Environmental health practice and quality of Nursing care: a protocol for systematic review

OBJECTIVE: To systematically synthesize studies that analyze the relationship between a healthy practice environment and quality of nursing care in hospital settings; to identify the most commonly used instruments to assess nurses' perceptions of a healthy practice environment; to identify the most commonly used instruments to assess nurses' perceptions of quality of nursing care. METHOD: A systematic literature review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The literature search will be conducted in the principal databases. Review of international scientific articles published in the last ten years, accessed through the database of the Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, on nurses' perceptions of the influence of the environment on healthy nursing practice and quality of care. Inclusion: Articles published after 2012 in Portuguese, Spanish, and English. The identified, selected and included studies will be highlighted for the selection process using the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P). If possible, quantitative data will be pooled into a meta-analysis using the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument (MASTARI).

Propylene glycol monomethyl ether isomers in workplace air determined by solvent desorption-gas chromatography / 环境与职业医学

Background Propylene glycol monomethyl ether (PGME) is a widely used organic solvent. It exists in the form of two isomers in the workplace, which will cause adverse effects such as eye and upper respiratory tract irritation in workers. However, there is still a lack of standard detection methods for simultaneous detection of two isomers of PGME in China. Objective To establish a solvent desorption-gas chromatographic method for two isomers of PGME [1-methoxy-2-propanol (α-PGME), 2-methoxy-1-propanol (β-PGME)] in workplace air. Methods A method of solvent desorption-gas chromatography for α-PGME and β-PGME in workplace air were proposed. Air samples were collected with solvent desorption activated carbon tubes, desorbed using a desorption solution of dichloromethane/methanol (85:15), and then separated on a free fatty acid phase (FFAP) fused silica capillary chromatography column , detected with a flame ionization detector (FID), and quantified by peak area. Standard evaluation protocol was followed to obtain key indicators: standard curve, limit of detection, lower limit of quantification, relative standard deviation (RSD) that measures precision, and spiked recovery of sample solutions that measures accuracy. Desorption efficiency, sampling efficiency, and adsorption capacity tests were conducted, sample stability was evaluated using spiked activated carbon tube preservation test, and interference test was also assessed. The developed method was then applied to field air sample testing. Results In this method, using dichloromethane/methanol (85:15) as the sample desorption solution, the quantitative detection ranges of α-PGME and β-PGME were 0.95-923.0 μg·mL−1 and 0.97-912.0 μg·mL−1 with both correlation coefficients of 0.999 9, the method limits of detection were 0.28 µg·mL−1 and 0.29 µg·mL−1, and the lower limits of quantification were 0.95 µg·mL−1 and 0.97 µg·mL1, respectively. The lowest concentrations detected were both 0.19 mg·m−3, and the lowest concentrations quantified were 0.63 mg·m−3 and 0.65 mg·m−3, respectively, under the conditions of sampling volume of 1.5 L and the volume of desorption solution of 1.0 mL. The intra-batch precisions for α-PGME and β-PGME were 2.8%-4.9% and 2.8%-5.1%, the inter-batch precisions were 4.2%-5.7% and 4.5%-5.9%, the spiked recoveries were 98.8%-100.3% and 96.4%-102.9%, and the desorption efficiencies were 92.7%-97.3% and 92.2%-98.1%, respectively. The average sampling efficiency was 100%, and the samples could be stored at room temperature (25-30 ℃) for at least 7 d and at 4 ℃ for at least 15 d. The adsorption capacities of the activated carbon sampling tube for α-PGME and β-PGME were greater than 13.9 mg and 2.7 mg (100 mg of activated carbon adsorbent), respectively. Possible co-existing components in workplace did not interfere with the determination of α-PGME and β-PGME. The short-time exposure concentrations of α-PGME and β-PGME in the spray painting unit of an automobile manufacturing company were determined to be 18.69 mg·m−3 and 2.19 mg·m−3, and the time-weighted average concentrations were 6.03 mg·m−3 and 1.08 mg·m−3 respectively. Conclusion This method is accurate, precise and suitable for on-site monitoring of the two isomers of PGME in workplace air.

Analyzing the monitoring results of occupational hazards in the workplace of key industries in Guangdong Province, 2020-2023 / 中国职业医学

ObjectiveTo understand the monitoring result of occupational hazard in the workplace of key industries in Guangdong Province from 2020 to 2023. Methods The data of occupational hazards in the workplace of 20 key industries in Guangdong Province from 2020 to 2023 were collected from the “Workplace Occupational Hazard Monitoring System” of the Chinese Disease Prevention and Control System subsystem. The monitoring result of occupational hazard factors, occupational health training, occupational health examination, occupational protection, detection of occupational hazardous agents such as dust, chemical substances and noise were analyzed. Results A total of 13 058 enterprises from key industries were recruited as the monitoring subjects in Guangdong Province. There were 290 large-, 1 342 medium-, 7 635 small-, and 3 791 micro-enterprises, with small and micro-enterprises accounting for 58.5% and 29.0% of the total, respectively. A total of 7 542 enterprises exceeded the national standard in the detection of occupational hazards, with a rate of 57.8%. A total of 1 942 517 workers from 13 058 enterprises were recruited, with 835 567 workers were exposed to occupational hazards, with a rate of 43.0%. The rate of occupational health training for enterprise leaders, occupational health management personnel, and workers was 71.9%, 73.8%, and 86.5%, respectively. The abnormal rate of occupational health examinations for workers exposed to noise, dust, and chemical agents was 2.0%, 0.6%, and 1.0%, respectively. The distribution rate of dust masks, anti-poisoning masks or face masks, and noise prevention earplugs or earmuffs was 83.3%, 71.3%, and 77.8%, respectively. The rate of installation of dust prevention facilities, anti-poisoning facilities, and noise prevention facilities was 85.6%, 81.2%, and 50.1%, respectively. The rate of exceeded the national standard of dust, noise in the worksites/types and workplaces showed a decreasing trend year by year (all P<0.01), while the rate of exceeded the national standard of chemical agents in worksites/types and workplaces showed an increasing trend year by year in various occupational hazards (all P<0.01). Conclusion Occupational hazards in the workplace of key industries in Guangdong Province are relatively common. The proportion of workers exposed to occupational hazards is relatively high. It is necessary to further improve the use of noise prevention facilities and protective equipment, strengthen occupational health training for enterprises throughout the province and regularly monitor occupational hazards to reduce the risk of occupational diseases.

