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Certified Nursing Assistants (CNAs) are responsible for the care of America's aging population. CNAs are paid a miniscule amount of money and are often ineligible for medical benefits through their employers. CNAs bathe, change, feed, and help toilet the residents of long-term care facilities. The stressful work and personal lives of CNAs leads to many problems such as high turnover rates, absenteeism, health problems, and elder abuse. In the United States, food insecurity is a concern for many of the uninsured working poor. The purpose of this study was to assess the overall perceived concerns, barriers, and solutions of CNAs in both their work and family environments, identify where nutrition and food security fits into the priorities of CNAs, and identify educational strategies to improve their health and overall quality of life. Twenty-nine CNAs participated in six focus groups across the state of Virginia. Triangulation techniques were used to compare both qualitative (focus groups) and quantitative (participatory activities and questionnaires) research. Participatory activities showed that the top home concern of CNAs was money management. CNAs ranked keeping their family healthy fourth (9.6%), and they ranked preparing fast easy meals eighth (1.7%). The top work concern of CNAs was time management. Staying healthy at work ranked fourth (12.9%), while packing a nutritious lunch was sixth (3.4%). The preferred methods of education for the participants were watching videotapes, attending classes at a central location, and having a mentor to help them with their problems. / Master of Science

Esta pesquisa emergiu de vivências práticas que geraram questionamentos a respeito da possibilidade que profissionais de enfermagem têm de conciliar cuidados de dimensões diversas. A história da enfermagem registra uma concentração em atividades tecnicistas, porém, acredita-se que o cuidado é uma atividade profissional complexa e ampliada envolvendo conciliações técnicas e subjetivas, entendido neste trabalho como cuidado continuum. Optou-se por uma pesquisa qualitativa, utilizando a técnica de grupo focal com o objetivo de descrever e analisar como os auxiliares de enfermagem enfrentam os aspectos emocionais das pessoas hospitalizadas, sendo o local de estudo o Hospital Abreu Sodré, no município de São Paulo. A análise de conteúdo, método utilizado para descrever os resultados, evidenciou uma dificuldade neste cuidado. Os relatos destacam a compreensão e a necessidade do cuidado ampliado, porém, fatores sociais, econômicos e pessoais que envolvem estes profissionais, quase o tornam inatingível. Estes fatores estão relacionados às exigências do mercado de trabalho, à necessidade de cumprir protocolos em um curto espaço de tempo, reforçando certa característica robotizada do cuidador. Os sujeitos da pesquisa consideraram o número reduzido de profissionais; excesso de tarefas; falta de tempo; baixos salários; dificuldade de manejo com a questão subjetiva; estresse físico e mental e outros como fatores impeditivos para a efetivação do cuidado continuum. O indicativo resultante da pesquisa é a criação de serviços de apoio, onde os profissionais de enfermagem poderão verbalizar seus sentimentos e “se sentirem mais leves", viabilizando uma outra modalidade de cuidado às pessoas hospitalizadas e seus acompanhantes / This research has come from practical living which generated questions about the possibility nursing professionals have to conciliate caring in many dimensions. Nursing history registers a concentration in technical activities; however, caring is believed to be a complex and enlarged professional activity involving technical and subjective conciliations, understood in this paper as continuum care. It was opted for a qualitative research, using the focus group technique under the objective of describing and analyzing how the nursing assistants face the hospitalized people emotional aspects and this study takes place in Abreu Sodré Hospital, in São Paulo. The contents analysis, method used to describe the results, has shown a difficulty in this caring. Reports show up comprehension and necessity of enlarged caring, however, social, economical and personal facts which involve these professionals, make it almost impossible to be reached. These factors are related to the working market and the necessity of caring out protocols in shortened time, reinforcing a kind of robotized characteristic to the person in charge of caring. The participants of the research have considered the shortened number of professional; excess of tasks; lack of time; low wages; difficulties on handling the subjective matters; physical and mental stress and others as inhibitive factors to put continuum care into effect. The research indicative resultant is the creation of supporting services, where nursing professionals can verbalize their feelings and “feel lighter", making another caring modality available to the hospitalized people and their chaperones

