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1.
Rev. enferm. UERJ ; 28: e50078, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1118065

RESUMO

Objetivo: compreender as causas dos conflitos entre as equipes de saúde na transferência do cuidado pré-hospitalar sob a perspectiva dos profissionais. Método: estudo qualitativo, descritivo e exploratório, realizado no Serviço de Atendimento Móvel de Urgência (SAMU) de Porto Alegre/RS. Foram entrevistados 28 profissionais do SAMU e observados 135 horas de atendimentos. Empregou-se a análise de conteúdo temática. Resultados: As causas atribuídas aos conflitos foram: (1) a superlotação dos hospitais e a pouca receptividade da equipe: os profissionais do SAMU se sentem culpabilizados pela superlotação dos serviços e punidos por meio da retenção de macas; e (2) a regulação e as (in)definições de fluxos na rede: há lacunas nas pactuações sobre o destino dos pacientes, recaindo aos profissionais o desafio de dar sequencia ao atendimento. Conclusão: o excesso de demandas e a baixa articulação dos serviços na rede causam conflitos entre as equipes de saúde na transferência do cuidado pré-hospitalar.


Objective: to understand, from the health personnel's perspective, the causes of conflicts between health care teams during transfer from pre-hospital care. Method: this exploratory, qualitative, descriptive study was conducted at the ambulance service (Serviço de Atendimento Móvel de Urgência, SAMU) of Porto Alegre, Rio Grande do Sul, Brazil. Twenty-eight SAMU personnel were interviewed and 135 hours of care service observed. Thematic content analysis was used. Results: the causes attributed to conflicts were: (1) hospital overcrowding and poor staff receptivity: SAMU personnel felt blamed for service overcrowding and punished by gurneys being withheld, and (2) the bed regulation center and (in)definition in patient flows: there were gaps in patient routing agreements, it then falling to SAMU personnel to meet the challenge of completing the service. Conclusion: excessive demands and poor coordination between services in the health care network cause conflicts between teams in transfer from pre-hospital care.


Objetivo: comprender, desde la perspectiva del personal de salud, las causas de los conflictos entre los equipos de salud durante el traslado desde el cuidado prehospitalario. Método: este estudio exploratorio, cualitativo y descriptivo se realizó en el servicio de ambulancia (Serviço de Atendimento Móvel de Urgência, SAMU) de Porto Alegre, Rio Grande do Sul, Brasil. Se entrevistó a 28 miembros del SAMU y se observaron 135 horas de servicio de atención. Se utilizó análisis de contenido temático. Resultados: las causas atribuidas a los conflictos fueron: (1) hacinamiento hospitalario y poca receptividad del personal: el personal del SAMU se sintió culpable por el hacinamiento del servicio y castigado con camillas retenidas, y (2) centro de regulación de camas y (in) definición en los flujos de pacientes: Hubo lagunas en los acuerdos de enrutamiento de pacientes, y luego le correspondió al personal de SAMU enfrentar el desafío de completar el servicio. Conclusion: las demandas excesivas y la mala coordinación entre los servicios de la red sanitaria provocan conflictos entre los equipos en el traslado desde el cuidado prehospitalario.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Serviços Médicos de Emergência , Assistência Pré-Hospitalar , Transferência da Responsabilidade pelo Paciente , Brasil , Carga de Trabalho , Pesquisa Qualitativa , Relações Interprofissionais
2.
Estima (Online) ; 18(1): e1120, jan.-dez. 2020.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1103092

RESUMO

Objectives: To correlate the incidence of pressure injury (PI) with the average time of nursing care in an intensive care unit (ICU). Method: Epidemiological, observational, retrospective study, carried out in the ICU of a university hospital. Data were collected by consulting the PI incidence and the average nursing care time from ICU databases between 2010 and 2014. Measures of central tendency and variability, and Pearson's correlation coefficient were used for data analysis. Results: The average incidence of PI between 2010 and 2014 was 10.83% (SD = 2.87) and the average time spent in nursing care for patients admitted to the ICU was 15 hours (SD = 0.94). There was no statistically significant correlation between the incidence of PI and the nursing care time (r = -0.17; p = 0.199), however, the results suggested an overload on the nursing team. Conclusion: This study confirms the importance of implementing and reassessing the effectiveness of preventive care protocols for PI, in addition to warning about the work overload of nursing in assisting critically ill patients.