Analysis on spectrum characteristics of high-intensity noise in key industries in Guangdong Province / 中国职业医学

ObjectiveTo analyze the spectrum distribution characteristics of high-intensity productive noise in key industries in Guangdong Province. Methods A total of 2 806 enterprises in 21 prefecture-level cities in Guangdong Province were selected as the study subjects using the stratified sampling method. On-site investigations were conducted in workplaces. Noise in workplaces and work-sites, and the noise spectrum of the workplaces with sound pressure level ≥85.0 dB(A) were detected. Results The noise of a total of 23 076 workplaces and 20 969 work sites from 30 key industries were monitored. The median (M) and 25th and 75th percentiles (P25, P75) of workplace sound pressure level were 82.3 (78.6, 86.5) dB(A). The rate of the noise exceeded national standard was 30.4%. The sound pressure level M (P25, P75) of work-site was 78.6 (70.0, 83.5) dB(A). The rate of the noise exceeded national standard was 18.0%. Workplace noise and work site noise were positively correlated (Spearman correlation coefficient=0.86, P<0.01). The rate of the noise exceeded national standard was 46.5% in key work sites where the rate of noise exceeded the national standard was ≥25.0%, and corresponding rate of the workplace noise exceeded national standard was 58.1%. The noise spectrum result of 5 636 workplaces sound pressure level>85.0 dB(A) showed that most of the noise source was from grinding machines (441 cases), and the highest average sound pressure level of noise source was from screening machines [93.0 dB(A)]. Cluster analysis results showed that the main noise sources could be divided into three categories, including wideband noise with levels >80.0 dB in all frequency bands except 8 000.0 Hz, medium-high-frequency noise with the highest sound pressure level at 1 000.0, 2 000.0, and 4 000.0 Hz and low frequencies <75.0 dB, and medium-low-frequency noise below 500.0 Hz with sound pressure level >85.0 dB. Conclusion The rate of the noise exceeded national standard in workplace of key industries in Guangdong Province is high, involving a wide range of industries, with high sound pressure levels and obvious spectrum characteristics of corresponding noise sources. Corresponding noise control strategies can be formulated based on different spectrum characteristics and magnitudes.

Analysis of current status of radiation protection in non-medical radiation workplaces in Yantai, China, 2022 / 中国辐射卫生

Objective To investigate the current status of radiation protection in non-medical radiation workplaces in Yantai, China, and to provide a scientific basis for occupational health management in non-medical radiation workplaces. Methods Non-medical radiation workplaces in Yantai were investigated using a questionnaire survey in 2022, including radiation source term, occupational health examination, personal dose monitoring, personal protective equipment, and radiation protection testing workplaces. Data were entered by a double-entry method and then analyzed. Results There were 56 non-medical radiation workplaces in Yantai, covering manufacturing, nonferrous metal ore mining, nuclear power plant, transportation, and technical services. There were 0 Class I radiation device, 150 Class II radiation devices, and 10 Class III radiation devices; there were 80 Class I radiation sources, 16 Class II radiation sources, 14 Class III radiation sources, 62 Class IV radiation sources, and 135 Class V radiation sources. There were 998 radiation workers, with an occupational health examination rate and personal dose monitoring rate of 98.3%. Among the 56 non-medical radiation workplaces, 47 (83.9%) were equipped with radiation protection monitoring instruments, 24 (51.1%) workplaces had verified the radiation protection monitoring instruments, with 2017 personal dose monitoring instruments and 2327 personal protective equipment in place, 42 (75%) workplaces carried out occupational health assessments, 44 (78.6%) workplaces carried out self-detection, and 53 (94.6%) workplaces carried out entrusting detections (monitoring pass rate: 100% [53/53]). The declaration rate of occupational hazard items was 87.5% (49/56). Conclusion There is still a gap between the current status and the requirements in the national regulations and standards regarding radiation protection in non-medical radiation workplaces. Therefore, the supervision and management of non-medical radiation workplaces should be further strengthened, especially the configuration and verification of radiation protection monitoring instruments.

Prevalence, pattern and factors associated with workplace violence against healthcare workers in Nigeria: A systematic review

Objective:This study aimed to describe the prevalence, pattern, and predictors of WPVagainst HCWs in Nigeria. Methods:Asystematic review was conducted using pre-defined keywords. The review was performed in line with the PRISMAguidelines on PubMed, Google Scholar, Scopus, and Web of Science. The population, intervention, comparator, and outcome (PICO) elements for this study were as follows: Population:Nigerian Healthcare workers; Intervention: Exposure to WPV; Comparator: Non-exposure to WPV; Outcome: Mental and Physical health outcomes of exposure to WPV. Of the 18,140 articles retrieved, 15 cross-sectional studies met the inclusion criteria and were included in the review. In all, 3,245 HCWs were included, and consisted majorly of nurses and doctors. Results:The overall prevalence of WPV(Physical > Verbal/Psychological > Sexual) against HCWs ranged between 39.1%-100%. The predictors of WPVare younger ages (AOR = 2.513, p = 0.012), working in psychiatric unit (AOR = 11.182, p = 0.006), and increased frequency of interaction with patients, and mostly perpetrated by patients and their relatives. Many health facilities lacked a formal reporting system and policies to protect HCWs from WPV. Conclusion:WPVagainst HCWs is a public health problem in Nigeria with dire implications on HCWs; the victims, and the aggressor. Administrators of health facilities should design protocols for WPVreporting, recognition, and management. Patient and 'relatives' education on the 'facilities' policy against WPVshould be undertaken, while orientation sessions on the risk factors for HCWs are scheduled.

The nursing practice environment in a university hospital during the covid-19 pandemic / Ambiente de la práctica profesional de la enfermería en un hospital universitario frente al covid-19 / Ambiente da prática profissional da enfermagem em hospital universitário frente à covid-19

ABSTRACT Objective: to assess the environment of nursing professional practice during the COVID-19 pandemic. Method: cross-sectional study addressing a sample comprising nursing workers from a university hospital. The Brazilian version of the Practice Environment Scale was used, with 24 items distributed into five subscales. The analyses were performed in Statistical Package for the Social Sciences, version 25; the statistical significance was set at 5% (p≤0.05), and the internal consistency was assessed with Cronbach's alpha. Results: 243 workers participated in the study: 62.1% of nursing technicians and aides and 37.9% of nurses. The mean score on the Practice Environment Scale was 2.58 (standard deviation=0.69). Three of the five subscales were poorly assessed: "Nursing foundations for quality of care" (mean 2.58 and SD ± 0.73), "Nursing manager, ability, leadership, and support of nurses" (mean 2.74 and SD ± 0.82), and "Collegial nurse-physician relations" (mean 2.78 and SD ± 0.76). The perception of the professionals who received training to care for Covid-19 patients was more favorable than those who did not receive any training. Conclusion: The nursing work environment during the pandemic was considered mixed; therefore, improvements are required to make nursing working conditions as adequate as possible.

