Patterns of change of multisite pain over 1 year of follow-up and related risk factors.

BACKGROUND: Multisite musculoskeletal pain is common and disabling. This study aimed to prospectively investigate the distribution of musculoskeletal pain anatomically, and explore risk factors for increases/reductions in the number of painful sites. METHODS: Using data from participants working in 45 occupational groups in 18 countries, we explored changes in reporting pain at 10 anatomical sites on two occasions 14 months apart. We used descriptive statistics to explore consistency over time in the number of painful sites, and their anatomical distribution. Baseline risk factors for increases/reductions by ≥3 painful sites were explored by random intercept logistic regression that adjusted for baseline number of painful sites. RESULTS: Among 8927 workers, only 20% reported no pain at either time point, and 16% reported ≥3 painful sites both times. After 14 months, the anatomical distribution of pain often changed but there was only an average increase of 0.17 painful sites. Some 14% workers reported a change in painful sites by ≥3. Risk factors for an increase of ≥3 painful sites included female sex, lower educational attainment, having a physically demanding job and adverse beliefs about the work-relatedness of musculoskeletal pain. Also predictives were as follows: older age, somatizing tendency and poorer mental health (each of which was also associated with lower odds of reductions of ≥3 painful sites). CONCLUSIONS: Longitudinally, the number of reported painful sites was relatively stable but the anatomical distribution varied considerably. These findings suggest an important role for central pain sensitization mechanisms, rather than localized risk factors, among working adults. SIGNIFICANCE: Our findings indicate that within individuals, the number of painful sites is fairly constant over time, but the anatomical distribution varies, supporting the theory that among people at work, musculoskeletal pain is driven more by factors that predispose to experiencing or reporting pain rather than by localized stressors specific to only one or two anatomical sites.

Problemas de salud enfermedad generados por el proceso de trabajo de la enfermería docente

RESUMEN Objetivo: Captar los problemas de salud enfermedad generados por el proceso de trabajo Enfermero Docente. Material y Método: Estudio descriptivo, exploratorio, cualitativo, desarrollado con enfoque en epidemiología crítica, realizado en una Escuela de Enfermería chilena. Los sujetos de investigación corresponden a 17 enfermeros docentes, se les realizaron entrevistas individuales semiestructuradas hasta la saturación del objeto de estudio. Se estableció categoría previa conforme a la literatura, planteando pregunta guía: ¿Qué problemas de salud relacionados al trabajo enfermero docente sufre usted? Se realizó análisis de contenido según Bardin. Para asegurar la validez de la investigación se siguieron los criterios de rigor de Guba y Lincoln, y se contó con la aprobación del Comité de Ética de la institución universitaria. Resultados: Frente a categoría Problemas de Salud Enfermedad emergen dos subcategorías: Subcategoría necesidades básicas con tres temas: cansancio y privación de sueño, malos hábitos de autocuidado y alimentación inadecuada, insatisfacción y desmotivación en el proceso de trabajo docente de enfermería; Subcategoría enfermedades manifestadas con dos temas: disturbios osteomusculares relacionados al trabajo y estrés. Conclusiones: El desarrollo del proceso de trabajo enfermero docente genera problemas de salud perjudiciales para el trabajador que impactan negativamente en su vida, llegando a producir patologías. Su identificación permite mejorar las condiciones de trabajo en la docencia en enfermería.

ABSTRACT Objective: To assess the health problems and diseases caused by the work process of the Nurse Educator. Material and Method: Descriptive, exploratory, qualitative study, developed with a focus on critical epidemiology, carried out in a School of Nursing in Chile. The research subjects consisted of 17 nurse educators who underwent individual semi-structured interviews until reaching data saturation. A previous category was established according to the literature, posing the question: What health problems related to the nursing teaching work do you suffer from? Content analysis was performed according to Bardin. To ensure the validity of the research, the rigor criteria of Guba and Lincoln were followed, and the approval of the Ethics Committee of the university was obtained. Results: Regarding the category health problems and diseases two subcategories emerged: The first subcategory related to "basic needs" includes three areas: fatigue and sleep deprivation, bad self-care habits and inadequate nutrition, dissatisfaction, and lack of motivation in the nursing teaching work process. The second subcategory "diseases" includes two areas: work-related musculoskeletal disorders and stress. Conclusions: The nursing teaching work process causes serious health problems for the worker that negatively impact their life and can even lead to pathologies. It is crucial to identify these problems in order to improve working conditions in the nursing teaching field.

RESUMO Objetivo: Captar os agravos à saúde gerados pelo processo de trabalho docente do enfermeiro. Material e Método: Estudo descritivo, exploratório, qualitativo, desenvolvido com enfoque na epidemiologia crítica, realizado em uma Escola de Enfermagem do Chile. Os sujeitos da pesquisa correspondem a 17 enfermeiras docentes, foram realizadas entrevistas individuais semiestruturadas até a saturação do objeto de estudo. Uma categoria anterior foi estabelecida de acordo com a literatura, que suscita uma questão norteadora: Quais são os problemas de saúde relacionados ao trabalho docente em enfermagem que você sofre? A análise de conteúdo foi realizada segundo Bardin. Para garantir a validade da pesquisa, foram seguidos os rigorosos critérios de Guba e Lincoln, que foi aprovada pelo Comitê de Ética da universidade. Resultados: Frente à categoria Problemas de Saúde Doença, emergem duas subcategorias: Subcategoria Necessidades básicas com três temas: fadiga e privação do sono, maus hábitos de autocuidado e alimentação inadequada, insatisfação e desmotivação no processo de trabalho docente em enfermagem; a subcategoria doenças manifestou-se com dois temas: distúrbios musculoesqueléticos relacionados ao trabalho e estresse. Conclusões: O desenvolvimento do processo de trabalho docente em enfermagem gera problemas à saúde do trabalhador que impactam negativamente em sua vida, gerando patologias. Sua identificação possibilita a melhoria das condições de trabalho no ensino de enfermagem.

Burnout among nurses: a multicentric comparative study.

