Made available in DSpace on 2016-04-04T18:28:12Z (GMT). No. of bitstreams: 1 ANDREIA ELISA GARCIA DE OLIVEIRA.pdf: 1697542 bytes, checksum: e3ad02cf40e9c3dfe6f3507a06629e5d (MD5) Previous issue date: 2013-12-17 / This research aimed to grasp the experience of caring for cancer patients using accounts of health care professionals who work in a chemotherapy s outpatient unit of a university hospital in the State of S?o Paulo. It is an exploratory qualitative research, phenomenologically inspired. Individual dialogical encounters were carried out with nine health professionals: physicians, psychologist, pharmacist, nurses, occupational therapists, social worker and nursing technician. After each encounter, narratives were written, registering what was reported by the participant well as the researcher s impressions. The construction process of the narratives included various versions in order to grasp the main elements involved in the experience of the participants. The narrative s analysis made it possible to conclude that the experience of caring in Oncology is signified by the professionals as rewarding and enriching, although it also involves certain amount of suffering due to physical and emotional fatigue. The reports of the participants highlighted also difficulties arising in the course of professional practice due to: a) academic training that didn t prepare then to deal with the approaching death of patients, either with the need to communicate information about the evolution of the disease; b) the lack of integration between team members; c) of the exhaustive workday; d) the lack of time to devote to themselves; e) the feeling of powerlessness when the treatment is not successful. Nevertheless, participants strive for the relationship with patients is not reduced to a purely technical-assistance dimension and demonstrated that would benefit from an intervention committed to facilitate the coming out of their experiences. / Esta pesquisa buscou apreender a experi?ncia de cuidar de pacientes oncol?gicos a partir do relato de profissionais da sa?de que atuam em um ambulat?rio de quimioterapia de um hospital universit?rio do Estado de S?o Paulo. Foi desenvolvida como uma pesquisa qualitativa, explorat?ria e de inspira??o fenomenol?gica. A pesquisadora realizou encontros dial?gicos individuais com nove profissionais da sa?de: m?dicos, psic?logo, farmac?utico, enfermeiro, terapeutas ocupacionais, assistente social e t?cnico de enfermagem. Ao t?rmino de cada encontro, foram redigidas narrativas nas quais se registrou o que foi relatado pelo participante acrescido das impress?es da pesquisadora. O processo de constru??o das narrativas incluiu diversas vers?es objetivando apreender os principais elementos envolvidos na experi?ncia dos participantes. A an?lise deste material possibilitou concluir que a experi?ncia de cuidado na ?rea de oncologia ? significada pelos profissionais como gratificante e enriquecedora, embora tamb?m envolva certa dose de sofrimento em fun??o do desgaste f?sico e emocional a que ficam expostos. Os relatos dos participantes revelaram tamb?m dificuldades no exerc?cio da pr?tica profissional decorrentes: a) de uma forma??o acad?mica que n?o os preparou para lidar com a aproxima??o da morte dos pacientes, tampouco com a necessidade de comunicar informa??es sobre a evolu??o da doen?a; b) da falta de integra??o entre os membros da equipe; c) da jornada de trabalho exaustiva; d) da falta de tempo para dedicar-se a si mesmos; e) do sentimento de impot?ncia quando o tratamento n?o ? bem-sucedido. Apesar disso, os participantes esfor?am-se para que o relacionamento com os pacientes n?o seja reduzido a uma dimens?o puramente t?cnico-assistencial e demonstraram que se beneficiariam de uma interven??o comprometida em facilitar o vir ? tona de suas experi?ncias.

