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Br J Nurs ; 29(1): 28-34, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31917951


A study was conducted to explore whether fatigue, workload, burnout and the work environment can predict the perceptions of patient safety among critical care nurses in Oman. A cross-sectional predictive design was used. A sample of 270 critical care nurses from the two main hospitals in the country's capital participated, with a response rate of 90%. The negative correlation between fatigue and patient safety culture (r= -0.240) indicates that fatigue has a detrimental effect on nurses' perceptions of safety. There was also a significant relationship between work environment, emotional exhaustion, depersonalisation, personal accomplishment and organisational patient safety culture. Regression analysis showed that fatigue, work environment, emotional exhaustion, depersonalisation and personal accomplishment were predictors for overall patient safety among critical care nurses (R2=0.322, F=6.117, P<0.0001). Working to correct these predictors and identifying other factors that affect the patient safety culture are important for improving and upgrading the patient safety culture in Omani hospitals.

Atitude do Pessoal de Saúde , Enfermagem de Cuidados Críticos/organização & administração , Recursos Humanos de Enfermagem no Hospital/psicologia , Cultura Organizacional , Segurança do Paciente , Adulto , Esgotamento Profissional/epidemiologia , Estudos Transversais , Fadiga/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Omã/epidemiologia , Carga de Trabalho , Local de Trabalho , Adulto Jovem
JAMA Netw Open ; 3(1): e1920092, 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31995218


Importance: In Canada, approximately 81% of residents of nursing homes live with mild to severe cognitive impairment. Care needs of this population are increasingly complex, but resources, such as staffing, for nursing homes continue to be limited. Staff risk missing or rushing care tasks and interfering with quality of care and life. Objective: To assess the association of work environment with missing and rushing essential care tasks in nursing homes. Design, Setting, and Participants: This cross-sectional study used survey data collected from a random sample of 93 urban nursing homes in Western Canada, stratified by health region, owner-operator model, and facility size, between May and December 2017. All 5411 eligible care aides were invited to participate, and 4016 care aides agreed and completed structured, computer-assisted interviews in person. Analyses were conducted from July 4, 2018, to February 27, 2019. Main Outcomes and Measures: Self-reported number of essential care tasks missed (range, 0-8) or rushed (range, 0-7) in the most recent shift. Two-level random intercept hurdle regressions controlled for care aide, care unit, and nursing home characteristics. Results: Of 4016 care aides, 2757 (68.7%) were 40 years or older, 3574 (89.1%) were women, and 1353 (66.3%) spoke English as an additional language. For their most recent shift, 2306 care aides (57.4%) reported missing at least 1 essential care task and 2628 care aides (65.4%) reported rushing at least 1 essential care task. Care aides on units with more favorable work environments (eg, more effective leadership, better work culture, higher levels of buffering resources) were less likely to miss any care tasks (odds ratio, 1.59; 95% CI, 1.34-1.90; P < .001) and less likely to rush any care task (odds ratio, 1.66; 95% CI, 1.38-1.99; P < .001). Conclusions and Relevance: This study found that rates of missed and rushed essential care in Canadian nursing homes were high and were higher in units with less favorable work environments. This finding suggests that work environment should be added to the list of modifiable factors associated with improving nursing home care, as it may be an important pathway for improving quality of care. Further research is needed to understand associations of missed and rushed care and of improving work environments with outcomes among residents of nursing homes.

Assistentes de Enfermagem/psicologia , Casas de Saúde/organização & administração , Carga de Trabalho/psicologia , Adulto , Canadá , Estudos Transversais , Humanos , Qualidade da Assistência à Saúde/normas , Local de Trabalho/psicologia
Medicine (Baltimore) ; 99(2): e18630, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914045


