Cross-sectional and longitudinal relationships between psychological violence and teacher burnout.

OBJECTIVE: This study aimed to identify cross-sectional and longitudinal relationships between psychological violence (PV) and burnout after two years of follow-up. METHODS: This is a longitudinal study involving 430 public school teachers from a city in southern Brazil. PV was defined as insults by students, humiliation or embarrassment by colleagues or superiors or threats by any member of the school. Burnout was measured using the emotional exhaustion (EE) and depersonalization (DP) subscales of the Maslach Burnout Inventory-Human Services Survey. Analyses were performed using structural equation models in R. RESULTS: Younger age (ß = - .167) and poor/fair relationship with students (ß = .275) had a direct effect on PV. Temporary employment (ß = - .111) and poor/fair perception of the number of students in the classroom (ß = .124) had a direct effect on EE. Cross-sectionally, PV showed a direct effect at both T0 and T1 on EE (T0: ß = .435; T1: ß = .334) and on DP (T0: ß = .332; T1: ß = .325). Longitudinally, PV at T0 did not have a significant direct effect on burnout at T1. However, indirect effects of PV on EE (ß = .459) and DP (ß = .428) at T1 were observed. CONCLUSIONS: The effect of PV on burnout occurs in a short period of time. However, the long-term effect should be considered because there is a cumulative burden of exposure to violence over time.

Recurrence of Violence Against Teachers: Two-Year Follow-Up Study.

The objective of this study was to analyze whether the experience of violence by teachers in the school environment increases the risk of teachers suffering violence again within a 2-year period. This longitudinal study included 430 primary and secondary public school teachers from a city in the south of Brazil, with data collected at two time points: T1 (2012-2013) and T2 (2014-2015). The data were obtained via face-to-face interviews and the completion of a questionnaire. The forms of violence investigated included reports of insults from students, humiliation or embarrassment by colleagues or superiors, and threats and physical violence from any member of the school occurring in the 12 months prior to the study. McNemar's test and the Poisson regression with robust error variance were used in the analyses, and the relative risk (RR) and 95% confidence interval (95% CI) were calculated. After 2 years, there was a reduction in violence reported by the teachers from 65.4% (T1) to 56.9% (T2) (p = .003). Teachers who suffered a certain form of violence had three times the risk of suffering that type of violence again. Those who reported three or four forms of violence at T1 had an RR of 2.23 of suffering any form of violence at T2 (95% CI [1.70, 2.93]) compared with those who did not report violence at T1. Psychological violence at T1 was not associated with physical violence at T2, nor was physical violence at T1 associated with psychological violence at T2. Despite the reduction in violence against teachers reported at T2, some forms of violence remained stable after 2 years. Suffering more forms of violence increases the risk of suffering any future violence.

Prospective association between burnout and road traffic accidents in teachers.

We investigated whether burnout (emotional exhaustion, depersonalization and reduced professional efficacy) is a risk factor for traffic accidents. A prospective cohort study was conducted with 509 school teachers. The teachers were interviewed in 2012-2013, and the Maslach Burnout Inventory was applied. After 2 years, the teachers were interviewed again to determine the occurrence of traffic accidents. Poisson regression models with robust variance were used to adjust the analyses. Relative risks (RRs) and 95% confidence intervals (95%CIs) were calculated to assess changes in c-units in the scores of each Burnout dimension, with c equal to 1, 5 and 10 units. The incidence rate of road traffic accidents at follow-up was 10.8%. After adjustments for sex, age, high workload/exposure to the traffic environment, daily consumption of alcoholic beverages and the other dimensions of burnout, depersonalization was a risk factor for traffic accidents. For each 1- and 10-point increase in the depersonalization score, the risk increased by 8 and 119%, respectively. Emotional exhaustion was not associated with these accidents. Increases in the professional efficacy score increased the risk of traffic accidents. The association of depersonalization with future road traffic accidents reinforces the need for measures to improve teachers' work conditions to reduce burnout.

Physical violence against schoolteachers: an analysis using structural equation models. / Violência física contra professores no espaço escolar: análise por modelos de equações estruturais.

