a pandemia da COVID-19. Método: Estudo transversal, amostragem tipo snowball com 113 enfermeiras(os) e técnicas(os) de enfermagem. De setembro/2020 a maio/2021, num formulário eletrônico, coletaram-se informações sociodemográficas, ocupacionais, epidemiológicas e de qualidade de vida, avaliada pelo questionário WHOQOL-BREF nos seus domínios Físico, Psicológico, Relações sociais e Meio ambiente. Utilizou-se regressão linear múltipla para identificar fatores associados à variação dos domínios do WHOQOL-BREF. Resultados: Baixos escores de qualidade de vida associaram-se significantemente a várias características dos profissionais: ser caso suspeito de COVID-19, no domínio Físico; ficar sem exercer a profissão por causa da COVID-19, nos domínios Físico e Psicológico; trabalhar exclusivamente em instituições privadas, no domínio Relações sociais; ter mais idade, no domínio Relações sociais; e não receber apoio social de outras pessoas, nos domínios Físico, Psicológico, Relações sociais e Meio Ambiente. Conclusão e implicações para a prática: Ter mais idade, vínculo exclusivo com instituição privada, ser caso suspeito de COVID-19, ficar sem exercer a profissão por causa da COVID-19 e não receber apoio social associaram-se à baixa qualidade de vida de profissionais de enfermagem durante a pandemia

Objective: To identify factors associated with the health-related quality of life of nursing professionals in Bahia, Brazil, during the COVID-19 pandemic. Method: Cross-sectional study with snowball sampling including 113 nurses and nursing technicians. From September 2020 to May 2021, sociodemographic, occupational, epidemiological, and quality of life information was collected in an electronic form and evaluated with the WHOQOL-BREF questionnaire, according to its Physical, Psychological, Social relations, and Environmental domains. Multiple linear regression was used to identify factors associated with variation in the four quality of life domains of the WHOQOL-BREF. Results: Low quality of life mean scores were significantly associated with being a suspected case of COVID-19 (in the Physical domain), withdrawing from professional practice due to COVID-19 (Physical and Psychological domains), working exclusively in private institutions (Social relations), older age (Social relations), and lack of social support (in the Physical, Psychological, Social Relations, and Environmental domains). Conclusion and implications for the practice: Older age, exclusive work in private institutions, being a suspected case of COVID-19, withdrawing from professional practice due to COVID-19, and lack of social support were associated with lower quality of life of nursing professionals during the pandemic

Objetivo: Identificar factores asociados a la calidad de vida relacionada con la salud de los profesionales de enfermería de Bahía, Brasil, durante la pandemia de COVID-19. Método: Estudio transversal, muestreo bola de nieve, con 113 enfermeros y técnicos de enfermería. De septiembre 2020 a mayo 2021, en formulario electrónico, fueron recolectadas informaciones sociodemográficas, ocupacionales, epidemiológicas y de calidad de vida, evaluadas por el cuestionario WHOQOL-BREF en sus dominios Físico, Psicológico, Relaciones Sociales y Medio Ambiente. Se utilizó la regresión lineal múltiple para identificar factores asociados con los dominios del WHOQOL-BREF. Resultados: Los puntajes bajos de calidad de vida se asociaron significativamente con ser un caso sospechoso de COVID-19 (en el dominio Físico); no ejercer la profesión a causa del COVID-19 (dominios Físico y Psicológico); trabajar exclusivamente en instituciones privadas (Relaciones Sociales); mayor edad (Relaciones Sociales); y no recibir apoyo social (en los dominios Físico, Psicológico, Relaciones Sociales y Medio Ambiente). Conclusión e implicaciones para la práctica: Mayor edad, tener vinculación exclusiva con una institución privada, ser caso sospechoso de COVID-19, no ejercer la profesión a causa del COVID-19 y no recibir apoyo social se asociaron con la baja calidad de vida de los profesionales de enfermería durante la pandemia

Construção e validação de instrumento de identificação de violência no trabalho de enfermagem no ambiente hospitalar e estratégias de prevenção no contexto de pandemia / Construction and validation of an instrument to identify violence in nursing work in the hospital environment and prevention strategies in the context of a pandemic