OBJETIVO: to identify and compare burnout levels between Portuguese, Spanish and Brazilian nurses. METHOD: quantitative, descriptive, correlational, comparative and cross-sectional study conducted using a sample of 1,052 nurses working in hospitals and primary care centers. A sociodemographic questionnaire and the Maslach Burnout Inventory were applied to nurses in Porto, Portugal (n=306), Oviedo, Spain (n=269) and S. Paulo, Brazil (n=477). Data analysis was performed using descriptive, inferential and multivariate analysis. RESULTS: approximately 42% of the nurses showed moderate/high levels of burnout, with no differences found between countries (Portugal and Brazil 42%, Spain 43%). Only depersonalization showed differences between countries, presenting Spain the highest level and Portugal the lowest one. Comparative analysis showed higher burnout levels in young nurses and those working by shifts. Considering job schedules, burnout was associated to shift work in Portugal, while in Spain and Brazil it was associated with fixed schedules. CONCLUSION: these results suggest that this syndrome among nurses is a global phenomenon. The daily stressors and higher demands of the nursing profession are crucial in the preparation of nurses to deal with complex situations, to avoid burnout, and to reduce the negative impact on nurses' health and on the quality of care they provide.

Factores generadores de calidad de vida en el trabajo del enfermero docente / Factors that Make up Quality of Life in the Work of Teaching Nurses

Introducción: La calidad de vida de cada grupo trabajador se da conforme a su inserción social, por medio de la reproducción social, que produce factores protectores y destructivos para la salud, modelando el perfil epidemiológico. Objetivo: Captar los factores generadores de calidad de vida referida por los enfermeros docentes según los procesos favorables y destructivos que conforman el perfil epidemiológico. Métodos: Estudio cualitativo desarrollado con enfoque en epidemiología crítica, realizado en una Escuela de Enfermería en Chile. Los sujetos de investigación corresponden a 17 enfermeros docentes, se les realizaron entrevistas individuales semiestructuradas hasta la saturación del fenómeno. Resultados: Perfil epidemiológico. Factores favorecedores: relación con estudiantes, satisfacción personal, medios que ofrece la institución, actividades saludables, apoyo económico e infraestructura, desarrollo profesional, libertad de cátedra, tener un objetivo común, compromiso docente, trabajo en equipo y sentimientos de trascendencia. Factores destructivos: falta de infraestructura y materiales, tiempo para desarrollar actividades docentes, extensa jornada y sobrecarga, ocupación del tiempo de descanso, tiempo de desplazamiento, demandas en la interacción con estudiantes, falta de introducción docente, ruidos en la comunicación, distribución de carga, remuneración, multiplicidad de tareas, dificultades en la enseñanza teórica y práctica. Conclusiones: Se establece el perfil epidemiológico de los enfermeros docentes de una Escuela de Enfermería en una Universidad Pública, identificando los factores generadores de calidad de vida que deben ser abordados para mejorar la vida de las personas(AU)

Introduction: The quality of life of each working group occurs according to its social insertion, through social reproduction, which produces protective and destructive factors for health, modeling the epidemiological profile. Objective: To identify the factors that generate quality of life referred by teaching nurses in accordance with the favorable and destructive processes that make up the epidemiological profile. Methods: Qualitative study developed with a focus on critical epidemiology, carried out at a School of Nursing in Chile. The research subjects were seventeen teaching nurses, who were conducted individual semistructured interviews until the phenomenon was saturated. Results: The epidemiological profile was obtained. The favorable factors identified are relationship with students, personal satisfaction, means offered by the institution, healthy activities, financial support and infrastructure, professional development, faculty freedom, having a common goal, teaching commitment, teamwork, and feelings of importance. The destructive factors identified are lack of infrastructure and materials, time to develop teaching activities, long hours and overload, occupation of rest time, travel time, demands on interaction with students, lack of teaching involvement, communication noises, load distribution, remuneration, multiplicity of tasks, and difficulties in theoretical or practical teaching. Conclusions: The epidemiological profile of the teaching nurses of a School of Nursing in a public university is established, which allowed identifying the factors that generate quality of life and must be addressed to improve people's lives(AU)

Burnout among nurses: a multicentric comparative study / Burnout entre enfermeiros: um estudo multicêntrico comparativo / Burnout entre enfermeros: un estudio multicéntrico comparativo

Objetivo: to identify and compare burnout levels between Portuguese, Spanish and Brazilian nurses. Method: quantitative, descriptive, correlational, comparative and cross-sectional study conducted using a sample of 1,052 nurses working in hospitals and primary care centers. A sociodemographic questionnaire and the Maslach Burnout Inventory were applied to nurses in Porto, Portugal (n=306), Oviedo, Spain (n=269) and S. Paulo, Brazil (n=477). Data analysis was performed using descriptive, inferential and multivariate analysis. Results: approximately 42% of the nurses showed moderate/high levels of burnout, with no differences found between countries (Portugal and Brazil 42%, Spain 43%). Only depersonalization showed differences between countries, presenting Spain the highest level and Portugal the lowest one. Comparative analysis showed higher burnout levels in young nurses and those working by shifts. Considering job schedules, burnout was associated to shift work in Portugal, while in Spain and Brazil it was associated with fixed schedules. Conclusion: these results suggest that this syndrome among nurses is a global phenomenon. The daily stressors and higher demands of the nursing profession are crucial in the preparation of nurses to deal with complex situations, to avoid burnout, and to reduce the negative impact on nurses' health and on the quality of care they provide.