RESUMEN Objetivo: evaluar el ambiente de la práctica profesional de la enfermería durante la pandemia del COVID-19. Método: estudio transversal, realizado en una muestra constituida por el equipo de enfermería que actuaba en un hospital universitario. Se utilizó la escalaPractice Environment Scale(versión brasileña) con 24 ítems distribuidos en cinco subescalas. Los análisis fueron realizados en elStatistical Package for the Social Sciences, versión 25, y se aplicó una significancia estadística de 5% (p≤0,05). La consistencia interna del instrumento fue evaluada con el Alfa de Cronbach. Resultados: participaron de la investigación 243 profesionales, siendo 62,1% técnicos y auxiliares de enfermería y 37,9% enfermeros. La media del puntaje para laPractice Environment Scalefue de 2,58 (Desviación Estándar = 0,69). Los participantes consideraron tres de las cinco subescalas favorables: "Fundamentos de enfermería orientados para la calidad del cuidado" (media 2,58 e DE ± 0,73); "Habilidad, liderazgo y soporte de los coordinadores/supervisores de enfermería a los enfermeros/equipo de enfermería" (media 2,74 y DE ± 0,82) y "Relaciones de compañerismo entre enfermeros y médicos" (media 2,78 y DE ± 0,76). Los profesionales capacitados para el cuidado de los pacientes con Covid-19 tuvieron una percepción más favorable en relación a aquellos que no lo fueron. Conclusión: el ambiente de trabajo de la enfermería fue considerado mixto, en la pandemia, por tanto, necesita de mejorías para que las condiciones de trabajo de la enfermería sean las más adecuadas posibles.

RESUMO Objetivo: avaliar o ambiente da prática profissional da enfermagem durante a pandemia da Covid-19. Método: estudo transversal, conduzido em uma amostra constituída pela equipe de enfermagem que atuava em um hospital universitário. Utilizou-se a escala Practice Environment Scale (versão brasileira) com 24 itens distribuídos em cinco subescalas. As análises foram realizadas no Statistical Package for the Social Sciences, versão 25, e aplicou-se significância estatística de 5% (p≤0,05). A consistência interna do instrumento foi avaliada pelo alfa de Cronbach. Resultados: participaram da pesquisa 243 profissionais, sendo 62,1% técnicos e auxiliares de enfermagem e 37,9% enfermeiros. A média do escore para a Practice Environment Scale foi de 2,58 (desvio-padrão = 0,69) e os participantes consideraram três das cinco subescalas favoráveis: "Fundamentos de enfermagem voltados para a qualidade do cuidado" (média 2,58 e dp ± 0,73); "Habilidade, liderança e suporte dos coordenadores/supervisores de enfermagem aos enfermeiros/equipe de enfermagem" (média 2,74 e dp ± 0,82) e "Relações colegiais entre enfermeiros e médicos" (média 2,78 e dp ± 0,76). Os profissionais capacitados para o cuidado dos pacientes com COVID-19 tiveram percepção mais favorável em relação àqueles que não o foram. Conclusão: o ambiente de trabalho da enfermagem foi considerado misto, na pandemia, portanto, necessita de melhorias para que as condições de trabalho da enfermagem sejam as mais adequadas possíveis.

Temporal trend and magnitude of previdenciary benefits for workplace accidents in Brazil / Tendência temporal e magnitude dos benefícios previdenciários de natureza acidentária no Brasil

ABSTRACT Objective: To analyze the temporal trend and magnitude of national indicators of previdenciary benefits for workplace accidents issued and granted by the Social Security of Brazil. Methods: Secondary data from Social Security from 2008 to 2019 were used. The trend and percentage variation of the indicators were estimated through Prais-Winsten generalized linear regression. Results: A total of 9,220,372 previdenciary benefits for workplace accidents were issued by the Social Security of Brazil in the period, costing approximately R$ 8.4 billion and representing about 2.0% of the net value of all benefits paid. None of the categories of previdenciary benefits for workplace accidents showed an increasing trend. The highest variation in the benefits granted and issued for workplace accidents occurred in temporary disability benefit (B91), with an annual percentage variation of -54.00% and -29.29%, respectively. Conclusion: A reduction in magnitude and an overall decreasing trend were observed in the historical series of national indicators of benefits granted and benefits issued related to workplace accidents in Brazil from 2008 to 2019.

RESUMO Objetivo: Analisar a tendência temporal e a magnitude dos indicadores nacionais de benefícios previdenciários emitidos e concedidos por acidentes do trabalho pela Previdência Social do Brasil. Métodos: Foram utilizados dados secundários da Previdência Social de 2008 a 2019. A tendência e variação percentual dos indicadores foram estimadas por meio de regressão linear generalizada de Prais-Winsten. Resultados: Um total de 9.220.372 benefícios previdenciários por acidentes do trabalho foi emitido pela Previdência Social do Brasil no período, custando aproximadamente R$ 8,4 bilhões e representando cerca de 2,0% do valor líquido de todos os benefícios pagos. Nenhuma das categorias de incapacidades relacionadas a acidentes do trabalho apresentou tendência de aumento. A maior variação nos benefícios concedidos e emitidos por acidentes do trabalho ocorreu no auxílio por incapacidade temporária (B91), com variação percentual anual de -29,29% e -54,00%, nessa ordem. Conclusão: Verificou-se redução na magnitude e tendência global decrescente em relação as séries históricas dos indicadores nacionais de benefícios concedidos e emitidos de natureza acidentária no Brasil, de 2008 a 2019.

Construção de uma escala de avaliação do ambiente de trabalho na atenção primária à saúde / Construcción de una escala de evaluación del ambiente laboral en la atención primaria de salud / Construction of an assessment scale for the work environment in primary health care

Resumo Objetivo Descrever as etapas da construção de uma escala para avaliar o ambiente de trabalho na Atenção Primária à Saúde (APS). Método Estudo metodológico com cinco etapas: estabelecimento da estrutura conceitual; construção das questões e da escala de respostas; estruturação; validade do conteúdo com especialistas; e análise semântica com profissionais de saúde. Resultados A construção da estrutura conceitual com revisão de literatura e a análise dos pesquisadores, especialistas e profissionais de saúde, finalizou a escala com 36 questões. O ambiente de trabalho é influenciado por condições de trabalho, questões de administração e gestão, saúde do trabalhador, cargas de trabalho, valorização e motivação, violência e estratégias para um ambiente de trabalho saudável. Foi realizado o Índice de Validade de Conteúdo (IVC) e Porcentagem de Concordância, com valores de 0,96 (IVC) e 96% de concordância, respectivamente. Conclusões e implicações para prática A escala foi elaborada e apresentou concordância, de acordo com o teste de validade de conteúdo, por especialistas e profissionais de saúde. Assim, a escala está apta a seguir para outros processos de validação e pode contribuir para a prática de pesquisadores das áreas de saúde na avaliação do ambiente de trabalho.

Resumen Objetivo Describir las etapas de la construcción de una escala para evaluar el clima laboral en la Atención Primaria de Salud (APS). Método Estudio metodológico con cinco etapas: establecimiento de la estructura conceptual; construcción de preguntas y escala de respuestas; estructuración; validez de contenido con expertos; y análisis semántico con profesionales de la salud. Resultados La construcción de la estructura conceptual con revisión de la literatura, el análisis de investigadores, expertos y profesionales de la salud finalizó la escala con 36 preguntas. El ambiente de trabajo está influenciado por las condiciones de trabajo, cuestiones de administración y gestión, salud de los trabajadores, cargas de trabajo, aprecio y motivación, violencia y estrategias para un ambiente de trabajo saludable. Se realizó el Índice de Validez de Contenido (IVC) y Porcentaje de Concordancia, con valores de 0,96 (IVC) y 96% de Concordancia, respectivamente. Conclusiones e implicaciones para la práctica La escala fue desarrollada y mostró concordancia, según la prueba de validez de contenido realizada por expertos y profesionales de la salud. Así, la escala está lista para pasar por otros procesos de validación y puede contribuir a la práctica de los investigadores de salud en la evaluación del clima laboral.