Work stress and burnout have become important issues. Changes in work patterns frequently, long working hours, and too much pressure among workers in high-tech companies may result in the chronic fatigue symptoms and increase the risk of cardiovascular diseases, even leading to sudden death. Changes of heart rate variability (HRV) can be treated as a warning from the autonomic nervous systems and as a long-term monitoring method for chronic disease, for example, cardiovascular diseases and sudden death. The purpose of this study was to explore the association between occupational burnout and HRV.Proportional stratified convenient sampling was performed and in total, 120 individuals participated in this study. Questionnaires and the "occupational burnout inventory" were used to collect biographical and burnout information. A novel wrist physiological monitor was used to measure autonomic nervous system-related data, including HRV, low-frequency (LF) %, high-frequency (HF) %, and LF/HF ratio. Descriptive statistics and logistic regressions were computed using SPSS 17.0 (Chinese version, IBM Corp., New York, NY).The results show that participants who were 20 to 25 years old, work overtime because of onerous personal tasks, had a medical history, and recently felt unwell have higher "personal burnout." "Participants with a graduate degree, with onerous tasks, who were indirect staff, and with a regular-hour job tended to overcommit to their work." Significant associations were found among medical history, recently feeling unwell, and "work-related burnout." There was a positive association between HRV and job seniority. LF%, HF%, and LF/HF ratio were significantly correlated with job category. "Work overcommitment" was related to LF/HF ratio among men. Some items in "personal burnout" and "work overcommitment" were also associated with HRV among women.The findings suggest that the measurement of HRV can be applied in occupational settings to assess burnout. It not only allows administrators to quickly select the colleagues who need health care, but also provides timely and appropriate care, thereby promoting the health of the worker.

Sistema Nervoso Autônomo/fisiopatologia , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/fisiopatologia , Frequência Cardíaca/fisiologia , Adulto , Fatores Etários , Índice de Massa Corporal , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/fisiopatologia , Ocupações , Projetos Piloto , Fatores Socioeconômicos , Taiwan/epidemiologia , Fatores de Tempo , Carga de Trabalho , Adulto Jovem
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 54-61, jan.-dez. 2020. ilus
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1048006


Objetivo: conhecer a percepção dos trabalhadores de enfermagem acerca das cargas de trabalho em uma Unidade de Terapia Intensiva Neonatal. Método: estudo qualitativo com 24 trabalhadores de enfermagem em uma unidade de Terapia Intensiva Neonatal em um hospital universitário, em junho de 2017, por meio de entrevistas semiestruturadas e analisadas por análise textual discursiva. Resultados: verificou-se que os trabalhadores de enfermagem percebem sua exposição às cargas de trabalho e as relacionam com a ocorrência de acidentes e doenças de trabalho. As cargas psíquicas foram as mais representativas no ambiente de trabalho, entretanto, destaca-se a relação identificada pelos trabalhadores entre as cargas químicas e os produtos utilizados na limpeza das incubadoras. Conclusão: o reconhecimento das cargas de trabalho oportuniza a criação de medidas que possam minimizá-las durante a assistência de recém-nascidos em cuidado intensivo, visando à saúde do trabalhador

Objective: the study's purpose has been to know the perception of nursing workers about the workloads in a Neonatal Intensive Care Unit. Method: this is a qualitative study performed with 24 nursing professionals in a Neonatal Intensive Care Unit at a University Hospital, on June 2017, through semi-structured interviews and analyzed through textual discourse analysis. Results: it has been verified that the nursing workers notice their exposition to workloads and relate them with the occurrence of accidents and illnesses at work. The psychic workloads were the most representative in the working environment, however, it is highlighted the relation identified by the workers between the chemical workloads and the products used in the cleaning of incubators. Conclusion: the recognition of workloads makes possible the creation of measures that can minimize them during the assistance to newborns in intensive care, aiming at the workers' health

