Percepção dos enfermeiros sobre condições de trabalho na atenção primária durante a pandemia de sars-cov-2 / Nurses perception of working conditions in primary care during the sars cov-2 pandemic / Percepción de las enfermeras sobre las condiciones de trabajo en atención primaria durante la pandemia por sars-cov-2

Objetivo: Analisar a percepção do enfermeiro acerca das condições de trabalho no contexto da Atenção Primária à Saúde (APS) durante a pandemia de SARS-CoV-2. Métodos: Trata-se de um estudo descritivo, transversal, de abordagem qualitativa, recorte de um estudo multicêntrico e de abrangência nacional. Os dados apresentados neste estudo correspondem aos obtidos no estado do Rio Grande do Norte, onde foram entrevistados 45 enfermeiros da APS no período de dezembro de 2020 a abril de 2021. Após as entrevistas, as narrativas gravadas foram transcritas e analisadas através da Análise de Conteúdo de Bardin. Resultados: A partir da fala dos enfermeiros, evidenciou-se que a utilização de Equipamentos de Proteção Individual, a organização e desenvolvimento de novos protocolos e fluxos assistenciais trouxeram sofrimento psíquico aos profissionais, tanto pelas condições de trabalho inadequadas, quanto pela proximidade com o sofrimento de pacientes e o medo de contágio. Conclusão: Mesmo com tantas dificuldades, os enfermeiros lotados na atenção primária à saúde tiveram que reconstruir suas práticas na perspectiva de garantir, dentro dos limites impostos pela situação adversa, a melhor assistência possível, mostrando a força e resiliência das equipes da APS nos mais diversos contextos. (AU)

Objective: To analyze the perception of nurses about working conditions in the context of PHC during the COVID-19 pandemic. Methods: This is a descriptive, cross-sectional study with a qualitative approach, part of a multicenter study with a national scope. The data presented in this study correspond to those obtained in the state of Rio Grande do Norte, in which 45 nurses from primary health care were interviewed from December 2020 to April 2021. After the interviews, the recorded narratives were transcribed and analyzed through the Bardin's Content Analysis. Results: The collective discourse showed that the use of Personal Protective Equipment, the organization and development of new protocols and care flows brought psychic suffering to professionals, both due to inadequate working conditions and the proximity to the suffering of patients and the fear of Contagion. Conclusion: Even with so many difficulties, nurses working in primary health care had to rebuild their practices in order to guarantee, within the limits imposed by the adverse situation, the best possible assistance, showing the strength and resilience of PHC teams in the most diverse contexts. (AU)

Objetivo: Analizar la percepción de los enfermeros sobre las condiciones de trabajo en el contexto de la APS durante la pandemia de COVID-19. Métodos: Se trata de un estudio descriptivo transversal con enfoque cualitativo, parte de un estudio multicéntrico de alcance nacional. Los datos presentados en este estudio corresponden a los obtenidos en el estado de Rio Grande do Norte, en el que fueron entrevistados 45 enfermeros de atención primaria de salud entre diciembre de 2020 y abril de 2021. Después de las entrevistas, las narraciones grabadas fueron transcritas y analizadas a través de la escala de Bardin. Análisis de contenido. Resultados: El discurso colectivo mostró que el uso de Equipos de Protección Individual, la organización y desarrollo de nuevos protocolos y flujos de atención trajeron sufrimiento psíquico a los profesionales, tanto por las inadecuadas condiciones de trabajo como por la proximidad al sufrimiento de los pacientes y el miedo al Contagio. Conclusión: Incluso con tantas dificultades, los enfermeros que actúan en la atención primaria de salud tuvieron que reconstruir sus prácticas para garantizar, dentro de los límites impuestos por la situación adversa, la mejor asistencia posible, mostrando la fortaleza y resiliencia de los equipos de APS en los más diversos contextos. (AU)

O enfermeiro recém-formado na condição de segunda vítima / El enfermero recién graduado en condición de segunda víctima / The newly graduated nurse as a second victim

Resumo Objetivo Descrever a prevalência de enfermeiros recém-formados como segundas vítimas de eventos adversos e conhecer as condições de apoio recebidas nas instituições de saúde. Métodos Estudo transversal, descritivo e de abordagem quantitativa, cuja população foi constituída por enfermeiros recém-formados, que aceitaram responder ao questionário online, com perguntas relacionadas à admissão na instituição, envolvimento em eventos adversos e gerenciamento da condição de segunda vítima, contatados por e-mail, intermediado pelo Conselho Regional de Enfermagem de São Paulo. Foi realizada a análise descritiva dos dados e teste de igualdade de proporções. Resultados A amostra final foi de 138 enfermeiros, 54,3% desconheciam o termo segunda vítima, 44,9% desconheciam a existência de protocolos institucionais para apoio emocional aos profissionais e 26,8% estiveram envolvidos em eventos adversos. Destes, 94,6% apresentaram como desfecho diante do evento o sofrimento emocional, frustração, culpa, tristeza, estresse, incapacidade, constrangimento e insegurança para realizar suas funções no trabalho; 59,5% receberam algum tipo de apoio e 21,6% receberam punição institucional. Conclusão A prevalência de enfermeiros recém-formados envolvidos em eventos adversos foi de 26,8%, e, entre os que vivenciaram esse incidente, a maioria apresentou como desfecho, sentimentos negativos e de insegurança na condução do trabalho. Após o evento, o apoio recebido partiu, na maioria das vezes, de colegas de trabalho e pessoas significativas, e, quanto ao apoio institucional, destaca-se ainda a necessidade de programas para suporte emocional, a fim de que esses profissionais superem quando se encontram na condição de segunda vítima.

Resumen Objetivo Describir la prevalencia de enfermeros recién graduados como segundas víctimas de eventos adversos y conocer las condiciones de apoyo recibidas en las instituciones de salud. Métodos Estudio transversal, descriptivo y de enfoque cuantitativo, cuya población estuvo compuesta por enfermeros recién graduados, que aceptaron responder un cuestionario digital con preguntas relacionadas con la admisión en la institución, la participación en eventos adversos y la gestión de la condición de segunda víctima, contactados por correo electrónico e intermediado por el Consejo Regional de Enfermería de São Paulo. Se realizó el análisis descriptivo de los datos y prueba de igualdad de proporciones. Resultados La muestra final fue de 138 enfermeros. El 54,3 % desconocía el término segunda víctima, el 44,9 % desconocía la existencia de protocolos institucionales para apoyo emocional a profesionales y el 26,8 % estuvo involucrado en eventos adversos. De estos, el 94,6 % presentó, como consecuencia del evento, sufrimiento emocional, frustración, culpa, tristeza, estrés, incapacidad, vergüenza e inseguridad para realizar sus funciones en el trabajo; el 59,5 % recibió algún tipo de apoyo, y el 21,6 % recibió sanción institucional. Conclusión La prevalencia de enfermeros recién graduados involucrados en eventos adversos fue del 26,8 % y, de los que pasaron por estos incidentes, la mayoría presentó, como consecuencia, sentimientos negativos y de inseguridad en la conducción de su trabajo. Después del evento, el apoyo recibido, la mayoría de las veces, surgió de compañeros de trabajo y personas importantes. Respecto al apoyo institucional, también se observa la necesidad de programas para apoyo emocional para que estos profesionales se sobrepongan cuando se encuentren en condición de segunda víctima.

