Studying daily fluctuations of emotional effort among nurses of intensive care units: the establishment of latent profiles and its relationship with daily secondary traumatic stress and vitality.

Introduction: Nursing professionals working in Intensive Care Units (ICU) face significant challenges that can result in secondary traumatic stress (STS). These challenges stem from witnessing patients' suffering and managing difficult tasks (i.e. communication with patients' relatives). Furthermore, these professionals encounter emotional demands, such as emotional effort, which is the dissonance between the emotion felt and the emotion that should be expressed to meet work expectations. Consequently, we aimed to investigate whether different profiles exist concerning nurses' levels of emotional effort over a five-day period and whether these profiles are related to daily STS and vitality. Methods: The sample comprised 44 nursing professionals from ICUs in Spanish hospitals. They were assessed daily, using a package of questionnaires twice per day for five working days: a) immediately after their shift and b) at a later time after working. Results: The findings revealed three distinct profiles based on emotional effort levels: high (Profile 1), moderate (Profile 2), and low (Profile 3). These profiles were found to be negative predictors for both daily shattered assumptions and symptomatology. Discussion: This study underscores the importance of assessing daily emotional demands in an ICU setting. Such assessments are crucial for establishing preventive measures to help nursing professionals manage lower-level emotional demands.

Work Intensification and Its Effects on Mental Health: The Role of Workplace Curiosity.

Work intensification is a psychosocial risk that has been increasing in recent decades and may have been accentuated after the COVID-19 pandemic. Its effects on health are negative, but they can be moderated by contextual and personal factors. The aim of this study was twofold: to analyze the effect of work intensification on workers' stress, anxiety, and depression and to explore the role of workplace curiosity in these relationships. The study design was cross-sectional, and a total of 766 Spanish workers (58.9% female) with different occupations completed the survey. The results showed that work intensification was associated with the symptomatology of stress, anxiety, and depression, with a medium effect size. Women workers showed higher work intensification, but its association with mental health was equally strong for both genders. Workers with higher levels of the workplace curiosity dimension "stress tolerance" showed less impaired mental health in the presence of work intensification. However, workers with higher levels of the workplace curiosity dimension "deprivation sensitivity" showed more symptoms of stress, anxiety, and depression when faced with high work intensification. The results were discussed in terms of their contributions to the field of study of work intensification, the future research they could inspire, and the prevention and intervention measures they could motivate.

Spanish Adaptation of the Intensified Job Demands Scale (IDS) / Adaptación Española de la Escala de Demandas Laborales Intensificadas (IDS)

Background: The Intensification of Job Demands Scale (IDS) is a multidimensional instrument designed to capture the phenomenon of work intensification that characterizes modern Western societies. However, in Spain the instrument has not been validated to assess this phenomenon. The aim of this study was to examine the psychometric properties of the IDS adaptation with a heterogeneous sample of Spanish workers. Method: The sample consisted of 722 Spanish workers (57.8% female, 42.2% male) who completed a survey between January and April 2022. Results: A five-factor correlated model, as in the original IDS, had an optimal fit with 15 items, and displayed invariance across gender, level of education, and organizational tenure. Reliability coefficients were all satisfactory, and scale adaptation showed evidence of convergent, discriminant, and incremental validity. Conclusions: The Spanish adaptation of the IDS is a valid, reliable measure for analyzing the phenomenon of work intensification and intensified job demands in Spain.(AU)

Antecedentes: La Escala de Intensificación de las Demandas Laborales (IDS) es un instrumento multidimensional diseñado para captar el fenómeno de la intensificación laboral que caracteriza a las sociedades occidentales modernas. Sin embargo, en España, el instrumento no ha sido validado para evaluar este fenómeno. Por ello, el objetivo de este estudio fue examinar las propiedades psicométricas de la IDS para su adaptación a una muestra heterogénea de trabajadores españoles. Método: La muestra estuvo formada por 722 trabajadores españoles (57,8% mujeres) que completaron una batería de cuestionarios entre enero-abril de 2022. Resultados: Un modelo correlacionado de cinco factores, como en la IDS original, tuvo un ajuste óptimo con 15 ítems, y mostró invarianza en género, nivel de estudios y antigüedad dentro de la organización. Los coeficientes de fiabilidad fueron satisfactorios, y la adaptación de la escala mostró evidencias de validez convergente, discriminante e incremental. Conclusiones: La adaptación española de la IDS es una medida válida y fiable para analizar el fenómeno de la intensificación laboral en España.(AU)

Passionate healthcare workers in demanding intensive care units: its relationship with daily exhaustion, secondary traumatic stress, empathy, and self-compassion.