O contexto da pandemia nas instituições de saúde está envolto a fatores estressantes devido as mudanças organizacionais, de tratamento e fluxos de atendimento da grande demanda de pessoas que necessitam de cuidados. Essa situação tem levado profissionais de enfermagem a serem vítimas de atos de violência ocupacional, os quais tem ocasionado absenteísmo e adoecimento desses profissionais pela Síndrome de Burnout. Objetivo: construir e validar de um instrumento para identificação dos tipos e formas da violência no trabalho de enfermagem e as estratégias de prevenção adotadas em situação de pandemia. Método: estudo desenvolvido em duas fases procedimentais: na primeira fase foi realizado um estudo de revisão integrativa da literatura com a finalidade de sumarizar os tipos e formas de violência ocupacional do ambiente hospitalar e as estratégias utilizadas pelos profissionais de enfermagem para preveni-las. A busca de evidências científicas foi realizada a artigos primários publicados em revistas indexadas nas bases Web of Science (WOS/ISI), SCOPUS, Medical Literature Analysis and Retrieval Online (MEDLINE/PuBMed), The Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Scientific Electronic Library Online (Coleção SciELO) e em servidores de Preprints bioRxiv e SciELO Preprints. Os descritores utilizados foram: "Violência no Trabalho", "Equipe de Enfermagem", "Enfermagem", "Infecções por Coronavirus " e os termos em inglês " Workplace Violence", "Nursing Time", " Nursing" e "Coronavirus Infections" publicados no período de 2015 a 2021. Na segunda fase foi realizado um estudo metodológico de elaboração e a validação de conteúdo e com validação com emprego da Técnica Delphi realizada por um comitê de especialistas em Junho/2021 e validação semântica realizada com 30 profissionais de enfermagem atuantes durante a crise sanitária prestando cuidados diretos ou indiretos a pacientes com COVID-19. O questionário foi construído a partir de evidências da literatura sumarizadas na primeira fase da pesquisa e com base no relatório mundial sobre violência da Organização Mundial de Saúde e nas Diretrizes Marco para Afrontar a Violência Laboral no setor Saúde. Os dados da segunda fase do estudo foram analisados por meio de estatística descritiva e foi aplicado o cálculo do Índice de Validade de Conteúdo (IVC) no processo de avaliação de conteúdo do questionário. Resultados: no estudo de revisão, 35 artigos científicos foram selecionados a partir dos critérios adotados e analisados quanto os tipos de violência no trabalho ambiente hospitalar praticados antes da pandemia e durante a pandemia. Os profissionais de enfermagem no ambiente hospitalar sofreram: agressão física, abuso verbal, assédio sexual, assédio moral, discriminação entre outros. O questionário construído e validado para identificar a violência ocupacional no ambiente hospitalar possui 64 questões, sendo 25 sociodemográficas e 39 relacionadas a violência. O questionário foi validado pelo comitê de especialistas com concordância de 68,7% dos membros na 1ª etapa e 100% de concordância na 2ª etapa. Na aplicação do questionário na amostra de profissionais de enfermagem durante a pandemia o IVC apresentado para todos os itens foi de 1.0. Conclusão: O "Questionário de identificação de violência no trabalho de Enfermagem no ambiente hospitalar no contexto de pandemia" foi validado e pode ser utilizado para identificar os tipos de violência no trabalho de enfermagem no ambiente hospitalar para oferecer subsídios para planejamento de ações de combate, controle e prevenção de violência no trabalho de enfermagem