Abstract Objective To describe the prevalence of newly graduated nurses as second victims of adverse events and to know the conditions of support received in health institutions. Methods Cross-sectional, descriptive, quantitative study. The population consisted of newly graduated nurses who agreed to answer the online questionnaire with questions related to being hired at the institution, involvement in adverse events and management of the second victim condition. Contacted was by email, intermediated by the Regional Nursing Council of São Paulo. Descriptive data analysis and the test of equality of proportions were performed. Results The final sample consisted of 138 nurses, 54.3% were unaware of the term 'second victim', 44.9% were unaware of the existence of institutional protocols for emotional support to professionals and 26.8% were involved in adverse events. Of these, 94.6% presented emotional distress, frustration, guilt, sadness, stress, inability, embarrassment and insecurity to perform their duties at work as an outcome of the event; 59.5% received some type of support and 21.6% received institutional punishment. Conclusion The prevalence of newly graduated nurses involved in adverse events was 26.8%, and among those who experienced this incident, the majority presented negative feelings and insecurity in performing their work as an outcome. After the event, most of the time, the support received came from work colleagues and significant others. Regarding institutional support, the need for programs for emotional support is also highlighted, so that these professionals can overcome when finding themselves in the place of the second victim.

Beyond direct exposure to violence: effects of living in disordered and violent communities on psychological distress in young Mexican people / Más allá de la exposición directa a la violencia: efectos de residir en comunidades desordenadas y violentas sobre el distrés psicológico entre jóvenes mexicanos / Além da exposição direta à violência: efeitos de viver em comunidades desordenadas e violentas sobre o estresse psicológico entre jovens mexicanos

Abstract: The association between community violence and mental health has been studied by reports of individual experiences, particularly in adolescents and youths, but little is known about the effect of living in disordered and violent communities. This study aims to determine the possible relation between living in disordered and violent community environments and psychological distress in Mexican adolescents and youths regardless of their individual experience of victimization and to assess the potential modifying effect of sex and age on this association. Data come from a cross-sectional survey with a representative sample of adolescents and youths living in Mexican municipalities, including 39,639 participants aged from 12 to 29 years. Disordered and violent community environments were assessed using reports from a secondary sample of adults who lived in the same communities as participants. Using exploratory factor analysis, three contextual variables related to disordered and violent community environment were created: social disorder, vandalism, and criminality. Multilevel linear regression models with random intercept were estimated. Adolescents and youths who lived in environments with higher social disorder had more psychological distress. Men in environments with greater vandalism had a higher level of psychological distress. Unexpectedly, women from communities with higher levels of crime had fewer symptoms. It is necessary to address the violence that exists in these communities, creating strategies that reduce not only crime, but also the social disorder and vandalism that could contribute to developing negative effects on mental health.

Resumen: La asociación entre la violencia comunitaria y la salud mental se ha evaluado mediante informes de experiencias individuales, especialmente de adolescentes y jóvenes, pero poco se sabe sobre el efecto de residir en comunidades desordenadas y violentas. El objetivo de este estudio fue comprobar si existe una relación entre residir en entornos comunitarios desordenados y violentos y el distrés psicológico en adolescentes y jóvenes mexicanos, independientemente de su experiencia individual de victimización, así como evaluar el posible efecto modificador del sexo y la edad en esta asociación. Los datos provienen de una encuesta transversal que tomó como muestra representativa a 39.639 adolescentes y jóvenes de entre 12 y 29 años, residentes en ciudades mexicanas. Los entornos comunitarios desordenados y violentos se evaluaron mediante informes de una muestra secundaria de adultos que residían en las mismas comunidades donde vivían los participantes. El análisis exploratorio de datos posibilitó crear tres variables contextuales relacionadas con el entorno comunitario desordenado y violento: desorden social, vandalismo y delincuencia. Se estimaron modelos de regresión lineal multinivel con intercepto aleatorio. Los adolescentes y jóvenes que residían en ambientes con mayor desorden social presentaron mayor distrés psicológico. Los varones en entornos con más vandalismo tenían un mayor nivel de distrés psicológico. Inesperadamente, las mujeres que viven en comunidades con mayores niveles de delincuencia tuvieron menos síntomas. Es necesario enfrentar la violencia existente en las comunidades para generar estrategias que reduzcan no solo la delincuencia, sino también el desorden social y el vandalismo que pueden contribuir al desarrollo de efectos negativos en la salud mental.

Resumo: A associação entre violência comunitária e saúde mental tem sido estudada por meio de relatos de experiências individuais, particularmente em adolescentes e jovens, mas pouco se sabe sobre o efeito de viver em comunidades desordenadas e violentas. O objetivo deste estudo é determinar se há relação entre viver em ambientes comunitários desordenados e violentos e estresse psicológico em adolescentes e jovens mexicanos, independentemente de sua experiência individual de vitimização, e avaliar o potencial efeito modificador do sexo e da idade sobre essa associação. Os dados são de uma pesquisa transversal com uma amostra representativa de adolescentes e jovens residentes em cidades mexicanas, incluindo 39.639 participantes com idades de 12 a 29 anos. Ambientes comunitários desordenados e violentos foram avaliados por meio de relatos de uma amostra secundária de adultos que viviam nas mesmas comunidades onde os participantes viviam. Por meio da análise exploratória de dados, foram criadas três variáveis contextuais relacionadas ao ambiente comunitário desordenado e violento: desordem social, vandalismo e criminalidade. Foram estimados modelos de regressão linear multinível com interceptação aleatória. Adolescentes e jovens que viviam em ambientes com maior desordem social apresentaram maior estresse psicológico. Homens em ambientes com mais vandalismo apresentaram maior nível de estresse psicológico. Inesperadamente, as mulheres de comunidades com níveis mais altos de criminalidade tiveram menos sintomas. É preciso enfrentar a violência existente nas comunidades, gerando estratégias que reduzam não só a criminalidade, mas também a desordem social e o vandalismo que possam contribuir para o desenvolvimento de efeitos negativos na saúde mental.

Gender, psychological distress, and subjective well-being two years after the onset of the COVID-19 pandemic in Spain / Género, trastorno psicológico y bienestar subjetivo a dos años del inicio de la pandemia de COVID-19 en España / Gênero, distúrbio psicológico e bem-estar subjetivo dois anos após o início da pandemia da COVID-19 na Espanha

Abstract This study aimed to examine gender differences in distress and well-being two years after the onset of the COVID-19 pandemic, analyzing risk and protective factors for psychological distress and subjective well-being. It is a repeated cross-sectional study with a sample of 1,588 women (50%) and men (50%) from the general Spanish population aged 18-74 years who were assessed online by seven questionnaires and scales. Descriptive, variance, and hierarchical multiple regression analyses were performed. From February to April 2022, 57.4% of women and 38.7% of men had psychological distress, percentages that totaled 50.5% and 41.5%, respectively, from October 2022 to February 2023. Women also had greater perceived vulnerability to diseases, more negative feelings, and lower affect balance, resilience, and self-esteem than men. The most important predictors of greater psychological distress refer to lower self-esteem, resilience, and social support and higher perceived vulnerability to diseases. Other statistically significant predictors included lower educational level in women and neither being married nor living with a partner in men. Lower self-esteem also best predicted lower subjective well-being, with lower social support and lower resilience also constituting significant predictors. Moreover, lower educational level and higher perceived vulnerability to diseases statistically and significantly predicted lower subjective well-being in women, as did not being a student in men. We conclude that psychological distress remains greatly prevalent in Spain two years after the beginning of the COVID-19 pandemic, especially in women.