This study focuses on Intensive Care Units (ICU) and aims to test whether daily job demands are related to daily emotional exhaustion and secondary traumatic stress (STS) after work through the experience of passion at work and whether personal resources in ICU, such as empathy and self-compassion, moderate these relationships. A diary study was designed to assess day-level job demands, passion, empathy, self-compassion at work; and day-level emotional exhaustion and STS after work. The sample was 97 healthcare workers from ICU from different Spanish hospitals being selected by the snowball technique. This sample was assessed 5 days x two moments per day through a diary questionnaire. The multilevel analysis showed a negative mediational effect of harmonious passion between daily job demands and both emotional exhaustion and STS. Also, in predicting emotional exhaustion, a moderator effect of empathy on harmonious passion was found, as well as a moderator effect of self-compassion on obsessive passion. In predicting STS, a direct positive effect was found in empathy. Our findings highlight the vocational work of these healthcare workers, considering job demands as challenging and enhancing their harmonious passion to overcome the drawbacks. Moreover, empathy revealed to have a negative effect whereas self-compassion the contrary. Thus, increase the awareness on these personal resources and how to train them could be considered as valuable preventative measures.

Satisfied as professionals, but also exhausted and worried!!: The role of job demands, resources and emotional experiences of Spanish nursing home workers during the COVID-19 pandemic.

Nursing home workers have been exposed to great physical and mental burdens during the COVID-19 pandemic. Although this has generated high levels of exhaustion, it may also have contributed to feelings of professional satisfaction. The objective of this study was to explore the levels of satisfaction among nursing home workers during the COVID-19 pandemic, as well as the role of job demands, resources and emotional experiences in explaining their levels of satisfaction. This cross-sectional study was conducted in Spain between March and May 2020. Three hundred and thirty-five nursing home workers participated. A quantitative analysis was conducted, as was a content analysis of the responses to an open-ended question about the respondents' perceptions of job demands and resources during the crisis. The results showed that workers had very high levels of satisfaction. Social pressure from work, contact with death and suffering, and emotional exhaustion were negatively associated with satisfaction. Moreover, under conditions of extensive contact with suffering people and great fear of contagion, social support at work was shown to promote professional satisfaction. In conclusion, nursing home workers in Spain experienced high rates of satisfaction during the COVID-19 crisis despite the high job demands, lack of job resources, fear of contagion and exhaustion. The main practical implication of this study is the importance of ensuring optimal working conditions in the nursing home sector in order to guarantee professional satisfaction, prevent burnout, reduce turnover and promote post-crisis resilience.

Daily Beneficial Effects of Work-to-Family Facilitation on Employees' Recovery and General Health: Is More Work Engagement Always Better?

This study of 104 Chilean employees examines the process of WFF-recovery-general health on a daily basis. Drawing on the work-home resources (W-HR) model, we hypothesized that daily work-to-family facilitation and work engagement predict recovery experiences during off-job time in the evening (i.e., detachment from work and relaxation) and subsequent general health at night. Furthermore, we explored whether daily work engagement moderates the relationships between daily work-to-family facilitation and recovery experiences during off-job time in the evening and general health at night. In addition, we expected employees' detachment from work to have a lagged effect on next-day general health at night. Participants completed a survey and a diary booklet over 5 consecutive working days (N = 520 occasions). Multilevel analyses show that, as expected, daily work-to-family facilitation predicted recovery experiences during off-job time in the evening (i.e., detachment from work and relaxation). However, contrary to our expectations, daily work engagement only predicted general health at night. Moreover, as expected, a moderation effect of daily work engagement shows that on days that employees experience low levels of daily work engagement, daily work-to-family facilitation is strongly related to detachment from work and relaxation during off-job time in the evening and to general health at night. Unexpectedly, on days on which employees experienced high levels of daily work engagement, daily work-to-family facilitation was weakly related to these outcomes. Finally, in accordance with our expectations, detachment from work had a lagged effect on next-day general health at night. These findings offer support for the W-HR model and have theoretical and practical implications for research and organizations.

The Role of Healthcare Professionals' Passion in Predicting Secondary Traumatic Stress and Posttraumatic Growth in the Face of COVID-19: A Longitudinal Approach.