Objetivo: identificar e comparar os níveis de burnout entre enfermeiros portugueses, espanhóis e brasileiros. Método: estudo quantitativo, descritivo, correlacional, comparativo e transversal, realizado com 1.052 enfermeiros em hospitais e unidades básicas de saúde. Um questionário sociodemográfico e o Maslach Burnout Inventory foram aplicados com enfermeiros de Porto-Portugal (n=306), Oviedo-Espanha (n=269) e São Paulo-Brasil (n=477). Os dados foram analisados por meio de estatística descritiva, inferencial e multivariada. Resultados: aproximadamente 42% dos enfermeiros apresentaram níveis moderados/altos de burnout, não sendo encontradas diferenças entre os países (Portugal e Brasil com 42%, Espanha com 43%). Apenas a dimensão despersonalização apresentou diferenças entre os países, com um nível mais elevado na Espanha e mais baixo em Portugal. A análise comparativa mostrou níveis mais elevados de burnout em enfermeiros jovens e naqueles que trabalhavam em turnos. Em relação às escalas de trabalho, burnout foi associada ao trabalho por turnos em Portugal e aos horários fixos na Espanha e no Brasil. Conclusão: esses resultados sugerem que essa síndrome em enfermeiros é um fenômeno global. Estressores diários e maiores demandas da profissão de enfermagem são elementos cruciais para preparar os enfermeiros para lidar com situações complexas, evitar burnout e reduzir o impacto negativo na sua saúde e na qualidade dos cuidados que prestam.

Objetivo: identificar y comparar los niveles de burnout entre enfermeros portugueses, españoles y brasileños. Método: estudio cuantitativo, descriptivo, correlacional, comparativo y transversal, realizado con 1.052 enfermeros de hospitales y unidades básicas de salud. Se aplicó un cuestionario sociodemográfico y el Maslach Burnout Inventory a enfermeras de Porto, Portugal (n=306), Oviedo, España (n=269) y São Paulo, Brasil (n=477). Los datos se analizaron mediante estadística descriptiva, inferencial y multivariada. Resultados: aproximadamente el 42% de los enfermeros presentaban niveles moderados/altos de burnout y no se encontraron diferencias entre países (Portugal y Brasil 42%, España 43%). Solo la dimensión de despersonalización mostró diferencias entre países, con un nivel mayor en España y menor en Portugal. El análisis comparativo mostró mayores niveles de burnout en enfermeros jóvenes y en los que trabajaban por turnos. En cuanto a los horarios de trabajo, el burnout se asoció con el trabajo por turnos en Portugal y con horario fijo en España y Brasil. Conclusión: estos resultados sugieren que el síndrome de burnout en enfermeros es un fenómeno global. Los estresores cotidianos y las mayores exigencias de la profesión de Enfermería son elementos cruciales para preparar a los enfermeros para enfrentar situaciones complejas, evitar el burnout y reducir el impacto negativo en la salud de los enfermeros y la calidad de la atención que brindan.

Presenteeism in nurses: comparative study of Spanish, Portuguese and Brazilian nurses.

AIM: To compare presenteeism levels among three samples of nurses and to identify the relationship between presenteeism and sociodemographic and professional characteristics. BACKGROUND: Presenteeism (going to work ill) is a phenomenon studied from different perspectives, and it has become especially important during the current COVID-19 outbreak; its connection to high healthcare costs, patient safety breaches and negative nurse well-being has been proved. INTRODUCTION: The nursing profession is particularly associated with caring for the culture of teamwork, loyalty to colleagues and professional identity. This condition enhances the 'super nurse phenomenon', even though nurses do not feel physically and psychologically able to work. METHODS: A multicentre, cross-sectional study was conducted in three different country contexts: Oviedo (Spain), Porto (Portugal) and São Paulo (Brazil). Nurses performing functions in hospitals and primary health care were enrolled. Informed consent and data collection questionnaires were hand delivered. The Stanford Presenteeism Scale-6 was applied. RESULTS: A total of 659 nurses participated. Portuguese nurses showed greater prevalence of presenteeism, followed by Brazilian and Spanish nurses. Younger nurses with less professional experience presented lower levels of presenteeism but greater psychological commitment. Male participants showed lower capacity to complete work when ill than female participants. CONCLUSIONS: Age and length of professional experience proved to be significant predictors of total presenteeism, although only professional experience revealed statistical significance in the adjusted model. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The knowledge of this phenomenon among nurses highlights the need for the development of strategies in the curriculum of nursing students and organizations. Resilience and ergonomic training should be applied in the training programmes of the students and reinforced by the health centre managers. It is essential that healthcare systems design worksite wellness programmes that pursue greater physical and mental well-being for healthcare professionals.

Associations of sickness absence for pain in the low back, neck and shoulders with wider propensity to pain.

OBJECTIVES: To explore the association of sickness absence ascribed to pain at specific anatomical sites with wider propensity to musculoskeletal pain. METHODS: As part of the CUPID (Cultural and Psychosocial Influences on Disability) study, potential risk factors for sickness absence from musculoskeletal pain were determined for 11 922 participants from 45 occupational groups in 18 countries. After approximately 14 months, 9119 (78%) provided follow-up information about sickness in the past month because of musculoskeletal pain, including 8610 who were still in the same job. Associations with absence for pain at specific anatomical sites were assessed by logistic regression and summarised by ORs with 95% CIs. RESULTS: 861 participants (10%) reported absence from work because of musculoskeletal pain during the month before follow-up. After allowance for potential confounders, risk of absence ascribed entirely to low back pain (n=235) increased with the number of anatomical sites other than low back that had been reported as painful in the year before baseline (ORs 1.6 to 1.7 for ≥4 vs 0 painful sites). Similarly, associations with wider propensity to pain were observed for absence attributed entirely to pain in the neck (ORs up to 2.0) and shoulders (ORs up to 3.4). CONCLUSIONS: Sickness absence for pain at specific anatomical sites is importantly associated with wider propensity to pain, the determinants of which extend beyond established risk factors such as somatising tendency and low mood. Better understanding of why some individuals are generally more prone to musculoskeletal pain might point to useful opportunities for prevention.