Objetivo: conocer la percepción de los trabajadores de enfermería acerca de las cargas de trabajo en una Unidad de Terapia Intensiva Neonatal. Método: estudio cualitativo con 24 trabajadores de enfermería en una unidad de Terapia Intensiva Neonatal en un hospital universitario, en junio de 2017, por medio de entrevistas semi-estructuradas y analizadas por análisis textual discursiva. Resultados: se verificó que los trabajadores de enfermería perciben su exposición a las cargas de trabajo y las relacionan con la ocurrencia de accidentes y enfermedades de trabajo. Las cargas psíquicas fueron las más representativas en el ambiente de trabajo, sin embargo, se destaca la relación identificada por los trabajadores entre las cargas químicas y los productos utilizados en la limpieza de las incubadoras. Conclusión: el reconocimiento de las cargas de trabajo proporciona la creación de medidas que puedan minimizarlas durante la asistencia de recién nacidos en cuidado intensivo, objetivando la salud del trabajador

Humanos , Saúde do Trabalhador , Carga de Trabalho , Enfermeiras e Enfermeiros , Brasil , Unidades de Terapia Intensiva Neonatal
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 78-86, jan.-dez. 2020. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1048098


Objetivos: descrever o perfil demográfico dos pacientes, mensurar a carga de trabalho da enfermagem por meio da aplicação do instrumento Nursing Activities Score (NAS) e apresentar o dimensionamento recomendado para a equipe de enfermagem. Método: estudo transversal, prospectivo e descritivo, desenvolvido na unidade de terapia intensiva, com 10 leitos, de um hospital Universitário do Rio de Janeiro entre maio e junho de 2017, tendo 138 avaliações, em 12 pacientes, num total de 20 dias. Resultados: houve predominância do sexo feminino (67%), com idade mediana de 60,5 anos, e tempo de internação em média de 11,58 dias, o percentual do NAS médio observado foi de 76,9%, correspondendo a 18,4 horas de assistência de enfermagem nas 24 horas, com recomendação de no mínimo 10 profissionais de enfermagem por turno, sendo 52% enfermeiros. Conclusão: a aplicação do NAS ajustado às recomendações do Conselho Federal de Enfermagem contribui para o dimensionamento adequado dos profissionais de enfermagem

Objectives: to describe the demographic profile of the patients, to measure the nursing workload through the application of the Nursing Activities Score (NAS) instrument and to present the recommended design for the nursing team. Method: a prospective and descriptive cross-sectional study developed in the intensive care unit with 10 beds, a university hospital in Rio de Janeiro between May and June 2017, with 138 evaluations in 12 patients for a total of 20 days. Results: there was a predominance of females (67%), with a median age of 60.5 years, and an average length of stay of 11.58 days, the percentage of mean NAS observed was 76.9%, corresponding to 18, 4 hours of nursing care in the 24 hours, with recommendation of at least 10 nursing professionals per shift, being 52% nurses. Conclusion: the application of NAS adjusted to the recommendations of the Federal Nursing Council contributes to the adequate dimensioning of nursing professionals

Objetivos: describirel perfil demográfico de los pacientes, medir la carga de trabajo de la enfermería a través de la aplicación del instrumento Nursing Activities Score (NAS) y presentar el dimensionamiento recomendado para el equipo de enfermería. Método: estudio transversal, prospectivo y descriptivo, desarrollado en la unidad de terapia intensiva, con 10 camas, de un hospital Universitario de Río de Janeiro entre mayo y junio de 2017, con 138 evaluaciones, en 12 pacientes, enun total de 20 días. Resultados: hubo predominancia del sexo femenino (67%), con edad mediana de 60,5 años, y tiempo de internación en promedio de 11,58 días, el porcentaje del NAS promedio observado fue del 76,9%, correspondiendo a 18,4 horas de asistencia de enfermería en las 24 horas, con recomendación de por lo menos 10 profesionales de enfermería por turno, siendo 52% enfermeros. Conclusión: la aplicación del NAS ajustado a las recomendaciones del Consejo Federal de Enfermería contribuye al dimensionamiento adecuado de los profesionales de enfermería

Humanos , Carga de Trabalho , Unidades de Terapia Intensiva , Equipe de Enfermagem , Brasil
Int J Radiat Oncol Biol Phys ; 106(1): 37-42, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31229573