COVID-19 has increased the likelihood of healthcare professionals suffering from Secondary Traumatic Stress (STS). However, the difficulty of this crisis may lead these professionals to display personal resources, such as harmonious passion, that could be involved in posttraumatic growth. The goal of this study is to examine the STS and posttraumatic growth among healthcare professionals and the demands and resources related to COVID-19. A longitudinal study was carried out in April 2020 (T1) and December 2020 (T2). The participants were 172 health professionals from different health institutions and they reported their workload, fear of contagion, lack of staff and personal protection equipment (PPE), harmonious passion, STS and posttraumatic growth. The results revealed that workload and fear of contagion in T2 were positive predictors for STS, whereas harmonious passion was a negative predictor. Fear of contagion of both times seemed to positively predict posttraumatic growth, as well as harmonious passion. One moderation effect was found concerning the lack of staff/PPE, as posttraumatic growth was higher when the workload was high, especially in those with a high lack of staff/PPE. All in all, these findings pointed out the need for preventative measures to protect these professionals from long-term negative consequences.

Daily Work-Family Conflict and Burnout to Explain the Leaving Intentions and Vitality Levels of Healthcare Workers: Interactive Effects Using an Experience-Sampling Method.

There is an intensification of work in global health systems, a phenomenon that could increase work-family conflict, exhaustion, and intentions to leave among healthcare workers. The main objective of this study is to analyze if daily work-family conflict and burnout could explain the daily leaving intentions and vitality of healthcare workers. This is a diary study, which employs an experience-sampling methodology (ESM). A total of 56 physicians, nurses, and nursing aides from intensive care and nephrology units filled out various quantitative scales during 5 working days (56 × 5 = 280 observations). Multilevel hierarchical analysis showed that daily work-family conflict and burnout were significantly associated with higher daily intentions of leaving the profession, and with lower levels of daily vitality. In addition, those workers who experienced more work-family conflict and depersonalization on a daily basis were those who showed more intentions to leave and less daily vitality, showing an interactive effect. The results highlight the importance of examining the psychosocial risks experienced by healthcare workers by employing experience-sampling methodologies, which could help us to deepen our understanding of the proximal antecedents of their intentions to leave and their psychological well-being.

The Job Demands and Resources Related to COVID-19 in Predicting Emotional Exhaustion and Secondary Traumatic Stress Among Health Professionals in Spain.

The current COVID-19 crisis may have an impact on the mental health of professionals working on the frontline, especially healthcare workers due to the increase of occupational psychosocial risks, such as emotional exhaustion and secondary traumatic stress (STS). This study explored job demands and resources during the COVID-19 crisis in predicting emotional exhaustion and STS among health professionals. The present study is a descriptive and correlational cross-sectional design, conducted in different hospitals and health centers in Spain. The sample consisted of 221 health professionals with direct involvement in treating COVID-19. An online survey was created and distributed nationwide from March 20 to April 15 which assessed: sociodemographic and occupational data, fear of contagion, contact with death/suffering, lack of material and human protection resources (MHRP), challenge, emotional exhaustion, and STS. Descriptive findings show high levels of workload, contact with death/suffering, lack of MHPR and challenge, and are moderately high for fear of contagion, emotional exhaustion, and STS. We found an indirect significant effect of lack of MHPR on predicting (1) emotional exhaustion through the workload and (2) on STS through fear of contagion, contact with death/suffering, and workload. To conclude, this study examines the immediate consequences of the crisis on health professionals' well-being in Spain, emphasizing the job demands related to COVID-19 that health professionals are facing, and the resources available in these health contexts. These findings may boost follow-up of this crisis among health professionals to prevent them from long-term consequences.

Overwhelmed by Emotional Job Demands in High Vigor Days! Its Detrimental Effects on Daily Recovery from Work among Health-Care Workers.

The objective of this study is twofold: first, to analyze whether the daily level of energy in terms of vigor at work could explain the way in which workers psychologically detach from their work, relax, practice challenging activities, and have the feeling of having control over their leisure time when arriving home. Second, to check if the daily emotional job demands could hinder that relationship, reversing the positive effect of vigor in recovery. For this purpose, a multilevel study with a diary methodology was designed. In total, 94 nurses from various hospital and primary care centers in Madrid and Basque Country (Spain) participated in this study. They completed daily questionnaires twice a day (in the afternoon after work and at night before going to bed) for five consecutive workdays from Monday to Friday (N = 94*5 = 470). The results revealed that on days that vigor at work was high, nurses experienced more psychological detachment, relaxation, feelings of mastery, and time control at home. Moreover, on days that emotional job demands were high, vigor was more negatively related to psychological detachment and time control at home. Additionally, vigor was more positively related to all recovery experiences at home in days that emotional demands were low. Therefore, daily vigor can act as an energy resource that helps the worker to recover. However, this effect can occur in situations in which stressors are not present in high intensity. These results have clear practical implications for both health organizations and workers.