Calidad de vida laboral y estrategias de mejora del trabajo de la enfermería docente / Quality of working life and strategies for improving the work of nurse educators / Qualidade de vida no trabalho e estratégias para melhorar o trabalho do ensino de enfermagem

RESUMEN Objetivo: Identificar los factores laborales que influyen en la calidad de vida laboral de los enfermeros y enfermeras docentes y construir estrategias para mejorarla. Material y Método: Estudio descriptivo, exploratorio, cualitativo, desarrollado con enfoque de epidemiología crítica, realizado en una escuela de enfermería en Chile. Los sujetos de investigación corresponden a 17 enfermeras y enfermeros docentes, a los que se les realizaron entrevistas individuales semiestructuradas y 9 participaron en un grupo focal. Se contó con la aprobación del Comité de Ética de Investigación de la unidad académica. Resultados: Respecto a la categoría Calidad de vida se establecen las subcategorías: Relaciones humanas favorables, Ambiente favorable, Bienestar - Satisfacción y Estrés. En la categoría Estrategias de mejora, las subcategorías: Desde la empresa y Desde el trabajador. Conclusiones: Los enfermeros y enfermeras que se desempeñan en docencia ven afectada su calidad de vida por factores laborales, de tal forma que se deben establecer estrategias de mejora desde la empresa y el individuo.

ABSTRACT Objective: To identify the occupational factors affecting the quality of working life of nurse educators and design strategies to improve it. Material and Method: Descriptive, exploratory, qualitative study, developed with a focus on critical epidemiology, conducted at a nursing school in Chile. The research subjects corresponded to 17 nurse educators, who were given individual semi-structured interviews and 9 participated in a focus group. The research was approved by the Research Ethics Committee of the institution. Results: Regarding the category Quality of Life, the following subcategories were established: Positive Human Relations, Favorable Environment, Well-being/Satisfaction and Stress. In the category Improvement Strategies, the subcategories From the Employer and From the Worker emerged. Conclusions: Nurses who work as educators see their quality of life affected by occupational factors, so that improvement strategies are needed from the employing institution as well as from the worker.

RESUMO Objetivo: Identificar os fatores trabalhistas que influenciam a qualidade de vida no trabalho do professor enfermeiro e construir estratégias para melhorá-lo. Material e Método: Estudo descritivo, exploratório, qualitativo, desenvolvido com foco em epidemiologia crítica, realizado em uma Escola de Enfermagem do Chile. Os sujeitos da pesquisa correspondem a 17 docentes de enfermagem, que foram submetidos a entrevistas individuais semiestruturadas e nove participaram de um grupo focal. Foi obtida a aprovação do Comité de Ética em Pesquisa da unidade académica. Resultados: Em relação à categoria qualidade de vida, foram estabelecidas as subcategorias: relações humanas favoráveis, ambiente favorável, bem-estar - satisfação e estresse. Na categoria estratégias de melhoria, as subcategorias: Desde a empresa e Desde o trabalhador. Conclusões: Os enfermeiros que atuam no ensino veem sua qualidade de vida afetada pelos fatores de trabalho, de maneira que a dialética nesse trabalho exige o estabelecimento de estratégias de melhoria por parte da empresa e do indivíduo.

Determinants of international variation in the prevalence of disabling wrist and hand pain.

BACKGROUND: Previous research has indicated that wide international variation in the prevalence of disabling low back pain among working populations is largely driven by factors predisposing to musculoskeletal pain more generally. This paper explores whether the same applies to disabling wrist/hand pain (WHP). METHODS: Using data from the Cultural and Psychosocial Influences on Disability (CUPID) study, we focused on workers from 45 occupational groups (office workers, nurses and other workers) in 18 countries. Among 11,740 participants who completed a baseline questionnaire about musculoskeletal pain and potential risk factors, 9082 (77%) answered a further questionnaire after a mean interval of 14 months, including 1373 (15%) who reported disabling WHP in the month before follow-up. Poisson regression was used to assess associations of this outcome with baseline risk factors, including the number of anatomical sites other than wrist/hand that had been painful in the 12 months before baseline (taken as an index of general propensity to pain). RESULTS: After allowance for other risk factors, the strongest associations were with general pain propensity (prevalence rate ratio for an index ≥6 vs. 0: 3.6, 95% confidence interval 2.9-4.4), and risk rose progressively as the index increased. The population attributable fraction for a pain propensity index > 0 was 49.4%. The prevalence of disabling WHP by occupational group ranged from 0.3 to 36.2%, and correlated strongly with mean pain propensity index (correlation coefficient 0.86). CONCLUSION: Strategies to prevent disability from WHP among working populations should explore ways of reducing general propensity to pain, as well as improving the ergonomics of occupational tasks.

Gerenciamento intra-hospitalar dos resíduos químicos perigosos manuseados pela enfermagem / Intra-hospital management of hazardous chemical waste handled by nurses / Gestión intrahospitalaria de los residuos químicos peligrosos manejados por la enfermería

Objetivo: avaliar as etapas de gerenciamento dos resíduos químicos perigosos - formaldeído e ortoftaldeído, manuseados pela enfermagem. Método: pesquisa descritiva e coleta de dados realizada de setembro a dezembro de 2012, no Hospital Universitário da Universidade de São Paulo, por meio da aplicação da Ficha de Informação de Gerenciamento de Resíduo Químico Perigoso dos resíduos formaldeído e ortoftaldeído gerados, respectivamente, no centro obstétrico e endoscopia. Projeto aprovado por Comitê de Ética em Pesquisa. Resultados: a análise estatística dos dados evidenciou que foram atendidas 3 (13%) especificações do total de 23 (100%) necessárias, com prevalência da identificação, seguida da segregação e nenhuma do transporte interno dos resíduos. Há necessidade de a instituição cumprir as especificações de identificações gerais em relação ao número total de avaliações nos recipientes de resíduos de formaldeído e ortoftaldeído. Conclusão: esta pesquisa proporcionou importantes diretrizes para a elaboração do Plano de Gerenciamento de Resíduos Químicos Perigosos da atenção hospitalar.

Objective: to evaluate the stages in management of hazardous chemical waste handled by nursing staff. Method: in this descriptive study, data was collected from September to December 2012 at São Paulo University Hospital, by applying the Hazardous Chemical Waste Management Information Sheet for formaldehyde and ortho-phthalaldehyde waste in the obstetric center and endoscopy, respectively. The study was approved by the research ethics committee. Results: data analysis showed that 3 (13%) of the 23 (100%) required specifications were met, predominantly identification, followed by segregation, and that none on internal waste transportation were met. The institution needs to comply with general identification specifications regarding the total number of evaluations of formaldehyde and orthophthaldehyde waste containers. Conclusion: this study also yielded important guidelines for preparation of the hospital care Hazardous Chemical Waste Management Plan.