Resumen Este estudio tuvo como objetivo analizar las diferencias de género en distrés psicológico y en el bienestar a dos años del inicio de la pandemia de COVID-19, analizando factores de riesgo y de protección para distrés psicológico y bienestar subjetivo. Se trata de un estudio transversal repetido con una muestra de 1.588 individuos de la población general de España, 50% mujeres y 50% hombres, con edades comprendidas entre 18 y 74 años. Los participantes fueron evaluados en línea mediante 7 cuestionarios y escalas. Se realizaron análisis descriptivos, de varianza y de regresión múltiple jerárquica. Entre febrero y abril del 2022, el 57,4% de las mujeres y el 38,7% de los hombres presentaron distrés psicológico, con porcentajes del 50,5% y 41,5%, respectivamente, entre octubre del 2022 y febrero del 2023. Las mujeres también presentaron una mayor vulnerabilidad percibida a la enfermedad, más sentimientos negativos, menos equilibrio afectivo y menor resiliencia y autoestima que los hombres. Los indicadores más importantes de un mayor distrés psicológico fueron la baja autoestima, la baja resiliencia, el escaso apoyo social y una mayor vulnerabilidad percibida a la enfermedad. Otros indicadores estadísticamente significativos fueron los siguientes: bajo nivel de educación entre las mujeres y no estar casado o no vivir con una compañera entre los hombres. La baja autoestima también fue el mejor indicador de un bajo bienestar subjetivo; además, el escaso apoyo social y la baja resiliencia también fueron indicadores importantes. Además, el bajo nivel de educación y la alta vulnerabilidad percibida a la enfermedad fueron indicadores estadísticamente significativos de bajo bienestar subjetivo entre las mujeres y de no ser estudiantes entre los hombres. Concluimos que el distrés psicológico sigue siendo muy prevalente en España dos años después del inicio de la pandemia de COVID-19, especialmente entre las mujeres.

Resumo Este estudo teve como objetivo analisar as diferenças de gênero em estresse psicológico e no bem-estar dois anos após o início da pandemia da COVID-19, analisando fatores de risco e de proteção para estresse psicológico e bem-estar subjetivo. Este foi um estudo transversal repetido com amostra de 1.588 indivíduos da população geral da Espanha - 50% do sexo feminino e 50% do sexo masculino, com idade entre 18 e 74 anos. Os participantes foram avaliados online por meio de sete questionários e escalas. Foram realizadas análises descritivas, de variância e de regressão múltipla hierárquica. Entre fevereiro e abril de 2022, 57,4% das mulheres e 38,7% dos homens apresentaram estresse psicológico, com porcentagens de 50,5% e 41,5%, respetivamente, entre outubro de 2022 e fevereiro de 2023. As mulheres também apresentaram maior vulnerabilidade percebida à doença, mais sentimentos negativos, menor equilíbrio afetivo e menor resiliência e autoestima do que os homens. Os indicadores mais importantes de maior estresse psicológico foram baixa autoestima, baixa resiliência, baixo apoio social e maior vulnerabilidade percebida à doença. Outros indicadores estatisticamente significativos foram: baixo nível de escolaridade entre as mulheres e não ser casado ou não viver com uma companheira entre os homens. Baixa autoestima também foi o melhor indicador de baixo bem-estar subjetivo; além disso, baixo apoio social e baixa resiliência também foram indicadores significativos. Além disso, baixo nível de escolaridade e alta vulnerabilidade percebida à doença foram indicadores estatisticamente significativos de baixo bem-estar subjetivo entre as mulheres e de não ser estudante entre os homens. Concluímos que estresse psicológico ainda é muito prevalente na Espanha dois anos após o início da pandemia da COVID-19, principalmente entre as mulheres.

Vivências no processo de aleitamento materno de mães de recém-nascidos prematuros internados em um hospital público do municipio de Guarapuava-PR / Experiences in the breastfeeding process of mothers of preterm newborns admitted to a public hospital in the city of Guarapuava-PR

Objetivo: Descrever os relatos de vivências no processo de amamentação de mães de recém-nascidos prematuros. Método: Estudo qualitativo realizado com mães de recém-nascidos prematuros, internados em uma Unidade de Terapia Intensiva Neonatal, de um hospitalpúblico de Guarapuava-PR, no período de junho a julho de 2018, mediante aplicação de um instrumento com questões fechadas e outro com questões relacionadas à amamentação de prematuros. Foram incluídas no estudo mães que já haviam amamentado seus filhos ao seio ou por meio da ordenha mamária, e excluídas mães com idade inferior a 18 anos ou que apresentavam condições clínicas que as impediam de amamentar, cujos filhos estavam internados em período menor que três dias. Resultados: Participaram do estudo 10 mães de recém-nascidos prematuros, das quais 70% tinham idade gestacional de 32 a 36 semanas, 10% de 28 semanas e 20% de 29 semanas gestacionais. As mães relataram dificuldades em manter a pega e a sucção do leite materno e sentimentos de nervosismo, receberam apoio dos profissionais e familiares no incentivo à amamentação e no cuidado humanizado pela equipe de saúde. Conclusões: Diante do conhecimento das dificuldades encontradas pelas mães na amamentação de prematuros, é possível estabelecer medidas para evitar o desmame precoce, respeitando a autonomia da mãe no cuidado ao bebê.

Objective: To describe the breastfeeding experiences of mothers of preterm newborns. Methods: Qualitative study carried out with mothers of preterm newborns admitted to a Neonatal Intensive Care Unit at a public hospital in Guarapuava-PR, from June to July 2018, using a questionnaire instrument with closed questions and another with questions related to breastfeeding premature babies. The study included mothers who had already breastfed their children, and excluded mothers under the age of 18 or who had medical conditions that prevented them from breastfeeding, and whose children had been hospitalized for less than three days. Results: Ten mothers of preterm newborns took part in the study, 70% of whom had a gestational age of 32 to 36 weeks, 10% 28 weeks and 20% 29 weeks. The mothers reported difficulties in maintaining the latch and sucking breast milk, as well as feelings of nervousness. They received support from professionals and family members in encouraging breastfeeding and humanized care from the health team. Conclusion: With knowledge of the difficulties encountered by mothers in breastfeeding preterm babies, it is possible to establish measures to prevent early weaning, while respecting the mother's autonomy in caring for the baby.

Psychological distress among South African healthcare workers during the COVID-19 pandemic

Background: The COVID-19 pandemic has placed immense pressure on healthcare workers (HCWs). Objectives: This study sought to find the prevalence and factors associated with psychological distress among HCWs in South Africa during the beginning phases of COVID-19 and make relevant recommendations. Method: The survey was administered online through a data-free platform. Data were benchmarked to the national population of over 500 000 healthcare professionals in South Africa. Multiple logistic regressions were used to determine association between psychological distress and potential explanatory variables. Results: A total of 7607 healthcare professionals participated in the study (1760 nurses, 2843 medical practitioners and 3004 other healthcare professionals). Half of the nurses, 41% of medical practitioners and 47% of other healthcare professionals were classified as psychologically distressed. Those who were of older age, provided with well-being support services and having a positive outlook on the healthcare system were significantly less likely to be distressed. Being female medical practitioners and female other healthcare professions, requesting routine counselling, being concerned about not having enough leave and that their life insurance policy did not cover COVID-19 were more likely to be distressed. Conclusion: Psychological well-being of HCWs in South Africa is at risk. We recommend that psychological distress of HCWs be routinely assessed and that routine counselling, well-being support services, appropriate hazardous leave and insurance be provided to all HCWs. Contribution: This study adds to the literature on the psychological distress faced by HCWs in South Africa during COVID-19.

