Dissertação(mestrado) - Universidade Federal do Rio Grande, Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, 2010. / Submitted by eloisa silva (eloisa1_silva@yahoo.com.br) on 2012-12-21T13:23:36Z No. of bitstreams: 1 michele barboza.pdf: 2418883 bytes, checksum: 7db66ed08d4a16ac1744797c9f61074f (MD5) / Approved for entry into archive by Bruna Vieira(bruninha_vieira@ibest.com.br) on 2013-01-08T18:11:37Z (GMT) No. of bitstreams: 1 michele barboza.pdf: 2418883 bytes, checksum: 7db66ed08d4a16ac1744797c9f61074f (MD5) / Made available in DSpace on 2013-01-08T18:11:37Z (GMT). No. of bitstreams: 1 michele barboza.pdf: 2418883 bytes, checksum: 7db66ed08d4a16ac1744797c9f61074f (MD5) Previous issue date: 2010 / A presente pesquisa teve como objetivo estudar o absenteísmo, sua relação com o ambiente de trabalho e sua interferência no cuidado de enfermagem. Trata-se de um estudo descritivo, exploratório com abordagem qualitativa, com base na teoria sistêmica, que considera seus elementos integrantes interdependentes, interrelacionados, influenciando-se mutuamente. A coleta de dados ocorreu nos meses de junho a agosto de 2009. Com a finalidade de conhecer a unidade com maior percentual de absenteísmo, conforme critério estabelecido, realizou-se, junto ao serviço de recursos humanos o levantamento das faltas dos trabalhadores de enfermagem no ano de 2008. Obteve-se como resultado a unidade de clínica cirúrgica com maior índice de absenteísmo. Como método para coleta de dados optou-se pela observação sistemática da unidade selecionada, a fim de encontrar relação do absenteísmo com o ambiente de trabalho e entrevista semi-estruturada com os enfermeiros dessa unidade. Para análise, interpretação e discussão dos dados foi utilizado o método da análise temática. Diante do objetivo, da questão pesquisa e dos respectivos pressupostos foram desenvolvidos dois artigos: “O absenteísmo dos profissionais de enfermagem hospitalar e sua relação com o ambiente de trabalho” e “O absenteísmo e sua interferência no cuidado ao cuidador de enfermagem hospitalar”. Os resultados do primeiro artigo mostraram que a estrutura física e recursos materiais apresentavam-se inadequados, tanto em quantidade como em qualidade e que os recursos humanos encontravam-se diminuídos gerando a sobrecarga de trabalho que desencadeou problemas como: insatisfação, falta de comprometimento e discussões entre equipe, os quais evidenciaram relação direta entre o absenteísmo e o ambiente de trabalho. E os resultados do segundo artigo demonstraram que a falta de dimensionamento de pessoal ou realizado de forma errônea, acarreta absenteísmo na unidade, sendo que o mesmo interfere, negativamente, no ser humano cuidador/trabalhador nas suas multidimensões, comprometendo sua dimensão biológica ao desenvolver o adoecimento; dimensão psicológica por ocasionar o estresse ocupacional. Além disso, compromete a dimensão social por prejudicar as relações interpessoais entre equipe, enquanto na dimensão espiritual ele predispõe a falta de comprometimento, solidariedade, insatisfação. Enfim, percebeu-se que, o absenteísmo repercutiu, negativamente, no cuidado prestado ao cliente, pois, o mesmo não foi atendido de forma integral, devido à sobrecarga de trabalho estabelecida pelos recursos humanos diminuídos. Da mesma forma ele causa prejuízos no cuidador, integrante da equipe de enfermagem, que necessita absorver as atividades do profissional que está ausente, gerando excesso de trabalho e predispondo-o ao adoecimento. Além disso, as outras dimensões humanas, de forma sistêmica, também sofrerão as conseqüências do absenteísmo. Desta maneira, conclui-se que existe relação entre o ambiente de trabalho com o absenteísmo dos trabalhadores de enfermagem hospitalar, e que, de forma sistêmica, irá interferir no cuidado prestado, repercutindo de forma desfavorável na saúde do cuidador nas suas multidimensões e na diminuição da qualidade do cuidado prestado ao cliente. / This research aimed at studying absenteeism, its relationship to the workplace and its influence on nursing care. It is a descriptive, exploratory study of qualitative approach based on the Systems Theory, which considers its integral parts as being independent and interacting, interrelated, and influencing each other. Data collection occurred between June and August 2009. In order to know the unit with the highest rate of absenteeism, according to established criteria, it was verified, next to the Human Resources Office, the number of absences of the nurse staff in 2008. The result was the unit of surgical clinic as the one presenting the highest rate of absenteeism. As a method for data collection it was chosen the systematic observation of the unit selected in order to find the relationship between absenteeism and workplace, as well as a semi-structured interview with nurses from that unit. For the analysis and interpretation it was used the thematic analysis method as a way to discuss and interpret data. Two articles were developed based on the goal, research question and underlying assumptions: “Absenteeism of hospital nursing staff and its relationship to the workplace” and “Absenteeism and its interference with the care for the hospital