STRESS E REAJUSTAMENTO SOCIAL EM AUXILIARES DE ENFERMAGEM

O presente estudo teve por objetivos, levantar o perfil sócio-demográfico e cultural, de auxiliares de enfermagem, avaliar o grau e presença de sintomas de stress, avaliar e descrever reajustamento social tecendo relação entre variáveis relacionadas ao labor e o stress. Participaram desse estudo 126 auxiliares de enfermagem que cursavam técnico em enfermagem. Utilizou-se os instrumentos: a) questionário Sócio-demográfico e cultural; b) Escala de Reajustamento Social de Holmes-Rahe e c) Inventário de Sintomas de Stress de Lipp (ISSL). Os dados foram coletados em salas de aula, de três escolas técnicas da grande São Paulo e esses dados foram tratados estatisticamente pelos testes X² e r Person para as relações entre variáveis, com auxílio do programa SPSS versão 17. Os resultados indicaram uma predominância de pessoas do gênero feminino, casados, com idade mínima de 19 anos e máxima de 56 anos e com práticas religiosas católicas e evangélicas. Desses profissionais (79%) trabalhavam em um só emprego, com experiência na profissão de cinco anos e o setor com maior quantidade de profissionais foi o home care . A maioria dos profissionais exercia suas atividades no horário matutino, e estudava no horário noturno. O estudo indicou que 57,9% apresentaram grau de stress significativo. Dentro deste grau de stress significativo, 41,3% dos profissionais estavam na fase de resistência e 37,3% dos auxiliares com grau de stress significativo, apresentavam predominância de stress de natureza psicológica. Quanto ao reajustamento social, os auxiliares de enfermagem a maioria, que correspondia a 48,4% estava dentro da média, com chances razoáveis de adoecer, ou seja, apresentavam capacidade regular para adaptação aos eventos novos e desconhecidos que ocorrem durante a vida. Os resultados indicaram que os profissionais que apresentaram stress significativo obtiveram pontuação maior (média) na escala de reajustamento social, em comparação aos profissionais que não apresentaram stress, indicando que esses sujeitos tinham maior probabilidade de estarem adoecidos ou virem a adoecer.

MANIFESTAÇÕES PSICOSSOMÁTICAS EM UNIVERSITÁRIOS PORTUGUESES, A PARTIR DA IDENTIFICAÇÃO DE SINTOMAS DE ANSIEDADE, DEPRESSÃO E STRESS

O presente trabalho teve como objetivos investigar a presença de manifestações psicossomáticas em estudantes universitários, a partir da identificação e da prevalência de sintomas de ansiedade, depressão e stress entre outros transtornos; identificar sinais e sintomas de ansiedade, depressão e stress em universitários portugueses; e correlacionar os sinais e sintomas entre si. Utilizou-se o método quantitativo descritivo de corte transversal. Como meio de investigação, foram utilizados três instrumentos: O Inventário de Ansiedade Traço-Estado de Spilberber IDATE, a Escala de Ansiedade, Depressão e Stress EADS-21 (DASS) e o Inventário de Sintomas de Stress para Adultos de Lipp ISSL. A amostra resultou em 147 universitários de primeiro ingresso na universidade com idade variando entre 18 e 26 anos da Universidade do Algarve Ualg (Portugal), em seus diversos cursos. Os dados obtidos foram analisados e correlacionados com o auxilio do software estatístico SPSS - Statistical Package for Social Science (SPSS), versão 19.0 para Windows, utilizando a análise estatística descritiva de frequência e média, Teste T de Student e ANOVA. Os resultados apontaram uma amostra em sua maioria de mulheres, solteiras, que saíram da casa dos pais para estudar e que no momento da coleta dos dados não exerciam atividades de trabalho, apenas estudavam. Houve presença de indicadores de ansiedade, depressão e stress, sendo o nível de ansiedade encontrado moderado e vinculado à probabilidade de depressão associada. Em relação a manifestações psicossomáticas, foi identificada uma dificuldade em auto-avaliação da presença destas, porém entendeu-se que há associação de manifestações psicossomáticas em relação aos sintomas de stress, ansiedade e depressão, encontrados. Levantou-se a hipótese de associação desses sintomas com a situação atual de crise econômica que passa a sociedade portuguesa, principalmente no período de coleta desses dados. Assim, verificou-se um possível estado de vulnerabilidade nesta população com alguma dificuldade em se adaptar às novas exigências de vida, necessitando então de medidas preventivas que auxiliem a adaptação e reestruturação do estilo de vida desses estudantes.