Assuntos
Incidência , Carga de Trabalho , Lesão por Pressão , Unidades de Terapia Intensiva , Cuidados de Enfermagem
3.
BMC Public Health ; 20(1): 1636, 2020 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-33138798

RESUMO

BACKGROUND: In this study, we aimed to evaluate the impact of the COVID-19 epidemic on the workload and mental health of Iranian medical staff using the General Health Questionnaire (GHQ-12) and NASA -Task Load Index (NASA-TLX) Questionnaire between March and April 2020, respectively. METHODS: The present cross-sectional study was conducted from March 5th to April 5th, 2020. To evaluate the workload and mental health of participants NASA-TLX and GHQ-12 online questionnaires were distributed. Data were entered into software SPSS (Version 23) and T-test, ANOVA, Regression methods were used for data analysis. RESULTS: Health workers who encountered COVID- 19 patients, were subjected to more task load compared to those who had no contact with COVID- 19 patients at the workplace (p <  0.001). In terms of the subscale score of NASA-TLX, nurses had more scores in mental pressure, physical pressure, time pressure (temporal), and frustration compared to the other jobs (p <  0.05). Moreover, nurses had significantly more workload compared to the other jobs. CONCLUSIONS: Type of job, the shift of work, educational level, and facing COVID-19 affected the score of NASA-TLX. NASA-TLX scores were higher in nursing compared to the scores of other health staff groups. The results of this study indicate that the scores of NASA-TLX and GHQ-12 among staff who had contact with COVID-19 patients were significantly higher than those who did not face COVID-19 patients. We suggested that a comprehensive assistance should be provided to support the well-being of healthcare workers especially nurses and healthcare workers who treated COVID-19 patients.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Epidemias , Pessoal de Saúde/psicologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Carga de Trabalho/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Inquéritos e Questionários , Adulto Jovem
4.
Artigo em Inglês | MEDLINE | ID: mdl-33143172

RESUMO

Nurses are exposed to psychosocial risks that can affect both psychological and physical health through stress. Prolonged stress at work can lead to burnout syndrome. An essential protective factor against psychosocial risks is emotional intelligence, which has been related to physical and psychological health, job satisfaction, increased job commitment, and burnout reduction. The present study aimed to analyze the effect of psychosocial risks and emotional intelligence on nurses' health, well-being, burnout level, and job satisfaction during the rise and main peak of the COVID-19 pandemic in Spain. It is a cross-sectional study conducted on a convenience sample of 125 Spanish nurses. Multiple hierarchical linear regression models were calculated considering emotional intelligence levels, psychosocial demand factors (interpersonal conflict, lack of organizational justice, role conflict, and workload), social support and emotional work on burnout, job satisfaction, and nurses' health. Finally, the moderating effect of emotional intelligence levels, psychosocial factors, social support, and emotional work on burnout, job satisfaction, and nurses' health was calculated. Overall, this research data points to a protective effect of emotional intelligence against the adverse effects of psychosocial risks such as burnout, psychosomatic complaints, and a favorable effect on job satisfaction.


