Invisibility and devaluation of nursing work: related factors and coping strategies

Nursing represents the largest professional category in the health field worldwide, with 27.9 million professionals, representing 59% of the entire health workforce.(1) The World Health Organization has warned of the need for greater investments in training, better working conditions and encouraging the development of nursing leadership as one of the means to achieve universal health coverage and the Sustainable Development Goals (SDGs).(1) However, even though they are essential to health systems, these professionals face problems related to the representation of their image, which contributes to a scenario of devaluation, which has proved to be an obstacle to the development of the profession. Thus, in an exercise of understanding this phenomenon, it is considered that the factors that follow contribute greatly to configure the devaluation scenario

Overview and Enlightenment of Codes of Ethics for Nurses at Home and Abroad / 中国医学伦理学

Formulating codes of ethics for nurses are not only the need of establishing nurses’ professional image and dignity, but also the demand of nursing discipline development. By combing the relevant documents of codes of ethics for nurses at home and abroad, this paper summarized the main contents and application of codes of ethics for nurses, found that codes of ethics for nurses were based on the basic principle of "patient-oriented", discussing the relationship between nurses and patients, collaborators, environment, society, specialty and personal development, and forming the constraint standard for nurses’ behavior in combination with the expectation of local cultural values for nursing industry. The codes of ethics for nurses in China need to further clarify the scope of nursing, formulate behavioral norms in various specialties, and through clinical evaluation, education, management and other aspects to promote its popularization and implementation.

Teoria das Representações Sociais e os Sentidos da Aposentadoria no Brasil / Theory of Social Representations and the Meanings of Retirement in Brazil / Teoría de las Representaciones Sociales y los significados de la jubilación en Brasil

Objetivo: refletir acerca das contribuições da Teoria das Representações Sociais para a compreensão dos sentidos da aposentadoria no Brasil. Conteúdo: trata-se de um estudo teórico-reflexivo elaborado com base em leitura crítica de artigos científicos, disponíveis on-line em diversas bases de dados e obras clássicas sobre a teoria das representações sociais bem como aquelas relativas ao fenômeno da aposentadoria. Estrutura-se em duas seções: i) Teoria das Representações Sociais e ii) Os sentidos da Aposentadoria no Brasil. Considerações finais: verifica-se que pesquisas utilizando a teoria das representações sociais possibilitam conhecer o modo como a aposentadoria é compreendida por diferentes grupos sociais e, assim, fornecer subsídios para melhor orientar estes grupos tanto durante o planejamento da aposentadoria quanto na decisão de aposentar-se ou não.

Objective: to reflect on the contributions of the Theory of Social Representations to understanding the meanings of retirement in Brazil. Content: this theoretical-reflective study, based on a critical reading of scientific articles available online in databases and both classic studies of social representations theory and studies of the phenomenon of retirement, is divided into two sections: i) Theory of Social Representations and ii) The meanings of retirement in Brazil. Final remarks: research using the social representations theory was found to help understand how retirement is understood by different social groups and, thus, provide input to guide these groups better, both during retirement planning and in deciding whether or not to retire.

Objetivo: reflexionar sobre los aportes de la Teoría de las Representaciones Sociales para la comprensión de los significados de la Jubilación en Brasil. Contenido: se trata de un estudio teórico-reflexivo basado en la lectura crítica de artículos científicos, disponibles en línea en varias bases de datos y obras clásicos sobre la teoría de las representaciones sociales, así como las relacionadas con el fenómeno de la jubilación. Se divide en dos apartados: i) Teoría de las Representaciones Sociales y ii) Los significados de la jubilación en Brasil. Consideraciones finales: se constata que investigaciones que utilizan la teoría de las representaciones sociales pueden ayudar a conocer la forma cómo los diferentes grupos sociales entienden la jubilación y, por lo tanto, proporcionar subsidios para orientar mejor a estos grupos, tanto durante la planificación de la jubilación, como en la decisión de jubilarse o no.

Sofrimento laboral e estratégias de defesa referidas por técnicas de enfermagem de maternidades públicas / Distress at work and defensive strategies reported by nursing technicians at public maternity hospitals / El sufrimiento laboral y las estrategias de defensa mencionadas por las técnicas en enfermería de maternidades públicas

Objetivo: analisar as vivências de sofrimento e as estratégias de defesa referidas por técnicas de enfermagem em maternidades públicas. Método: pesquisa qualitativa, exploratória e descritiva, com 11 técnicas de enfermagem de maternidades públicas do Rio de Janeiro. Os dados foram coletados em maio de 2019, por meio de entrevistas semiestruturadas, submetidos à análise de conteúdo temática e discutidos à luz da Psicodinâmica do Trabalho. Resultados: os relatos apontam para condições laborais geradoras de desgaste e sofrimento, que repercutem na saúde das participantes. Diante disso, elas elaboram estratégias defensivas individuais, como isolamento emocional, soluções criativas, espiritualidade, religiosidade e momentos de lazer. Na perspectiva coletiva, recorrem a períodos de conversa e ao apoio mútuo no turno laboral. Conclusão: as estratégias defensivas referidas são relevantes para lidar com o sofrimento e atender às demandas do trabalho, mas parecem não evitar o adoecimento nem promover mudanças no contexto laboral das maternidades.