Objetivo: evaluar las etapas de la gestión de los residuos químicos peligrosos - formaldehído y ortoftaldehído, manejados por la enfermería. Métodos: investigación descriptiva y recolección de datos realizada, de septiembre a diciembre de 2012, en el Hospital Universitario de la Universidad de São Paulo, por medio de la aplicación de la Ficha de Información de Gestión de Residuo Químico Peligroso de los residuos de formaldehído y ortoftaldehído generados, respectivamente, en el Centro de Obstetricia y Endoscopía. Proyecto aprobado por el Comité de Ética en Investigación. Resultados: el análisis estadístico de los datos mostró que fueron atendidas 3 (13%) especificaciones del total de 23 (100%) requeridas, con prevalencia de la identificación, seguida por la segregación y ninguna relacionada al transporte interno de los residuos. Es necesario que la institución cumpla con las especificaciones de identificaciones generales en relación al número total de evaluaciones en los recipientes de residuos de formaldehído y ortoftaldehído. Conclusión: la investigación proporcionó importantes directrices para la elaboración del Plan de Gestión de Residuos Químicos Peligrosos de la atención hospitalaria.

Absenteeism due to musculoskeletal disorders in Brazilian workers: thousands days missed at work. / Absenteísmo por distúrbios musculoesqueléticos em trabalhadores do Brasil: milhares de dias de trabalho perdidos.

OBJECTIVE: To describe and analyze the absenteeism of Brazilian workers notified with musculoskeletal disorders, from 2007 to 2012. METHODS: This is a quantitative, cross-sectional and descriptive study, including retrospective and secondary data. The records came from the Information System of Notifiable Diseases, which notifies workers on a social security system, as well as informal workers. The study lasted for six years. We analyzed sociodemographic, work organization and injury variables. RESULTS: There were approximately 5 million working days lost for 18,611 workers who were notified and removed from the position. The groups that stood out in the analysis were the illiterate people, in the age group of 50 to 59 years, with daily working hours higher than 6 hours, from the great occupational group 4, the ICD-10 M50 and M51, and workers with mental disorders. CONCLUSIONS: High absenteeism among workers with musculoskeletal disorders, illiterate, aged from 50 to 59 years, administrative service workers, ICD-10 M51 and workers with mental disorders. It is necessary to outline public policies that contemplate the absenteeism caused by the disease, in order to reduce morbidity, as well as the socioeconomic losses.

Presenteeism and musculoskeletal symptoms among nursing professionals.

OBJECTIVE: to identify the prevalence of musculoskeletal symptoms in two stages (before and after six months of the first stage) and its association with presenteeism among nursing professionals. METHOD: longitudinal study with quantitative data conducted in a Brazilian teaching hospital with 211 nursing professionals. The instruments used for data collection were: Cultural and Psychosocial Influences on Disability - CUPID Questionnaire, used to identify the musculoskeletal symptoms and the Stanford Presenteeism Scale, used to verify presenteeism. The instruments were validated for Brazilian Portuguese. The study was approved by the Human Research Ethics Committee. Descriptive statistics, Mann Whitney test and regression analysis were used to analyze the data. RESULTS: 158 (74.9%) professionals experienced presenteeism and 151 (71.6%) reported low back pain as musculoskeletal symptom. Professionals with low back pain had lower scores on the presenteeism scale and shoulder pain was related to loss of concentration during work. CONCLUSION: presenteeism lead to a reduction in work performance and was manifested in the presence of musculoskeletal symptoms. In addition, shoulder pain caused loss of concentration at work.

Presenteeism and musculoskeletal symptoms among nursing professionals / Presenteísmo e sintomas musculoesqueléticos entre trabalhadores de enfermagem / Presentismo y síntomas musculoesqueléticos entre trabajadores de enfermería

To identify the prevalence of musculoskeletal symptoms in two stages (before and after six months of the first stage) and its association with presenteeism among nursing professionals. Method: longitudinal study with quantitative data conducted in a Brazilian teaching hospital with 211 nursing professionals. The instruments used for data collection were: Cultural and Psychosocial Influences on Disability - CUPID Questionnaire, used to identify the musculoskeletal symptoms and the Stanford Presenteeism Scale, used to verify presenteeism. The instruments were validated for Brazilian Portuguese. The study was approved by the Human Research Ethics Committee. Descriptive statistics, Mann Whitney test and regression analysis were used to analyze the data. Results: 158 (74.9%) professionals experienced presenteeism and 151 (71.6%) reported low back pain as musculoskeletal symptom. Professionals with low back pain had lower scores on the presenteeism scale and shoulder pain was related to loss of concentration during work. Conclusion: presenteeism lead to a reduction in work performance and was manifested in the presence of musculoskeletal symptoms. In addition, shoulder pain caused loss of concentration at work.

Identificar as prevalências de sintomas musculoesqueléticos em duas etapas (antes e após seis meses da primeira etapa) e sua associação com o presenteísmo entre trabalhadores de enfermagem. Método: estudo longitudinal com abordagem quantitativa dos dados desenvolvido em um hospital de ensino brasileiro com 211 trabalhadores de enfermagem. Os instrumentos utilizados para a coleta de dados foram o Cultural and Psychosocial Influences on Disability - CUPID Questionnaire, para identificar os sintomas musculoesqueléticos e a Stanford Presenteeism Scale, para verificar o presenteísmo. Os respectivos instrumentos foram validados para a língua portuguesa falada no Brasil. O estudo foi aprovado pelo comitê de ética em pesquisa com seres humanos. Para a análise dos dados, foi utilizada a estatística descritiva, teste Mann Whitney e análise de regressão. Resultados: 158 (74,9%) trabalhadores apresentaram presenteísmo e 151 (71,6%) referiram como sintoma musculoesquelético a dor lombar. Os trabalhadores com dor lombar apresentaram menor pontuação na escala do presenteísmo. A dor no ombro estava relacionada à perda de concentração durante o trabalho. Conclusão: o presenteísmo ocasionou redução no desempenho do trabalho, manifestou-se na presença dos sintomas musculoesqueléticos e a dor no ombro causou perda de concentração no trabalho.

