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Incontinencia urinaria : problema ocupacional entre profissionais de enfermagemHiga, Rosangela 19 February 2004 (has links)
Orientador: Maria Helena Baena de Moraes Lopes / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-04T01:02:28Z (GMT). No. of bitstreams: 1
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Previous issue date: 2004 / Resumo: Pesquisas realizadas relatam que a Incontinência Urinária (lU) causa nas mulheres conseqüências físicas, econômicas e psicossociais que interferem na qualidade de vida e estudos recentes têm mostrado que a lU interfere também nas atividades ocupacionais. O objetivo do presente estudo foi avaliar a prevalência da lU, suas associação com alguns fatores, sua interferência no desenvolvimento das atividades diárias ocupacionais e seu manejo entre mulheres profissionais de enfermagem de um hospital-escola na cidade de Campinas - SP, Brasil. O estudo foi tipo corte transversal. A população de estudo foi composta por todas as profissionais de enfermagem que se encontravam em atividade no mês de fevereiro de 2003. A coleta de dados foi realizada em duas fases. Na primeira fase foi distribuído um questionário que identificou as funcionárias que apresentavam queixa de perda involuntária de urina pelo menos uma vez por mês, durante o último ano, além de questões sobre algumas variáveis de interesse. Na segunda fase foi realizada entrevista com as profissionais que apresentavam queixa de lU, identificando-se sua interferência nas atividades ocupacionais, as estratégias para manejo da lU e outros aspectos. Para verificar associações, os grupos com ou sem lU foram comparados utilizando-se os testes t de Student, qui-quadrado, exato de Fisher ou Mann-Whitney. Através da análise de regressão logística univariada e multivariada, pelo processo de seleção das variáveis "Stepwise", foram selecionadas as variáveis mais significativas. Dentre os 378 formulários distribuídos, 291 (77%) foram respondidos de maneira adequada e completa. A queixa de lU foi relatada por 80 funcionárias (27,5%). A análise multivariada indicou que as mulheres que engordaram e emagreceram tinham 26 vezes mais chance de queixa de lU, sendo esta possibilidade de 4,2 vezes entre mulheres que emagreceram; 3,8 vezes entre as mulheres com hipertensão arterial; 3,1 vezes entre as que tinham constipação intestinal e 3,0 vezes após os 41 anos de idade. A lU causou restrições nas atividades ocupacionais, sexuais e sociais. As atividades que demandavam maiores esforços físicos como carregar peso, empurrar maca e cadeira de rodas, tomaram a lU mais freqüente. A incontinência durante a jornada de trabalho foi responsável por problemas como: estresse, vergonha, constrangimento, raiva e falta de concentração no trabalho. As estratégias mais utilizadas foram: usar forro ou absorvente higiênico e reduzir a ingestão hídrica. O manejo inadequado causou prejuízos à saúde como: irritação, assadura, alergia na pele e infecção urinária. Foram identificadas facilidades para o manejo, como poder utilizar o toalete sempre que necessário e trocar de roupa, forro ou absorvente higiênico durante a jornada de trabalho. As dificuldades mais citadas foram: distância do toalete maior que 12 metros, quantidade insuficiente de toalete nas unidades e não poder interromper a atividade para o uso do toalete. Concluiu-se que o aumento da freqüência da perda urinária devido às atividades que demandavam maiores esforços físicos, dificuldades para manejo adequado e a interferência no desempenho profissional caracterizaram o impacto da lU nestas trabalhadoras. Medidas educativas de prevenção e tratamento se fazem necessárias para melhorar o desempenho profissional e a qualidade de vida destas mulheres / Abstract: The urinary incontinence (UI) causes physical, economic and psychosocial effects to the women. The aim of this present study was to assess the UI prevalence, its association to some factors, its interference at the performance of the occupational daily activities and its management among nurse female staff of a school hospital at Campinas, São Paulo State, Brazil. It was a cross-sectional cohort study. The population studied was composed by ali the nursing staff that working during the month of February of 2003. The data collecting was performed into two phases. At the first phase, it was delivered a questionnaire that had identified the employers who complaint of UI at least once a month during the past year, a part from the issues about some variables of interesting. At the second phase, it was performed an interview to the employers who had presented complaints of U I, its interference at the occupational activities, the management strategies of the UI and other aspects. In order to verify the association, the groups with or without UI were compared using the following tests t Student, Qui-square, Fisher Exact or Mann Whitney. The univariate and multivariate analysis of logistic regression by the selection process of -"stepwise" variables had selected the most significant variables. Of the 378 questionnaires delivered, 291 (77%) were completely answered. The UI complaint was reported by 80 employers (27.5%). The multivariate analysis had shown that the women that having gained and lost weight has had 26 times more chance to complaints of UI; this possibility was 4,2 time more among women that having lost weigth; 3,8 time more among women that having arterial hypertension; 3,1 times more among those that having intestinal constipation and 3,0 time more after 41 years of age was. The UI was reported as being responsible by restrictions at the occupational, sexual and social activities. The activities which require more effort, like to lifI: heavy things and to push stretchers and wheelchairs became the UI more frequento The UI during the working was responsible by stress, shame, restraint, angry, lack of concentration at work among other complaints. The most used strategies were: wearing pads, diapers and decreasing oral fluid intake. The inadequate management caused damages to health, such as: irritation, skin rash, skin allergy and urinary tract infection. It was identified facilities for the management, as uses the toilette as much as necessary changes the dothes and the diapers or pads. The most important difficulties were: a distance of more than 12 meters of the toilette trom the workplace, not enough amounts of toilettes available at the workplace unit, and impossibility of not interrupting the activity that they were performing to go the toilette. It was concluded that the trequency increased of the UI due to developrnent effort activities at work, difficulties for the adequate managernent of the UI and professional performance interference characterized the impact of urinary incontinence in these working women. Preventable educational rneasures and treatment are necessary in order to irnprove the professional developrnent and quality of Ufe of these wornen / Mestrado / Enfermagem e Trabalho / Mestre em Enfermagem
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South African medical practitioners’ experiences of the current health-care delivery systemStoyanov, Joan Ellen January 2011 (has links)
A thesis submitted in partial fulfilment of the requirements for the degree of Masters of Arts in Clinical Psychology at the University of Zululand, South Africa, 2011. / South Africa is at a critical point in the debate about the future of health-care in the occupation-specific dispensation (OSD). It also faces the exodus of valuable human resources that was perceived as greener pastures, as medical practitioners become increasingly dissatisfied with governmental policy, wage negotiations, work-place disillusionment, lack of service delivery, expressions of corruptions, and lack of resources. This research aimed to thematically analyse the experiences, opinions and feelings of medical practitioners in both the public and private health-care sectors as well as explored international trends with the intention of drawing comparisons, highlighting problem areas, and discussion of possible solutions. It was hoped that this research would contribute towards understanding the dynamics that marked the exodus of medical practitioners from South Africa, at a time when change in the health-care system was imminent. In order for the medical practitioners to remain in the current health-care system, a new dialogue would have been opened in which their concerns could be raised and evaluated.
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