Quality indicators applied in a nursing continuing education program of a high complexity university hospital from Brazil: I ­ attendance indicators / Indicadores de qualidade aplicados a um programa de educação continuada de um hospital universitário brasileiro de alta complexidade: I ­ indicadores de comparecimento

Studies with nursing continuing education are common in the literature with a predominance of qualitative approaches. Quantitative assessments are punctual and focused on a single quality indicator, and few studies relate these indicators to the profile of nursing staff. The objective of the study was to describe the Training Cycles of the Clinical Hospital of Uberlândia as a strategy of a Nursing Continuing Education Program and evaluate the attendance indicators and their association with the nursing staff profile. The Training Cycles of the Clinical Hospital of Uberlândia are cyclic courses that are offered continually, in a mandatory participation regime, during work hours, outside of the hospital, focused on Nursing staff. The study was conducted in 2013/2014 and has a documentary character. It was held in a public high complexity university hospital in Brazil. The Relative Frequency Attendance was calculated in relation to the nursing professional category and shift. Attendance indicators were affected by professional category. Participation increased over time for the technical level (assistants and nursing technicians) and decreased for nurses. We found an attendance rate of 54.49% in nursing hospital staff. The attendance indicators were also different for the period/shift of the course (gradual decrease of attendance from morning to afternoon to night). We also observed a decrease in attendance indicators over time. Attendance indicators were effective in describing the results of the Continuing Education Program and allowed the service administrators to associate the indicator results to the nursing profile. These results served as a basis for adjustments in the continuing education program of the institution.

Estudos com educação continuada em enfermagem são comuns na literatura, embora com predominância de abordagem qualitativa. Avaliações quantitativas são pontuais e concentradas em um único indicador de qualidade, e em raros casos relacionam estes indicadores com o perfil da enfermagem. O objetivo deste estudo foi descrever o Ciclo de Capacitação do Hospital de Clínicas de Uberlândia como uma estratégia de um Programa de Educação Continuada em Enfermagem e avaliar os indicadores de comparecimento desse programa e sua associação com o perfil dos profissionais de enfermagem. O Ciclo de Capacitação do Hospital de Clínicas de Uberlândia é um curso cíclico que é oferecido continuamente, em um regime de participação obrigatória, durante as horas de trabalho, fora do hospital, e dedicado à equipe de enfermagem. O estudo foi realizado em 2013/2014, tem caráter documental, foi realizado num hospital público, de alta complexidade e universitário no Brasil. Foi calculado a Frequência Relativa de Comparecimento em função da categoria profissional e do plantão. Observamos uma taxa de comparecimento de 54.49% para os profissionais de enfermagem do hospital. Os indicadores de comparecimento foram afetados pela categoria profissional (aumento da participação ao longo do tempo para os profissionais de nível técnico (auxiliares e técnicos de enfermagem) e diminuição da participação dos enfermeiros. Houve diferenças entre os turnos de oferecimento do curso (diminuição gradativa da participação da manhã para a tarde e desta para a noite). Observou-se também a redução nos indicadores de comparecimento ao longo dos cursos em função do tempo de oferecimento. Os indicadores de comparecimento propostos foram eficazes em descrever os resultados e o comportamento do programa de educação continuada e permitiram associar seus resultados ao perfil dos profissionais de enfermagem e serviram de embasamento para ajustes no programa de educação permanente da instituição.

Health and leisure of workers of day and night shifts / Salud y ocio de los trabajadores de los turnos de día y noche