Objetivo. Os estudos sobre envolvimento religioso e espiritual para os pacientes idosos com doenças crônicas e a concepção que os profissionais de saúde têm frente a este processo são quase inexpressivos no Brasil. Realizou-se uma pesquisa com o objetivo de identificar o significado da intervenção médica e da fé religiosa para o paciente idoso com câncer, e também de identificar o significado atribuído pelos profissionais de saúde a fé religiosa no tratamento e na vida do paciente idoso com câncer. Métodos. A pesquisa foi descritiva e utilizou o método qualitativo. A amostra foi intencional, composta por 20 médicos, 20 pacientes idosos com câncer, 10 enfermeiras, 1 O psicólogos e cinco capelães. A coleta de dados ocorreu mediante a técnica da entrevista semi-estruturada e foi desenvolvida de 9.01 a 28.03.01 no Hospital do Servidor Público Estadual \"Francisco Morato de Oliveira\" - IAMSPE e no Hospital Pérola Byington/Núcleo de referência em saúde da mulher, São Paulo. Para o tratamento dos dados empregou-se a análise temática do Discurso do Sujeito Coletivo, sendo utilizadas três figuras metodológicas: a Idéia Central (/C), as Expressões-chave(EC) e o Discurso do Sujeito Coletivo (DSC). Resultados. Os pacientes apresentaram 20 ICe 20 DSC, os médicos, os enfermeiros e os capelães 10 IC e 10 DSC, e os psicólogos 8 IC e 8 DCS. Os resultados são discursivos, demandando extenso volume de material. Considerações Finais. Os discursos dos profissionais de saúde se apresentaram em várias tendências, no sentido da importância e do fortalecimento da fé, enquanto recurso de enfrentamento dos desafios da vida. Quanto aos discursos dos pacientes idosos com câncer houve destaque para as situações de conforto, otimismo e segurança frente à intervenção médica instituída A fé ou fé religiosa na vida dos idosos foi instrumento muito valorizado e dotado grande capacidade para proporcionar conforto e esperança, como meio importante para o enfrentamento de doenças ameaçadoras. / Objective. Studies about religious and spiritual involvement in the lives of elderly patients with chronic illnesses and the concept that health professionals have to face this process are scarce in Brazil. Research was done with the objective of identifYing the meaning o f medicai intervention and religious faith in the life o f the elderly patient with cancer, as well as identifYing their meaning for health professionals in the treatment and life of the patient. Methods. This study was descriptive and used the qualitative method. The sample was intentional, composed of 20 physicians, 20 elderly patients with cancer, 1 O nurses, I O psychologists and 5 chaplains. The semistructured interview technique was used in the data collection and developed from January 9th 2001 to March 28th 2001 at \"Francisco Morato de Oliveira\" State Workers\' Hospital - IAMSPE and at Pérola Byington Hospitai!Women\'s Health Center, São Paulo. The thematic analysis Discourse of the Collective Subject was used to treat the data. Three methodological figures were used: I) the Central Idea (CI), 2) Key Expressions (KE) and 3) the Discourse ofthe Collective Subject (DCS). Results. The patients presented 20 CI and 20 DCS, the physicians, nurses and chaplains I O CI and I O DCS, the psychologists 8 CI and 8 DCS. The results are discursive, demanding an extensive volume of material. Final considerations. The discourses of the health professionals presented various tendencies regarding the importance and strengthening o f faith while facing the challenges o f life. As regards the discourses ofthe elderly patients with cancer, situations ofcomfort, optirnism and security in the face of medicai intervention predominated. Faith or religious faith in the Iives o f the elderly was highly valued instrument and endowed with great ability to provide comfort and hope as essential means to face threatening illnesses.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-03-27T10:21:54Z No. of bitstreams: 1 Vinicius Martins Dias Batista.pdf: 1543209 bytes, checksum: 0d8e882a87ce71946ea5ad1860282d27 (MD5) / Made available in DSpace on 2017-03-27T10:21:54Z (GMT). No. of bitstreams: 1 Vinicius Martins Dias Batista.pdf: 1543209 bytes, checksum: 0d8e882a87ce71946ea5ad1860282d27 (MD5) Previous issue date: 2017-03-14 / Background: The concept of radioprotection is usually recognized as important among the technical level of health professionals and higher. However, the information on the formal knowledge and its application in practice are scarce. Noticing the discrepancy in radiation protection process in sectors using ionizing radiation, decided to search the knowledge that health professionals have on radiation protection and the need for educational intervention for professionals to work consciously and with adequate protection. Objectives: To assess the knowledge that the health professionals of a university hospital (UH) have about radioprotection, educate staff about the harmful effects of ionizing radiation and application of the ALARA (As Low As Reasonably Achievable) principle in routine work and implement the knowledge of radioprotection through playful learning using teaching materials and easy to understand. Methods: This is an exploratory cross-sectional study with a qualitative analysis of the open questions and the quantitative issues