Estrategias de afrontamiento ante la crisis sanitaria: un estudio comparativo en enfermeros de costa y sierra ecuatoriana / Coping strategies in the face of the health crisis: A comparative study in nurses from the Ecuadorian coast and highlands

Se realizó una encuesta transversal de dos muestras separadas por conveniencia de enero a marzo de 2021 a fin de comparar la prevalencia de percepción de riesgo e identificar diferentes estrategias de afrontamiento en enfermeros de la costa y la sierra ecuatoriana. Las muestras incluyeron dos grupos de profesionales de enfermería para un total de 518. El 49,0% (n= 254) de los participantes laboraban en la sierra ecuatoriana y el 50,8% (n= 263) prestaban sus servicios en la costa ecuatoriana. Muestreados provenientes de varias clínicas, tanto en la costa como en la sierra ecuatoriana, fueron abordados aleatoriamente por el entrevistador para participar en el estudio. Se examinaron y compararon los resultados de las pruebas de las tres muestras. Los grupos se eligieron en función de la conveniencia del muestreo y la supuesta conciencia de los factores de riesgo de COVID-19. En cuanto a la percepción de riesgo, su prevalencia es significativamente mayor para las enfermeras de la costa que las de la sierra. Las enfermeras que prefieren trabajar en equipo durante la crisis sanitaria tenían probabilidades alrededor de 0,30 más bajas, lo que puede interpretarse como un factor protector. Respecto al miedo al contagio no se hallaron diferencias entre enfermeras de la costa o la sierra(AU)

A cross-sectional survey of two samples separated by convenience was carried out from January to March 2021 to compare the prevalence of risk perception and identify different coping strategies in nurses from the Ecuadorian coast and highlands. The samples included two groups of nursing professionals for a total of 518. 49.0% (n= 254) of the participants worked in the Ecuadorian highlands and 50.8% (n= 263) provided their services on the ecuadorian coast. Samples from various clinics, both on the coast and in the Ecuadorian highlands, were randomly approached by the interviewer to participate in the study. The test results of the three samples were examined and compared. Groups were chosen based on sampling convenience and presumed awareness of COVID-19 risk factors. Regarding the perception of risk, its prevalence is significantly higher for nurses from the coast than those from the mountains. Nurses who prefer to work in a team during the health crisis had probabilities around 0.30 lower, which can be interpreted as a protective factor. Regarding the fear of contagion, no differences were found between nurses from the coast or the mountains(AU)

Síndrome de Burnout y desempeño laboral del personal de salud durante la pandemia COVID 19 / Burnout syndrome and work performance of health personnel during the COVID 19 pandemic

La investigación tiene como objetivo contrastar el síndrome de Burnout con el desempeño laboral en el contexto del Covid-19. Se desarrolla un estudio descriptivo transversal de tipo cuantitativo, se utilizan dos encuestas validadas: escala de Maslach Burnout Inventory y desempeño laboral, la población corresponde al personal de salud que labora en la unidad de cuidados intensivos. Los resultados determinan que existe mediana prevalencia en padecer síndrome de burnout en relación al desempeño laboral, el mayor porcentaje se encuentra con una evaluación alta caracterizando a los profesionales casados con un mejor desempeño laboral que los solteros, la mayor fuerza laboral se sitúa en la población adulta madura en rangos de 30 a 40 años, se obtiene correlación significativa entre el síndrome de burnout y desempeño laboral, no existe relación significativa entre las variables sociodemográficas y el síndrome de burnout.

The objective of the research is to contrast the Burnout syndrome with work performance in the context of Covid-19. A cross-sectional descriptive study of quantitative type is developed using two validated surveys: the Maslach Burnout Inventory scale and work performance, the population corresponds to health personnel who work in the intensive care unit. The results determine that there is a medium prevalence of suffering from burnout syndrome in relation to work performance, the highest percentage is found with a high evaluation, characterizing married professionals with better work performance than single ones, the highest workforce is located in the mature adult population in the 30 to 40 years age range, there is a significant correlation between burnout syndrome and work performance, there is no significant relationship between sociodemographic variables and burnout syndrome.

Conductas ansiógenas y depresivas en el personal de salud de Ecuador ante la emergencia covid-19 / Anxiogenic and depressive behaviors in Ecuador's health personnel in the face of the COVID-2019 emergency

RESUMEN Introducción: la covid-2019 es una de las grandes pandemias que ha azotado la humanidad, ocasionando millones de infectados y la muerte de miles de personas. Ecuador está entre los ocho primeros países de América Latina y el Caribe más afectados por la enfermedad, que ha generado un colapso en el sistema de salud y otras consecuencias dañinas, como la afectación de la salud mental de los profesionales que atienden a los pacientes infectados. Objetivo: identificar la presencia de conductas ansiógenas y depresivas en el personal de salud de Ecuador ante la emergencia sanitaria por covid-2019. Materiales y métodos: se realizó un estudio descriptivo, transversal de 400 profesionales de diversas áreas de la salud en Ecuador. Se utilizó una ficha sociodemográfica y la Escala Hospitalaria de Ansiedad y Depresión. Se estudiaron las variables edad, sexo, especialidad y sintomatología de ansiedad y depresión. Resultados: del total de profesionales estudiados, el 46,40 % presentó ansiedad, y en el 34,50 % se identificó sintomatología depresiva. Las puntuaciones más altas de ansiedad y depresión se reportaron en el personal de enfermería. Conclusiones: el estudio descriptivo mostró la presencia de conductas ansiógenas y depresivas en los trabajadores sanitarios, en especial en el personal de enfermería, seguido de médicos y psicólogos. Se demostró que los trabajadores de salud se encuentran en el grupo vulnerable a presentar afectaciones psicológicas derivadas del enfrentamiento a la pandemia covid-19 (AU).