Assuntos
Esgotamento Profissional/psicologia , Esgotamento Psicológico/psicologia , Infecções por Coronavirus/psicologia , Inteligência Emocional/fisiologia , Satisfação no Emprego , Enfermeiras e Enfermeiros/psicologia , Pandemias/prevenção & controle , Pneumonia Viral/psicologia , Adulto , Betacoronavirus , Esgotamento Profissional/epidemiologia , Esgotamento Psicológico/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cultura Organizacional , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Justiça Social , Apoio Social , Espanha/epidemiologia , Inquéritos e Questionários , Carga de Trabalho
6.
Rev Esp Salud Publica ; 942020 Oct 09.
Artigo em Espanhol | MEDLINE | ID: mdl-33034306

RESUMO

BACKGROUND: Covid-19 is a latent threat; a sector of the population with a labor obligation carries out its work not in person in an unplanned context due to the extraordinary social distancing expressed in remote work, without previous experience in many cases and with health exposure due to psychosocial risk factors conditioning stress. Our objective was to describe the fatigue and mental burden in teleworkers through a bibliographic review, of interest for occupational health, public health, clinical research, psychology and other areas of knowledge. We also intend to inform the community about these issues to promote safe telework and ensure a balanced quality of life. METHODS: Structured information on the topics of fatigue and mental load was presented, based on the analysis of international literature, mainly from recent years, obtained from the search engine reviews of scientific publications Ebsco, PubMed, and supplemented with Google Scholar, according to recognized thesauri, in English and Spanish. RESULTS: There are also psychosocial risks in teleworking; work-related stress can be linked to fatigue, which should also be addressed as a psychosocial risk. Fatigue, although multi-causal, can be occupational in origin and may be conditioned by various aspects of labour, such as the mental workload, which is pernicious at its extremes. CONCLUSIONS: We conclude that both fatigue and mental workload must be watched, their extremes threaten the quality of work life.


Assuntos
Betacoronavirus , Infecções por Coronavirus/psicologia , Fadiga/etiologia , Estresse Ocupacional/etiologia , Pneumonia Viral/psicologia , Quarentena/psicologia , Distância Social , Isolamento Social/psicologia , Infecções por Coronavirus/prevenção & controle , Fadiga/psicologia , Saúde Global , Humanos , Saúde do Trabalhador , Estresse Ocupacional/psicologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Qualidade de Vida , Fatores de Risco , Carga de Trabalho/psicologia
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3216-3219, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018689

RESUMO

Real-time monitoring of mental workload (MWL) is a crucial step to build closed-loop adaptive aiding systems for human-machine systems. MWL estimators based on spontaneous electroencephalography (EEG) and event-related potentials (ERPs) have shown great potentials to achieve this goal. However, the previous studies show that the between-task robustness of these EEG/ERP-based MWL estimators is still an unsolved intractable question. This study attempts to examine the task-irrelevant auditory event-related potentials (tir-aERPs) as MWL indicators. A working memory task (verbal n-back) and a visuo-motor task (multi-attribute task battery, MATB), both with two difficulty levels (easy and hard), were used in the experiment, along with task-irrelevant auditory probes that did not need any response from the participants. EEG was recorded from ten participants when they were performing the tasks. The tir-aERPs elicited by the auditory probes were extracted and analyzed. The results show that the amplitudes of N1, early P3a (eP3a) and the late reorienting negativity (RON) significantly decreased with the increasing MWL in both n-back and MATB. Task type has no obvious influence on the amplitudes and topological layout of the MWL-sensitive tir-aERPs features. These results suggest that the tir-aERPs are potentially more constant MWL indicators across very different task types. Therefore, the tir-aERPs should be taken into consideration in future task-independent MWL monitoring studies.


