[Distribution of the nursing workforce in the Region of the AmericasDistribuição de pessoal de enfermagem na Região das Américas]. / Distribución de la fuerza de trabajo en enfermería en la Región de las Américas.

OBJECTIVE: Describe the distribution of the nursing workforce in countries of the Region of the Americas and the relation between the number of human resources in nursing and maternal mortality ratios. METHODS: Descriptive and exploratory analysis of 27 countries of the Region. The variables in the study were the proportion of health professionals per country and subregion; professional category; and nurse-to-physician ratio. The maternal mortality ratio was used as an overall indicator of the health of the population to analyze its relationship to the number of nurses. Frequency distribution and density of human resources in nursing were analyzed per country and subregion. RESULTS: The distribution of nursing personnel was heterogeneous. Some countries had more than 80 nurses per 10 000 population and others had fewer than five professionals per 10 000 population. In 34.1% of the countries, the nurse-to-physician ratio was less than 1. Differences in the distribution of nursing personnel were observed between regions and subregions, and within countries. CONCLUSIONS: In several countries, the number of nurses per capita was less than expected. The majority of the countries showed a significantly lower proportion of licensed nurses with respect to technical and auxiliary personnel. It is necessary to implement initiatives to increase the number of licensed nurses throughout the Region.

OBJETIVO: Descrever a distribuição de pessoal de enfermagem nos países da Região das Américas e estabelecer a relação do número de profissionais de enfermagem com o índice de mortalidade materna. MÉTODOS: Estudo descritivo e exploratório conduzido em 27 países da Região das Américas. As variáveis estudadas foram proporção de profissionais por país e subregião, categoria profissional e relação enfermeiro-médico. O índice de mortalidade materna, por ser um indicador geral de saúde da população, foi usado para analisar a relação com o aspecto quantitativo de enfermeiros. Foram analisadas a distribuição de frequências e a densidade dos profissionais de enfermagem por país e sub-região. RESULTADOS: Verificou-se uma distribuição heterogênea do pessoal de enfermagem, com alguns países com mais de 80 enfermeiros por 10 mil habitantes e outros com menos de cinco profissionais por 10 mil habitantes. Observou-se uma relação enfermeiro-médico inferior a um em 34,1% dos países. Houve diferenças na distribuição de pessoal de enfermagem por região, sub-região e dentro do próprio país. CONCLUSÕES: Em vários países da Região das Américas, o número de enfermeiros por habitantes é menor que o esperado. A maioria dos países tem uma defasagem considerável na razão do número de enfermeiros licenciados em relação ao pessoal de enfermagem técnico e auxiliar. É necessário implementar iniciativas para aumentar o número de enfermeiros licenciados em toda a Região.

Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization.

OBJECTIVE: To estimate the cost of hospitalization of patients with severe sepsis or septic shock admitted or diagnosed in the Urgent and Emergency sector at a university hospital and followed until the clinical outcome. METHOD: An epidemiological, prospective, observational study conducted in a public hospital in southern Brazil for the period of one year (August 2013 to August 2014). Sepsis notification forms, medical records and data of the cost sector were used for the collection of clinical and epidemiological data. RESULTS: The sample comprised 95 patients, resulting in a total high cost of hospitalization (R$ 3,692,421.00), and an average of R$ 38,867.60 per patient. Over half of the total value of the treatment of sepsis (R$ 2,215,773.50) was assigned to patients who progressed to death (59.0%). The higher costs were related to discharge, diagnosis of severe sepsis, the pulmonary focus of infection and the age group of up to 59 years. CONCLUSION: The high cost of the treatment of sepsis justifies investments in training actions and institution of protocols that can direct preventive actions, and optimize diagnosis and treatment in infected and septic patients. OBJETIVO: Estimar o custo da internação de pacientes com sepse grave ou choque séptico admitidos ou diagnosticados no setor de Urgências e Emergências de um hospital universitário e seguidos até o desfecho clínico. MÉTODO: Estudo epidemiológico, prospectivo e observacional, realizado em um hospital público do sul do Brasil, no período de 1 ano (agosto de 2013 a agosto de 2014). A coleta dos dados clínico-epidemiológicos utilizou fichas de notificação de sepse, prontuários e dados do setor de custos. Foi realizada análise de tendência central, dispersão e quartis dos custos das internações. RESULTADOS: Amostra composta por 95 pacientes que totalizaram elevado custo da internação (R$ 3.692.421,00), com média de R$ 38.867,60 por paciente. Mais da metade do valor total do tratamento da sepse (R$ 2.215.773,50) destinou-se a pacientes que evoluíram a óbito (59,0%). Os maiores custos foram relacionados à alta, ao diagnóstico de sepse grave, ao foco infeccioso pulmonar e à faixa etária até os 59 anos. CONCLUSÃO: O elevado custo com o tratamento da sepse justificam investimentos em ações de capacitação e instituição de protocolos que possam direcionar ações preventivas, otimizar o diagnóstico e a terapêutica em pacientes infectados e séptico.

Factors associated with work activity of technical-administrative staff from state universities retired due to disability.

OBJECTIVE: To verify the factors associated with the type of work activity performed by university technical-administrative staff retired due to disability. METHOD: Cross-sectional research with 68 workers, conducted using an electronic questionnaire between November 2019 and September 2020. Data were collected on sociodemographic, occupational characterization and causes of disability. Data were analyzed descriptively and by multiple logistic regressions. RESULTS: Health professionals were more likely to have mental and behavioral disorders, associated with females and regardless of age. The chances of the nervous system diseases were higher in workers who performed administrative work, being associated with higher education. Operational employees were more likely to have musculoskeletal diseases associated with primary and secondary education and were male, regardless of age. CONCLUSION: There was an association between work activity performed before retirement and the diseases responsible for disability, with differences between gender, age, and educational levels.