The context of the pandemic in health institutions is surrounded by stressors due to organizational changes, treatment and care flows of the great demand of people in need of care. This situation has led nursing professionals to be victims of acts of occupational violence, which have caused absenteeism and illness in these professionals due to Burnout Syndrome. Objective: to constructo and validate na instrument for identifying the types and forms of violence in nursing work and strategies for adopted in a pandemic situation. Method: a study developed in two procedural phases: the first phase was an integrative review of the literature with the purpose of stumarizing the types and forms of occupational violence in the hospital environment and the strategies used by nursing professional to prevent them. The search for scientific evidence was performed in primary articles, review of the literature published in journals indexed in the Web of Science (WOS/ISI), SCOPUS. Medical Literature Analysis and Retrieval Online (MEDLINE/PuBMed), The Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Latin American and Caribbean Literature on Health Sciences (LILACS) and Scientific Electronic Library Online (SCIELO collection) and on Preprints servers bioRxiv and SciELO preprints. The descriptors used were: "Violence at Work", "Nursing Team", "Nursing" and "Coronavirus Infections" and the English terms "Workplace Violence", "Nursing Time", "Nursing" and "Coronavirus Infections", published from 2015 to 2021. In the second phase, a methodological study was carried out for the elaboration and validation of content and with validation using the Delphi Technique carried out by a committee of experts in June/2021 and semantic validation carried out with 30 nursing professionals working during the health crisis providing direct care or indirect to patients with COVID-19. The questionnaire was built from evidence from the literature summarized in the first phase of the research and based on the World Health Organization's World Report on Violence and the Framework Guidelines for Addressing Violence at Work in the Health Sector. Data from the second phase of the study were analyzed using descriptive statistics and the calculation of the Content Validity Index (CVI) was applied in the questionnaire content evaluation process. Results: in the review study, 35 scientific articles were selected based on the criteria adopted and analyzed regarding the types of violence at work in the hospital environment practiced before the pandemic and during the pandemic. Nursing professionals in the hospital environment suffered: physical aggression, verbal abuse, sexual harassment, moral harassment, discrimination among others. The questionnaire constructed and validated to identify occupational violence in the hospital environment has 64 questions, 25 of which are sociodemographic and 39 are related to violence. The questionnaire was validated by the expert committee with agreement of 68.7% of the members in the 1st stage and 100% of agreement in the 2nd stage. When applying the questionnaire to the sample of nursing professionals during the pandemic, the CVI presented for all items was 1.0. Conclusion: The "Questionnaire for the identification of violence in nursing work in the hospital environment in the context of a pandemic" was validated and can be used to identify the types of violence in nursing work in the hospital environment to provide subsidies for planning actions to combat, control and prevention of violence in nursing work

Transtornos mentais comuns em profissionais de enfermagem de serviços de emergência / Trastornos mentales comunes en profesionales de enfermería de servicios de emergencia / Common mental disorders in emergency services nursing professionals

Resumo Objetivo Analisar as variáveis sociodemográficas e de trabalho quanto ao risco de transtorno mental comum em profissionais de enfermagem que atuam em serviços de atenção às urgências e emergências. Métodos Estudo observacional, transversal com abordagem quantitativa, realizado no Pronto Socorro Adulto e nas Unidades de Terapia Intensiva Adulto e Coronariana de um hospital público de ensino e em duas Unidades de Pronto Atendimento públicos, do interior de Minas Gerais, Brasil. A coleta de dados ocorreu por meio de dois instrumentos: questionário sociodemográfico e profissional e o Self-Reporting Questionnaire. Para as análises foi realizada a estatística descritiva, Qui-quadrado de Pearson, exato de Fisher e regressão logística binomial. Resultados Participaram 302 profissionais de enfermagem. Observou-se prevalência de 20,5% para transtornos mentais comuns. Na análise bivariada, as variáveis relacionadas aos transtornos mentais comuns foram: não ter filhos (p=0,025), trabalhar nos setores da atenção terciária (p=0,008), regime de contrato estatutário (p=0,041). Na análise multivariada, os setores hospitalares (p=0,001) e o cargo de enfermeiro (p=0,017) indicaram risco elevado para transtornos mentais comuns. Conclusão As variáveis setor e cargo se comportaram como risco e apresentaram razão de chance de prevalência de 4,21 e 2,80, respectivamente, indicando que as condições de trabalho nos ambientes de urgência e emergência associadas ao cargo de enfermeiro favorecem o desenvolvimento de transtornos mentais comuns nos profissionais de enfermagem. Este estudo possibilitou conhecer a necessidade de implantação de estratégias para identificação precoce de transtornos mentais comuns e a promoção da saúde mental dos profissionais, visando a melhoria dos aspectos psicossociais nos ambientes de trabalho.

