Autoeficacia académica y ansiedad, como incidente crítico, en mujeres y hombres universitarios / Academic Self-efficacy and Anxiety, as a Critical Incident in Female and Male University Students

Resumen Con el objetivo de explorar las relaciones entre la autoeficacia académica y la ansiedad, como inciden te crítico, el presente estudio descriptivo-correlacional incluyó una muestra de 310 estudiantes (183 mujeres y 127 hombres), quienes respondieron a la Escala de Autoeficacia en Conductas Académicas (EACA), la Escala de Ansiedad ZUNG y el Inventario de Ansiedad Estado-Rasgo (IDARE). La prueba de Pearson indicó una correlación positiva significativa entre las puntuaciones de autoeficacia percibida, deseable y alcanzable en EACA, pero una correlación negativa con el índice de mejora de la misma prueba; es decir, los puntajes de autoeficacia percibida, deseable y alcanzable se com portan de manera similar; pero, a medida en que los puntajes de estos tres indicadores disminuyen, la puntuación del índice de mejora es mayor. Por lo tanto, la autoeficacia percibida se tomó como el principal indicador de EACA, la cual se correlacionó inversamente con los puntajes de las escalas de ZUNG e IDARE; es decir, cuanto menor es la autoeficacia percibida mayor es el nivel de ansie dad. En un segundo análisis, un criterio arbitrario permitió definir tres rangos de puntuaciones en autoeficacia percibida: baja (puntuación 1-7.4), intermedia (puntuación 7.5-8.9) y alta (puntuación 9.0-10.0). Un ANOVA de dos vías indicó que los estudiantes, con niveles de autoeficacia percibida baja, obtuvieron los niveles de ansiedad más altos con la conocida tendencia del género femenino a desarrollar mayores puntajes de ansiedad. En conclusión, los estudiantes con baja autoeficacia perci bida manifiestan ansiedad en el momento de la prueba. Permanece pendiente la exploración de una relación causa-efecto.

Abstract: With the aim of exploring relationships between academic self-efficacy and anxiety, as critical incidents, this des criptive study included a sample of 310 students (183 women and 127 men). Volunteers responded to the Self-efficacy in Academic Behavior Scale (EACA), ZUNG anxiety scale and State-Trait Anxiety Inventory (STAI). A correlation analysis was performed between the different levels of perceived, desirable, achievable self-efficacy and an improvement index with anxiety indicators. A Pearson analysis indicated a moderate but significant positive correlation among perceived, desirable, and attainable self-efficacy scores in the EACA test, but a negative corre lation among these three indicators and the same test's improvement index. In other words, perceived, desirable, and attainable self-efficacy scores tabulated similarly, but as the scores of these three indicators rose, the score of the improvement index declined. Therefore, the perceived self-efficacy was taken as main indicator of EACA. The perceived self-efficacy correlated inversely with the scores obtained on ZUNG and STAI scales, i.e., as lower the perceived self-efficacy, the higher the level of anxiety. In second analyses, an arbitrary criterion allowed the esta blishment of three ranges of perceived self-efficacy scores into low (score 1-7.4), intermediate (score 7.5-8.9) and high (score 9.0-10.0). A two-way ANOVA indicated that students in the low range of perceived self-efficacy also scored the highest anxiety levels, with the well-known trend of feminine gender to express high levels of anxiety. In conclusion, students with low perceived self-efficacy are also anxious at the moment of the test, leaving for the future an exploration of a cause and effect relationship.

Retrospective review of critical incidents in the post-anaesthesia care unit at a major tertiary hospital