Objective: to examine experiences of distress and related defensive strategies reported by nursing technicians at public maternity hospitals. Method: in this exploratory, qualitative, descriptive study of 11 nursing technicians from public maternity hospitals in Rio de Janeiro, data were collected in May 2019 by semi-structured interviews, subjected to thematic content analysis, and discussed in the light of the Psychodynamics of Work. Results: the reports point to wearing and distressing working conditions, which affected participants' health. In response, they developed individual defensive strategies, such as emotional isolation, creative solutions, spirituality, religiosity, and moments of leisure. Collectively, they resort to periods of conversation and mutual support during shifts. Conclusion: the defensive strategies reported are important in coping with suffering and meeting work demands, but they do not seem to prevent illness nor promote changes in the maternity hospital work environment.

Objetivo: analizar las experiencias de sufrimiento y las estrategias de defensa mencionadas por técnicas de enfermería en maternidades públicas. Método: investigación cualitativa, exploratoria y descriptiva, junto a 11 técnicas de enfermería de maternidades públicas de Rio de Janeiro. Los datos se recopilaron en mayo de 2019, por medio de entrevistas semiestructuradas. Luego se sometieron a un análisis de contenido temático y se discutieron a la luz de la Psicodinámica del Trabajo. Resultados: los relatos apuntan hacia condiciones laborales que generan desgaste y sufrimiento y que afectan la salud de las participantes. Por tanto, desarrollan estrategias defensivas individuales como: aislamiento emocional, soluciones creativas, espiritualidad, religiosidad y momentos de ocio. Desde una perspectiva colectiva, recurren a las conversaciones y al apoyo mutuo durante la jornada laboral. Conclusión: las estrategias defensivas mencionadas son relevantes para enfrentar el sufrimiento y satisfacer las demandas del trabajo, pero no parecen prevenir enfermedades ni promover cambios en el contexto laboral de las maternidades.

Tecnologias de informação e comunicação: interfaces com o processo de trabalho da enfermagem no contexto hospitalar / Information and communication technologies: interfaces with the nursing work process in the hospital context

Introdução: Nas últimas décadas as informações e o processo de comunicação sofreram significativas modificações, sobretudo no que concerne os acelerados mecanismos de acesso à informação em tempo real. Nessa conjuntura, é necessário destacar as Tecnologias de Informação e Comunicação, pois, permeiam a capacidade de acesso e disseminação de informações que podem influenciar a dinâmica de gestão do conhecimento que permeia o processo de trabalho da enfermagem e, consequentemente, o gerenciamento do cuidado de enfermagem. Portanto, diante do exposto, a pesquisa tem como objetivos: compreender os significados que enfermeiros, no contexto hospitalar, atribuem às Tecnologias de Informação e Comunicação para o processo de trabalho da Enfermagem; identificar as inter-retro-ações entre esses significados e o processo de trabalho da enfermagem para os aspectos relacionados à gestão do conhecimento e gerenciamento do cuidado de enfermagem. Metodologia: O presente estudo caracteriza-se como explicativo, de abordagem qualitativa, utilizando, para tanto, a Teoria Fundamentada nos Dados (TFD) como referencial metodológico e a Teoria da Complexidade, na perspectiva de Edgar Morin, como referencial teórico. Para a coleta de dados foram empregadas entrevistas semiestruturadas, gravadas em dispositivo formato mp3, entre janeiro de 2019 e junho de 2019. Os participantes da pesquisa compuseram dois grupos amostrais, compostos por 12 enfermeiros assistenciais e sete residentes de Enfermagem que atuaram nos setores de clínica médica e cirúrgica de um hospital universitário federal, situado na cidade do Rio de Janeiro. Resultados: cinco categorias emergiram do processo de codificação dos dados, a saber: Fatores condicionantes para o reconhecimento e utilização das TIC por enfermeiros no processo de trabalho; Tecnologias de Informação e Comunicação: apontando finalidades, recursos e a dinâmica de utilização no processo de trabalho da enfermeiro; Revelando ações-interações entre as tecnologias de informação e comunicação e gestão do conhecimento no processo de trabalho do enfermeiro; Identificando fatores intervenientes à utilização de TIC no processo de trabalho de enfermagem e; Vislumbrando consequências a partir da utilização da TIC no processo de trabalho da enfermagem. Conclusões: Resultado desse processo, reflexões na dimensão da comunicação que apresentam conexões com o processo de trabalho, que por sua vez, demandam estratégias para as atividades da TIC no cenário do estudo. Através do referencial metodológico da Teoria Fundamentada dos Dados proporcionou a compreensão e a explicação dos dados de maneira profunda resultando na formulação do fenômeno central Tecnologias de Informação e Comunicação: mecanismos para o estabelecimento de conexões necessárias ao processo de trabalho da enfermagem. Ademais a hipótese inicial do estudo de que as gerações poderiam influenciar na utilização das Tecnologias de Informação e Comunicação fora parcialmente refutada, sendo considerada pelos participantes do estudo como um fator desencadeador, no entanto, não condicionante.