Psychological Distress and Its Association with Functional Disability Index Among Acne Patients Attending Dermatology Clinics in the Kuantan Tertiary Hospitals

@#Introduction: Acne is the most common skin disease among adolescents and has significant psychological distress. Our objective is to assess acne severity, functional disability, and its psychological distress among acne patients. Methods: A cross-sectional study was conducted from November 2021 to May 2022 among 163 acne patients attending Dermatology Clinics in the district of Kuantan, Pahang. The severity of acne was graded using the Comprehensive Acne Severity Scale (CASS). The functional disability index was measured using a Cardiff Acne Disability Index (CADI), while Depression, Anxiety and Stress Scale (DASS-21) questionnaires were used as a screening tool to detect the psychological distress of acne. Data were analysed using a Chi-square test, Fisher’s exact test and multiple logistic regression. Results: The mean age was 23 years, 60.1% were female, 94.5% were Malay, and 68.1% were unemployed. The severity of acne was more prominent in the mild (30.7%) and moderate (28.2%) categories. A total of 20.2%, 11.7%, and 4.9% of the respondents had anxiety, depression, and stress symptoms, respectively. Regarding the respondents’ functional disability, 40.5% had mild impairment, 38.0% had moderate impairment, and 13.5% had severe impairment. Acne severity was found to be significantly associated with the functional disability index (P<0.05). The functional disability index was also found to be significantly associated with depression (p=0.019) and anxiety symptoms (p=0.042). Conclusion: Clinical management of acne patients should include not only pharmacological treatment but also consideration of the disease’s functional disability status and psychological distress.

Association between Moral Distress and Burnout Syndrome in university-hospital nurses / Associação do Sofrimento Moral e Síndrome de Burnout em enfermeiros de hospital universitário / Asociación del Sufrimiento Moral y Síndrome de Burnout en enfermeros de un hospital universitario

Abstract Objective: to analyze the association between moral distress and Burnout Syndrome among nurses in a university hospital. Method: descriptive, analytical study conducted with 269 nurses working in a university hospital located in Rio Grande do Sul, Brazil. Data were collected in person in 2019 by previously trained collectors. A sociodemographic and employment questionnaire, the Brazilian Scale of Moral Distress in Nurses and the Maslach Burnout Inventory were applied. Descriptive and analytical statistical analysis was used. Results: an association was identified between moral distress intensity and frequency and its dimensions with Burnout Syndrome and its dimensions. Nurses with low professional achievement and high emotional exhaustion showed a higher prevalence of moral distress. Conclusion: an association between moral distress and Burnout Syndrome, as well as between their dimensions, was evidenced. The results suggest the need to investigate urgent interventions to mitigate the situations and manifestations of moral distress and Burnout Syndrome by developing strategies for workers' health.

Resumo Objetivo: analisar a associação entre sofrimento moral e síndrome de Burnout em enfermeiros de hospital universitário. Método: estudo descritivo-analítico, realizado com 269 enfermeiros atuantes em um hospital universitário localizado no Rio Grande do Sul, Brasil. A coleta de dados ocorreu de maneira presencial no ano de 2019 por coletadores previamente capacitados. Aplicaram-se questionário sociodemográfico e laboral, Escala Brasileira de Distresse Moral em Enfermeiros e o Inventário Maslach de Burnout. Empregou-se análise estatística descritiva e analítica. Resultados: identificou-se associação entre intensidade e frequência de sofrimento moral e suas dimensões com a síndrome de Burnout e suas dimensões. Enfermeiros em baixa realização profissional e alta exaustão emocional apresentaram prevalências mais elevadas para sofrimento moral. Conclusão: evidenciou-se a associação entre sofrimento moral e síndrome de Burnout bem como entre suas dimensões. Os resultados sinalizam a necessidade de investigar intervenções urgentes para amenizar as situações e as manifestações do sofrimento moral e a síndrome de Burnout, elaborando estratégias para a saúde dos trabalhadores.

Resumen Objetivo: analizar la asociación entre sufrimiento moral y síndrome de Burnout en enfermeros de un hospital universitario. Método: estudio descriptivo y analítico, realizado en 269 enfermeros que actuaban en un hospital universitario localizado en el estado de Rio Grande del Sur, en Brasil. La recogida de datos se realizó de manera presencial en el año de 2019 por colectores previamente capacitados. Se aplicaron el cuestionario sociodemográfico y laboral, la Escala Brasileña de Estrés Moral en Enfermeros y el Inventario Maslach de Burnout. Se empleó el análisis estadístico descriptivo y analítico. Resultados: se identificó asociación entre intensidad y frecuencia de sufrimiento moral y sus dimensiones con el síndrome de Burnout y sus dimensiones. Los enfermeros que tuvieron baja realización profesional y alta extenuación emocional, presentaron prevalencias más elevadas para el sufrimiento moral. Conclusión: se evidenció asociación entre sufrimiento moral y síndrome de Burnout así como entre sus dimensiones. Los resultados señalan la necesidad urgente de investigar intervenciones para amenizar las situaciones y las manifestaciones del sufrimiento moral y el síndrome de Burnout, elaborando estrategias para la salud de los trabajadores.

A experiência da COVID-19 pelo olhar de quem apresentou a doença: um estudo qualitativo / The experience of COVID-19 through the eyes of those who presented the disease: a qualitative study

Conhecer e compreender, por meio do olhar da pessoa que apresentou a COVID-19, como foi ter passado por essa experiência. Pesquisa descritiva exploratória qualitativa. População do estudo composta por indivíduos com diagnóstico de COVID-19encaminhados para tratamento em um centro de reabilitação física. Coleta de dados realizada por meio de um questionário (caracterização) e entrevista semiestruturada. As respostas da entrevista foram analisadas com a Análise do Conteúdo (Bardin).Os participantes relataram uma experiência ruim e difícil, com uma doença desconhecida. Diversos sentimentos foram vivenciados, sendo o medo muito enfatizado. Os entrevistados apresentaram limitações físicas, emocionais e perda da independência. Passaram a se preocupar mais com sua saúde e valorizar mais a família, amigos e profissionais da saúde. É importante a assistência precoce a essa população, disponibilizando meios de informações sobre a doença, atendimento psicoterapêutico e de reabilitação, prevenindo efeitos a longo prazo, que dificultam sua recuperação.

To know and understand, through the eyes of the person who had COVID-19, what it was like to have gone through this experience. Qualitative exploratory descriptive research. Study population composed of individuals diagnosed with COVID-19referred for treatment at a Physical Rehabilitation Center. Data collection performed through a questionnaire (characterization) and semi-structured interview. The interview responses were analyzed using Content Analysis (Bardin). Participants reported a bad and difficult experience with an unknown illness. Several feelings were experienced, fear being very emphasized. Respondents had physical and emotional limitations and loss of independence. They started to worry more about their health and value family, friends, and health professionals. Early assistance to this population is important, providing means of information about the disease, psychotherapeutic and rehabilitation care, preventing long-term effects that hinder their recovery

Influencia del tiempo psicológico y el autocontrol en el malestar psicológico en adultos argentinos / Influence of psychological time and self-control on psychological distress in Argentinian adults

Resumen El objetivo de este estudio fue conocer si la temporalidad subjetiva -perspectiva y foco temporales- y la capacidad de autocontrol e impulsividad repercuten en el malestar psicológico, en particular durante la pandemia por COVID-19. La conjetura teórica es que el tiempo psicológico está estrechamente vinculado a la autorregulación, que influye en el desarrollo de la impulsividad y el autocontrol e impacta en el malestar psicológico. Se diseñó un modelo y se realizó un estudio empírico cuantitativo, no experimental y transversal (. = 279; 78 % mujeres; ME = 30.14 años; DE = 11.21). Los resultados del análisis de correlación mostraron relaciones significativas entre las variables de interés. Para determinar las variables predictoras del malestar psicológico se realizó un análisis de regresión lineal múltiple. El 48 % de la varianza del malestar psicológico fue explicado por el pasado negativo, autocontrol e impulsividad, y focos temporales futuro y presente. Finalmente, se probó el modelo teórico diseñado para analizar los efectos directos e indirectos del malestar psicológico a través de un análisis de senderos que presentó un buen ajuste a los datos, ya que explicó el 50 % de la varianza de aquel. La perspectiva y el foco temporal explicaron el 53 % de la variabilidad del autocontrol, y presentaron efectos indirectos sobre el malestar psicológico a través del autocontrol. El autocontrol influyó de manera inversa en el malestar. Los hallazgos indican que el tiempo subjetivo y el autocontrol sirven para explicar estados psicológicos, incluso en pandemia, lo cual confirma estudios previos que muestran la importancia de las variables de personalidad -además de las biológicas y contextuales- en la aparición de malestar psicológico.

