Monalisa de Cássia Fogaça

Fatores que tornam estressante o trabalho de médicos e enfermeiros em terapia intensiva pediátrica e neonatal: estudo de revisão bibliográfica

OBJETIVOS: Revisao de literatura sobre estresse ocupacional e sindrome de burnout em medicos e enfermeiros que trabalham em unidade de terapia intensiva pediatrica e neonatal. METODOS: Os artigos foram identificados a partir das bases de dados MedLine, LILACS e SciElo, usando as palavras-chave estresse, burnout, medicos, enfermagem, unidade de terapia intensiva, unidade de cuidados intensivos pediatricos e unidades de cuidados intensivos neonatais. O periodo pesquisado foi de 1990 a 2007. RESULTADOS: Medicos e enfermeiros que trabalham em unidade de terapia intensiva pediatrica e neonatal sao candidatos a apresentarem estresse, alteracoes psicologicas e sindrome de Burnout. Pesquisas sobre o tema identificaram alteracoes importantes que acometem medicos e enfermeiros intensivistas: sobrecarga de trabalho, burnout, desejo de abandonar o trabalho e niveis elevados de cortisol entre outros fatores. CONCLUSOES: Os profissionais que trabalham em unidade de terapia intensiva pediatrica e neonatal , pela especificidade do seu trabalho, estao expostos ao risco do estresse ocupacional e, consequentemente ao Burnout. Estes dados sugerem a necessidade de serem feitas pesquisas, com o objetivo de desenvolver medidas preventivas e modelos de intervencao.

Salivary cortisol as an indicator of adrenocortical function in healthy infants, using massage therapy.

CONTEXT AND OBJECTIVE The evaluation of adrenocortical function with the use of therapeutic massage has been little studied in Brazil. The purpose of this study was to evaluate the salivary cortisol levels before and after Shantala massage therapy on healthy infants. DESIGN AND SETTING Prospective case series, in a public nursery, in São Paulo. METHODS Saliva was obtained from 11 infants at the times of 8:00-9:00 a.m. and 4:00-5:00 p.m. in a nursery and 9:00-10:00 p.m. at home. They received a 15-minute therapeutic massage on two consecutive days, and saliva was collected before and after the massage. The procedure was repeated after a one-week interval. Cortisol values (intra-assay < 5%; inter-assay < 10%) at different times of the day were compared by ANOVA. RESULTS The mean cortisol values (nmol/l +/- SD) on the first day were: morning (M) = 14.1 +/- 5.7, afternoon (A) = 8.3 +/- 2.7, night (N) = 3.3 +/- 1.1; after two consecutive days of therapeutic massage: M = 22.3 +/- 13.5, A = 13.4 +/- 6.0, N = 5.8 +/- 3.5; after a one-week interval: M = 15.8 +/- 7.7, A = 14.3 +/- 7.7, N = 3.4 +/- 2.0. CONCLUSION There was a modification in the salivary cortisol values following massage, thus reflecting possible adaptation of the hypothalamic-pituitary-adrenal axis.

Estresse ocupacional e suas repercussões na qualidade de vida de médicos e enfermeiros intensivistas pediátricos e neonatais

OBJETIVO: Investigar as relacoes entre trabalho e qualidade de vida de medicos e enfermeiros em unidades de terapia intensiva pediatrica e neonatal. METODOS: Estudo transversal com 37 medicos e 20 enfermeiros. O Job Content Questionnarie (JCQ), Effort-Reward Imbalance (ERI) e World Health Organization Quality of Life (WHOQOL-100) foram utilizados. A correlacao foi estimada atraves do coeficiente de correlacao de Spearman. RESULTADOS: O esforco e inversamente correlacionado com os dominios: fisico, psicologico, nivel de independencia, meio ambiente (p<0,01) e relacao social (p<0,05). A recompensa e inversamente correlacionada com os dominios psicologico (p<0,05) e nivel de independencia (p<0,01). Controle sobre o trabalho e diretamente correlacionado com o dominio fisico (p<0,05). A demanda psicologica e inversamente correlacionada com os dominios fisico (p<0,05), psicologico (p<0,01) e nivel de independencia (p<0,05). A demanda fisica e inversamente correlacionada com os dominios fisico, nivel de independencia, meio ambiente (p<0,01) e psicologico (p<0,05) . Inseguranca no trabalho e inversamente correlacionada com os dominios psicologico, nivel de independencia (p<0,05) e meio ambiente (p<0,01). Suporte do supervisor e diretamente correlacionado com nivel de independencia (p<0,05). CONCLUSAO: Medicos e enfermeiros apresentaram altos esforcos, demandas psicologicas, fisicas e inseguranca no trabalho que repercutem na qualidade de vida.