addressed by a semi-structured questionnaire was applied to 59 employees from different sectors of UH to assess the degree of knowledge. From the findings it was prepared a booklet with playful images to be distributed to all employees of the UH. In the internal prevention week of work accidents at the UH it was made by the employees a performance about radioprotection. Results: According to the participants with technical or graduated degree, they did not have training on radiation protection as students or it was insufficient to practice. The work environment, even in a UH, provides little information about radiation protection and the rules which govern it. Much of the respondents (25%) even knowing not observe the radiation protection procedures. In the assessment of formal knowledge on the concept and the usual measures of radioprotection we observed that 1/3 of the participants have good theoretical knowledge, 1/3 have incomplete knowledge and 1/3 is completely unaware of the concept and radioprotection actions. Conclusion: The employees of a UH, even at graduated level, need training on radiation protection, because the training course failed in this respect. We believe the same should happen in other health institutions. The actions aimed at training in radiation protection were very well accepted by employees and their effective translation greater individual and collective protection is being evaluated / Introdução: O conceito de radioproteção é habitualmente reconhecido como importante entre os profissionais de saúde de nível técnico e superior, porém, são escassas as informações sobre o conhecimento formal e sua aplicação na prática. Percebendo a defasagem no processo de proteção radiológica nos setores que utilizam radiação ionizante, resolvi pesquisar o conhecimento que os profissionais da saúde têm sobre proteção radiológica e a necessidade de intervenção educativa para que os profissionais trabalhem de forma consciente e com proteção adequada. Objetivos: Avaliar o conhecimento que os profissionais de saúde de um hospital de ensino (HE) têm sobre radioproteção; conscientizar as equipes sobre os efeitos danosos das radiações ionizantes e aplicação do princípio ALARA (As Low As Reasonably Achievable) na rotina de trabalho e implementar o conhecimento sobre radioproteção através do ensino lúdico utilizando material didático e de fácil compreensão. Métodos: Trata-se de um estudo transversal exploratório com análise qualitativa das questões abertas e quantitativa das questões dirigidas. Foi aplicado um questionário semiestruturado a 59 funcionários dos diferentes setores do HE para avaliar o grau de conhecimento existente. A partir dos achados foi elaborada uma cartilha com imagens lúdicas para ser distribuída a todos os funcionários do HE. Na semana interna de prevenção de acidentes de trabalho do HE foi feita pelos funcionários teatralização sobre a radioproteção. Resultados: Na opinião dos participantes o curso técnico ou superior que fizeram não forneceu formação sobre radioproteção ou esta foi insuficiente para a prática. O ambiente de trabalho, mesmo em um HE, disponibiliza poucas informações sobre radioproteção e as normas que a regem. Boa parte dos entrevistados (25%) mesmo tendo conhecimento não observam as medidas de radioproteção. Na aferição do conhecimento formal sobre o conceito e as medidas habituais de radioproteção observamos que 1/3 dos participantes tem bom conhecimento teórico, 1/3 tem conhecimento incompleto e 1/3 desconhece completamente o conceito e as ações de radioproteção. Conclusão: Os funcionários de um HE, mesmo os de nível superior, têm necessidade de capacitação sobre radioproteção, pois o curso de formação falhou neste aspecto. Acreditamos que o mesmo deve acontecer em outras instituições de saúde. As ações objetivando a capacitação em radioproteção foram muito bem aceitas pelos funcionários e sua tradução efetiva em maior proteção individual e coletiva está sendo avaliada

Submitted by Erika Demachki (erikademachki@gmail.com) on 2014-10-08T21:42:51Z No. of bitstreams: 2 Dissertação - Bruna Lígia Ferreira de Almeida - 2013.pdf: 856377 bytes, checksum: bb3d1938f40e066ea7486b9a556bcf59 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2014-10-09T11:14:40Z (GMT) No. of bitstreams: 2 Dissertação - Bruna Lígia Ferreira de Almeida - 2013.pdf: 856377 bytes, checksum: bb3d1938f40e066ea7486b9a556bcf59 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2014-10-09T11:14:40Z (GMT). No. of bitstreams: 2 Dissertação - Bruna Lígia Ferreira de Almeida - 2013.pdf: 856377 bytes, checksum: bb3d1938f40e066ea7486b9a556bcf59 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-04-05 / The feminization of the epidemic have many consequences, among them, the increasing number of HIV-infected children with mother to child transmission as the main route of infection. In 2010, the Ministry of Health created the recommended prophylaxis manual of mother to child HIV transmission and antiretroviral therapy in pregnant women and other behaviors related to prevention of mother to child HIV transmission. The objective of this study was to analyze if the recommendations of the Ministry of Health as control of mother to child HIV transmission are being taken by pregnant women and health professionals of a public maternity hospital in Goiânia. Research