Quality of life and factors associated among public university employees retired due to disabilities.

OBJECTIVE: to analyze quality of life and factors associated among public university employees retired due to disabilities. METHOD: a cross-sectional study conducted with a sample of public university employees retired due to disabilities. A characterization questionnaire and the World Health Organization Quality of Life - Disabilities instrument were applied via telephone or online contacts from November 2019 to September 2020. The associated factors were verified through multiple linear regression. RESULTS: of the 80 retirees due to disability, 15% were professors and 85% had a technical-administrative career. As for the factors associated with Quality of Life, continuous medication use (ßadj: -0.25; p=0.02) and problems in the nervous system (ßadj: -0.21; p<0.05) were associated with the Overall domain; continuous medication use (ßadj: -0.23; p=0.04), to the Physical domain; smoking (ßadj: -0.21; p<0.05) and mental and behavioral disorders (ßadj: -0.21; p<0.01), to the Psychological domain; smoking (ßadj: -0.46; p<0.01) and respiratory (ßadj: -0.21; p=0.03) and circulatory (ßadj: -0.21; p=0.03) problems, to the Social domain; smoking (ßadj: -0.33; p<0.01) and problems in the nervous system (ßadj: -0.22; p=0.04), to the Environmental domain; mental and behavioral disorders, to the Disabilities module (ßadj: -0.29; p<0.01) and to the Discrimination domain (ßadj: -0.21; p<0.05); and smoking (ßadj: -0.32; p<0.01) and problems in the nervous system (ßadj: -0.20; p<0.05), to the Inclusion domain. The Autonomy domain did not present any association. CONCLUSION: the retirees under study presented impaired Quality of Life.

Burnout syndrome and workplace violence among nursing staff: a cross-sectional study.

BACKGROUND: Among healthcare professionals, nursing workers are the most prone to becoming victims of workplace violence and present the highest burnout levels. OBJECTIVES: To investigate the association between burnout syndrome and workplace violence among nursing workers. DESIGN AND SETTING: Cross-sectional study carried out at a teaching hospital in southern Brazil. METHODS: This study involved 242 nursing workers. We collected data over a six-month period using a sociodemographic and occupational survey, the Survey Questionnaire Workplace Violence in the Health Sector and the Maslach Burnout Inventory - General Survey. For occupational violence, we selected the Survey Questionnaire Workplace Violence in the Health Sector. Burnout syndrome was evaluated using the Maslach Burnout Inventory - General Survey. The data were analyzed in the Statistical Package for the Social Sciences (SPSS). Categorical variables were described as absolute and relative frequencies and numerical variables in terms of central trend and dispersion measurements. For data analysis, we applied descriptive statistics and multiple logistic regression. RESULTS: The multiple models indicated that the workers who had experienced verbal abuse, physical violence and concern about workplace violence over the past 12 months had significantly higher chances of presenting high emotional exhaustion (P < 0.05) and depersonalization (P < 0.05) and low professional accomplishment (P < 0.05). CONCLUSION: Occurrence of violence significantly increased the chances of great emotional exhaustion and depersonalization and low professional achievement, within burnout syndrome. Therefore, workplace violence prevention strategies need to be put in place to provide workers with a safe workplace in which to conduct their activities.

Workaholism and burnout among stricto sensu graduate professors.

OBJECTIVE: To analyze the association of excessive work and compulsive work with the dimensions of the burnout syndrome in masters and doctoral professors of Languages, Literature, and Linguistics in Brazil. METHODS: Cross-sectional study carried out with 585 permanent professors of stricto sensu graduate studies in Languages, Literature, and Linguistics in Brazil. Data collection took place between February and August 2019, by an online questionnaire. The outcomes of this study were the compulsive work and excessive work dimensions of the Dutch Work Addiction Scale, the Maslach Burnout Inventory TM dimensions and their associated factors, identified by multiple logistic regression models. RESULTS: Professors with a high level of excessive work (29.40%) had 2.75 times the chance of high emotional exhaustion and 2.08 times the chance of high depersonalization. Regarding professors with a high level of compulsive work (8.03%), they had 4.88 times the chance of high emotional exhaustion and 2.97 times the chance of high depersonalization. No association of excessive work and compulsive work with low professional fulfillment was identified. CONCLUSION: The results showed a statistically significant association of excessive work and compulsive work with high emotional exhaustion and high depersonalization, allowing managers and professors to reflect the criteria that guide their work processes, to adopt management models, institutional regulatory policies, and strategies to improve the working conditions and health of professors.

Associated factors of professional burnout among faculty members of graduate stricto sensu programs in language teaching and linguistics: a cross-sectional study.

BACKGROUND: The burnout syndrome can be avoided and/or have its signs and symptoms reduced by knowing the five associated factors that help identify the health and working conditions of the professors of graduate programs. OBJECTIVE: To analyze the factors associated with burnout among faculty members of graduate stricto sensu programs. DESIGN AND SETTING: A cross-sectional study was conducted among 585 faculty members of Graduate Programs in Language Teaching and Linguistics in Brazil. METHODS: Data were collected through an online questionnaire. The outcomes were the dimensions of burnout and its related factors identified through multiple templates of logistic regression. RESULTS: Faculty members with increased chances of emotional exhaustion and depersonalization mentioned the use of medications due to labor activities. The negative influence of pace and intensity of work, thoughts about quitting the program, and having to produce three or more scientific articles were associated with higher chances of emotional exhaustion, while having to achieve nine hours per week in undergraduate programs was related to reduced personal accomplishment. Having a conjugal relationship, satisfaction with health and work, post-doctoral degree, autonomy, and good interpersonal relationships with faculty members of the program reduced the chances of emotional exhaustion. Reduced chances of depersonalization occurred among those who were satisfied with work, had good interpersonal relationships with advisees and faculty members, and received productivity funding. CONCLUSION: Sociodemographic, health, and occupational factors related to the dimensions of burnout were identified.

