Study of adaptation and validation of the Practice environment scale of the nursing work index for the portuguese reality

Objective: Testing the psychometric properties of the Portuguese version of the Practice Environment Scale of the Nursing Work Index. Method: A descriptive, analytical and cross-sectional study, for the cross-cultural adaptation and validation of the psychometric properties of the scale. The study participants were 236 nurses from two hospitals in the regions of Lisbon and Vale do Tejo. Results: The 0.92 Cronbach’s alpha was obtained for overall reliability and support of a five-dimension structure. Conclusion: The excellent quality of adjustment of analysis confirms the validity of the adapted version to hospital care settings, although there was no total coincidence of items in the five dimensions


The work environment and leadership in nursing: an integrative review

Objective: To investigate the relationship between the work environment and leadership in nursing. Method: An integrative review of literature which was based on data from LILACS, PubMed, CINAHL and the SciELO portal for journals covering the period from January to April 2013. The inclusion criteria were: the indexing of research covering leadership exercised by nurses over a team and whether the research was available in English, Spanish or Portuguese. Results: The sample consisted of 12 articles that met the criteria. Conclusion: The results showed that leadership had an impact on the work environment. However, no studies were found that showed the influence of the working environment on leadership in nursing.

Higher education in nursing: the faculty work process in different institutional contexts

Objective To analyze the characteristics of faculty work in nursing higher education. Method An exploratory qualitative study with a theoretical-methodological framework of dialectical and historical materialism. The faculty work process was adopted as the analytical category, grounded on conceptions of work and professionalism. Semi-structured interviews were conducted with 24 faculty members from three higher education institutions in the city of São Paulo, classified according to the typology of institutional contexts. Results The faculty members at these higher education institutions are a heterogeneous group, under different working conditions. Intensification and precarious conditions of the faculty work is common to all three contexts, although there are important distinctions in the practices related to teaching, research and extension. Conclusion Faculty professionalization can be the starting point for analyzing and coping with such a distinct reality of faculty work and practice.


Interdisciplinary intervention for work-related musculoskeletal disorders

The proposed research aims to address the work-related MSD management issue through an interdisciplinary intervention involving clinical and occupational health competencies (rheumatology, occupational medicine, ergonomics). Workers enduring MSD (especially back-pain) and absent from work are selected from volunteering companies (construction, hospitals, public transport, delivery networks). The workers are randomly placed into two groups : the control group benefits from an usual MSD management strategy and the intervention group benefits from a case-management strategy including workhardening treatment (work oriented reeducation) and ergonomic intervention in the workplace. The comparison of health and work-related variables prior and after intervention in the two groups will be used to assess the intervention efficiency and its economic benefits. We expect to produce new strategies for the management of MSD and workplace rehabilitation as well as guidelines for both authorities and companies.

Psychological transformations in kidney transplantation: A prospective qualitative study

The aim of this IRB-approved study was to prospectively analyze psychological transformations in ESRD patients before and after transplantation (KT). Semi-structured interviews were conducted in 30 patients (mean age = 53±10) after their inclusion on the waiting-list (Gr. A). Follow-up interviews were performed 6 months later in 15 patients still awaiting KT (Gr. B6), and in 15 patients 6 months (Gr. C6) and 12 months (Gr. C12) after KT. Qualitative analysis was performed. Gr: A:All patients underlined loss of freedom, 87% devoted much energy to maintain normality, 57% modified medical directives. All reported emotional fragility related to dialysis and loss of quality of life (QOL), negative (43%) or suicidal thoughts (20%). Professional stigma was underlined (26%). Gr: B6:40% reported no change, 60% mentioned increase of illness intrusiveness, 46% dialysis side-effects, 40% communication problems, 33% tension with medical staff and waiting list handling. Fear of emotional breakdown (40%), couple problems (47%) and worsened professional difficulties (20%) were reported. Gr: C6:All patients mentioned improved QOL and freedom recovery (87%). All expressed concerns about possible acute rejection, 73% were anxious about laboratory results, 93% experienced dependence to immunosuppressants, 47% reported difficulties in handling medication, 21% feared to forget them, 47% were concerned about side-effects, 67% had resumed work but medical constraints led to professional tension (40%). Gr: C12:All mentioned recovered QOL. Medical controls were accepted as a routine (87%) and adherence to medication was mandatory (100%). All mentioned the limited long-term graft survival and 47% were anxious about possible return to dialysis, especially younger patients (27%). Positive identity and existential changes were reported (60%). This prospective qualitative study identifies psychological modifications in the course of KT. It provides a basis to adequately address concerns, but it shows also that KT is clearly associated with positive psychological transformations.