This study aimed to identify associations between sociodemographic, workplace, and school environmental factors and the occurrence of physical violence against teachers at school. This was a cross-sectional study of teachers that had been working for at least a year in elementary or middle schools in the state school system in Londrina, Paraná State, Brazil. A convenience sample was taken of the 20 schools with the most teachers in the city of Londrina. Data were obtained through interviews and self-completed questionnaires in 2012 and 2013. Physical violence was defined as reports of attempted or actual physical aggression using cold steel weapons or firearms in the 12 months prior to the study. Structural equation models were used for the data analysis. Of the 937 teachers eligible for the study, 789 (84.2%) were interviewed. The physical violence victimization rate in schoolteachers was 8.4%. Work conditions (number of schools where the teachers worked and type of employment contract) showed a direct effect on physical violence (p = 0.032), as did having experienced previous situations of violence in the school (p = 0.059). Age (up to 40 years) was indirectly related to physical violence, correlating with worse work conditions. The results highlight the importance of improving teachers' work conditions and implementing measures to prevent violence both in schools and in society as a whole.

Violência física contra professores no espaço escolar: análise por modelos de equações estruturais / Violencia física contra profesores en el ámbito escolar: análisis mediante modelos de ecuaciones estructurales / Physical violence against schoolteachers: an analysis using structural equation models

Objetivou-se identificar associações de fatores sociodemográficos, do trabalho e do ambiente escolar com a ocorrência de violência física no espaço escolar contra professores. Trata-se de um estudo transversal com professores que atuavam há pelo menos um ano no Ensino Fundamental ou Médio da rede estadual de Londrina, Paraná, Brasil. Foram selecionadas, por conveniência, as 20 escolas com o maior número de professores do município. Os dados foram obtidos por meio de entrevistas e questionários autopreenchidos, nos anos de 2012 e 2013. Violência física foi definida como relatos de tentativas ou agressões físicas, com o uso de armas brancas ou de fogo, nos 12 meses anteriores à pesquisa. Modelos de equações estruturais foram utilizados para a análise dos dados. Dos 937 docentes elegíveis para a pesquisa, 789 (84,2%) foram entrevistados. A frequência de relatos de vitimização por violência física na escola foi de 8,4%. As condições de trabalho (número de locais e tipo de contrato de trabalho) apresentaram efeito direto sobre a violência física (p = 0,032), assim como ter vivenciado outras situações de violência na escola (p = 0,059). A idade (até 40 anos) apresentou relação indireta com a violência física, correlacionando-se com piores condições de trabalho. Com base nesses resultados, destaca-se a importância de melhora das condições de trabalho dos professores e de implantação de ações de prevenção à violência na escola e na sociedade.

El objetivo de este estudio fue identificar asociaciones entre factores sociodemográficos, laborales y de ambiente escolar con la ocurrencia de violencia física contra profesores en el ámbito escolar. Se trata de un estudio transversal, con profesores que ejercían desde hacía por lo menos un año en la enseñanza primaria o secundaria en la red estatal educativa de Londrina, Paraná, Brasil. Se seleccionaron, por su conveniencia, las 20 escuelas con mayor número de profesores del municipio. Los datos se obtuvieron mediante entrevistas y cuestionarios autocompletados, durante los años 2012 y 2013. La violencia física se definió como relatos de tentativas o agresiones físicas, con el uso de armas blancas o de fuego, durante los 12 meses anteriores a la investigación. Se utilizaron modelos de ecuaciones estructurales para los análisis de los datos. De los 937 docentes elegibles para la investigación, se les realizó la entrevista a 789 (84,2%). La frecuencia de relatos de victimización por violencia física en la escuela fue de 8,4%. Las condiciones de trabajo (número de locales y tipo de contrato de trabajo) presentaron un efecto directo sobre la violencia física (p = 0,032), así como haber vivido otras situaciones de violencia en la escuela (p = 0,059). La edad (hasta 40 años) presentó una relación indirecta con la violencia física, correlacionándose con peores condiciones de trabajo. En base a esos resultados, se destaca la importancia de una mejora en las condiciones de trabajo de los profesores y de la implantación de acciones de prevención frente a la violencia en la escuela y en la sociedad.

This study aimed to identify associations between sociodemographic, workplace, and school environmental factors and the occurrence of physical violence against teachers at school. This was a cross-sectional study of teachers that had been working for at least a year in elementary or middle schools in the state school system in Londrina, Paraná State, Brazil. A convenience sample was taken of the 20 schools with the most teachers in the city of Londrina. Data were obtained through interviews and self-completed questionnaires in 2012 and 2013. Physical violence was defined as reports of attempted or actual physical aggression using cold steel weapons or firearms in the 12 months prior to the study. Structural equation models were used for the data analysis. Of the 937 teachers eligible for the study, 789 (84.2%) were interviewed. The physical violence victimization rate in schoolteachers was 8.4%. Work conditions (number of schools where the teachers worked and type of employment contract) showed a direct effect on physical violence (p = 0.032), as did having experienced previous situations of violence in the school (p = 0.059). Age (up to 40 years) was indirectly related to physical violence, correlating with worse work conditions. The results highlight the importance of improving teachers' work conditions and implementing measures to prevent violence both in schools and in society as a whole.

Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies.

Burnout is a syndrome that results from chronic stress at work, with several consequences to workers' well-being and health. This systematic review aimed to summarize the evidence of the physical, psychological and occupational consequences of job burnout in prospective studies. The PubMed, Science Direct, PsycInfo, SciELO, LILACS and Web of Science databases were searched without language or date restrictions. The Transparent Reporting of Systematic Reviews and Meta-Analyses guidelines were followed. Prospective studies that analyzed burnout as the exposure condition were included. Among the 993 articles initially identified, 61 fulfilled the inclusion criteria, and 36 were analyzed because they met three criteria that must be followed in prospective studies. Burnout was a significant predictor of the following physical consequences: hypercholesterolemia, type 2 diabetes, coronary heart disease, hospitalization due to cardiovascular disorder, musculoskeletal pain, changes in pain experiences, prolonged fatigue, headaches, gastrointestinal issues, respiratory problems, severe injuries and mortality below the age of 45 years. The psychological effects were insomnia, depressive symptoms, use of psychotropic and antidepressant medications, hospitalization for mental disorders and psychological ill-health symptoms. Job dissatisfaction, absenteeism, new disability pension, job demands, job resources and presenteeism were identified as professional outcomes. Conflicting findings were observed. In conclusion, several prospective and high-quality studies showed physical, psychological and occupational consequences of job burnout. The individual and social impacts of burnout highlight the need for preventive interventions and early identification of this health condition in the work environment.

Coronary risk assessment in primary health care: a descriptive study / Avaliação do risco coronariano na atenção primária à saúde: um estudo descritivo / Evaluación de riesgo coronario en la atención primaria de salud: estudio descriptivo

Problem: The risk of coronary disease in the Brazilian population has increased along with other chronic non-communicable diseases and accounts for more than 70% of the mortality in this population. Aim: Determine the health profile and risk of coronary disease among youth, adults, and elderly people in primary health care. Method: A descriptive study was conducted in a basic health unit in Londrina city, Brazil. We interviewed 120 individuals. Their personal, anthropometric, and biochemical data; daily habits; history of disease; and coronary risk scores were analyzed using a mobile application. Results: The results showed 66.5% of individuals were overweight, 36.5% were physically active, 39% had hypercholesterolemia, 21.5% were hypertensive, 29% were smokers, 25.5% consumed alcoholic drinks, and 11% had hyperglycemia. The coronary risks were 88% and 68% in men and women, respectively. Conclusion: The results demonstrated a substantial risk for developing coronary heart disease in this population.

Problema: O risco de doença coronariana na população brasileira aumentou junto com outras doenças crônicas não transmissíveis, representando mais de 70% da mortalidade nessa população. Objetivo: Determinar o perfil de saúde e o risco de doença coronariana entre jovens, adultos e idosos na atenção primária à saúde. Método: Estudo descritivo realizado em uma Unidade Básica de Saúde da cidade de Londrina, Brasil. Entrevistamos 120 pessoas. Os dados pessoais, antropométricos e bioquímicos; hábitos diários; história de doença, e os escores de risco coronariano foram analisados usando uma aplicação móvel. Resultados: Os resultados mostraram 66,5% de sobrepeso, 36,5% fisicamente ativos, 39% de hipercolesterolemia, 21,5% hipertensos, 29% tabagistas, 25,5% consumiam bebidas alcoólicas e 11% apresentavam hiperglicemia. Os riscos coronarianos foram 88% e 68% em homens e mulheres, respectivamente. Conclusão: Os resultados demonstraram um risco substancial para o desenvolvimento de doença coronariana nessa população.

Problema: El riesgo de cardiopatía coronaria en la población de Brasil ha aumentado junto con otras enfermedades crónicas no transmisibles, y alcanza más del 70% de la mortalidad en esta población. Objetivo: Determinar el perfil de salud y el riesgo de sufrir enfermedad coronaria entre jóvenes, adultos y ancianos en atención primaria de salud. Método: Se llevó a cabo un estudio descriptivo en una Unidad Básica de Salud en la ciudad de Londrina, Brasil. Se entrevistaron 120 personas; mediante una aplicación móvil se analizaron sus datos personales, antropométricos y bioquímicos, hábitos diarios, historial médico y puntuación de riesgo coronario. Resultados: Los resultados mostraron un 66,5% de sobrepeso, un 36,5% eran físicamente activos, el 39% tenían hipercolesterolemia, el 21,5% eran hipertensos, el 29% eran fumadores, el 25,5% consumían bebidas alcohólicas y el 11% tenían hiperglucemia. El riesgo coronario fue del 88% y 68% en hombres y mujeres, respectivamente. Conclusión: Los resultados demostraron un riesgo sustancial para el desarrollo de enfermedad coronaria en esta población.