OBJECTIVE: To analyze differences in health, leisure and work accord ing to work shift in industry workers of Florianopolis, Brazil. METHOD: participants were 885 workers on fixed work shift (649 of the gen eral shift, 101 of the 1st shift, 84 of the 2nd shift and 51 of the 3rd shift). Health was investigated using the International Physical Activity Questionnaire - Short Form (IPAQ-SF), the Pittsburgh Sleep Quality Index (PSQI) and the Horne-Ostberg morningness and eve ningness questionnaire for physical activity, sleep quality and chro- notype, respectively. Leisure activities were investigated based on the Scale of practices in leisure (Escala de Práticas no Lazer - EPL). To calculate difference between means, the Kruskall-Wallis test (Dunn or Student-Newman-Keuls post hoc) and the chi-square test were used. In the correlation analysis among continuous variables, the Spearman test was used. Data were analyzed using SPSS 20.0, BioEstat 5.0 and GPower 3.0 softwares. A 5% significance level was adopted. RESULTS: The average age of workers was 31.1 (8.5) years, and 58.0% were female. Significant differences among work shifts with respect to sleep quality (p<0.001) were identified, with prevalence of 35.6% of sleep disorders in the night shift. Among these, 16.7% showed morn ing characteristics and 68.6% reported absence from work for health reasons in the last year. The consumption of caffeinated beverages (33.3%) and cigarettes (21.6%) were also higher among night shift workers. Nevertheless, the time in vigorous physical activity was higher, averaging 75.5 minutes per week. Furthermore, night shift workers had lower income (p<0.001) and seek a second job for income complementation (p=0.002). Among issues related to leisure, differences in artistic (p=0.046), physical-sport (p=0.048) and touris tic content (p=0.004) were identified. CONCLUSION: substantial differ ences regarding labor, health and leisure issues were evidenced in different shifts, especially in the night shift. Although, theoretically, there is more time for leisure activities, night shift workers seek for a second job for income complementation. The excess of work associ ated with waking at night and risk behaviors result in damages to health and leisure.

OBJETIVO: analizar las diferencias en salud, ocio y trabajo según el turno de trabajo en trabajadores de la industria de Florianópolis, Brasil. MÉTODO: los participantes fueron 885 trabajadores en el turno de traba jo fijo (649 del turno general, 101 del primer turno, 84 del segundo turno y 51 del tercer turno). La salud se investigó utilizando el Cuestionario Internacional de Actividad Física - Forma Corta (IPAQ-SF), el Índice de Calidad de Sueño de Pittsburgh (PSQI) y el cuestionario de mañana y noche de Horne-Ostberg para actividad física, calidad del sueño y cronotipo, respectivamente. Las actividades de ocio se investi garon en función de la Escala de prácticas en el ocio (Escala de Práticas no Lazer - EPL). Para calcular la diferencia entre medias, se utilizó la prueba de Kruskall-Wallis (Dunn o Student-Newman-Keuls post hoc) y la prueba de chi-cuadrado. En el análisis de correlación entre variables continuas, se utilizó la prueba de Spearman. Los datos se analizaron utilizando los softwares SPSS 20.0, BioEstat 5.0 y GPower 3.0. Se adop tó un nivel de significancia del 5%. RESULTADOS: la edad promedio de los trabajadores fue de 31,1 (8,5) años, y el 58,0% fueron mujeres. Se identificaron diferencias significativas entre los turnos de trabajo con respecto a la calidad del sueño (p <0,001), con una prevalencia del 35,6% de los trastornos del sueño en el turno de la noche. Entre estos, el 16,7% mostró características matinal y el 68,6% informó ausencia del trabajo por razones de salud en el último año. El consumo de bebidas con cafeína (33,3%) y cigarrillos (21,6%) también fue mayor entre los trabajadores del turno nocturno. Sin embargo, el tiempo en la actividad física vigorosa fue mayor, con un promedio de 75,5 minutos por semana. Además, los trabajadores del turno de noche tenían ingresos más bajos (p <0,001) y buscaban un segundo trabajo para complementarlos (p = 0,002). Entre los temas relacionados con el ocio, se identificaron diferencias en el contenido artístico (p = 0,046), físico-deportivo (p = 0,048) y turístico (p = 0,004). CONCLUSIÓN: las diferencias sustanciales en cuanto a trabajo, salud y ocio se evidenciaron en diferentes turnos, especialmente en el turno de noche. Aunque, teóricamente, hay más tiempo para las actividades de ocio, los trabajadores del turno de noche buscan un segundo empleo para la complementación de ingresos. El exceso de trabajo asociado al despertarse por la noche y los comporta mientos de riesgo resultan en daños a la salud y al ocio.

