A doctor at a PHC clinic: A 'must-have' or 'nice-to-have'?

Background. Many patients have their healthcare needs met at primary healthcare (PHC) clinics in KwaZulu-Natal (KZN), without having to travel to a hospital. Doctors form part of the teams at many PHC clinics throughout KZN, offering a decentralised medical service in a PHC clinic. Objectives. To assess the benefit of having a medical doctor managing patients with more complex clinical conditions at PHC clinic level in uMgungundlovu District, KZN. Two key questions were researched: (i) were the patients whom the clinic doctors managed of sufficient clinical complexity that they warranted a doctor managing them, rather than a PHC nurse clinician? and (ii) what was the spectrum of medical conditions that the clinic doctors managed? Methods. Doctors collected data at all medical consultations in PHC clinics in uMgungundlovu during February 2020. A single-page standardised data tool was used to collect data at every consultation. Results. Thirty-five doctors were working in 45 PHC clinics in February 2020. Twenty-six of the clinic doctors were National Health Insurance (NHI)-employed. The 35 doctors conducted 7 424 patient consultations in February. Staff in the PHC clinics conducted 143 421 consultations that month, mostly by PHC nurse clinicians. The doctors concluded that 6 947 (93.6%) of the 7 424 doctor consultations were of sufficient complexity as to warrant management by a doctor. The spectrum of medical conditions was as follows: (i) consultations for maternal and child health; n=761 (10.2%); (ii) consultations involving non-communicable diseases (NCDs), n=4 372 (58.9%) ­ the six most common NCDs were, in order: hypertension, diabetes, arthritis, epilepsy, mental illness and renal disease; (iii) consultations involving communicable diseases constituted 1 745 (23.5%) of cases; and (iv) consultations involving laboratory result interpretation 1 180 (15.9%).Conclusion. This research showed that at a PHC clinic the more complex patient consultations did indeed require the skills and knowledge of a medical doctor managing these patients. These data support the benefit of a doctor working at every PHC clinic: the doctor is a 'must-have' member of the PHC clinic team, offering a regular, reliable and predictable medical service.

Práticas profissionais em instituições psiquiátricas: desafios para o atendimento humanizado e integral / Professional practices in psychiatric hospitals: challenges for humanized and comprehensive care

Modelo de estudo: Estudo transversal de abordagem misto (quantitativa e qualitativa). Objetivo: Analisar as prá-ticas de profissionais em hospitais psiquiátricos no atendimento a pessoas com transtornos mentais, com vistas a contribuir para a abordagem humanizada e integral. Metodologia: Estudo realizado em dois hospitais psiquiátricos do Rio Grande do Norte, tendo como participantes 60 profissionais de saúde. Os dados quantitativos foram sub-metidos ao software estatísticoe analisados através de estatística bivariada; e nos dado qualitativos, recorreu-se ao tratamento do software Alceste e a técnica de análise de conteúdo. Resultados: Observou-se o predomínio de práticas profissionais associadas a intervenções tradicionais no contexto da abordagem realizada, reforçados nos dois temas centrais, oriundos dos achados qualitativos, a saber: Práticas profissionais no hospital psiquiátricos: cotidianos e políticas, e, Entraves e caminhos para o atendimento integral e humanizado em instituições psiquiá-tricas. Conclusão: As práticas profissionais desenvolvidas no âmbito das instituições psiquiátricas apontam para o enfoque terapêutico biológico e individual, tendo em vista os desafios de articular um atendimento integral e humanizado condizente com as diretrizes propostas pelo movimento de reforma psiquiátrica brasileiro. (AU)

Study model: cross-sectional study with a mixed approach (quantitative and qualitative). Objective: to analyze the practices of professionals in psychiatric hospitals in the care of people with mental disorders, with a view to contributing to a humanized and integral approach. Methodology: study carried out in two psychiatric hospitals in Rio Grande do Norte, with 60 health professionals as participants. The quantitative data were submitted to statis-tical software and analyzed through bivariate statistics; and in the qualitative data, the Alceste software treatment and the content analysis technique were used. Results: it was observed the predominance of professional practices associated with traditional interventions in the context of the approach performed, reinforced in the two central themes, arising from the qualitative findings, namely: Professional practices in the psychiatric hospital: daily life and policies, and, Barriers and paths to comprehensive and humanized care in psychiatric institutions. Conclusion:the professional practices developed within psychiatric institutions point to the biological and individual therapeutic focus, in view of the challenges of articulating a comprehensive and humanized care consistent with the guidelines proposed by the Brazilian psychiatric reform movement. (AU)

Desgaste laboral en personal prehospitalario en México durante la pandemia de 2020 / Burnout in prehospital staff in Mexico during the 2020 pandemic