Introduction: In the last de cades the information and the communication process have under gone significant changes, especially regarding the accelerated mechanisms of Access to information in real time. At this juncture, it is necessary to highlight the Information and Communication Technologies, as they permeate the ability to Access and disseminate information that may influence the dynamics of knowledge management that permeates the nursing work process and, consequently, the management of nursing care nursing. Therefore, in light of the above, there search aims to: Understand the meanings that nurses, in the hospital context, attribute to Information and Communication Technologies in the context of the nursing work process; Identify the inter-retro-actions between these meanings and the nursing work process for knowledge management and nursing care management. Methodology: This study is characterized as explanatory, qualitative approach, qualitative approach, using the Grounded Theory (GT) as the methodological framework and the Complexity Theory, in Edgar Morin's perspective, as the theoretical framework. For data collection, semi-structured interviews were used, recorded in format mp3, between January 2019 and June 2019. The research participants consisted of two sample groups, composed of 12 assisting nurses and seven nursing presidents Who worked in the medical clinic and surgery at the Clementino Fraga Filho University Hospital (HUCFF). Results: After the data coding process, five categories emerged, namely: Conditioning Factors for the Recognition and Use of ICT by Nurses in the Work Process; Information and Communication Technologies: pointing purposes, resources and the dynamics of use in the nursing work process; Revealing Actions- Interactions between information and communication Technologies and Knowledge Management in the Nursing Work Process, Identifying Intervening Factors to the use of ICT in the Nursing Work Process and Glimpsing Consequences from the use of ICT in the Nursing Work Process. Conclusions: As a result of this process, reflections on the communication dimension that present connections with the work process, which in turn demand strategies for ICT activities in the study scenario. Through the methodological framework of the Grounded Theory of Data, it provided the understanding and explanation of the data in a profound way, resulting in the formulation of the central phenomenon Information and Communication Technologies: mechanisms for establishing the necessary connections to the nursing work process. In addition, the initial hypothesis of the study that generations could influence the use of Information and Communication Technologies had been partially refuted, being considered by the study participants as a triggering factor, however, not a conditioning factor.

Introducción: En las últimas décadas, La información y El proceso de comunicación han sufrido cambios significativos, especialmente em relación com los mecanismos acelerados de acceso a La información em tiempo real. Em esta coyuntura, es necesario destacar lãs Tecnologías de La Información y La Comunicación, ya que impregnan la capacidad de acceder y difundir información que puede influir em La dinámica de La gestión Del conocimiento que impregna El proceso de trabajo de enfermería y, em consecuencia, La gestión de los cuidados de enfermería. enfermeria Por lo tanto, a la luz de lo anterior, La investigación tiene como objetivo: Comprender los significados que lãs enfermeras, enel contexto del hospital, atribuyen a lãs Tecnologías de La Información y La Comunicación enel contexto Del proceso de trabajo de enfermería; Identificar lãs interacciones entre estos significados y elproceso de trabajo de enfermería para La gestión Del conocimiento y La gestión del cuidado de enfermería. Metodología: Este estudio se caracteriza por su enfoque explicativo, cualitativo, enfoque cualitativo, utilizando lateoría fundamentada (GT) como marco metodológico y lateoría de lacomplejidad, enla perspectiva de Edgar Morin, como marco teórico. Para larecopilación de datos se utilizaron entrevistas semiestructuradas grabadas enel dispositivo format mp3, entre enero de 2019 y junio de 2019. Los participantes de La investigación consisti eronen dos grupos de muestra, que constaban de 12 enfermeras auxiliares y enfermeras de séptima enfermería que trabajaba nen la clínica médica y cirugíaenel Hospital Universitario Clementino Fraga Filho (HUCFF). Resultados: Después Del proceso de codificación de datos, surgieron cinco categorías, a saber: Factores condicionantes para El reconocimiento y uso de las TIC por lãs enfermeras enel proceso de trabajo; Tecnologías de La información y la comunicación: propósitos de apuntamiento, recursos y ladinámica de uso enelproceso de trabajo de enfermería; Acciones reveladoras: interacciones entre lãs tecnologías de La información y la comunicación y la gestión Del conocimiento enel proceso de trabajo de enfermería, identificando factores intervinientes para el uso de las TIC enel proceso de trabajo de enfermería y vislumbrando lãs consecuencias del uso de las TIC enel proceso de trabajo de enfermería. Conclusiones: Como resultado de este proceso, reflexiones sobre la dimensión de comunicación que presentan conexiones con el proceso de trabajo, que a su vez exigen estrategias para actividades de TIC en el escenario de estudio. Através del marco metodológico de Grounded Theory, proporcionó la comprensión y explicación de los datos de una manera profunda, lo que resultó en la formulación del fenómeno central Tecnologías de la información y la comunicación: mecanismos para establecer las conexiones necesarias con el proceso de trabajo de enfermería.

Acidentes de trabalho envolvendo profissionais de enfermagem no Brasil: 2007-2017 / Work accidents involving nursing professionals in Brazil: 2007-2017 / Accidentes de trabajo de profesionales de enfermería en Brasil: 2007-2017

Analisar a frequência de registros de acidentes de trabalho (ATs) com PEs no Brasil entre 2007 a 2017. Método: Trata-se de um estudo epidemiológico, exploratório, descritivo com abordagem quantitativa. Foram utilizados dados extraídos dos Anuários Estatísticos de Acidentes do Trabalho (AEAT) e Sistema Eletrônico do Serviço de Informações ao Cidadão (e-SIC) desenvolvidos pelo Ministério da Economia (ME). Resultados: Após o processo de organização e análise dos dados foi identificado o universo de 2.706 registros. A maior preponderância identificada entre as categorias foi de 48,8% (n=1.321) técnicos em enfermagem (TEs) e por tipo de acidente o típico com 49,6% (n=1.129). Conclusão: Por meio da presente pesquisa foi verificado ascensão progressiva da frequência de registros de casos de ATs envolvendo PEs no recorte histórico e geográfico analisado.