Identificar la prevalencia de síntomas musculoesqueléticos en dos etapas (antes y después de seis meses de la primera etapa) y su asociación con el presentismo entre trabajadores de enfermería. Método: estudio longitudinal con abordaje cuantitativo de los datos, realizado en un hospital brasileño de enseñanza, entre 211 trabajadores de enfermería. Los instrumentos utilizados para la colecta de datos fueron: el cuestionario Cultural and Psychosocial Influences on Disability - CUPID, para identificar los síntomas musculoesqueléticos y la Escala Stanford Presenteeism, para comprobar el presentismo. Los respectivos instrumentos se validaron al portugués brasileño. El comité de ética de investigación científica con seres humanos aprobó el estudio. Se utilizó la estadística descriptiva para el análisis de los datos, la prueba de Mann Whitney y el análisis de regresión. Resultados: 158 (74,9%) trabajadores demostraban presentismo y 151 (71,6%) se refirieron al dolor lumbar como síntoma musculoesquelético. Los trabajadores con dolor lumbar presentaban puntuación menor en la escala del presentismo y el dolor en el hombro estaba relacionado con la pérdida de concentración durante el trabajo. Conclusión: el presentismo ocasionó reducción en el desempeño del trabajo, se manifestó en la presencia de los síntomas musculoesqueléticos y el dolor en el hombro causó pérdida de concentración en el trabajo.

Absenteísmo por distúrbios musculoesqueléticos em trabalhadores do Brasil: milhares de dias de trabalho perdidos / Absenteeism due to musculoskeletal disorders in Brazilian workers: thousands days missed at work

RESUMO: Objetivo: Descrever e analisar o absenteísmo dos trabalhadores do Brasil notificados com distúrbios musculoesqueléticos, do período de 2007 a 2012. Métodos: Estudo quantitativo, transversal e descritivo, com dados retrospectivos e secundários. Os registros foram do Sistema de Informação de Agravos de Notificação, que notifica trabalhadores em regime de previdência, bem como os informais. O período do estudo foi de seis anos. As variáveis foram: sociodemográficas, organizacionais do trabalho e específicas do agravo. Resultados: Foram aproximadamente 5 milhões de dias perdidos de trabalho, de 18.611 trabalhadores afastados e notificados com o agravo. Os grupos que mais se destacaram na análise foram os analfabetos, na faixa etária dos 50 aos 59 anos, com carga horária diária de trabalho acima de 6 horas, do grande grupo ocupacional 4, os CID-10 M50 e M51 e os trabalhadores com transtornos mentais. Conclusões: Elevado absenteísmo entre os trabalhadores com distúrbios musculoesqueléticos, analfabetos, idade dos 50 aos 59 anos, trabalhadores de serviços administrativos, CID-10 M51 e trabalhadores com transtornos mentais. Há necessidade de traçar políticas públicas que contemplem o absenteísmo causado pelo agravo, a fim de reduzir a morbidade, bem como os prejuízos socioeconômicos.

ABSTRACT: Objective: To describe and analyze the absenteeism of Brazilian workers notified with musculoskeletal disorders, from 2007 to 2012. Methods: This is a quantitative, cross-sectional and descriptive study, including retrospective and secondary data. The records came from the Information System of Notifiable Diseases, which notifies workers on a social security system, as well as informal workers. The study lasted for six years. We analyzed sociodemographic, work organization and injury variables. Results: There were approximately 5 million working days lost for 18,611 workers who were notified and removed from the position. The groups that stood out in the analysis were the illiterate people, in the age group of 50 to 59 years, with daily working hours higher than 6 hours, from the great occupational group 4, the ICD-10 M50 and M51, and workers with mental disorders. Conclusions: High absenteeism among workers with musculoskeletal disorders, illiterate, aged from 50 to 59 years, administrative service workers, ICD-10 M51 and workers with mental disorders. It is necessary to outline public policies that contemplate the absenteeism caused by the disease, in order to reduce morbidity, as well as the socioeconomic losses.

Work process of nursing professors.

OBJECTIVE: to analyze the work process of nursing professors. METHOD: descriptive, exploratory and qualitative study, developed with a focus on critical epidemiology, carried out at a School of Nursing in Chile. The research subjects consist of 17 nursing professors, with whom individual semi-structured interviews were carried out and nine participated in a focus group. The Ethics Committee approved this study. RESULTS: 88.2% were female, mean age of 42 years, 47% were married, 94% were Chilean, average length of service in the institution of 2.8 years, and 23.5% had a master's degree. Regarding the work process, the students were the work object, the tools used were the knowledge and the experience as a nurse, and the work environment was considered good. Regarding the form of work organization, 76% have a 44-hour workweek, the wage was considered inadequate and the workload was higher than foreseen in the contract. The dialectic of the nursing work process is evidenced, demonstrating the contradiction between the low wages and labor overload and the narratives reporting a good work environment, personal fulfillment and transcendence that goes far beyond work. CONCLUSIONS: the work process allows describing the work components of the nursing professors, which are consistent with the results of the literature and show the dialectic of the nursing work process.

O absenteísmo entre os trabalhadores de saúde de um hospital público do sul do Brasil / El absentismo entre los trabajadores de salud de un hospital público en el sur de Brasil / The absenteeism among health workers in a public hospital at south region of Brazil

Caracterizar o perfil de adoecimento dos trabalhadores de saúde e seu absenteísmo, em um hospital público na região sul do Brasil. Método: descritivo, quantitativo e retrospectivo, no qual foi avaliado o absenteísmo referente ao ano de 2013, captado pela ferramenta "Sistema de Monitoramento da Saúde do Trabalhador de Enfermagem”. Resultados: o perfil dos trabalhadores afastados em sua maioria era do sexo do trabalho, totalizando 4.619 dias perdidos. Observou-se a prevalência de doenças do sistema osteomuscular (16,4%), sendo a mais frequente a dorsalgia (7,14%). Conclusão: a partir dos resultados, faz-se necessário o acompanhamento e verificação dos indicadores de absenteísmo para estabelecer estratégias que visem a sua redução. Oabsenteísmo-doença é um importante indicador da saúde do trabalhador decorrente de múltiplos fatores.