nursing caregiver”. The results of the first article showed that the physical structure and material resources were inadequate both in quantity and quality, and that human resources were reduced, generating the workload that triggered problems such as dissatisfaction, lack of commitment and arguments among staff, therefore pointing to a direct relationship between absenteeism and workplace. The results of the second article demonstrated that no staff sizing or the latter done wrongly leads to absenteeism in the unit, as it also interferes negatively in the human being caregiver / employee in his multiple dimensions, affecting his biological dimension by developing illness and his psychological dimension by causing occupational stress. In addition, it compromises the social dimension, as it harms interpersonal relationships among the staff, while in the spiritual dimension it predisposes a lack of commitment, solidarity, and dissatisfaction. Ultimately, it was noticed that absenteeism impacted negatively on the care provided to the client, which was not granted in full due to work overload established by reduced human resources. Likewise, it causes damage to the caregiver, a member of the nursing staff who needs to absorb the activities of the professional who is absent, the latter creating extra work and predisposing the first to become ill. Moreover, the other human dimensions, in a systemic way, will also suffer the consequences of absenteeism. Thus, we conclude that there is a relation between workplace and the absenteeism of hospital nursing, which, in a systemic way, will interfere in the care provided, reflecting unfavorably on the caregiver's health in its multiple dimensions and in a reduced quality of the care provided to the client. / La investigación que presentamos tiene como objetivo estudiar el absentismo, su relación con el ambiente de trabajo y su interferencia en el cuidado de enfermería. Se trata de un estudio descriptivo, de exploración con un abordaje cualitativo, con base en la teoría sistémica, que considera sus elementos integrantes interdependientes, interrelaccionados, infuenciándose mútuamente. La compilación de datos ocurrió en los meses de Junio a Agosto del 2009. Con la finalidad de conocer la unidad com mayor porcentaje de absentismo, conforme al criterio establecido, se realizó, junto al servicio de recursos humanos el levantamiento de las faltas de los trabajarores de enfermería en el año de 2008. Se obtuvo como resultado la unidad de clínica cirúrgica con mayor índice de absentismo. Como método para la colecta de datos se optó por la observación de la unidad seleccionada, a fin de encontrar relaciones del absentismo con el ambiente de trabajo y entrevista semiestructurada con los enfermeros de esa unidad. Para analisis e interpretación fue utilizado el método de análisis temático como forma de interpretar y discutir los datos. Delante del objetivo, cuestión investigación y respectivos presupuestos fueron desarrollados dos artículos: “O absentismo de los profesionales de enfermería hospitalar y su relación con el ambiente de trabajo” y “O absentismo y su interferencia en el cuidado al cuidador de enfermería hospitalar”. Los resultados del primer artículo mostraron que la estructura física y los recursos materiales se presentaban inadecuadamente, tanto en cantidad como en cualidad, y que los recursos humanos se encontraban disminuidos, generando la sobrecarga de trabajo que desencadenó problemas como: insatisfacción, falta de compromiso y discusiones de equipo, los cuales evidenciaron la relación directa entre el absentismo y el ambiente de trabajo. Y los resultados del segundo artículo demostraron que la falta de dimensionamiento del personal o realizado de forma equivocada, acarrea absentismo en la unidad, por lo que interfiere de igual manera, negativamente, en el ser humano cuidador/trabajador en sus multi-dimensiones, comprometiendo su dimensión biológica al desarrollar patologías; dimensión psicológica por ocasionar el estrés ocupacional. Además de eso, compromente la dimensión social por perjudicar las relaciones inter-personales entre el equipo, mientras que la dimensión espiritual, predispone la falta de compromiso, solidaridad e insatisfacción. O sea, se observó que, el absentismo repercutió, negativamente, en el cuidado prestado al cliente, ya que, el mismo no fue atendido de forma integral, debido a la sobrecarga de trabajo establecida por los recursos humanos disminuidos. De esta misma forma, el absentismo, causa perjuicios a su cuidador, integrante del equipo de enfermeros, que necesita absorver las actividades del profesional que está ausente, generando exceso de trabajo y predisponiendolo a que él mismo enferme. Además de eso, las aotras dimensiones humanas, de forma sistemática, también sufrirán las consecuencias del absentismo. De esta manera, concluimos que existe relación entre el ambiente de trabajo con el absentismo de los trabajadores de emfermería hospitalar, y que, de forma sistemática, interferirá en el cuidado prestado, repercutiendo de forma desfavorable en la salud del cuidador en sus multidimensiones y en la disminución de la calidad del cuidado prestado al cliente.