PURPOSE: We sought to characterize temporal trends of radiation oncology resident-reported external beam radiation therapy (EBRT) case experience with respect to various disease sites, including trends in stereotactic radiosurgery and stereotactic body radiation therapy cases. METHODS AND MATERIALS: Summarized, deidentified case logs for graduating radiation oncology residents between 2007 and 2018 were obtained from the Accreditation Council for Graduate Medical Education national summary data report. Mean number of cumulative cases and standard deviations per graduating resident by year were evaluated. Cases were subdivided into 12 disease-site categories using the Accreditation Council for Graduate Medical Education classification. Analysis of variance was used to determine significant differences, and strength of association was evaluated using Pearson correlation. RESULTS: The number of graduating residents per year increased by 66% from 114 in 2007 to 189 in 2018 (P < .001, r = 0.88). The overall mean number of EBRT cases per graduating resident decreased by 13.2% from 521.9 in 2007 to 478.5 in 2018, with a decrease in the ratio of nonmetastatic to metastatic cases per graduating resident. There was significant variation among the disease categories analyzed; however, the largest proportionate decreases were seen in hematologic, lung, and genitourinary malignancies. Stereotactic radiosurgery volume per graduating resident increased from an average of 27.9 cases in 2007 to 50.3 in 2018 (P < .001, r = 0.96). Stereotactic body radiation therapy volume per graduating resident increased as well, from a mean of 6 cases in 2007 to 55.6 cases in 2018 (P < .001, r = 0.99). CONCLUSIONS: We report a longitudinal summary of resident-reported experience in EBRT cases. These findings have implications for future efforts to optimize residency training programs and requirements.

Internato e Residência/tendências , Neoplasias/radioterapia , Radioterapia (Especialidade)/tendências , Carga de Trabalho , Análise de Variância , Competência Clínica , Neoplasias Hematológicas/radioterapia , Humanos , Internato e Residência/estatística & dados numéricos , Estudos Longitudinais , Neoplasias Pulmonares/radioterapia , Metástase Neoplásica/radioterapia , Neoplasias/classificação , Radioterapia (Especialidade)/estatística & dados numéricos , Radiocirurgia/estatística & dados numéricos , Radiocirurgia/tendências , Radioterapia/estatística & dados numéricos , Radioterapia/tendências , Estudos Retrospectivos , Fatores de Tempo , Neoplasias Urogenitais/radioterapia , Carga de Trabalho/estatística & dados numéricos
Int J Radiat Oncol Biol Phys ; 106(1): 32-36, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31647968


PURPOSE: Radiation treatment planning (RTP) is a unique skill that requires interdisciplinary collaboration among radiation oncologists (ROs), dosimetrists, and medical physicists (MP) to train and assess residents. With the adoption of competency-based medical education (CBME) in Canada, it is essential residency program curricula focuses on developing competencies in RTP to facilitate entrustment. Our study investigates how radiation oncology team members' perspectives on RTP education align with requirements of the CBME approach, and its implications for improving residency training. METHODS AND MATERIALS: This qualitative research study took place in the Department of Oncology at a midsize academic institution. Through convenience sampling, focus groups were conducted with radiation oncologists (n = 11), dosimetrists (n = 7), medical physicists (n = 7), and residents (n = 7). Thematic design was adopted to analyze the transcripts through open coding resulting in 3 overarching themes. RESULTS: The results identified existing strengths and weaknesses of the residency program and future opportunities to redesign the curriculum and assessment process within a CBME model. Three overarching themes emerged from the analysis: (1) the strengths of RTP in the CBME environment; (2) challenges of RTP in CBME; and (3) opportunities for change. Stakeholders were optimistic CBME will help enrich resident learning with the increased frequency and quality of competency-based assessments. Participants suggested building a library of cases and developing computer-based learning resources to provide a safe environment to develop skills in contouring, dosimetry, and plan evaluation, in accordance with CBME training. CONCLUSIONS: This study identified future opportunities to redesign the RTP curriculum and assessment process within a CBME model. The need for innovative teaching and learning strategies, including case libraries, computer-based learning, and quality assessments, were highlighted in designing an innovative RTP planning curriculum.

