Expectativas y realización profesional en Cirugía General y subespecialidades quirúrgicas: situación actual de los cirujanos jóvenes en Córdoba / Expectations and professional fulfillment in general surgery and surgical sub-specialties: current situation of young surgeons in Cordoba

RESUMEN Antecedentes: en la Argentina, la especialidad Cirugía General se encuentra en crisis y esta situación alarmante se halla vinculada a las malas condiciones laborales del cirujano general. Objetivo: describir la percepción que el cirujano joven tiene al terminar su programa de formación, en relación con su perspectiva laboral, actividad quirúrgica y académica. Material y métodos: estudio transversal basado en una encuesta dirigida a cirujanos jóvenes en Córdoba, Argentina. Resultados: participaron 53 encuestados. El 58% eran hombres y la mediana de edad fue 32 años. El 72% ejercía Cirugía General y el 55% trabajaba en el sector privado. El 34% pertenecía a la Asociación de Cirugía de Córdoba y el 23% a la Asociación Argentina de Cirugía. En cuanto a la experiencia profesional, el 53,1% eran cirujanos junior y el 64% eran competentes para realizar procedimientos de baja o mediana complejidad. En relación con la perspectiva laboral, el 89% consideró que el cirujano joven no consigue salida laboral rápida y el 96,2% refirió que sus prácticas no eran bien remuneradas. Respecto de la calidad de vida personal y laboral, el 57% manifestó frustración e incertidumbre económica. En cuanto a las cirujanas, la tasa de inequidades de género y hostigamiento sexual en el ámbito laboral fue del 73% y 50%, respectivamente. Conclusión: encontramos la percepción de un bajo nivel de competencia para las cirugías de mayor complejidad y una baja tasa de adherencia a sociedades quirúrgicas. Debido a la escasa oferta laboral existe gran frustración e incertidumbre económica. Actualmente, predomina y persiste el maltrato y hostigamiento hacia las cirujanas.

ABSTRACT Background: In Argentina, the specialty of general surgery is in crisis, and this alarming situation is associated with the poor working conditions of general surgeons. Objective: The aim of this study is to describe the perception of young surgeons at the end of their training program, in relation to their job prospects, surgical and academic activity. Material and methods: We conducted a cross-sectional study based on a survey responded by young surgeons in Cordoba, Argentina. Results: The survey was responded by 53 young surgeons; 58% were men and median age was 32 years. Seventy-two percent practiced general surgery and 55% worked in the private setting. Thirtyfour percent were members of Asociación de Cirugía de Córdoba and 23% belonged to Asociación Argentina de Cirugía. As for professional experience, 53.1% were junior surgeons and 64% were capable of performing low or medium complexity procedures. Eighty-nine percent considered that young surgeons do not get a job quickly and 96.2% reported that they were not well paid for their practice. When asked about their personal and professional quality of life, 57% expressed frustration and economic uncertainty. Among women surgeons, 73% reported gender inequities and 50% reported sexual harassment in the workplace. Conclusion: Young surgeons perceived they had low level of competencies for high complexity surgical procedures and reported low rate of membership in surgical societies. Most of them feel frustrated due to scarce job opportunities and expressed economic uncertainty. Nowadays, abuse and harassment of women surgeons still prevails and persists.

Mobbing-Acoso moral: estudio prospectivo en hospitales públicos de la provincia de Buenos Aires, Argentina / Mobbing - Moral Harassment: Prospective Study in Public Hospitals of the Province of Buenos Aires, Argentina

Antecedentes: el mobbing se define como acoso, ofensa, exclusión social de alguien e interferencia negativa en sus tareas por uno o más individuos del mismo ambiente laboral. Objetivo: identificar los factores de riesgo, procedencia y análisis de la incidencia del mobbing, así como su relación con los factores de riesgo psicosociales y su afectación en los trabajadores de la salud. Material y métodos: estudio prospectivo, observacional descriptivo, con participante natural y de campo. Se utilizaron encuestas anónimas a personal sanitario incluido en las Leyes No 10.471 y No 10.430 de hospitales públicos de la provincia de Buenos Aires, durante un período de 12 meses consecutivos. Resultados: se incluyeron 147 participantes, de los cuales 101 (68,7%) fueron mujeres, 42 (28,5%) varones, y 4 (2,8%) no contestaron. El grupo más numeroso correspondió a la franja etaria 41-50 años (n = 51; 36%). La antigüedad laboral presentó una distribución bimodal de los grupos 1-5 años (27,25%) y 16-20 años (24%). El número que se consideró acosado fue de 86 agentes (58,5% de la muestra). Hubo mayor preponderancia de los superiores como los principales acosadores con 52,4% (n = 77). Conclusiones: la incidencia hallada es mayor que la informada en la literatura al comparar solo un sector laboral con la totalidad de la población activa (58,5% vs. 11,4%). Las variables sociodemográficas, como sexo, nacionalidad de origen, estado civil, nivel de estudios cursados y alcanzados y el tipo de contratación no se asociaron a una mayor incidencia de mobbing, como sí tuvieron una relación directa tanto la edad como la antigüedad, lo que confirma el acoso moral como un estresor crónico en el trabajo. Los motivos del ausentismo de naturaleza psicológica (depresión y crisis de ansiedad) producidos por el mobbing no solo afectan los síntomas psicosomáticos evaluados, sino también aumentan el ausentismo laboral, afectando la productividad de la empresa hospital.