Made available in DSpace on 2014-07-29T15:04:34Z (GMT). No. of bitstreams: 1 Dissertacao Claudia Cleinne Barcelos Cunha.pdf: 1623906 bytes, checksum: 23b284fd9c188471088ad2655980ff55 (MD5) Previous issue date: 2011-03-17 / This descriptive quantitative study aimed to evaluate quantitatively and qualitatively the nurse staff in a surgery clinic unit at a school hospital in Brazilian Center West Region. Search subjects were all the inpatients of a surgery clinic unit in the period of data collecting. The project followed the terms of the Resolution 196/1996 and it was approved under Protocol nr. 032/2008. Data were collected from September to October 2009, during 30 consecutive days. One used the design method used was that proposed by Gaidzinski (1998). It includes an impatient classification stage concerning to nurse care dependence. Fugulin instrument (2002) was used. The parameters of COFEN Resolution 293/2004 were used for establishing assistance hours and percentage distribution of each professional category. Absenteeism rates were determined by Gaidzinski s definitions and equations (1998). The inpatients were daily classified in an amount of 1464 evaluations in that period. From them, 53.7% needed minimal care; 39.3% intermediate, 5.9% high dependence, 9.9% semi-intensive and 0.2% intensive care. The determined technical safety index in this study was 58% for nurses and 68% for middle level professionals. Among previewed absences, weekly holiday ones showed the highest rate, 40%. Among not previewed ones, the higher index was for medical licensees: 0.8% for nurses, 3.0% for technical nurse assistants and 1.5% for trainees. Technical nurse assistant showed the higher index for not planned absences (7.5%). The designed scale had 29 nurses and 62 technical assistants. It was noted that the number of nurses corresponds to 27.6% of the designed ones and the middle level professionals complete the table, which shows a deficit of 30.4% in the staff. The rate of registered nurses found in this study is far below what is recommended by COFEN and this may compromise assistance quality and improve adverse events occurrence as well length and costs of hospital stay. A reduced amount of professionals in the team may have negative consequences on nurse staff health, which could increase absenteeism. This search considered that is no denying the importance of design staff as a management instrument and indicator to consider the amount of nursing human resources. However, it cannot grantee alone attendance quality. One needs also actions concerning to planning and implementation of strategies of Continuing Education as well motivation work processes that may give to nurse team more satisfaction in work environment in order to get a continuum improvement in patient assistance. / Estudo descritivo de natureza quantitativa que objetivou avaliar o quantitativo e qualitativo de pessoal de Enfermagem da Unidade de Clínica Cirúrgica de um hospital universitário da Região Centro-Oeste. A população constituiu-se por todos os pacientes internados na Unidade de Clínica Cirúrgica no período da coleta dos dados. O projeto seguiu a Resolução 196/1996 e foi aprovado sob Protocolo 032/2008. A coleta de dados ocorreu de setembro a outubro de 2009, durante 30 dias consecutivos. O método de dimensionamento utilizado foi o proposto por Gaidzinski (1998) que inclui a etapa de classificação dos pacientes com relação à dependência dos cuidados de Enfermagem, em que se utilizou o instrumento de Fugulin (2002). Para as horas de assistência e distribuição percentual de cada categoria profissional foram adotados os parâmetros da Resolução 293/2004 do COFEN e a determinação dos índices de absenteísmo foi feita por meio das definições e equações elaboradas por Gaidzinski (1998). Os pacientes internados foram classificados diariamente. Foram realizadas 1464 avaliações nesse período. Dos pacientes classificados, 53,7% requeriam cuidados mínimos; 39,3% cuidados intermediários; 5,9% cuidados de alta dependência; 0,9% cuidados semi-intensivos e 0,2% cuidados intensivos. O índice de segurança técnico determinado pelo estudo foi de 58% para os Enfermeiros e de 68% para os profissionais de nível médio. Entre as ausências previstas, a por folga semanal apresentou o maior índice, com 40%. Das ausências não previstas, o maior índice foi para as licenças médicas, de 0,8% para os Enfermeiros, 3,0% para os Técnicos/Auxiliares de Enfermagem e 1,5% para os estagiários. Os Técnicos/Auxiliares de Enfermagem se destacaram com os maiores índices de ausências não previstas, 7,5%. O quadro projetado foi de 29 Enfermeiros e 62 Técnicos e Auxiliares de Enfermagem. Observou-se que o número de enfermeiros existentes corresponde a 27,6% do projetado e o número de profissionais de Enfermagem de nível médio corresponde a 89,7%, existindo no quadro geral um déficit de 30,4% profissionais. A proporção de Enfermeiros encontrada no estudo está muito aquém do que é preconizado pelo COFEN, o que pode comprometer a qualidade da assistência prestada, aumentando a ocorrência de eventos adversos, o tempo de internação e os custos. Um quantitativo reduzido de profissionais na equipe pode trazer consequências negativas sobre a saúde dos profissionais de Enfermagem, causando adoecimento e aumentando o absenteísmo. A pesquisa considerou que é inegável a importância do dimensionamento de pessoal como instrumento de gestão e indicador para equacionar o quantitativo de recursos humanos em Enfermagem, mas ele, por si só, não garante a qualidade do serviço prestado. São necessárias ainda, ações voltadas para o planejamento e implantação de estratégias de educação continuada e processos de trabalho motivacionais que proporcione à equipe de enfermagem maior satisfação no ambiente de trabalho e o alcance da melhoria contínua na assistência ao paciente.