Internal Regulation Center in hospitals: Repercussions of its implementation on the health services' indicators. / Núcleo Interno de Regulação hospitalar: repercussões da implantação nos indicadores dos serviços de saúde.

OBJECTIVE: To evaluate the hospital indicators and their repercussions on the number of monthly admissions to a public university hospital, before and after implementing the Internal Regulation Center. METHOD: An evaluative research study, of the Case Study type, developed in a public university hospital. A total of 28 indicators related to structure, production, productivity and quality were measured, which are part of internal Benchmarking. The data were analyzed by means of descriptive statistics and multiple regression to identify the independent factors and those associated with the number of monthly hospitalizations with 95% confidence intervals. RESULTS: Implementation of the Center significantly increased (p<0.001) the number of discharges, the bed utilization factor and the bed renewal rate, emergency hospitalization, bed occupancy percentage, surgical procedures performed and the patient-day mean value (p=0.027). There was a reduction (p<0.001) in the number of visits to the medical, obstetric and orthopedic emergency room, in the rates of in-hospital infection and infant mortality, as well as a mean reduction of 0.81/day, approximately one day less of hospitalization per patient, or a gain of 40 available beds per month. CONCLUSION: Although the number of available beds was lower in the post-implementation period, the bed replacement interval was reduced, representing an increase of 40 more beds per month due to the reduction in the patients' length of stay in the institution.

Workaholism among stricto sensu graduate nursing professors in Brazil.

OBJECTIVE: to identify the prevalence and factors associated with workaholism among stricto sensu graduate nursing professors. METHOD: a cross-sectional study with 333 professors of master's/doctorate degrees from 47 Brazilian public universities. Participants answered a characterization questionnaire and the Dutch Work Addiction Scale, which were analyzed descriptively and by multiple logistic regression. RESULTS: the prevalence of workaholism was 10.5%. The factors associated with the dimensions of workaholism were: having a marital relationship, being dissatisfied with work and sleep, indicating low ability to concentrate and few leisure opportunities, belonging to Graduate Programs with grades 3, 4 and 5, receiving a research productivity grant, considering the influence of work on life as negative, showing difficulty in combining work with personal life, to present work-related anxiety, feel pressure for scientific publishing, elaborate more than 11 articles simultaneously, give more than 21 opinions in the last year, work an extra 11 hours a week in addition to the work schedule and dedicate less than 10 hours a week to graduate school. CONCLUSION: there is an indication of workaholism in the investigated professors, and the associated factors were related to working conditions and requirements. Universities must adhere to management models that include occupational health promotion.

Hospitalization costs and their determining factors among patients undergoing kidney transplantation: a cross-sectional descriptive study.

BACKGROUND: Cost evaluation is a key tool in monitoring expenditure for budget management. It increases the efficiency of possible changes through identifying potential savings and estimating the resources required to make such changes. However, there is a lack of knowledge of the total cost of hospitalization up to the clinical outcome, regarding patients admitted for kidney transplantation. Likewise, there is a lack of data on the factors that influence the amounts spent by hospital institutions and healthcare systems. OBJECTIVES: To describe the costs and determining factors relating to hospitalization of patients undergoing kidney transplantation. DESIGN AND SETTING: Cross-sectional descriptive study with a quantitative approach based on secondary data from 81 patients who were admitted for kidney transplantation at a leading transplantation center in southern Brazil. METHODS: The direct costs of healthcare for patients who underwent kidney transplantation were the dependent variable, and included personnel, expenses, third-party services, materials and medicines. The factors that interfered in the cost of the procedure were indirect variables. The items that made up these variables were gathered from the records of the internal transplantation committee and from the electronic medical records. The billing sector provided information on the direct costs per patient. RESULTS: The estimated total cost of patients' hospitalization was R$ 1,257,639.11 (US$ 571,010.44). Out of this amount, R$ 1,237,338.31 (US$ 561,793.20) was paid by the Brazilian National Health System and R$ 20,300.80 (US$ 9,217.24) by the transplantation center's own resources. The highest costs related to the length of hospital stay and clinical complications such as sepsis and pneumonia. CONCLUSIONS: The costs of hospitalization for kidney transplantation relate to the length of hospital stay and clinical complications.

Factors associated with work activity of technical-administrative staff from state universities retired due to disability / Factoresasociados a laactividad laboral de técnicos-administrativos de universidades estatales jubilados por invalidez / Fatores associados à atividade laboral de técnico-administrativos de universidades estaduais aposentados por invalidez

ABSTRACT Objective: To verify the factors associated with the type of work activity performed by university technical-administrative staff retired due to disability. Method: Cross-sectional research with 68 workers, conducted using an electronic questionnaire between November 2019 and September 2020. Data were collected on sociodemographic, occupational characterization and causes of disability. Data were analyzed descriptively and by multiple logistic regressions. Results: Health professionals were more likely to have mental and behavioral disorders, associated with females and regardless of age. The chances of the nervous system diseases were higher in workers who performed administrative work, being associated with higher education. Operational employees were more likely to have musculoskeletal diseases associated with primary and secondary education and were male, regardless of age. Conclusion: There was an association between work activity performed before retirement and the diseases responsible for disability, with differences between gender, age, and educational levels.