Stressors, Job Resources, Fear of Contagion, and Secondary Traumatic Stress Among Nursing Home Workers in Face of the COVID-19: The Case of Spain.

This study aimed to analyze the psychological consequences of the COVID-19 pandemic on nursing home workers, as well as the influence of certain related stressors and job resources. Two-hundred twenty-eight nursing home workers in Spain participated in this cross-sectional study. High levels of workload, social pressure from work, contact with suffering, and fear of contagion were found. In nursing homes where cases of COVID-19 had been detected, workers experienced higher levels of secondary traumatic stress. Social pressure from work, high doses of exposure to suffering, lack of personnel and personal protective equipment, and minimal supervisor support were significant in explaining traumatic stress. Supervisor and coworker support moderated some of these relationships. The results are discussed in terms of the need to implement urgent psychosocial protection strategies and to provide personal protective equipment (PPE) to help prevent future psychological disorders in this worker population.

Pilot study of a brief psychological intervention for reducing emotional exhaustion and secondary traumatic stress among physicians of intensive care units in Mexico / Estudio piloto de una intervención psicológica breve para reducir el agotamiento emocional y el estrés traumático secundario en personal médico de las unidades de cuidados intensivos en México

Abstract Introduction Physicians of Intensive Care Units (ICU) have a potential risk to develop negative outcomes such as emotional exhaustion and secondary traumatic stress (STS). Specifically, job demands in these units (i.e., work stressors and emotional effort) may positively predict these outcomes, whereas personal resources such as harmonious passion and self-compassion may diminish them. Objetive To design a specific intervention for physicians in ICU and provide preliminary evidence of its effectiveness. Method A brief intervention of five weekly sessions (two hour-sessions) was carried out with four physicians in ICU in a hospital in Mexico. Other four physicians were selected as a control group. The intervention was aimed at reducing emotional exhaustion and STS by increasing harmonious passion and self-compassion, and diminishing the emotional effort. Results The intervention group showed a significant reduction in: a) work stressors (2/4 physicians; RCI = .21); emotional effort (1/4 physicians; (RCI = .60); emotional exhaustion (2/4 physicians; RCI = .34); and STS (3/4 physicians; RCI = .26). One physician experienced a significant increase in harmonious passion (RCI = 1.00), but the intervention seems to maintain high levels of this and self-compassion in comparison with the control group. The control group showed a worse result in its outcomes. Discussion and conclusion Despite the limitations, this study provides preliminary evidence for effectively reducing emotional exhaustion and STS. Our findings highlight the individual analysis of the effective tools per physician and address interventions focused on harmonious passion and self-compassion. This study calls for future research concerning intervention proposals in ICU with follow-up measures to diminish the negative consequences in the long-term.

Resumen Introducción Los médicos de las unidades de Cuidados Intensivos (UCI) presentan un riesgo de desarrollar agotamiento emocional y estrés traumático secundario (ETS). Las demandas laborales en estas unidades (estresores laborales y esfuerzo emocional) pueden predecir positivamente estos resultados, mientras que los recursos personales como la pasión armoniosa y la autocompasión pueden disminuirlos. Objetivo Diseñar una intervención específica para médicos de UCI y proporcionar evidencia preliminar de su efectividad. Método Se realizó una intervención de cinco sesiones semanales (de dos horas de duración cada una) con cuatro médicos de una UCI en un hospital de México. Otros cuatro médicos fueron seleccionados como grupo control. El objetivo fue reducir el agotamiento emocional y el ETS mediante el aumento la pasión armoniosa y la autocompasión; y la disminución del esfuerzo emocional. Resultados En el grupo de intervención se halló una disminución significativa en: a) estresores laborales (2/4 médicos; RCI = .21); esfuerzo emocional (1/4 médicos; RCI = .60); agotamiento emocional (2/4 médicos; RCI = .34); y ETS (3/4 médicos; RCI = .26). Un médico experimentó un aumento significativo en la pasión armoniosa (RCI = 1.00), en tanto que el resto mantuvo altos niveles de ésta y autocompasión en comparación con el grupo control. Discusión y conclusión A pesar de las limitaciones, este estudio proporciona evidencia preliminar para reducir el agotamiento emocional y el ETS. Nuestros hallazgos destacan el análisis individual de las herramientas efectivas y destaca las intervenciones centradas en la pasión armoniosa y la autocompasión. Nuestro estudio recalca la importancia de desarrollar investigaciones futuras sobre intervenciones en UCI con medidas de seguimiento que puedan disminuir las consecuencias negativas a largo plazo.