Qualidade de Vida de Enfermeiros do Serviço de Atendimento Móvel de Urgência com Dupla Jornada de Trabalho / Nurses' Life Quality of Mobile Urgency Service with Double Work Shift

Objetivou-se descrever a qualidade de vida de enfermeiros do Serviço de Atendimento Móvel de Urgência com Dupla Jornada de Trabalho. Trata-se de um estudo exploratório e descritivo realizado de julho a agosto de 2015 com enfermeiros do Serviço de Atendimento Móvel de Urgência em Sobral ­ Ceará. Para coleta das informações foi usado o questionário validado Whoqol-Bref. Os dados foram apresentados, de forma descritiva, e discutidos de acordo com a literatura pertinente sobre o assunto. O estudo mostrou que quase a metade dos profissionais não está satisfeita com a qualidade de suas vidas. Contudo, no domínio físico, se mostraram bem fisicamente, no psicológico se mostraram positivos nos sentimentos negativos, quanto à ansiedade. Nas relações sociais, os enfermeiros estavam satisfeitos e no domínio do meio ambiente, eles demonstraram opiniões divididas entre satisfeitos e insatisfeitos e enfatizaram os riscos que estão sujeitos nas ocorrências. Portanto, o enfermeiro, em qualquer serviço em que atua, merece apoio, respeito e valorização, neste sentido é preciso políticas que promovam saúde, previnam doenças com vistas a melhor qualidade de vida. (AU)

The purpose of this study was to describe the nurses' life quality at the Double Emergency Mobile Service work shift. This is an exploratory and descriptive study carried out from July to August 2015 with nurses from the Mobile Emergency Care Service in Sobral - Ceará. To collect the information, the validated Whoqol-Bref questionnaire was used. The data were presented descriptively and discussed according to relevant literature on the subject. The study showed that nearly half of professionals are not satisfied with the their lives quality. However in the physical domain, they were physically well, in the psychological, they were positive regarding their feelings and negative when it comes to anxiety. In social relationships, nurses were satisfied and in the environmental domain, they demonstrated divided opinions between satisfied and unsatisfied and emphasized the risks that they are subject in the occurrences. Therefore, the nurse, in any service in which he / she works, deserves support, respect and appreciation, in this sense it is necessary policies that promote health, prevent diseases with a view to a better life quality. (AU)

Estrés laboral en auxiliares de enfermería, Medellín-Colombia, 2011: Estrés laboral en auxiliares de enfermería / Job stress in nursing assistants, Medellín-Colombia, 2011

Objetivo: Identificar la presencia de estrés laboral en auxiliares de enfermería que trabajan en salas de hospitalización de adultos y las condiciones institucionales que lo configuran. Metodología: Estudio cualitativo de caso colectivo que parte de la determinación de características comunes o no entre los datos obtenidos de los casos individuales para su posterior análisis. Participaron seis casos: cinco mujeres y un hombre, auxiliares de enfermería con menos de 10 años de experiencia laboral en salas de hospitalización de adultos. Se utilizó la entrevista semiestructurada y se aplicó el consentimiento informado. Resultados: Las condiciones que provocaron el estrés fueron la Jornada laboral con tiempos reales de 13 ó 14 horas seguidas, sin espacios para la alimentación y el descanso, y actividades adicionales que no se encuentran dentro de las funciones normatizadas pero que son delegadas por otros profesionales de la salud y que se vuelven una carga más para ellas, tales como el transporte de pacientes, apoyo durante transfusiones sanguíneas, limpieza del carro de medicamentos y el estar ahí dando cuidado permanente a los pacientes. Como aminorante del estrés aparecen las relaciones entre el equipo de trabajo. Conclusión: Se identifica la presencia del estrés laboral en las auxiliares de enfermería que trabajan en salas de hospitalización de adultos. Las condiciones descritas limitan el tiempo para el cuidado de los pacientes y el cuidado de sí mismas y alteran su condición física, psicológica y emocional, factores que se relacionan con el estrés laboral. Salud UIS 2013; 45 (1): 23-31.