RESUMEN Objetivo: Verificar los factores asociados al tipo de trabajo desempeñado por trabajadores universitarios técnico-administrativos jubilados por invalidez. Método: Studio transversal con 68 trabajadores, realizada mediante cuestionario electrónico entre noviembre de 2019 y septiembre de 2020. Se recolectaron datos sociodemográficos, ocupacionales y causas de discapacidad. Los datos se analizaron de forma descriptiva y mediante regresiones logísticas múltiples. Resultados: Los profesionales de la salud tenían mayor probabilidad de presentar trastornos mentales y del comportamiento, asociados al sexo femenino e independientemente de la edad. Las posibilidades de enfermedades del sistema nervioso fueron mayores en los trabajadores que realizaban labores administrativas. Los servidores operativos tenían más probabilidades de tener enfermedades musculoesqueléticas asociadas a la educación primaria y secundaria y eran del sexo masculino, independientemente de la edad. Conclusión: Hubo asociación entre el trabajo realizado antes de la jubilación y las enfermedades responsables de la invalidez, con diferencias entre sexo, edad y nivel educativo.

RESUMO Objetivo: Verificar os fatores associados ao tipo de atividade laboral exercida por trabalhadores técnico-administrativos universitários aposentados por invalidez. Método: Pesquisa transversal com 68 trabalhadores, realizada por meio de questionário eletrônico entre novembro de 2019 e setembro de 2020. Foram coletados dados sobre a caracterização sociodemográfica, ocupacional e causas da invalidez. Os dados foram analisados descritivamente e por regressões logísticas múltiplas. Resultados: Os profissionais da saúde tiveram mais chances de apresentarem os transtornos mentais e comportamentais, associados ao sexo feminino e independentemente da idade. As chances de doenças do sistema nervoso foram maiores em trabalhadores que exerceram trabalho administrativo, sendo associadas ao ensino superior. Servidores operacionais apresentaram maiores chances de doenças osteomusculares associadas ao ensino fundamental e médio e ao sexo masculino, independentemente da idade. Conclusão: Houve associação da atividade laboral exercida anteriormente à aposentadoria com as doenças responsáveis pela invalidez, com diferenças entre sexo, idade e níveis educacionais.

Quality of life and factors associated among public university employees retired due to disabilities / Qualidade de vida e fatores associados entre servidores aposentados por invalidez de universidades públicas / Calidad de vida y factores asociados de empleados jubilados por invalidez de universidades públicas

Abstract Objective: to analyze quality of life and factors associated among public university employees retired due to disabilities. Method: a cross-sectional study conducted with a sample of public university employees retired due to disabilities. A characterization questionnaire and the World Health Organization Quality of Life - Disabilities instrument were applied via telephone or online contacts from November 2019 to September 2020. The associated factors were verified through multiple linear regression. Results: of the 80 retirees due to disability, 15% were professors and 85% had a technical-administrative career. As for the factors associated with Quality of Life, continuous medication use (βadj: -0.25; p=0.02) and problems in the nervous system (βadj: -0.21; p<0.05) were associated with the Overall domain; continuous medication use (βadj: -0.23; p=0.04), to the Physical domain; smoking (βadj: -0.21; p<0.05) and mental and behavioral disorders (βadj: -0.21; p<0.01), to the Psychological domain; smoking (βadj: -0.46; p<0.01) and respiratory (βadj: -0.21; p=0.03) and circulatory (βadj: -0.21; p=0.03) problems, to the Social domain; smoking (βadj: -0.33; p<0.01) and problems in the nervous system (βadj: -0.22; p=0.04), to the Environmental domain; mental and behavioral disorders, to the Disabilities module (βadj: -0.29; p<0.01) and to the Discrimination domain (βadj: -0.21; p<0.05); and smoking (βadj: -0.32; p<0.01) and problems in the nervous system (βadj: -0.20; p<0.05), to the Inclusion domain. The Autonomy domain did not present any association. Conclusion: the retirees under study presented impaired Quality of Life.

Resumo Objetivo: analisar a qualidade de vida e os fatores associados entre servidores de universidades públicas aposentados por invalidez. Método: estudo transversal, com amostra de servidores aposentados por invalidez de universidades públicas. Um questionário de caracterização e o World Health Organization Quality of Life - Disabilities foram aplicados por contato telefônico ou online no período de novembro de 2019 a setembro de 2020. Verificaram-se os fatores associados por regressão linear múltipla. Resultados: dos 80 aposentados por invalidez, 15% eram docentes e 85% da carreira técnica-administrativa. Quanto aos fatores associados à qualidade de vida, o uso de medicação contínua (βaj: -0,25; p=0,02) e os problemas do sistema nervoso (βaj: -0,21; p<0,05) associaram-se ao domínio Overall; o uso de medicação contínua (βaj: -0,23; p=0,04) ao domínio físico; o tabagismo (βaj: -0,21; p<0,05) e os transtornos mentais e comportamentais (βaj: -0,21; p<0,01) ao domínio psicológico; o tabagismo (βaj: -0,46; p<0,01), os problemas respiratórios (βaj: -0,21; p=0,03) e circulatórios (βaj: -0,21; p=0,03) ao domínio social; o tabagismo (βaj: -0,33; p<0,01) e os problemas do sistema nervoso (βaj: -0,22; p=0,04) ao domínio ambiental; os transtornos mentais e comportamentais ao módulo incapacidades (βaj: -0,29; p<0,01) e ao domínio discriminação (βaj: -0,21; p<0,05); o tabagismo (βaj: -0,32; p<0,01) e os problemas do sistema nervoso (βaj: -0,20; p<0,05) ao domínio inclusão. O domínio autonomia não apresentou associação. Conclusão: os aposentados estudados apresentaram uma qualidade de vida prejudicada.