Background: mobbing is defined as harassment, offense, social exclusion of someone and negative interference in their work tasks by one or more individuals from the same work environment. Objective: to identify the risk factors, origin and analysis of the incidence of mobbing, as well as its relationship with psychosocial risk factors and their involvement in health workers. Material and methods: prospective, observational, descriptive study with natural and field participant. Anonymous surveys were used for health personnel included in Laws No. 10471 and No. 10430 from public hospitals in the province of Buenos Aires, during a 12-month period. Results: a total of 147 participants were included, 101 (68.7%) were female, 42 (28.5%) were male, and 4 (2.8%) did not answer. The largest group corresponded to the age group 41-50 years (n= 51; 36%). The age of labor presented a bimodal distribution of groups 1-5 years (27.25%) and 16-20 years (24%). The number that was considered harassed was 86 agents (58.5% of the sample). There was greater preponderance of superiors as the main stalkers with 52.4% (n= 77). Conclusions: the incidence found is greater than that reported in the literature when comparing a single labor sector with the total of the active population (58.5% vs. 11.4%). Sociodemographic variables such as gender, national origin, marital status, level of studies completed and type of recruitment, were not associated with a higher incidence of mobbing, as were age and seniority in a direct proportion, confirming moral harassment as a chronic stressor at work. The reasons for leave of absence of a psychological nature (depression and crisis of anxiety) produced by mobbing, not only affects the psychosomatic symptoms evaluated, but also increase work leaves of absence, affecting the productivity of the hospital.

Assédio moral: evidências de validade de escala e relações com qualidade de vida no trabalho / Workplace bullying: scale validity evidence and relationship to quality of work life / Acoso moral: evidencias de validez para una escala y relaciones con calidad de vida en el trabajo

O presente estudo teve por objetivo principal encontrar evidências de validade para a Escala Laboral de Assédio Moral – ELAM, por meio de sua correlação com a Escala de Qualidade de Vida no Trabalho – Escala-QVT. Participaram 338 trabalhadores de distintas organizações do estado de Sergipe, com idade entre 18 e 61 anos. Do total, 56,5% (191) eram mulheres. Como resultados encontraramse correlações negativas de magnitude fraca entre os fatores das escalas, apontando evidências de validade para a ELAM. A análise de diferenças entre grupos indicou que o assédio moral laboral prejudica a percepção a respeito da qualidade de vida no trabalho.

The present study aimed to find validity evidence for the Workplace Bullying Scale (ELAM), through its correlation with the Quality of Work Life Scale (QVT). The participants were 338 employees of several organizations from the state of Sergipe in Brazil, aged between 18 and 61 years. Of the total, 56.5% (191) were women. Negative correlations of low magnitude were found among the scales’ factors, indicating validity evidence for ELAM. The analysis of differences between groups indicated that workplace bullying undermines the perception of the quality of work life.

El presente estudio tuvo como principal objetivo encontrar evidencias de validez para la Escala Laboral de Acoso Moral – ELAM, por medio de la correlación a la Escala de Calidad de Vida en el Trabajo. Participaron 338 trabajadores de diferentes organizaciones del estado de Sergipe, con edades entre 18 y 61 años. Del total, 56,5% (191) eran mujeres. En los resultados se encontraron correlaciones negativas de baja magnitud entre los factores de las escalas, mostrando evidencia de validez para la ELAM. El análisis de diferencias entre grupos indicó que el acoso moral perjudica la percepción a respecto de la calidad de vida en el trabajo.

Workplace Violence and Job Outcomes of Newly Licensed Nurses

PURPOSE: The purpose of this study was to examine the prevalence of workplace violence toward newly licensed nurses and the relationship between workplace violence and job outcomes. METHODS: An online survey was conducted of newly licensed registered nurses who had obtained their license in 2012 or 2013 in South Korea and had been working for 5-12 months after first being employed. The sample consisted of 312 nurses working in hospitals or clinics. The Copenhagen Psychosocial Questionnaire II was used to measure violence and nurse job outcomes. Multiple linear and logistic regression analyses were conducted to examine the relationship between violence and job outcomes. RESULTS: Verbal abuse was most prevalent (59.6%), followed by threats of violence (36.9%), physical violence (27.6%), bullying (25.6%), and sexual harassment (22.4%). Approximately three quarters of the nurses had experienced at least one type of violence. The main perpetrators were patients and nurse colleagues, although the distribution of perpetrators varied depending on the type of violence. Bullying had a significant relationship with all four job outcomes (job satisfaction, burnout, commitment to the workplace, and intent to leave), while verbal abuse was associated with all job outcomes except for intent to leave. Violence perpetrated by nurse colleagues had a significant relationship with all four job outcomes, while violence by physicians had a significant inverse relationship with job satisfaction. CONCLUSIONS: Workplace violence is experienced by a high percentage of newly licensed nurses, and is associated with their job outcomes.