ABSTRACT Introduction: COVID-2019 is one of the great pandemics that have struck humanity, causing millions of infected people and the deaths of thousands. Ecuador is among the top eight countries in Latin America and the Caribbean most affected by the disease, which has led to a collapse in the health system and other harmful consequences, such as affecting the mental health of professionals who care for infected patients. Objective: to identify the presence of anxiogenic and depressive behaviors in the health personnel of Ecuador in the face of the health emergency by COVID-2019. Materials and methods: a descriptive, cross-sectional study of 400 professionals from various health areas in Ecuador was carried out. A socio-demographic chart and the Hospital Scale of Anxiety and Depression were used. The variables age, sex, specialty and symptoms of anxiety and depression were studied. Results: of the total number of professionals studied, 46.40 % had anxiety, and in 34.50 % depressive symptoms were identified. The highest anxiety and depression scores were reported in the nursing staff. Conclusions: the descriptive study showed the presence of anxiogenic and depressive behaviors in health workers, especially in the nursing staff, followed by doctors and psychologists. It was shown that health workers are in the group vulnerable to having psychological effects arising from the confrontation with the COVID-19 pandemic (AU).

Estrés laboral y dinámica familiar en el personal de enfermería / Occupational Stress and Family Dynamics in the Nursing Personnel

Introducción: El profesional de enfermería se encuentra expuesto a situaciones emocionalmente fuertes, ya que a diario toman decisiones vitales para para salvar vidas y enfrentan la muerte. Estas tensiones pueden generar estrés, el cual no solo afecta la productividad o desempeño en su trabajo, sino que influyen en la salud física, mental y emocional, lo cual perturba incluso las relaciones con los miembros de su familia. Objetivo: Determinar la relación existente entre la dinámica familiar y el estrés laboral que presentan las enfermeras que laboran en del Hospital Regional de la Policía Nacional del Perú Julio Pinto Manrique, Arequipa, Perú. Métodos: Estudio descriptivo, transversal y correlacional. Población de 72 enfermeras activas, del Hospital Regional de la Policía Nacional del Perú Julio Pinto Manrique. La muestra estuvo conformada por 50 enfermeras, quienes consintieron participar en el estudio y no se encontraban de licencia. Fueron aplicados dos cuestionarios: uno para estimar el grado de estrés conocido como Escala de Estrés de la vida profesional de 22 ítems, y otro para valorar la Dinámica Familiar de 18 ítems. Los datos fueron procesados por estadística descriptiva y para el análisis inferencial se aplicó la prueba Chi cuadrado de Pearson (X 2) con un nivel de significancia del 5 por ciento. Resultados: Presentó nivel de estrés leve el 70 por ciento de las enfermeras y la dinámica familiar fue valorada como aceptable y satisfactoria en el 38 y 30 por ciento, respectivamente. Las enfermeras que presentaron niveles de estrés entre moderado y alto, reflejaron dinámicas familiares insatisfactorias. Conclusiones: El personal de enfermería del Hospital Regional de la Policía Nacional del Perú Julio Pinto Manrique; presentó bajo nivel de estrés, el cual deriva de las actividades propias de la profesión. La asociación de estrés con la dinámica familiar no fue significativa, muy probablemente debida al número de muestra(AU)

Introduction: Nursing professionals are exposed to emotionally strong situations, since they make vital decisions day by day, in order to save lives and face death. These tensions can generate stress, which not only affects productivity or performance at work, but also affects their physical, mental and emotional health, which even disturbs their relationships with their family members. Objective: To determine the relationship between family dynamics and occupational stress presented by nurses who work at Julio Pinto Manrique Regional Hospital of the National Police of Peru, in Arequipa. Methods: Descriptive, cross-sectional and correlational study carried out with a population of 72 active nurses from Julio Pinto Manrique Regional Hospital of the National Police of Peru. The sample consisted of fifty nurses, who consented to participate in the study and were not out of work. Two questionnaires were applied: one for estimating the degree of stress, known as Professional Life Stress Scale and made up of 22 items; and another for assessing family dynamics, made up of eighteen items. The data were processed using descriptive statistics, while Pearson's chi-square test (X2) was applied for inferential analysis, with a significance level of 5 percent. Results: 70 percent of the nurses presented a mild stress level, while family dynamics was assessed as acceptable and satisfactory in 38 percent and 30 percent, respectively. The nurses who presented moderate-to-high stress levels showed unsatisfactory family dynamics. Conclusions: The nursing personnel of Julio Pinto Manrique Regional Hospital of the National Police of Peru presented a low level of stress, which derives from professional practice itself. The association of stress with family dynamics was not significant, most likely due to the number of samples(AU)

Spiritual care performed in a drug user clinic / El cuidado espiritual realizado en una unidad de internación en adición / O cuidado espiritual realizado em uma unidade de internação em adição

ABSTRACT Objective: To know the spiritual care practices of health workers in the context of an inpatient unit for the treatment of addictive disorders, aiming to incorporate an expanded care practice. Method: Qualitative study considering the Convergent Care Research theoretical framework. The data collection occurred using semi-structured interviews, with three rounds of conversations and informal chats with 14 health professionals, from July to November 2017. The analysis followed the steps of apprehension, synthesis, theorization and transference. Results: Four categories emerged: respect for user ethical values; addressing the beliefs and values of professionals; the health professional-user relationship; and collective spiritual care. The main actions highlighted were individual (relaxation and prayer) and collective (meditation, spirituality and the 12 steps). Conclusion: The rounds of conversations carried out in this research allowed workers to talk about spiritual care in addiction, to better understand its relevance to meet the needs of the patient.

RESUMEN Objetivo: Conocer las prácticas de cuidado espiritual de los trabajadores de la salud en el contexto de una unidad de hospitalización para el tratamiento de trastornos adictivos, con el objetivo de incorporar una práctica de atención ampliada. Método: Estudio cualitativo con referencial metodológico de la Investigación Convergente Asistencial. Se realizaron entrevistas semiestructuradas, tres rondas de conversaciones y conversaciones informales con 14 trabajadores de salud en una internación por adición de julio a noviembre de 2017. El análisis de las informaciones siguió las etapas de aprehensión, síntesis, teorización y transferencia. Resultados: Surgieron cuatro categorías: respeto de los valores éticos de los usuarios; creencias y valores de la persona; relaciones profesional de salud-usuario; y cuidado espiritual en grupo. Las principales acciones destacadas fueron individuales (relajación y oración) y colectivas (meditación, espiritualidad y 12 pasos). Conclusión: Las rondas de conversaciones, realizadas en esta investigación, permitieron a los trabajadores conversar sobre el cuidado espiritual en la adición, comprendiendo mejor su relevancia asistencial para atender las necesidades del paciente.