Resumen Objetivo: analizar la calidad de vida y los factores asociados de empleados de universidades públicas jubilados por invalidez. Método: estudio transversal, con una muestra de trabajadores jubilados por invalidez de universidades públicas. Se aplicó un cuestionario de caracterización y el World Health Organization Quality of Life - Disabilities mediante contacto telefónico u online desde noviembre de 2019 hasta septiembre de 2020. Los factores asociados se verificaron mediante regresión lineal múltiple. Resultados: de los 80 jubilados por invalidez, el 15% era docente y el 85% era técnico-administrativo. En cuanto a los factores asociados a la calidad de vida, el uso continuo de medicamentos (βaj: -0,25; p=0,02) y los problemas del sistema nervioso (βaj: -0,21; p<0,05) se asociaron al dominio overall; el uso continuo de medicamentos (βaj: -0,23; p=0,04) el dominio físico; el tabaquismo (βaj: -0,21; p<0,05) y los trastornos mentales y conductuales (βaj: -0,21; p<0,01) al dominio psicológico; el tabaquismo (βaj: -0,46; p<0,01), los problemas respiratorios (βaj: -0,21; p=0,03) y circulatorios (βaj:-0,21;p=0,03) al dominio social; el tabaquismo (βaj: -0,33; p<0,01) y los problemas del sistema nervioso (βaj: -0,22; p=0,04) al dominio ambiental; los trastornos mentales y conductuales al módulo discapacidad (βaj: -0,29; p<0,01) y al dominio discriminación (βaj: -0,21; p<0,05); el tabaquismo (βaj: -0,32; p<0,01) y los problemas del sistema nervioso (βaj: -0,20; p<0,05) al dominio inclusión. El dominio autonomía no mostró asociación. Conclusión: la calidad de vida de los jubilados por invalidez que participaron del estudio estaba deteriorada.

Associated factors of professional burnout among faculty members of graduate stricto sensu programs in language teaching and linguistics: a cross-sectional study

Abstract BACKGROUND: The burnout syndrome can be avoided and/or have its signs and symptoms reduced by knowing the five associated factors that help identify the health and working conditions of the professors of graduate programs. OBJECTIVE: To analyze the factors associated with burnout among faculty members of graduate stricto sensu programs. DESIGN AND SETTING: A cross-sectional study was conducted among 585 faculty members of Graduate Programs in Language Teaching and Linguistics in Brazil. METHODS: Data were collected through an online questionnaire. The outcomes were the dimensions of burnout and its related factors identified through multiple templates of logistic regression. RESULTS: Faculty members with increased chances of emotional exhaustion and depersonalization mentioned the use of medications due to labor activities. The negative influence of pace and intensity of work, thoughts about quitting the program, and having to produce three or more scientific articles were associated with higher chances of emotional exhaustion, while having to achieve nine hours per week in undergraduate programs was related to reduced personal accomplishment. Having a conjugal relationship, satisfaction with health and work, post-doctoral degree, autonomy, and good interpersonal relationships with faculty members of the program reduced the chances of emotional exhaustion. Reduced chances of depersonalization occurred among those who were satisfied with work, had good interpersonal relationships with advisees and faculty members, and received productivity funding. CONCLUSION: Sociodemographic, health, and occupational factors related to the dimensions of burnout were identified.

Burnout syndrome and workplace violence among nursing staff: a cross-sectional study

ABSTRACT BACKGROUND: Among healthcare professionals, nursing workers are the most prone to becoming victims of workplace violence and present the highest burnout levels. OBJECTIVES: To investigate the association between burnout syndrome and workplace violence among nursing workers. DESIGN AND SETTING: Cross-sectional study carried out at a teaching hospital in southern Brazil. METHODS: This study involved 242 nursing workers. We collected data over a six-month period using a sociodemographic and occupational survey, the Survey Questionnaire Workplace Violence in the Health Sector and the Maslach Burnout Inventory - General Survey. For occupational violence, we selected the Survey Questionnaire Workplace Violence in the Health Sector. Burnout syndrome was evaluated using the Maslach Burnout Inventory - General Survey. The data were analyzed in the Statistical Package for the Social Sciences (SPSS). Categorical variables were described as absolute and relative frequencies and numerical variables in terms of central trend and dispersion measurements. For data analysis, we applied descriptive statistics and multiple logistic regression. RESULTS: The multiple models indicated that the workers who had experienced verbal abuse, physical violence and concern about workplace violence over the past 12 months had significantly higher chances of presenting high emotional exhaustion (P < 0.05) and depersonalization (P < 0.05) and low professional accomplishment (P < 0.05). CONCLUSION: Occurrence of violence significantly increased the chances of great emotional exhaustion and depersonalization and low professional achievement, within burnout syndrome. Therefore, workplace violence prevention strategies need to be put in place to provide workers with a safe workplace in which to conduct their activities.

Via aérea avançada: sentimentos vivenciados por pacientes na pré e pós extubação endotraqueal / Advanced airway: feelings experienced by patients in pre and post endotracheal extubation / Vía aérea avanzada: sentimientos experimentados por pacientes en pre ypost extubación endotraqueal

Objetivo: desvelar os sentimentos vivenciados por pacientes internados em um pronto socorro no período pré e pós extubação endotraqueal.Métodos:pesquisa qualitativa desenvolvida com pacientes de um Hospital Universitário do Estado do Paraná, no primeiro semestre de 2017. A coleta de dados se deu por meio de sete entrevistas semiestruturadas, que foram submetidas a análisede conteúdo temática. Resultados: identificaram-se quatro categorias temáticas que desvelaram sentimentos de uma experiência traumática pela dor, falta de diálogo, desconhecimento do profissional que estava prestando os cuidados, dificuldade de comunicação e angústia. Considerações finais: torna-se importante humanizar a assistência de maneira a perceber que o paciente não é mais um corpo doente e, sim, um ser humano holístico que deve ser atendido para além dos procedimentos meramente técnicos.

Objective: to reveal the feelings experienced by patients hospitalized in an emergency room in the period before and after endotracheal extubation. Methods:qualitative research developed with patients at a University Hospital in the State of Paraná, in the first half of 2017. Data collection took place through seven semi-structured interviews, which were subjected to thematic content analysis. Results:four thematic categories were identified that revealed feelings of a traumatic experience due to pain, lack of dialogue, lack of knowledge of the professional who was providing care, communication difficulties and anguish. Final considerations:it is important to humanize care in order to realize that the patient is no longer a sick body, but a holistic human being who must be attended to beyond merely technical procedures.