Competência Clínica , Educação Baseada em Competências , Internato e Residência , Radioterapia (Especialidade)/educação , Planejamento da Radioterapia Assistida por Computador , Canadá , Competência Clínica/normas , Educação Baseada em Competências/normas , Grupos Focais , Previsões , Humanos , Internato e Residência/normas , Cultura Organizacional , Pesquisa Qualitativa , Radio-Oncologistas , Radioterapia (Especialidade)/normas , Ensino/organização & administração , Carga de Trabalho
Tidsskr Nor Laegeforen ; 139(18)2019 Dec 10.
Artigo em Norueguês, Inglês | MEDLINE | ID: mdl-31823588


BACKGROUND: Increasing the utilisation of unused capacity in hospitals is a health policy goal, but there is concern that little unused capacity remains. The objective of the study was to examine how healthcare personnel experience and deal with pressure on capacity in the somatic specialist health services. MATERIAL AND METHOD: In this qualitative study, we conducted semi-structured interviews with unit heads and doctors and nurses involved in discharging patients in two Norwegian hospital trusts. Nine interviews (both individual and group) with altogether 19 informants were carried out in the period October 2017-February 2018. The interviews were analysed using systematic text condensation. RESULTS: Pressure on hospital capacity was described as continual pressure to treat more patients. The informants used the term 'undercapacity': a situation in which increased demands without sufficient resources were detrimental to something or someone. Elderly patients who had completed their treatment and were waiting for the provision of municipal services were regarded as particularly vulnerable, since they were often overrepresented among the patients moved between departments and wards in order to free up capacity when beds were urgently needed. The hospital staff felt they had little influence on the type of municipal services the patients were offered following discharge. INTERPRETATION: The informants stated that their daily work was negatively affected by undercapacity. Health professionals' perceptions of pressure on hospital capacity constitute vital knowledge in policy formation in the field.

Atitude do Pessoal de Saúde , Pessoal de Saúde , Medicina , Carga de Trabalho , Idoso , Recursos em Saúde , Humanos , Noruega , Recursos Humanos em Hospital/psicologia , Pesquisa Qualitativa
Estud. pesqui. psicol. (Impr.) ; 19(3): 583-603, dez. 2019. tab
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-1045918


O artigo trata de uma investigação realizada em um restaurante universitário, visando identificar relações entre as condições de trabalho e a saúde dos trabalhadores, a partir do referencial teórico e metodológico da ergonomia da atividade. A pesquisa, de natureza qualitativa, apontou a presença de fatores de risco ergonômicos e psicossociais relacionados às exigências da atividade, a carga de trabalho elevada, às dificuldades nas relações socioprofissionais e a forma como as tarefas eram distribuídas. A presença de doenças físicas foi apontada pelos entrevistados como uma das principais repercussões da atividade. As condições contratuais e de gestão também foram apontadas como fatores que afetavam a atividade dos entrevistados. Esses achados corroboram os dados já apresentados pela literatura e evidenciam a importância de um diagnóstico organizacional com foco na saúde do trabalhador que considere o trabalho em todos os seus componentes: condições físicas, contratuais, os processos e características da atividade e as condições sociogerenciais.(AU)

The article addresses an investigation carried out in a university restaurant, aiming to identify relationships between working conditions and workers' health, based on the Activity Ergonomics theoretical and methodological framework. The qualitative research showed the presence of ergonomic and psychosocial risk factors related to the demands of the activity, the high workload, the difficulties in the socio-professional relations and the tasks distribution. The presence of physical illnesses was pointed out by the interviewees as one of the main repercussions of the activity. Contractual and management conditions were also identified as factors that affected the activity of the interviewees. These findings corroborate the data already presented in the literature and show the importance of an organizational diagnosis focused on workers' health that considers work in all its components: physical, contractual conditions, processes and characteristics of the activity and socio-political conditions.(AU)