Assuntos
Eletroencefalografia , Potenciais Evocados , Humanos , Memória de Curto Prazo , Carga de Trabalho
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4165-4168, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018915

RESUMO

Wearable motion sensor-based complex activity recognition during working hours has recently been studied to evaluate and thereby improve worker productivity. In the application of this technique to practical fields, one of the biggest challenges is performing time-consuming modeling tasks such as data labeling and hand-crafted feature extraction. One way to enable faster modeling is to decrease the time required for the manual tasks by making use of unlabeled motion datasets and the characteristics of complex activities. In this study, we propose a working activity recognition method that combines unsupervised encoding of the activity patterns of motions (denoted as "atomic activities"), the representation of working activities by combination of atomic activities, and the integration of additional information such as sensor time. We evaluated our method using an actual dataset from the caregiving field and found that it had an equivalent recognition performance (70.3% macro F-measure) to conventional hand-crafted feature extraction method. This is also comparable to that of previous methods using large labeled datasets. We also found that our method could visualize daily work processes with the accuracy of 71.2%. These results indicate that the proposed method has the potential to contribute to the rapid implementation of working activity recognition in actual working fields.


Assuntos
Mãos , Atividades Humanas , Aprendizado de Máquina , Movimento , Carga de Trabalho , Humanos , Movimento (Física)
9.
Inquiry ; 57: 46958020963711, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33034257

RESUMO

Brazil is in a critical situation due to the COVID-19 pandemic. Healthcare workers that are in the front line face challenges with a shortage of personal protective equipment, high risk of contamination, low adherence to the social distancing measures by the population, low coronavirus testing with underestimation of cases, and also financial concerns due to the economic crisis in a developing country. This study compared the impact of COVID-19 pandemic among three categories of healthcare workers in Brazil: physicians, nurses, and dentists, about workload, income, protection, training, feelings, behavior, and level of concern and anxiety. The sample was randomly selected and a Google Forms questionnaire was sent by WhatsApp messenger. The survey comprised questions about jobs, income, workload, PPE, training for COVID-19 patient care, behavior and feelings during the pandemic. The number of jobs reduced for all healthcare workers in Brazil during the pandemic, but significantly more for dentists. The workload and income reduced to all healthcare workers. Most healthcare workers did not receive proper training for treating COVID-19 infected patients. Physicians and nurses were feeling more tired than usual. Most of the healthcare workers in all groups reported difficulties in sleeping during the pandemic. The healthcare workers reported a significant impact of COVID-19 pandemic in their income, workload and anxiety, with differences among physicians, nurses and dentists.


Assuntos
Atitude do Pessoal de Saúde , Betacoronavirus , Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Pneumonia Viral/psicologia , Carga de Trabalho/psicologia , Adulto , Brasil , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pandemias , Pneumonia Viral/epidemiologia , Carga de Trabalho/estatística & dados numéricos , Local de Trabalho/estatística & dados numéricos
10.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 6070-6073, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019355

RESUMO

Increasing workload is one of the main problems that surgical practices face. This increase is not only due to the increasing demand volume but also due to increasing case complexity. This raises the question on how to measure and predict the complexity to address this issue. Predicting surgical duration is critical to parametrize surgical complexity, improve surgeon satisfaction by avoiding unexpected overtime, and improve operation room utilization. Our objective is to utilize the historical data on surgical operations to obtain complexity groups and use this groups to improve practice.Our study first leverages expert opinion on the surgical complexity to identify surgical groups. Then, we use a tree-based method on a large retrospective dataset to identify similar complexity groups by utilizing the surgical features and using surgical duration as a response variable. After obtaining the surgical groups by using two methods, we statistically compare expert-based grouping with the data-based grouping. This comparison shows that a tree-based method can provide complexity groups similar to the ones generated by an expert by using features that are available at the time of surgical listing. These results suggest that one can take advantage of available data to provide surgical duration predictions that are data-driven, evidence-based, and practically relevant.