Resumen Objetivo Analizar las variables sociodemográficas y de trabajo respecto al riesgo de trastornos mentales comunes en profesionales de enfermería que actúan en servicios de atención de urgencias y emergencias. Métodos Estudio observacional, transversal, con enfoque cuantitativo, realizado en el Servicio de Urgencias Adulto y en las Unidades de Cuidados Intensivos Adulto y Coronaria de un hospital público universitario y en dos Unidades de Pronta Atención públicas del interior de Minas Gerais, Brasil. La recopilación de datos se realizó mediante dos instrumentos: cuestionario sociodemográfico y profesional y el Self-Reporting Questionnaire. Para los análisis, se utilizó la estadística descriptiva, ji cuadrado de Pearson, exacta de Fisher y regresión logística binomial. Resultados Participaron 302 profesionales de enfermería. Se observó prevalencia del 20,5 % de trastornos mentales comunes. En el análisis bivariado, las variables relacionadas con los trastornos mentales comunes fueron: no tener hijos (p=0,025), trabajar en sectores de atención terciaria (p=0,008) y el régimen de contrato estatutario (p=0,041) En el análisis multivariado, los sectores hospitalarios (p=0,001) y el cargo de enfermero (p=0,017) indicaron riesgo elevado de trastornos mentales comunes. Conclusión Las variables sector y cargo se comportan como riesgo y presentaron razón de momios de prevalencia de 4,21 y 2,80, respectivamente, lo que indica que las condiciones de trabajo en los ambientes de urgencias y emergencias asociadas al cargo de enfermero favorecen el desarrollo de trastornos mentales comunes en los profesionales de enfermería. Este estudio permitió conocer la necesidad de implementar estrategias para la identificación temprana de trastornos mentales comunes y la promoción de la salud mental de los profesionales, con el objetivo de mejorar los aspectos psicosociales en el ambiente de trabajo.

Abstract Objective To analyze sociodemographic and work variables regarding the risk for common mental disorders in nursing professionals working in urgent and emergency care services. Methods Observational, cross-sectional, quantitative study conducted in the Adult Emergency Room and Adult and Coronary Intensive Care Units of a public teaching hospital and in two public Emergency Care Units in the countryside of Minas Gerais, Brazil. Data collection was performed with use of two instruments: sociodemographic and professional questionnaire and the Self-Reporting Questionnaire. Descriptive statistics, Pearson's Chi-square, Fisher's exact and binomial logistic regression were performed in the analyzes. Results Participation of 302 nursing professionals. There was a prevalence of 20.5% for common mental disorders. In the bivariate analysis, the variables related to common mental disorders were: not having children (p=0.025), working in tertiary care departments (p=0.008), statutory contract regime (p=0.041). In the multivariate analysis, the hospital departments (p=0.001) and the nurse position (p=0.017) indicated a high risk for common mental disorders. Conclusion The variables of department and position behaved as risk and had a prevalence odds ratio of 4.21 and 2.80, respectively, indicating that the working conditions in urgent and emergency environments associated with the nurse position favor the development of common mental disorders in nursing professionals. Through this study, it was possible to understand the need to implement strategies for the early identification of common mental disorders and the promotion of mental health among professionals, aiming at improving psychosocial aspects in work environments.

Suporte ético-emocional à profissionais de enfermagem frente à pandemia de COVID-19: relato de experiência / Ethical-emotional support for nursing professionals facing the COVID-19 pandemic: An experience report / Soporte ético-emocional a profesionales de enfermería ante la pandemia COVID-19: relato de experiencia

Objetivo: Descrever a experiência de planejamento, execução e avaliação de um serviço de suporte ético-emocional para profissionais de enfermagem frente à pandemia de COVID-19. Método: Relato de experiência no âmbito da Comissão de Suporte Ético-Emocional do Conselho Regional de Minas Gerais, Brasil, desenvolvido entre os meses de abril e dezembro de 2020 e operacionalizado através de ligações telefônicas e mensagens via aplicativo de comunicação. Resultados: Foram atendidos 241 profissionais. Foram revelados e declarados sentimentos, emoções, vivências e problemas oriundos do cotidiano de trabalho da enfermagem diante do contexto pandêmico. Tais problemas reforçam a eminência, a urgência e o valor que o suporte teve para a vida, trabalho e saúde dos profissionais atendidos, configurando-se como uma estratégia de saúde e de intervenção indispensável à promoção, prevenção, segurança e proteção da saúde mental frente à pandemia. Os atendimentos culminaram na redução de sentimentos negativos; na percepção aumentada (identificação de potenciais ameaças e contextos de "gatilhos"); na valorização pessoal; no autoconhecimento e autocuidado. Considerações finais e implicações para a prática: O suporte fez-se inovador para área da saúde e da enfermagem ao constituir-se como uma estratégia multidisciplinar promotora, aconselhadora e facilitadora do cuidado em tempos de COVID-19. Encoraja-se a manutenção desta estratégia após a pandemia