El artículo trata de una investigación realizada en un restaurante universitario, buscando identificar relaciones entre las condiciones de trabajo y la salud de los trabajadores, a partir del referencial teórico y metodológico de la ergonomía de la actividad. La investigación, de naturaleza cualitativa, apuntó la presencia de factores de riesgo ergonómicos y psicosociales relacionados con las exigencias de la actividad, la carga de trabajo elevada, las dificultades en las relaciones socioprofesionales y la forma en que las tareas eran distribuidas. La presencia de enfermedades físicas fue señalada por los entrevistados como una de las principales repercusiones de la actividad. Las condiciones contractuales y de gestión también fueron apuntadas como factores que afecta la actividad de los entrevistados. Estos hallazgos corroboran los datos ya presentados por la literatura y evidencian la importancia de un diagnóstico organizacional con foco en la salud del trabajador que considere el trabajo en todos sus componentes: condiciones físicas, contractuales, los procesos y características de la actividad y las condiciones sociogenerativas.(AU)

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Condições de Trabalho , Saúde do Trabalhador , Ergonomia , Restaurantes , Carga de Trabalho/psicologia
BMJ ; 367: l6446, 2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31852676


OBJECTIVE: To determine the validity of the superstition that utterance of the word "quiet" in a clinical setting increases workload. DESIGN: Prospective randomised controlled non-inferiority study. SETTING: Microbiology department of a large teaching hospital in Lancashire, UK. PARTICIPANTS: Two members of the medical microbiology team carried out the duty work on any given week day and an on-call team member on any weekend day. 29 days were assigned in which staff were to say "Today will be a quiet day" and 32 days were assigned in which staff were to refrain from saying the word "quiet" in any context. INTERVENTIONS: Each day was randomly allocated to either saying "Today will be a quiet day" (intervention group) or refraining from saying the word "quiet" (control group) in any context. MAIN OUTCOME MEASURES: The primary outcome was mean overall workload: a composite of number of clinically related telephone calls, clinically significant results, or validated results processed by the duty medical microbiology team during a 24 hour period referred to collectively as "clinical episodes." A difference of 30 clinical episodes was considered as the margin of non-inferiority. Secondary outcomes included the individual components of the primary outcome. RESULTS: Workload was measured each day over a 61 day period (1 May to 30 June 2019). A mean 139.0 clinical episodes occurred on control days compared with 144.9 on days when the experimental intervention was uttered, a difference of 5.9 (95% confidence interval-12.9 to 24.7). The upper bound was less than the specified margin of 30, providing evidence for non-inferiority. No evidence of a difference in workload was found between interventions with any of the four components, whether considering unadjusted or adjusted analyses, or looking at the subgroups of week days or weekends. CONCLUSIONS: The study findings refute the long held superstition that utterance of the word "quiet" impacts on clinical workload, and therefore it should not be avoided. In the era of considerable staff shortages and increased work related stress, doctors should look to other methods to increase resilience and protect their wellbeing and mental health. TRIAL REGISTRATION: Lancashire Teaching Hospitals NHS Foundation Trust's research department SE-259.

Pessoal de Saúde/psicologia , Superstições/psicologia , Carga de Trabalho/psicologia , Local de Trabalho/psicologia , Adaptação Psicológica , Adulto , Feminino , Humanos , Linguagem , Masculino , Estudos Prospectivos
Environ Health Prev Med ; 24(1): 64, 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31775617