Assuntos
Neoplasias da Mama , Cirurgiões , Bases de Dados Factuais , Humanos , Estudos Retrospectivos , Carga de Trabalho
11.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4530-4533, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019001

RESUMO

Heart rate variability (HRV) has been studied in the context of human behavior analysis and many features have been extracted from the inter-beat interval (RR) time series and tested as correlates of constructs such as mental workload, stress and anxiety. Such constructs are crucial in assessing quality-of-life of individuals, as well as their overall performance when doing critical tasks. Most studies, however, have been conducted in controlled laboratory environments with artificially-induced psychological responses. While this assures that high quality data are collected, the amount of data is limited and the transferability of the findings to more ecologically-appropriate settings remains unknown. Additionally, it is desirable for such mental state monitoring systems to have high temporal resolution, thus allowing for quick feedback and adaptive decision making. In this article, we explore the use of features computed from time windows much shorter than typically reported in the literature. More specifically, we evaluate the potential of HRV and breathing features computed over so-called ultra-short-term segments (i.e., < 5 minutes) for stress and mental workload prediction. Experiments with 27 police academy trainees show that short time windows as low as 60 seconds can provide useful insights, in particular for mental workload assessment. Moreover, the fusion of HRV and breathing features showed to be an important aspect for reliable behavioural assessment in highly ecological settings.


Assuntos
Polícia , Respiração , Transtornos de Ansiedade , Frequência Cardíaca , Humanos , Carga de Trabalho
12.
Artigo em Inglês | MEDLINE | ID: mdl-33031651

RESUMO

Objective: Amid the ongoing coronavirus disease 2019 (COVID-19) pandemic, health care workers of multiple disciplines have been designated as frontline doctors. This unforeseen situation has led to psychological problems among these health care workers. The objective of this study was to evaluate the mental health status of pan-Indian frontline doctors combating the COVID-19 pandemic. Methods: A cross-sectional, observational study was conducted among frontline doctors of tertiary care hospitals in India (East: Kolkata, West Bengal; North: New Delhi; West: Nagpur, Maharashtra; and South: Thiruvananthapuram, Kerala) from May 23, 2020, to June 6, 2020. Doctors involved in clinical services in outpatient departments, designated COVID-19 wards, screening blocks, fever clinics, and intensive care units completed an online questionnaire. The 9-item Patient Health Questionnaire and the Perceived Stress Scale were used to assess depression and perceived stress. Results: The results of 422 responses revealed a 63.5% and 45% prevalence of symptoms of depression and stress, respectively, among frontline COVID-19 doctors. Postgraduate trainees constituted the majority (45.5%) of the respondents. Moderately severe and severe depression was noted in 14.2% and 3.8% of the doctors, respectively. Moderate and severe stress was noted in 37.4% and 7.6% of participants, respectively. Multivariate regression analysis showed working ≥ 6 hours/day (adjusted odds ratio: 3.5; 95% CI, 1.9-6.3; P < .0001) to be a significant risk factor for moderate or severe perceived stress, while single relationship status (adjusted odds ratio: 2.9; 95% CI, 1.5-5.9; P = .002) and working ≥ 6 hours/day (adjusted odds ratio: 10.3; 95% CI, 4.3-24.6; P < .0001) significantly contributed to the development of moderate, moderately severe, or severe depression. Conclusions: The pandemic has taken a serious toll on the physical and mental health of doctors, as evident from our study. Regular screening of medical personnel involved in the diagnosis and treatment of patients with COVID-19 should be conducted to evaluate for stress, anxiety, and depression.


Assuntos
Infecções por Coronavirus , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Pandemias , Médicos/psicologia , Pneumonia Viral , Estresse Psicológico/epidemiologia , Adulto , Betacoronavirus , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Internato e Residência , Masculino , Pessoa de Meia-Idade , Questionário de Saúde do Paciente , Admissão e Escalonamento de Pessoal , Médicos/estatística & dados numéricos , Prevalência , Características de Residência , Fatores de Risco , Carga de Trabalho , Adulto Jovem
13.
Sante Publique ; Vol. 31(5): 611-621, 2020 Jan 13.
Artigo em Francês | MEDLINE | ID: mdl-33124787