Submitted by Luanna Matias (lua_matias@yahoo.com.br) on 2015-03-06T17:44:14Z No. of bitstreams: 2 Dissertação - Ana Lúcia de Melo Leão - 2012.pdf: 873518 bytes, checksum: 2e0b9cdd3da6e6f1df2a3f976192afcd (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luanna Matias (lua_matias@yahoo.com.br) on 2015-03-06T18:38:18Z (GMT) No. of bitstreams: 2 Dissertação - Ana Lúcia de Melo Leão - 2012.pdf: 873518 bytes, checksum: 2e0b9cdd3da6e6f1df2a3f976192afcd (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-03-06T18:38:18Z (GMT). No. of bitstreams: 2 Dissertação - Ana Lúcia de Melo Leão - 2012.pdf: 873518 bytes, checksum: 2e0b9cdd3da6e6f1df2a3f976192afcd (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2012-02-02 / Background: Sickness absence (SA), known as work disability justified by sick leave, can be an indicator of workers health status. In municipal government, like the rest of the country, the prevalence of SA and its main causes are still poorly documented, and are restricted to the analysis of some occupational groups, especially those who engage in health care or in institutions education. Estimates of the magnitude of SA vary widely and socio-demographic aspects related to nature and working conditions are among the main factors associated with the frequency and duration. Aims: To study the prevalence and the factors related to SA workers from the public sector in the municipality of Goiânia. Methods: Cross-sectional population-based study assessing prevalence and factors associated with sick leave lasting longer than three days for the health treatment from 2005 to 2010, in civil servants. Outcomes: 40.578 sick leave were assessed among 14.484 absent workers which generated 944.722 absent days. The indicators of sickness absence in that period were: prevalence of sick leave of 39.0%, higher among education professionals (47.7%) and health (41.9%), the mean duration of SA was 40 days / year per worker away and the average duration of Licenses was 23 days per episode. Predominance of female sexual workers, aged between 41 and 50 years, married, white, with high educational background, earning up to three minimal salaries, with their own house, with from 3 to 10 years of public service, having a professional bond and basically in operational tasks registered in the Municipal Secretariat of Education and Health. The main cause of sickness was mental and behavioral disorder followed by musculoskeletal diseases. The Multivariate analysis showed an association between sickness absence and the female subjects (OR 1,54 IC95%1,41-1,68), being older (OR 1,86 IC95% 1,48-2,32), married (OR 1,51 IC95% 1,13-2,02), having elementary school degree (OR 12,35 IC95% 10,39-14,69), income of up to three minimal salaries (OR 1,37 IC95% 1,21-1,55), having more working experience concerning the time(OR 3,39 IC95% 2,50-4,59), being professional in the health and educational area (OR 2,96 IC95% 2,60-3,38 and OR 2,90 IC95% 2,51- 3,36), as well as being part of the staff in the Municipal Secretariat of Education and Health (OR 1,69 IC95% 1,30-2,21 e OR 1,60 IC95% 1,23-2,09 ). Conclusions: The indicators of SA express the magnitude of this phenomenon in public service and can assist in the planning of health worker prioritizing the most vulnerable occupational groups whose socio-demographic characteristics and work organization influence on absenteeism due to illness. / Introdução: O absenteísmo-doença (AD), entendido como ausência ao trabalho por motivo de doença, é um importante indicador das condições de saúde dos trabalhadores. Na administração pública municipal, a exemplo do restante do país, a prevalência de AD e as suas principais causas ainda estão insuficientemente documentadas, e restringem-se a analise de alguns grupos ocupacionais, sobretudo daqueles que desenvolvem atividades nos serviços de saúde ou em instituições de ensino. Estimativas da magnitude do AD variam amplamente e características sóciodemográficas, aspectos ligados à natureza e às condições de trabalho situam-se entre os principais fatores associados à sua frequência e duração. Objetivos: Estudar a prevalência e os fatores associados ao absenteísmo-doença entre os servidores públicos estatutários do Município de Goiânia. Métodos: Estudo populacional de corte transversal, com análise de todas as licenças para tratamento de saúde (LTS), com duração superiores a três dias, cerificadas pela junta médica municipal no período janeiro de 2005 a dezembro de 2010. Resultados: Foram analisadas 40.578 LTS concedidas a 14.484 servidores que geraram 944.722 dias de ausências. Os indicadores de AD demonstraram uma prevalência média anual de 23,0% de servidores ausentes em decorrência de problemas de saúde; prevalência de licenças de 39,0%, sendo maior entre os profissionais de educação (47,7%) e saúde (41,9%); a duração média do AD foi de 40 dias/ano por servidor licenciado e a duração média das Licenças foi de 23 dias por episódio. Considerando os episódios de LTS houve Predomínio dos seguintes grupos: mulheres, faixa etária entre 41 a 50 anos, casados, brancos, com ensino superior, renda de até três salários mínimos, com até 10 anos de serviço público, lotados nas secretarias de educação e de saúde. A análise de regressão de Poisson demonstrou, no período, tendência de estabilidade dos indicadores entre as mulheres, e de aumento da prevalência de licenças entre os homens. A principal causa de AD foi por transtornos mentais e comportamentais seguidas pelas doenças do sistema osteomuscular e Lesões/causas externas. A análise Multivariada demonstrou associação estatisticamente significativa entre os afastamentos e ser do sexo feminino (OR 1,54 IC95%1,41-1,68), ter mais que 60 anos (OR 1,86 IC95% 1,48-2,32), ser casado (OR 1,51 IC95% 1,13-2,02), possuir até o ensino fundamental (OR 12,35 IC95% 10,39- 14,69), receber de até três salários mínimos (OR 1,37 IC95% 1,21-1,55), ter maior tempo de serviço (OR 3,39 IC95% 2,50-4,59), ser profissional de saúde e educação (OR 2,96 IC95% 2,60-3,38 e OR 2,90 IC95% 2,51-3,36 respectivamente), bem como estar lotado nas Secretarias Municipais de Saúde e Educação (OR 1,69 IC95% 1,30- 2,21 e OR 1,60 IC95% 1,23-2,09 respectivamente). Conclusões: Os indicadores de AD expressam a magnitude desse fenômeno no serviço público e podem auxiliar no planejamento das ações de saúde do trabalhador priorizando os grupos ocupacionais mais vulneráveis, cujas características sócio-demográficas e de organização do trabalho influenciaram nos afastamentos por motivos de doença.