BACKGROUND: Flourishing, defined as the coexistence of hedonic and eudaimonic well-being, is the most favorable end of the mental health spectrum. A growing body of evidence has demonstrated the association between flourishing mental health and favorable work-related outcomes. However, epidemiology of flourishing mental health is scarce in Japan. Moreover, the relationship between flourishing mental health and occupational stress has not been elaborated. Therefore, the aim of this study was to elucidate (1) the prevalence of flourishing mental health and (2) the association between flourishing mental health and occupational stress among Japanese workers. METHODS: The present survey was conducted in from February to March 2017 via an anonymous, self-administered, and web-based questionnaire among workers in Tsukuba Science City, Japan. Mental Health Continuum Short Form was used to assess flourishing mental health. We performed binomial logistic regression analyses to calculate the adjusted odds ratios (AOR) and 95% confidence intervals (CI) of occupational stress for flourishing mental health, controlling for sociodemographic factors. RESULTS: A total of 7012 respondents (4402 men, 2610 women) were analyzed. The overall prevalence of flourishing mental health among the respondents was 12.4%. Full-time (permanent) workers were less likely to be flourishing. Reward from work (AOR = 2.34, 95% CI = 2.04-2.68), support from colleagues and superiors (AOR = 1.67, 95% CI = 1.44-1.94), and workload (AOR = 1.19, 95% CI = 1.05-1.36) were positively associated with flourishing mental health, whereas mental workload (AOR = 0.65, 95% CI = 0.57-0.75) was inversely associated with flourishing mental health. CONCLUSIONS: The findings of the present study shed light on the association between flourishing mental health and occupational stress.

Saúde Mental , Saúde do Trabalhador , Estresse Ocupacional/psicologia , Local de Trabalho/psicologia , Adulto , Estudos Transversais , Emprego/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Japão/epidemiologia , Masculino , Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Estresse Ocupacional/epidemiologia , Razão de Chances , Prevalência , Carga de Trabalho/psicologia , Adulto Jovem
Artigo em Russo | MEDLINE | ID: mdl-31765544


The publication presents the definition of key terms in pricing, sets out pricing methods, lists the current legal documents on cost indicators in health care. Methodical approaches to the calculation of remuneration, as one of the components of the cost of medical care, involve the use of labor standards of medical workers, differentiated by their participation in the therapeutic and diagnostic process. The analysis of the regulatory framework for labor in health made the need for its revision.

Assistência à Saúde , Pessoal de Saúde , Local de Trabalho , Humanos , Carga de Trabalho , Local de Trabalho/normas
Z Evid Fortbild Qual Gesundhwes ; 147-148: 90-96, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31759889


OBJECTIVE: The aims of the study were the translation and a first reflection of the psychometric properties of the Aeronautics and Space Administration-Task Load Index (NASA-TLX), a multidimensional instrument to measure workload in general practice. METHODS: During April and September 2015, the NASA-TLX was translated and evaluated. For this purpose, a questionnaire composed of the NASA-TLX items and others items related to demographic data, was developed. Postgraduate family medicine trainees and family physicians were then asked to assess patient consultations by applying the questionnaire. The psychometric properties of the NASA-TLX were identified using explorative and confirmatory factor analysis. Reliability was assessed using Cronbach's α. RESULTS: Overall, 16 participants completed 769 surveys after a single patient consultation. The highest average was observed for the item 'mental demand' (mean 6.9 ± 5.4), followed by the item 'effort' (mean 6.6 ± 5.5). Factor analysis revealed a one-factor solution with an explained variance of 56.9 %. The German version of NASA-TLX demonstrated a high internal consistency (Cronbach's α = 0.84). Confirmatory factor analysis showed that there was an acceptable consistency between the expected unidimensional structure and the data. CONCLUSIONS: The German version of NASA-TLX provides preliminary indications of psychometric properties and presents an important tool to evaluate family physicians' workload in direct patient contact.

Medicina Geral , Clínicos Gerais/psicologia , Psicometria , Carga de Trabalho , Medicina de Família e Comunidade , Alemanha , Humanos , Encaminhamento e Consulta , Reprodutibilidade dos Testes , Análise e Desempenho de Tarefas
Nihon Hoshasen Gijutsu Gakkai Zasshi ; 75(11): 1249-1259, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31748450