Abstract Psychological time is an essential aspect of humans. Two of the most important notions of subjective temporality are time perspective and temporal focus. Time perspective is a process by which the flow of personal and social experiences are framed in five different temporal categories: past negative, past positive, present hedonistic, present fatalistic and future. Temporal focus refers to the attention people devote to thinking about the past, present, and future. Previous research shows there is a strong relation between psychological time and self-regulatory processes, specifically self-control and impulsivity. Self-control is the ability to inhibit impulsive behaviors or reactions that can keep the person from pursuing the proposed goals. On the other hand, impulsivity refers to a short attention span and a tendency to engage in risky behaviors, and to prefer immediate rewards. Both subjective temporality and self-regulatory processes influence behaviors and psychological states such as psychological distress. In particular, the objective of this study was to find out if subjective temporality -time perspective and temporal focus-- and self-control and impulsivity have repercussions on psychological distress, particularly during the COVID-19 pandemic, in an Argentinian sample. The theoretical conjecture is that subjective temporality is closely linked to self-regulation, which influences the development of impulsivity and self-control, and impacts psychological distress. A quantitative, non-experimental, and cross-sectional empirical study was carried out (. = 279; 78 % women; ME = 30.14 years old; SD = 11.21). Firstly, the results of the correlational analysis showed significant relations between the variables. Then, to facilitate further analyses, an index variable of self-control was created, which included the scores of self-control and three dimensions of impulsivity. An optimal parallel analysis was performed. It indicated the existence of a single dimension. Then a semi-confirmatory factor analysis was ran, which showed acceptable results (KMO = .68; X. (6) = 198.8, . < .001; GFI = .99; RMSR = 0.03). Thirdly, to determine the predictive variables of psychological distress, a multiple linear regression analysis was performed. It was found that 48 % of the variance of psychological distress was explained by negative past, self-control index, and future and present temporal focuses (. (4, 266) = 64.66, . < .001, R. = .49, R. adjusted = .48). The best predictor variable was past negative. Afterwards, a theoretical model was tested to explain the direct and indirect causes of psychological distress. It presented a good fit (X./gl = 1.63; GFI = .99; RMSEA = .04). Time perspective and temporal focus explained 53 % of the variability of self-control and presented indirect effects on psychological distress through self-control. Self-control inversely influenced psychological distress; more self-control generates less psychological distress. The model explained half of the variance of psychological distress (R. = .50). The findings indicate that subjective temporality and self-control explain psychological states, even during a pandemic, which confirms previous studies that show the importance of personality variables -in addition to biological and contextual variables- in the manifestation of psychological distress. The results support the theory that psychological time can be considered as a personality trait underlying self-control and psychological distress. A theoretical and practical discussion of the results is presented.

Uso pasivo de redes sociales y malestar psicológico. El rol de la comparación social / Passive use of social media sites and psychological distress. The role of social comparison

Resumen La presente investigación se focalizó en los diferentes tipos de uso (activo/pasivo) que hacen los usuarios de redes sociales y los efectos psicológicos que esto puede conllevar, sobre todo en aquellos sujetos tendientes a compararse con los demás. Por un lado, se examinó el poder predictor de variables relacionadas al uso de redes sociales (i. e., tiempo de conexión, tipo de uso -pasivo/activo-, motivaciones de uso) y la comparación social, sobre el malestar psicológico percibido (i. e., depresión, ansiedad, estrés). Por otro lado, se analizó el rol mediador de la comparación social en la relación entre el uso pasivo de redes sociales y la percepción de malestar psicológico percibido. La muestra fue de conveniencia y estuvo compuesta por 420 sujetos de población general (211 hombres, 209 mujeres), con una media de edad de 40.29 años (DE = 14.93). Se utilizaron los siguientes instrumentos de recolección de datos: Motives for SMSs use Scale; Iowa-Netherlands Comparison Orientation Measure (INCOM-E), Depression, Anxiety and Stress Scale (DASS-21) y una escala diseñada ad-hoc para evaluar el uso activo y pasivo que se hace de redes sociales. Los resultados obtenidos mostraron que la comparación social es el principal predictor de malestar psicológico junto con el motivo de uso relacionado con pasatiempo/exhibicionismo. Además, se pudo comprobar un efecto indirecto del uso pasivo sobre el malestar psicológico considerando a la comparación social como variable mediadora. Por lo tanto, usar pasivamente las redes generaría mayor malestar si el usuario tiende a compararse con quienes realizan las publicaciones.

Abstract The present investigation is framed in the field of cyberpsychology. It aimed to analyze the predictive power of variables related to the use of social media sites -SMSs- (i. e., connection time, type of use -passive / active-, motivations for use) and social comparison, on perceived psychological distress (i. e., depression, anxiety, stress). Furthermore, the mediating role of social comparison in the relationship between the passive use of SMSs and the perceived psychological distress, was also analyzed. It is important to study these topics since different international studies have shown inconsistent and contradictory results regarding the effects of SMSs use on individuals' well-being (e. g., Frison y Eggermont, 2015; Kraut et al., 2002; Nie et al., 2015). Consequently, some studies have focused on understanding whether the manner in which people use the networks, whether actively or passively, explains how technology impacts on users' well-being and/or psychological distress (Verduyn et al., 2015). The negative impact of passive use of SMSs can be explained by the Social Comparison Theory (Festinger, 1954), which suggests that people tend to evaluate themselves in comparison with others. These comparisons might generate negative effects on the individual (Giagkou et al., 2018) and, according to Lup et al. (2015), social comparison may be a mediating variable in this association. Regarding participants of the study, a convenience sample of 420 subjects of general population was studied (211 men, 209 women). The mean age was 40.29 years old (SD = 14.93). The majority of the participants (n = 278) lived in Buenos Aires City and surroundings. In terms of variables related to the use of SMSs, when asked about type of SMSs, most participants reported using more than one SMS, mainly Facebook (72 %) and Instagram (57 %). Regarding time spent on SMSs, 60 % of the respondents used their favorite SMS more than three times a day. The mean daily time engaged on all the SMSs exceeded five hours. Data were gathered using the Motives for SMSs use Scale (Lupano Perugini y Castro Solano, 2021a), the Iowa-Netherlands Comparison Orientation Measure (INCOM-E) (Buunk et al., 2005; Gibbons y Buunk, 1999), the Depression, Anxiety and Stress Scale (DASS-21) (Antúnez y Vinet, 2012; Lovibond y Lovibond, 1995). Furthermore, a survey to assess individuals' use of social networks was designed. The first part explored the most frequently used SMSs, the number and type of friends/followers, and the time spent on SMSs. The main SMSs were listed and participants were asked to indicate whether they used them or not, and if they did, they rated the amount of time spent on SMSs daily. The total amount of time per day was also surveyed. The second part of the survey was designed based on The Passive Active Use Measure (PAUM, Gerson et al., 2017) and some users' suggestions. This instrument assesses the frequency of certain activities performed on the networks to find out if participants make active use (e. g., posting information, commenting) or passive use (e. g., viewing profiles and posts, scrolling). The obtained results showed that social comparison is the main predictor of psychological distress. The motivation for use related to pass time / exhibitionism was also a significant predictor. In addition, an indirect effect of passive use on perceived psychological distress could be verified, considering social comparison as a mediating variable. Therefore, using the social networks passively would generate greater discomfort if the user tends to compare themselves with those who make the publications. The results of this study allow both users and healthcare and education providers to have greater knowledge of the consequences of using social media on individuals' overall well-being, and to promote their proper use.

