Para identificar os principais indícios de estresse, coping e estressores do mestrando de enfermagem, relacionando o processo da dissertação com sua inserção profissional realizou-se uma pesquisa exploratória qualitativa através de entrevistas com 18 mestrandos e seis orientadores da EEUSP. Verificou-se que o mestrado era visto como um espaço de legitimação do saber e de ser trabalho intelectual, para conquistar reconhecimento que não encontrava na assistência, onde era desprestigiada e o espaço acadêmico era idealizado como algo que traria prestígio e poder, sendo coping para lidar como trabalho. Porém a Universidade sofria das mesmas vicissitudes da assistência: carreira docente feminina, hierárquica e dificuldade para conciliar ensino e pesquisa, teoria e prática e ensino e assistência / In order to identify the main signs of stress, coping and stressors of the nursing masters' degree students, connecting the dissertation process with their occupation, an exploratory qualitative research was elaborated, analyzing interviews with 18 marters' degree students and 6 orientation professors at EEUSP. It was found that the masters' degree was seen as legitimation of the knowledge of their intellectual occupation, in order to acquire the recognition that they didn't find at nursing care, and they idealized Academy as a forum for prestige and authority, however university had similar adversities as the academic career was feminine, hierarchic, and there were difficulties to conciliate teaching and research, theory and practice and teaching and care

Orientador: Maria Beatriz Duarte Gavião / Texto em português e inglês / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-24T18:01:40Z (GMT). No. of bitstreams: 1 Aranha_MariaFernandaMontans_D.pdf: 1980605 bytes, checksum: 9f4ae0a15227cd5ca93e4bb7d7713aaf (MD5) Previous issue date: 2014 / Resumo: A dor miofascial (DM), proveniente de um ponto gatilho miofascial (Pg), é a principal causa de dor de cabeça e pescoço. A sua presença é associada à rigidez muscular e estresse e pode influenciar a qualidade de vida de pacientes sintomáticos. Imagens ultrassonográficas do tecido disfuncional têm sido realizadas com o intuito de avaliar objetivamente o Pg. Com o objetivo de avaliar o efeito da acupuntura e da eletroacupuntura no tratamento da DM da parte superior do músculo trapézio, sessenta voluntárias com idade entre 18 e 40 anos, índice de massa corpórea entre 18 e 30 Kg/m2, com pelo menos um ponto gatilho na parte superior do músculo trapézio, dor local ou referida por mais de seis meses foram randomizadas em três grupos: eletroacupuntura (EA), acupuntura (AC) e acupuntura SHAM (SHAM). O avaliador e as voluntárias eram cegos aos tratamentos. Os pontos de acupuntura utilizados foram: VB20, VB21, F3 e IG4, além de no máximo, 2 pontos ashi em cada lado do trapézio superior. A efetividade do tratamento, assim como a manutenção dos resultados até um mês após o final do tratamento, foram avaliada pela intensidade de dor (escala visual analógica: EVA), amplitude de movimento cervical (fleximetria), qualidade de vida (SF-36), estresse (área abaixo da curva: AUCG; resposta do cortisol ao acordar: CAR), imagem de ultrassom (área do Pg). De acordo com sua distribuição os dados foram analisados pelos testes: teste-t pareado, Wilcoxon signed rank, ANOVA para medidas repetidas ou teste de Friedman, ANOVA ou Kruskal Wallis. Foi aplicado o teste de correlação de Pearson. O nível de significância foi de ?