O presente estudo tem como objetivos investigar junto a pacientes de clínica médica, cirúrgica e psiquiátrica sua compreensão sobre Relacionamento Interpessoal, qual a importância desta habilidade, como ela ocorre entre os técnicos e auxiliares de enfermagem com os pacientes das referidas clínicas, o motivo que os levou a este relacionamento e a freqüência desta interação. A metodologia adotada foi a descritivo-exploratória na abordagem qualitativa. O estudo foi realizado em dois hospitais que atendem pacientes conveniados ao Sistema Único de Saúde (SUS), em Passos, Minas Gerais, sendo um hospital geral com clínicas médica e cirúrgica e o outro um hospital psiquiátrico. Fizeram parte do estudo oitenta e sete (87) pacientes dos quais quinze (15) foram submetidos à uma entrevista prévia e setenta e dois (72) foram observados por observadores treinados que a prática da habilidade descrita acima desenvolvida pelos técnicos e auxiliares de enfermagem referidos. Os resultados das entrevistas apresentaram a visão dos pacientes de como são tratados pelos técnicos e auxiliares de enfermagem que trabalham nos referidos hospitais, os conteúdos de suas conversas com esses profissionais, como essas conversas os ajudam, seus sentimentos, o que mais valorizam para o seu bem estar e suas sugestões para melhorar a assistência de enfermagem. Evidenciouse que apesar dos pacientes relatarem que são bem tratados, suas falas levam ao entendimento de que eles evitam fazer comentários negativos da assistência por medo de serem mal tratados e também por medo de ofender os profissionais. As conversas que ocorreram foram breves, superficiais e mecânicas. Constatou-se a predominância por parte dos técnicos e auxiliares de enfermagem em realizar as técnicas, deixando evidente sua formação instrumental, não sendo incluído nesta o relacionamento interpessoal como técnica. Ficou claro seu despreparo para se comunicarem ou se relacionarem com os pacientes, apesar desses relatarem que um dos fatores que mais influenciam em seu bem estar é o relacionamento interpessoal. / The objective of this present study was to investigate the relationship among patients from medical, surgical and psychiatrist clinics, their understanding about this subject, what is the importance of this hability, how it happens between nursing technicians and nursing assistants and the patients from those clinics, the reason that these professionals decided to apply this relation and how often it has been applied. The metodology adopted was the exploratory – descriptive with qualitative research. The study was performed in a psychiatrist hospital and in a hospital where there were medical and surgical clinics. Both of hospitals attend patients connected to Basic Heath Units, in Passos, Minas Gerais. 87 patients participated in this study, 15 of them were interviewed and 72 patients were observed by trained observers. The results of these interviews related what the patients really think about the way they are treated by the nursing technicians and the nursing assistants that work at those hospitals, and the content of their talks with those professionals, how these talks help them, their feelings, their well being and their suggestions to improve the nursing assistance. Even though the patients reported that they are well treated by the nursing technicians and the nursing assistants it was realized that they tend to avoid making negative comments about the assistance afraid of offending the professionals and being bad treated by them. The talks were brief, superficial and mechanic. It was showed the predominance / willingness of those nursing technicians and assistants in appling the technics, their instrumental formation clearly. Relationship was not include as a technic. What it was also clear was that they were not prepared to communicate or to have a relationship with those patients, even though the patients say relationship is one of the reasons that most brought them their well being.

Workplace violence (WPV) is ranked as one of the leading causes of occupational injury in the United States and is common in health settings. Nurses have the highest rate of violent victimization reported in the U.S., thus presenting a significant issue for healthcare leaders. Various researchers focus on prevalence rates of WPV among nurses discussing types of violence, location, and the setting where the WPV occurred. Less information exists regarding time taken off work and factors associated with WPV among nurses versus nursing assistants (NAs). This information is important due to the impact on safe work environments for nursing employees. The research questions for the study examined the prevalence of WPV and time taken off work among nurses compared to NAs. The study employed a retrospective secondary analysis of data collected by the Bureau of Labor Statistics, from 2011 to 2014, of nurses and NAs in the State of Texas. Multivariate analysis, partial correlation statistical test, and partition of the sum of squares (ANOVA) determined that NAs experienced more incidents of WPV and spent more time away from work due to injuries than nurses. The study was limited because the data did not provide clear indications of environmental factors that led to the injuries, nor did data related to the culture of the working environments and injuries exist. A recommendation for future research is evaluation of the impact of WPV on productivity, patient safety, and quality of care when nurses continue to work or return to work after experiencing WPV. Results of the study reveal the differences in injuries between the two groups and factors impacting the injuries. This information is important for social change as healthcare leaders evaluate opportunities to create a safe working environment for their staff and provide additional resources for nurses to prevent WPV incidents.

The relationship between learning styles and achievement has been thoroughly studied by many researchers. However, the nursing assistant population is under represented in these studies. Hence, the purpose of this study was to understand the relationship between learning styles, demographics, and achievement of nursing assistant students in Illinois. The sample for the study consisted of 916 nursing assistant students' in Illinois. The VARK learning style inventory was used to measure the students' learning styles, and a demographic questionnaire was used to gather demographic data. The Illinois Nurse Aide Competency Test score was used to measure the achievement of students. The findings showed that there was a relationship between learning styles and achievement of nursing assistant students. Also, there was a relationship between demographics and learning styles. The dominant learning style was the multimodal all four (VARK) preference. Females were the highest representation in the sample and the majority of students were in age ranges 18-25.