RESUMO Objetivo: Conhecer as práticas de cuidado espiritual de trabalhadores de saúde no contexto de uma unidade de internação para o tratamento de transtornos aditivos, visando incorporar uma prática assistencial ampliada. Método: Estudo qualitativo com referencial metodológico da Pesquisa Convergente Assistencial. Foram realizadas entrevistas semiestruturadas, três rodadas de conversas e conversas informais com 14 trabalhadores de saúde em uma unidade de internação em adição de julho a novembro de 2017. A análise das informações seguiu as etapas apreensão, síntese, teorização e transferência. Resultados: Emergiram quatro categorias: evocação dos valores éticos dos trabalhadores; respeito às crenças e valores do usuário; encontro trabalhador de saúde-usuário e cuidado espiritual em grupo. As principais ações destacadas foram individuais (relaxamento e oração) e coletivas (meditação, espiritualidade e 12 passos). Conclusão: As rodadas de conversas, realizadas nesta pesquisa, permitiram aos trabalhadores conversarem sobre o cuidado espiritual na adição, compreendendo melhor a sua relevância assistencial para atender às necessidades do paciente.

El precio de la vocación en el personal de enfermería y su familia / The Price of Vocation for the Nursing Staff and their Families

RESUMEN Introducción: La enfermería es una de las profesiones con mayor exposición a riesgos laborales. Uno de los principales es el conflicto trabajo - familia. Aun cuando este fenómeno impacta negativamente la salud e interacciones sociales de los trabajadores, la investigación sobre el mismo en el contexto de las profesionales de enfermería y desde una perspectiva cualitativa es limitada. Objetivo: Comprender el significado que tiene la relación trabajo-familia y las consecuencias asociadas para el personal de enfermería. Métodos: Estudio cualitativo utilizando herramientas de la teoría fundada para el análisis y comprensión de la información. Se realizaron nueve entrevistas semi-estructuradas. Las participantes fueron seleccionadas utilizando la técnica de bola de nieve y el muestreo teórico. La triangulación de la información se realizó en una entrevista grupal. Resultados: Para las enfermeras, la vocación por el cuidado del otro sigue siendo un valor esencial en enfermería. Paradójicamente, las condiciones laborales y el cumplimiento de sus funciones les implican que deban descuidarse a sí mismas y no puedan cuidar a sus otros significativos. Conclusiones: En enfermería, el contexto laboral no solo expone a las enfermeras a múltiples riesgos laborales que las afectan durante la jornada, también fomenta el conflicto en la relación trabajo - familia. Sin embargo, las enfermeras debido a su vocación por el cuidado del otro, aceptan y tratan de adaptarse a estas condiciones de trabajo y como consecuencia, terminan descuidándose y apoyándose en terceros para el cuidado de sus otros significativos(AU)

ABSTRACT Introduction: Nursing is one of the professions with greater exposure to occupational risks, one of which is the work-family conflict. Yet this phenomenon negatively affects the health and social interactions of workers, research on the subject is limited in the context of nursing professionals and from a qualitative perspective. Objective: To understand the meaning of the work-family relationship and the consequences for the nursing staff. Methods: Qualitative study with theoretical tools developed for information analysis and understanding. Nine semistructured interviews were conducted. The participants were selected using the snowball technique and theoretical sampling. The triangulation of the information was carried out in a group interview. Results: For female nurses, a vocation for the care of others continues to be an essential value in nursing. The working conditions and the fulfillment of their functions paradoxically imply that they must neglect themselves and cannot take care of other significant aspects of their life as they would like. Conclusions: In nursing, the work context not only exposes nurses to multiple occupational risks that affect them during the day, but it also fosters conflict in the work-family relationship. However, nurses, due to their vocation for the care of others, accept and try to adapt to these working conditions and, as a consequence, end up neglecting and relying on third parties to care for other significant aspects of their lives(AU)

Construction and validation of a tool to assess nursing interpersonal relations / Construcción y validación de instrumento para evaluar las relaciones interpersonales en la Enfermeira / Construção e validação de instrumento para avaliar as relações interpessoais na Enfermagem

ABSTRACT Objective: construct and validate a tool to identify the factors that influence interpersonal relations and the health of nursing workers in a University Hospital in the South of Brazil. Method: methodological study, in nine steps. The face validation was carried out, with the participation of five experts, professor nurses doctors in Nursing, content with 26 nurses, stricto sensu Nursing Postgraduate students, and the validation of the construct was performed through a quantitative approach with 213 nursing workers. We used the exploratory factorial analysis and the Cronbach's Alpha in the validation of the construct. Results: the tool consisted of 29 questions and six constructs were identified. The Cronbach's Alpha value.879 showed satisfactory internal consistency. Conclusion: the tool was valid and reliable for use in the assessment of interpersonal relations among nursing workers in Brazilian University Hospitals.

RESUMEN Objetivo: construir y validar un instrumento para identificar los factores que influencian las relaciones interpersonales y la salud de los trabajadores de enfermería en un Hospital Universitario en el Sur de Brasil. Método: estudio metodológico, en nueve etapas. Se realizó la validación de cara, con la participación de cinco expertos, enfermeros docentes doctores en Enfermería, de contenido con 26 enfermeros, estudiantes de la Postgrado en Enfermería stricto sensu, y la validación de construto fue realizada mediante abordaje cuantitativo con 213 trabajadores de enfermería. En la validación del construto, se utilizó el análisis factorial exploratorio y el Alfa de Cronbach. Resultados: el instrumento quedó compuesto por 29 cuestiones y se identificaron seis construtos. El valor de Alfa de Cronbach, 879 presentó consistencia interna satisfactoria. Conclusión: el instrumento se presentó válido y fidedigno para ser utilizado en la evaluación de las relaciones interpersonales entre trabajadores de enfermería en Hospitales Universitarios brasileños.