To analyze the frequency of records of work accidents(WAs) with PEs in Brazil between 2007 and 2017. Method: This is an epidemiological, exploratory, descriptive study with a quantitative approach. Data extracted from the Statistical Yearbook of Accidents at Work (AEAT) and the Electronic System of the Citizen Information Service (e-SIC) developed by the Ministry of Economy (ME) were used. Results: After organizing and analyzing the data, a universe of 2,706 records was identified. The highest preponderance identified among the categories was 48.8% (n=1,321) nursing technicians (TEs) and by type of accident the typical with 49.6% (n=1,129). Conclusions: Through this research, there was a progressive increase in the frequency of records of TA cases involving PEs in the analyzed historical and geographic cut.

Analizar la frecuencia de registros de accidentes de trabajo (ATs) con EP en Brasil entre 2007 y 2017. Método: Se trata de un estudio epidemiológico, exploratorio, descriptivo con enfoque cuantitativo. Se utilizaron datos extraídos del Anuario Estadístico de Accidentes de Trabajo (AEAT) y del Sistema Electrónico del Servicio de Información al Ciudadano (e-SIC) desarrollado por el Ministerio de Economía (ME). Resultados: Luego de organizar y analizar los datos, se identificó un universo de 2.706 registros. La mayor preponderancia identificada entre las categorías fue del 48,8% (n=1.321) técnicos de enfermería (ET) y por tipo de accidente el típico con 49,6% (n=1.129). Conclusión: A través de esta investigación, se produjo un aumento progresivo en la frecuencia de registros de casos de AT que involucran a EP en el corte histórico y geográfico analizado.

Factors affecting Organizational Commitment of General Hospital Nurses in Small and Medium Sized Cities / 간호행정학회지

PURPOSE: This study was done to investigate the relationships between nursing work environment, leader-member exchange(LMX), peer support, and organizational commitment in one city with a severe nurse shortage. METHODS: Participants were 198 nurses who had worked for more than 6 months with the same head nurse. They worked in five general hospitals located in one city. In April 2016 participants completed a survey questionnaire about their nursing work environment, LMX, peer support, and organizational commitment. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and multiple regression. RESULTS: There was a significant difference in nursing work environment by experience of turnover (t=−2.58, p=.010). LMX showed significant difference by department (F=3.81, p=.011). Factors influencing nurses' organizational commitment were nurse participation in hospital affairs (β=.23, p=.028) and nurse manager ability, leadership and support (β=.18, p=.022). Explanatory power was 18.2% in the regression model. CONCLUSION: The results suggest that it is necessary to improve the nursing work environment in order to increase organizational commitment. Improvement of the nursing system should be considered along with supplementation of nurses particularly during a severe nurse shortage.

Influence of nursing work environment on nurse job satisfaction from 25 hospitals in China / 中国实用护理杂志

Objective@#To describe job satisfaction of paediatric intensive care units in China, and analyze the relationship of nursing work environment between job satisfaction.@*Methods@#From November 2017 to May 2018, a total of 1 414 nurses of paediatric intensive care units from 25 hospitals of 16 provinces and cities nationwide in China were selected using convenient sampling, and surveyed by Nurses Job Satisfaction Scale and Practice Environment Scale. Descriptive statistics and Hierarchical multiple regression analysis were performed by SPSS 20.0.@*Results@#The average score of nurse job satisfaction of paediatric nurses was 3.29 ± 0.49, which was in the middle level in China. Hierarchical regression results showed that the area where the hospital was located, monthly income could affect the nurse job satisfaction, and nursing work environment played an important role for nurses job satisfaction, the model explained 73.1% amount of variance (R2=0.731, P<0.01).@*Conclusions@#The nursing work environment is the important factor influencing the nurses job satisfaction of paediatric intensive care unit, how to balance the domestic resources and reduce the regional differences, we work together to create a healthy environment in paediatric intensive care unit, further improving the nurses job satisfaction will be the important issues in the future.

Influence of nursing work environment on nurse job satisfaction from 25 hospitals in China / 中国实用护理杂志

Objective To describe job satisfaction of paediatric intensive care units in China, and analyze the relationship of nursing work environment between job satisfaction. Methods From November 2017 to May 2018, a total of 1414 nurses of paediatric intensive care units from 25 hospitals of 16 provinces and cities nationwide in China were selected using convenient sampling, and surveyed by Nurses Job Satisfaction Scale and Practice Environment Scale. Descriptive statistics and Hierarchical multiple regression analysis were performed by SPSS 20.0. Results The average score of nurse job satisfaction of paediatric nurses was 3.29 ± 0.49, which was in the middle level in China. Hierarchical regression results showed that the area where the hospital was located, monthly income could affect the nurse job satisfaction, and nursing work environment played an important role for nurses job satisfaction, the model explained 73.1％ amount of variance (R2=0.731, P<0.01). Conclusions The nursing work environment is the important factor influencing the nurses job satisfaction of paediatric intensive care unit, how to balance the domestic resources and reduce the regional differences, we work together to create a healthy environment in paediatric intensive care unit, further improving the nurses job satisfaction will be the important issues in the future.