Demandas do trabalho e controle: implicações em unidades de terapia intensiva pediátrica e neonatal

Comparar a demanda e o controle sobre trabalho de medicos e enfermeiros que trabalham em unidades de tratamento intensivo pediatrica e neonatal. Estudo transversal com 37 medicos e 20 enfermeiros. Utilizou-se o Job Content Questionnarie. Medicos da UTI Neonatal diferem em suporte social recebido do supervisor (p=0,01) em relacao aos da UTI Pediatrica. Enfermeiros da UTI Neonatal apresentam inseguranca no trabalho (p=0,05). Medicos e enfermeiros da UTI Pediatrica diferem em controle sobre o trabalho; demanda psicologica do trabalho; esforco fisico e suporte do supervisor (p<0,05). Medicos e enfermeiros da UTI Neonatal apresentam diferencas estatisticas em controle sobre o trabalho; esforco fisico e suporte do supervisor (p<0,05). O ambiente de trabalho nas UTIs apresenta alta demanda e baixo controle sobre o trabalho.Comparacion de la demanda y control sobre el trabajo de los medicos y enfermeras que trabajan en las unidades de tratamiento intensivo pediatrico y neonatal. Estudio transversal con 37 medicos y 20 enfermeras. Se utilizo el Job Content Questionnarie. Los medicos de la UCI Neonatal difieren en el apoyo social recibido desde el supervisor (p= 0,01) en comparacion com la UCI Pediatrica. Enfermeras de la UCI Neonatal actualmente la inseguridad en el empleo (p = 0,05). Los medicos y enfermeras de la UCI Pediatrica difieren em el control sobre el trabajo, las exigencias psicologicas del trabajo, esfuerzo fisico y el apoyo del supervisor (p<0,05). Los medicos y enfermeras de la UCI Neonatal demostrar diferencias estadisticamente significativas en el control de la labor, esfuerzo fisico y el apoyo del supervisor (p <0,05). El entorno de trabajo en la UCI estan en alta demanda y bajo el control de la obra.

Preliminary study about occupational stress of physicians and nurses in pediatric and neonatal intensive care units: the balance between effort and reward

This study compared the balance between effort (E) and reward (R) among physicians and nurses working in pediatric (PED) and neonatal (NEO) Intensive Care Units. This descriptive cross-sectional study was carried out with 37 physicians and 20 nurses. The Effort-Reward Imbalance Questionnaire was used. Statistically significant differences were not found among physicians (p>0.05) or nurses from PED and NEO in relation to E and R (p>0.05). No statistically significant differences were found between physicians and nurses in PED in the several studied variables. Comparison between the professionals working in NEO revealed that physicians presented more over-commitment than nurses (p=0.01). The organizational setting of NEO proved to be more demanding for physicians, exacting a greater commitment to their work, while demands presented in both units seemed to be the same for nurses.O objetivo do estudo foi comparar o equilibrio entre esforco (E) e recompensa (R) entre medicos de unidades de terapia intensiva pediatrica (PED) e neonatal (NEO) e entre enfermeiros das mesmas unidades. Este e estudo transversal descritivo com 37 medicos e 20 enfermeiros. O questionario Effort-Reward Imbalance foi utilizado. Nao se encontrou diferenca estatistica entre medicos da PED e da NEO em relacao ao E e R (p>;0,05). Da mesma forma, enfermeiros da PED e da NEO nao diferiram estatisticamente em relacao ao E e R (p>;0,05). Comparando medicos com enfermeiros da PED, nao foram encontradas diferencas entre as variaveis estudadas. Em relacao a comparacao feita entre profissionais da NEO, encontrou-se maior supercomprometimento dos medicos do que de enfermeiros (p=0,01). O ambiente organizacional da NEO mostrou-se mais exigente para os medicos, determinando maior comprometimento com o trabalho, enquanto que, para os enfermeiros de ambas as unidades, a demanda pareceu ser a mesma.