Objetivo: revelar los sentimientos experimentados por pacientes hospitalizados en una sala de urgencias en el período pre y post extubación endotraqueal. Métodos:investigación cualitativa desarrollada con pacientes de un Hospital Universitario del Estado de Paraná, en el primer semestre de 2017. La recolección de datos ocurrió a través de siete entrevistas semiestructuradas, que fueron sometidas a análisis de contenido temático. Resultados:se identificaron cuatro categorías temáticas que revelaron sentimientos de una experiencia traumática por dolor, falta de diálogo, desconocimiento del profesional que atendía, dificultades de comunicación y angustia. Consideraciones finales:es importante humanizar el cuidado para comprender que el paciente ya no es un cuerpo enfermo, sino un ser humano holístico que debe ser atendido más allá de procedimientos meramente técnicos.

Workaholism and burnout among stricto sensu graduate professors / Workaholism e burnout entre docentes de pós-graduação stricto sensu

ABSTRACT OBJECTIVE To analyze the association of excessive work and compulsive work with the dimensions of the burnout syndrome in masters and doctoral professors of Languages, Literature, and Linguistics in Brazil. METHODS Cross-sectional study carried out with 585 permanent professors of stricto sensu graduate studies in Languages, Literature, and Linguistics in Brazil. Data collection took place between February and August 2019, by an online questionnaire. The outcomes of this study were the compulsive work and excessive work dimensions of the Dutch Work Addiction Scale, the Maslach Burnout Inventory TM dimensions and their associated factors, identified by multiple logistic regression models. RESULTS Professors with a high level of excessive work (29.40%) had 2.75 times the chance of high emotional exhaustion and 2.08 times the chance of high depersonalization. Regarding professors with a high level of compulsive work (8.03%), they had 4.88 times the chance of high emotional exhaustion and 2.97 times the chance of high depersonalization. No association of excessive work and compulsive work with low professional fulfillment was identified. CONCLUSION The results showed a statistically significant association of excessive work and compulsive work with high emotional exhaustion and high depersonalization, allowing managers and professors to reflect the criteria that guide their work processes, to adopt management models, institutional regulatory policies, and strategies to improve the working conditions and health of professors.

RESUMO OBJETIVO Analisar a associação entre trabalho excessivo e trabalho compulsivo com as dimensões da síndrome de burnout em docentes de mestrado e doutorado em Letras e Linguística do Brasil. MÉTODOS Estudo transversal realizado com 585 docentes permanentes de pós-graduação stricto sensu em Letras e Linguística do Brasil. A obtenção dos dados ocorreu entre fevereiro e agosto de 2019, por meio de um questionário online. Os desfechos deste estudo foram as dimensões trabalho compulsivo e trabalho excessivo da escala Dutch Work Addiction Scale, as dimensões da Maslach Burnout Inventory TM e seus fatores associados, identificados por modelos múltiplos de regressão logística. RESULTADOS Docentes com alto nível de trabalho excessivo (29,40%) apresentaram 2,75 vezes a chance de exaustão emocional alta e 2,08 vezes a chance de despersonalização alta. Quanto aos docentes com alto nível de trabalho compulsivo (8,03%), apresentaram 4,88 vezes a chance de exaustão emocional alta e 2,97 vezes a chance de despersonalização alta. Não foi identificado associação entre trabalho excessivo e trabalho compulsivo com a baixa realização profissional. CONCLUSÃO Os resultados mostraram que existe uma associação estatisticamente significativa entre trabalho excessivo e trabalho compulsivo com exaustão emocional alta e despersonalização alta, possibilitando aos gestores e docentes refletirem os critérios que norteiam seus processos laborais, a fim de adotarem modelos de gestão, políticas reguladoras institucionais e estratégias adequadas para melhorar as condições de trabalho e saúde dos docentes.

Sepse entre potenciais doadores de órgãos para transplante: prevalência e fatores associados / Sepsis among potential organ donors for transplantation: prevalence and associated factors / Sepsis entre potenciales donantes de órganos para trasplante: prevalencia y factores asociados

Objetivo: Identificar a prevalência de sepse e os fatores associados entre potenciais doadores de órgãos para transplante. Métodos: Estudo transversal realizado com 7.383 relatórios de óbitos notificados por 16 instituições hospitalares da Macrorregional Norte do Paraná em 2015. Os dados foram analisados por estatística descritiva e regressão logística múltipla. Resultados: Entre os 3.806 potenciais doadores de órgãos para transplante, a prevalência de sepse foi de 30,8%, dos quais nenhum se tornou doador efetivo. Os fatores associados foram: idade menor que 64 anos (p=0,047), óbitos por parada cardiorrespiratória (p<0,001), notificados nas unidades de terapia intensiva (p<0,001), em hospitais públicos (p=0,015) e filantrópicos (p<0,001), sobretudo nos centros transplantadores (p=0,016). Conclusão: Identificou-se alta prevalência da sepse entre os potenciais doadores de órgãos. A sepse esteve associada às características clínicas e institucionais. (AU)

Objective: To identify the prevalence of sepsis and associated factors among potential organ transplant donors. Methods: Cross-sectional study with 7,383 reports of deaths notified by 16 hospital institutions in the Northern Macroregion of Paraná in 2015. Data were analyzed using descriptive statistics and multiple logistic regression. Results: Among the 3,806 potential organ donors for transplantation, the prevalence of sepsis was 30.8%, of which none became an effective donor. The associated factors were: age under 64 years (p=0.047), deaths from cardiopulmonary arrest (p<0.001), reported in intensive care units (p<0.001), in public hospitals (p=0.015) and philanthropic hospitals (p <0.001), especially in transplant centers (p=0.016). Conclusion: A high prevalence of sepsis was identified among potential organ donors, which was associated with clinical and institutional characteristics. (AU)