<p><b>INTRODUCTION</b>We reviewed patients with critical incidents that occurred in the post-anaesthesia care unit (PACU) at a major tertiary hospital, and assessed the effect of these incidents on PACU length of stay and discharge disposition.</p><p><b>METHODS</b>A retrospective review was conducted of patients in the PACU over a two-year period from 24 June 2011 to 23 August 2013. Data on critical incidents was recorded in the administrative database using a standardised data form.</p><p><b>RESULTS</b>There were 701 incidents involving 364 patients; 203 (55.8%) patients had American Society of Anesthesiologists (ASA) physical status I or II. The most common critical incidents were cardiovascular-related (n = 293, 41.8%), respiratory (n = 155, 22.1%), neurological (n = 52, 7.4%), surgical (n = 47, 6.7%) and airway-related (n = 34, 4.9%). There were two incidents of cardiac arrest and 25 incidents of unexpected reintubations. Many patients (n = 186, 51.2%) stayed for over four hours in the PACU due to critical incidents and 184 (50.5%) patients required a higher level of care postoperatively than initially planned. Some patients (n = 34, 9.3%) returned to the operation theatre for further management. A proportion of patients (n = 64, 17.6%) had unplanned intensive care unit admissions due to adverse events in the PACU.</p><p><b>CONCLUSION</b>A wide spectrum of critical incidents occur in the PACU, many of which are related to the cardiovascular and respiratory systems. Critical incidents have a major impact on healthcare utilisation and result in prolonged PACU stays and higher levels of postoperative care than initially anticipated.</p>

Hardiness em profissionais de primeira resposta: uma revisão sistemática / Hardiness in first responders: a systematic revision

Esta revisão sistemática da literatura trata do construto teórico de hardiness dirigido a profissionais de primeira resposta, detectando sua aplicabilidade em contextos de exposição regular a incidentes críticos. Consultou-se bases de dados (EBSCO, Web of Science e PsycINFO) no período de abril a junho de 2013, restringindo-se a artigos em português, inglês e espanhol publicados entre 2003 e 2013. Assim, 10 artigos compuseram esta revisão, sendo estes agrupados em um bloco temático ­ hardiness como agente amortecedor dos efeitos nocivos do estresse. Bombeiros, profissionais de enfermagem, médicos, paramédicos, militares e policiais compuseram os profissionais estudados. Hardiness mostrou estar negativamente relacionado ao mal-estar psíquico, ao desenvolvimento de quadros de adoecimento emocional e exercer influência negativa no uso de mecanismos desadaptativos e de risco, considerando as amostras elencadas nas pesquisas. Também mostrou relação positiva com bem estar psicológico e com a capacidade de enfretamento eficiente, útil e saudável em ambientes altamente estressantes.(AU)

This article provides a systematic revision in the literature regarding the hardiness construct, aimed to first responders, checking its applicability on scenarios where there is a regular exposure to critical incidents. From April to June, 2013, the EBSCO, Web of Science and PsycINFO databases were searched, looking for articles in Portuguese, English and Spanish, published between 2003 and 2013. After applying the inclusion and exclusion criteria, 10 articles ended up being included in this revision. They were then grouped, based on their goals and identified associations, in a single thematic block ­ hardiness as a weakening agent from the harmful effects of stress. The professionals studied comprised firemen, nurses, doctors, paramedics, military and policemen. From the studies analysis it is concluded that hardiness was shown to be negatively related to psychological distress, development of emotional illness and negatively influence the use of maladaptive and risky mechanisms, considering the samples listed in researches. Likewise, it showed a positive relationship with psychological well-being and the ability of efficient, helpful and healthful coping in highly stressful environments.(AU)

What Aspects of Patient Affect Medical Students? A Qualitative Analysis of the Experiences of Medical Students at General Medical Ward and Clinic / 医学教育

<B>Objective:</B> To identify the usefulness of critical-incident reports for reflective learning and for classifying the types of experiences that medical students regarded most memorable during clinical clerkship at general medical ward and clinic.<BR><B>Design:</B> Descriptive qualitative study using the critical-incident technique.<BR><B>Setting:</B> General medical ward and clinic of a university hospital.<BR><B>Participants:</B> Fifth-year medical students that took part in the clinical care of patients during the clerkship from October 1, 1996 to September 31, 1997.<BR><B>Measurements and Main Results:</B> Ninety-five reports were collected over one year and subjected to the analysis. Reports were classified for seven major themes, with a mean of 1.85 themes per narrative. As for the distribution of themes, 68 reports (72%) dealt with biomedical topics, 45 (47%) with communication with patients and families, 26 (27%) with personal feelings, 19 (20%) with the physician's role, 11 (12%) with ethics, 7 (7%) with psychosocial subjects, and 1 (1%) with recognition of alternative medicine. Reports from men and women contained a similar mean number (men 1.82; women 2.09) and distribution of themes.<BR><B>Conclusions:</B> Medical students have divergent meaningful experiences on non-biomedical themes as well as biomedical issues during their general medicine rotation.