RESUMO

OBJECTIVE: The objective of the article is to describe the follow-up of pregnancies at work and occupational exposure to potential risks for pregnancy. METHODS: A descriptive cross-sectional study was performed from April 1, 2017 to October 31, 2017 in the occupational health departments of French hospitals. After delivery and at the time of returning to work, 1,165 eligible workers were interviewed by occupational health physicians (OHPs). Socio-demographic information was self-reported. Occupational exposures were assessed by an OHP. Birth weight, gestational age, and sick leaves were also collected. RESULTS: Among recruited workers, 51.8% were exposed to more than 5 occupational hazards. Biological and physical hazards were the most common hazards at the workplace. Note that heavy lifting ≥ 15 kg concerned 9.5% of workers. Only 20.1% of workers had a specific "pregnancy at work" medical visit with OHP during pregnancy; 26.8% benefited from workstation adjustments. In contrast, the level of sick leaves was high (86.7%). CONCLUSIONS: Our data suggest that pregnant workers in hospitals must be strictly supervised.


Assuntos
Exposição Ocupacional/efeitos adversos , Complicações na Gravidez/prevenção & controle , Gestantes , Estresse Psicológico , Carga de Trabalho/psicologia , Local de Trabalho , Estudos Transversais , Feminino , França/epidemiologia , Hospitais , Humanos , Estresse Ocupacional , Gravidez , Estresse Psicológico/complicações , Mulheres Trabalhadoras , Trabalho/psicologia
15.
Sr Care Pharm ; 35(11): 473-475, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33121566

RESUMO

The novel coronavirus disease 2019 (COVID-19) pandemic has impacted pharmacists in a variety of ways, including increased workloads, reduced hours, and ever-changing recommendations for managing this unique infection. Trainees, both students and residents, have also dealt with numerous challenges and changes during this pandemic.


Assuntos
Infecções por Coronavirus , Educação em Farmácia/tendências , Internato e Residência/tendências , Pandemias , Pneumonia Viral , Betacoronavirus , Humanos , Carga de Trabalho
16.
Artigo em Inglês | MEDLINE | ID: mdl-33050004

RESUMO

The COVID-19 pandemic potentially increases doctors' work demands and limits their recovery opportunity; this consequently puts them at a high risk of adverse mental health impacts. This study aims to estimate the level of doctors' fatigue, recovery, depression, anxiety, and stress, and exploring their association with work demands and recovery experiences. This was a cross-sectional study among all medical doctors working at all government health facilities in Selangor, Malaysia. Data were collected in May 2020 immediately following the COVID-19 contagion peak in Malaysia by using self-reported questionnaires through an online medium. The total participants were 1050 doctors. The majority of participants were non-resident non-specialist medical officers (55.7%) and work in the hospital setting (76.3%). The highest magnitude of work demands was mental demand (M = 7.54, SD = 1.998) while the lowest magnitude of recovery experiences was detachment (M = 9.22, SD = 5.043). Participants reported a higher acute fatigue level (M = 63.33, SD = 19.025) than chronic fatigue (M = 49.37, SD = 24.473) and intershift recovery (M = 49.97, SD = 19.480). The majority of them had no depression (69.0%), no anxiety (70.3%), and no stress (76.5%). Higher work demands and lower recovery experiences were generally associated with adverse mental health. For instance, emotional demands were positively associated with acute fatigue (adj. b = 2.73), chronic fatigue (adj. b = 3.64), depression (adj. b = 0.57), anxiety (adj. b = 0.47), and stress (adj. b = 0.64), while relaxation experiences were negatively associated with acute fatigue (adj. b = -0.53), chronic fatigue (adj. b = -0.53), depression (adj. b = -0.14), anxiety (adj. b = -0.11), and stress (adj. b = -0.15). However, higher detachment experience was associated with multiple mental health parameters in the opposite of the expected direction such as higher level of chronic fatigue (adj. b = 0.74), depression (adj. b = 0.15), anxiety (adj. b = 0.11), and stress (adj. b = 0.11), and lower level of intershift recovery (adj. b = -0.21). In conclusion, work demands generally worsen, while recovery experiences protect mental health during the COVID-19 pandemic with the caveat of the role of detachment experiences.