Abstract Objective To describe the stages of constructing a scale to evaluate the work environment in Primary Health Care. Method methodological study with five stages: establishment of the conceptual structure; construction of questions and response scale; structuring; content validity with experts and semantic analysis with health professionals. Results construction of the conceptual structure with literature review, the analysis of researchers, experts and health professionals finalized the scale with 36 questions. The work environment is influenced by working conditions, administration and management issues, worker health, workloads, appreciation and motivation, violence and strategies for a healthy work environment. The Content Validity Index (CVI) and Percentage of agreement were performed, with values of 0.96 (CVI) and 96% agreement, respectively. Conclusions and implications for practice the scale was developed and showed agreement, according to the content validity test by experts and health professionals. Thus, the scale is capable of being used for other validation process and can contribute to the practice of health researchers in assessing the work environment.

Tecnologias de informação e comunicação: revisão de escopo dos instrumentos de avaliação dos fatores de risco psicossociais no trabalho contemporâneo / Information and communication technologies: a scoping review of instruments to evaluate psychosocial risk factors at contemporary work

Resumo Introdução: a pandemia da COVID-19 desencadeou uma recessão global e o aumento da precarização do trabalho. Nesse cenário, o uso intensivo das Tecnologias de Informação e Comunicação (TIC) contribuiu para o surgimento de novos fatores de riscos psicossociais no trabalho (FRPT) e para o aumento da ocorrência de transtornos mentais nos trabalhadores. Objetivos: identificar instrumentos que avaliam os FRPT disponíveis na literatura e verificar se eles incorporaram as novas dimensões psicossociais do trabalho mediadas pelas TIC. Métodos: revisão de escopo, com busca nas bases PubMed, Biblioteca Virtual em Saúde, Embase, Scopus e Web of Science, de artigos publicados no período de 1990 a 2023 seguindo as recomendações do Instituto Joanna Briggs e do PRISMA-ScR . Buscou-se agrupar estudos e instrumentos relevantes e identificar lacunas. Resultados: foram selecionados 18 instrumentos, de 3.424 artigos. Dez deles incluíram escalas/dimensões previstas no PRIMA-EF, dois incluíram dimensões do uso das TIC e seis foram considerados específicos para a avaliação de FRPT por TIC. Conclusão: destacam-se a importância do uso dos instrumentos de acordo com o contexto em que foram desenvolvidos, os fatores de estresse digital que ainda não foram considerados nesses questionários e a relevância do suporte da organização para a redução do tecnoestresse nos trabalhadores.

Abstract Introduction: the COVID-19 pandemic triggered a global recession and increased work precarity. In this scenario, the intensive use of Information and Communication Technologies (ICT) contributed to the appearance of new occupational psychosocial hazards, and the increase of mental disorders among workers. Objectives: to identify instruments that assess occupational psychosocial risks and stress available in literature and verify whether they include the new psychosocial work dimensions caused by ICTs. Methods: a scope review was conducted by searching the PubMed, BvS, Embase, Scopus and Web of Science databases for articles published between 1990 and 2023, following the Joanna Briggs Institute and PRISMA-ScR recommendations. It sought to group the relevant studies and instruments and identify gaps that should be observed. Results: bibliographic search identified 18 instruments, from 3424 articles. Ten included scales/dimensions foreseen by PRIMA-EF, two included dimensions on ICT use and six were considered specific for assessing ICT-related occupational psychosocial risks. Conclusion: the study highlights the importance of using context-appropriate instruments, the digital stress factors yet to be included in these questionnaires and the relevance of organizational support to reduce technostress in workers.

Workplace health promotion programs among health workers: a systematic literature review

Objective: To identify the effect of workplace health promotion activities (WHPA) on the health status of health personnel. Methodology: A systematic literature review was performed. Six computerized databases were used to search for studies on the effect of at least one health promotion activity on the health status of health personnel. Studies were included if they were published in peer-reviewed and indexed journals and were written either in English, Spanish, or Portuguese. Information such as study population, sample size, type of study, outcome, and health promotion activities performed were extracted from each publication. All the included articles were measured in terms of their methodological quality, including the risk of bias. Results: Lower scores on perceived stress, emotional exhaustion, and mood symptoms were reported. An improvement in sleep hours and quality and a reduction in dietary sodium intake were informed. Improvements in participants' dietary habits, weight loss, and body fat percentage, along with increased physical activity and a reduction in pain levels were reported. A reduction in the prevalence of cigarette smoking was found. Conclusions: WHPAs can enhance physical and mental health, and overall well-being, and encouraging healthier behaviors among health personnel. Most of the studies targeting mental health focused their efforts primarily on reducing healthcare workers' perceived stress. WHPAs that addressed both diet and physical activity behaviors were more effective at improving weight outcomes than those that used only one approximation. Overall, this study offers valuable information on the impact of worksite-based health promotion interventions, including the effect of different strategies applied.

Objetivo: Identificar el efecto de las actividades de promoción de la salud en el lugar de trabajo (APST) sobre el estado de salud del personal sanitario. Metodología: Se realizó una revisión sistemática de la literatura. Se utilizaron seis bases de datos computarizadas para buscar estudios sobre el efecto de al menos una actividad de promoción de la salud en el estado de salud del personal sanitario. Se incluyeron los estudios publicados en revistas revisadas por pares e indexadas y escritos en inglés, español o portugués. De cada publicación se extrajo información como la población del estudio, el tamaño de la muestra, el tipo de estudio, el resultado y las actividades de promoción de la salud realizadas. Se analizaron todos los artículos incluidos en términos de su calidad metodológica, teniendo en cuenta el riesgo de sesgo. Resultados: Se registraron puntuaciones menos elevadas en el estrés percibido, agotamiento emocional y alteración del estado de ánimo. Se informó de una mejoría en las horas y la calidad del sueño, y de una reducción de la ingesta de sodio en la dieta. Se registraron mejorías en los hábitos alimentarios de los participantes, pérdida de peso y porcentaje de grasa corporal, así como un aumento de la actividad física y una reducción de los niveles de dolor. Se observó una reducción de la prevalencia del tabaquismo. Conclusiones: Las AMPS pueden mejorar la salud física y mental, así como el bienestar general, y fomentar comportamientos más saludables entre el personal sanitario. La mayoría de los estudios dirigidos a la salud mental centraron sus esfuerzos principalmente en reducir el estrés percibido por el personal sanitario. Las AMPS que abordaron tanto los comportamientos relacionados con la alimentación como con la actividad física fueron más eficaces a la hora de mejorar los resultados en cuanto al peso que las que sólo utilizaron una aproximación. En general, este estudio ofrece información valiosa sobre el impacto de las intervenciones de promoción de la salud en el lugar de trabajo, así como el efecto de las distintas estrategias aplicadas