RESUMO Objetivo: construir e validar um instrumento para identificação dos fatores que influenciam as relações interpessoais e a saúde dos trabalhadores de enfermagem em um Hospital Universitário no Sul do Brasil. Método: estudo metodológico, em nove etapas. Realizou-se a validação de face, com a participação de cinco experts, enfermeiros docentes doutores em Enfermagem, de conteúdo com 26 enfermeiros, estudantes da Pós-Graduação em Enfermagem stricto sensu, e a validação de construto foi realizada mediante abordagem quantitativa com 213 trabalhadores de enfermagem. Na validação do construto, utilizou-se a análise fatorial exploratória e o Alfa de Cronbach. Resultados: o instrumento ficou composto por 29 questões e foram identificados seis construtos. O valor de Alfa de Cronbach ,879 apresentou consistência interna satisfatória. Conclusão: o instrumento se apresentou válido e fidedigno para ser utilizado na avaliação das relações interpessoais entre trabalhadores de enfermagem em Hospitais Universitários brasileiros.

Validación de un cuestionario sobre condiciones de salud y bienestar psicológico en el personal de enfermería / Validation of a Questionnaire about Health Conditions and Psychologic Well-being among the Nursing Staff

Introducción: Las condiciones de salud del personal de enfermería no solo influyen en su estado de vida, sino en la calidad de las intervenciones que ofrecen a sus pacientes. Diagnosticarlas acertadamente posibilita la implementación de planes de prevención de la enfermedad más eficaces. Objetivo: Validar un cuestionario sobre condiciones de salud y bienestar psicológico del personal de enfermería en sus ambientes de trabajo. Métodos: Estudio cuantitativo con 357 enfermeros, entre los 18 y 58 años de edad, con más de un año de experiencia y que laboraban para instituciones de salud de 39 municipios de Antioquia, Colombia. Incluyó estudio de validez a partir del análisis factorial exploratorio y los niveles de confiabilidad empleando el Alfa de Cronbach. Resultados: La inclusión de los factores de la escala de bienestar psicológico de Ryff permitió evaluar integralmente el concepto de salud. La fiabilidad del instrumento se logró al no vincular atributos que valoraban aspectos como: alcoholismo, tabaquismo, sedentarismo, hábito por el chequeo médico periódico y sentimientos como felicidad y tristeza. Conclusiones: El instrumento es fiable y explica las condiciones de salud en ambientes laborales de la muestra y puede servir de referencia para otros estudios. Se concluye que la inclusión del bienestar psicológico según Ryff enriquece la evaluación integral de la salud para esta población(AU)

Introduction: The health conditions among the nursing staff influence not only their state of life, but also the quality of the interventions offered to their patients. Diagnosing such conditions accurately permits the implementation of more effective disease prevention plans. Objective: To validate a questionnaire about health conditions and psychological well-being of the nursing staff in their working environments. Methods: Quantitative study with 357 nurses, aged between 18 and 58 years, with more than one year of experience and working for health institutions in 39 municipalities of Antioquia, Colombia. It included a validity study based on exploratory factor analysis and reliability levels using Cronbach's alpha. Results: The included factors of Ryff's Scales of Psychological Well-being made it possible to evaluate comprehensively the concept of health. The reliability of the instrument was achieved by not linking attributes for assessing aspects such as alcoholism, smoking, sedentary lifestyle, habit to undergo periodic medical check-up, and feelings such as happiness and sadness. Conclusions: The instrument is reliable and explains the health conditions in working environments among the sample and can serve as a reference for other studies. It is concluded that the inclusion of psychological well-being, according to Ryff, enriches the comprehensive health assessment for this population(AU)

Dinâmica de geração e dissipação do estresse na equipe de enfermagem num centro de oncologia / Dynamics of stress generation and reduction in the nursing team at an oncology center / Dinámica de generación y disipación del estrés en el equipo de enfermería en un centro de oncología

Objetivo: representar a dinâmica de geração, acumulação e dissipação do estresse na equipe de enfermagem em um centro de terapia oncológica. Método: um modelo de simulação matemático de dinâmica de sistemas foi desenvolvido com base na coleta de dados in loco. O modelo serviu para testar o impacto de três políticas direcionadas a reduzir o estresse na equipe: i) incremento na carga de atendimento; ii) incremento do tamanho das equipes de turno e iii) redução de horas de atendimento por leito. Resultados: o modelo demonstrou que a política de incremento de tamanho da equipe obteve os melhores resultados, sintetizados com o índice de absenteísmo, estabilizando-se em 8%; pessoal afastado também se estabilizando em 4-5 pessoas por mês, bem como o estresse acumulado reduzido aos níveis do cenário base. Conclusão: as medidas no sentido de acompanhamento das demandas físicas e emocionais, a contratação de pessoal, um melhor treinamento técnico para as atividades ditas estressantes e uma melhor distribuição de tarefas podem ser eficazes na redução dos índices de absenteísmo e melhorar a qualidade de vida desses trabalhadores.

Objective: to represent the dynamics of stress generation, accumulation and reduction in the nursing team at an oncology therapy center. Method: a mathematical simulation model of system dynamics was developed based on data collection in loco. The model served to test the impact of three policies aimed at reducing stress in the team, namely i) increase in the service load; ii) increase in the size of shift teams and iii) reduction of service hours per bed. Results: the model showed that the policy of increasing the size of the team obtained the best results, with the absenteeism index stabilizing at 8%; staff at leave also stabilizing at 4-5 people per month, as well as accumulated stress reduced to baseline levels. Conclusion: measures to monitor physical and emotional demands, hiring staff, better technical training for so-called stressful activities, and a better distribution of tasks can be effective in reducing absenteeism rates and improving the quality of life of these workers.

Objetivo: representar la dinámica de generación, acumulación y disipación del estrés en el equipo de enfermería en un centro de terapia oncológica. Método: un modelo de simulación matemático de dinámica de sistemas fue desarrollado basado en la recolección de datos in loco. El modelo sirvió para testar el impacto de tres políticas dirigidas a reducir el estrés en el equipo: i) incremento en la carga de atendimiento; ii) incremento del tamaño de los equipos de turno y iii) reducción de horas de atendimiento por lecho. Resultados: el modelo demostró que la política de incremento de tamaño del equipo obtuvo los mejores resultados, sintetizados con el índice de ausentismo estabilizándose en 8%; personal alejado también estabilizándose en 4-5 personas por mes, así como el estrés acumulado reducido a los niveles del escenario base. Conclusión: las medidas en el sentido de acompañamiento de las demandas físicas y emocionales, la contratación de personal, mejor entrenamiento técnico para actividades llamadas estresantes y una mejor distribución de tareas pueden ser eficaces en la reducción de los índices de ausentismo y mejorar la calidad de vida de esos trabajadores.

