Orientadora: Profª. Drª. Leila Maria Mansano Sarquis / Dissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação Mestrado Profissional em Enfermagem. Defesa: Curitiba, 18/11/2016 / Inclui referências : f.90-101 / Resumo: O adoecimento crônico dos trabalhadores está associado a capacidade reduzida para o trabalho gerando o absenteísmo, o que dificulta a manutenção da saúde e prejudica a qualidade de vida dos trabalhadores. Estudo do tipo transversal, descritivo-analítico, com os seguintes objetivos: analisar a relação entre absenteísmo, doenças crônicas e a capacidade para o trabalho entre trabalhadores de saúde de um hospital público do Paraná; caracterizar o perfil de absenteísmo dos trabalhadores de saúde; descrever a capacidade para o trabalho dos trabalhadores de saúde com doenças crônicas; e identificar o absenteísmo relacionado às doenças crônicas. O cenário do estudo foi uma instituição hospitalar em Curitiba, Paraná. A população constituiu-se de 373 trabalhadores de saúde que tiveram licença médica no ano de 2014. Os dados foram coletados em 2016 por meio de dois questionários: o primeiro, com características sociodemográficas, ocupacionais e estilo de vida; e o segundo, com o Índice de Capacidade para o Trabalho (ICT). Para o preenchimento do ICT, foram selecionados apenas os trabalhadores que responderam ter alguma doença crônica no primeiro questionário. Para a análise dos dados, utilizou-se o software estatístico SPSS 19.0 para a comparação de médias, correlação de Spearmam, ANOVA, regressão linear múltipla e os testes de significância Qui-quadrado e t-Student. Em todas as análises, considerou-se estatisticamente significativo valor-p ? 0,05. Os resultados evidenciaram 2.580 dias de trabalho perdidos em um ano, com prevalência entre mulheres (81,2%), e média de idade de 40,66 anos. Os trabalhadores com doença crônica apresentaram média de 7,9 dias de absenteísmo/ano. O absenteísmo apresentou relação com o turno de trabalho, com a carga horária, com o número de empregos e com a presença de doença crônica. A enxaqueca e o grupo de outras doenças tiveram relação com o absenteísmo, independentemente da quantidade de dias de ausência. Os trabalhadores com doença crônica totalizaram 51% dos pesquisados. Desses, 54,2% apresentaram uma e 45,8% duas ou mais doenças crônicas. As doenças prevalentes foram: 14,7% doenças osteomusculares, 12,9% hipertensão arterial, 11% enxaqueca e 9,9% depressão. Houve relação entre ICT e a média de dias de absenteísmo, além do absenteísmo de poucos dias de ausências (? 9 dias), com a presença de uma doença crônica segundo o sexo. O sexo feminino teve as menores médias de ICT. Não foi possível provar a relação entre ICT e número de doenças crônicas. Destacou-se o percentual de ICT reduzido em 46,8% dos trabalhadores, com diferença significativa entre as médias. Evidenciou-se 38% da variabilidade do absenteísmo relacionado ao ICT e, consecutivamente, ao sexo, idade e setor de trabalho. As idades entre 45 a 54 anos e 55 ou mais e os trabalhadores do setor de apoio técnico, influenciaram no absenteísmo de acordo com o ICT apresentado. Foi possível provar a relação entre absenteísmo, com o ICT e as doenças crônicas na hipertensão arterial. Conclui-se que existe relação entre dias de absenteísmo, a capacidade reduzida para o trabalho e as doenças crônicas. A identificação dessas associações é importante para determinar a suscetibilidade dos trabalhadores, devido ao adoecimento, sua ausência no trabalho e sua incapacidade laboral, para que a criação de estratégias voltadas à vigilância em saúde seja concentrada na individualidade do trabalhador e do ambiente de trabalho. Palavras-chave: Absenteísmo. Avaliação da capacidade de trabalho. Doença crônica. Enfermagem. / Abstract: The chronic illness of workers is associated with reduced work capacity generating absenteeism, is the main factor that influences, negatively, not only the health but also the quality of life of health workers. The present study is both cross-sectional and descriptive-analytical. Its objectives are: to analyze the connection between absenteeism, chronic diseases and work ability among health workers in a public hospital in Paraná; to characterize the profile of absenteeism among health workers; to describe work ability among health workers with chronic diseases; and to identify absenteeism in relation to chronic diseases. The study was conducted in a hospital in Curitiba, in the State of Paraná. The population consisted of 373 health workers who asked for sick leave in the year of 2014. Data were collected in 2016, two questionnaires were used: the first with sociodemographic characteristics, such as occupation and lifestyle; and the second based on the Work Ability Index (WAI). Only those workers who reported having a chronic disease in the first questionnaire responded the WAI. The software SPSS 19.0 was used for the data analysis: comparison of means, Spearmam correlation, ANOVA, multiple linear regression and the significance tests Chi-square and Student's t. As statistically significant, we considered p-value ? 