Objective: To identify the presence of stress in nursing assistants working in adult hospital rooms and institutional conditions that shape it. Methodology: Qualitative study of collective case, it parts on the determination of common or not characteristics between obtained dates of individual cases for later analysis. Six participant cases composed by five female and one male nursing assistants with less than 10 years of experience in adults hospital rooms. A semi-structured interview and a informed consent was applied. Results: The conditions that mediate stress were the workday with times of 13 or 14 hours continues without spaces for eating and resting and additional activities which aren’t in theirs functions but are delegated by other health professionals that increase their workload, like a moving patients, supporting blood’s transfusions, medication cart cleansing, and giving permanently care to patients. The relationships among the team appear as buffering of stress. Conclusion: The presence of occupational stress in nursing assistants that work in adults hospital rooms was identified. The conditions described limits the time for patient care and self care and affects their physical, psychological and emotional conditions, factors related to job stress. Salud UIS 2013; 45 (1): 23-31.

Occupational Stress and Related Factors among Aged Security Guards / 산업간호학회지

PURPOSE: Occupational stress is a determinant risk factor for cardiovascular disease and work disability. This study aims to describe occupational stress and identify its related factors among aged security guards. METHODS: A random sample of 76 aged security guards were interviewed by three research assistants. The criteria of the subjects were as follows : 50 or older male with 40 or more working hours a week working with colleagues ranged from 3 to 50. The data were collected in September, 2007 and analyzed by multiple regression using SAS Version 9.1. RESULTS: The mean score of occupational stress among aged security guards was 47.2. The mean scores of its sub-scales were 31.3(physical environment), 33.8(occupational demand), 80.8occupational control), 44.6(interpersonal conflict), 51.3 (occupational insecurity), 53.6(occupational system), 57.5(lack of reward), and 30.3(work environment). The scores of occupational control, interpersonal conflict, and occupational insecurity were higher than the scores of Korean average occupational stress sub-scales. Significant variables affecting occupational stress and its sub-scales were work place, work type, and employment type. CONCLUSION: In order to reduce occupational stress among security guards, sufficient occupational control and interpersonal conflict control, appropriate reward, and employment stability should be considered. Also long working hours and work shift should be improved.

Occupational Stress and Related Factors among Aged Security Guards / 산업간호학회지

PURPOSE: Occupational stress is a determinant risk factor for cardiovascular disease and work disability. This study aims to describe occupational stress and identify its related factors among aged security guards. METHODS: A random sample of 76 aged security guards were interviewed by three research assistants. The criteria of the subjects were as follows : 50 or older male with 40 or more working hours a week working with colleagues ranged from 3 to 50. The data were collected in September, 2007 and analyzed by multiple regression using SAS Version 9.1. RESULTS: The mean score of occupational stress among aged security guards was 47.2. The mean scores of its sub-scales were 31.3(physical environment), 33.8(occupational demand), 80.8occupational control), 44.6(interpersonal conflict), 51.3 (occupational insecurity), 53.6(occupational system), 57.5(lack of reward), and 30.3(work environment). The scores of occupational control, interpersonal conflict, and occupational insecurity were higher than the scores of Korean average occupational stress sub-scales. Significant variables affecting occupational stress and its sub-scales were work place, work type, and employment type. CONCLUSION: In order to reduce occupational stress among security guards, sufficient occupational control and interpersonal conflict control, appropriate reward, and employment stability should be considered. Also long working hours and work shift should be improved.