Violence, Burnout and Minor Psychiatric Disorders in Hospital Work

OBJECTIVE Identifying the violence suffered by the health team workers and their association with Burnout and minor psychiatric disorders. METHODS Cross-sectional study with 269 health team professionals of a public hospital in southern Brazil. Data were collected through the use of the Survey Questionnaire: Workplace Violence in the Health Sector, Maslach Inventory Burnout and Self-Report Questionnaire. RESULTS Workplace violence struck 63.2% of workers, prevailing mostly in women (p = 0.001), among nursing auxiliaries/technicians (p=0.014) and was associated with minor psychiatric disorders (p<0.05), as exposure to different forms of violence increased the chances of these disorders by 60% (CI 95%: 1.2-2.1). The three Burnout dimensions were also associated to violence at work (p<0.05). CONCLUSION Health workers experience violence in the workplace and this exposure is associated with Burnout symptoms and minor psychiatric disorders.

Pleasure-suffering indicators of nursing work in a hemodialysis nursing service

OBJECTIVE To measure the pleasure and suffering indicators at work and relate them to the socio-demographic and employment characteristics of the nursing staff in a hemodialysis center in southern Brazil. METHOD Quantitative research, with 46 workers. We used a self-completed form with demographic and labor data and the Pleasure and Suffering Indicators at Work Scale (PSIWS). We conducted a bivariate and correlation descriptive analysis with significance levels of 5% using the Epi-Info® and PredictiveAnalytics Software programs. RESULTS Freedom of Speech was considered critical; other factors were evaluated as satisfactory. The results revealed a possible association between sociodemographic characteristics and work, and pleasure and suffering indicators. There was a correlation between the factors evaluated. CONCLUSION Despite the satisfactory evaluation, suffering is present in the studied context, expressed mainly by a lack of Freedom of Speech, with the need for interventions to prevent injury to the health of workers.

Managers' perspective on continuous health education in a region of São Paulo State

OBJECTIVEAnalysing the concepts of Continuous Health Education - CHE (EPS - in Portuguese), operated by municipal managers and translated into official documents.METHODQualitative research with the use of official documents and semi-structured interviews with the Municipal Health Secretaries or Coordinators of Primary Health Care in the Northeast Region of São Paulo State, and thematic analysis of empirical material.RESULTSResults indicate difficulties in the municipalities problematizing their management practices, services and health care; EPS tools presented are insufficient and unsatisfactory for amending the array of problems raised and are still far from the routine of Primary Care services.CONCLUSIONDespite efforts to implement EPS actions for the strengthening of primary care, the process appears to be incipient.

Offshore work and the work of nurses on board: an integrative review

OBJECTIVETo know the production of theoretical approaches on issues related to offshore work and the work of offshore nurses.METHODIntegrative literature review conducted in the databases of LILACS, BDENF, MEDLINE, SciELO and Index PSI.RESULTSWe selected 33 studies published in national and international journals between 1997 and 2014. The thematic analysis corpus resulted in four central themes: offshore work environment; amid work adversities, an escape; structuring of offshore health and safety services; in search of safe practices.CONCLUSIONThis study contributes to the offshore work of nurses in relation to the nature of work, acting amid adversities and the restless search for safe practices in the open sea.

Limited clinical benefit of minority K103N and Y181C-variant detection in addition to routine genotypic resistance testing in antiretroviral therapy-naive patients.