Objetivo: Identificar o efeito das atividades de promoção da saúde no local de trabalho (APST) sobre o estado de saúde do pessoal sanitário. Metodologia: Realizou-se uma revisão sistemática da literatura. Utilizaram-se seis bases de dados computadorizadas para procurar estudos sobre o efeito de pelo menos uma atividade de promoção da saúde no estado da saúde do pessoal sanitário. Incluíram-se os estudos publicados em revistas revisadas por pares e indexadas e escritos em inglês, espanhol ou português. De cada publicação coletou-se informação como a população do estudo, o tamanho da amostra, o tipo de estudo, o resultado e as atividades de promoção da saúde realizadas. Analisaram-se todos os artigos incluídos em termos de sua qualidade metodológica, levando em consideração o risco de viés. Resultados: Registraram-se números menos elevados no estresse percebido, esgotamento emocional e alteração do estado de ânimo. Foi informada uma melhora nas horas e na qualidade do sono, e uma redução da ingesta de sódio na dieta. Registraram-se melhoras nos mejorías en los hábitos alimentarios de los participantes, pérdida de peso y porcentaje de grasa corporal, así como un aumento de la actividad física y una reducción de los niveles de dolor. Se observó una reducción de la prevalencia del tabaquismo. Conclusiones: Las APST pueden mejorar la salud física y mental, así como el bienestar general, y fomentar comportamientos más saludables entre el personal sanitario. La mayoría de los estudios dirigidos a la salud mental centraron sus esfuerzos principalmente en reducir el estrés percibido por el personal sanitario. Las APST que abordaron tanto los comportamientos relacionados con la alimentación como con la actividad física fueron más eficaces a la hora de mejorar los resultados en cuanto al peso que las que sólo utilizaron una aproximación. En general, este estudio ofrece información valiosa sobre el impacto de las intervenciones de promoción de la salud en el lugar de trabajo, así como el efecto de las distintas estrategias aplicadas.

Impact of a Three-Week Workplace Vocal Health Promotion Program on a Teacher and Students' Voice Parameters

Objective: To determine the effect on voice parameters in pupils and their teacher of a three-week Workplace Vocal Health Promotion Program (WVHPP) in a school setting. Methods: Longitudinal study with a design phase and a pilot phase. Voice recordings of connected speech were used to collect information on voice functioning before and after the implementation of the program. The workplace vocal health promotion program was implemented with two purposes: (1) to reduce noisy conditions inside the classrooms that may cause loud voice production, which has been found associated with voice disorders among teachers and students and (2) to increase awareness about the relationship between noise and voice inside the classrooms. Results: The WVHPP was found to be statistically associated with a decrease in the fundamental frequency, standard deviation of the fundamental frequency, sound pressure levels, and SPL standard deviation among both pupils and their teacher. However, there was no statistically significant effect on cepstral peak prominence smoothed. Conclusion: The three-week WVHPP was found to have a significant impact on several acoustic parameters, such as the fundamental frequency and sound pressure levels. These findings highlight the potential of the WVHPP as an effective intervention for improving the vocal health of both teachers and students. However, the lack of a significant effect on cepstral peak prominence smoothed suggests that further research is needed to fully understand the impact of the WVHPP on voice quality.

Objetivo: Determinar el efecto en los parámetros de voz de los alumnos y su profesora de un Programa de tres semanas de Promoción de la Salud Vocal en el lugar de trabajo en un entorno escolar. Métodos: Estudio longitudinal con una fase de diseño y una fase piloto. Se utilizaron grabaciones de voz de habla conectada para recopilar información sobre el funcionamiento de la voz antes y después de la implementación del programa. El programa de promoción de la salud vocal en el lugar de trabajo se implementó con dos propósitos: (1) Reducir las condiciones ruidosas dentro de las aulas que pueden causar una producción de voz a alta intensidad, lo que se ha encontrado asociado con trastornos de la voz entre profesores y estudiantes; y (2) Aumentar la conciencia sobre la relación entre el ruido y la voz dentro de las aulas. Resultados: Se encontró que el Programa de Promoción de la Salud Vocal en el lugar de trabajo estaba estadísticamente asociado con una disminución de la frecuencia fundamental, la desviación estándar de la frecuencia fundamental, los niveles de presión sonora y la desviación estándar de la presión sonora, tanto en los alumnos como en su profesor. Sin embargo, no hubo un efecto estadísticamente significativo en la prominencia del pico cepstral suavizado. Conclusión: Se encontró que el programa de tres semanas tenía un impacto significativo en varios parámetros acústicos, como la frecuencia fundamental y los niveles de presión sonora. Estos hallazgos destacan el potencial del programa como una intervención eficaz para mejorar la salud vocal tanto de profesores como de estudiantes. Sin embargo, la falta de un efecto significativo en la prominencia del pico cepstral suavizado sugiere que se necesita más investigación para comprender completamente el impacto del programa en la calidad vocal.

Percepción de enfermeros colombianos sobre un entorno laboral saludable para la práctica asistencial en el ámbito hospitalario

Objetivo: Explorar la percepción de enfermeros profesionales colombianos sobre la definición y las principales características de un entorno laboral saludable (ELS) para la práctica asistencial de enfermería en el ámbito hospitalario. Metodología: Estudio de tipo cualitativo descriptivo. Se realizaron entrevistas semiestructuradas a nueve enfermeros profesionales reclutados mediante un muestreo no probabilístico. Las entrevistas fueron grabadas, transcritas literalmente y codificadas. A través de la organización y estructuración de estos códigos se logró establecer categorías y subcategorías. Resultados: Del análisis de los datos fue posible establecer una definición de entorno laboral saludable y se obtuvieron dos dimensiones (categorías) y diez características principales (subcategorías) del concepto. Conclusiones: Los hallazgos de este estudio permiten tener una mejor comprensión acerca de la percepción de los enfermeros colombianos sobre la definición y características esenciales de un ELS para la práctica de enfermería en el ámbito hospitalario. Estos hallazgos aportan al desarrollo de herramientas de medición de los ELS que se ajusten a las condiciones y a la realidad del ejercicio profesional en el ámbito hospitalario colombiano.

Objective: To explore the perception of Colombian professional nurses about the definition and the main characteristics of a healthy work environment (HWE) for nursing care practice in the hospital setting. Methodology: Descriptive qualitative study. Semi-structured interviews were conducted with nine professional nurses recruited through non-probabilistic sampling. The interviews were recorded, literally transcribed and coded. Through the organization and structuring of these codes, it was possible to establish categories and subcategories. Results: From the data analysis it was possible to establish a definition of healthy work environment and two dimensions (categories), and 10 main characteristics (subcategories) of the concept were obtained. Conclusions: The findings of this study allow a better understanding of the perception of Colombian nurses about the definition and essential characteristics of an HWE for nursing practice in the hospital setting. These findings contribute to the development of HWE measurement tools that are adjusted to the conditions and reality of professional practice in the Colombian hospital setting.