Esta pesquisa emergiu de vivências práticas que geraram questionamentos a respeito da possibilidade que profissionais de enfermagem têm de conciliar cuidados de dimensões diversas. A história da enfermagem registra uma concentração em atividades tecnicistas, porém, acredita-se que o cuidado é uma atividade profissional complexa e ampliada envolvendo conciliações técnicas e subjetivas, entendido neste trabalho como cuidado continuum. Optou-se por uma pesquisa qualitativa, utilizando a técnica de grupo focal com o objetivo de descrever e analisar como os auxiliares de enfermagem enfrentam os aspectos emocionais das pessoas hospitalizadas, sendo o local de estudo o Hospital Abreu Sodré, no município de São Paulo. A análise de conteúdo, método utilizado para descrever os resultados, evidenciou uma dificuldade neste cuidado. Os relatos destacam a compreensão e a necessidade do cuidado ampliado, porém, fatores sociais, econômicos e pessoais que envolvem estes profissionais, quase o tornam inatingível. Estes fatores estão relacionados às exigências do mercado de trabalho, à necessidade de cumprir protocolos em um curto espaço de tempo, reforçando certa característica robotizada do cuidador. Os sujeitos da pesquisa consideraram o número reduzido de profissionais; excesso de tarefas; falta de tempo; baixos salários; dificuldade de manejo com a questão subjetiva; estresse físico e mental e outros como fatores impeditivos para a efetivação do cuidado continuum. O indicativo resultante da pesquisa é a criação de serviços de apoio, onde os profissionais de enfermagem poderão verbalizar seus sentimentos e “se sentirem mais leves”, viabilizando uma outra modalidade de cuidado às pessoas hospitalizadas e seus acompanhantes / This research has come from practical living which generated questions about the possibility nursing professionals have to conciliate caring in many dimensions. Nursing history registers a concentration in technical activities; however, caring is believed to be a complex and enlarged professional activity involving technical and subjective conciliations, understood in this paper as continuum care. It was opted for a qualitative research, using the focus group technique under the objective of describing and analyzing how the nursing assistants face the hospitalized people emotional aspects and this study takes place in Abreu Sodré Hospital, in São Paulo. The contents analysis, method used to describe the results, has shown a difficulty in this caring. Reports show up comprehension and necessity of enlarged caring, however, social, economical and personal facts which involve these professionals, make it almost impossible to be reached. These factors are related to the working market and the necessity of caring out protocols in shortened time, reinforcing a kind of robotized characteristic to the person in charge of caring. The participants of the research have considered the shortened number of professional; excess of tasks; lack of time; low wages; difficulties on handling the subjective matters; physical and mental stress and others as inhibitive factors to put continuum care into effect. The research indicative resultant is the creation of supporting services, where nursing professionals can verbalize their feelings and “feel lighter”, making another caring modality available to the hospitalized people and their chaperones