Effects of Emotional Intelligence and Nursing Working Environment on Nursing Performance of Nurses Caring for Cancer Patients in Small and Medium Hospitals: The Mediating Effect of Communication Competence

PURPOSE: The purpose of this study was to investigate whether the effects of emotional intelligence and working environment on nursing performance of nurses caring for cancer patients in small and medium hospitals were mediated by communication competence.METHODS: The data was collected between Aug. 1 and Aug. 30, 2018 from 240 nurses caring for cancer patients from 11 small and medium hospitals in B city. Variables included in this study were the Wong and Law Emotional Intelligence Scale (WLEIS), the Practice Environment Scale of Nursing Work Index (PES-NWI), the Global Interpersonal Communication Competence (GICC), and nursing performance. The collected data were analyzed by t-tests, ANOVA and Scheffe's test, Pearson's correlation coefficients, and 3 step multiple regression using SPSS/WIN 24.0 and the Sobel test.RESULTS: Communication competence, in the relationship between emotional intelligence and nursing working environment on nursing performance in nurses caring for cancer patients in small and medium hospitals, showed a partial mediating effect (Z=5.24, p < .001; Z=2.44, p=.001 respectively).CONCLUSION: The results of this study showed the effects of emotional intelligence and nursing working environment on nursing performance of nurses caring for cancer patients in small and medium hospitals were mediated by communication competence.

Gerenciamento intra-hospitalar dos resíduos químicos perigosos manuseados pela enfermagem / Intra-hospital management of hazardous chemical waste handled by nurses / Gestión intrahospitalaria de los residuos químicos peligrosos manejados por la enfermería

Objetivo: avaliar as etapas de gerenciamento dos resíduos químicos perigosos - formaldeído e ortoftaldeído, manuseados pela enfermagem. Método: pesquisa descritiva e coleta de dados realizada de setembro a dezembro de 2012, no Hospital Universitário da Universidade de São Paulo, por meio da aplicação da Ficha de Informação de Gerenciamento de Resíduo Químico Perigoso dos resíduos formaldeído e ortoftaldeído gerados, respectivamente, no centro obstétrico e endoscopia. Projeto aprovado por Comitê de Ética em Pesquisa. Resultados: a análise estatística dos dados evidenciou que foram atendidas 3 (13%) especificações do total de 23 (100%) necessárias, com prevalência da identificação, seguida da segregação e nenhuma do transporte interno dos resíduos. Há necessidade de a instituição cumprir as especificações de identificações gerais em relação ao número total de avaliações nos recipientes de resíduos de formaldeído e ortoftaldeído. Conclusão: esta pesquisa proporcionou importantes diretrizes para a elaboração do Plano de Gerenciamento de Resíduos Químicos Perigosos da atenção hospitalar.

Objective: to evaluate the stages in management of hazardous chemical waste handled by nursing staff. Method: in this descriptive study, data was collected from September to December 2012 at São Paulo University Hospital, by applying the Hazardous Chemical Waste Management Information Sheet for formaldehyde and ortho-phthalaldehyde waste in the obstetric center and endoscopy, respectively. The study was approved by the research ethics committee. Results: data analysis showed that 3 (13%) of the 23 (100%) required specifications were met, predominantly identification, followed by segregation, and that none on internal waste transportation were met. The institution needs to comply with general identification specifications regarding the total number of evaluations of formaldehyde and orthophthaldehyde waste containers. Conclusion: this study also yielded important guidelines for preparation of the hospital care Hazardous Chemical Waste Management Plan.

Objetivo: evaluar las etapas de la gestión de los residuos químicos peligrosos - formaldehído y ortoftaldehído, manejados por la enfermería. Métodos: investigación descriptiva y recolección de datos realizada, de septiembre a diciembre de 2012, en el Hospital Universitario de la Universidad de São Paulo, por medio de la aplicación de la Ficha de Información de Gestión de Residuo Químico Peligroso de los residuos de formaldehído y ortoftaldehído generados, respectivamente, en el Centro de Obstetricia y Endoscopía. Proyecto aprobado por el Comité de Ética en Investigación. Resultados: el análisis estadístico de los datos mostró que fueron atendidas 3 (13%) especificaciones del total de 23 (100%) requeridas, con prevalencia de la identificación, seguida por la segregación y ninguna relacionada al transporte interno de los residuos. Es necesario que la institución cumpla con las especificaciones de identificaciones generales en relación al número total de evaluaciones en los recipientes de residuos de formaldehído y ortoftaldehído. Conclusión: la investigación proporcionó importantes directrices para la elaboración del Plan de Gestión de Residuos Químicos Peligrosos de la atención hospitalaria.

Acidentes de trabalho entre profissionais de enfermagem / Accidentes de trabajo entre profesionales de enfermería / Work accidents among nursing professionals

RESUMO Introdução: Historicamente, os trabalhadores têm sofrido diversos infortúnios no ambiente de trabalho, com grandes repercussões nos âmbitos social, econômico e na saúde. Objetivo: Identificar os acidentes de trabalho entre os profissionais de enfermagem no Brasil. Métodos: Revisão integrativa da literatura, com pesquisa em bases de dados, entre maio e junho de 2015 utilizando os descritores "acidentes de trabalho", "equipe de enfermagem" e "enfermagem do trabalho". Foram incluídos estudos com data de publicação entre 2000 e 2015, chegou-se a amostra final de 16 artigos. Conclusões: A partir da análise da produção científica, sugere-se a implementação de um programa de educação permanente no ambiente de trabalho dos profissionais de enfermagem para fomentar a aquisição de conhecimento, e incentivá-los a refletir sobre sua prática e responsabilidade social(AU)