conducted between March and May 2012, divided into two stages: cross-sectional study, which consisted in the analysis of medical records of 323 HIV positive pregnant women seen at a public hospital in the State of Goiás between years 2006 to 2011, and second it is cross-sectional study involving 25 professionals working in maternity and obstetric center of this institution. Among the 323 records analyzed, 48.9% of pregnant women were included in the age group between 25 to 34 years old, 68.7% were single, 65.6% brown, 50.5% had study time between 4-7 years and 74.9% were unemployed. We checked the main risks related to mother to child HIV transmission in the 323 analyzed records. Among of the professionals surveyed, 76% have inadequate knowledge about HIV testing in pregnant women, 80% unaware the gestational age in what is realized elective caesarean, 66% do not know the dose to attack AZT and the elapsed time before child-birth, 84% do not know which method is indicated for lactation inhibition. The data observed in our study are alarming and show gaps in care for HIV positive pregnant women and newborns exposed, through information obtained that contradict this practice. / Nos últimos anos houve uma mudança do perfil da epidemia do HIV/aids, chamado por feminização da epidemia de HIV, um número crescente de mulheres em todo o mundo estão infectadas, sendo que mulheres e meninas constituem quase metade de todas as pessoas que vivem com vírus. A feminização da epidemia têm numerosas consequências, dentre elas, o aumento do número de crianças infectadas pelo HIV tendo a transmissão vertical como principal via de infecção. Em 2010, o Ministério da saúde criou o manual de Recomendações de profilaxia de transmissão vertical do HIV e terapia antirretroviral em gestantes e as demais condutas relacionadas a profilaxia da transmissão vertical do HIV. Assim, o objetivo geral deste estudo foi analisar se as medidas recomendadas pelo Ministério da Saúde como controle da transmissão vertical do HIV estão sendo adotadas por gestantes e profissionais de saúde de uma maternidade pública de Goiânia, Goiás. Pesquisa realizada entre março a maio de 2012, dividida em duas etapas: a primeira trata-se de estudo transversal, que consistiu na análise de 323 prontuários de gestantes HIV positivo atendidas em uma maternidade pública do Estado de Goiás entre os anos de 2006 a 2011, e a segunda trata-se de um estudo transversal envolvendo 25 profissionais atuantes na Maternidade e Centro Obstétrico desta Instituição. Dentre o 323 prontuários analisados, 48,9% das gestantes estavam inseridas na faixa etária entre 25 a 34 anos de idade, 68,7% eram solteiras, 65,6% pardas, 50,5% possuíam tempo de estudo entre 4 a 7 anos e 74,9% não possuíam vínculo empregatício. Foram verificados os principais riscos relacionados à transmissão vertical do HIV nos 323 prontuários analisados. Dos profissionais investigados 76% apresentam conhecimento inadequado sobre o teste anti-HIV na gestantes, 80% desconhecem com que idade gestacional realiza-se a cesárea eletiva, 66% não sabem a dose para ataque do AZT e o tempo utilizado antes do parto, 84% não conhecem qual o método indicado para inibição da lactação. Os dados observados em nosso estudo são preocupantes e evidenciam lacunas existentes na assistência prestada às gestantes HIV positivos e RN expostos, através de informações obtidas que contradizem essa prática.

Objetivo. Os estudos sobre envolvimento religioso e espiritual para os pacientes idosos com doenças crônicas e a concepção que os profissionais de saúde têm frente a este processo são quase inexpressivos no Brasil. Realizou-se uma pesquisa com o objetivo de identificar o significado da intervenção médica e da fé religiosa para o paciente idoso com câncer, e também de identificar o significado atribuído pelos profissionais de saúde a fé religiosa no tratamento e na vida do paciente idoso com câncer. Métodos. A pesquisa foi descritiva e utilizou o método qualitativo. A amostra foi intencional, composta por 20 médicos, 20 pacientes idosos com câncer, 10 enfermeiras, 1 O psicólogos e cinco capelães. A coleta de dados ocorreu mediante a técnica da entrevista semi-estruturada e foi desenvolvida de 9.01 a 28.03.01 no Hospital do Servidor Público Estadual \"Francisco Morato de Oliveira\" - IAMSPE e no Hospital Pérola Byington/Núcleo de referência em saúde da mulher, São Paulo. Para o tratamento dos dados empregou-se a análise temática do Discurso do Sujeito Coletivo, sendo utilizadas três figuras metodológicas: a Idéia Central (/C), as Expressões-chave(EC) e o Discurso do Sujeito Coletivo (DSC). Resultados. Os pacientes apresentaram 20 ICe 20 DSC, os médicos, os enfermeiros e os capelães 10 IC e 10 DSC, e os psicólogos 8 IC e 8 DCS. Os resultados são discursivos, demandando extenso volume de material. Considerações Finais. Os discursos dos profissionais de saúde se apresentaram em várias tendências, no sentido da importância e do fortalecimento da fé, enquanto recurso de enfrentamento dos desafios da vida. Quanto aos discursos dos pacientes idosos com câncer houve destaque para as situações de conforto, otimismo e segurança frente à intervenção médica instituída A fé ou fé religiosa na vida dos idosos foi instrumento muito valorizado e dotado grande capacidade para proporcionar conforto e esperança, como