Sociodemografía y estrés en enfermeras cuidadoras de pacientes crónicos / Sociodemography and stress on caregivers and nurses chronic patients

RESUMEN Introducción: Las enfermedades crónicas constituyen hoy en día un problema de salud pública que van en aumento. Objetivo: Describir las características socio demográficas y factores estresores de las enfermeras profesionales. Métodos: Estudio descriptivo, cuantitativo, transversal, en una población de 105 enfermeras que laboran en instituciones prestadoras de salud de Santa Marta cuyo objeto es el cuidado de pacientes con enfermedad crónica. Se aplicó el instrumento de caracterización sociodemográfica y la escala de estresores laborales para personal de enfermería "Nursing Stress Scale" Se procesó la información mediante el paquete estadístico IBM SPSS Statistics Versión 21.0, usando estadísticos descriptivos. Resultados: El 45,00 por ciento de los enfermeros se encontraban en el rango de edad entre 31 y 40 años; predominó el género femenino, con un 88,00 por ciento; el 47,00 por ciento tenía contrato a término fijo y un 24,00 por ciento a término indefinido; para la mayoría de los entrevistados las relaciones laborales producen una tensión moderada. Conclusiones: La presencia de estrés en los profesionales de Enfermería que cuidan a pacientes con enfermedades crónicas tiene factores personales, laborales y relacionados con el cuidado directo de sus pacientes(AU)

ABSTRACT Introduction: Chronic diseases constitute today a problem of public health that are on the rise. Objective: To describe the characteristics and factors demographic partner stressors professional nurses. Methods: Descriptive study, quantitative, transversal, in a sample of 105 nurses working in institutions providing health of Santa Marta whose object is the care of patients with chronic disease, the instrument was administered of sociodemographic characterization and the scale of job stressors for nursing personnel "Nursing Stress Scale" information was processed using SSPS version 21, using statistical descriptive. Results: 45.00 percent of the nurses were in the age range between 31 and 40 years there was a predominance of the female gender, with a 88,00 percent, 47,00 percent has fixed-term contract, a 24,00 percent to undefined term; for the majority of the interviewees labor relations produce a moderate tension. Conclusions: The presence of stress in nursing professionals who care for patients with chronic diseases has personal factors, labor and related to the direct care of their patients(AU)

Empowerment, vulnerabilidad al estrés y burnout en enfermeros portugueses / Empowerment, stress vulnerability and burnout among Portuguese nursing staff

Resumen El contexto laboral en los hospitales portugueses, caracterizado por los recortes económicos, puede contribuir al aumento de los niveles de burnout experimentados por el personal de enfermería. Además, la vulnerabilidad al estrés en estos profesionales afecta negativamente a la percepción del estrés en el contexto de trabajo. No obstante, el empowerment estructural es un proceso organizacional que puede prevenir y aliviar el burnout en este colectivo profesional. En este sentido, el objetivo de este estudio es comprobar el papel predictor del empowerment estructural y la vulnerabilidad al estrés sobre el burnout en una muestra de enfermeros portugueses. Se utilizó una muestra por conveniencia de 297 profesionales enfermeros de hospitales de Portugal. El core burnout se relacionó negativa y significativamente con todas las dimensiones del empowerment estructural, y positivamente con la vulnerabilidad al estrés. Los modelos de regresión lineal múltiple mostraron como predictores significativos del core burnout el acceso a recursos, el acceso a oportunidades y la vulnerabilidad al estrés. Las administraciones deben diseñar intervenciones centradas en el empowerment estructural, pero también en intervenciones individuales que mejoren las capacidades de afrontamiento del estrés.

Abstract The work environment in Portuguese hospitals, characterized by economic cutbacks, can lead to higher levels of burnout experienced by nursing staff. Furthermore, vulnerability to stress can negatively affect the perception of burnout in the workplace. However, structural empowerment is an organizational process that can prevent and decrease burnout among nurses. Consequently, the aim of the study was to examine to what extent structural empowerment and vulnerability to stress can play a predictive role in core burnout in a sample of Portuguese nurses. A convenience sample of 297 nursing staff members from Portuguese hospitals was used in this study. Core burnout was negatively and significantly related to all the dimensions of structural empowerment, and it was positively and significantly related to vulnerability to stress. Regression models showed that core burnout was significantly predicted by access to funds, access to opportunities and vulnerability to stress. Organizational administrations must make every effort in designing interventions focused on structural empowerment, as well as interventions focused on individual interventions that enhance skills for coping with stress.

Estratégias de coping da equipe de enfermagem atuante em centro de tratamento ao queimado / Estrategias de afrontamiento del personal de enfermería de un centro de tratamiento para el paciente quemado / Coping strategies of the nursing team acting in a burn treatment center

Resumo OBJETIVO Conhecer as estratégias de coping relatadas pela equipe de enfermagem atuante em Centro de Tratamento ao Queimado. MÉTODO Estudo qualitativo, descritivo e exploratório, desenvolvido com quatro enfermeiras e seis técnicas de enfermagem de um Centro de Tratamento ao Queimado do sul do Brasil. Os dados foram coletados de setembro a novembro de 2013, mediante entrevista semiestruturada e analisados por meio da técnica de análise de conteúdo, com auxílio do software Atlas.ti 7.0. RESULTADOS Emergiram dois temas: coping focalizado no problema e coping focalizado na emoção. Entre as principais estratégias de coping com foco no problema, destacaram-se ações de tomada de decisão e reavaliação positiva; no coping focado na emoção, ações voltadas para aceitação resignada e extravasamento emocional. CONCLUSÕES Como os profissionais optaram por estratégias de cunho objetivo e prático, compatíveis com coping focado no problema, acredita-se que sua elaboração é influenciada pelo contexto individual, coletivo e institucional do trabalhador.