El burnout (desgate emocional) es una problemática que tiene consecuencias en las y los trabajadores expuestos a determinados riesgos y exigencias. Durante la pandemia por COVID-19 en México aumentó la carga laboral del personal de salud, por lo que esta investigación tiene como propósito explorar la relación entre los datos sociodemográficos, de salud, de las condiciones laborales y burnout entre los profesionales de salud de atención prehospitalaria a inicios de la pandemia en México. Materiales y Métodos: Estudio cuantitativo y descriptivo, se realizó una encuesta en línea en la que participaron 80 trabajadores/as del área prehospitalaria de un universo de aproximadamente 21 mil personas para indagar sus condiciones laborales y la exposición a factores estresantes, así como la prevalencia de la despersonalización, el agotamiento emocional y la realización personal, dimensiones emocionales que definen el burnout. Resultados: El 11.25% de la muestra presenta burnout de acuerdo con el instrumento; en el resto de la muestra destaca que un porcentaje alto de participantes, no tienen burnout, refieren niveles elevados de despersonalización y agotamiento emocional, lo que indica un síndrome en proceso, por lo que es importante dar seguimiento para evitar el avance del burnout en el personal de salud en general y el prehospitalario en particular. Conclusiones: El personal prehospitalario reconoce su trabajo como actividad de riesgo, no obstante, también destacan que su labor favorece la realización personal y la ayuda a otros, que funcionan como factores protectores(AU)

Burnout (emotional exhaustion) is a problem that has consequences for workers, exposed to certain risks and demands. During the COVID-19 pandemic in Mexico, the workload of health workers increased, so this research aims to explore the relationship between sociodemographic, health, working conditions and burnout syndrome data between prehospital care health professionals at the beginning of the pandemic in Mexico. Materials and Methods: Quantitative and descriptive study, an online survey was carried out in which 80 workers from the pre-hospital area participated to investigate their working conditions and exposure to stressors, as well as the prevalence of depersonalization, exhaustion emotional and personal fulfillment, which are the emotional dimensions that define burnout. Results: 11.25% of the sample presents burnout according to the instrument; In the rest of the sample, it stands out that a high percentage of participants, who do not have burnout, report high levels of depersonalization and emotional exhaustion, which indicates a syndrome in process, so it is important to follow up to avoid the progression of burnout in health personnel in general and pre-hospital personnel in particular. Conclusions: The prehospital staff recognize their work as a risky activity; however, they also emphasize that their work favors personal fulfillment and helps others, which function as protective factors(AU)

Prevalence and correlates of psychological distress and coronavirus anxiety among hospital essential services workers in Singapore

INTRODUCTION@#The COVID-19 pandemic has affected almost all populations, with frontline workers experiencing a higher risk of mental health effects compared to other groups. Although there are several research studies focusing on the mental health effects of the pandemic on healthcare workers, there is little research about its impact on workers in outsourced hospital essential services. This study aims to examine the prevalence and correlates of psychological distress and coronavirus anxiety among staff working in 3 outsourced hospital essential services-housekeeping, porter service and maintenance services.@*METHODS@#A cross-sectional study was conducted among outsourced hospital essential services workers in a tertiary hospital. Data on demographics, medical history, lifestyle factors, psychosocial factors and mental well-being were collected using self-administered questionnaires. Robust logistic regression was used to determine risk factors associated with psychological distress and dysfunctional anxiety related to COVID-19.@*RESULTS@#A total of 246 hospital essential services workers participated in the study. The prevalence of psychological distress was 24.7%, and dysfunctional anxiety related to COVID-19 was 13.4%. Social support and workplace support were found to be independently associated with a lower risk of psychological distress, and social connectivity was associated with a lower risk of dysfunctional anxiety related to COVID-19.@*CONCLUSION@#These findings highlight the crucial roles of communities and workplaces in combating the mental health consequences of the pandemic. Public health programmes that aim to tackle the emerging mental health crisis in hospital essential services workers should incorporate strategies to address psychosocial factors, in addition to traditional self-care approaches.

Apego a higiene de manos en 5 momentos y protección específica en un hospital de tercer nivel ante la pandemia de COVID-19 / Adherence to hand hygiene at five moments and specific protection in a tertiary care hospital during the COVID-19 pandemic

Resumen Introducción: Ante la pandemia de COVID-19, el apego a las medidas de higiene es un objetivo para disminuir la morbimortalidad. Objetivo: Evaluar el apego a la higiene de manos y medidas de protección durante la pandemia de COVID-19 en un hospital de tercer nivel. Métodos: Estudio transversal acerca del lavado de manos del personal de salud en los cinco tiempos recomendados por la Organización Mundial de la Salud, así como sobre el uso del equipo de protección personal específico. Resultados: Fueron observadas 117 oportunidades de higiene de manos en personal de salud: 40 (34 %) respecto al lavado de manos y 76 (65 %) respecto a su omisión; sobre el apego al uso de careta en cinco (4 %) y sobre la falta de apego en 112 (96 %). Se identificó apego al uso de mascarilla en 65 profesionales de enfermería (87 %), uso adecuado de mascarilla en 56 de ellos (60 %) y uso de careta en uno (1 %.) Conclusión: El personal mostró baja proporción de apego a la higiene de manos y al uso de equipo para la protección específica durante la pandemia de COVID-19.