meio importante para o enfrentamento de doenças ameaçadoras. / Objective. Studies about religious and spiritual involvement in the lives of elderly patients with chronic illnesses and the concept that health professionals have to face this process are scarce in Brazil. Research was done with the objective of identifYing the meaning o f medicai intervention and religious faith in the life o f the elderly patient with cancer, as well as identifYing their meaning for health professionals in the treatment and life of the patient. Methods. This study was descriptive and used the qualitative method. The sample was intentional, composed of 20 physicians, 20 elderly patients with cancer, 1 O nurses, I O psychologists and 5 chaplains. The semistructured interview technique was used in the data collection and developed from January 9th 2001 to March 28th 2001 at \"Francisco Morato de Oliveira\" State Workers\' Hospital - IAMSPE and at Pérola Byington Hospitai!Women\'s Health Center, São Paulo. The thematic analysis Discourse of the Collective Subject was used to treat the data. Three methodological figures were used: I) the Central Idea (CI), 2) Key Expressions (KE) and 3) the Discourse ofthe Collective Subject (DCS). Results. The patients presented 20 CI and 20 DCS, the physicians, nurses and chaplains I O CI and I O DCS, the psychologists 8 CI and 8 DCS. The results are discursive, demanding an extensive volume of material. Final considerations. The discourses of the health professionals presented various tendencies regarding the importance and strengthening o f faith while facing the challenges o f life. As regards the discourses ofthe elderly patients with cancer, situations ofcomfort, optirnism and security in the face of medicai intervention predominated. Faith or religious faith in the Iives o f the elderly was highly valued instrument and endowed with great ability to provide comfort and hope as essential means to face threatening illnesses.

Bakgrund: Sexuella- och könsminoriteter faller utanför hetero- och tvåkönsnormen som finns i samhället och utsätts för diskriminering på olika sätt överallt i världen. Personer inom gruppen sexuella- och könsminoriteter har rapporterat negativa erfarenheter av vårdmötet, till exempel i form av homofoba och transfoba attityder, vilket kan medföra att hbtq-personer undviker att söka vård. Sjuksköterskan kan vara med och förbättra detta då hen har ett ansvar att främja insatser som tar särskild hänsyn till utsatta gruppers hälsa och sociala behov.  Syfte: Syftet var att beskriva vilka faktorer som påverkar upplevelsen av bemötande från vårdpersonal enligt personer som ingår i gruppen sexuella- och könsminoriteter. Metod: Deskriptiv litteraturöversikt användes som metod och i resultatanalysen ingick 14 originalartiklar som undersökte sexuella- och könsminoriteters upplevelse av vårdmötet. Resultat: Det visade sig vara viktigt när vårdpersonal gav personcentrerad vård, respekterade patientens identitet och att de utvecklade en tillits- och förtroendefull relation. Det var även viktigt att vårdpersonal hade specifik kunskap inom området och använde ett könsneutralt språk i vårdmötet. Negativa faktorer var upplevelse av diskriminering och att vårdpersonal gjorde hetero- eller cisnormativa antaganden.  Slutsats: Vårdpersonal bör vara medveten om att normer och förutfattade meningar kan påverka vårdmötet utan att de tänker på det. För att undvika stereotypt bemötande bör vårdpersonal respektera patientens identitet och ha mer kunskap om behov som är unika för sexuella- och könsminoriteter. / Background: Sexual and gender minorities do not conform to heterosexual and gender-binary social norms and are subjected to different forms of discrimination all over the world. Members of these minorities have reported instances of negative experiences of healthcare encounters which can result in a hesitation to seek further care. Given their responsibility to promote healthcare interventions tailored to the needs of marginalised groups, nurses could play an important role in resolving this issue. Aim: The aim of the study was to describe which factors affect the experience of an encounter with a health professional according to people who identify as a sexual or gender minority.  Method: The study comprised a descriptive literature review of 14 empirical studies which explored the experience of sexual and gender minorities in relation to the healthcare encounter. Result: The following factors were revealed to be particularly influential in determining the healthcare experiences of sexual and gender minorities. Positive factors included: when health professionals delivered person-centered care, respected the patient’s sexual and gender identity, and when they could develop a trusting relationship with a healthcare professional. It was also important that health professionals were knowledgeable and used gender-neutral language. Negative factors included instances of discrimination and when health professionals made hetero- or cis-normative assumptions.  Conclusion: Health professionals need to be aware of the impact that norms and preconceptions can have on the healthcare encounter. To avoid stereotypical treatment, health professionals should respect the patient’s identity and have more knowledge about sexual and gender minority-specific needs.