In recent years, workload has increased with higher precision of radiotherapy. Although both efficiency and thoroughness of treatment are crucial, in such conditions, human error is easy to occur. In this study, five incident cases that occurred in four facilities were studied and analyzed from the viewpoint of human factors that contribute to errors using variation tree analysis. We also analyzed resilience (the ability to return to one's original state even if the system deviates from a stable state), which has attracted attention in recent safety research. There were potential factors represented by patient factors in all cases. These factors caused deviations from standard operations, and incidents occurred due to unfamiliar situations and operations. Furthermore, in four of the five cases, the cause of the incident was a resilience action or judgment that was deemed to have required "some sort of ingenuity or adjustment." It was found that human error occurred due to multiple simultaneous occurrences of potential factors, i.e., patient and human factors such as high workload, impatience, and work interruptions. A reduction in human errors can be achieved by avoiding time pressure and multitasking, creating work environment and working conditions that make resilience work well, revising ambiguous rules and procedures, and promoting standardized working methods.

Radioterapia , Carga de Trabalho , Local de Trabalho , Humanos , Erros Médicos
Methodist Debakey Cardiovasc J ; 15(3): 234-235, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687108


Through the generosity of Charles R. Millikan, DMin, vice president for Spiritual Care and Values Integration, an annual award competition was established at Houston Methodist Hospital among the resident staff. To enter the writing competition, residents must submit a poem or essay of 1,000 words or less on the topic, "On Being a Doctor." A committee of seven was selected from Houston Methodist Hospital Education Institute to establish the judging criteria and select the winning entries. The following is the second-place winning entry for 2019; the third-place entry will be published in the next issue of this journal.

Prestação Integrada de Cuidados de Saúde/organização & administração , Unidade Hospitalar de Ginecologia e Obstetrícia/organização & administração , Médicos/organização & administração , Carga de Trabalho , Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Internato e Residência , Médicos/psicologia , Triagem
BMC Health Serv Res ; 19(1): 812, 2019 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-31699084


BACKGROUND: Human workload is a key factor for system performance, but data on emergency medical services (EMS) are scarce. We investigated paramedics' workload and the influencing factors for non-emergency medical transfers. These missions make up a major part of EMS activities in Germany and are growing steadily in number. METHODS: Paramedics rated missions retrospectively through an online questionnaire. We used the NASA-Task Load Index (TLX) to quantify workload and asked about a variety of medical and procedural aspects for each mission. Teamwork was assessed by the Weller teamwork measurement tool (TMT). With a multiple linear regression model, we identified a set of factors leading to relevant increases or decreases in workload. RESULTS: A total of 194 non-emergency missions were analysed. Global workload was rated low (Mean = 27/100). In summary, 42.8% of missions were rated with a TLX under 20/100. TLX subscales revealed low task demands but a very positive self-perception of performance (Mean = 15/100). Teamwork gained high ratings (Mean TMT = 5.8/7), and good teamwork led to decreases in workload. Aggression events originating from patients and bystanders occurred frequently (n = 25, 12.9%) and increased workload significantly. Other factors affecting workload were the patient's body weight and the transfer of patients with transmittable pathogens. CONCLUSION: The workload during non-emergency medical transfers was low to very low, but performance perception was very positive, and no indicators of task underload were found. We identified several factors that led to workload increases. Future measures should attempt to better train paramedics for aggression incidents, to explore the usefulness of further technical aids in the transfer of obese patients and to reconsider standard operating procedures for missions with transmittable pathogens.

Pessoal Técnico de Saúde , Serviços Médicos de Emergência/estatística & dados numéricos , Carga de Trabalho/estatística & dados numéricos , Adulto , Pessoal Técnico de Saúde/estatística & dados numéricos , Estudos Transversais , Feminino , Alemanha , Pesquisa sobre Serviços de Saúde , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e Questionários , Adulto Jovem
Stomatologiia (Mosk) ; 98(5): 15-19, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31701924


The study of regulatory legal documentation indicates that the labor standards of dentists-orthopedists are not approved at the state level. The current technical-organizational and medical conditions activities of these specialists have led to the need to establish the existing norms of the workload and the development of modern normative documents on work of dentists-orthopedists.

Odontólogos , Carga de Trabalho , Humanos