Prevalencia del síndrome del impostor y nivel de autoestima en estudiantes de una facultad de medicina del Ecuador / Prevalence of impostor syndrome and level of self-esteem in students of a medical school in Ecuador

INTRODUCCIÓN. El síndrome del impostor es un trastorno caracterizado por la incapacidad del individuo para reconocer sus habilidades e interiorizar sus logros, lo cual impacta negativamente en la salud mental y desempeño académico-laboral. OBJETIVO. Identificar la prevalencia del síndrome del impostor y nivel de autoestima en estudiantes de una facultad de medicina del Ecuador. MATERIALES Y MÉTODOS. Estudio transversal descriptivo, aplicado en los estudiantes de medicina de segundo a décimo nivel, de la facultad de medicina de la Pontificia Universidad Católica del Ecuador en el periodo febrero a junio de 2022. Para el análisis estadístico se aplicaron frecuencias absolutas y relativas, tablas cruzadas, razón de prevalencia, chi cuadrado como contraste de hipótesis. RESULTADOS. La mayoría de estudiantes con síndrome de impostor fueron mujeres (74,2%); pertenecer al sexo femenino aumentó dos veces su probabilidad (Razón de prevalencia: 2,12; Índice de confianza: 95% 1,66-2,17; p: <0,001). Para el sexo masculino autopercibirse como perfeccionista incrementó dos veces la probabilidad (Razón de prevalencia: 2,3; Índice de confianza: 95% 1,53-3,46; p: < 0,001). La autoestima baja no se asoció a mayor probabilidad de desarrollar este síndrome. En contraste, no percibir apoyo social incrementó al doble su probabilidad (Razón de prevalencia: 1,72; Índice de confianza: 95% 1,16-2,55; p 0,007). DISCUSIÓN. Estudios previos muestran elevada prevalencia de este síndrome en estudiantes medicina, con predominio en mujeres. En concordancia con la literatura citada, no existió asociación entre nivel de carrera y síndrome del impostor; el perfeccionismo se asocia a mayor probabilidad de síndrome del impostor. CONCLUSIÓN. El síndrome del impostor es frecuente en estudiantes de medicina, existen factores determinantes que incrementan la probabilidad del síndrome como ser mujer, autopercibirse como perfeccionista en la población masculina y no percibir apoyo social, la importancia de su reconocimiento reside en la prevención del distrés psicológico y la deserción académica.

INTRODUCTION. Impostor syndrome is a disorder characterized by an individual's inability to recognize his or her abilities and internalize his or her accomplishments, which negatively impacts mental health and academic and occupational performance. OBJECTIVE. To identify the prevalence of impostor syndrome and level of self-esteem in students of a medical school in Ecuador. MATERIALS AND METHODS. Descriptive cross-sectional study, applied to medical students from second to tenth level, of the medical school of the Pontificia Universidad Católica del Ecuador in the period January to June 2022. For the statistical analysis, absolute and relative frequencies, cross tables, prevalence ratio, chi-square and hypothesis testing were applied. RESULTS. The majority of students with impostor syndrome were female (74.2%); belonging to the female sex increased their probability twice (Prevalence ratio: 2.12; Confidence index: 95% 1.66-2.17; p: < 0.001). For the male sex, self-perceiving oneself as a perfectionist increased the probability twice (Prevalence ratio: 2.3; Confidence index: 95% 1.53-3.46; p: < 0.001). Low self-esteem was not associated with a higher probability of developing this syndrome. In contrast, not perceiving social support doubled its probability (Prevalence ratio: 1.72; Confidence index: 95% 1.16-2.55; p 0.007). DISCUSSION. Previous studies show a high prevalence of this syndrome in medical students, with a predominance in women. In agreement with the literature cited, there was no association between career level and impostor syndrome; perfectionism is associated with a higher probability of impostor syndrome. CONCLUSIONS. Impostor syndrome is frequent in medical students, there are determinant factors that increase the probability of the syndrome such as being a woman, self-perceived perfectionism in the male population and not perceiving social support, the importance of its recognition lies in the prevention of psychological distress and academic desertion.

Exam Anxiety and Its Associated Risk Factors Among Indian Medical Undergraduates

Background: Exam anxiety is a global troublesome psychological problem, impairing the academic perfor-mance of medical students. This study was planned to estimate the prevalence and associated risk factors of Exam anxiety among Indian medical students Methodology: A cross-sectional analytical study was conducted among 230 Indian medical undergraduate students. Westside Test Anxiety Inventory (WTAI) was used to estimate the level of Exam anxiety among medical students. We utilized multivariable logistic regression to identify independent risk factors among medical students. Results: The prevalence of high Exam Anxiety among medical students was 49.6 % (95% CI 43.9-57.0). The mean age of the students was 21.3 years. Multivariable logistic regression revealed the presence of excessive course load [AOR=2.22,95% CI:(1.03,4.78)], the presence of psychological stress [AOR=2.89,95% CI:(1.51,5.48)] and low self-esteem [AOR=8.15,95% CI:(1.51,43.96)] to be independent risk factors for exam anxiety. Conclusions: Our studyfindings suggest that the prevalence of Exam anxiety is very high among Indian un-dergraduate medical students. Our study also showed that the perception of excessive course load, psycholog-ical stress and low self-esteem were the independent risk factors in medical students.

General Health Questionnaire (GHQ12): new evidence of construct validity / Questionário de Saúde Geral (QSG-12): novas evidências de validade de construto

Abstract This study aimed to gather evidence on the adequacy of the General Health Questionnaire (GHQ-12) in Brazil, considering a random sample of Brazilian physicians. Specifically aimed: (1) to test the GHQ-12 bifactor structure compared to alternative models, (2) to check its factorial invariance regarding to gender and the diagnosis of mental and behavioral disorders, and (3) to know the association of this measure with indicators of poor health (e.g., suicidal thoughts, decreased libido, medication use). The study included 1,085 physicians with a mean age of 45.7 (SD = 10.6), mostly male (61.5%), married (72.6%) and Catholic (59.2%). They answered the GHQ-12, the Positive and Negative Suicidal Ideation Inventory, and demographic questions. The best fit model was the bifactor structure composed of anxiety and depression, in addition to a general dimension, which presented Cronbach's alpha, McDonald's ω and composite reliability higher than 0.70 just for a general fact. Psychological distress scores correlated with suicidal ideation and indicators of health and sexual satisfaction. This is a psychometrically suitable instrument that can be used in terms of its total, but its specific factors need to be used with caution.

Resumo Este estudo teve como objetivo reunir evidências sobre a adequação do Questionário de Saúde Geral (QSG-12) no Brasil, considerando uma amostra aleatória de médicos brasileiros. Especificamente, objetivou-se: (1) testar uma estrutura bifactor em comparação com modelos alternativos, (2) verificar invariância fatorial em relação ao gênero e ao diagnóstico de transtornos mentais e comportamentais, e (3) conhecer a associação com indicadores de saúde precária (por exemplo: pensamentos suicidas, diminuição da libido e uso de medicamentos). Participaram do estudo 1.085 médicos, com média de idade de 45,7 (DP = 10,6), maioria de sexo masculino (61,5%), casados ​​(72,6%) e católicos (59,2%). Eles responderam ao QSG-12, ao Inventário de Ideação Suicida Positiva e Negativa e a questões demográficas. O modelo de melhor ajuste foi a estrutura bifactor (composta por ansiedade, depressão e uma dimensão geral), que apresentou alfa de Cronbach, ômega de McDonald e confiabilidade composta superior a 0,70 apenas para o fato geral. Pontuações de sofrimento psicológico se correlacionaram a ideação suicida e indicadores negativos de saúde e satisfação sexual. O instrumento foi psicometricamente adequado e pode ser utilizado em termos de sua pontuação total, mas seus fatores específicos precisam ser utilizados com cautela.