Entrevista e análise do discurso de um usuário de um NAPS: Sandro e a injustiça institucionalizada / Interview and analyses of a NAPS's user discourse: Sandro and the institucionalized injustice / Entretien et analyse du discours d'un usager d'un NAPS: sandro et l'injustice institutionalisee / Entrevista y análisis del discurso de un usuario de un NAPS: Sandro y la injusticia institucionalizada

No presente artigo analisou-se a transcrição de uma entrevista com um usuário de um Núcleo de Atenção Psicossocial (NAPS) do Estado de São Paulo segundo o método de análise institucional de discurso. Visou-se, com isso, ao estudo da constituição do sujeito no discurso - o que implica tanto o seu vínculo com a instituição quanto a interlocução que se configura com o entrevistador no ato mesmo da entrevista. Empreendendo uma analítica do discurso do usuário - em detrimento de classificações psiquiátricas ou psicopatológicas impostas aos sujeitos -, realizou-se o delineamento de sua singularidade por meio da positivação de seu discurso. Buscou-se, ainda, mapear as correlações de força presentes em diversos temas recorrentes em sua fala, tais como a injustiça, a violência, os médicos, a sexualidade, medicamentos e cotidiano institucional. Por fim, propôs-se uma abordagem que, longe de corroborar com uma concepção da verdade como ente subterrâneo aguardando ser descoberto pelo pesquisador, toma o par usuário/instituição como uma produção única e indissociável

The present article analyses the transcrption of an interview with an user of a Social and Psychological Attention Centre (NAPS) in the state of São Paulo according to the institutional analyses of discourse method. It aimed at the study of the subject's constituon through his own discourse, which comprehends his relationship with the institution and the interlocution built with the interviewer during the interview. Focusing on the user's discourse analyses - instead of psychiatrical or psychpatologics classifications imposed on the subject- we obtained the outlining of his singularities through the positiveness of his discourse. Another goal was to map the power correlations founded in many constant topics of his discourse, like injustice, violence, doctors, sexuality, medicines and institutional routine. At last, the choosen approach doesn't confirm the idea of truth as an underground entity waiting to be discovered by a researcher, it takes the partnership 'user/institution' as a unique and unseparable production

Dans le présent article il a été analysé la transcription d'un entretien avec un usager d'un Centre d'Attention Psychosociale (NAPS) de l'état de São Paulo selon la méthode d'analyse institutionnelle du discours. L'objectif a été l'étude de la constitution du sujet dans le discours - ce qui implique aussi bien son lien avec l'institution que l'interlocution établie avec l'intervieweur dans l'acte même de l'entretien. En entreprenant une analyse du discours de l'usager - en détriment des classifications psychiatriques ou psychopathologiques inculquées aux sujets -, il a été question de délinéer sa singularité par la positivation de son discours. Par ailleurs, l'article a cherché à tracer les corrélations de force présentes entre plusieurs thèmes récurrents dans son discours, tels que l'injustice, la violence, les médecins, la sexualité, les médicaments et le quotidien institutionnel. Enfin, l'on propose une approche que, loin de corroborer une conception du sujet en tant qu'être souterrain qui attend d'être découvert par le chercheur, prend la paire usager/institution comme production unique et indissociable

El presente artículo analiza la transcripción de una entrevista con un usuario de un Núcleo de Atenção Psicossocial (NAPS) del Estado de San Pablo según el método de análisis institucional de discurso. Para ello, se ha seguido el estudio de la constitución del sujeto en el discurso -lo que implica tanto su vínculo con la institución como la interlocución que se configura con el entrevistador en el propio acto de la entrevista. Al emprender una analítica del discurso del usuario - abandonando clasificaciones psiquiátricas o psicopatológicas impuestas a los sujetos - se ha realizado el delineamiento de su singularidad por medio de la positivación de su discurso. Se ha intentado, aún, mapear las correlaciones de fuerza presentes en diversos temas recurrentes en su habla, tales como la injusticia, la violencia, los médicos, la sexualidad, medicamentos y cotidiano institucional. Finalmente, se propuso un abordaje que, al contrario de corroborar una concepción de la verdad como ente subterráneo a la espera de ser descubierto por el investigador, toma el par usuario/institución como una producción única e indisociable

Victimario: una mirada psicosocial / Victimario: a psychosocial look

La investigación, Perfil Psicosocial de víctimas y victimarios de abuso sexual se inscribe dentro del marco teórico de la psicología social, motivo por el cual se pretende conocer las identidades y significaciones sociales de ambos actores, en relación con un contexto socio-cultural donde se incluyan aspectos individuales y colectivos influyentes en la dinámica psíquica y relacional del sujeto.

The research, Psychosocial Profile of victims and perpetrators of sexual abuse is part of the theoretical framework of social psychology, which is why we want to know the identities and social meanings of both actors, in relation to a socio-cultural context where they are included individual and collective aspects influencing the psychic and relational dynamics of the subject.