A INFLUÊNCIA DO STRESS NA EXPRESSÃO CLÍNICA DA ASMA INFANTIL

A asma é a doença crônica mais freqüente na infância e o stress é considerado um dos agentes desencadeantes e agravantes do broncoespasmo nesses pacientes. O objetivo deste trabalho foi investigar a influência do stress na expressão clínica da asma e sua associação com as crises em crianças. Para verificar a presença de stress, utilizou-se a Escala de Stress Infantil (LIPP E LUCARELLI, 1998) e por meio de um questionário aplicado aos pais, observou-se freqüência de sintomas e crises de asma, as alterações do sono, o absenteísmo escolar, as limitações à prática de atividade física, a freqüência de uso de broncodilatador, as condutas dos pais durante as crises de asma, os fatores associados ao desencadeamento das crises, o poder aquisitivo e o grau de instrução do chefe da família. Observou-se que as crianças com asma estavam mais estressadas que as crianças do grupo controle, principalmente aquelas com maior gravidade da doença. Os resultados indicam que a presença de stress pode intensificar a freqüência de sintomas da asma, a limitação à atividade física, o absenteísmo escolar e as interrupções do sono. O maior tempo de diagnóstico de asma implicou em menor ocorrência de stress, sugerindo a existência de um fator de adaptação à doença. Conclui-se que o stress é um fator importante no desencadeamento e agravamento das crises de asma nas crianças e observa-se a necessidade de maiores pesquisas na aérea para aprofundar os conhecimentos sobre esse assunto.

Journey to work:exploring difficulties, solutions and the impact of aging

A study was conducted in the UK, as part of the New Dynamics of Ageing Working Late project, of the journey to work among 1215 older workers (age groups 45-49, 50-55, 56-60 and 60 + ). The aim was to identify problems or concerns that they might have with their commute, strategies that have been adopted to address them, and the role that employers can play to assist them. Follow-up interviews with 36 employees identified many strategies for assisting with the problems of journeys to work, ranging from car share and using public transport to flexible working and working some days from home. Further interviews with a sample of 12 mainly larger companies showed that employers feel a responsibility for their workers’ commute, with some offering schemes to assist them, such as adjusting work shift timings to facilitate easier parking. The research suggests that the journey to work presents difficulties for a significant minority of those aged over 45, including issues with cost, stress, health, fatigue and journey time. It may be possible to reduce the impact of these difficulties on employee decisions to change jobs or retire by assisting them to adopt mitigating strategies. It does not appear that the likelihood of experiencing a problem with the journey to work increases as the employee approaches retirement; therefore, any mitigating strategy is likely to help employees of all ages. These strategies have been disseminated to a wider audience through an online resource at www.workinglate.org.

An investigation of the mechanics of wire drawing with the superposition of an oscillatory drawing stress