RESUMEN Introducción: Históricamente, los trabajadores han sufrido diversos infortunios en el ambiente de trabajo, con grandes repercusiones en los ámbitos social, económico y en la salud. Objetivo: Identificar los accidentes de trabajo entre los profesionales de enfermería en Brasil. Métodos: Revisión integradora de la literatura, con investigación en las bases de datos, entre mayo y junio de 2015 utilizando las palabras claves "accidentes de trabajo", "equipo de enfermería" y "enfermería del trabajo". Fueron incluidos estudios con fecha de publicación entre 2000 y 2015, llegándose a la muestra final de 16 artículos. Conclusiones: A partir del análisis de la producción científica, se sugiere la implementación de un programa de educación permanente en el ambiente de trabajo de los profesionales de enfermería para fomentar la adquisición de conocimiento, e incentivarlos a reflexionar sobre su práctica y responsabilidad social(AU)

ABSTRACT Introduction: Historically, workers have suffered several misfortunes in the workplace, with big repercussions in the social, economic and health areas. Objective: To identify work accidents among nursing professionals in Brazil. Methods: This is an integrative review of the literature with research in databases between May and June 2015 using the keywords "work accidents", "nursing team" and "nursing work." Studies with a publication date between 2000 and 2015 were included, having a final sample of 16 articles. Conclusions: From the analysis of the scientific literature, it is suggested the implementation of a continuing education program in nursing professional working environment to foster the acquisition of knowledge, and encourage them to reflect on their practice and social responsibility(AU)

Influence of Nurses' Work Environment, Organizational Commitment, and Nursing Professionalism on Turnover Intention of Nurses in Long Term Care Hospitals / 간호행정학회지

PURPOSE: The study was undertaken to investigate influence of nurses' work environment, organizational commitment, and nursing professionalism on turnover intention of nurses working in long term care hospitals. METHODS: The study was cross-sectional study. Participants were 199 nurses working in one of 7 long term care hospitals. Data were collected from May 1 to June 30, 2016 and analysed using two stage hierarchial regression analysis with SPSS 22.0. RESULTS: There was a statistically significant difference in turnover intention according to age (F=6.23, p < .001), present work career (t=−2.11, p=.036), frequency of night duty (t=−3.53, p=.001), and present position (t=−4.07, p < .001). The significant predictors of turnover intention were attachment (β=−0.29, p=.005), nursing professionalism (β=−.21, p=.030), identification (β=−.21, p=.014), continuance (β=−.19, p=.008), collegial nurse-physician relations (β=−.16, p=.039), and originality of nursing (β=.16, p=.014). These factors explained 50.4% of the variance. CONCLUSION: The results suggest that several points need to be considered in order to reduce turnover intention in long term care hospital nurses. These points include building work environments to improve collegial nurse-physician relations, promoting recognition of nurses' organizational commitment, nursing professionalism and the political efforts of organizations supporting nursing originality.

Correlation study of nursing work environment and clinical decision making perception among junior nurses / 中国实用护理杂志

Objective To investigate the status quo of junior nurses' nursing work environment and clinical decision making perception,and to analyze the influence of nursing work environment on clinical decision making perception.Methods The general data questionnaire,nursing work environment scale and clinical decision making perception scale was used to investigate 633 Junior nurses in hospitals.Results The overall mean score of nursing work environment was (2.99±0.37) points,the dimensions score from high to low were:medical cooperation (3.12 ± 0.47) points,nursing management and leadership style (3.06 ± 0.47) points,nurse participation in hospital affairs (2.91 ±0.48) points,high quality nursing service (2.78 ± 0.48) points,sufficient manpower and material resources (2.75 ± 0.52) points,;clinical decision—making perception of Junior nurses was (143.36 ± 14.01) points,the dimensions score from high to low were:the decision—evaluative feedback (37.31 ± 4.53) points,determine the goal of solving the problem (36.16 ± 4.39) points,find the information again (35.04 ± 3.76) points,gather information ability (30.98 ± 3.80) points.The Total score of nursing work environment were positively correlated with the clinical decision making perception of junior nurses(r =0.08-0.28,P＜ 0.01).Conclusions Junior nurse's nursing work environment remains to be improved,nursing work environment has a good effect on clinical decision making perception,therefore,nursing managers should create a positive working atmosphere.It is beneficial to improve the awareness of nursing clinical decision-making by giving specific support to the needs of junior nurses.

Review on the research status of the nursing work environment / 中国实用护理杂志

A health nursing work environment can improve nurses' working satisfaction and job retention, which is an important indicator reflecting the quality of nursing care and patient safety. This article expounds the connotation of nursing working environment,reviews the research status and extracts the improvement strategies for the future.

The Effect of Job Stress on Health Promotion Behaviors of Nurses in a Regional General Hospital: The Mediating Effects of Positive Psychological Capital and Nursing Work Environment / 산업간호학회지

PURPOSE: The purpose of this study is to provide preliminary data for alleviating nurses' job stress and support health promotion behaviors. Further, the study reviews the mediating effects of positive psychological capital and nursing work environment in relation to job stress and health promotion behaviors among nurses in a regional general hospital. METHODS: A study survey was conducted from June 9 to 16, 2017. The subjects were current nurses working at a regional general hospital in D city. Analysis of a survey questionnaire from 147 participants was conducted. RESULTS: Upon reviewing the mediating effects of positive psychological capital and nursing work environment in relation with health promotion behaviors and job stress, it was found that positive psychological capital (Z=−4.78, p < .001) and nursing work environment (Z=−4.17, p < .001) were significant mediators. CONCLUSION: As demonstrated through the results of this research, it is necessary to build programs to strengthen individual positive psychological capital and increase the practice of health promotion behaviors among nurses. It is also evident that a systematic approach is needed to improve the nursing work environment.