Introdução - As ausências ao trabalho por doença são usadas como indicador da saúde dos trabalhadores e consideradas um significante problema de Saúde Pública. Diversos fatores são descritos como associados ao absenteísmo-doença, independentemente do agravo. A Previdência Social do Brasil regulamenta a concessão de benefício para trabalhadores que comprovarem incapacidade para o trabalho acima de quinze dias por adoecimento. Em 2010, transtornos mentais e comportamentais foram a terceira principal causa de concessão de auxílio-doença por incapacidade laborativa. Objetivo - Avaliar os fatores associados às longas ausências ao trabalho por transtornos mentais e comportamentais. Materiais e Método - Estudo de caso-controle composto por 385 participantes. Os casos foram requerentes de benefício previdenciário por transtorno mental incapacitante na cidade de São Paulo, Brasil. Foram realizadas entrevistas para preenchimento de questionários sociodemográfico e de hábitos/estilo de vida, ocupacional inclusive percepção de fatores psicossociais no trabalho, avaliação de condição de saúde e dados do laudo médico-pericial da Previdência Social. Foi realizada regressão logística múltipla hierarquizada para a avaliação da associação das variáveis independentes ao desfecho. Resultados - Os fatores associados foram: sexo feminino, alta escolaridade, cor da pele autorreferida como branca, alto grau de consumo de fumo e de ingesta de álcool, vínculo com empresa estatal, exposição à violência no trabalho, baixo apoio social, elevado comprometimento com o trabalho, atendimento médico por mais de dois diagnósticos no último ano. Na modelagem com interação entre as dimensões dos modelos de estresse ocupacional, a exposição à alta exigência com baixo apoio social, o desequilíbrio esforço-recompensa com elevado comprometimento e a interação entre essas quatro dimensões estão associadas ao desfecho de forma significativa. Considerações Finais - Aspectos sociodemográficos, hábitos e estilo de vida, característica e condição de trabalho, além do status de saúde, estão associados ao longo afastamento do trabalho por transtorno mental e comportamental. A exposição ocupacional a fatores desfavoráveis de natureza psicossocial é importante contribuidora no desfecho. Vê-se a necessidade de atenção para tais situações no intuito de ampliar as perspectivas de antecipação ao risco e implantação de ações intervencionistas que minimizem impactos negativos na saúde dos trabalhadores / Introduction - The absences from work due to illness are used as an indicator of the health of workers and are considered a significant public health problem. Several factors are described as associated with absenteeism and illness, regardless of condition. Brazilian Social Security regulates the payment of benefits to workers who prove work-disability longer than fifteen days due to illness. In 2010, mental and behavioral disorders were the third leading cause for granting disability benefits. Objective - To assess the factors associated with long-term sickness absences from work due to mental and behavioral disorders. Methods - A case-control study comprising 385 participants applicants for social security benefits due mental sickness was performed in the city of São Paulo, Brazil. Interviews were conducted and participants answered questionnaires about sociodemographic and habits/lifestyle, occupational characteristics (including perceptions of psychosocial factors at work), assessment of health status. Social Security medical expert data report were analyzed. It was performed hierarchical logistic regression to assess variables associated with the outcome. Results - The associated factors were: sex (female), college education, self-reported skin color as white, high consumption of tobacco and alcohol intake, working for a public company, exposure to violence at work, low social support, high overcommitment and more than two medical conditions diagnoses in the past year. There was observed interaction among the dimensions of occupational stress theorical models, exposure to high strain and low social support, effort-reward imbalance with high overcommitment. The interaction among those four dimensions were statistical significant to the outcome. Conclusions - Demographic aspects, habits and lifestyle, work features and condition of employment, and health status are associated with long-term sickness absence due mental and behavioral disorders. Occupational exposure to adverse psychosocial factors is an important contributor to the outcome. It´s necessary attention to negative psychosocial factor at work in order to detect risk factors and promote interventions to minimize negative impacts on workers health

Este estudo objetivou analisar a relação entre estilo de vida e absenteísmo e a relação entre estilo de vida e gastos com serviços de saúde em trabalhadores de uma empresa de viação aérea. Foi realizado um estudo longitudinal retrospectivo que avaliou 2201 trabalhadores de uma companhia aérea em São Paulo, SP. Os desfechos de interesse foram absenteísmo por doença e gastos com serviços de saúde. As variáveis independentes obtidas por entrevista foram sexo, idade, nível educacional, tipo de trabalho, estresse e fatores relacionados ao estilo de vida (índice de massa corporal, atividade física e tabagismo). Além disso, o risco para doenças coronarianas foi estimado com base nas medidas de pressão arterial, colesterol e níveis de glicemia. O número de dias de absenteísmo durante os 12 meses de seguimento foi obtido junto aos registros da companhia aérea e as informações sobre gastos com serviços de saúde foram obtidas junto à operadora de saúde responsável pelo plano de saúde dos funcionários da empresa. Foi realizada regressão logística para determinar a influência das variáveis sócio-demográficas, tipo de trabalho e estilo de vida no absenteísmo e regressão linear multivariada para estudar a associação das as variáveis independentes com gastos diretos com saúde e indiretos com absenteísmo. Durante os 12 meses de seguimento do estudo, 53.5% dos sujeitos tiveram pelo menos um episódio de afastamento por doença e entre esses, a média de absenteísmo foi de 8.3 dias de trabalho. A média de gastos por trabalhador com serviços de saúde foi de US$505. Tanto absenteísmo quanto gastos com saúde foram maiores em mulheres. Após ajuste pelas variáveis sócio demográficas, tabagismo foi associado a maior absenteísmo e excesso de peso foi associado a maiores gastos com saúde. Estes resultados reforçam a importância de ações de promoção de saúde que estimulem uma dieta saudável, atividade física e cessação do tabagismo na população estudada, a fim de controlar absenteísmo e reduzir gastos com serviços de saúde / This study aimed to analyze the relationships among lifestyle-related factors with