= 0,05. Foi observada redução na dor geral (DG) nos grupos EAC (P<0.001) e AC (P<0.001) após todas as sessões. Na reavaliação, a dor no trapézio direito (TPzD) diminuiu para os grupos EA (P<0.001) e AC (P=0.025), já no trapézio esquerdo (TPzE), apenas o grupo EA mostrou melhora (P<0.001). Em relação à DG correu interação dos fatores "fase de avaliação" e "grupo" para AC e EAC, e para dor no TPzD e E apenas para o grupo EA. Após o tratamento houve aumento da rotação para a esquerda no grupo EA (P=0.049), e aumento da inclinação e rotação para a direita no grupo AC (P=0.005; P=0.032). Houve aumento da AUCG (P=0.006) e CAR (P<0.001) no grupo AC. Em relação aos dados obtidos pelo SF-36, o grupo SHAM apresentou aumento significativo da dor (P=0.005); os grupos EA e AC mostraram aumento nos mesmos domínios, com valores respectivos de P: capacidade funcional (P=0.011; P=0.016), aspectos físicos (P=0.027; P=0.13), dor (P=0.010; P=0.003), estado geral da saúde (P=0.017; P=0.011), vitalidade (P=0.010; P=0.011), saúde mental (P=0.018; P=0.014) e componente físicos (P=0.019; 0.002). Ocorreu diminuição na área do ponto gatilho (US) nos grupos EA (TPzD: P<0.001; TPzE: P=0.001) e AC (TPzD e TPzE P<0.001), e no grupo SHAM apenas no TPzE (P=0.036). A EA se mostrou mais eficaz no alívio da dor quando comparada aos outros grupos. Tanto AC quanto EA foram eficazes na melhora da morfologia do tecido muscular (US) e da qualidade de vida. A AC parece ser mais indicada na diminuição do estresse e na melhora da amplitude de movimento cervical em mulheres com dor miofascial no trapézio superior / Abstract: Myofascial pain (MP), caused by myofascial trigger points (MTrP), is of the main cause of headache and neck pain. It is associated with muscular stiffness, stress and can influence the quality of life of symptomatic patients. Ultrasound images of dysfunctional tissue have been used aiming to objectively evaluate the myofascia trigger point. Aiming to evaluate the effect of acupuncture and electroacupuncture on the treatment of MP at the upper trapezius muscle, sixty women aged between 18 and 40 years old, body max index between 19 and 30 Kg/m2, presenting at least one trigger point at the upper trapezius and local or referred pain for more than six months were randomized in to and three groups: electroacupuncture (EAC), acupuncture (AC) and SHAM-acupuncture (SHAM). Both examiner (CEEM) and volunteers were blinded to the treatments. The selected acupoints were VB20, VB21, F3 and IG4, besides a maximum of 2 "ashi points" in each upper trapezius. The effectiveness of treatment (eight sessions), as well as it maintenance till one month follow up, were evaluated concerning the intensity of pain (Visual analog scale: VAS), range of motion (fleximetry), quality of life (SF-36), stress (area under the curve to the ground: AUCG; cortisol awaking response: CAR) and ultrasound image (area of MTrP). Influencing factors and the menstrual cycle phases were monitored. According to its distribution, data were analyzed by pared t-test, Wilcoxon signed rank, ANOVA repeated measures, Friedman test, ANOVA or Kruskal Wallis. Pearson¿s correlation was applied. The level of significance was set in ?= 0.05. It was observed reduction on general pain (GP) on treated groups after all sessions (EA: P<0.001; AC: P<0.001). After treatment, intensity of pain on the right trapezius (RTPz) decreased in the EA (P<0.001) and AC (P=0.025) groups, but on the left trapezius (LTPz) it was only observed in the EA group (P<0.001). There was interaction of factor "time of evaluation" with factor "group" for GP in the AC and EA groups; and for pain at the RTPz and LTPz only in the EA group. There was increase on rotation to the left in the EA group (P=0.049) and on inclination and rotation to the right on group AC (P=0.005; P=0.032). There was increase on AUCG (P=0.006) and CAR (P<0.001) in the AC group. While SHAM presented significant increase only on bodily pain (P=0.005), EA and AC showed increase at the same following domains, with respectively P values: physical function (P=0.011; P=0.016), role physical (P=0.027; P=0.13), bodily pain (P=0.010; P=0.003), general health (P=0.017; P=0.011), vitality (P=0.010; P=0.011), mental health (P=0.018; P=0.014) and physical components (P=0.019; 0.002). It was observed a decrease on MTrP area (US) in the groups EA (TPzD: P<0.001; TPzE: P=0.001) and AC (RTPz e LTPz P<0.001), and in the SHAM groups only at the LTPz (P=0.036). The EA group has shown to be more effective on pain relief when compared to other groups. Both AC and EA were effectiveness improving tissue morphology (US) and quality of life. AC seems to be more indicated to the decrease stress and increase cervical range of motion than EA in women with myofascial pain at the upper trapezius / Doutorado / Anatomia / Doutora em Biologia Buco-Dental