Influência do turno laboral na formação de edema dos membros inferiores em indivíduos normais / Influence of working shift on the formation of lower limb edema in normal individuals

CONTEXTO: A presença de edema vespertino nos membros inferiores de indivíduos normais, após jornada habitual de trabalho, foi demonstrada na literatura nacional e internacional. O ritmo de formação e o acúmulo desse edema variam de acordo com os distintos turnos laborais. OBJETIVO: O edema de membros inferiores tem sido descrito após jornadas habituais de trabalho e representa uma queixa freqüente na prática vascular. O objetivo deste estudo foi avaliar a evolução do edema em indivíduos normais durante os distintos turnos laborais. MÉTODO: Foram feitas avaliações volumétricas de ambos os membros inferiores em 20 profissionais da área da saúde do Hospital e Maternidade São Marcos de Maringá, no Paraná. A escolha dos participantes foi por ordem de chegada, e as volumetrias foram feitas por técnica de deslocamento de água às 7, 13 e 19 h. Para análise estatística foi utilizado o teste t de Student, considerando erro alfa de 5%. RESULTADO: Dos 20 participantes, 19 eram do sexo feminino e 1 do masculino, sem evidência de doença venosa nos membros inferiores e pertencentes a C0 e C1 da classificação CEAP (C = clínica, E = etiologia, A = segmento anatômico, P = fisiopatologia). As idades dos participantes variaram entre 20 e 53 anos. Detectou-se aumento significativo de volume nos membros inferiores entre os distintos períodos avaliados, com p = 0,0001 e 0,0001, respectivamente. A maior variação ocorreu no período da manhã, com média ± desvio padrão de 107,2±63,5 mL, enquanto que à tarde, a variação foi de 44,5±35,4 mL. CONCLUSÃO: O edema é uma constante durante atividades laborais, mesmo em pessoas sem doença venosa manifesta e sofre influência do turno laboral ao qual o trabalhador se encontra exposto.

BACKGROUND: Presence of evening edema of lower limbs in normal individuals after a regular working shift has been shown in the national and international literature. Formation rhythm and accumulation of this type of edema vary according to different work shifts. OBJECTIVE: Edema of the legs has been described after regular work shifts and is a common complaint in vascular practice. The objective of this study was to evaluate the evolution of edema in apparently normal individuals during distinct work shifts. METHOD: Volumetric assessments of both legs were performed in 20 healthcare professionals at São Marcos Hospital and Maternidade in Maringá, Brazil. Individuals were selected on a consecutive basis with water displacement volumetry being performed at 7:00 a.m., 1:00 p.m. and 7:00 p.m. Student's t test was used for statistical analysis with an alpha error of 5% being considered acceptable. RESULTS: The study group consisted of 19 women and one man with ages ranging from 20 to 53 years old. The participants had no evidence of venous diseases of the lower limbs and were C0 or C1 according to the CEAP classification (C = clinical, E = etiology, A = anatomy, P = pathophysiology). Significant increases in the volume of both legs were seen after both shifts (p = 0.0001 in both cases). The greatest variation occurred during the morning with a mean ± standard deviation of 107.2±63.5 mL, while in the afternoon mean increase was 44.5±35.4 mL. CONCLUSION: Edema is constant in work activities, even in individuals without obvious venous diseases, and is influenced by work shift.

Combined Effects of Individual Background, Work Shift and Job Stress on the Prevalence of Sleep Problems in Hospital Employers

BACGROUND: The accuracy and efficiency of a job performed by hospital employee can be linked directly with patients' health and life. It is considered that their irregular work and stress are relatively high as compared with other workplaces. In this article we tried to look into how job stress, working environment and factors of life-style influence sleep problems in hospital employees. METHODS: This research was conducted among 248 workers of a hospital in Busan on April, 2002. Sleep problems were categorized into insomnia, sleep deprivation, daytime sleepiness and snoring on the basis of the factor analysis of 11-item questions. The job stress was proposed by Karasek, etc., and measured by 14-item modified questions. The statistical analysis was conducted using Chi-square test and multiple logistic regression analysis. RESULTS: Statistically insomnia, sleep deprivation and daytime sleepiness showed a significant increase in women (OR:2.1/2.69/3.16) and shift workers (OR:4.67/3.28/1.98) and snoring showed a significant increase in obesity (OR:5.0) and smokers (OR:2.34). CONCLUSION: This research showed that many hospital employees perceive sleep disorders as critical. Especially, work shift seemed to be an important risk factor for sleep disorders.