Abstract Introduction: During the COVID-19 pandemic, adherence to hygiene measures is an objective aimed at reducing morbidity and mortality. Objective: To evaluate adherence to hand hygiene and protection measures during the COVID-19 pandemic in a tertiary care hospital. Methods: Cross-sectional study on health personnel handwashing at the five moments recommended by the World Health Organization, as well as on the use of specific personal protective equipment. Results: One hundred and seventeen hand hygiene opportunities were observed in health personnel. Hand washing was observed in 40 (34 %) and omission in 76 (65 %). Adherence to the use of face shield was observed in five (4 %), and lack of adherence in 112 (96%). Adherence to the use of face mask was observed in 65 nursing professionals (87 %), with appropriate use of the mask in 56 of them (60 %) and use of face shield in one (1 %). Conclusion: Health personnel showed low proportions of adherence to hand hygiene and use of equipment for specific protection during the COVID-19 pandemic.

Qualidade de vida no trabalho em diferentes áreas de atuação profissional em um hospital / Quality of working life from the perspective of different groups of professionals working in a maternity hospital

Resumo A relação do homem com o trabalho pode impactar diretamente em sua qualidade de vida e condição de saúde. O objetivo deste artigo é comparar as condições de Qualidade de Vida no Trabalho (QVT) de três diferentes áreas de atuação profissional. Estudo transversal com amostra aleatória de 172 trabalhadores de um hospital (37,9±10,3 anos; 73,8% mulheres). Os participantes responderam ao inventário de avaliação de qualidade de vida no trabalho (IA_QVT). A Anova e o teste de Tukey foram utilizados para análise dos dados. 36,4% dos itens que avaliaram condições de trabalho e 35,7% dos itens sobre reconhecimento e crescimento profissional apresentaram diferenças entre os grupos (p<0,05). Nos âmbitos de relações socioprofissionais, organização do trabalho e elo trabalho-vida social, os índices foram de 12,5%, 11,1% e 10,0%, respectivamente. No geral, 21,7% dos itens pesquisados apresentaram diferenças significativas entre os grupos. Foram encontradas diferenças importantes na percepção de QVT entre áreas distintas, sugerindo que um planejamento eficiente pode resultar em promoção da saúde caso atenda demandas setorizadas.

Abstract The relationship between people and work has a direct impact on quality of life and health. The objective of this article is to compare perceived levels of Quality of Working Life (QWL) across three different groups of professionals. Cross-sectional study with a random sample of 172 hospital workers (37.9±10.3 years; 73.8% women). Participants filled out the Quality of Working Life Assessment Inventory (QWL-AI). The data was analyzed using Anova and Tukey's test. Statistically significant differences were found between the groups in 36.4% of the items assessing work conditions, 35.7% of the items assessing professional growth and recognition (p<0.05), 12.5% of the items assessing socioprofessional workplace relationships, 11.1% of the items assessing work organization, and 10% of the items assessing link between work and social life. Overall, 21.7% of the items showed significant differences between groups. We found significant differences in perceived QWL between the different groups, suggesting that QWL interventions should be tailored to the address the specific needs and demands of different sectors and departments to be effective.

Frequency of acute stress disorder in health care workers of a tertiary level pediatric hospital during the National Safe Distance Strategy for COVID-19 prevention / Frecuencia de trastorno por estrés agudo en el personal de salud de un hospital pediátrico de tercer nivel durante la Jornada Nacional de Sana Distancia para la prevención de la COVID-19

Abstract Background: Acute stress disorder (ASD) is one of the most frequent mental illnesses occurring during sanitary emergencies. This study aimed to estimate the frequency of ASD in health care workers of a tertiary level pediatric hospital during the coronavirus disease (COVID-19) pandemic. Methods: We conducted a cross-sectional study in which health care workers completed a virtual questionnaire, including sociodemographic information and the ASD scale. Results: We analyzed 206 questionnaires. The population was divided into three groups: attending physicians, medical residents, and nursing personnel. The frequency of health care workers who showed at least nine symptoms of ASD was 88.8%. No significant differences were found between the studied groups. Conclusions: ASD is a frequent condition in health care workers in the context of the COVID-19 pandemic. We need to investigate further and assess risk and protective factors for developing this and other psychopathologies in this population.