Characterize an illness profile of health care workers and their absenteeism, in a public hospital in the south region ofBrazil. Method: descriptive, quantitative and retrospective, which was evaluated the absenteeism regarding the year 2013, a toolcalled “Monitoring System of Nursing Worker Health” collected the data. Results: the retired workers profile was mostly female,from nursing category, celetista work scheme and between the 21- 30 years age group. During this period, 2.309 retirements fromwork were registered, totaling 4619 workdays lost. There was a prevalence of musculoskeletal system diseases (16,4%), being themost frequent the upper back pain (7,14%). Conclusion: from the results it is necessary monitoring and verification of absenteeismindicators to establish strategies for their reduction. The sickness absenteeism is an important indicator of the workers’ healtharising from multiple factors.

Caracterizar el patrón de la enfermedad entre los trabajadores de salud y su absentismo en un hospital público en el surde Brasil. Metodo: descriptivo, cuantitativo y retrospectivo, que se evaluó el absentismo para el año 2013, capturado por lafunción" Vigilancia Trabajador Enfermería de Salud del sistema". Resultados: el perfil de los trabajadores de distancia eran en sumayoría mujeres, la categoría de enfermería, régimen laboral celetista y entre el grupo de edad de 21 a 30 años. En este período seregistraron 2.309 bajas por enfermedad por un total de 4619 días perdidos. Allí estaba la prevalencia de las enfermedades delaparato locomotor del sistema (16,4 %), siendo el dolor de espalda más comunes (7,14 %). Conclusión: a partir de los resultados esla vigilancia y verificación de los indicadores de absentismo necesario establecer estrategias destinadas a reducir. Absentismoenfermedad es un importante indicador de la salud del trabajador debido a múltiples factores.

Planta física dos abrigos de resíduos químicos perigosos da atenção hospitalar / Physical plant of hazardous shelteres with chemical waste from hospital care

Objetivo: avaliar as especificações da planta física dos abrigos de resíduos químicos perigosos gerados em hospital. Metodologia: pesquisa descritiva, realizada no Hospital Universitário da Universidade de São Paulo. Os dados foram coletados por meio da Ficha de Informação de Gerenciamento de Resíduo Químico Perigoso. Resultados: os dados evidenciaram 11 especificações, sendo sete (63,63%) não conformidades no armazenamento interno e seis (54,54%) conformidades no armazenamento externo. Os resultados apontaram os aspectos a serem revistos pelo hospital quanto à adequação da planta física dos abrigos de resíduos químicos perigosos no aguardo da coleta externa. Indicaram, ainda, diretrizes quanto às normas para construção dos abrigos, subsidiando o Plano de Gerenciamento de Resíduos Químicos Perigosos. Conclusão: o Plano tornou possível a prevenção de acidentes e doenças relacionados ao trabalho e a promoção da saúde humana e ambiental, como fatores de sustentabilidade no setor saúde hospitalar.

Objective: to evaluate the specifications of the physical plant for residues of dangerous hazardous chemical waste shelters generated at a hospital. Methodology: This is a descriptive research that takes place at University Hospital of the University of Sao Paulo. Data collection was carried out through the Chemical Waste Management Data Sheet Dangerous. Results: The data showed 11 specifications, 7 (63.63%) non-conformities in the internal storage and 6 (54.54%) conformities in external storage. The results pointed out the aspects to be reviewed by the Hospital, with respect to the adequacy of the physical plant of hazardous chemical waste shelters, awaiting external collection. They also offered guidelines for the standards of construction of shelters, supporting the Waste Management Plan of hazardous chemicals. Conclusion: With this Plan it was possible to prevent accidents and diseases related to work and the promotion of human and environmental health and sustainability factors within the hospital sector.

Objetivo: evaluar las especificaciones de la planta física de los lugares de almacenamiento de residuos químicos peligrosos generados en hospital. Metodología: Investigación descriptiva realizada en el Hospital Universitario de la Universidad de São Paulo. La recolección de datos se realizó mediante Hoja de Información de Gestión de Residuos Químicos Peligrosos. Resultados: Los datos mostraron que 11 especificaciones, 7 (63.63%) del almacenamiento interno no estaba en conformidad y 6 (54,54%) cumplian los requisitos de almacenamiento externo. Los resultados también mostraron los aspectos que deben ser revisados por el Hospital, como la adecuación de la planta física, los lugares de almacenamiento de residuos químicos peligrosos, en espera del transporte externo. También fueron ofrecidas directrices como normas para la construcción de depósitos, apoyo al Plan de Gestión de Residuos Químicos Peligrosos. Conclusión: Con el Plan se hizo posible la prevención de accidentes y enfermedades relacionadas al trabajo y a la promoción de la salud humana y ambiental, como factores de sostenibilidad en el sector salud hospitalario.

A formação de pesquisadores na temática da saúde do trabalhador de Enfermagem / The training of researchers in the issue of health of the working nurse

Objetivo: verificar a formação máxima dos pesquisadores promovida por um grupo de pesquisa. Metodologia: estudo documental, descritivo de abordagem quantitativa, realizado com participantes do grupo de estudos sobre a saúde dos trabalhadores de enfermagem e saúde (GESTES). Foram coletados dados do período de 1997 a 2014, por meio de busca online de currículo lattes dos membros e submetidos à análise estatística descritiva. Resultados: participaram do grupo 50 mulheres e seis homens. Aproximadamente 40% dos integrantes concluíram a graduação, 36% o mestrado, 14% o doutorado e 4% o pós-doutorado. Identificou-se a alta inserção dos doutores e dos mestres em instituições de ensino superior, tanto públicas como privadas. Ainda, verificou-se que a formação de mestres e doutores é dependente dos recursos humanos disponibilizados pelo programa de pós-graduação, como orientadores. Conclusão: o grupo cumpriu a sua finalidade, tanto em relação à formação numérica de pesquisadores, quanto à promoção da sua inserção em universidades.