Resumen OBJETIVO Conocer las estrategias de afrontamiento relatadas por el personal de enfermería de un centro de tratamiento para el paciente quemado. MÉTODO Estudio cualitativo, descriptivo y exploratorio, desarrollado con cuatro enfermeras y seis técnicos de enfermería de un Centro de Tratamiento para el Paciente Quemado del sur de Brasil. Se recolectaron los datos entre septiembre y noviembre de 2013, por medio de entrevista semiestructurada, y se analizaron por medio de la técnica de análisis de contenido y del software Atlas.ti 7.0. RESULTADOS Surgieron dos temáticas: afrontamiento con enfoque en el problema y afrontamiento con enfoque en la emoción. Entre las estrategias con enfoque en el problema se destacaron las acciones de tomada de decisión y la reevaluación positiva, y en el afrontamiento con enfoque en la emoción se destacaron las acciones dirigidas a la aceptación resignada y al desborde emocional. CONCLUSIONES Como los profesionales entrevistados optaron por estrategias objetivas y prácticas, compatibles con el afrontamiento con base en el problema, se cree que su elaboración está influenciada por el contexto individual, colectivo e institucional del trabajador.

Abstract OBJECTIVE To know the strategies of coping reported by the nursing team that works at a burn center. METHOD This is a qualitative, descriptive and exploratory study carried out with four nurses and six practical nurses at a burn center in southern Brazil. The data was collected from September to November 2013 through semi-structured interviews, and it was analyzed through the content analysis technique, which happened with the software Atlas.ti 7.0. RESULTS Two themes have emerged: coping focused on the problem, and coping focused on the emotion. Among the main strategies of coping focused on the problem, decision-making and re-evaluation actions should be highlighted; and in the coping focused on the emotion, actions centered on resigned acceptance and emotional extravasation stand out. CONCLUSIONS As the professionals interviewed opted for objective and practical strategies, compatible with coping based on the problem, it is believed that the elaboration is influenced by the workers' individual, collective and institutional contexts.

Flexibilidad psicológica y atención plena: analizando su valor añadido sobre los niveles de energía y motivación entre enfermeras procedentes de España y Cuba / Psychological flexibility and mindfulness: analyzing their added value on the levels of energy and motivation among nurses from Spain and Cuba

La energía y motivación de los profesionales de enfermería son fundamentales para su bienestar, para garantizar la calidad asistencial, así como la permanencia de los trabajadores dentro de las organizaciones con altos niveles de compromiso. El objetivo de este trabajo fue explorar el valor añadido que tenían dos recursos personales del propio trabajador: su flexibilidad psicológica y atención plena, sobre sus niveles de vigor y agotamiento emocional relacionados con el trabajo, así como sobre su vitalidad y fatiga, controlando previamente otras demandas y recursos laborales. En el estudio participaron un total de 171 profesionales de enfermería procedentes de España y 50 profesionales de Cuba (10.9% varones y 86.9% mujeres). Se realizaron análisis descriptivos, correlacionales, contraste de medias y análisis de regresión jerárquica. Los resultados revelaron que la flexibilidad psicológica explicaba una parte significativa de la varianza en las puntuaciones de vigor, vitalidad y fatiga, mientras que la atención plena explicaba de forma significativa una parte de la varianza del agotamiento emocional. Demandas laborales como la ambigüedad de rol y recursos laborales como la autonomía, también mostraron un efecto directo importante. Los resultados se discuten en términos de la importancia de incorporar estas variables en los planes de prevención y promoción de la salud dentro de las organizaciones sanitarias.

Nurses' energy and motivation are fundamental to explain their well-being, to guarantee the quality of care, as well as the permanence of the workers within organizations with high levels of job commitment. Thus, the main aim of this study was to explore the added value of two personal resources of the worker, their psychological flexibility and mindfulness, on their levels of vigor and emotional exhaustion at work, as well as on their levels of vitality and fatigue, previously controlling other job demands and job resources. The study involved a total of 171 nursing professionals from Spain and 50 professionals from Cuba (10.9% male and 86.9% female). Descriptive, correlational, mean contrasts and hierarchical regression analyses were performed. The results showed that psychological flexibility explained a significant portion of the variance in vigor, vitality, and fatigue scores, while mindfulness significantly explained a portion of the variance in emotional exhaustion. Job demands such as role ambiguity and job resources such as autonomy also showed a significant direct effect on the energy and motivation variables. The results are discussed in terms of the importance of considering these variables in health prevention and promotion plans within health organizations.

Danos à saúde dos trabalhadores de enfermagem em um serviço de hemodiálise / Daños a la salud de los trabajadores de enfermería en un servicio de hemodiálisis / Health problems among nursing workers in a haemodialysis service

RESUMO Objetivo Mensurar os danos à saúde relacionados ao trabalho e associá-los com as características sociolaborais de trabalhadores de enfermagem de um serviço de hemodiálise do Sul do Brasil. Método Pesquisa quantitativa, realizada com 46 trabalhadores. Utilizou-se um questionário autopreenchível com dados sociolaborais e a Escala de Danos Relacionados ao Trabalho. Realizou-se a análise descritiva, bivariada e correlacional, com níveis de significância de 5%, usando os programas Epi-info® e Predictive Analytics Software. Resultados Os danos físicos, psicológicos e sociais foram avaliados como suportáveis, sendo identificada associação com a satisfação com a remuneração atual e afastamento do trabalho para tratamento de saúde (p< 0,05). As dores nas costas (3,74±2,04) e nas pernas (3,48±2,10) foram consideradas graves. Houve correlação direta entre os danos à saúde (r> 0,31, p< 0,05). Conclusão Apesar da avaliação positiva dos danos à saúde na população estudada, reitera-se a necessidade de medidas que favoreçam a saúde dos trabalhadores.

RESUMEN Objetivo Se objetivó medir los daños a la salud relacionados al trabajo y asociarlos con las características sociolaborales de trabajadores de enfermería de un servicio de hemodiálisis en el Sur de Brasil. Método Investigación cuantitativa, realizada con 46 trabajadores. Se utilizó un cuestionario autorrellenable con datos sociolabolares y la Escola de Danos Relacionados ao Trabalho. Se realizó el análisis descriptivo, bivariado y correlacional, con niveles de significación de 5%, utilizándose los programas Epi-info® y Predictive Analytics Software. Resultados Los daños físicos, psicológicos y sociales fueron considerados soportables, siendo identificada asociación con la satisfacción con la remuneración actual y licencia del trabajo para tratamiento de salud (p< 0,05). Hubo correlación directa entre los daños a la salud (r> 0,31, p< 0,05). Conclusión A pesar de la valoración positiva de los daños a la salud en esta población, se confirma la necesidad de medidas para promover la salud de los trabajadores.