Prevalence of psychological stress among health care workers during COVID-19 pandemic – A cross-sectional questionnaire-based survey in a tertiary care teaching hospital

Background: Health care workers (HCWs) exposed to COVID-19 are at increased risk of developing mental health problems. This study aims to access the prevalence of psychological stress among HCWs during COVID-19 pandemic. Aims and Objectives: The aim of the study was to assess the prevalence of psychological stress among HCWs during COVID-19 pandemic. Materials and Methods: A cross-sectional study was conducted among HCWs working in a tertiary care teaching hospital. A total of about 100 HCWs who participated in the study were randomly distributed prestructured questionnaire pertaining to sociodemographic parameters and variables related to psychological stress and their responses were graded accordingly. Results: It was found that HCWs showed significant rise in psychological distress with moderate-to-severe elevated levels of anxiety (69%), depression (21%), and insomnia (41%). Nurses were significantly more likely to experience anxiety than other HCWs in our present study and the most of the participants were engaged in some form of stress reduction activities. Conclusion: The high levels of psychological distress were reported in HCWs in hospital dealing with COVID-19 patients. Increase efforts are needed for promotion of mental health well-being of HCWs exposed to COVID-19

Perception of danger, coping strategies, and mental health in university population / Percepción de peligro, estrategias de afrontamiento y salud mental en población universitaria

Objective: This study aimed to relate life satisfaction and psychological distress to coping with the perception of criminal danger in university students. Method: Three scales were used: The Life Satisfaction Scale, the K-10 Psychological Distress Scale, and the Coping with Perceived Danger Scale. A total of 370 university students participated, of whom 65.4% were female, and 13.8% had experienced crime in the previous two years. Result: A positive and statistically significant relationship was found between coping with perceived danger, such as cautious avoidance (r=0.274, p ≤ 0.00), preventive coping (r=0.344, p ≤ 0.00), and extreme avoidance (r=0.207, p ≤ 0.00), with psychological distress. These relationships were even stronger for victims of crime. Women show higher levels of psychological distress and more cautious, avoidant and extreme coping strategies in the face of danger compared to men. Finally, a negative and significant relationship was observed between psychological distress and life satisfaction. Conclusion: It appears that regardless of whether a person has been a victim of crime in the last two years, perceptions of danger and strategies of cautious and even extreme crime prevention are related.

Objetivo: El objetivo de este estudio fue relacionar la satisfacción con la vida y el malestar psicológico con el afrontamiento frente a la percepción de peligro delictual en universitarios. Método: Se utilizaron tres escalas, la escala de satisfacción con la vida, la escala de malestar psicológico k-10, y la escala de afrontamiento frente a la percepción de peligro. Participaron 370 estudiantes universitarios, de los cuales un 65,4% son mujeres y un 13,8% han sufrido un delito en los últimos 2 años. Resultados: Se encontró una relación positiva, con un tamaño del efecto pequeño entre el afrontamiento frente la percepción de peligro, como evitación prudente (r=0,274, (p ≤ 0,00), afrontamiento preventivo (r=0,344, p ≤ 0,00) y evitación extrema (r=0,207, p ≤ 0,00) con malestar psicológico. En víctimas de delitos, estas relaciones se hacen más fuertes. Las mujeres muestran un mayor malestar psicológico, así como también estrategias de afrontamiento frente al peligro más prudentes, preventivas y extremas que los hombres. Por último, se observa una relación negativa y significativa entre malestar psicológico y satisfacción con la vida. Conclusión: Se videncia que independiente de que, si la persona es víctima de un delito en los últimos dos años, la percepción de peligro y las estrategias llevadas a cabo para prevenir el delito de forma prudente e incluso extrema, se relacionan entre sí.

Professional quality of life and occupational stress in nursing workers during the COVID-19 pandemic / Calidad de vida profesional y estrés ocupacional en trabajadores de enfermería durante la pandemia del COVID-19 / Qualidade de vida profissional e estresse ocupacional em trabalhadores de enfermagem durante pandemia por COVID-19

ABSTRACT Objective: To identify the levels of professional quality of life and the occupational stress in nursing professionals. Method: Cross sectional study conducted between April and August 2020, with nursing professionals working in inpatient units for clinical and surgical patients of a large hospital. The Work Stress Scale and the Professional Quality of Life Scale were applied. Results: The sample consisted of 150 professionals, with a mean age of 43 ± 8.89 years, being 84.7% (127) female. The mean of the work stress scale was 1.9 (± 0.71), a moderate level of stress. It was found that compassion satisfaction had a median of 50.3 (9.1 - 64.6), burnout of 48.5 (32.2 - 84.8) and post-traumatic stress disorder of 47.1 (38.6 - 98.3). Conclusion: Stress at work and Compassion Fatigue were identified in the sample, especially in secondary-level professionals, demonstrating the need to implement strategies to reduce psycho-emotional harm in these professionals.

RESUMEN Objetivo: Identificar los niveles de calidad de vida profesional y estrés laboral en los profesionales de enfermería. Método: Estudio transversal realizado entre abril y agosto de 2020, con profesionales de enfermería que laboran en unidades de internación para pacientes clínicos y quirúrgicos de un gran hospital. Se aplicó la Escala de Estrés Laboral y la Escala de Calidad de Vida Profesional. Resultados: La muestra estuvo formada por 150 profesionales, con una edad media de 43 ± 8,89 años, siendo el 84,7% (127) mujeres. El promedio de la escala de estrés en el trabajo fue de 1,9 (± 0,71), un nivel de estrés moderado. Se encontró que la satisfacción a través de la compasión tuvo una mediana de 50,3 (9,1 - 64,6), el agotamiento de 48,5 (32,2 - 84,8) y el trastorno de estrés postraumático de 47,1 (38,6 - 98,3). Conclusión: En la muestra se identificaron estrés en el trabajo y fatiga por compasión, especialmente en profesionales de nivel medio, lo que demuestra la necesidad de implementar estrategias para reducir el daño psicoemocional en estos profesionales.

RESUMO Objetivo: Identificar os níveis de qualidade de vida profissional e o estresse ocupacional em profissionais da enfermagem. Método: Estudo transversal realizado entre abril e agosto de 2020, com profissionais da enfermagem atuantes em unidades de internação para pacientes clínicos e cirúrgicos de um hospital de grande porte. Os instrumentos utilizados foram a Escala de Estresse no Trabalho e Escala de Qualidade de Vida Profissional. Resultados: A amostra foi constituída por 150 profissionais, com média de idade de 43 ± 8,89 anos, sendo 84,7% (127) do sexo feminino. A média da escala de estresse no trabalho foi 1,9 (± 0,71), nível moderado de estresse. Verificou-se que satisfação por compaixão apresentou mediana de 50,3 (9,1 - 64,6), burnout de 48,5 (32,2 - 84,8) e estresse pós-traumático de 47,1 (38,6 - 98,3). Conclusão: Identificou-se estresse no trabalho e Fadiga por Compaixão na amostra, principalmente nos profissionais de nível médio, demonstrando a necessidade de implementar estratégias para a redução do dano psicoemocional nestes profissionais.