Resumen Introducción: El trastorno por estrés agudo es una de las enfermedades mentales más frecuentemente manifestadas en emergencias sanitarias. El objetivo de este estudio fue conocer la frecuencia con la que se presentó el trastorno por estrés agudo en el personal de salud de un hospital pediátrico de tercer nivel durante la epidemia de COVID-19. Método: Se realizó un estudio transversal en el que trabajadores de la salud contestaron un cuestionario virtual que incluyó datos sociodemográficos y la Escala de Trastorno por Estrés Agudo. Resultados: Se analizaron 206 encuestas. La población se dividió en tres grupos: médicos adscritos, residentes y personal de enfermería. El 88.8% de los trabajadores de la salud reportaron más de nueve síntomas de trastorno por estrés agudo. No se encontraron diferencias significativas entre los grupos de estudio. Conclusiones: Los síntomas del trastorno por estrés agudo son frecuentes en los trabajadores de la salud en el contexto de la COVID-19. Es necesario investigar acerca de los factores de riesgo y protectores asociados al desarrollo de esta y otras psicopatologías en dicha población.

Perception de la tension au travail (job strain) en milieu hospitalier à Pointe-Noire, Congo-Brazzaville / Perception of job strain in the hospital environment at Pointe-Noire, Congo-Brazzaville

Objectif : Evaluer la situation de job strain et les manifestations psychosomatiques ressenties par les personnels soignants des hôpitaux de Pointe-Noire. Méthodologie : L'étude était une enquête transversale analytique. Un auto-questionnaire monté selon le modèle « demande-contrôle-soutien ¼ de KARASEK, avait été utilisé pour recueillir de manière anonyme des données sociodémographiques, des informations relatives à l'état de santé, à leur poste de travail et d'identifier des facteurs de risques psychosociaux. Résultats : Sur l'ensemble des cent cinquante (150) soignants retenus, 47,02% présentaient une faible latitude décisionnelle contre 52,98% avec une forte latitude. La forte demande psychologique était perçue par 50,33% des soignants contre 49,67% avec une faible demande. La situation de job strain était retrouvée chez 26,67% des soignants. Les services des urgences et de médecine étaient les plus exposés avec respectivement 25% et 20% du personnel en situation de job strain. Une faible ancienneté au travail prédisposait à une perception de job strain plus élevée. Les médecins spécialistes et les infirmiers représentaient les catégories professionnelles les plus tendus avec respectivement 42,86% et 30,23% des individus concernés. Un lien statistique était retrouvé entre d'une part le job strain et d'autre part les troubles musculosquelettiques et l'auto-estimation de l'impact du travail sur la santé. Conclusion : Les risques psychosociaux notamment le stress sont une préoccupation réelle dans les établissements de soins et cette enquête a permis de noter qu'ils pourraient avoir des conséquences sur la santé des soignants à Pointe-Noire.

Objective: To assess the job strain situation and the psychosomatic manifestations felt by the health care worker of the Pointe-Noire hospitals. Methodology: It was an analytical cross-sectional survey. A self-questionnaire set up according to the KARASEK "demand-control-support" model had been used to anonymously collect sociodemographic data, information on their health situation, at their workplace and identify psychosocial risk factors. Results: of one hundred and fifty (150) caregivers considered, 47.02% had low decision latitude versus 52.98% with high latitude. The high psychological demand was felt by 50.33% of the medics versus 49.67% with a low demand. The job strain situation was found among 26.67% of medics. Emergency and medical departments were the most exposed with 25% and 20% of staff in a job-strain situation respectively. Low job seniority predisposed to a higher feeling of job-strain. Specialist doctors and nurses represented the most strained professional categories with 42.86% and 30.23% of the individuals concerned respectively. A statistical relation was found between job strain on the one hand and musculoskeletal trouble and self-estimation of the impact of work on health on the other hand. Conclusion: Psychosocial risks, particularly stress, are a real concern in health institutions and this survey note that there could be impact on medics' health in Pointe-Noire.

Psychosocial impact of the COVID-19 pandemic on paediatric healthcare workers

INTRODUCTION@#Frontline healthcare workers (HCWs) exposed to coronavirus disease 2019 (COVID-19) are at risk of psychological distress. This study evaluates the psychological impact of COVID-19 pandemic on HCWs in a national paediatric referral centre.@*METHODS@#This was a survey-based study that collected demographic, work environment and mental health data from paediatric HCWs in the emergency, intensive care and infectious disease units. Psychological impact was measured using the Depression, Anxiety, Stress Scale-21. Multivariate regression analysis was performed to identify risk factors associated with psychological distress.@*RESULTS@#The survey achieved a response rate of 93.9% (430 of 458). Of the 430 respondents, symptoms of depression, anxiety and stress were reported in 168 (39.1%), 205 (47.7%) and 106 (24.7%), respectively. Depression was reported in the mild (47, 10.9%), moderate (76, 17.7%), severe (23, 5.3%) and extremely severe (22, 5.1%) categories. Anxiety (205, 47.7%) and stress (106, 24.7%) were reported in the mild category only. Collectively, regression analysis identified female sex, a perceived lack of choice in work scope/environment, lack of protection from COVID-19, lack of access to physical activities and rest, the need to perform additional tasks, and the experience of stigma from the community as risk factors for poor psychological outcome.@*CONCLUSION@#A high prevalence of depression, anxiety and stress was reported among frontline paediatric HCWs during the COVID-19 pandemic. Personal psychoneuroimmunity and organisational prevention measures can be implemented to lessen psychiatric symptoms. At the national level, involving mental health professionals to plan and coordinate psychological intervention for the country should be considered.