OBJECTIVE: The presence of minority nonnucleoside reverse transcriptase inhibitor (NNRTI)-resistant HIV-1 variants prior to antiretroviral therapy (ART) has been linked to virologic failure in treatment-naive patients. DESIGN: We performed a large retrospective study to determine the number of treatment failures that could have been prevented by implementing minority drug-resistant HIV-1 variant analyses in ART-naïve patients in whom no NNRTI resistance mutations were detected by routine resistance testing. METHODS: Of 1608 patients in the Swiss HIV Cohort Study, who have initiated first-line ART with two nucleoside reverse transcriptase inhibitors (NRTIs) and one NNRTI before July 2008, 519 patients were eligible by means of HIV-1 subtype, viral load and sample availability. Key NNRTI drug resistance mutations K103N and Y181C were measured by allele-specific PCR in 208 of 519 randomly chosen patients. RESULTS: Minority K103N and Y181C drug resistance mutations were detected in five out of 190 (2.6%) and 10 out of 201 (5%) patients, respectively. Focusing on 183 patients for whom virologic success or failure could be examined, virologic failure occurred in seven out of 183 (3.8%) patients; minority K103N and/or Y181C variants were present prior to ART initiation in only two of those patients. The NNRTI-containing, first-line ART was effective in 10 patients with preexisting minority NNRTI-resistant HIV-1 variant. CONCLUSION: As revealed in settings of case-control studies, minority NNRTI-resistant HIV-1 variants can have an impact on ART. However, the implementation of minority NNRTI-resistant HIV-1 variant analysis in addition to genotypic resistance testing (GRT) cannot be recommended in routine clinical settings. Additional associated risk factors need to be discovered.

Do you work or do you study? Children's work in a comparative historical perspective

In this paper we compare two historical scenarios very different one to each other bothin institutional and geographical terms. What they have in common is the situation ofrelative poverty of most of the population. On the one side we are dealing withhistorical industrializing Catalonia in the North East of Spain, a country exhibiting pooreconomic yields in the context of European and non European industrializing nations inthe 19th century. We compare children s work patterns in 19th century Catalonia withthose of current developing countries in Latin America, Africa and South and East Asia.This kind of exercise in which the nexus of the comparison are the levels of wealth ofcountries that are unsuccessful to achieve high standards of economic growth allows usto combine the micro historical analysis (in the Catalan case) with the macrocomparative approach in current developing countries. By means of both, the microhistorical analysis and the macro regression analysis we obtain the result that adultwomen s skills and real wages are a key factor when we want to explain the patterns ofchildren work. While female real wages increased a sharp rate in 19th century Cataloniawe obtain very different results in the case of developing countries. This differentgender bias helps to explain why in some cases children continue to work and also whysome parts of the world continue to be poor according to our regression analysis.

The implicit theory of historical change in the work of Alan S. Milward

Alan S. Milward was an economic historian who developed an implicit theory ofhistorical change. His interpretation which was neither liberal nor Marxist positedthat social, political, and economic change, for it to be sustainable, had to be agradual process rather than one resulting from a sudden, cataclysmicrevolutionary event occurring in one sector of the economy or society. Benignchange depended much less on natural resource endowment or technologicaldevelopments than on the ability of state institutions to respond to changingpolitical demands from within each society. State bureaucracies were fundamentalto formulating those political demands and advising politicians of ways to meetthem. Since each society was different there was no single model of developmentto be adopted or which could be imposed successfully by one nation-state onothers, either through force or through foreign aid programs. Nor coulddevelopment be promoted simply by copying the model of a more successfuleconomy. Each nation-state had to find its own response to the political demandsarising from within its society. Integration occurred when a number of nation states shared similar political objectives which they could not meet individuallybut could meet collectively. It was not simply the result of their increasinginterdependence. It was how and whether nation-states responded to thesedomestic demands which determined the nature of historical change.

Human Resource Information System; individual Users with Work Reporting Guide, April 2003

Guide manual for using the Human Resource Information System for the state of Iowa.