Educação que produz saúde: atuação da enfermagem em grupo de hipertensos / Educación que produce salud: práctica de enfermería en el grupo de pacientes hipertensos / Education that provides health: nursing role in a hypertensive group

Objetivo: conhecer a importância das ações educativas para um grupo de hipertensos. Método: estudo qualitativo realizado com dez pacientes hipertensos que frequentaram os encontros de educação em saúde de um projeto de pesquisa no Instituto Federal do Paraná, Londrina, Brasil. Os dados foram coletados em dezembro de 2012, por meio de entrevistas semiestruturadas gravadas e, posteriormente submetidas à análise de conteúdo. Resultados: emergiram duas categorias temáticas denominadas: Educação em saúde: plantando frutos e Educação em saúde: colhendo frutos. Os pacientes valorizaram às ações de educação em saúde no âmbito do autocuidado e prevenção das onsequências da hipertensão arterial sistêmica. Considerações finais: a educação em saúde torna-se ferramenta imprescindível no trabalho dos profissionais de enfermagem junto aos hipertensos visando, especialmente, a prevenção de complicações advindas da doença e a promoção de bem estar e qualidade de vida.

Aim: to understand the importance of educational activities for a group of hypertensive patients. Method: qualitative study with ten hypertensive patients who attended to educational health meetings of a research project at the Federal Institute of Paraná, Londrina, Brazil. Data were collected in December 2012, through semi structured recorded interviews and later submitted to content analysis. Results: two thematic categories emerged: Health education: planting fruit and Health education: reaping fruit. It was observed that patients valued the health education activities in the self-care and prevention of hypertension consequences. Final Remarks: health education becomes essential tool in the work of nursing professionals with the hypertensive patients, aiming especially the prevention of complications arising from the disease and the promotion of wellness and quality of life.

Objetivo: entender la importancia de las actividades de educación para un grupo de pacientes hipertensos. Método: estudio cualitativo con diez hipertensos que asistieron reuniones educativas sobre salud de un proyecto de investigación en el Instituto Federal de Paraná, Londrina, Brasil. Los datos fueron recolectados en diciembre de 2012 através de entrevistas semiestructuradas grabadas y posteriormente sometidas a análisis de contenido. Resultados: dos categorías temáticas surgieron: Educación para la salud: sembrando frutos y Educación para la salud: recogiendo frutos. Los pacientes valoraron actividades de educación para la salud referentes al autocuidado y prevención de las consecuencias de la hipertensión. Consideraciones finales: educación para la salud es herramienta esencial en el trabajo de los profesionales de enfermería junto a los hipertensos, apuntando sobre todo, la prevención de las complicaciones de la enfermedad y la promoción del bienestar y la calidad de vida.

Significance of clay art therapy for psychiatric patients admitted in a day hospital.

OBJECTIVE: To understand the significance of clay art therapy for psychiatric patients admitted in a day hospital. METHODOLOGY: Qualitative, descriptive and exploratory research, undertaken with 16 patients in a day hospital in Londrina, in the state of Parana, Brazil, who participated in seven clay therapy sessions. Data collection took place from January to July 2012 through interviews guided by a semi structured questionnaire and the data were submitted to content analysis. RESULTS: Three themes emerged: Becoming familiar with clay art therapy; Feeling clay therapy; and Realizing the effect of clay therapy. CONCLUSION: The use of clay as a therapeutic method by psychiatric patients promoted creativity, self-consciousness, and benefited those who sought anxiety relief.

O envelhecer e a morte: compreendendo os sentimentos de idosos institucionalizados / Aging and death: understanding the feelings of institutionalized elderly people

Objetivo: compreender os sentimentos dos idosos institucionalizados em relação ao processo de envelhecimento e morte. Método: trata-se de uma pesquisa qualitativa, realizada junto a sete idosas que se encontravam institucionalizadas, no mês de julho de 2012. Resultados: a análise das falas possibilitou a construção de três categorias temáticas: Apreendendo o envelhecer, desvelando a morte e sentindo a institucionalização. Algumas idosas entendem o envelhecimento como processo natural e outras não acreditam estar velhas. A morte, em sua maioria, foi desejada pelas idosas, sendo correlacionada em muitos momentos com a institucionalização. Conviver em uma instituição desencadeia os sentimentos de solidão, frustração ou abandono. Considerações finais: os resultados retratam a necessidade de um melhor planejamento, nas instituições, ofertando apoio psicológico, capaz de proporcionar um processo de envelhecimento mais humanizado e agradável à população estudada.