Objective: To describe the experience of planning, implementing and evaluating an ethical-emotional support service for Nursing professionals facing the COVID-19 pandemic. Method: An experience report in the scope of the Ethical-Emotional Support Commission of the Regional Council of Minas Gerais, Brazil, developed between April and December 2020 and operationalized through phone calls and messages via a communication application. Results: A total of 241 professionals were assisted. Feelings, emotions, experiences and problems arising from the daily Nursing work in the pandemic context were revealed and stated. Such problems reinforce the prominence, urgency and value that the support service had for the life, work and health of the professionals assisted, configuring itself as a health and intervention strategy, indispensable for mental health promotion, prevention, safety and protection in the face of the pandemic. The consultations culminated in the reduction of negative feelings; in increased perception (identification of potential threats and "trigger" contexts); in personal appreciation; and in self-knowledge and self-care. Final considerations and implications for the practice: The support service was innovative for the Health and Nursing areas by constituting a multidisciplinary strategy that promotes, counsels, and facilitates care in times of COVID-19. We encourage the maintenance of this strategy after the pandemic

Objetivo: Describir la experiencia de planificación, implementación y evaluación de un servicio de soporte ético-emocional para los profesionales de enfermería ante la pandemia de COVID-19. Método: Relato de experiencia en el ámbito de la Comisión de Soporte Ético-Emocional del Consejo Regional de Minas Gerais, Brasil, desarrollado entre los meses de abril y diciembre de 2020 y operacionalizado a través de enlaces telefónicos y mensajes vía la aplicación de comunicación. Resultados: Se atendió a 241 profesionales. Se revelaron y declararon los sentimientos, las emociones, las experiencias y los problemas derivados del trabajo diario de las enfermeras ante el contexto de la pandemia. Estos problemas refuerzan la eminencia, la urgencia y el valor que el soporte tiene para la vida, el trabajo y la salud de los profesionales atendidos, configurándose como una estrategia de salud y de intervención indispensable para la promoción, prevención, seguridad y protección de la salud mental frente a la pandemia. Las consultas culminaron en la reducción de los sentimientos negativos; en el aumento de la percepción (identificación de posibles amenazas y contextos "desencadenantes"); en la valoración personal; en el autoconocimiento y el autocuidado. Consideraciones finales e implicaciones para la práctica: El soporte fue innovador en el ámbito de la salud y la enfermería como estrategia multidisciplinaria para promover, asesorar y facilitar la asistencia en tiempos de COVID-19. Se fomenta el mantenimiento de esta estrategia después de la pandemia

Fatores associados ao estresse, ansiedade e depressão na enfermagem intensivista no contexto da pandemia de COVID-19 / Factors associated with stress, anxiety and depression in intensive care nursing in the context of the COVID-19 pandemic / Factores asociados al estrés, la ansiedad y la depresión en la enfermería de cuidados intensivos en el contexto de la pandemia del COVID-19

Objetivo: descrever por meio da literatura, os fatores associados ao estresse, ansiedade e depressão em profissionais de enfermagem atuantes nos cuidados a pacientes graves acometidos pela COVID-19. Método: revisão integrativa da literatura realizada nos recursos informacionais PubMed, Cochrane, LILACS, BDENF, e SciELO utilizando os descritores: COVID-19; Unidades de terapia intensiva; Saúde mental; Ansiedade; Enfermagem, com artigos publicados entre 2020 e 2021. Resultados: foram selecionados 10 estudos completos para análise interpretativa. Fatores como o desconhecimento da doença, sobrecarga de trabalho, falta de equipamentos de proteção individual dentre outros, foram identificados como principais fatores associados ao desenvolvimento e elevação de ansiedade estresse e depressão em profissionais de enfermagem atuantes nos cuidados aos pacientes graves infectados pela COVID-19. Conclusão: evidenciou-se que os profissionais de enfermagem experimentaram sofrimento psicológico significativo causado pela pandemia de COVID-19. E que esses sofrimentos, perduram tanto em seu ambiente de trabalho quanto em sua vida pessoal.

Objective: to describe, through the literature, the factors associated with stress, anxiety and depression in nursing professionals working in the care of critically ill patients affected by COVID-19. Method: integrative literature review carried out in the information resources PubMed, Cochrane, LILACS, BDENF, and SciELO using the descriptors: COVID-19; Intensive care units; Mental health; Anxiety; Nursing, with articles published between 2020 and 2021. Results: 10 complete studies were selected for interpretive analysis. Factors such as lack of knowledge about the disease, work overload, lack of personal protective equipment, among others, were identified as the main factors associated with the development and elevation of anxiety, stress and depression in nursing professionals working in the care of critically ill patients infected by COVID-19. Conclusion: it became evident that nursing professionals experienced significant psychological suffering caused by the COVID-19 pandemic. And that these sufferings last both in your work environment and in your personal life.