Asociación entre comportamientos ofensivos y riesgo de burnout y depresión en trabajadores de la salud / Association between offensive behaviors and burnout and depression risks in health workers / Associação entre comportamentos ofensivos e risco de burnout e de depressão em trabalhadores de saúde

Objetivo: evaluar la incidencia de conductas ofensivas en el trabajo, las características y la asociación con el sexo, el estrés, el burnout y la depresión en trabajadores de la salud. Método: estudio transversal, descriptivo, cuantitativo, realizado con 125 trabajadores del Sistema Único de Salud brasileño. Los datos fueron recolectados entre junio de 2021 y abril de 2022, por medio de tres cuestionarios autoadministrados que evalúan características personales y ocupacionales; comportamientos ofensivos, estrés y burnout y síntomas de depresión. Se aplicó estadística descriptiva, prueba de asociación chi-cuadrado y análisis de regresión logística Resultados: el 44% de la muestra declararon 83 conductas y las amenazas de violencia fueron las más frecuentes (26%). Técnicos/auxiliares de enfermería, enfermeros y médicos fueron los profesionales más expuestos. El principal agresor fue el paciente; excepto en el caso del bullying, que fue perpetrado por los compañeros de trabajo (48%). Hubo asociación entre conductas ofensivas y burnout (OR: 4,73; IC 95%: 1,29-17,3; p=0,02) y entre conductas ofensivas y síntomas de depresión (OR: 1,05; IC 95%: 1,01-1,10; p=0,02). Conclusión: la práctica de conductas ofensivas en el trabajo en salud es frecuente y característica; el burnout y los síntomas de depresión aumentaron, respectivamente, 4,73 y 1,05 veces las posibilidades de que el trabajador sufriera esas conductas ofensivas en el ambiente de trabajo.

Objective: to evaluate the occurrence of offensive behaviors at work, their characteristics and association with sex, stress, burnout and depression in health workers. Method: a cross-sectional, descriptive and quantitative study carried out with 125 workers from the Brazilian Unified Health System. The data were collected from June 2021 to April 2022 through three self-applied questionnaires that assess personal and occupational characteristics; offensive behaviors, stress and burnout; and depressive symptoms. Descriptive statistics, the chi-square association test and logistic regression analysis were applied. Results: 44% of the sample reported 83 behaviors, with threats of violence as the most frequent ones (26%). Nursing technicians/assistants, nurses and physicians were the most exposed professionals. The main aggressors were the patients, except for bullying, which was perpetrated by co-workers (48%). There was an association between offensive behaviors and burnout (OR: 4.73; 95% CI: 1.29-17.3; p=0.02) and between offensive behaviors and depression symptoms (OR: 1.05; 95% CI: 1.01-1.10; p=0.02). Conclusion: the occurrence of offensive behaviors in health work is frequent and characteristic and burnout and depressive symptoms respectively increased 4.73 and 1.05 times the chances of workers suffering these offensive behaviors in the work environment.

Objetivo: avaliar a ocorrência de comportamentos ofensivos no trabalho, suas características e associação com o sexo, estresse, burnout e depressão em trabalhadores de saúde. Método: estudo transversal, descritivo, de natureza quantitativa, realizado com 125 trabalhadores do Sistema Único de Saúde brasileiro. Os dados foram coletados no período de junho de 2021 a abril de 2022, por meio de três questionários autoaplicáveis que avaliam as características pessoais e ocupacionais; comportamentos ofensivos, estresse e burnout e sintomas depressivos. Estatística descritiva, teste de associação Qui-Quadrado e análise de regressão logística foram aplicados. Resultados: 44% da amostra referiram 83 comportamentos, sendo as ameaças de violência mais frequentes (26%). Técnicos/auxiliares de enfermagem, enfermeiros e médicos foram os profissionais mais expostos. O principal agressor foi o paciente, exceto quanto ao bullying, perpetrado por colegas de trabalho (48%). Houve associação entre comportamentos ofensivos e burnout (OR: 4,73; IC 95%: 1,29-17,3; p=0,02) e entre comportamentos ofensivos e sintomas de depressão (OR: 1,05; IC 95%: 1,01-1,10; p=0,02). Conclusão: a ocorrência de comportamentos ofensivos no trabalho em saúde é frequente e característica; o burnout e os sintomas depressivos aumentaram, respectivamente, 4,73 e 1,05 vezes as chances de o trabalhador sofrer estes comportamentos ofensivos no ambiente de trabalho.

Estratégias para promoção do clima ético positivo sob a perspectiva de enfermeiros hospitalares / Strategies to promote a positive ethical climate from the perspective of hospital nurses / Estrategias para promover un clima ético positivo desde la perspectiva de los enfermeros hospitalarios

Objetivo: analisar as estratégias de promoção do clima ético positivo sob a perspectiva de enfermeiros hospitalares. Método: estudo qualitativo e descritivo exploratório, realizado com 182 enfermeiros de um hospital universitário do sul do Brasil. A coleta dos dados ocorreu por meio de um questionário sociodemográfico, laboral e uma pergunta aberta sobre estratégias de promoção do clima ético positivo. A organização dos dados ocorreu no software Atlas TI 8.0, versão 2019, e aplicou-se análise temática dos dados. Recebeu aprovação do Comitê de Ética em Pesquisa da instituição envolvida. Resultados: a macro categoria "Organização do trabalho" elencou itens sobre as relações na equipe, gestão, educação permanente e condições de trabalho. A macro categoria "Dimensão ética do trabalho" se referiu a exigências, valores pessoais e profissionais, expressão e sensibilidade moral. Conclusão: as estratégias de melhores condições de trabalho e organização, bem como o tratamento das questões éticas e relações interpessoais promovem o clima ético positivo(AU)

Objective: to analyze strategies for promoting a positive ethical climate from the perspective of hospital nurses. Method: qualitative and descriptive exploratory study, carried out with 182 nurses from a university hospital in southern Brazil. Data collection occurred through a sociodemographic and employment questionnaire and an open question about strategies for promoting a positive ethical climate. The data was organized using the Atlas TI 8.0 software, version 2019, and thematic analysis of the data was applied. It received approval from the Research Ethics Committee of the institution involved. Results: the macro category "Work organization" listed items on team relationships, management, continuing education and working conditions. The macro category "Ethical dimension of work" referred to demands, personal and professional values, expression and moral sensitivity. Conclusion: strategies for better working conditions and organization, as well as the treatment of ethical issues and interpersonal relationships promote a positive ethical climate(AU)