Estudo preliminar sobre o estresse ocupacional de médicos e enfermeiros em UTI pediátrica e neonatal: o equilíbrio entre esforço e recompensa

This study compared the balance between effort (E) and reward (R) among physicians and nurses working in pediatric (PED) and neonatal (NEO) Intensive Care Units. This descriptive cross-sectional study was carried out with 37 physicians and 20 nurses. The Effort-Reward Imbalance Questionnaire was used. Statistically significant differences were not found among physicians (p>0.05) or nurses from PED and NEO in relation to E and R (p>0.05). No statistically significant differences were found between physicians and nurses in PED in the several studied variables. Comparison between the professionals working in NEO revealed that physicians presented more over-commitment than nurses (p=0.01). The organizational setting of NEO proved to be more demanding for physicians, exacting a greater commitment to their work, while demands presented in both units seemed to be the same for nurses.O objetivo do estudo foi comparar o equilibrio entre esforco (E) e recompensa (R) entre medicos de unidades de terapia intensiva pediatrica (PED) e neonatal (NEO) e entre enfermeiros das mesmas unidades. Este e estudo transversal descritivo com 37 medicos e 20 enfermeiros. O questionario Effort-Reward Imbalance foi utilizado. Nao se encontrou diferenca estatistica entre medicos da PED e da NEO em relacao ao E e R (p>;0,05). Da mesma forma, enfermeiros da PED e da NEO nao diferiram estatisticamente em relacao ao E e R (p>;0,05). Comparando medicos com enfermeiros da PED, nao foram encontradas diferencas entre as variaveis estudadas. Em relacao a comparacao feita entre profissionais da NEO, encontrou-se maior supercomprometimento dos medicos do que de enfermeiros (p=0,01). O ambiente organizacional da NEO mostrou-se mais exigente para os medicos, determinando maior comprometimento com o trabalho, enquanto que, para os enfermeiros de ambas as unidades, a demanda pareceu ser a mesma.

Preliminary study about qualify of life of physicians and nurses working in pediatric and neonatal intensive care units

Compare the Quality of Life (QL) of doctors and nurses who work in Pediatric (PED) and Neonatal (NEO) Intensive Care Units, and to evaluate whether there are differences between the QL in the same job category, but differing according to the work unit. This descriptive study was performed with 37 physicians and 20 nurses. The WHOQOL100 was used. Physicians from the PED differ statistically in the field VI (p = 0.003) compared with physicians from the NEO. Physicians and nurses from the PED showed a statistically significant difference in field V (p < 0.01), while physicians and nurses from the NEO showed a statistically significant difference in field VI (p = 0.05). The QL assessment of physicians and nurses working in pediatric and neonatal intensive care units was below the scores found in scientific literature, compared to studies that evaluated patients with chronic pain and mental health disorders, indicating the occurrence of occupational stress.Compare the Quality of Life (QL) of doctors and nurses who work in Pediatric (PED) and Neonatal (NEO) Intensive Care Units, and to evaluate whether there are differences between the QL in the same job category, but differing according to the work unit. This descriptive study was performed with 37 physicians and 20 nurses. The WHOQOL100 was used. Physicians from the PED differ statistically in the field VI (p=0.003) compared with physicians from the NEO. Physicians and nurses from the PED showed a statistically significant difference in field V (p<0.01), while physicians and nurses from the NEO showed a statistically significant difference in field VI (p=0.05). The QL assessment of physicians and nurses working in pediatric and neonatal intensive care units was below the scores found in scientific literature, compared to studies that evaluated patients with chronic pain and mental health disorders, indicating the occurrence of occupational stress.

Demands and control of work: implications in pediatric and neonatal intensive care units

Comparar a demanda e o controle sobre trabalho de medicos e enfermeiros que trabalham em unidades de tratamento intensivo pediatrica e neonatal. Estudo transversal com 37 medicos e 20 enfermeiros. Utilizou-se o Job Content Questionnarie. Medicos da UTI Neonatal diferem em suporte social recebido do supervisor (p=0,01) em relacao aos da UTI Pediatrica. Enfermeiros da UTI Neonatal apresentam inseguranca no trabalho (p=0,05). Medicos e enfermeiros da UTI Pediatrica diferem em controle sobre o trabalho; demanda psicologica do trabalho; esforco fisico e suporte do supervisor (p<0,05). Medicos e enfermeiros da UTI Neonatal apresentam diferencas estatisticas em controle sobre o trabalho; esforco fisico e suporte do supervisor (p<0,05). O ambiente de trabalho nas UTIs apresenta alta demanda e baixo controle sobre o trabalho.Comparacion de la demanda y control sobre el trabajo de los medicos y enfermeras que trabajan en las unidades de tratamiento intensivo pediatrico y neonatal. Estudio transversal con 37 medicos y 20 enfermeras. Se utilizo el Job Content Questionnarie. Los medicos de la UCI Neonatal difieren en el apoyo social recibido desde el supervisor (p= 0,01) en comparacion com la UCI Pediatrica. Enfermeras de la UCI Neonatal actualmente la inseguridad en el empleo (p = 0,05). Los medicos y enfermeras de la UCI Pediatrica difieren em el control sobre el trabajo, las exigencias psicologicas del trabajo, esfuerzo fisico y el apoyo del supervisor (p<0,05). Los medicos y enfermeras de la UCI Neonatal demostrar diferencias estadisticamente significativas en el control de la labor, esfuerzo fisico y el apoyo del supervisor (p <0,05). El entorno de trabajo en la UCI estan en alta demanda y bajo el control de la obra.