Objetivo: describir, a través de la literatura, los factores asociados al estrés, la ansiedad y la depresión en profesionales de enfermería que trabajan en la atención de pacientes críticos afectados por COVID-19. Método: revisión integradora de la literatura realizada en los recursos de información PubMed, Cochrane, LILACS, BDENF y SciELO utilizando los descriptores: COVID-19; Unidades de cuidados intensivos; Salud mental; Ansiedad; Enfermería, con artículos publicados entre 2020 y 2021. Resultados: Se seleccionaron 10 estudios completos para análisis interpretativo. Factores como el desconocimiento de la enfermedad, la sobrecarga laboral, la falta de equipo de protección personal, entre otros, fueron identificados como los principales factores asociados al desarrollo y elevación de la ansiedad, el estrés y la depresión en los profesionales de enfermería que laboran en el cuidado de enfermos críticos. pacientes infectados por COVID-19. Conclusión: se hizo evidente que los profesionales de enfermería experimentaron un importante sufrimiento psicológico causado por la pandemia de COVID-19. Y que estos sufrimientos perduran tanto en tu entorno laboral como en tu vida personal.

Behavioral aspects of nurse practitioners associated with optimal multiple sclerosis care in Spain.

BACKGROUND: Nurse practitioners (NPs) play a critical role in the multidisciplinary management of patients with multiple sclerosis (MS). Neurologists´ behavioral characteristics have been associated with suboptimal clinical decisions. However, limited information is available on their impact among NPs involved in MS care. The aim of this study was to assess nurses´ therapeutic choices to understand behavioral factors influencing their decision making process. METHODS: A non-interventional, cross-sectional, web-based study was conducted. NPs actively involved in the care of patients with MS were invited to participate in the study by the Spanish Society of Neurology Nursing. Participants answered questions regarding their standard practice and therapeutic management of seven simulated relapsing-remitting MS (RRMS) case scenarios. A behavioral battery was used to measure participants´ life satisfaction, mood, positive social behaviors, feeling of helpfulness, attitudes toward adoption of evidence-based innovations, occupational burnout, and healthcare-related regret. The outcome of interest was therapeutic inertia (TI), defined as the lack of treatment escalation when there is clinical and radiological evidence of disease activity. A score to quantify TI was created based on the number of simulated scenarios where treatment intensification was warranted. RESULTS: Overall, 331 NPs were invited to participate, 130 initiated the study, and 96 (29%) completed the study. The mean age (SD) was 44.6 (9.8) years and 91.7% were female. Seventy-three participants (76.0%) felt their opinions had a significant influence on neurologists´ therapeutic decisions. Sixteen NPs (16.5%) showed severe emotional exhaustion related to work and 13 (13.5%) had depressive symptoms. The mean (SD) TI score was 0.97 (1.1). Fifty-six of NPs showed TI in at least one case scenario. Higher years of nursing experience (p = 0.014), feeling of helpfulness (p = 0.014), positive attitudes toward innovations (p = 0.046), and a higher intensity of care-related regret (p = 0.021) were associated with a lower risk of TI (adjusted R2 = 0.28). Burnout was associated with higher risk of TI (p = 0.001). CONCLUSIONS: Although NPs cannot prescribe MS treatments in Spain, their behavioral characteristics may influence the management of patients with RRMS. Continuing education and specific strategies for reducing occupational burnout may lead to better management skills and improve MS care.

Clinician Conceptualization of the Benefits of Treatments for Individual Patients.