O presente estudo tem como objetivos investigar junto a pacientes de clínica médica, cirúrgica e psiquiátrica sua compreensão sobre Relacionamento Interpessoal, qual a importância desta habilidade, como ela ocorre entre os técnicos e auxiliares de enfermagem com os pacientes das referidas clínicas, o motivo que os levou a este relacionamento e a freqüência desta interação. A metodologia adotada foi a descritivo-exploratória na abordagem qualitativa. O estudo foi realizado em dois hospitais que atendem pacientes conveniados ao Sistema Único de Saúde (SUS), em Passos, Minas Gerais, sendo um hospital geral com clínicas médica e cirúrgica e o outro um hospital psiquiátrico. Fizeram parte do estudo oitenta e sete (87) pacientes dos quais quinze (15) foram submetidos à uma entrevista prévia e setenta e dois (72) foram observados por observadores treinados que a prática da habilidade descrita acima desenvolvida pelos técnicos e auxiliares de enfermagem referidos. Os resultados das entrevistas apresentaram a visão dos pacientes de como são tratados pelos técnicos e auxiliares de enfermagem que trabalham nos referidos hospitais, os conteúdos de suas conversas com esses profissionais, como essas conversas os ajudam, seus sentimentos, o que mais valorizam para o seu bem estar e suas sugestões para melhorar a assistência de enfermagem. Evidenciouse que apesar dos pacientes relatarem que são bem tratados, suas falas levam ao entendimento de que eles evitam fazer comentários negativos da assistência por medo de serem mal tratados e também por medo de ofender os profissionais. As conversas que ocorreram foram breves, superficiais e mecânicas. Constatou-se a predominância por parte dos técnicos e auxiliares de enfermagem em realizar as técnicas, deixando evidente sua formação instrumental, não sendo incluído nesta o relacionamento interpessoal como técnica. Ficou claro seu despreparo para se comunicarem ou se relacionarem com os pacientes, apesar desses relatarem que um dos fatores que mais influenciam em seu bem estar é o relacionamento interpessoal. / The objective of this present study was to investigate the relationship among patients from medical, surgical and psychiatrist clinics, their understanding about this subject, what is the importance of this hability, how it happens between nursing technicians and nursing assistants and the patients from those clinics, the reason that these professionals decided to apply this relation and how often it has been applied. The metodology adopted was the exploratory – descriptive with qualitative research. The study was performed in a psychiatrist hospital and in a hospital where there were medical and surgical clinics. Both of hospitals attend patients connected to Basic Heath Units, in Passos, Minas Gerais. 87 patients participated in this study, 15 of them were interviewed and 72 patients were observed by trained observers. The results of these interviews related what the patients really think about the way they are treated by the nursing technicians and the nursing assistants that work at those hospitals, and the content of their talks with those professionals, how these talks help them, their feelings, their well being and their suggestions to improve the nursing assistance. Even though the patients reported that they are well treated by the nursing technicians and the nursing assistants it was realized that they tend to avoid making negative comments about the assistance afraid of offending the professionals and being bad treated by them. The talks were brief, superficial and mechanic. It was showed the predominance / willingness of those nursing technicians and assistants in appling the technics, their instrumental formation clearly. Relationship was not include as a technic. What it was also clear was that they were not prepared to communicate or to have a relationship with those patients, even though the patients say relationship is one of the reasons that most brought them their well being.

Teamwork in healthcare is recognized as a significant factor in achieving patient safety and impacting patient outcomes. Despite the general focus on teamwork in healthcare, there has been little research on teamwork among nurses and nursing assistants working on patient care units. The purpose of this doctoral project was to identify, compare, and analyze perceptions of teamwork in a group of nurses and nursing assistants in a community hospital setting where the TeamSTEPPS program has been implemented. The framework of this project was the concept of shared mental model and Imogene King's conceptual system and middle-range theory of goal attainment. Teamwork perceptions were measured using the TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ), which is composed of five constructs: (a) team structure, (b) leadership, (c) situation monitoring, (d) mutual support, and (e) communication. Sixty-three nurses and 42 nursing assistants participated in the study. There was a significant difference between nursing assistants and staff nurses with respect to the Total T-TPQ mean score (4.03 and 4.26, respectively; p < 0.03), leadership (4.11 and 4.44, respectively; p < 0.01), and communication (4.13 and 4.35, respectively; p < 0.04). Nurses had a higher level of agreement than nursing assistants for Total T-TPQ, leadership, and communication. The results underscore the need to close the gap between nursing assistants' and nurses' perceptions of teamwork. Hospital and nursing leaders should make significant efforts to improve teamwork to build cohesive and highly functional nursing teams that can improve patient safety and thus create lasting social change.

The purpose of the current study was to examine how job resources, job demands, personal resource, personal demands, and demographic characteristics predict job satisfaction and job search behavior of certified nursing assistants (CNAs) working in nursing homes. The study used data from the 2004 National Nursing Assistant Survey (NNAS). The job demands-resources (JD-R) model (Demerouti, Bakker, Nachreiner, & Schaufeli, 2001) provided the basis for the conceptual framework of the study. First, a series of multinomial logistic regression analyses were performed to determine how the five categories of predictor variables predicted the levels of job satisfaction among CNAs. Next, a series of binary logistic regressions was used to assess the effects of the predictor variables on job search behavior. Lastly, binary logistic regression was used to examine the effect of job satisfaction on job search behavior, controlling for other predictor variables. Findings indicated that job resource variables related to positive administrative climate, opportunity for self-advancement, supportive supervisory practices, peer support, and positive interactions with residents predicted job satisfaction. Among job demand variables, lack of perceived respect and physical demands significantly and negatively predicted job satisfaction. In the job search behavior model, CNAs who reported respectful administrative climate, opportunity for self-advancement, and supervisor quality were less likely to search for a new job. Among job demand variables, perceived lack of respect/appreciation for work, perceived racial/ethnic discrimination, and problems with scheduling predicted job search behavior. When the job satisfaction variable was entered into the final job search behavior model, two variables became insignificant: supervisor quality and perceived lack of respect/appreciation for work. In the final model, job satisfaction had the strongest explanatory power of job search behavior. The findings of this study did not support the role of personal resources and demands in determining job attitudes and behavior of CNAs working in nursing homes. Research, education, policy, and practice implications are addressed.