Assuntos
Infecções por Coronavirus/terapia , Transtornos Mentais/epidemiologia , Pandemias , Médicos/psicologia , Pneumonia Viral/terapia , Adaptação Psicológica , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Humanos , Malásia/epidemiologia , Pneumonia Viral/epidemiologia , Carga de Trabalho/psicologia
17.
JCO Glob Oncol ; 6: 1494-1509, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33017179

RESUMO

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has had a global impact, and Singapore has seen 33,000 confirmed cases. Patients with cancer, their caregivers, and health care workers (HCWs) need to balance the challenges associated with COVID-19 while ensuring that cancer care is not compromised. This study aimed to evaluate the psychological effect of COVID-19 on these groups and the prevalence of burnout among HCWs. METHODS: A cross-sectional survey of patients, caregivers, and HCWs at the National Cancer Centre Singapore was performed over 17 days during the lockdown. The Generalized Anxiety Disorder-7 and Maslach Burnout Inventory were used to assess for anxiety and burnout, respectively. Self-reported fears related to COVID-19 were collected. RESULTS: A total of 624 patients, 408 caregivers, and 421 HCWs participated in the study, with a response rate of 84%, 88%, and 92% respectively. Sixty-six percent of patients, 72.8% of caregivers, and 41.6% of HCWs reported a high level of fear from COVID-19. The top concern of patients was the wide community spread of COVID-19. Caregivers were primarily worried about patients dying alone. HCWs were most worried about the relatively mild symptoms of COVID-19. The prevalence of anxiety was 19.1%, 22.5%, and 14.0% for patients, caregivers, and HCWs, respectively. Patients who were nongraduates and married, and caregivers who were married were more anxious. The prevalence of burnout in HCWs was 43.5%, with more anxious and fearful HCWs reporting higher burnout rates. CONCLUSION: Fears and anxiety related to COVID-19 are high. Burnout among HCWs is similar to rates reported prepandemic. An individualized approach to target the specific fears of each group will be crucial to maintain the well-being of these vulnerable groups and prevent burnout of HCWs.


Assuntos
Ansiedade/epidemiologia , Esgotamento Profissional/epidemiologia , Cuidadores/psicologia , Infecções por Coronavirus/psicologia , Neoplasias/psicologia , Pneumonia Viral/psicologia , Adulto , Idoso , Ansiedade/diagnóstico , Ansiedade/psicologia , Betacoronavirus/patogenicidade , Esgotamento Profissional/diagnóstico , Esgotamento Profissional/psicologia , Institutos de Câncer/organização & administração , Institutos de Câncer/normas , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Estudos Transversais , Medo/psicologia , Feminino , Pessoal de Saúde/psicologia , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/normas , Humanos , Controle de Infecções/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Masculino , Oncologia/organização & administração , Oncologia/normas , Pessoa de Meia-Idade , Neoplasias/terapia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Prevalência , Singapura/epidemiologia , Carga de Trabalho/psicologia
18.
Curr Opin Anaesthesiol ; 33(6): 788-792, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33093302

RESUMO

PURPOSE OF REVIEW: The goal of automation is to decrease the anesthesiologist's workload and to decrease the possibility of human error. Automated systems introduce problems of its own, however, including loss of situation awareness, leaving the physician out of the loop, and training physicians how to monitor autonomous systems. This review will discuss the growing role of automated systems in healthcare and describe two types of automation failures. RECENT FINDINGS: An automation surprise occurs when an automated system takes an action that is unexpected by the user. Mode confusion occurs when the operator does not understand what an automated system is programmed to do and may prevent the clinician from fully understanding what the device is doing during a critical event. Both types of automation failures can decrease a clinician's trust in the system. They may also prevent a clinician from regaining control of a failed system (e.g., a ventilator that is no longer working) during a critical event. SUMMARY: Clinicians should receive generalized training on how to manage automation and should also be required to demonstrate competency before using medical equipment that employs automation, including electronic health records, infusion pumps, and ventilators.