Objective: to evaluate the highest training level of researchers of a research group. Methodology: documentary and descriptive study, with participants from the study group on the health of nursing and health workers (GESTES). From 1997 to 2014, data were collected through on-line search of members’ lattes curriculum and submitted to descriptive statistical analysis. Results: Fifty women and six men participated in GESTES in this period. Approximately 40% of the members concluded undergraduate level, followed by masters (36%) and doctors (14%) degrees. Both doctors and masters are dedicated to higher education in public or private universities. The qualification of masters and doctors is dependent on the human resources available by the pos-graduate program and mentors. Conclusion: GESTES fulfilled its purpose, in regards to the training of a considerable number of researches and in the promotion of their inclusion in universities.

Objetivo: evaluar las especificaciones de la planta física de los lugares de almacenamiento de residuos químicos peligrosos generados en hospital. Metodología: Investigación descriptiva realizada en el Hospital Universitario de la Universidad de São Paulo. La recolección de datos se realizó mediante Hoja de Información de Gestión de Residuos Químicos Peligrosos. Resultados: Los datos mostraron que 11 especificaciones, 7 (63.63%) del almacenamiento interno no estaba en conformidad y 6 (54,54%) cumplian los requisitos de almacenamiento externo. Los resultados también mostraron los aspectos que deben ser revisados por el Hospital, como la adecuación de la planta física, los lugares de almacenamiento de residuos químicos peligrosos, en espera del transporte externo. También fueron ofrecidas directrices como normas para la construcción de depósitos, apoyo al Plan de Gestión de Residuos Químicos Peligrosos. Conclusión: Con el Plan se hizo posible la prevención de accidentes y enfermedades relacionadas al trabajo y a la promoción de la salud humana y ambiental, como factores de sostenibilidad en el sector salud hospitalario.

Saúde do trabalhador de enfermagem: resgate da produção científica / Nursing worker health: identification of scientific production / Salud del trabajador de enfermería: rescate de la producción científica

Este estudo teve como objetivo resgatar e analisar a produção de conhecimento publicada sobre a saúde do trabalhador de enfermagem e de saúde gerada pelos integrantes do Grupo de Estudos Sobre a Saúde do Trabalhador de Enfermagem e Saúde. Trata-se de um estudo documental, descritivo e exploratório, com análise quantitativa dos dados referentes à produção entre 1997 e 2016. Em 20 anos, foram geradas 343 publicações. A análise mostrou o predomínio de publicações de pesquisadores doutores (146; 42,57%), seguidos dos mestres (105; 30,61%) e graduandos (62; 18,08%), sendo a maioria "resumos e resumos expandidos publicados em anais" (172; 50,15%), seguidos de artigos publicados em periódicos científicos (74; 21,57%). A temática "Exposições a cargas de trabalho e/ou Processo de desgaste no Trabalho" foi a predominante, evidenciando os riscos à saúde do trabalhador. Conclui-se que o grupo de pesquisa apresentou produção científica expressiva no período estudado, contribuindo com o avanço do conhecimento científico sobre o tema em foco (AU).

The present study aimed to identify and analyze the scientific publications on health and nursing worker health generated by members of the Study Group on Occupational Health of Nursing and Health Personnel (GESTES). Descriptive-exploratory, documentary study of quantitative approach of data related to scientific publications of 1997 and 2016. In 20 years, 343 publications were generated. Analysis showed a predominance of publications by doctors (146; 42, 57%), followed by masters (105; 30, 61%) and graduate students (62; 18, 08%), most of them "abstracts and extended abstracts published in annals" (172; 50.15%), followed by articles published in scientific journals (74; 21, 57%). The theme "Exposure to workloads and/or work wear Process" prevailed, demonstrating the risks to worker health. It is concluded that the research group identified a significant volume of scientific publications on the referred theme during the study period (AU).

Estudio cuyo objetivo fue rescatar y analizar la producción de conocimiento publicada acerca del tema salud del trabajador de enfermería y salud generada por los integrantes del Grupo de Estudios Sobre Salud del Trabajador de Enfermería y Salud. Es un estudio documental, descriptivo y exploratorio, con análisis cuantitativo de los datos referentes a la producción entre 1997 y 2016. En 20 años, fueron producidas 343 publicaciones. El análisis ha apuntado predominio de publicaciones de doctores (146; 42,57%), maestros (105; 30,61%) y graduandos (62; 18,08%), siendo la mayoría "resúmenes y resúmenes expandidos publicados en anales" (172; 50,15%), además de artículos publicados en periódicos científicos (74; 21,57%). La temática "Exposiciones a cargas de trabajo y/o Proceso de desgaste en el Trabajo" fue la predominante, evidenciándose los riesgos a la salud del trabajador. Se concluye que el grupo de investigación ha presentado producción científica expresiva en el dicho periodo, contribuyendo con el desarrollo del conocimiento científico acerca del tema en cuestión (AU).

Mental health problems among nurses in paediatric cardiac intensive care.

At present, there are growing rates of psychiatric symptoms among some occupational categories, with emphasis on health professionals who work in hospitals. This study aimed to identify the occurrence of mental health problems (anxiety and depression) among 92 nursing workers in a paediatric cardiac intensive care unit. This is an exploratory, cross-sectional study, with a quantitative approach. The research was conducted in a public university hospital specialising in cardiology, pneumology, and thoracic and cardiac surgery. The data were collected between June and July of 2012 through socio-demographic and Self-Reporting Questionnaire (SRQ-20) instruments. The analysis of the results revealed the occurrence of mental health problems in 45% (41) of the workers. There was the prevalence of tension, nervousness and worry symptoms, followed by headache. Findings highlight the need for protective measures towards the mental health of workers who assist children with serious heart disease.