Estudo retrospectivo dos registros de mesotelioma maligno no período de 1995 a 2015 / Retrospective study of malignant mesothelioma records from 1995 to 2015

RESUMO : O objetivo deste estudo foi analisar os casos registrados de mesotelioma maligno em um hospital oncológico do Paraná no período de 1995 a 2015. Foram analisados 142 prontuários do Registro Hospitalar de Câncer de um Centro de Alta Complexidade em Oncologia de Curitiba, Paraná, registrados com os códigos topográficos C38 e C48. A coleta de dados ocorreu na instituição entre agosto de 2016 e julho de 2017, com a utilização de instrumento elaborado para a pesquisa. Para a manipulação dos dados e análises estatísticas utilizou-se o software Stata 14®. Foram identificados 16 casos de mesotelioma maligno, com 11 casos pleurais e cinco casos peritoneais. Foi observada maior prevalência em homens brancos, casados, com mais de 50 anos de idade, procedentes de Curitiba e com segundo grau de escolaridade. As ocupações relatadas na admissão foram variadas, com relato de exposição ocupacional ao amianto de apenas um paciente. Não foi possível estabelecer o perfil ocupacional devido à ausência de informações complementares. Em sete Declarações de Óbito as causas básicas dos óbitos eram diferentes dos diagnósticos registrados nas evoluções. Os principais sintomas relatados na busca por atendimento foram emagrecimento, dispneia e dor. Em 68,8% dos casos o tumor apresentava estádio IV, o que denota busca tardia por assistência. O tratamento utilizado foi paliativo multimodal, sendo a quimioterapia o tratamento de eleição em 68,8%. A Sensibilidade dos registros da doença foi de 81%, uma vez que três casos foram notificados com topografias inadequadas. A Especificidade foi de 97%. Divergências encontradas entre alguns diagnósticos estabelecidos em prontuários e os repassados ao Sistema de Informação de Mortalidade e Registro Hospitalar de Câncer apontam para a possibilidade de subnotificação e a necessidade de treinamentos sobre completude de registros e o uso de códigos de classificação de doenças.

Abstract: The objective of this study was to describe the reported cases of Malignant Mesothelioma at a cancer hospital in Paraná between 1995 and 2015. A total of 142 medical records of a Hospital Registry of Cancer of the Center of High Complexity in Oncology in Curitiba. Were analyzed, in which 142 were registered with the topographic codes C38 and C48. Data collection took place between August 2016 and July 2017, with the use of an instrument developed by the researcher. For the manipulation of the data and statistical analysis was used the software Stata 14®. Sixteen cases of Malignant Mesothelioma were identified, with 11 pleural cases and five peritoneal cases. It was observed a higher prevalence in white men, married, over 50 years old, coming from Curitiba and with a second degree of education. The occupations reported on admission were varied, with reports of occupational exposure to asbestos from only one patient. It was not possible to establish the occupational profile due to the lack of complementary information. In seven death certificates the basic causes of death were different from the diagnoses recorded in the evolutions. The main symptoms reported in the search of care were weight loss, dyspnea and pain. In 68.8% of the cases the tumor presented stage IV, denoting a late search by the patient for assistance. The treatment used was multimodal palliative, with chemotherapy being the treatment of choice in 68.8%. The sensitivity of the disease records was 81%, since three cases were reported with inadequate topographies. Specificity was 97%. Divergences were found between some diagnoses established in medical records and those passed on to the Mortality Information System and Cancer Hospital Registry pointed to the possibility of underreporting and the need for training on completeness of registries and use of disease classification codes.

RESUMEN: El objetivo de este estudio fue describir los casos registrados de mesotelioma maligno en un hospital oncológico del Paraná entre 1995 y 2015. Se analizaron 142 historias clínicas de un Registro Hospitalar de Cáncer de un Centro de Alta Complejidad en Oncología de Curitiba, que fueron registrados con los códigos topográficos C38 y C48. La colecta de datos se realizó entre agosto de 2016 y julio de 2017, con utilización de instrumento elaborado por la investigadora. Para la manipulación de los datos y el análisis estadístico se utilizó el software Stata 14®. Se identificaron 16 casos de mesotelioma maligno,11 casos pleurales y cinco peritoneales. Se observó mayor prevalencia en hombres blancos, casados, de más de 50 años de edad, procedentes de Curitiba, con escolaridad correspondiente a la enseñanza secundaria. Las ocupaciones relatadas en la admisión fueron variadas, solamente un paciente relató exposición ocupacional al amianto. No fue posible establecer el perfil ocupacional debido a la ausencia de informaciones complementarias. En siete Declaraciones de Óbito las causas básicas de estos óbitos eran diferentes de los diagnósticos registrados en las evoluciones. Los principales síntomas relatados al buscar atendimiento fueron adelgazamiento, dispneia y dolor. En 68,8% de los casos el tumor presenta estadio IV, lo que denota búsqueda de asistencia tardía. El tratamiento utilizado fue paliativo multimodal, siendo la quimioterapia el tratamiento elegido en 68,8% de los casos. La Sensibilidad de los registros de la enfermedad fue de 81%, ya que tres casos fueron notificados con topografías inadecuadas. La Especificidad fue de 97%. Divergencias encontradas entre algunos diagnósticos establecidos en historias clínicas y los enviados al Sistema de Información de Mortalidad y Registro Hospitalar de Cáncer indican posible subnotificación y necesidad de capacitación sobre completitud de registros y uso de códigos de clasificación de enfermedades.