Orientador: Milva Maria Figueiredo De Martino / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-23T01:40:43Z (GMT). No. of bitstreams: 1 Andreoli_CarlaParadaPazinatto_D.pdf: 2612922 bytes, checksum: 9bd8bce829aaf9cf0113b467e4aef0e1 (MD5) Previous issue date: 2013 / Resumo: Introdução - O sistema de temporização do organismo humano se expressa pela ritmicidade de seus eventos fisiológicos e são conhecidos por ritmos biológicos ou circadianos pelo fato de imprimirem variações periódicas e comportamentais. Naturalmente, a temperatura corporal exibe uma flutuação diária que resulta da inter-relação contínua entre ritmicidade e homeostase. A sincronização dos horários depende de uma tendência individual caracterizada pelos cronótipos que são parâmetros biológicos e comportamentais apresentados com diferenças interindividuais que afetam a expressão dos ritmos circadianos. Contudo os seres humanos têm a capacidade de se adaptar a mudanças diárias, embora a vida proporcione situações que geram desequilíbrio físico e emocional. Essas manifestações são reações de estresse e refletem sobremaneira no desempenho pessoal e profissional. O estudo e o trabalho noturno são condições que propiciam o surgimento de sintomas de estresse e levam a consequências negativas para a saúde física, social, afetiva e profissional. Objetivo - Analisar a ritmicidade circadiana da temperatura oral, identificar o cronótipo e os índices de estresse em estudantes e em profissionais da enfermagem dos turnos diurno e noturno. Método - Estudo descritivo, transversal, com enfoque quantitativo e comparativo, em que participaram estudantes (n=56) e profissionais de enfermagem (n=34). Os estudantes cursavam o 3º e o 5º período do Curso de Graduação de Tecnologia em Estética e Cosmética e os profissionais da equipe de Enfermagem da Santa Casa de Misericórdia. Utilizaram-se os seguintes instrumentos: Questionário de informações pessoais; Questionário para identificação de indivíduos matutinos e vespertinos elaborado por Horne e Östberg (1976) e adaptado para o Brasil por Benedito-Silva et al. (1990) e Inventário de Sintomas de Stress de LIPP (ISSL, 1989). Para as medidas da temperatura oral usaram-se termômetros clínicos digitais de haste flexível, e as medidas foram verificadas a cada três horas pelos dois grupos do estudo. Resultados - Observaram-se para o tempo de trabalho entre os profissionais de enfermagem o valor médio de 10,9 anos (dp±8,4) e para os estudantes trabalhadores valores médios de 10,1 anos (dp±9,6), demonstrando diferença significante (p<0.0001). Verificou-se quanto ao gênero, para o grupo de estudantes 96.43% do sexo feminino e 82,35% para os profissionais de enfermagem. Os resultados da temperatura oral, dos estudantes do período da manhã, demonstraram os seguintes parâmetros: Mesor = 36.4609, Amplitude = 0.2335 e a Acrofase =14.4658, com (p - valor = 0.0009) e para os profissionais de enfermagem: Mesor = 36.2196, Amplitude = 0.4007e a Acrofase =15.0746, com (p - valor < 0.0001). A comparação entre os cronotipos e as fases do estresse mostrou dados significantes pelo (Teste Fisher, p=0.0311). As comparações dos sintomas do estresse entre os grupos demonstraram dados significantes (Teste Fisher, p=0.0139). Conclusão. Observou-se que a curva da temperatura ajustou se a uma curva senoide demonstrando ritmicidade circadiana. Para a classificação do cronotipo obteve-se prevalência do tipo indiferente para a equipe de enfermagem e para os estudantes o tipo vespertino. Verificou-se a presença de sintomas de estresse físicos para a enfermagem