Investigation of mental health among hospital workers in the COVID-19 pandemic: a cross-sectional study

ABSTRACT BACKGROUND: The rapid spread of the COVID-19 epidemic has led to extraordinary measures taken worldwide, and has led to serious psychological disorders. Healthcare professionals face greater severity of stress burden, due both to their direct contact with patients with the virus and to the isolation dimension of this outbreak. OBJECTIVE: To examine psychiatric disorders such as anxiety, depression and sleep disorders among healthcare professionals working in an emergency department and a COVID-19 clinic. DESIGN AND SETTING: Cross-sectional study including healthcare professionals in the emergency department and other units serving patients with COVID-19, of a training and research hospital in Turkey. METHODS: 210 volunteers, including 105 healthcare professionals in the emergency department and 105 healthcare professionals working in other departments rendering services for COVID-19 patients, were included in this study. A sociodemographic data form and the Hospital Anxiety Depression Scale (HAD), Pittsburg Sleep Quality Index (PSQI), World Health Organization Quality of Life scale (WHOQOL-BREF-TR) and Religious Orientation Scale were applied to the volunteers. RESULTS: The perceived stress levels and PSQI subscores were found to be significantly higher among the volunteers working in the emergency department than among those in other departments. The risk of development of anxiety among women was 16.6 times higher than among men. CONCLUSIONS: Healthcare professionals on the frontline need systematic regular psychosocial support mechanisms. Anxiety due to fear of infecting family members can be prevented through precautions such as isolation. However, it should be remembered that loneliness and feelings of missing family members consequent to isolation may increase the risk of depression.

Percepción del equipo de salud sobre los beneficios del calostro como factor protector de enterocolitis necrotizante en recién nacidos prematuros / Health professionals perception about the use of human colostrum, as preventive measure for necrotizing enterocolitis in preterm newborns

INTRODUCCIÓN: La incidencia de enterocolitis necrotizante (ECN), en Chile es de 0,3 a 2,4 por mil recién nacidos vi vos, siendo principalmente afectados los neonatos prematuros, y de 8 a 12 por ciento en prematuros menores a 1.500 gramos. OBJETIVO: Describir la percepción de profesionales de salud sobre el uso de calostro en recién nacidos prematuros, como factor protector de enterocolitis necrotizante. SUJETOS Y MÉTODO: Estudio cualitativo, mediante entrevista semiestructurada a 18 profesionales de la salud en tres hospitales públicos de la región de Valparaíso. La pauta de entrevista incluyó 3 temas: Conocimientos, percepción del suministro temprano de calostro y opinión acerca de la extensión de la medida, y 6 subtemas, 2 para cada tema respectivamente: Autopercepción del nivel de conocimiento y fuentes de información; Experiencia: aspectos positivos/eventos adversos y opinión del calostro como factor protector de enterocolitis; aspectos facilitadores u obstaculizadores y opinión acerca de la medida como política nacional. Procesamiento de datos mediante análisis de contenido cualitativo, temático. RESULTADOS: El uso de calostro en prematuros se da de modo protocolizado en dos de las tres unidades de alta complejidad neonatal de la región de Valparaíso. Los participantes opinan positivamente acerca de los resultados preventivos de esta medida. Aun cuando en un tercer estable cimiento no se aplique, hay una percepción favorable acerca de su potencial beneficio y su bajo costo de implementación. Se señala, no obstante, que ésta requiere de mayor evidencia y de un protocolo de aplicación. Otras limitantes serían la insuficiente dotación y formación del personal, y la necesidad de adquirir equipamiento e insumos. CONCLUSIONES: Profesionales que han aplicado un protocolo de administración de calostro en neonatos prematuros en la Región de Valparaíso, reportan buenos resultados de salud, y promueven la motivación del equipo hacia esta praxis. Sin embargo, se considera relevante la difusión y discusión de protocolos nacionales e internacionales, así como el desarrollo de investigación local. Dadas las experiencias en curso en Chile, y el debate internacional, se considera oportuno que el tema sea abordado y discutido en la comunidad sanitaria nacional.