ABSTRACT Objective The aim was to measure work-related health problems among nursing workers at a haemodialysis unit in southern Brazil and associate these issues with the socio-occupational characteristics of the workers. Method This is a qualitative study conducted with 46 nursing workers. Data were collected using a general health questionnaire with socio-occupational information and a work-related health assessment scale. The data were subjected to descriptive, correlational, bivariate analysis with significance levels of 5% using Epi-info® and Predictive Analytics Software. Results Physical, psychological, and social problems were considered bearable, and job satisfaction was associated with current income and work absenteeism for health treatment (p< 0.05). Back pain (3.74 ± 2.04) and leg pain (3.48 ± 2.10) were considered severe. There was a direct correlation between the health issues (r> 0.31, p <0.05). Conclusion In spite of the positive results of the work-related health assessment among the studied population, the results confirm the need to promote the health of nursing workers.

Toward validating the Italian version of the "Spanish Burnout Inventory": a preliminary study / Validação da versão Italiana do "Spanish Burnout Inventory": um estudo preliminar / Validación de la versión Italiana del "Spanish Burnout Inventory": un estudio preliminar

AbstractOBJECTIVEThe aim of this study was to develop the Italian version of the Spanish Burnout Inventory (SBI) and to examine its psychometric properties within a sample of nursing staff.METHODThe study was cross-sectional and not randomized. The data were gathered using an anonymous, self-report questionnaire. The sample consisted of 391 staff nurses employed in three hospitals in the Northern Region of Italy To evaluate burnout, the SBI and the Maslach Burnout Inventory were administered.RESULTSAn Exploratory Factor Analysis showed a four-factor structure close to the expected one. All Cronbach's alpha values were satisfactory. Furthermore, correlations support the concurrent validity.CONCLUSIONOverall, the results of this study provided evidence that the SBI is an adequate instrument to study burnout in the Italian nursing sample and indicated the feeling of guilt as an important dimension to gauge the structure of this phenomenon.

ResumoOBJETIVOO objetivo deste estudo foi desenvolver a versão italiana do SBI (Spanish Burnout Inventory) e analisar as suas propriedades psicométricas numa amostra de enfermeiros.MÉTODOO estudo foi de caráter transversal, e não randomizado. Os dados foram coletados através de um questionário autopreenchido de maneira anônima. A amostra foi composta por 391 enfermeiros funcionários de três hospitais de uma região do norte da Itália. Para avaliar o burnout, utilizou-se o Spanish Burnout Inventory e o Maslach Burnout Inventory.RESULTADOSOs resultados da Análise Fatorial Exploratória mostraram uma estrutura de quatro fatores, como era esperado. Todos os valores de alfa de Cronbach foram satisfatórios. Além disso, as correlações apoiar validade concorrente.CONCLUSÃONo geral, os resultados deste estudo forneceram evidências de que o SBI é um instrumento adequado para estudar o burnout numa amostra de enfermagem italiana e indicou que os sentimentos de culpa são uma dimensão importante para avaliar a estrutura do fenômeno.

ResumenOBJETIVODesarrollar la versión italiana del Spanish Burnout Inventory (SBI) y analizar sus propiedades psicométricas en una muestra de enfermeros.MÉTODOEstudio de carácter transversal y no randomizado. Los datos fueron recogidos mediante un cuestionario autorrellenado de manera anónima. La muestra estuvo compuesta de 391 enfermeros funcionarios de tres hospitales de una zona del norte de Italia. A fin de evaluar el burnout, se empleó el Spanish Burnout Inventory y el Maslach Burnout Inventory.RESULTADOSLos resultados del Análisis Factorial Exploratorio mostraron una estructura de cuatro factores, como era esperado. Todos los valores de alfa de Cronbach fueron satisfactorios. Además, las correlaciones apoyaron la validez concurrente.CONCLUSIÓNLos resultados de este estudio proporcionaron evidencias de que el SBI es un instrumento adecuado para estudiar el burnout en una muestra de enfermería italiana y señaló que los sentimientos de culpa son una dimensión importante para evaluar la estructura del fenómeno.

Processo de trabalho e seu impacto nos profissionais de enfermagem em serviço de saúde mental / Work process and its impact on mental health nursing professionals

Objetivo: Analisar o processo de trabalho e seu impacto nos profissionais de Enfermagem em serviço de saúde mental destinado à atenção aos usuários de substâncias psicoativas. Métodos Estudo transversal que incluiu os profissionais de enfermagem em um serviço de saúde mental comunitário. O instrumento de pesquisa foi o SATIS-BR e um questionário com as categorias de análise do trabalho realizado. Para os dados qualitativos, empregou-se a hermenêutica dialética. Os dados foram processados e analisados no programa Statistical Package for Social Sciences. Resultados Foram identificadas sobrecargas de trabalho que interferiram na satisfação percebida pelos trabalhadores e refletiram em sua saúde física e psíquica. Conclusão Os profissionais de Enfermagem, em seu processo de trabalho, estiveram expostos a todas as cargas de desgaste, sendo o desgaste psíquico mais intenso que o físico, o qual refletiu na insatisfação com a atividade laboral e na saúde física dos trabalhadores.

Objective: To analyze the work process and its impact on nursing professionals in a mental health service for the care of drug users. Methods Cross-sectional study including nursing professionals in a community mental health service. The research instrument was the SATIS-BR and a questionnaire with analysis categories of the work performed. Dialectic hermeneutics was used for the qualitative data. Data were processed and analyzed using the Statistical Package for the Social Sciences. Results The work overloads identified have interfered with the satisfaction experienced by workers and reflected in their physical and mental health. Conclusion In their work process, nursing professionals were exposed to all work overloads, with mental burnout more intense than the physical, reflecting in dissatisfaction with the work activity and in workers’ physical health.