A number of investigators have studied the application of oscillatory energy to a metal undergoing plastic deformation. Their results have shown that oscillatory stresses reduce both the stress required to initiate plastic deformation and the friction forces between the tool and workpiece. The first two sections in this thesis discuss historically and technically the devolopment of the use of oscillatory energy techniques to aid metal forming with particular reference to wire drawing. The remainder of the thesis discusses the research undertaken to study the effect of applying longitudinal oscillations to wire drawing. Oscillations were supplied from an electric hydraulic vibrator at frequencies in the range 25 to 500 c/s., and drawing tests were performed at drawing speeds up to 50 ft/m. on a 2000 lbf. bull-block. Equipment was designed to measure the drawing force, drawing torque, amplitude of die and drum oscillation and drawing speed. Reasons are given for selecting mild steel, pure and hard aluminium, stainless steel and hard copper as the materials to be drawn, and the experimental procedure and calibration of measuring equipment arc described. Results show that when oscillatory stresses are applied at frequencies within the range investigated : (a) There is no reduction in the maximum drawing load. (b) Using sodium stearate lubricant there is a negligible reduction in the coefficient of friction between the die and wire. (c) Pure aluminium does not absorb sufficient oscillatory energy to ease the movement of dislocations. (d) Hard aluminium is not softened by oscillatory energy accelerating the diffusion process. (e) Hard copper is not cyclically softened. A vibration analysis of the bull-block and wire showed that oscillatory drawiing in this frequency range, is a mechanical process of straining; and unstraining the drawn wire, and is dependent upon the stiffness of the material being drawn and the drawing machine. Directions which further work should take are suggested.

The management of stress amongst professional carers within a social services department

This thesis considers four broad areas:(i) ANALYSIS OF THE STRESS FIELD.(a) research studies, relevant to the British Social Services considering the cultural setting, and the rigor with which they were conducted; (b) models of stress, specifically examining the theoretical soundness and practical application of the Medical, Engineering and Transactional models;(c) organisational models of stress relating specifically to human service organisations.(ii) QUALITATIVE AND QUANTITATIVE RESEARCH METHODOLOGIES.(a) the appropriate application of each respective methodology and the particular usefulness of qualitative research designs; (b) the relevance of understanding the language and terminology associated with the subject area prior to the implementation of survey methods; (iii) FIELDWORK.(a) Phase 1. By use of focus groups, in-depth interviews and diary keeping amongst a small range of teams and managers, the Researcher develops a basic conceptual framework of stress within a Social Services context. In addition a small scale personality inventory was administered to participants.(b) Phase 2. This consisted of three key elements: 6 case studies in which the Researcher implements and appraises the impact of a range of intervention strategies designed to assist teams and their managers in dealing more effectively with stress; the administration of a large scale survey to all the field social work teams within the Social Services Department; an analysis of the user role within the stress process by way of two focus groups.(iv) THEORETICAL DEVELOPMENT.

Work stressors, strains and hospital unit performance

Hospital employees who work in an environment with zero tolerance to error, face several stressors that may result in psychological, physiological, and behavioural strains, and subsequently, in suboptimal performance. This thesis includes two studies which investigate the stressor-to-strain-to-performance relationships in hospitals. The first study is a cross-sectional, multi-group investigation based on secondary data from 65,142 respondents in 172 acute/specialist UK NHS trusts. This model proposes that senior management leadership predicts social support and job design which, in turn, moderate stressors-to-strains across team structure. The results confirm the model's robustness. Regression analysis provides support for main effects and minimal support for moderation hypotheses. Therefore, based on its conclusions and inherent limitations, study one lays the framework for study two. The second study is a cross-sectional, multilevel investigation of the strain-reducing effects of social environment on externally-rated unit-level performance based on primary data from 1,137 employees in 136 units, in a hospital in Malta. The term "social environment" refers to the prediction of the moderator variables, which is to say, social support and decision latitude/control, by transformational leadership and team climate across hospital units. This study demonstrates that transformational leadership is positively associated with social support, whereas team climate is positively associated with both moderators. At the same time, it identifies a number of moderating effects which social support and decision latitude/control, both separately and together, had on specific stressor-to-strain relationships. The results show significant mediated stressor-to-strain-to-performance relationships. Furthermore, at the higher level, unit-level performance is positively associated with shared unit-level team climate and with unit-level vision, the latter being one of the five sub-dimension of transformational leadership. At the same time, performance is also positively related to both transformational leadership and team climate when the two constructs are tested together. Few studies have linked the buffering effects of the social environment in occupational stress with performance. Therefore, this research strives to make a significant contribution to the occupational stress and performance literature with a focus on hospital practice. Indeed, the study highlights the wide-ranging and far-reaching implications that these findings provide for theory, management, and practice.