Objetivo: analizar las estrategias para promover un clima ético positivo desde la perspectiva de los enfermeros hospitalarios. Método: estudio cualitativo y descriptivo exploratorio, realizado junto a 182 enfermeros de un hospital universitario del sur de Brasil. La recolección de datos tuvo lugar mediante un cuestionario sociodemográfico y laboral y una pregunta abierta sobre estrategias para promover un clima ético positivo. Los datos se organizaron por medio del software Atlas TI 8.0, versión 2019, y se aplicó análisis temático de los datos. Recibió la aprobación del Comité de Ética en Investigación de la institución involucrada. Resultados: la macro categoría "Organización del trabajo" enumeró ítems sobre las relaciones en el equipo, la gestión, la educación continua y las condiciones de trabajo. La macro categoría "Dimensión ética del trabajo" hacía referencia a exigencias, valores personales y profesionales, expresión y sensibilidad moral. Conclusión: las estrategias para mejores condiciones de trabajo y organización, así como el tratamiento de las cuestiones éticas y las relaciones interpersonales promueven un clima ético positivo(AU)

Promoção de saúde ocupacional: capacidade para o trabalho de cirurgiões dentistas / Occupational health promotion: dental surgeons' work capacity

Este estudo teve o objetivo de analisar os fatores associados à capacidade para o trabalho de cirurgiões-dentistas atuantes na cidade de Cuiabá (MT). Pesquisa quantitativa e transversal realizada em agosto de 2020 com 64 cirurgiões-dentistas. A avaliação da capacidade de trabalho foi realizada por meio do Índice de Capacidade para o Trabalho (ICT), validado em português do Brasil. A análise de dados foi realizada pelos testes Kolmogorov-Smirnov e qui-quadrado ou o teste exato de Fisher (p < 0,05). A pontuação média geral do ICT foi de 36,89 pontos. Entre as características avaliadas, apenas o último nível de ensino concluído e o tempo de trabalho no local atual apresentaram associação significativa com a classificação do ICT (p < 0,001 e de p = 0,007). Os cirurgiões-dentistas que atuam em Cuiabá (MT) apresentaram satisfatório ICT, sendo que foi encontrada associação entre o melhor ICT e o maior nível de escolaridade e maior tempo de atuação no trabalho atual

This study aimed to analyze the factors associated with the work ability of dentists working in the city of Cuiabá (MT). Quantitative and cross-sectional research carried out in August 2020 with 64 dentists. The assessment of work ability was performed using the Work Ability Index (WAI), validated in Brazilian Portuguese. Data analysis was performed using Kolmogorov-Smirnov and chi-square tests or Fisher's exact test (p < 0.05). The overall average ICT score was 36.89 points. Among the evaluated characteristics, only the last level of education completed and the time working in the current location showed a significant association with the WAI classification (p < 0.001 and p= 0.007). Dental surgeons who work in Cuiabá (MT) had a satisfactory ICT, and an association was found between the best ICT and the highest level of education and longer time working in the current job.

Adaptación y validación del Cuestionario de Tensión T3/15 en trabajadores de salud del Perú / Adaptation and Validation of the T3/15 Stress Questionnaire among Peruvian Healthcare Workers / Adaptação e validação do questionário de estresse T3/15, em trabalhadores de saúde no Peru

Introducción: la alta prevalencia de afecciones mentales relacionadas con los estados de tensión laboral en trabajadores del ámbito sanitario requiere una detección oportuna. Para su valoración se necesitan instrumentos válidos, confiables y fáciles de administrar. El objetivo de este trabajo fue adaptar y validar el Cuestionario de Tensión T3/15 de Meliá (1994), en una muestra de trabajadores de salud del Perú. Materiales y métodos: estudio de tipo instrumental, en que participaron 302 trabajadores del sistema sanitario peruano, seleccionados por muestreo aleatorio estratificado. El proceso incluyó cambios en la terminología de algunos ítems, evaluación del contenido por jueces y prueba piloto. La validez de constructo se evaluó mediante un análisis factorial exploratorio. El número de factores se definió con el análisis paralelo de Horn y con el ajuste con análisis factorial confirmatorio. Resultados: se obtuvo una versión reducida de diez ítems agrupados en dos factores que explicaron el 67.13 % de la varianza total y un ajuste aceptable [χ2/gl = 3.08; nfi = 0.94; cfi = 0.95; srmr = 0.013; rmsea = 0.080 (ic90 %: 0.66-0.10)]. Los ítems discriminan satisfactoriamente; así como el cuestionario, según la variable sexo y grupo ocupacional. El alfa ordinal para incidencias sociopsicológicas de la tensión laboral fue de 0.752 y de 0.931 para tensión inducida por el trabajo; el omega de McDonald fue de 0.867 y 0.965, respectivamente. Conclusiones: la nueva versión reducida del cuestionario de tensión posee propiedades métricas aceptables; por tanto, se recomienda su uso para valorar la tensión laboral en trabajadores de salud y estudios de validación. Palabras clave: estrés laboral; personal de salud; encuestas de salud; psicometría, estudio de validación

Adaptación y validación del Cuestionario de Tensión T3/15 en trabajadores de salud del Perú2Rev. Cienc. Salud. Bogotá, Colombia, vol. 21(3): 1-12, septiembre-diciembre de 2023la terminología de algunos ítems, evaluación del contenido por jueces y prueba piloto. La validez de constructo se evaluó mediante un análisis factorial exploratorio. El número de factores se definió con el análisis paralelo de Horn y con el ajuste con análisis factorial confirmatorio. Resultados: se obtuvo una versión reducida de diez ítems agrupados en dos factores que explicaron el 67.13 % de la varianza total y un ajuste aceptable [χ2/gl = 3.08; nfi = 0.94; cfi = 0.95; srmr = 0.013; rmsea = 0.080 (ic90 %: 0.66-0.10)]. Los ítems discriminan satisfactoriamente; así como el cuestionario, según la variable sexo y grupo ocupacional. El alfa ordinal para incidencias sociopsicológicas de la tensión laboral fue de 0.752 y de 0.931 para tensión inducida por el trabajo; el omega de McDonald fue de 0.867 y 0.965, respectivamente. Conclusiones: la nueva versión reducida del cuestionario de tensión posee propiedades métricas aceptables; por tanto, se recomienda su uso para valorar la tensión laboral en trabajadores de salud y estudios de validación. Palabras clave: estrés laboral; personal de salud; encuestas de salud; psicometría, estudio de validación.AbstractIntroduction: The high prevalence of stress-related mental disorders among healthcare workers requires timely assessment and intervention. Accordingly, valid, reliable, and easy-to-administer instruments are required for this purpose. This study aimed to adapt and validate the T3/15 Tension Questionnaire by Meliá (1994) in a sample of Peruvian healthcare workers. Materials and methods: In this instrumental study, 302 workers from the Peruvian health system selected through stratified random sampling were included. The process included changes in the terminology of some items, content evaluation by judges, and pilot testing. Construct validity was assessed via exploratory factor analysis; the number of factors was defined using Horn's parallel analysis and the fit using confirmatory factor analysis. Results: A reduced version of 10 items was finally obtained, which were grouped into two factors that explained 67.13% of the total variance and an acceptable adjustment (χ²/gl = 3.08; nfi = 0.94; cfi = 0.95; srmr = 0.013; rmsea = 0.080 [ic90% = 0.66­0.10]). The items in the questionnaire satisfactorily discriminated according to the variable sex and occupational group. Ordinal alpha for sociopsychological incidences of stress at work was 0.752 and 0.931 for work-induced stress and McDonald's Omega was 0.867 and 0.965, respectively. Conclusions: The new reduced ver-sion of the stress questionnaire demonstrates acceptable metric properties and hence can be recommended for assessing the state of occupational stress among healthcare workers and validation studies