Objetivo: Identificar la prevalencia de sepsis y factores asociados entre posibles donantes de órganos para trasplante. Métodos: Estudio transversal realizado con 7.383 reportes de defunciones notificadas por 16 instituciones hospitalarias de la Macro Región Norte del estado do Paraná en 2015. Los datos fueron analizados mediante estadística descriptiva y regresión logística múltiple. Resultados: Entre los 3.806 potenciales donantes de órganos para trasplante, la prevalencia de sepsis fue del 30,8%, de los cuales ninguno se convirtió en donante efectivo. Los factores asociados fueron: edad menor de 64 años (p = 0.047), muertes por parada cardiopulmonar (p <0.001), reportadas en unidades de cuidados intensivos (p <0.001), en hospitales públicos (p = 0.015) y hospitales filantrópicos (p < 0,001), especialmente en centros de trasplante (p = 0,016). Conclusión: Una alta prevalencia de sepsis fue identificada entre los potenciales donantes de órganos, la cual se asoció con características clínicas e institucionales. (AU)

Violência laboral contra professores da rede pública de nível fundamental e médio / Workplace violence against teachers of public elementar and high schools

O presente estudo teve por objetivo identificar a prevalência da violência laboral perpetrada contra professores da rede pública de nível fundamental e médio. Trata-se de um estudo transversal com dados coletados entre julho de 2018 e fevereiro de 2019, com 200 professores de 18 escolas públicas urbanas, de um município do interior do estado do Paraná, Brasil. Análises descritivas e inferenciais foram realizadas e razões de prevalência (RP) calculadas. A prevalência de atos violentos físicos e verbais foi de 3% e 28%, respectivamente, sendo cometidos principalmente por alunos do sexo masculino. A violência verbal foi mais frequente contra professores do sexo masculino (p=0,021; RP=1,12) e com mais de 40 anos (p=0,034; RP=1,10), ocorreu mais de três vezes no último ano, dentro da instituição e configurou-se em experiências que geraram perda da satisfação com o trabalho, permeadas por sentimento de injustiça e impotência. Pode-se concluir que os professores sofreram violência laboral de natureza física e verbal nos ambientes educacionais. (AU)

The objective of the present study is to identify theprevalence of workplace violence against teachers in public elementary and high schools. This is a cross-sectional study with data collected from July 2018 to February 2019, with 200 teachers from 18 urban public schools, in a municipality located in the center-west of the state of Paraná, Brazil. Descriptive and inferential analyses were performed, and prevalence ratios (PR) were calculated. The prevalence of physical and verbal violent acts was 3% and 28%, respectively, and male students were the main agents. Verbal violence was more frequent against male teachers (p=0.021; PR=1.12) and those over 40 years old (p=0.034; PR=1.10), it occurred more than three times in the past year, within the educational environment and were events that resulted in loss of professional satisfaction associated with feelings of injustice and powerlessness. The study concluded that teachers suffered physical and verbal workplace violence in educational environments.(AU)

Núcleo Interno de Regulação hospitalar: repercussões da implantação nos indicadores dos serviços de saúde / Internal Regulation Center in hospitals: Repercussions of its implementation on the health services' indicators / Centro Interno de Regulación hospitalaria: repercusiones de la implantación en los indicadores de los servicios de salud

Resumo Objetivo Avaliar os indicadores hospitalares e suas repercussões, antes e após a implantação do Núcleo Interno de Regulação, no número de internações mensais em hospital universitário público. Método Pesquisa avaliativa, do tipo Estudo de Caso desenvolvida em hospital universitário público. Foram mensurados 28 indicadores relacionados à estrutura, produção, produtividade e qualidade, que integram o referencial de Benchmarking interno. Os dados foram analisados por estatística descritiva e regressão múltipla para identificar os fatores independentes e associados ao número de internações mensais com intervalos de confiança de 95%. Resultados A implantação do Núcleo aumentou significativamente (p<0,001) o número de altas, o fator de utilização e índice de renovação dos leitos, internação de urgência, porcentagem de ocupação dos leitos, procedimentos cirúrgicos realizados e média de paciente-dia (p=0,027). Houve redução (p<0,001) no número de atendimentos no pronto socorro médico, obstétrico e ortopédico, nas taxas de infecção hospitalar e de mortalidade infantil, bem como na diminuição média de permanência de 0,81/dia, aproximadamente um dia a menos de internação por paciente, ou um ganho de 40 leitos disponíveis ao mês. Conclusão Embora o número de leitos disponíveis tenha sido menor no período pós-implantação, o intervalo de substituição de leitos reduziu, representando o aumento de mais 40 leitos ao mês devido à diminuição do tempo de permanência dos pacientes na instituição.

Abstract Objective To evaluate the hospital indicators and their repercussions on the number of monthly admissions to a public university hospital, before and after implementing the Internal Regulation Center. Method An evaluative research study, of the Case Study type, developed in a public university hospital. A total of 28 indicators related to structure, production, productivity and quality were measured, which are part of internal Benchmarking. The data were analyzed by means of descriptive statistics and multiple regression to identify the independent factors and those associated with the number of monthly hospitalizations with 95% confidence intervals. Results Implementation of the Center significantly increased (p<0.001) the number of discharges, the bed utilization factor and the bed renewal rate, emergency hospitalization, bed occupancy percentage, surgical procedures performed and the patient-day mean value (p=0.027). There was a reduction (p<0.001) in the number of visits to the medical, obstetric and orthopedic emergency room, in the rates of in-hospital infection and infant mortality, as well as a mean reduction of 0.81/day, approximately one day less of hospitalization per patient, or a gain of 40 available beds per month. Conclusion Although the number of available beds was lower in the post-implementation period, the bed replacement interval was reduced, representing an increase of 40 more beds per month due to the reduction in the patients' length of stay in the institution.