Psychiatric Symptoms in Women with High-risk Pregnancy in the Postpartum Period: A Case-control Study

Abstract Objective: Psychiatric symptoms are common mental issues in pregnancy and the postpartum period. There is limited information regarding the psychiatric symptoms of women with high-risk pregnancy in the postpartum period. This study aimed to compare the severity of psychiatric symptoms and psychological distress in women with high-risk and low-risk pregnancies in the postpartum period. Methods: This case-control study examined 250 women in the postpartum period in two groups with low-risk (n = 112) and high-risk (n = 138) pregnancies. Women completed the Brief Symptom Inventory-53 (BSI-53) and the Risk Postnatal Psychosocial Depression Risk Questionnaire (PPDRQ). Results: The mean severity of psychiatric symptoms in women with high-risk pregnancies was significantly higher than that in women with low-risk pregnancies (39.34 ± 17.51 vs. 30.26 ± 17.08). Additionally, the frequency of psychological distress in women with high-risk pregnancies was approximately twice higher than that in women with low-risk pregnancies (30.3% vs. 15.2%). Furthermore, the risk factors for depression in women with high-risk pregnancies were almost 1.5 times (59.8% vs. 39.8%) higher than the factors in women with low-risk pregnancies. The results of the logistic analysis indicated that high-risk pregnancies could be twice the odds ratio of developing postpartum psychological distress (ß = 2.14, 95% CI 1.4-6.3, p= 0.036). Conclusion: Psychiatric symptoms and the psychological distress index are higher in postpartum women with high-risk pregnancies than in postpartum women with low-risk pregnancies. The study suggests that obstetricians and pregnant women's health care providers should strongly consider screening of psychiatric symptoms in women with high-risk pregnancies both during pregnancy and after delivery as the women's routine care priorities.

Stress and suffering in hospital nurses: relationship with personal and work variables and life habits / Estrés y sufrimiento en enfermeras de hospitales: relación con variables personales, laborales y hábitos de vida / Estresse e sofrimento em enfermeiros hospitalares: relação com variáveis pessoais, laborais e hábitos de vida

ABSTRACT Objective: to identify the possible associations between stress and suffering with personal, work and lifestyle variables. Method: cross-sectional, quantitative, exploratory, correlational, conducted from June 2019 to February 2020. Data on personal characteristics, life habits and working conditions were obtained with the application of a questionnaire. To assess stress, the Nurses' Stress Inventory (Inventário de Estresse em Enfermeiros) was used and, for suffering, the Pleasure and Suffering Indicators at Work Scale was applied, both in the Brazilian versions. Results: stress was associated with dissatisfaction with remuneration, indicators of suffering and interest in changing jobs and professions. The comparisons between the indicators of suffering and the domains of stress investigation were significant. Conclusion: the stress experienced in nurses' work activity is strongly influenced by low remuneration, leading them to wish to change jobs and professions. Professional burnout and lack of recognition are stressors that drive defense mechanisms, among them, the desire to change jobs.

RESUMEN Objetivo: identificar posibles asociaciones entre estrés y sufrimiento con variables personales, laborales y hábitos de vida. Método: estudio transversal, cuantitativo, exploratorio, correlacional, realizado de junio de 2019 a febrero de 2020. Los datos sobre características personales, hábitos de vida y condiciones de trabajo se obtuvieron mediante la aplicación de un cuestionario. Para la evaluación del estrés, se utilizó el Inventario de Estrés en Enfermeras y, para el sufrimiento, se aplicó la Escala de Indicadores de Placer y Sufrimiento en el Trabajo, ambas en versiones brasileñas. Resultados: el estrés se asoció a la insatisfacción con el salario, indicadores de sufrimiento e interés por cambiar de trabajo y profesión. Las comparaciones entre los indicadores de angustia y los dominios de investigación del estrés fueron significativas. Conclusión: el estrés experimentado en el trabajo de los enfermeros está fuertemente influenciado por la baja remuneración, llevándolos a querer cambiar de trabajo y de profesión. El agotamiento profesional y la falta de reconocimiento son factores estresantes que impulsan los mecanismos de defensa, incluido el deseo de cambiar de trabajo.

RESUMO Objetivo: identificar as possíveis associações entre o estresse e o sofrimento com as variáveis pessoais, laborais e hábitos de vida. Método: estudo transversal, quantitativo, exploratório, correlacional, realizado no período de junho de 2019 a fevereiro de 2020. Os dados sobre as características pessoais, hábitos de vida e as condições de trabalho foram obtidos com a aplicação de questionário. Para avaliação do estresse, utilizou-se o Inventário de Estresse em Enfermeiros e, para o sofrimento, aplicou-se a Escala de Indicadores de Prazer e sofrimento no Trabalho, ambos nas versões brasileiras. Resultados: o estresse esteve associado à insatisfação com a remuneração, indicadores de sofrimento e interesse em mudar de emprego e profissão. As comparações entre os indicadores de sofrimento e os domínios de investigação do estresse foram significativas. Conclusão: o estresse vivenciado na atividade laboral do enfermeiro recebe forte influência da baixa remuneração, levando-o a desejar mudar de emprego e profissão. O esgotamento profissional e a falta de reconhecimento são estressores que impulsionam mecanismos de defesa, dentre eles, o desejo de mudar de emprego.

Intensity and frequency of moral distress in mental health nurses in Brazil / Intensidad y frecuencia del sufrimiento moral en enfermeros de salud mental en Brasil / Intensidade e frequência de distresse moral em enfermeiros de saúde mental no Brasil

ABSTRACT Objective: To assess the intensity and frequency of moral distress in mental health nurses in Brazil. Method: Cross-sectional study with 173 nurses from the Psychosocial Care Network in Brazil. The Brazilian Scale of Moral Distress in Nurses, adapted for the context of mental health, was used. For data processing, descriptive and inferential statistical analysis was used. Results: Mostly moderate levels of intensity and frequency of moral distress (medians between 2.25 - 3.73 and 2.00 - 3.22, respectively) were observed, with emphasis on the factors working conditions and social conflicts. Conclusion: The level of moral distress evidenced in mental health nurses in Brazil reflects the dimension and amplitude of the phenomenon in different points of the Psychosocial Care Network. The relevance of discussions on coping strategies for moral distress is highlighted, articulating elements such as sensitivity, resilience, and moral courage, so that ethical deliberation is applied in care and management settings.

RESUMEN Objetivo: Evaluar la intensidad y frecuencia del sufrimiento moral en enfermeros de salud mental en Brasil. Método: Estudio transversal con 173 enfermeros de la Red de Atención Psicosocial del territorio brasileño. Se utilizó la Escala Brasileña de Sufrimiento Moral en Enfermeros adaptada para el contexto de la salud mental. Se utilizó análisis estadístico descriptivo e inferencial para el procesamiento de datos. Resultados: Se observó, en su mayoría, niveles moderados de intensidad y frecuencia de sufrimiento moral (medianas entre 2,25 - 3,73 y 2,00 - 3,22, respectivamente), con énfasis en los factores condiciones de trabajo y conflictos sociales. Conclusión: El nivel de sufrimiento moral evidenciado en enfermeros de salud mental en Brasil refleja la dimensión y amplitud del fenómeno en los diferentes puntos de la Red de Atención Psicosocial. Se destaca la relevancia de las discusiones sobre estrategias de enfrentamiento del sufrimiento moral, articulando elementos como la sensibilidad, la resiliencia y el coraje moral, para que la deliberación ética sea aplicada en contextos de cuidado y gestión.

RESUMO Objective: To assess the intensity and frequency of moral distress in mental health nurses in Brazil. Method: Cross-sectional study with 173 nurses from the Psychosocial Care Network in Brazil. The Brazilian Scale of Moral Distress in Nurses, adapted for the context of mental health, was used. For data processing, descriptive and inferential statistical analysis was used. Results: Mostly moderate levels of intensity and frequency of moral distress (medians between 2.25 - 3.73 and 2.00 - 3.22, respectively) were observed, with emphasis on the factors working conditions and social conflicts. Conclusion: The level of moral distress evidenced in mental health nurses in Brazil reflects the dimension and amplitude of the phenomenon in different points of the Psychosocial Care Network. The relevance of discussions on coping strategies for moral distress is highlighted, articulating elements such as sensitivity, resilience, and moral courage, so that ethical deliberation is applied in care and management settings.