O processo de trabalho em um ambulatório de oncologia na percepção dos técnicos de enfermagem / El proceso de trabajo en un ambulatorio oncología en la percepción del personal de enfermería / The process of working in an oncology outpatient clinic in the perception of the nursing technical team

Objective: to describe how the technical nursing staff perceives and describes the work process in an Oncology Clinic. Method: A qualitative study. Data was obtained through the use of focus groups and analyzed using content analysis method Result: From the analysis of the participant’s reports emerged the following category: (re)organization of team work. The units of analysis were established to organize and sequence discussions: Barriers in health care network; Work organization focused on professional; Assistance provided to the patientas the central character; Difficulty in linking the micro processes carried out at the Clinic. Conclusion: It is concluded that the work is exercised in a fragmented way and that the work process reorganizes, changing its components, but maintaining the same product.

Objetivo: descrever como a equipe técnica de enfermagem percebe e relata o processo de trabalho em um ambulatório de oncologia. Método: Estudo qualitativo. Os dados foram obtidos por meio da utilização de grupo focal e analisados através da modalidade de Análise de Conteúdo. Resultado: A partir da análise dos relatos das participantes emergiu a seguinte categoria: (re)organização do trabalho em equipe. Foram estabelecidas as unidades de análise para organizar e sequenciar as discussões: Entraves na rede de atenção à saúde; Organização do trabalho centrado no profissional; Assistência fornecida ao paciente como personagem central; Dificuldade na articulação entre os microprocessos realizados no ambulatório. Conclusão: Conclui-se que o trabalho é exercido de forma fragmentada e que o processo de trabalho se reorganiza, alterando seus componentes,porém mantendo o mesmo produto.

Objetivo: describir cómo la técnica del personal de enfermería percibe y describe el proceso de trabajo en una Clínica de Oncología. Método: Estudio cualitativo. Los datos fueron obtenidos por medio del uso de grupos de enfoque y analizados a través del Análisis del Contenido. Resultado: A partir del análisis de los informes de los participantes surgieron las siguientes categorías: (re)organización del trabajo en equipo. Se establecieron las unidades de análisis para organizar y secuenciar discusiones: Barreras en la red de atención de la salud; La organización del trabajo se centró en profesional; La asistencia prestada al paciente como el personaje central; Dificultad en la vinculación de los procesos micro realizadas en la Clínica. Conclusión: Se concluye el trabajo que se lleva a cabo de una manera gradual y que el proceso de trabajo se reorganiza cambiando sus componentes, manteniendo al mismo tiempo el mismo producto.

Application of TISS-28 in the management for ICU nursing / 中国医学装备

Objective:To explore the application value of therapeutic intervention scoring system-28(TISS-28) in the management for intensive care unit (ICU) nursing.Methods: 120 elderly patients who received cure in ICU were divided into observation group (60 cases) and control group (60 cases) according to treatment time. Patients of observation group received the nursing method of TISS-28, and patients of control group received traditional nursing method. The average work time of nursing, the satisfactory degree of patients for nursing work and the satisfactory degree of paramedics for the manpower management of nursing of the two groups were compared.Results: The average work time of nursing of observation group was significantly less than that of control group (t=16.886, P<0.05). The satisfactory degrees for nursing work included life care, health education, communication with family member and humanistic care of observation group were significantly higher than that of control group, respectively (x2=5.175,x2=4.183,x2=4.227,x2=5.175;P<0.05). The general satisfactory degree for nursing work of observation group was significantly higher than that of control group (x2=4.227,P<0.05). The satisfactory degrees of doctor and paramedic for the nursing manpower management of observation group were significantly higher than that of control group (x2=4.571,P<0.05).Conclusion: It is benefit for scientific management of nursing that TISS-28 is adopted to manage the nursing of ICU, and it can enhance work efficiency of nursing and quality of nursing, and improve the satisfactory degrees of patients for nursing work and paramedics for the personnel management.

Analysis and counter measures of working stress related factors of nurses in intensive care unit: report from three top hospitals in Beijing / 中国中西医结合急救杂志

Objective To analyze the working stress related factors of nurses in intensive care unit (ICU), and put forward the corresponding counter measures.Methods During January to March 2016, a questionnaire survey was conducted with a commonly used nurses working pressure source scale on 110 ICU nurses in three People's Liberation Army (PLA) 3A grade hospitals in Beijing. The questionnaire survey involved 35 items within 5 main categories, including nursing professional issues, nursing workload and time allocation, working environment and resources, special care for critical patients and inter-personnel relationships between the head of nurses and other nurses. The correlations between the ICU nursing working stress and alternative factors were analyzed.Results Ninety-six nurses said the job was stressful, and 88.5% of them expressed that the degree of pressure was more than medium. The correlation analysis showed that ICU nurse working stress was correlated with 29 items in the survey scale (allP < 0.05), of which the top 6 items the mostly closely related were the frequent working shift (r = 0.58,P = 0.000), low nursing social status (r = 0.54,P = 0.000), less promotion opportunities (r = 0.54,P = 0.000), less opportunities to pursue further study (r = 0.53, P = 0.000), nurse low salary (r = 0.52,P = 0.000) and excessive workload (r= 0.50,P = 0.000).Conclusions ICU nurses face a lot of pressure in their work, the management departments should pay more attention to them, and actively energetically improve the nurse system construction, raise ICU nurses' pride, enhance the quality of nurse care and promote the healthy development of nursing profession.