Resumen Objetivo Evaluar los indicadores hospitalarios y sus repercusiones, antes y después de la implantación del Centro Interno de Regulación, sobre el número de internaciones mensuales en un hospital universitario público. Método Investigación evaluativa, del tipo Estudio de Caso, desarrollada en un hospital universitario público. Se midieron 28 indicadores relacionados con la estructura, producción, productividad y calidad, que forman parte del Benchmarking interno. Los datos fueron analizados por estadística descriptiva y regresión múltiple para identificar factores independientes y asociados con el número de hospitalizaciones mensuales con un intervalo de confianza del 95%. Resultados La implantación del Centro incrementó significativamente (p<0,001) el número de altas, el factor de utilización y tasa de renovación de camas, la hospitalización de urgencia, el porcentaje de ocupación de camas, los procedimientos quirúrgicos realizados y el promedio de pacientes/día (p =0,027). Se registró una reducción (p<0,001) en el número de las consultas de emergencias médicas, obstétricas y ortopédicas, en las tasas de infección hospitalaria y mortalidad infantil, además de una disminución promedio de la estancia del 0,81/día, aproximadamente un día menos de hospitalización por paciente, o 40 camas disponibles más mes. Conclusión Aunque el número de camas disponibles fue menor en el período posterior a la implantación, el intervalo de sustitución de camas se redujo, lo que representó un aumento de 40 camas más por mes debido a la disminución de la estancia de los pacientes en la institución.

Estresse ocupacional em equipes saúde da família certificadas e não certificadas com selo de qualidade assistencial / Estrés laboral en equipos de salud familiar certificados y no certificados con sello de calidad asistencial / Occupational stress in family health teams certified and non-certified with assistance quality seal

Resumo Objetivo comparar o estresse ocupacional em trabalhadores de equipes saúde da família certificadas e não certificadas com selo de qualidade assistencial pela Tutoria da Atenção Primária à Saúde. Métodos estudo transversal realizado com 178 trabalhadores das equipes da Estratégia Saúde da Família de dois municípios do Paraná. Os dados foram coletados por um questionário de caracterização e a Job Stress Scale, e analisados descritiva e inferencialmente por meio de regressão logística bruta e ajustada. Resultados os trabalhadores vinculados às equipes certificadas apresentaram chances significativamente maiores de alta demanda psicológica (p<0,001; ORaj: 4,164) e baixo apoio social (p=0,048; ORaj: 1,896) em relação aos das não certificadas. O controle sobre o trabalho não apresentou diferença significativa (p=0,891; ORaj: 1,047). Os participantes de equipes certificadas apresentaram maior chance de job strain (p<0,001; ORaj: 4,956) e entre aqueles de equipes não certificadas predominou o trabalho passivo (p<0,001; ORaj: 0,293). Conclusão os trabalhadores de equipes de saúde com certificação de qualidade na prestação de serviços apresentaram maiores chances de estresse ocupacional em relação aqueles vinculados a equipes não certificadas. Implicações para a prática torna-se premente que os modelos gerenciais de qualidade da assistência considerem a saúde dos trabalhadores envolvidos.

Resumen Objetivo comparar el estrés laboral en trabajadores de los equipos de salud familiar certificados y no certificados con sello de calidad en la atención de la Mentoría de Atención Primaria. Métodos estudio transversal con 178 trabajadores de los equipos del plan Estrategia Salud de la Familia de dos municipios de Paraná. Los datos fueron recolectados a través de un cuestionario de caracterización y de la Job Stress Scale, por medio de análisis descriptivo e inferencial, mediante regresión logística bruta y ajustada. Resultados los trabajadores vinculados a equipos certificados presentaron probabilidades significativamente mayores de alta demanda psicológica (p<0,001; OR: 3,781) y bajo apoyo social (p=0,030; OR: 1,896) en relación a los de equipos no certificados. El control sobre el trabajo no mostró diferencia significativa (p=0,891; ORaj: 1,047). Los participantes de equipos certificadas obtuvieron una mayor probabilidad de padecer tensión laboral (p<0,001; ORaj: 4,956) y entre los de equipos no certificadas predominó el trabajo pasivo (p<0,001; ORaj: 0,293). Conclusión los trabajadores de equipos de salud con certificación de calidad en la prestación de servicios presentaban mayor probabilidad de estrés ocupacional en relación a los vinculados a equipos no certificados. Implicaciones para la práctica es imperativo que los modelos de gestión de la calidad de la atención consideren la salud de los trabajadores involucrados.

Abstract Objective to compare occupational stress in professionals from family health teams certified and non-certified with assistance quality seal by the Primary Health Care Mentoring. Method a cross-sectional study carried out with 178 workers from the Family Health Strategy teams of two municipalities in Paraná. The data were collected through a characterization questionnaire and the Job Stress Scale, and analyzed descriptively and inferentially by means of crude and adjusted logistic regression. Results professionals linked to certified teams had significantly greater chances of high psychological demand (p<0.001; OR: 3.781) and low social support (p=0.030; OR: 1.896) in relation to those from non-certified teams. Control over work showed no significant difference (p=0.891; ORadj: 1.047). Participants from the certified teams had a higher chance of job strain (p<0.001; ORadj: 4.956) and among those from the non-certified teams, passive work predominated (p<0.001; ORadj: 0.293). Conclusion Professionals from teams with quality certification in the provision of services had a greater chance of occupational stress in relation to those linked to non-certified teams. Implications for the practice it is imperative that the management models of quality of care consider the health of the workers involved.