Objective: to understand the feelings of the institutionalized elderly related to aging and death. Method: this is a qualitative study conducted in seven elderly who areinstitutionalized, in July 2012. Results: the analysis of speeches made possible the construction of three thematic categories: Seizing the stale, unveiling death andinstitutionalization feeling. Some elderly understand aging as a natural process and notothers believe they are old. Death, in its majority, was desired by the elderly, and in many instances correlated with institutionalization. Living in an institution triggerstriggers feelings of loneliness, frustration or abandonment. Final Thoughts: results depict the need for better planning, institutions, offering psychological support, capable of delivering an aging process more humane and pleasant to the studied population.

Objetivo: comprender los sentimientos de los ancianos institucionalizados en relación al proceso de envejecimiento y muerte. Método: se trata de un estudio cualitativo realizado con siete ancianos que estaban institucionalizados, en julio de 2012. Resultados: el análisis de los discursos hicieron posible la construcción de tres categorías temáticas: Aprender el envejecimiento, descubriendo la muerte y sentindo la institucionalización. Algunos ancianos entienden el envejecimiento como un proceso natural y no otros creen queson viejos. La muerte, en su mayoría, era deseada por los ancianos, y en muchos casosrelacionada con la institucionalización. Vivir en una institución provoca sentimientos desoledad, frustración o abandono. Consideraciones finales: los resultados muestran lanecesidad de una mejor planificación en las instituciones, ofreciendo apoyo psicológico, capazde ofrecer un proceso de envejecimiento más humano y agradable a la población estudiada.

Perfil da mortalidade de menores de cinco anos em Maringá-Paraná de 1996-2006 / Mortality profile of children under five years old in Maringá-Parana, 1996 -2006

Objetivo: identificar o perfil da mortalidade de menores de cinco anos no município de Maringá-Paraná, por meio de construção de série histórica, no período de 1996-2006. Metodologia: estudo descritivo utilizando o Sistema de Informações sobre Mortalidade, o Sistema de Informações sobre Mortalidade Infantil e o Sistema de Informação sobre Nascidos Vivos. Resultados: observou-se o predomínio do óbito em menores de seis dias de vida (50,3%); a causa principal de óbito tem relação com afecções do período perinatal (30,9 óbitos/ano); 67,7% dos óbitos aconteceram em crianças de mães entre 15 e 29 anos, com escolaridade acima de oito anos (56,7%). Ao aplicar o risco relativo, constatou-se que os óbitos ocorreram em uma freqüência cinco vezes maior em partos cesáreas quando comparados a partos normais. Conclusão: este estudo possibilitou o conhecimento das características dos óbitos, entendidos como elemento indispensável para realização de intervenções estratégicas na organização dos serviços de saúde.

Objective: to identify mortality profile of children under five years old in Maringá, through the construction of historic series,on the timeframe of1996-2006. Method: descriptive study using the Mortality Information System, System Information and Infant Mortality Information System on Live Births. Results: prevalence of death in children under six years old (50.3%), the leading cause of death is related to disorders in perinatal timeframe (30.9 deaths / year); 67.7% of deaths occurred in children of mothers aged 15 to 29 years of schooling above eight years (56.7%). Through applying relative risk, it was found that the deaths occurred at a frequency five times higher incesarean sections compared to vaginal deliveries. Conclusion: the construction of the series allowed the knowledge of the characteristics and circumstances of deaths in children, seen as indispensable for the realization of strategic interventions in the care and organization of health services.

Objetivo: identificar el perfil de la mortalidad de menores de cinco años en Maringá-Paraná, en el período 1996-2006. Metodología: estudio descriptivo de datos basados en el Sistema de Informaciones sobre Mortalidad, el Sistema de Información sobre Mortalidad Infantil y nacidos vivos. Resultados: prevalencia de muerte en niños menores de seis días de vida (50,3%), la causa principal de muerte está relacionada con los trastornos del período perinatal (30,9 muertes anuales), el 67,7% de las muertes ocurrieron en niños del madres entre 15 hasta 29 años de escolaridad por encima de ocho años (56,7%). Al aplicar el riesgo relativo, se encontró que las muertes ocurrieron a una frecuencia cinco veces mayor en cesáreas cuando comparados a los partos vaginales. Conclusión: Este estudio permite el conocimiento de las características de la muerte, considerada como indispensable para la realización de intervenciones estratégicas en la organización de los servicios de salud.