The Moderator Role of Passion for Work in the Association between Work Stressors and Secondary Traumatic Stress: A Cross-Level Diary Study among Health Professionals of Intensive Care Units.

BACKGROUND: Secondary traumatic stress (STS), a construct formed by compassion fatigue, shattered assumptions, and symptomatology, has been scarcely studied in intensive care units (ICU). In these units, healthcare workers encounter daily work stressors which impact on their health and well-being. Also, previous literature revealed a passion for caring among these workers, finding two types: harmonious passion, which may protect them against negative outcomes, and obsessive passion, which may boost negative consequences. We aim to study whether both types of passion could moderate the relationships between daily work stressors and STS. METHODS: In all, 265 assessments were collected at ICUs from different hospitals in Spain through a diary approach (53 health workers × 5 days at two time points per day). RESULTS: First, daily work stressors were positive predictors of symptomatology; secondly, dispositional harmonious passion was a negative predictor of both compassion fatigue and shattered assumptions, also presenting a buffering effect between daily work stressors and daily shattered assumptions. Finally, dispositional obsessive passion showed positive relationships with both shattered assumptions and symptomatology, also presenting a boosting effect between daily work stressors and daily symptomatology. CONCLUSIONS: This study allows us to deepen our understanding of STS in ICUs and to boost preventive proposals. Practical implications are discussed.

Spanish validation of the short-form of the Avoidance and Fusion Questionnaire (AFQ-Y8) with children and adolescents.

The Avoidance and Fusion Questionnaire for Youth-Short Form (AFQ-Y8) was designed to measure psychological inflexibility in children and adolescents. However, it has not yet been validated to the Spanish population. The present study examines the factorial structure, internal consistency, convergent and incremental validity, and measurement invariance between children and adolescents, male and female, and male and female across age of the AFQ-Y8 with 982 students from Spain (children = 459, adolescents = 523). The results confirmed, in both children and adolescents, a unifactorial structure of general psychological inflexibility. AFQ-Y8 was positively related to negative psychological health outcomes, and negatively related to positive psychological health outcomes and acceptance-related skills, such as mindfulness. In addition, psychological inflexibility showed incremental validity in the explanation of negative psychological health over mindfulness. Measurement invariance across age and gender groups was supported, suggesting that the scores in the AFQ-Y8 are comparable between children and adolescents, and between males and females. In conclusion, results show that the Spanish version of the AFQ-Y8 is a reliable and valid measure of psychological inflexibility in children and adolescents. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Effects of Co-worker and Supervisor Support on Nurses' Energy and Motivation through Role Ambiguity and Psychological Flexibility.

One of the job resources most strongly associated with nurses' well-being and motivation is social support. However, the psychosocial mechanisms that would explain this relationship have not been sufficiently researched. Thus, the main aim of this study was analyze whether this relationship could be mediated by two variables: role ambiguity and psychological flexibility. A total of 196 nurses from various Spanish hospitals and primary health care centers participated in this cross-sectional study. A multiple mediation analysis was run using the "PROCESS" macro script in SPSS 23.0. The results showed that co-worker support was related to higher levels of vigor and vitality through role ambiguity (Estimate = .158, 95% CI [.050, .298], and Estimate = .212, 95% CI [.076, .390], respectively). The same applied to supervisor support, (Estimate = .197, 95% CI [.059, .378], and Estimate = .212, 95% CI [.076, .390], respectively). Co-worker support was also related to higher levels of vigor and vitality through psychological flexibility, (Estimate = .132, 95% CI [.048, .271], and Estimate = .216, 95% CI [.086, .394], respectively). The same applied to supervisor support (Estimate = .092, 95% CI [.024, .208], and Estimate = .157, 95% CI [.035, .333], respectively). However, in the relationships between co-worker, supervisor support and exhaustion, only psychological flexibility played a mediating role. In conclusion, social support in nursing is a job resource that is associated with high levels of energy and motivation among nurses through the mediating role of certain job demands and personal resources.