Background: Difficulties with anxiety among children and young people are common and can impact upon their developmental trajectory leading to adverse outcomes in later life. There is, therefore, a need to increase access to early intervention services. Existing research has indicated that school-based cognitive behavioural interventions are effective for children and young people experiencing difficulties with anxiety, yet there remains a proportion of the population for whom they are not effective. In addition, there is a lack of research on how these may be implemented in real world settings as opposed to a research trial. The present research focuses on the provision of cognitive behavioural school-based interventions in two parts: a systematic review of psychological, interpersonal and social variables as predictors, mediators and moderators of mental health outcomes following a school-based intervention and an empirical mixed methods evaluation of the facilitators and barriers to the implementation of a school-based intervention. Method: A systematic search of electronic databases for studies examining interpersonal, psychological and social predictors, moderators and mediators of mental health outcome following school-based cognitive behavioural interventions was conducted. Effect sizes for these analyses were calculated and the quality of eligible studies was assessed using a standardised rating tool. Within the empirical project, the implementation of a school-based cognitive behavioural intervention was evaluated through a mixed methods approach. Semi-structured interviews with stakeholders in the intervention were analysed using grounded theory integrated with framework analysis. Quantitative data on the reach of the intervention, practitioner evaluation of training and coaching as well as routine outcome measures from children and young people receiving the intervention was collected. Results: Within the systematic review, twenty-two studies (N=22) met the predefined eligibility criteria. There was heterogeneity in the variables explored, effect size of these on treatment outcome and the quality of the literature within the included studies. Cognitive style was found to mediate treatment outcome, but there was limited evidence for other predictors, mediators and moderators of treatment outcome within the review. Quantitative results of the empirical project indicated that the model of the intervention was acceptable to both practitioners and children and young people, and preliminary data indicated a significant improvement in mental health outcomes. Facilitators that emerged from qualitative data included an enabling context, therapeutic engagement, motivation and congruence, self-efficacy and containment and encouragement. The exclusivity of the intervention, a lack of systemic understanding and transparency as well as demands and pressure on resources were barriers to implementation. Conclusions: Although preliminary evidence for potential predictors, mediators and moderators is presented, further research with improvements in the design and reporting of explanatory variables on treatment outcome is required prior to informing clinical decision-making. The successful implementation of school-based interventions requires multi-agency integration and collaboration as well as on-going support in managing systemic pressures and skill development.

Introdução: Os profissionais que atuam na área de emergência lidam constantemente com diversas mudanças, tornando uma área de atuação que exige muito dos profissionais. Estima-se que o estresse afete mais de 90% da população mundial e que, por não ser considerada uma doença em si, é subestimado, tendo como consequência a ausência de tratamentos e prevenção ao adoecimento. Entende-se cultura organizacional condutas experimentais e símbolo em processo de assimilação, padrões e hábitos razoavelmente estabelecidos. Clima organizacional é o indicador do grau de satisfação dos membros de uma empresa, em relação a diferentes aspectos da cultura ou realidade aparente da organização. O estresse pode ocasionar graves consequências e entre trabalhadores em saúde sua ocorrência ainda carece ser avaliada em estudos ampliados que contemplem sua complexidade de maneira mais abrangente, considerando fatores pessoas, ambientais e psicossociais. Dessa forma, avaliar o clima e cultura organizacional é importância para entender como funcionam as instituições, quais são os pontos fortes e frágeis do local e assim propor melhorias aos pontos frágeis e potencializar os pontos fortes. Objetivo: O objetivo do estudo é identificar o clima e a cultura organizacional de uma organização de um serviço hospitalar de emergência e sua relação com a prevalência de estresse. Métodos: Foi desenvolvido um estudo transversal, analítico, exploratório, de abordagem quantitativa. Em um serviço público de emergência de Ribeirão Preto. A amostra do estudo foi constituída por 155 participantes. O estudo foi realizado no período de janeiro de 2016 a outubro de 2018, em um serviço público de emergência de Ribeirão Preto/SP. Resultados: Na amostra estudada observou-se 47,1% de profissionais com estresse atual, sendo que entre estes profissionais que tinham estresse: 82,2% eram mulheres. Os resultados evidenciaram que os profissionais com estresse estavam em sua maioria na fase de resistência (76,7%), 17,8% na fase de quase-exaustão, 4,1% na fase de exaustão e 1,4% na fase de alerta. Destaca-se maiores escores médios relacionados à cultura organizacional e o estresse