sick leave and health care costs in workers of a Brazilian airline company. In this longitudinal study with one-year follow-up among 2201 employees of a Brazilian airline company, sick leave and health care costs were the primary outcomes of interest. Independent variables collected by interview at enrolment in the study were gender, age, educational level, type of work, stress, and lifestyle related factors (body mass index, physical activity and smoking). In addition, the risk for coronary heart disease was determined based on measurement of blood pressure, total cholesterol and glucose levels. Total number of days on sick leave during 12 months follow-up was available from the company register and information about health care costs was obtained from the health care insurance. Logistic regression analysis was used to determine the influence of socio-demographic, type of work and lifestyle-related factors on sick leave, and multivariate linear regression analysis was performed to study the association of health care costs with the independent variables. During the 12 month follow-up period, 53.5% of the subjects had at least one sickness absence episode and among them, the average sick leave was 8.3 workdays. The average expenditures per worker with health care was US$505. Both sick leave and health care costs were higher among women. After adjustment by socio-demographic variables, smoking was determinant for more days of sick leave and excess weight was determinant for higher health care costs. Physical inactivity was not associated with sick leave or health procedures total costs, but it was associated with higher odds for hospitalization. These results suggest that healthy diet, physical activity and anti-tobacco actions are important targets for health promotion in this study population, in order to reduce health care costs and productivity loss costs

De plus en plus de contraintes pèsent sur les organisations avec de plus en plus de règles et de procédures à respecter. Ces contraintes ont une répercussion sur les salariés et se traduisent notamment par un surcroît de pression et de stress. Le secteur de la santé n’est pas épargné par ce phénomène de société avec des défis majeurs à relever : contenir l’augmentation des dépenses de santé, faire face aux progrès de la médecine et de la technologie, faire face également à la pression du public pour l’amélioration de la qualité et de la sécurité des soins, et répondre à une demande accrue due au vieillissement de la population. Ces défis peuvent générer chez le personnel soignant de l’absentéisme et du turnover. L’absentéisme et le turnover du personnel infirmier représentent un problème de santé publique coûteux et désorganisant. Les travaux réalisés sur l’absentéisme et l’intention de départ montrent qu’il s’agit de concepts à la mécanique complexe. Une lecture de ces comportements à travers les concepts d’implication organisationnelle, de satisfaction au travail et de tensions de rôle permet d’appréhender la complexité de ces phénomènes. Les précédents travaux sur les tensions de rôle n’ont jusqu’à présent jamais mesuré conjointement les trois formes de tensions de rôle. En effet, ils ont en majorité porté sur le conflit de rôle au détriment des deux autres formes de tensions de rôle (ambiguïté de rôle et surcharge de rôle). Une analyse simultanée des trois formes de tensions de rôle représenterait pourtant un intérêt managérial important puisqu’elle permettrait d’orienter préférentiellement les actions managériales sur la ou les formes de tensions de rôle qui sont véritablement des facteurs explicatifs des variables dépendantes. Cela conduirait à une meilleure adaptation des pratiques de Gestion des Ressources Humaines, et à terme favoriserait leur efficacité. Telle est l'ambition de notre travail de thèse. Une première étude qualitative exploratoire, adossée à une revue rigoureuse de la littérature, nous a permis de construire des modèles de recherche que nous avons ensuite confrontés à l'épreuve des faits dans une étude quantitative mobilisant plus de 300 personnels infirmiers et une trentaine de cadres de santé. Notre travail contribue à éclairer le déterminisme des tensions de rôle dans le phénomène de turn-over, ou plus précisément dans les intentions de départ des personnels, ainsi que dans la satisfaction au travail, et l'implication organisationnelle. Nos résultats sont plus décevants s'agissant de l'absentéisme, ce qui souligne la difficulté de son étude et tend à confirmer la complexité de ce phénomène. / There are more and more constraints weighing on organizations, with more and more rules and procedures to respect. These constraints have a repercussion on employees, in particular through increased pressure and stress. The health sector has not been spared by this societal phenomenon and must face major challenges that lie ahead: contain increased health care costs, face technological and medical advances, deal with public pressure to improve the quality and security of health care and respond to a rising demand due to the ageing population.These challenges may give rise to absenteeism and turnover among caregivers. Absenteeism and turnover among nursing staff constitutes a major public health problem that is both costly and disrupting. Work carried out on absenteeism and departure intentions shows that complicated, intricate concepts are involved. Interpreting these behaviours through the concepts of organisational commitment, job satisfaction and role stressors allows one to grasp the complexity of these phenomena. Previous work done so far on role tensions has never jointly measured the three different forms of role tensions. In fact, the majority have concentrated on role conflict, to the detriment to the two other forms (role ambiguity and role overload). A simultaneous analysis of the three forms of role tensions, however, would be of great managerial interest as it would preferentially orientate management action on the form or forms of role tension which are the true explanatory factors in dependent variables. This would lead to better adaptation of the Human Resources Management practices and, in the end, boost their efficiency. This is the aim of our research. An exploratory qualitative study, supported by rigorous review of the literature, allowed us to construct research models that were tested in a quantitative study involving 300 nurses and around 30 health professionals. Our work contributes to shedding light on the determination of role tensions in the turnover phenomenon, or more precisely on the intent to leave of personnel, as well as job satisfaction and organisational commitment. Our findings are more disappointing in regard to absenteeism, which highlights the difficulty of its study and tends to confirm the complexity of this phenomenon.