0.05. The results point out that 2580 workdays were lost in a year, with prevalence among women (81.2%), and mean age of 40.66 years. Workers with chronic diseases took 7.9 days off every year. Absenteeism related with the shift, the hours, the number of jobs and the presence of chronic diseases. Migraine and a group called "other diseases" have shown correlation with absenteeism, regardless of the quantity of absent days. Workers with chronic disease amounted to 51% of respondents. Of these, 54.2% had one chronic disease and 45.8% had two or more chronic diseases. The prevalent diseases were: 14.7%, musculoskeletal disorders; 12.9%, hypertension; 11% and 9.9%, migraine and depression, respectively. There was a relationship between WAI and the average days of absenteeism, in addition to low-frequency absenteeism (? 9 days) in the presence of a chronic disease, according to genre. Women presented the lowest mean of WAI. There was no correlation between WAI and the number of chronic diseases. We highlight a WAI low percentage in 46.8% of workers, with a significant difference between the means. It is also relevant to highlight a 38% of variability related to WAI and, consecutively, to sex, age and job sector. Ages between 45-54 and 55 or more, and workers in the technical support industry, influenced absenteeism conforming to WAI. The was relationship between absenteeism, WAI and chronic disease in the hypertension. It is concluded that there is a relation between absenteeism days, reduced work capacity and chronic diseases. The identification of these associations is important to determine the susceptibility of workers their illness, their absence at work and their inability to work. So that creation of strategies for health surveillance, is focused on worker's individuality and work environment, Keywords: Absenteeism. Work capacity evaluation. Chronic diseases. Nursing.

Hierdie navorsing het die bevordering van die regering se gesondheidsbevorderingsdoelwitte soos vervat in die Witskrif vir die Transformasie van die Gesondheidstelsel in Suid-Afrika, Kennisgewing 667 van 1997 (White Paper for the Transformation of the Health System in South Africa Notice 667 of 1997) ten doel. 'n Verdere doel was om die behoefte na beroepsgesondheidsbevorderende programme in geselekteerde beroepsituasies vanuit 'n verpleegkundige perspektief vas te stel. Die resultate van hierdie navorsing het aangedui dat daar wel 'n behoefte bestaan aan beroepsgesondheidsbevorderende programme in geselekteerde beroepsituasies. Hierdie behoefte is vasgestel deur middel van die literatuurstudie en deur die versameling van inligting deur middel van 'n opname. 'n Holistiese en bemagtigingsbenadering tot beroepsgesondheidsbevorderende, asook 'n gesondheidsbevorderende verplegingsbenaderingsraamwerk word voorgestel. Addisioneel word riglyne vir die ontwikkeling en implementering van beroepsgesondheidsbevorderingsprogramme asook 'n gesondheidsbevorderende verpleegopleidingsprogram voorgestel. Daar word aanbeveel dat gesondheidsbevorderende verpleegkunde ingesluit word in alle verpleegkunde praktyke en verpleegkunde kurrikula. Aanbevelings ten opsigte van toekomstige navorsing sentreer rondom 'n ondersoek na die huidige status van beroepsgesondheidsbevordering, navorsing met betrekking tot die gesondheidsbevorderende werkplek en kampus - wat alle belanghebbendes insluit - die status van gesondheidsbevorderende opleiding; en navorsing gelyksoortig aan hierdie een in ander streke van Suid-Afrika. Die skeiding tussen beroeps- en primere gesondheidsorg in werkplekke behoort ook ondersoek te word. / This research is aimed at furthering the health promotion and occupational health objectives of the government as is set out in the "The White Paper for the Transformation of the Health System in South Africa Notice 667 of 1997". The aim of this research was to determine the need for occupational health promotion programmes in selected occupational settings from a nursing perspective. The overall outcome of this research demonstrated