INTRODUCTION: In Chile, necrotizing enterocolitis (NEC) mainly affects preterm infants, with an incidence of 0.3 to 2.4 per 1,000 live births, and 8 to 12% in preterm infants weighing less than 1,500 grams. OBJECTIVE: To describe health professionals perceptions on the use of human colostrum as a preventive measu re against necrotizing enterocolitis in preterm newborns. SUBJECTS AND METHOD: Qualitative study, using 18 semi-structured individual interviews of health professionals in three public hospitals of the Valparaíso Region. The interview included 3 topics: Knowledge, Perception of early colostrum supply and Opinion about the extent of the measure, and 6 subtopics, 2 for each topic respectively: Self-perception of knowledge level and Sources of information; Experience: positive aspects/adverse events and Opinion of colostrum as a protective factor for enterocolitis; Facilitating or hindering aspects and Opinion about the measure as national policy. Data were processed through qualitative content analysis. RESULTS: Two of the three high-complexity neonatal units of the Valparaíso Re gion have a protocol for administrating colostrum in premature infants. Participants have a positive opinion about the preventive results of this measure. Even in the third hospital where there is no protocol, they have a favorable perception of its potential benefit and its low cost of implementa tion. However, we observed that this procedure requires more evidence and an application protocol. Other limitations would be the lack of staffing and training and the need for equipment and supplies. CONCLUSIONS: Professionals who have applied a colostrum administration protocol in preterm infants in the Valparaíso Region report good health outcomes and promote team motivation towards this practice. However, it is relevant to the dissemination and discussion of national and international protocols, as well as the development of local research. Given the ongoing experiences in Chile and the international debate, we considered appropriate to address and discuss the topic within the na tional health community.

Análisis citogenético en linfocitos de trabajadores expuestos a radiación ionizante en una unidad de cardiología intervencional de Chile: estudio piloto y revisión de la literatura / Citogenetic effects upon lymphocyes in subjects exposed to ionizing radiadion in an interventional laboratory cardiology: pilot study and literature review

ANTECEDENTES: Un número creciente de artículos está llamando la atención en forma consistente sobre la eventual asociación que existe entre los denominados trabajadores ocupacionalmente expuestos a bajos niveles de radiación ionizante (POEs) y una mayor frecuencia de aberraciones cromosómicas, a nivel Sudamericano estos estudios son escasos. OBJETIVO: Evaluar la frecuencia de aberraciones cromosómicas en linfocitos de sangre periférica de POEs de un hospital y de sujetos sanos. Adicionalmente, se realizó una revisión exhaustiva de los artículos que a la fecha abordaron este tema. MATERIAL Y MÉTODO: Se condujo un análisis citogenético destinado a cuantificar las aberraciones cromosómicas en sangre periférica de linfocitos de 6 POEs de la unidad de Cardiología Intervencional y, como controles, 6 muestras de sujetos de la población general fueron analizadas. RESULTADOS: Se observó un importante contraste en el número de aberraciones cromosómicas presentadas en los POEs versus la población general no expuesta a radiaciones ionizantes, siendo esta de una relación de 6:1, respectivamente. CONCLUSIÓN: Los resultados preliminares indican una mayor frecuencia de aberraciones cromosómicas en los POEs versus la población general, sin embargo, se deberá esperar los resultados de la segunda fase de investigación, donde al ampliar la muestra en análisis se podrán obtener conclusiones estadísticamente significativas.

BACKGROUND: There is growing evidence of an increased number of chromosomes aberrations in subjects exposed to low levels of ionizing radiation (POEs). There are few studies on this subject in Latin America AIM: To evaluate the frequency of chromosome aberrations in lymphocytes obtained from peripheral blood in subjects working in laboratories where low levels of ionizing radiation are present and to compare these findings to those of unexposed subjects. METHODS: A cytogenic analysis to quantify chromosome aberrations was performed in 6 POs subjects from a cardiology invasive laboratory and 6 controls from a general unexposed population. RESULTS: Compared to controls, an approximately 6-fold increase in the number of chromosome aberrations was observed.in subjects exposed to ionizing radiation CONCLUSION: These preliminary results indicate that there is an increased number of chromosome aberrations in subjects exposed to low levels of ionizing radiation, as occurs in people working in a cardiology interventional laboratory. Studies in large numbers of subjects and preferably followed prospectively are needed to evaluate more precisely this effect.

Personalidade hardiness e fatores associados em profissionais da saúde atuantes em serviços que atendem pacientes críticos / Hardy personality and associated factors in health professionals active in services that treat critical patients

Resumo Objetivou-se identificar os fatores associados à personalidade hardiness em profissionais de saúde atuantes em serviços hospitalares que atendem a pacientes críticos. Estudo epidemiológico, transversal e analítico, realizado com 469 profissionais de saúde. Como instrumento, utilizou-se a Escala Hardiness (EH) associada a um questionário para investigar as condições sociodemográficas, ocupacionais e de saúde. Foi realizada a análise descritiva e bivariada por meio do teste qui-quadrado e modelo múltiplo através de regressão logística múltipla, utilizando o teste Hosmer Lemeshow e PseudoR2, estimando razão das chances (odds ratio). A classificação dos escores totais na EH evidenciou preponderância de moderado hardiness (48,4%). A chance de alto hardiness entre profissionais com estilo de vida fantástico regular ou ruim reduziu em 74% quando comparado aos considerados muito bons e excelentes. Também esteve aumentada entre os profissionais que não tiveram licença/afastamento, que apresentavam alta satisfação por compaixão no trabalho, baixo estresse e baixo burnout. A personalidade hardiness influência direta e indiretamente a saúde e o bem-estar do profissional de saúde atuante em serviços hospitalares que atendem a pacientes críticos.