Introdução: a alta prevalência de doenças mentais relacionadas a estados de estresse laboral em trabalha-dores da saúde requer detecção oportuna. Instrumentos válidos, confiáveis e de fácil administração são necessários para sua avaliação. O objetivo deste trabalho foi adaptar e validar o Questionário de Estresse T3/15 de Meliá (1994), em uma amostra de profissionais de saúde do Peru. Materiais e métodos: estudo instrumental, participaram 302 trabalhadores do sistema de saúde peruano, selecionados por amostragem aleatória estratificada. O processo incluiu mudanças na terminologia de alguns itens, avaliação de conteúdo por juízes e teste piloto. A validade de construto foi avaliada pela análise fatorial exploratória, o número de fatores foi definido pela análise paralela de Horn e o ajuste pela análise fatorial confirmatória. Resultados:obteve-se uma versão reduzida de dez itens agrupados em dois fatores, que explicaram 67,13% da variância total e um ajuste aceitável (χ²/gl = 3,08;nfi = 0,94; cfi = 0,95; srmr = 0,013; rmsea = 0,080 [90% ic: 0,66-0,10]). Os itens discriminam satisfatoriamente; bem como o questionário de acordo com a variável sexo e grupo ocupacional. O alfa ordinal para incidências sociopsicológicas de estresse no trabalho foi de 0,752 e 0,931 para tensão induzida pelo trabalho, o ômega de McDonald foi de 0,867 e 0,965, respectivamente. Conclusões:a nova versão reduzida do questionário de estresse tem propriedades métricas aceitáveis; portanto, seu uso é recomendado para avaliar o estresse no trabalho em trabalhadores da saúde e estudos de validação

Mean rate of progression of visual fields in patients with primary open-angle glaucoma and ocular hypertension attending a tertiary care center in South India – A prospective cohort study using FORUM® Glaucoma Workplace software

Purpose: To find out the mean rate of progression (MROP) of visual fields (VF) in patients with primary open?angle glaucoma (POAG) and ocular hypertension (OHT) using FORUM® Glaucoma Workplace. Methods: Two hundred and one eyes of 105 patients were included in this prospective cohort study. Patients with POAG and OHT were recruited, and VF analysis with 24?2 and or 10?2 was done using SITA standard strategy in Zeiss Humphrey Visual Field Analyzer (HFA). All the previous VFs were identified from FORUM software, and the baseline indices were recorded from the first reliable VF analysis. The present VF analysis was compared to the previous one using FORUM software, and the rate of progression (ROP) in VF was obtained by Guided Progression Analysis. Results: MROP of VF in the POAG group was ? 0.085 dB/ year, ranging from ?2.8 to 2.8 dB/year with a standard deviation (SD) of 0.69. In the OHT group, the MROP of VF was ?0.003 dB/year, ranging from ? 0.8 to 0.5 dB/year with an SD of 0.27. The MROP of VF in medically treated eyes with POAG was ?0.14 dB/year with an SD of 0.61 and in surgically treated eyes was ?0.02 dB/year with an SD of 0.78. The overall baseline mean VF index (VFI) was 83.19% and the final mean VFI was 79.80%. There was a statistically significant decrease in the mean VFI value from baseline to the final visit (P?value 0.0005). Conclusion: The mean ROP of VF in the POAG group was ?0.085 dB/year and in the OHT group was ? 0.003 dB/year

Diagramas complejos de salud en el trabajo: metodología para el estudio sistémico de los procesos laborales / Complex diagrams of health in the workplace: A methodology for the systemic study of work processes

El estudio de los procesos de trabajo es una tarea «compleja¼ que incluye el conocimiento exhaustivo y preciso de los riesgos y exigencia laborales ahí presentes. Dichos riesgos y exigencias son el resultado de cómo se relacionan los elementos fundamentales del proceso laboral que, al interactuar con el hombre que trabaja, pueden afectar su salud. La finalidad de estas líneas es mostrar una metodología de carácter etnográfico, para investigar los procesos de trabajo en las entidades productivas y plantear las acciones preventivas conducentes. Esta metodología está basada en la observación directa y en la experiencia obrera de los procesos laborales. Consta de tres instrumentos de recolección de información: 1) Diagramas de Flujo del Proceso de trabajo; 2) Descripción de los Diagramas de Flujo de los Procesos de Trabajo; y 3) Cuadros de Resumen de los Diagramas Complejos de Salud en el Trabajo. A partir de los datos que proporcionan los Cuadros de Resumen, se estructura un repertorio de recomendaciones para el centro laboral. En cuanto a la utilidad de esta metodología, ha sido ampliamente probada en diversos sectores económicos, como: agricultura, industrias extractivas, de la transformación y la construcción, así como de los servicios, ya sean micro, pequeñas, medianas o grandes empresas. En síntesis, es una herramienta que proporciona el conocimiento integral de los procesos de trabajo, de los riesgos y exigencias que de ahí se derivan, y suministra las medidas preventivas para eliminar o controlar los peligros que acechan a los trabajadores en sus labores(AU)

The study of work processes is a complex task that includes exhaustive and precise knowledge of the labor demands and risks in a given workplace. These risks and demands result from the relationship among the fundamental elements of the work process, whose interaction with a worker can affect his health. The purpose of this study is to show how an ethnographic methodology was used to investigate work processes in productive industry workplaces and propose appropriate preventive actions. The methodology is based on direct observation and workers' experience of work processes. It consists of three data collection instruments: 1) Work process flow charts; 2) description of the flow diagrams of the work processes; and 3) summary tables of complex diagrams of workplace health. Based on the data provided in the summary tables, a set of recommendations for the workplace was designed. This methodology has been widely tested in various economic sectors, such as agriculture; extractive, transformative, and construction industries; and services, whether in micro, small, medium, or large companies. In summary, this is a tool that provides integrated knowledge about work processes and the risks and demands inherent in them and provides preventive measures to eliminate or control dangers to workers(AU)

Blumenau, April 5, 2023: The point of view of psychiatry / Blumenau, 5 de abril de 2023: O ponto de vista da psiquiatria

ABSTRACT The goal of this editorial is to analyse a recent case of mass murder under the psychiatric perspective.

RESUMO O objetivo do presente editorial é o de analisar, sob a perspectiva da psiquiatria, um caso recente de homicídio em massa.