Assuntos
Anestesia/métodos , Anestésicos/administração & dosagem , Automação/métodos , Segurança do Paciente , Falha de Equipamento , Humanos , Carga de Trabalho
19.
Can J Surg ; 63(5): E454-E459, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33107817

RESUMO

SUMMARY: Small surgical residency programs like plastic surgery can be challenging environments to accommodate parental leave. This study aimed to report the experiences, attitudes and perceived support of Canadian plastic surgery residents, recent graduates and staff surgeons with respect to pregnancy and parenting during training. Residents and staff surgeons were invited via email to participate in an online survey. The results presented here explore experiences of pregnancy and parental leave of current plastic surgery residents and staff surgeons. Residents' and staff surgeons' perceptions of program director support, policies, negative comments and the impact of parental leave on the workload of others were also explored. Although the findings suggest that there may be improvements in the support of program directors, there continues to be a negative attitude in surgical culture toward pregnancy during residency. The perceived confusion of respondents with respect to programspecific policies emphasizes the need for open conversations and standardization of parental leave.


Assuntos
Atitude do Pessoal de Saúde , Internato e Residência/estatística & dados numéricos , Licença Parental/estatística & dados numéricos , Gravidez/psicologia , Cirurgia Plástica/educação , Adulto , Canadá , Feminino , Humanos , Internato e Residência/organização & administração , Masculino , Pessoa de Meia-Idade , Diretores Médicos/psicologia , Políticas , Gravidez/estatística & dados numéricos , Cirurgiões/psicologia , Cirurgiões/estatística & dados numéricos , Cirurgia Plástica/psicologia , Cirurgia Plástica/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos
20.
Can J Surg ; 63(5): E475-E482, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33107818

RESUMO

BACKGROUND: American studies have shown that higher provider and hospital volumes are associated with reduced risk of mortality following colorectal surgical interventions. Evidence from Canada is limited, and to our knowledge only a single study has considered outcomes other than death. We describe associations between provider surgical volume and all-cause mortality and postoperative complications following colorectal surgical interventions in New Brunswick. METHODS: We used hospital discharge abstracts linked to vital statistics, the provincial cancer registry and patient registry data. We considered all admissions for colorectal surgeries from 2007 through 2013. We used logistic regression to identify odds of dying and odds of complications (from any of anastomosis leak, unplanned colostomy, intra-abdominal sepsis or pneumonia) within 30 days of discharge from hospital according to provider volume (i.e., total interventions performed over the preceding 2 years) adjusted for personal, contextual, provider and hospital characteristics. RESULTS: Overall, 9170 interventions were performed by 125 providers across 18 hospitals. We found decreased odds of experiencing a complication following colorectal surgery per increment of 10 interventions performed per year (odds ratio 0.94, 95% confidence interval 0.91-0.96). We found no associations with mortality. Associations remained consistent across models restricted to cancer patients or to interventions performed by general surgeons and across models that also considered overall hospital volumes. CONCLUSION: Our results suggest that increased caseloads are associated with reduced odds of complications, but not with all-cause mortality, following colorectal surgery in New Brunswick. We also found no evidence of volume having differential effects on outcomes from colon and rectal procedures.


Assuntos
Doenças do Colo/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Doenças Retais/cirurgia , Carga de Trabalho/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Colo/cirurgia , Doenças do Colo/mortalidade , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Feminino , Mortalidade Hospitalar , Hospitais com Alto Volume de Atendimentos/estatística & dados numéricos , Hospitais com Baixo Volume de Atendimentos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Novo Brunswick/epidemiologia , Razão de Chances , Complicações Pós-Operatórias/etiologia , Doenças Retais/mortalidade , Reto/cirurgia , Sistema de Registros/estatística & dados numéricos , Resultado do Tratamento
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