Abstract This study aimed to identify factors associated with the hardy personality in health professionals working in hospital services that treat critically ill patients. This is an epidemiological, cross-sectional, and analytical study conducted with 469 health professionals. We used the Hardiness Scale (HS), coupled with a questionnaire to investigate sociodemographic, occupational, and health conditions. A descriptive and bivariate analysis was performed using the chi-square test and the multiple model through multiple logistic regression, using the Hosmer-Lemeshow and PseudoR2 tests, estimating odds ratios. The classification of total scores in HS showed prevailing moderate hardiness (48.4%). Professionals with a fair or poor fantastic lifestyle (FL) were 74% less likely to show high hardiness than those with very good and excellent FL. Also, professionals who were not on leave, who had high satisfaction with compassion at work, low stress, and low burnout were more likely to show high hardiness. The hardy personality, directly and indirectly, influences the health and well-being of health professionals working in hospital services that treat critically ill patients.

Effect of radiation on endothelial functions in workers exposed to radiation

SUMMARY OBJECTIVE Our aim is to determine whether radiation affects the endothelial function of hospital staff working in the radiation unit for diagnostic and therapeutic purposes. We have evaluated endothelial function with vascular imaging parameters such as flow-mediated dilatation (FMD) and aortic stiffness index (ASI). METHODS A total of 75 employees, 35 of whom are exposed to radiation due to their profession and 40 as the control group, were included in our single-centered study. Demographic data, FMD, aortic stiffness, and echocardiographic findings of the two groups were compared. RESULTS There were no significant differences in demographic data. Median FMD values tended to be lower in the radiation exposure group [7.89 (2.17-21.88) vs. 11.69 (5.13-27.27) p=0.09]. The FMD value was significantly lower in the catheter laboratory group than in the radiation-exposed (p=0.034) and control (p=0.012) groups. However, there was no statistically significant difference between the non-catheter lab radiation exposed group and the control group (p=0.804). In addition, there was no statistically significant difference in the ASI value between the groups (p=0.201). CONCLUSION We have found that FMD is decreased among hospital staff working in radiation-associated areas. This may be an early marker for radiation-induced endothelial dysfunction.

RESUMO OBJETIVO O nosso objetivo é determinar se a radiação afeta a função endotelial de funcionários do hospital que trabalham em unidades com exposição à radiação para fins diagnósticos e terapêuticos. Avaliamos a função endotelial com parâmetros de imagens vasculares, tais como dilatação fluxo-mediada (FMD) e o índice de rigidez aórtica (ASI). METODOLOGIA Um total de 75 funcionários, 35 expostos à radiação devido à sua ocupação e 40 como grupo de controle, foram incluídos em nosso estudo monocêntrico. Os dados demográficos, de FMD, rigidez aórtica e ecocardiográficos dos dois grupos foram comparados. RESULTADOS Não houve diferenças significativas nos dados demográficos. Os valores médios de FMD, em geral, foram mais baixos no grupo de exposição à radiação [7,89 (2,17-21,88) e 11,69 (5,13-27,27) p=0,09]. O valor de FMD foi significativamente menor no grupo laboratorial com cateter do que no exposto à radiação (p=0,034) e no de controle (p=0,012). No entanto, não houve diferença estatisticamente significativa entre o grupo laboratorial sem cateter e exposto à radiação e o grupo de controle (p=0,804). Além disso, não houve diferença estatisticamente significativa quanto ao valor de ASI entre os grupos (p=0,201). CONCLUSÃO Observamos que a FMD é menor entre funcionários que trabalham em setores hospitalares associados à radiação. Isso pode ser um marcador inicial de disfunção endotelial induzida por radiação.

Psychological status of the staff in a general hospital during the outbreak of coronavirus disease 2019 and its influential factors / 中南大学学报(医学版)

OBJECTIVES@#To understand the psychological status of the staff in a general hospital during the coronavirus disease 2019 and its influential factors, and to provide references for the mental health services to hospital staff.@*METHODS@#Using star platform of questionnaire, the staff in the general hospital were investigated via Depression, Anxiety, Stress Scale (DASS-21), Social Support Rating Scale (SSRS) and Simplified Coping Style Questionnaire (SCSQ). The influential factors were discussed by descriptive analysis, rank sum test, single factor analysis, correlation analysis and multiple factors binary logistic regression analysis.@*RESULTS@#A total of 2 060 valid questionnaires were collected. The negative emotions of nurses and cleaners were the most obvious. The depression scores, anxiety scores and stress scores for nurses and cleaners were 5.06±7.47, 6.36±7.84, 9.75±8.65, and 6.72±8.84, 4.51±6.56, 9.69±9.56, respectively. Multivariate binary logistic regression analysis showed that staff types, education levels, job status, economic situation and concerns on the supplies of protective goods were the main influential factors for depression; staff types, contacting status with infected patients, economic situation, concerns on the supplies of protective goods, history of disease were the main influential factors for anxiety; contacting status with infected patients, economic situation, concerns on the supplies of protective goods were the main influential factors for stress.@*CONCLUSIONS@#There are differences in psychological characteristics among different groups of staff in the general hospital under the outbreak. Thus psychological protection and intervention measures should be formulated according to different groups and work status.