e os sintomas psicológicos nos estudantes / Abstract: Background: The time system of the human body is expressed by the rhythmicity of its physiological events and known by biological or circadian rhythms by the fact of producing periodical and behavioral variations. The body temperature naturally exhibits a daily fluctuation resulting from the continuous interrelationship between rhythmicity and homeostasis. The time synchronization depends on an individual trend characterized by chronotypes, which are biological and behavioral parameters presented with interindividual differences that affect the expression of circadian rhythms. However, human beings are capable of adapting to daily changes, although life may provide situations that generate physical and emotional imbalance. These manifestations are stress reactions and reflect greatly on personal and professional performance. Study at night and night work shift are conditions that favor the appearance of stress symptoms and lead to negative consequences for physical, social, emotional, and professional health. Objective: Analyze circadian rhythmicity of oral temperature, identify the chronotypes and stress indexes in students and nursing professionals of day and night shifts. Method: A quantitative descriptive transverse quantitative approach and comparative study comprising students (56) and nursing professionals the (34). The students attended the 3th and 5th periods at the undergraduate course in esthetics and cosmetics technology, and the nursing professionals worked at the Santa Casa de Misericórdia. The following instruments were used: personal information questionnaire; questionnaire for identification of morning and afternoon individuals elaborated by Horne and Östberg (1976) and adapted to Brazil by Benedito-Silva et al. (1990); and LIPP stress symptom inventory (ISSL, 1989). Digital clinical thermometers of flexible stem were used for measuring oral temperature, and measurements were verified every three hours in the two groups of study. Results: Working time among nursing professionals observed a mean of 10.9 years (SD ± 8.4) and for the students workers average of 10.1 years (SD ± 9.6), demonstrating a significant difference (p <0.0001). It was observed that belong to females 96.43% for the group of students and 82.35% for nursing professionals. The results of oral temperature, students of the morning, showed the following parameters: 36.4609 = mesor, amplitude and acrophase = 0.2335 = 14.4658 with (p - value = 0.0009), and nursing professionals: mesor = 36.2196, Amplitude = 0.4007 and acrophase = 15.0746 with (p - value <0.0001). Associations between the chronotype and stress phases generally showed significant data (Fisher's exact test, p = 0.0311). Comparisons of stress symptoms between the groups, it was observed that significant data (Fisher's exact test, p =0.0139). Conclusion: It was observed that the temperature curve fitted to a sine curve showing circadian rhythmicity. For the classification of chronotype was obtained prevalence of type indifferent to the nursing profissionals and students the type evening. It is the presence of physical symptoms of stress for nursing and psychological symptoms in students / Doutorado / Enfermagem e Trabalho / Doutora em Ciências da Saúde

Orientadores: João Palermo Neto, Antonio Armario Garcia / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T19:54:17Z (GMT). No. of bitstreams: 1 Queiroz_JuliadeSouza_D.pdf: 6420413 bytes, checksum: 5de0fbd4bbb6451ff5729cbdc2fc74ce (MD5) Previous issue date: 2012 / Resumo: A exposição do organismo a estressores psicossociais e ambientais altera de forma significativa o funcionamento do sistema imune. Os efeitos do estresse sobre a resposta imune têm sido atribuídos, principalmente, à ativação do eixo hipotálamo-pituitária-adrenal (HPA) com consequente aumento nos níveis de ACTH e glicocorticóides e à ativação do sistema nervoso autônomo simpático (SNAS), com