On the stress analysis of cracked bodies by means of finite elements

The work described in this thesis deals with the development and application of a finite element program for the analysis of several cracked structures. In order to simplify the organisation of the material presented herein, the thesis has been subdivided into two Sections : In the first Section the development of a finite element program for the analysis of two-dimensional problems of plane stress or plane strain is described. The element used in this program is the six-mode isoparametric triangular element which permits the accurate modelling of curved boundary surfaces. Various cases of material aniftropy are included in the derivation of the element stiffness properties. A digital computer program is described and examples of its application are presented. In the second Section, on fracture problems, several cracked configurations are analysed by embedding into the finite element mesh a sub-region, containing the singularities and over which an analytic solution is used. The modifications necessary to augment a standard finite element program, such as that developed in Section I, are discussed and complete programs for each cracked configuration are presented. Several examples are included to demonstrate the accuracy and flexibility of the technique.

Autonomic dysfunction and systemic oxidative stress associated with glaucomatous optic neuropathy

There were four principal sections to the work: 1. Investigation of ocular and systemic vascular risk factors in POAG. The principal findings of this work were: a). Glaucoma patients exhibit an anticipatory reaction to the physical stress, similar to subjects at risk for cardiovascular diseases; a blunted BP response and a reduction in ONH blood flow in response to cold provocation was also recorded. b). Silent myocardial ischaemic episodes occurred during peaks in systemic BP and HR. c). Independent of a positive history for cardiovascular diseases, patients suffering from POAG demonstrate a blunt circadian rhythm of the ANS. 2. Assessment of the relationship between vascular and systemic vascular risk factors in GON. The principal findings of this work were: a). POAG patients demonstrate a high sympathetic tonus over a 24-h period. b). POAG patients with lower OBF demonstrate both 24-h systemic BP and HRV abnormalities. c). OBF alterations observed in some glaucoma patients could be either primary or secondary to systemic haemodynamic disturbances and not a consequence of ONH damage. 3. Assessment of the level of systemic anti-oxidant defence in POAG patients. The principal finding of this work was: Patients suffering from POAG demonstrated significantly lower GSH and t-GSH levels than normal controls. 4. Investigation of the effect of treatment with latanoprost 0.005% on visual function and OBF. The findings of this work were: a). Treatment with latanoprost 0.005% resulted in a significant decrease in IOP and increase in OPP. VF damage progression has also been stopped. b). Treatment with latanoprost 0.005% resulted in a significant increase in the OBF parameters measured at the ONH and peripapillary retina levels. Finally, the importance of a clear protocol for managing new POAG cases is highlighted and a clinical conduit is proposed.

Attributions, cognitions, and coping styles:teleworkers' reactions to work-related problems

Based on the attributional reformulation of learned helplessness theory (Abramson, Seligman, & Teasdale, 1978) and Lazarus and Launier's (1978) primary-secondary appraisal theory of stress, the present study sought to examine teleworkers' reactions to their work-related problems. The role of attributions about the sources, and cognitions about the consesquences, of these problems in promoting positive adaptation was addressed. In particular, it was predicted that teleworkers who made optimistic attributions and cognitions would be more likely to employ problem-focused coping strategies and, as a result, report more positive psychological and job-related outcomes. Based on a survey sample of 192 teleworkers, the results indicated that a tendency to engage in self-blame was related to the use of emotion-focused coping strategies. In turn, there was evidence linking emotion-focused coping strategies to negative outcomes and problem-focused coping strategies to positive outcomes. The results are discussed in relation to attributional approaches to stress which highlight the importance of cognitions about the consequences of negative events. Finally, implications for the training of teleworkers are presented.