that a need exists for occupational health promotion programmes in selected occupational settings. This was illustrated by the literature study and by the information collected through a survey. Three frameworks are proposed, namely a holistic approach to an occupational health promotion programme, an empowerment occupational health promotion approach, and a health promoting nursing framework. In addition, guidelines for the development and implementation of an occupational health promotion programme and a health promotion and health promoting nursing training programme are recommended. It is also recommended that health promoting nursing be included in all nursing practice and nursing training curricula. Recommendations for future research centred on the investigation of the present status of occupational health promotion, research regarding the health promoting workplace and campus that involves all stakeholders, the status of health promotion training, and research similar to this one in other regions of South Africa. The division of occupational health and primary health care in occupational health settings needs to be investigated as well. / Health Studies / M.A. (Advanced Nursing Sciences)

Hierdie navorsing het die bevordering van die regering se gesondheidsbevorderingsdoelwitte soos vervat in die Witskrif vir die Transformasie van die Gesondheidstelsel in Suid-Afrika, Kennisgewing 667 van 1997 (White Paper for the Transformation of the Health System in South Africa Notice 667 of 1997) ten doel. 'n Verdere doel was om die behoefte na beroepsgesondheidsbevorderende programme in geselekteerde beroepsituasies vanuit 'n verpleegkundige perspektief vas te stel. Die resultate van hierdie navorsing het aangedui dat daar wel 'n behoefte bestaan aan beroepsgesondheidsbevorderende programme in geselekteerde beroepsituasies. Hierdie behoefte is vasgestel deur middel van die literatuurstudie en deur die versameling van inligting deur middel van 'n opname. 'n Holistiese en bemagtigingsbenadering tot beroepsgesondheidsbevorderende, asook 'n gesondheidsbevorderende verplegingsbenaderingsraamwerk word voorgestel. Addisioneel word riglyne vir die ontwikkeling en implementering van beroepsgesondheidsbevorderingsprogramme asook 'n gesondheidsbevorderende verpleegopleidingsprogram voorgestel. Daar word aanbeveel dat gesondheidsbevorderende verpleegkunde ingesluit word in alle verpleegkunde praktyke en verpleegkunde kurrikula. Aanbevelings ten opsigte van toekomstige navorsing sentreer rondom 'n ondersoek na die huidige status van beroepsgesondheidsbevordering, navorsing met betrekking tot die gesondheidsbevorderende werkplek en kampus - wat alle belanghebbendes insluit - die status van gesondheidsbevorderende opleiding; en navorsing gelyksoortig aan hierdie een in ander streke van Suid-Afrika. Die skeiding tussen beroeps- en primere gesondheidsorg in werkplekke behoort ook ondersoek te word. / This research is aimed at furthering the health promotion and occupational health objectives of the government as is set out in the "The White Paper for the Transformation of the Health System in South Africa Notice 667 of 1997". The aim of this research was to determine the need for occupational health promotion programmes in selected occupational settings from a nursing perspective. The overall outcome of this research demonstrated that a need exists for occupational health promotion programmes in selected occupational settings. This was illustrated by the literature study and by the information collected through a survey. Three frameworks are proposed, namely a holistic approach to an occupational health promotion programme, an empowerment occupational health promotion approach, and a health promoting nursing framework. In addition, guidelines for the development and implementation of an occupational health promotion programme and a health promotion and health promoting nursing training programme are recommended. It is also recommended that health promoting nursing be included in all nursing practice and nursing training curricula. Recommendations for future research centred on the investigation of the present status of occupational health promotion, research regarding the health promoting workplace and campus that involves all stakeholders, the status of health promotion training, and research similar to this one in other regions of South Africa. The division of occupational health and primary health care in occupational health settings needs to be investigated as well. / Health Studies / M.A. (Advanced Nursing Sciences)