atual, notadamente no fator 2 \"Rigidez na estrutura hierárquica de poder\" (média 3,02 + dp 0,77) e no fator 3 \"Profissionalismo competitivo e individualista\" (2,28 + dp 0,66). Destaca-se maiores escores médios do clima organizacional e o estresse atual no fator 1 \"Apoio da chefia e da organização\" (média 2,69 + dp 0,71), fator 2 \"Recompensa\" (1,91 + dp 0,63), fator 3 \"Conforto físico\" (2,97 + dp 0,84) e fator 5 \"Coesão entre colegas\" (2,95 + dp 0,72). Os resultados evidenciaram que nas análises entre o estresse com as variáveis sóciodemográficas e de trabalho, apenas a variável sexo esteve associada com o estresse, já nas análises entre cultura e clima organizacional houve correlação estatisticamente significativa entre o fator 1 - \"Profissionalismo cooperativo\", 4 - \"Satisfação e bem-estar dos empregados\", 5 - \"Práticas de integração externa\" e 6 - \"Práticas de recompensa e treinamento\" da cultura organizacional com todos os fatores do clima organizacional (Apoio da chefia e da organização, Recompensa, Conforto físico, Controle/Pressão e Coesão entre colegas), todas com um nível de significância abaixo de 0,01. No teste da regressão foi possível observar a relação do estresse com as variáveis: sexo (p 0,017; Exp(B) 2,766), vínculo empregatício (p 0,049; Exp(B) 1,403) e o fator 2 \"Recompensa\" da escala de clima organizacional (p 0,002; Exp(B) 0,396). Conclusões: O presente estudo possibilitou concluir a influencia da cultura e clima organizacional de uma organização de saúde hospitalar de emergência e sua relação com a prevalência de estresse. Também identificou a ligação entre cultura e clima organizacional, mostrando a influência da cultura sobre o clima organizacional / Introduction: The professionals who work in the emergency area constantly deal with several changes, making it an area of practice that demands a lot of professionals. It is estimated that stress affects more than 90% of the world population and, because it is not considered a disease in itself, is underestimated, resulting in the absence of treatments and prevention of illness. Organizational culture is understood as experimental conduct and symbol in process of assimilation, patterns and habits reasonably established. Organizational climate is the indicator of the degree of satisfaction of the members of a company, in relation to different aspects of the culture or apparent reality of the organization. Stress can cause serious consequences and among health workers, its occurrence still needs to be evaluated in expanded studies that contemplate its complexity in a more comprehensive way, considering personal, environmental and psychosocial factors. Thus, assessing the climate and organizational culture is important to understand how the institutions work, what are the strengths and weaknesses of the site and thus propose improvements to the fragile points and potentiate the strengths. Objective: The objective of the study is to identify the organizational climate and organizational culture of an emergency hospital service and its relation to the prevalence of stress. Methods: A transversal, analytical, exploratory, quantitative approach was developed. In an emergency public service of Ribeirão Preto. The study sample consisted of 155 participants. The study was conducted from January 2016 to October 2018, in a public emergency service in Ribeirão Preto / SP. Results: In the sample studied, 47.1% of professionals with current stress were present, and among these professionals who had stress: 82.2% were women. The results showed that the professionals with stress were mostly in the resistance phase (76.7%), 17.8% in the near-exhaustion phase, 4.1% in the exhaustion phase and 1.4% in the phase of exhaustion. alert. It is worth mentioning that higher scores are related to organizational culture and current stress, especially in factor 2 \"Rigidity in the hierarchical structure of power\" (average 3.02 + dp 0.77) and factor 3 \"Competitive and individualistic professionalism\" (2 , 28 + dp 0.66). It is worth noting the higher average scores of the organizational climate and the current stress in the factor 1 \"Support of management and organization\" (average 2.69 + dp 0.71), factor 2 \"Reward\" (1.91 + dp 0.63 ), factor 3 \"Physical comfort\" (2.97 + dp 0.84) and factor 5 \"Cohesion among colleagues\" (2.95 + dp 0.72). The results showed that in the analyzes between stress and socio-demographic and work variables, only the gender variable was associated with stress. In the analyzes between culture and organizational climate, there was a statistically significant correlation between factor 1 - \"Cooperative professionalism\" , 4 - \"Employees\' satisfaction and well-being\", 5 - \"External integration practices\" and 6 - \"Reward and training practices\" of organizational culture with all organizational climate factors (Support of leadership and organization, Reward , Physical Comfort, Control / Pressure and Cohesion among colleagues), all with a level of significance below 0.01. In the regression test, it was possible to observe the relationship of stress with the variables: sex (p 0.017, Exp (B) 2,766), employment bond (p 0.049, Exp (B) 1,403) and factor 2 \"Reward\" organizational (p 0.002; Exp (B) 0.396). Conclusions: The present study made it possible to conclude the influence of the organizational culture and climate of an emergency hospital health organization and its relation with the prevalence of stress. It also identified the link between culture and organizational climate, showing the influence of culture on the organizational climate