Satisfacción laboral y motivación en profesionales obstetras en un hospital en Chile / Job satisfaction and motivation in obstetric professionals of a Chilean hospital

El principal activo de las organizaciones está constituido por sus trabajadores, por lo cual se debe prestar una especial atención a su motivación y satisfacción, y también a la relación con el desempeño. La satisfacción laboral de los profesionales del sistema de salud se relaciona directamente con la calidad de servicio ofrecido, de ahí la importancia de su medición. La insatisfacción puede repercutir negativamente en la calidad de atención. La presente investigación tiene por objetivo determinar el nivel de satisfacción y motivación laboral de los y las profesionales matronas del Hospital de Puerto Montt-Chile, para lo cual se realizó un estudio de carácter cuantitativo, descriptivo y transversal. Para medir la motivación se empleó el Job Diagnostic Survey y para la satisfacción se utilizó la escala de satisfacción laboral SL-SPC. Se logró determinar que los profesionales poseen niveles de motivación media-alta en todas las dimensiones estudiadas. Respecto a los factores de satisfacción, el estudio arrojó un nivel medio-bajo, en la mayoría de los factores medidos.

The main asset of an organization is its workers. Special attention must be paid to their motivation and satisfaction and also to how they relate to performance. Job satisfaction of health care professionals is directly related to the quality of care provided, hence the importance of its measurement. Dissatisfaction can negatively impact the quality of care. The purpose of this study is to determine the level of satisfaction and work motivation of the midwifery professionals of the Hospital of Puerto Montt (Chile). We used a quantitative, descriptive, and cross-sectional study. To measure motivation, we used the Job Diagnostic Survey, and to measure satisfaction, we used the SL-SPC scale. It was possible to determine that the professionals have medium-high levels of motivation in all the dimensions studied. Regarding satisfaction factors, the study showed a medium-low level, in most of the factors measured.

Patient safety culture from the perspective of all the workers of a general hospital / Cultura de seguridad del paciente desde la perspectiva de todos los trabajadores de un hospital general / Cultura de segurança do paciente na perspectiva de todos os trabalhadores de um hospital geral

ABSTRACT Objective: To assess the patient safety culture among the workers of a hospital institution in southern Brazil. Method: This is a cross-sectional study, which was performed with 630 hospital workers, at Santa Rosa, Rio Grande do Sul, Brazil, through the Safety Attitudes Questionnaire tool, in the month of April 2017. Results: We found positive scores in all the safety culture domains, except for the perceived stress domain. Conclusion: Job satisfaction and teamwork spirit showed better scores for nursing and health professionals, when compared to the support team. Schooling, gender, operation time and the choice of workplace positively influenced the safe atmosphere.

RESUMEN Objetivo: Evaluar la cultura de seguridad del paciente entre los trabajadores de una institución hospitalaria de Santa Rosa, Río Grande del Sur, Brasil. Método: Estudio transversal, el cual se desarrolló con un equipo multidisciplinario de una institución hospitalaria, mediante el instrumento Safety Attitudes Questionnaire, en el mes de abril de 2017. Resultados: Se encontraron puntuaciones positivas en todos los dominios de la cultura de seguridad, excepto para el dominio sobre la percepción del estrés. Conclusión: La satisfacción laboral y el clima de trabajo en equipo demostraron mejores puntuaciones para profesionales de la enfermería y del área de la salud, en comparación con el equipo de apoyo. La escolaridad, el género, el tiempo activo en la profesión y la elección por el sitio de trabajo influenciaron el clima de seguridad de manera positiva.

RESUMO Objetivo: Avaliar a cultura de segurança do paciente entre todos os trabalhadores de uma instituição hospitalar no sul do Brasil. Método: Estudo transversal, realizado com 630 trabalhadores de um hospital de Santa Rosa, no Rio Grande do Sul, Brasil, por meio do instrumento Safety Attitudes Questionnaire, no mês de abril de 2017. Resultados: Encontraram-se escores positivos em todos os domínios da cultura de segurança, exceto para o domínio percepção do estresse. Conclusão: A satisfação do trabalho e o clima de trabalho em equipe demonstraram melhores escores para profissionais da enfermagem e da área da saúde, se comparado à equipe de apoio. Escolaridade, gênero, tempo de atuação e a escolha pela unidade de trabalho influenciaram positivamente o clima de segurança.