Estudio preliminar sobre el estrés ocupacional de médicos y enfermeros en UTI pediátrica y neonatal: el equilibrio entre esfuerzo y recompensa

This study compared the balance between effort (E) and reward (R) among physicians and nurses working in pediatric (PED) and neonatal (NEO) Intensive Care Units. This descriptive cross-sectional study was carried out with 37 physicians and 20 nurses. The Effort-Reward Imbalance Questionnaire was used. Statistically significant differences were not found among physicians (p>0.05) or nurses from PED and NEO in relation to E and R (p>0.05). No statistically significant differences were found between physicians and nurses in PED in the several studied variables. Comparison between the professionals working in NEO revealed that physicians presented more over-commitment than nurses (p=0.01). The organizational setting of NEO proved to be more demanding for physicians, exacting a greater commitment to their work, while demands presented in both units seemed to be the same for nurses.O objetivo do estudo foi comparar o equilibrio entre esforco (E) e recompensa (R) entre medicos de unidades de terapia intensiva pediatrica (PED) e neonatal (NEO) e entre enfermeiros das mesmas unidades. Este e estudo transversal descritivo com 37 medicos e 20 enfermeiros. O questionario Effort-Reward Imbalance foi utilizado. Nao se encontrou diferenca estatistica entre medicos da PED e da NEO em relacao ao E e R (p>;0,05). Da mesma forma, enfermeiros da PED e da NEO nao diferiram estatisticamente em relacao ao E e R (p>;0,05). Comparando medicos com enfermeiros da PED, nao foram encontradas diferencas entre as variaveis estudadas. Em relacao a comparacao feita entre profissionais da NEO, encontrou-se maior supercomprometimento dos medicos do que de enfermeiros (p=0,01). O ambiente organizacional da NEO mostrou-se mais exigente para os medicos, determinando maior comprometimento com o trabalho, enquanto que, para os enfermeiros de ambas as unidades, a demanda pareceu ser a mesma.

Estudio preliminar sobre la calidad de vida de médicos y enfermeros intensivistas pediátricos y neonatales

Compare the Quality of Life (QL) of doctors and nurses who work in Pediatric (PED) and Neonatal (NEO) Intensive Care Units, and to evaluate whether there are differences between the QL in the same job category, but differing according to the work unit. This descriptive study was performed with 37 physicians and 20 nurses. The WHOQOL100 was used. Physicians from the PED differ statistically in the field VI (p = 0.003) compared with physicians from the NEO. Physicians and nurses from the PED showed a statistically significant difference in field V (p < 0.01), while physicians and nurses from the NEO showed a statistically significant difference in field VI (p = 0.05). The QL assessment of physicians and nurses working in pediatric and neonatal intensive care units was below the scores found in scientific literature, compared to studies that evaluated patients with chronic pain and mental health disorders, indicating the occurrence of occupational stress.Compare the Quality of Life (QL) of doctors and nurses who work in Pediatric (PED) and Neonatal (NEO) Intensive Care Units, and to evaluate whether there are differences between the QL in the same job category, but differing according to the work unit. This descriptive study was performed with 37 physicians and 20 nurses. The WHOQOL100 was used. Physicians from the PED differ statistically in the field VI (p=0.003) compared with physicians from the NEO. Physicians and nurses from the PED showed a statistically significant difference in field V (p<0.01), while physicians and nurses from the NEO showed a statistically significant difference in field VI (p=0.05). The QL assessment of physicians and nurses working in pediatric and neonatal intensive care units was below the scores found in scientific literature, compared to studies that evaluated patients with chronic pain and mental health disorders, indicating the occurrence of occupational stress.