<p>Bakgrund: Psykiska sjukdomar beräknas drabba var fjärde person i världen. Patienter med psykisk sjukdom drabbas i högre grad av somatiska sjukdomar och vårdas då inom somatisk vård. Syfte: Syftet var att beskriva faktorer som påverkar attityder till patienter med psykisk sjukdom hos vårdpersonal inom somatisk vård. Metod: Allmän litteraturstudie med kvalitativ ansats bestående av systematisk granskning av fjorton kvalitativa och kvantitativa artiklar. Resultat: Resultatet visade på att vårdpersonalens attityder påverkades av deras upplevelse av brist på kunskap om att vårda psykiskt sjuka. Attityderna påverkades även av brist på stöd från organisationen, negativa känslor inför patienterna som exempelvis rädsla och upplevelser och föreställningar om hur patienterna var. Diskussion: De centrala fynden som framkom var: vårdpersonalens negativa attityder till patienternas tillfrisknande och framtidsutsikter, vårdpersonalens upplevelse av brist på kunskap som gjorde att de undvek patienterna och vårdpersonalens rädsla för att de psykiskt sjuka patienterna skulle bli aggressiva och våldsamma. Dessa fynd diskuterades utifrån Watsons teori om transpersonell omsorg. Slutsatser: Sjuksköterskor måste bli bättre på att tillfredsställa psykologiska, sociala och andliga behov samt uppmuntra och stödja hopp om framtiden hos patienten.</p> / <p>Background: Approximately one out of four people in the world are afflicted by mental illness. These patients suffer from somatic diseases to a higher degree and will then require non-psychiatric specialized care. Aim: The aim was to describe factors that affect health professionals' attitudes to patients with mental illness within somatic care. Method: Literature review with a qualitative approach consisting of systematic review of fourteen qualitative and quantitative articles. Results: The results showed that the health professionals experience of lack of knowledge in caring for mentally ill patients which affected their attitudes towards them. Their attitudes were also affected by the lack of support from the organisation, their negative feelings towards the patients as fear and experiences and preconceptions of how the patients are. Discussion: The main findings were: the health professionals' negative attitudes towards the patients' recovery and future, the health professionals' experience of lack of knowledge which made them avoid their patients and the health professionals' fear of aggression and violence from the patients. These findings were discussed against Watson’s theory of transpersonal caring. Conclusions: Nurses needs to improve their ability to satisfy psychological, social and spiritual needs as well as encourage and support hope for the future within the patient.</p>

Bakgrund: Psykiska sjukdomar beräknas drabba var fjärde person i världen. Patienter med psykisk sjukdom drabbas i högre grad av somatiska sjukdomar och vårdas då inom somatisk vård. Syfte: Syftet var att beskriva faktorer som påverkar attityder till patienter med psykisk sjukdom hos vårdpersonal inom somatisk vård. Metod: Allmän litteraturstudie med kvalitativ ansats bestående av systematisk granskning av fjorton kvalitativa och kvantitativa artiklar. Resultat: Resultatet visade på att vårdpersonalens attityder påverkades av deras upplevelse av brist på kunskap om att vårda psykiskt sjuka. Attityderna påverkades även av brist på stöd från organisationen, negativa känslor inför patienterna som exempelvis rädsla och upplevelser och föreställningar om hur patienterna var. Diskussion: De centrala fynden som framkom var: vårdpersonalens negativa attityder till patienternas tillfrisknande och framtidsutsikter, vårdpersonalens upplevelse av brist på kunskap som gjorde att de undvek patienterna och vårdpersonalens rädsla för att de psykiskt sjuka patienterna skulle bli aggressiva och våldsamma. Dessa fynd diskuterades utifrån Watsons teori om transpersonell omsorg. Slutsatser: Sjuksköterskor måste bli bättre på att tillfredsställa psykologiska, sociala och andliga behov samt uppmuntra och stödja hopp om framtiden hos patienten. / Background: Approximately one out of four people in the world are afflicted by mental illness. These patients suffer from somatic diseases to a higher degree and will then require non-psychiatric specialized care. Aim: The aim was to describe factors that affect health professionals' attitudes to patients with mental illness within somatic care. Method: Literature review with a qualitative approach consisting of systematic review of fourteen qualitative and quantitative articles. Results: The results showed that the health professionals experience of lack of knowledge in caring for mentally ill patients which affected their attitudes towards them. Their attitudes were also affected by the lack of support from the organisation, their negative feelings towards the patients as fear and experiences and preconceptions of how the patients are. Discussion: The main findings were: the health professionals' negative attitudes towards the patients' recovery and future, the health professionals' experience of lack of knowledge which made them avoid their patients and the health professionals' fear of aggression and violence from the patients. These findings were discussed against Watson’s theory of transpersonal caring. Conclusions: Nurses needs to improve their ability to satisfy psychological, social and spiritual needs as well as encourage and support hope for the future within the patient.