Incivility at work, upset at home? Testing the cross-level moderation effect of emotional dysregulation among female nurses from primary health care.

Workplace incivility is a growing problem in nursing. However, most studies that explore this psychosocial risk and its consequences do so considering a single level and a between-person perspective. The aims of the study were to explore whether the effects of experiencing incivility during work-time could explain the daily levels of well-being of nurses at home; and to analyze if that relationship could be moderated by their levels of emotional dysregulation as a trait. This is a multilevel study with diary methodology. The study was carried out in 18 primary health-care centers belonging to Madrid and the Basque Country, in Spain. Ninety-four nurses completed a general questionnaire and 54 of them a diary booklet over five consecutive working days in two different moments, immediately after work and at bedtime. The results showed that nurses' emotional dysregulation moderated the relationship between daily workplace incivility and daily fatigue, and positive affect at night at home. However, there were no direct effects of daily incivility on these outcome variables. In conclusion, the presence of difficulties in emotional regulation among nurses can increase the negative effects of daily workplace incivility on their health and well-being.

Effects of co-worker and supervisor support on nurses' energy and motivation through role ambiguity and psychological flexibility

One of the job resources most strongly associated with nurses' well-being and motivation is social support. However, the psychosocial mechanisms that would explain this relationship have not been sufficiently researched. Thus, the main aim of this study was analyze whether this relationship could be mediated by two variables: role ambiguity and psychological flexibility. A total of 196 nurses from various Spanish hospitals and primary health care centers participated in this cross-sectional study. A multiple mediation analysis was run using the "PROCESS" macro script in SPSS 23.0. The results showed that co-worker support was related to higher levels of vigor and vitality through role ambiguity (Estimate = .158, 95% CI [.050, .298], and Estimate = .212, 95% CI [.076, .390], respectively). The same applied to supervisor support, (Estimate = .197, 95% CI [.059, .378], and Estimate = .212, 95% CI [.076, .390], respectively). Co-worker support was also related to higher levels of vigor and vitality through psychological flexibility, (Estimate = .132, 95% CI [.048, .271], and Estimate = .216, 95% CI [.086, .394], respectively). The same applied to supervisor support (Estimate = .092, 95% CI [.024, .208], and Estimate = .157, 95% CI [.035, .333], respectively). However, in the relationships between co-worker, supervisor support and exhaustion, only psychological flexibility played a mediating role. In conclusion, social support in nursing is a job resource that is associated with high levels of energy and motivation among nurses through the mediating role of certain job demands and personal resources

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Estrés y bienestar en profesionales de enfermería intensiva dentro del ámbito de la donación y el trasplante de órganos: una propuesta desde la psicología de la salud ocupacional / Stress and well-being in nursing professionals of intensive care within the organ donation and transplantation field: a proposal from the occupational health psychology

Los profesionales de enfermería que trabajan en unidades de cuidados intensivos y que participan en las actividades relacionadas con la donación y trasplante de órganos están expuestos a un número importante de estresores en su trabajo, lo que favorece la aparición de determinados riesgos psicosociales como son el estrés laboral, el desgaste profesional, el trabajo emocional, el estrés traumático secundario, el estrés moral y el conflicto entre el trabajo y la familia. Además, los nuevos escenarios que se presentan y van consolidando en nuestro país en relación a la donación de órganos, como son la donación en asistolia controlada y no controlada, o los cuidados intensivos orientados a la donación, generan nuevas situaciones y estresores a estos profesionales que aumentan su exposición al riesgo psicosocial en su trabajo. Por todo ello, aquí llevamos a cabo una revisión y propuesta de las demandas específicas y las causas que podrían influir en el desarrollo de estos riesgos entre estos profesionales, así como sus posibles consecuencias. También se proponen una serie de recursos laborales y personales que podrían ser útiles para afrontar las demandas laborales y que satisfacen muchas de las necesidades apuntadas por organismos de referencia en éste ámbito para la prevención y promoción de la salud y bienestar dentro de este colectivo, así como para la mejora del proceso de donación y trasplante de órganos