The importance of using quality indicators in nursing care / La importancia de la utilización de indicadores de calidad en la atención de enfermería / Opinião dos enfermeiros sobre a utilização dos indicadores de qualidade na assistência de enfermagem

OBJECTIVE: To investigate the opinion of hospital nurses on the use of quality indicators for nursing care. METHOD: Research based on the qualitative approach, conducted with 41 nurses from two charity hospitals in Minas Gerais, from September to October 2013. Interviews with a semi-structured script were used to collect data. The empirical data were organized by means of content analysis. RESULTS: Indicators are important for assessing the provided care, for improving the quality of care, and for defining strategies to achieve goals. CONCLUSIONS: The difficulties encountered when using these indicators revealed the following constituent elements: lack of time, inadequate number of professionals and lack of knowledge on the subject. It was concluded that nurses understand that indicators are instruments that enable evaluations and improvements, but their understanding of how to use these instruments is incomplete and fragmented. .

OBJETIVO: Investigar la opinión de los hospitales las enfermeras en el uso de indicadores de calidad de los cuidados de enfermería. Las investigaciones realizadas por el enfoque cualitativo realizado con 41 enfermeros de dos hospitales filantrópicos en Minas Gerais en el período septiembre-octubre de 2013. MÉTODO: Se utilizó entrevistas con guión semiestructurado. Los datos empíricos se organizaron de acuerdo con el análisis de contenido. RESULTADOS: Se encontró que los indicadores son importantes para la evaluación de la atención, mejorar la calidad de la atención y el desarrollo de estrategias para alcanzar las metas. CONCLUSIÓN: Entre las dificultades encontradas en el uso de indicadores, que era posible enumerar los siguientes componentes básicos: la falta de tiempo, el número insuficiente de profesionales y la falta de conocimiento sobre el tema en cuestión. Llegamos a la conclusión de que las enfermeras entienden los indicadores como herramientas de evaluación y mejoras, sin embargo, tienen una comprensión incompleta y fragmentada de cómo utilizarlos. .

OBJETIVO: Investigar a opinião de enfermeiros de instituições hospitalares sobre a utilização dos indicadores de qualidade da assistência de enfermagem. MÉTODO: Pesquisa conduzida pela abordagem qualitativa realizada com 41 enfermeiros de dois hospitais filantrópicos no interior de Minas Gerais, no período de setembro a outubro de 2013. Utilizaram-se entrevistas com roteiro semiestruturado. Os dados empíricos foram organizados mediante análise de conteúdo. RESULTADOS: Constatou-se que os indicadores são importantes para avaliação da assistência prestada, melhoria da qualidade da assistência e para definição de estratégias para alcançar metas. CONCLUSÕES: Dentro das dificuldades encontradas na utilização dos indicadores, foi possível elencar os seguintes elementos constitutivos: falta de tempo, número inadequado de profissionais e falta de conhecimento a respeito do tema abordado. Conclui-se que os enfermeiros entendem os indicadores como instrumentos de avaliação e melhorias, entretanto, possuem um entendimento incompleto e fragmentado sobre sua utilização. .

The Psychosocial Adaptation Process of Psychiatric Nurses Working in Community Mental Health Centers

PURPOSE: The aim of this study was to verify psychosocial issues faced by psychiatric and community mental health nurse practitioners (PCMHNP) working in community mental health centers, and to identify the adaptation processes used to resolve the issues. METHODS: Data were collected through in-depth interviews between December 2013 and August 2014. Participants were 11 PCMHNP working in community mental health centers. Analysis was done using the grounded theory methodology. The first question was "How did you start working at a community mental health center; what were the difficulties you faced during your employment and how did you resolve them?" RESULTS: The core category was 'regulating within relationships.' The adaptation process was categorized into three sequential stages: 'nesting,' 'hanging around the nest,' and 'settling into the nest.' Various action/interaction strategies were employed in these stages. The adaptation results from using these strategies were 'psychiatric nursing within life' and 'a long way to go.' CONCLUSION: The results of this study are significant as they aid in understanding the psychosocial adaptation processes of PCMHNP working in community mental health centers, and indicate areas to be addressed in the future in order for PCMHNP to fulfill their professional role in the local community.

Psychometric Properties of the Alzheimer's Disease Knowledge Scale-Korean Version

PURPOSE: The purpose of this study was to evaluate the psychometric properties of the Korean version of the Alzheimer's Disease Knowledge Scale (ADKS-K) to determine its applicability to Korean adults. METHODS: Cross-cultural validity was performed according to Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN). The Kuder-Richardson Formula 20 for internal consistency and Intraclass Correlation Coefficient (ICC) for test-retest reliability were conducted. Content validity, criterion related validity and construct validity were evaluated. The Classical Test Theory (CTT) model and the Item Response Theory (IRT) model were applied in performing the item analysis. RESULTS: The KR 20 was .71, and the ICC was .90, indicating that the ADKS-K has internal consistency and stability reliability. Thirty items of the ADKS-K had significant Content Validity Ratio (CVR) values, i.e., mean of 0.82 and range of 0.60~1.00. Mean item difficulty and discrimination indices calculated by TestAn program were 0.63 and 0.23, respectively. Mean item difficulty and discrimination indices calculated by BayesiAn program were -0.60 and 0.77, respectively. These tests indicate that ADKS-K has an acceptable level of difficulty and discriminating efficiency. CONCLUSION: Results suggest that ADKS-K has the potential to be a proper instrument for assessing AD knowledge in Korean adults.

Development and Evaluation of an Education Program for Professional Palliative Care Nursing

PURPOSE: This study aimed to develop a "Palliative Care Professional" education program and evaluate its effects on the recognition of good death, palliative care, and the meaning of life for nurses. METHODS: It was developed based on the hospice care program for volunteers being used in the Hospice Palliative Care Research Center of S University in Seoul. It was also based on the studies which investigated the educational needs of nurses in palliative care. This program consisted of 5 sessions and 16 content items for 2 weeks. A non-equivalent control group non-synchronized design was utilized and participants were assigned to the experimental group (n=42) or the control group (n=44). RESULTS: The recognition of a good death (F=11.44, p=.001), palliative care (F=4.15, p=.045), and the meaning of life (F=5.12, p=.026) increased more significantly for participants in the experimental group than in the control group. Participants felt that they gained further knowledge in palliative patient management and refined their clinical practice. CONCLUSION: The results of the study indicate that this program could serve as a practical program for palliative care nursing in the nursing field and suggests that more attention should be directed to the diverse educational needs of nurses.