This study explores how HIV-positive teachers within a specific social context understand, interpret and act on HIV and Life Skills policy. My aim was to illuminate the experiences of teachers living with AIDS and how their experiences affect the ways in which they understand and act on government policy. As a constructivist, I worked on the premise that people’s experiences can best be understood by interacting with them and listening to them. I chose a narrative research design because it allowed me to explore and understand the perceptions and complexity of my research partners’ experiences, and to faithfully present and represent the stories told by teachers living with AIDS. I used the data collected from the teachers’ stories to write narratives that gave a first person account of the experiences of each teacher. To express my own voice in the text I created a column on the side of each page where I recorded my own experience of the process of the inquiry. I used inductive analysis in order to make sense of the field data. Rather than beginning with a theory, inductive analysis allowed me to expose the dominant and significant themes in the raw data without imposing preconceptions on the data. Three distinct themes emerged from the analysis, and formed my conceptualisation of the experiences of teachers living with AIDS: a) conflict between teacher as role model and ideal citizen, and teacher as an HIV-positive person; b) HIV illness and its impact on the body of the teacher; c) teachers as emotional actors. The main findings from the study suggest that in a context with AIDS there are limits to what education policy can achieve if it remains out of touch with a real world in which school is attended by children and teachers whose bodies are either infected or affected by the HIV virus. This is substantiated by the fact that while the HIV/AIDS policy is about bodies and about emotions, it is blind to the bodies and the emotions of those implementing it. I contend that it is this oversight that creates the wide gap between policy intentions and outcomes. Secondly the study highlights the uniqueness of HIV/AIDS education policy and its implementation which, unlike other education policies, powerfully brings to the fore the emotions of the implementers. I conclude the study by suggesting that the policy-making process be reconstructed to inscribe the real bodies and real emotions of the teachers into the policy, to shift from a purely prevention mode to one that looks at the whole prevention-to-care continuum and acknowledges that a significant majority of school pupils and teachers are infected and affected. / Thesis (PhD)--University of Pretoria, 2009. / Education Management and Policy Studies / unrestricted

In 2010, the Financial Services Regulatory Authority (FSRA) of Swaziland noticed a significant increase in employee absenteeism which they discovered was related mainly to: poor health (sick leave), personal and financial stress (garnishee orders were increasing), and low staff morale, the consequence of which was low productivity and missed deadlines (FSRA, 2010:7). High levels of absenteeism meant that a sizeable number of employees were unable to complete their daily tasks (FSRA, 2010:7). Consequently, in 2011, the FSRA Human Resource Department started a wellness programme for all employees in the organization in an attempt to respond to the human resource challenges reported in 2009/10 financial year. By the end of 2012, FSRA management reported that the introduction of the EWP had not yielded the expected results. This therefore prompted management to request an evaluation of the FSRA employee wellness programme. The aim of this research was to identify and prioritize the needs of employees in terms of requirements of a wellness programme and how it should be delivered. The specific objectives of the study are as follows: to identify the wellness needs of employees, to identify employee preferences in terms of the type of interventions to be included in a wellness programme, to identify the preferred mode of delivery of the wellness programme and to make recommendations to management on the design of a wellness programme. Questionnaires with closed ended questions were used to collect data for this survey. The questionnaire used is attached as Appendix A. By means of a needs analysis survey, this research was designed to assess the FSRA employees’ needs in terms of an employee wellness programme, as well as the preferred EWP delivery methods. About 70 percent of FSRA employees participated in the survey. The respondents completed the questionnaire and submitted it online over a period of 10 working days (2 weeks). This report is structured into three sections, namely; section one, which is the evaluation report that gives details of the importance of the study, highlights research methods and then present the results, discussions and recommendations. Section two deals with the literature review while section three reports on the research methodology, research design and procedures and the limitation of the study. In light of the findings on the wellness needs of employees, 72 percent of the respondents felt the current wellness programme was very inadequate and a further 10 percent added that it was inadequate in addressing their wellness needs largely because the needs were not known. The most important wellness needs identified included: exercise, nutrition, personal hygiene, disease awareness and treatment of illness, coping with stress, coping with workload, ventilation, safety, bereavement, personal debt, and retirement planning. The most preferred wellness interventions that respondents proposed include Flexible Work Schedule, Safe Workplace, Improved Ventilation, Retirement Planning Advice and Gymnasium. Further analysis done using correlation analysis indicated that there was a significant positive relationship between the wellness needs and the wellness interventions. Concerning the delivery of the wellness programme, most of the employees indicated that outsourcing certain services was better than having them in house. The highest ranking of the services for out sourcing were nutrition education and medical checkups that ranked between 82 percent and 75 percent respectively. The respondents indicated that they want almost all the chosen interventions to be outsourced. Time slots should also be taken into consideration to ensure employee participation in the wellness programme services. The respondent FSRA employees seem to prefer interventions of an educational nature to be during the lunch hour. These include Nutrition Education, Health Education, Hygiene Education and Medical Check ups and Treatment, whereas Gymnasium was preferred to be after working hours.