Nursing professionals who work in intensive care units and participate in activities related to organ donation and transplantation are exposed to a significant number of stressors their work, which favors the appearance of certain psychosocial risks such as work stress, burnout, secondary traumatic stress, moral stress, and the conflict between work and family. In addition, the new scenarios in our country in relation to organ donation, such as uncontrolled and controlled donation after cardiac death, or the intensive cares oriented to organ donation, generate new situations and stressors among these professionals that increase their exposure to psychosocial risks. Therefore, this paper reviews and proposes the specific demands and causes that could influence the development of these risks these professionals, as well as their possible consequences. It also proposes a series of job and personal resources that could be useful to these workers to face these job demands. These proposals meet many of the needs pointed by reference institutions in this field to prevention and promotion of health and well-being in this group of professionals, as well as to improve the process of organ donation and transplantation

Diagnóstico de muerte encefálica en víctimas de accidentes: análisis del proceso / Diagnóstico de morte encefálica em vítimas de acidentes: análise do proceso / Brain death diagnosis in victims of traffic accidents: process analysis

Objetivo: Las víctimas de las causas externas de trauma, causadas ya sea por accidentes de tránsito o por la violencia en general, son en su mayoría jóvenes que evolucionan a muerte encefálica y posibles donantes. Teniendo en cuenta que el tiempo para determinar la muerte encefálica puede interferir en la calidad de los órganos ofrecidos, el propósito de este estudio fue analizar el período del proceso de diagnóstico de muerte encefálica. Material y métodos: Es un estudio descriptivo retrospectivo sobre el proceso de diagnóstico de muerte encefálica y su duración en pacientes víctimas mortales por causas externas de traumatismo en una ciudad del noroeste de Paraná, Brasil, desde enero a diciembre de 2012. Resultados: El promedio de tiempo para el período entre la confirmación del coma y el protocolo inicial para la determinación de la muerte encefálica en los cuatro hospitales fue de 18.90 ± 13.62 horas; el promedio de cierre del protocolo con Examen Complementario para los cuatro hospitales estudiados fue de 12 ± 8 horas, y el cierre con prueba clínica indicó 10 ± 6 horas. Conclusión: Los datos presentados describen una falla en todo el proceso de muerte encefálica, desde la detección de coma hasta el cierre del protocolo de diagnóstico de muerte encefálica, lo que aumenta considerablemente el tiempo de diagnóstico

As vítimas de causas externas por traumas, seja por acidentes de trânsito ou violência em geral, são em sua maioria jovens que evoluem para morte encefálica tornando-se potenciais doadores. Considerando que o tempo de determinação de morte encefálica pode interferir na qualidade dos órgãos ofertados, o objetivo deste estudo foi analisar o tempo do processo de determinação de morte encefálica. Trata-se de um estudo retrospectivo e descritivo sobre o processo de determinação de morte encefálica e sua duração, em pacientes vítimas fatais por causas externas ocasionadas por traumas, em um município do Noroeste do Paraná Brasil, no período de janeiro a dezembro de 2012. A média de tempo entre período compreendido entre a constatação do coma e início do protocolo de determinação de morte encefálica, nos quatro hospitais analisados foi de 18,90±13,62 horas e a média de encerramento do protocolo com Exame Complementar dos quatro hospitais estudados foi de 12±8 horas e do encerramento com prova clínica foi de 10±6 horas. Os dados apresentados descrevem uma falha em todo o processo de morte encefálica, desde a detecção do coma até a finalização do protocolo de determinação de morte encefálica, aumentando consideravelmente o período de tempo de seu diagnóstico

Objective: Victims of external causes of trauma, caused either by traffic accidents or by violence in general, are mostly youngsters who evolve to brain death and potential donors. Considering that the time to determine brain death may interfere on the quality of the offered organs, the purpose of this study was to analyze the period of brain death diagnosis process. Material and Methods: It is a retrospective, descriptive study on brain death diagnosis process and its duration in patients who are fatal victims due to external causes of trauma in a city in the Northwest of Paraná, Brazil, ranging from January to December 2012. Results: The average of time for the period between the coma confirmation and the initial protocol for brain death determination in the four hospitals consisted of 18.90±13.62 hours; the average of protocol closure with Complementary Examination for the four studied hospitals consisted of 12±8 hours, and closure with clinical proof indicated 10±6 hours. Conclusion: The data presented describe a failure in the entire brain death process, since coma detection until brain death diagnosis protocol closure, considerably increasing diagnosis time