Controlling system uncertainty in sport and work

An applied psychological framework for coping with performance uncertainty in sport and work systems is presented. The theme of personal control serves to integrate ideas prevalent in industrial and organisational psychology, the stress literature and labour process theory. These commonly focus on the promotion of tacit knowledge and learned resourcefulness in individual performers. Finally, data from an empirical evaluation of a development training programme to facilitate self-regulation skills in professional athletes are briefly highlighted.

Advanced manufacturing technology and work design:towards a theoretical framework

This paper introduces a theoretical framework to guide research into the psychological effects of advanced manufacturing technology (AMT) on shopfloor operators. The framework has two main aspects. First, based on the emerging literature on the job content implications of AMT, it identifies four key constructs, namely: control, cognitive demand, production responsibility and social interaction. Second, by drawing on the more established job design, stress and related literatures, it predicts how these independent variables differentially affect system performance, job-related strain and job satisfaction. The wider implications and limitations of the theoretical framework are discussed.

Cross-cultural variations in climate for autonomy, stress and organizational productivity relationships:A comparison of Chinese and UK manufacturing organizations

Cross-cultural researchers have questioned the extent to which European–American management practices can be transported to major markets in Asia, such as the People's Republic of China. Applying employee involvement theory, we examined the relationships between climate for autonomy, work demands climate, employee stress and organizational productivity in a cross-national study of 51 UK and 104 Chinese manufacturing organizations. We predicted and found that climate for autonomy was positively and negatively related to stress in the Chinese and UK contexts, respectively. The interaction of climate for autonomy and work demands climate was significant: climate for autonomy was positively related to organizational productivity only when work demands climate was low.

Gene network and proteomic analyses of cardiac responses to pathological and physiological stress

Background—The molecular mechanisms underlying similarities and differences between physiological and pathological left ventricular hypertrophy (LVH) are of intense interest. Most previous work involved targeted analysis of individual signaling pathways or screening of transcriptomic profiles. We developed a network biology approach using genomic and proteomic data to study the molecular patterns that distinguish pathological and physiological LVH. Methods and Results—A network-based analysis using graph theory methods was undertaken on 127 genome-wide expression arrays of in vivo murine LVH. This revealed phenotype-specific pathological and physiological gene coexpression networks. Despite >1650 common genes in the 2 networks, network structure is significantly different. This is largely because of rewiring of genes that are differentially coexpressed in the 2 networks; this novel concept of differential wiring was further validated experimentally. Functional analysis of the rewired network revealed several distinct cellular pathways and gene sets. Deeper exploration was undertaken by targeted proteomic analysis of mitochondrial, myofilament, and extracellular subproteomes in pathological LVH. A notable finding was that mRNA–protein correlation was greater at the cellular pathway level than for individual loci. Conclusions—This first combined gene network and proteomic analysis of LVH reveals novel insights into the integrated pathomechanisms that distinguish pathological versus physiological phenotypes. In particular, we identify differential gene wiring as a major distinguishing feature of these phenotypes. This approach provides a platform for the investigation of potentially novel pathways in LVH and offers a freely accessible protocol (http://sites.google.com/site/cardionetworks) for similar analyses in other cardiovascular diseases.

Fatigue cracking from stress concentration in mild steel

Pulsating; tension fatigue tests have been carried out on edge notched specimens of a mild steel. An electrical potential drop technique was used to determine the number of cycles taken to initiate cracks and the rate at which the cracks grew across the specimen. The results could be described by the range of stress intensity factor, which for crack initiation was modified to take account of the notch root radius. Analysis of elastic stress distributions at cracks and notches and models of plasticity at crack tips are used to discuss the results. Limited evidence in the literature indicates that the fracture mechanics approach may provide a general description of crack initiation and growth in notched specimens, and a simple graphical method of calculating fatigue lives is described. The results are used to illustrate the effects of specimen size and geometry on the fatigue life of notched specimens. The relevance of the work to the assessment of the significance of defects in welds is discussed.