This research hypothesises a statistical positive significant correlation between job satisfaction and absenteeism among the shop floor workers of a motor manufacturing plant in the impoverished province of the Eastern Cape in South Africa. According to the literature review, two schools of thought exist that argue on the nature of the relationship. One believes that absence from work is in some way a natural consequence of job dissatisfaction, i.e. arguing for a job satisfaction-absenteeism relationship. The second one argues for a no relationship, arguing that absence is a result of habitual behaviour and or behaviours influenced by socioeconomic factors such as poverty that affect the employees' ability and pressure to attend work. A sample of 150 workers was randomly selected from the 2500 shop floor workers. The Job Descriptive Index (lDI) questionnaires were used to measure the satisfaction index of the workers. The absence statistics for the sample workers were gathered from the organisation's Human Resources department and statistical tests for correlation and regression were conducted on the two variables - lDI and absence data. Contrary to the expectations of the study, the results showed that overall job satisfaction and absenteeism were not correlated. It concluded that the job dissatisfaction theory of absenteeism is empirically unsupportable and alternative conceptualisations of absence contributors and potentially fruitful research strategies are discussed.

L’absentéisme et le décrochage scolaire sont aujourd’hui au cœur du débat public. Les discours politiques et institutionnels semblent découvrir ces questions. Pourtant ces phénomènes ne sont pas nouveaux. En effet, pourquoi l’absentéisme et le décrochage scolaire qui étaient invisibles médiatiquement et socialement à une certaine époque deviennent-ils visibles et médiatiques aujourd’hui ? Faut- il y voir l’action de l’homme ou le coup du sort ? Cette recherche s’inscrit dans le champ de la sociologie de la connaissance. Il s’agit de savoir quelle connaissance on a de ces questions mais également de comprendre l’apparition de ces problématiques dans le champ du social .Sur le terrain, la réalité est tout autre car aux discours sur l’absentéisme et le décrochage scolaire succède l’action et les contraintes auxquelles les acteurs sont confrontés. Le regard porté par les acteurs scolaires devient plus distant, plus raisonné et raisonnable face aux problèmes auxquels ils doivent faire face et surtout trouver des solutions. L’hypothèse générale est que les discours institutionnels (circulaires et rapports d’inspection) et politiques, sur l’absentéisme et le décrochage scolaire davantage construits sur un discours globalisant et anxiogène lié à des problématiques sociales comme la délinquance, s’opposent aux acteurs de terrain dont les discours hétérogènes laissent place à des récits et réflexions mesurés et réalistes face à l’immensité des phénomènes auxquels ils sont confrontés. Dans cette recherche, il s’agit essentiellement de joindre à cette approche socio-historique dans une première partie, une approche empirique dans une deuxième partie dont l’objectif réside dans la confrontation du discours public et médiatique : le discours d’ « en haut » et du discours des acteurs de terrain : le discours d’ « en bas ». Si le Lycée Professionnel (LP) comme terrain de recherche s’inscrit dans un espace social et scolaire marginalisé depuis un certain nombre d’années , il n’en demeure pas moins que les discours et actions des acteurs ainsi que les résultats obtenus sur les questions d’absentéisme et de décrochage scolaire laissent à penser que chaque LP est singulier et développe un effet propre. / Absenteeism and dropping out are at the heart of public debate. The political and institutional discourses seem to find these issues. Yet these phenomena are not new. Indeed, why absenteeism and school dropout who were invisible mediatically socially and at one time they become visible and media today? Should we see the action of the man or the twist of fate? This research is in the field of sociology of knowledge. This is to know what knowledge we have of these issues but also to understand the occurrence of these problems in the social field .On the ground, the reality is quite different because the discourse on absenteeism and dropping succeeds the action and the constraints, the actors face. The look worn by school actors becomes more distant, more reasoned and reasonable deal with the problems they face and especially solutions. The general assumption is that institutional discourse (circular and inspection reports) and policy on absenteeism and dropping out more built on a globalizing discourse and anxiety related to social problems such as delinquency, are opposed to actors of land including heterogeneous discourse gave way to stories and reflections measured and realistic given the immensity of the phenomena they face. In this research, it's basically join this socio-historical approach in the first part, an empirical approach in the second part whose objective is the confrontation of the public and media discourse: the discourse of "top "and the speech field players: the discourse of " down ". If the vocational school as field research is part of a marginalized social and academic space for a number of years, the fact remains that the speeches and actions of the actors and the results obtained on the issues of absenteeism and dropout suggests that each LP is unique and develops its own effect.