Importance: Knowing the expected effect of treatment on an individual patient is essential for patient care. Objective: To explore clinicians' conceptualizations of the chance that treatments will decrease the risk of disease outcomes. Design, Setting, and Participants: This survey study of attending and resident physicians, nurse practitioners, and physician assistants was conducted in outpatient clinical settings in 8 US states from June 2018 to November 2019. The survey was an in-person, paper, 26-item survey in which clinicians were asked to estimate the probability of adverse disease outcomes and expected effects of therapies for diseases common in primary care. Main Outcomes and Measures: Estimated chance that treatments would benefit an individual patient. Results: Of 723 clinicians, 585 (81%) responded, and 542 completed all the questions necessary for analysis, with a median (interquartile range [IQR]) age of 32 (29-44) years, 287 (53%) women, and 294 (54%) White participants. Clinicians consistently overestimated the chance that treatments would benefit an individual patient. The median (IQR) estimated chance that warfarin would prevent a stroke in the next year was 50% (5%-80%) compared with scientific evidence, which indicates an absolute risk reduction (ARR) of 0.2% to 1.0% based on a relative risk reduction (RRR) of 39% to 50%. The median (IQR) estimated chance that antihypertensive therapy would prevent a cardiovascular event within 5 years was 30% (10%-70%) vs evidence of an ARR of 0% to 3% based on an RRR of 0% to 28%. The median (IQR) estimated chance that bisphosphonate therapy would prevent a hip fracture in the next 5 years was 40% (10%-60%) vs evidence of ARR of 0.1% to 0.4% based on an RRR of 20% to 40%. The median (IQR) estimated chance that moderate-intensity statin therapy would prevent a cardiovascular event in the next 5 years was 20% (IQR 5%-50%) vs evidence of an ARR of 0.3% to 2% based on an RRR of 19% to 33%. Estimates of the chance that a treatment would prevent an adverse outcome exceeded estimates of the absolute chance of that outcome for 60% to 70% of clinicians. Clinicians whose overestimations were greater were more likely to report using that treatment for patients in their practice (eg, use of warfarin: correlation coefficient, 0.46; 95% CI, 0.40-0.53; P < .001). Conclusions and Relevance: In this survey study, clinicians significantly overestimated the benefits of treatment to individual patients. Clinicians with greater overestimates were more likely to report using treatments in actual patients.

Perceptions and beliefs about the regulation of advanced nurse practitioners.

BACKGROUND: The role of the advanced nurse practitioner (ANP) is not regulated in the UK, which has led to wide variation in the skills, competencies and academic qualifications of nurses using this title. Urgent treatment centres (UTCs) require a broad and experienced knowledge base to meet the demand of patients presenting with undifferentiated illnesses and injuries, which can be stressful and challenging. AIM: To examine the perceptions and beliefs about ANP regulation, and to explore and discuss any ideas about proposed regulation. METHOD: The author used interpretative phenomenological analysis to uncover valuable insights into the experiences of two ANPs working in an UTC, and their beliefs around regulation of the ANP role. RESULTS: Both ANPs had different backgrounds and qualifications yet still had similar perceptions and beliefs regarding the regulation of ANPs. Five main themes were developed from the interview transcripts. CONCLUSION: This study identified the need to consider the importance of ANPs' identity and the complex regulatory process required to standardise the role.

Nursing practices in the family health strategy in Brazil: interfaces with illness.

OBJECTIVE: To identify Nursing practices in the Family Health Strategy in Brazil and interfaces in the illness of these professionals. METHOD: Qualitative research, carried out in the five Regions of Brazil, with 79 nursing professionals from 20 health units. Data were collected from 2015 to 2017, using interviews, observation and documentary study. The analysis with the aid of the software ATLAS.ti 8.0, guided by the theorization of the Work Process and Workloads. RESULTS: The practices of the care dimension prevailed, followed by the administrative-managerial and educational dimensions. The illness resulting from workloads, predominantly psychic, was related to care practices, potentiated by overload and poor working conditions. CONCLUSION: The centrality of nursing practices in the dimension of care and administrative management characterized the professional work in Primary Care. The findings indicate that improved working conditions may minimize the wear and tear of these professionals in this scenario.

Nurse practitioner hospitalists: An empowered role.

BACKGROUND: Nurse practitioners (NPs) are increasingly employed by hospital medicine groups and contribute to the care of the hospitalized adult patient. Prior research indicates NP hospitalists are empowered in their role. PURPOSE: This national study describes the work experience of the NP hospitalist workforce. METHOD: A qualitative exploratory study using five focus group sessions with NP hospitalists is described using thematic analysis and synthesis of transcriptions. Inductive coding identified and further refined themes explained by NP hospitalist participants. FINDINGS: Psychological empowerment was reaffirmed as the overarching theme to describe the experience of NP hospitalists. Five subthemes of this empowerment emerged: collegiality, autonomy, role preparation, the road traveled, and pathfinder. DISCUSSION: Three main implications of the study include: the need for educational programs to align with practice; hospital bylaws require updating to support current practice; and the APRN Consensus Model does not fully reflect hospitalist roles.