liberação de catecolaminas. Nos últimos anos, a alga Chlorella vulgaris (CV) tem despertado o interesse da comunidade científica pelos seus efeitos moduladores sobre as defesas do hospedeiro imunossuprimido. Em estudos anteriores mostramos que o restabelecimento da geração de granulócitos-macrófagos nos órgãos hematopoéticos e a ativação das funções efetoras de fagócitos e linfócitos são cruciais na expressão da atividade imunomoduladora da alga. No entanto, nada se sabe sobre os efeitos da CV no sistema nervoso central em situações de estresse. Sendo assim, neste trabalho realizamos estudos pioneiros com relação ao efeito do tratamento com a alga sobre: 1) a ativação neuronal (c-fos) no córtex pré-frontal, septum lateral, núcleo da Rafe e lócus coeruleus; 2) a ativação do eixo HPA através da expressão do gen de hnCRF na região parvocelular do núcleo paraventricular do hipotálamo, mpdPVN, liberação de ACTH e de corticosterona e, 3) avaliação indireta da atividade do SNAS através dos níveis de glicose no plasma de animais estressados. Considerando-se a medula óssea ser o sítio de origem das células pluripotenciais das quais se originam as células do sistema hematopoético, e que este sistema é totalmente vulnerável ao controle neuroendócrino, avaliamos os efeitos do tratamento com CV sobre a hematopoese de animais estressados através dos 4) crescimento e diferenciação de precursores para granulócitos e macrófagos (CFU-GM); 5) presença de fatores estimuladores da formação de colônias do soro (colony stimulating activity - CSA); 6) quantificação de populações de células maduras e imaturas e 7) morte celular na população de células tronco. A regulação da produção de células hematopoéticas pelas células do estroma da medula óssea em camundongos estressados foi avaliada pela técnica de cultura líquida de longa duração de células da medula óssea (LTBMC), que consiste em um modelo ex vivo para o estudo das interações entre as células progenitoras hematopoéticas e as células do estroma. Nela avaliamos 8) o CFU-GM, níveis de IL-1? / IL-6 e quantificamos uma população madura e uma imatura. Nossos resultados mostraram que a aplicação do estressor produziu um aumento na expressão de c-fos em todas as áreas cerebrais avaliadas, assim como na expressão do gen de hnCRF na região mpdPVN. Os níveis de ACTH e corticosterona também estavam aumentados após o estresse, assim como os níveis de glicose. Na medula óssea observamos que a aplicação do estressor reduziu o número de CFU-GM, e aumentou os níveis de CSA no plasma. Houve um aumento na morte celular e redução no número de precursores hematopoéticos e de células maduras. Na LTBMC, um prejuízo na atividade funcional do estroma medular foi observado através: da redução do CFU-GM, dos níveis de IL-1? / IL-6 e do número de células imaturas e maduras. O aumento na expressão de c-fos após o estresse foi prevenida pelo tratamento com CV em todas as áreas avaliadas, com exceção da região magnocelular do PVN. O resultado mais acentuado do tratamento com CV foi observado na redução da expressão de c-fos no núcleo da Rafe e do gen para hnCRF no mpdPVN, que se encontrou em níveis semelhantes aos observados no grupo controle após o estresse. Todas as alterações hematopoéticas causadas pelo estresse foram prevenidas pelo tratamento com CV. Tomados em seu conjunto, nossos resultados mostraram que o efeito protetor da hematopoese pode ser devido a uma prevenção na ativação neuronal de áreas cerebrais relacionadas à decodificação do estressor do tipo emocional, reduzindo a amplitude de ativação do eixo HPA e do SNAS / Abstract: The exposition of the organism to psychosocial and environmental stressful stimuli alters the functioning of the immune system in a significant way. The effects of stress on the immune response are mainly attributed to the activation of the hypothalamic-pituitary axis (HPA) with consequent increment on ACTH and glucocorticoids levels and, to the activation of the autonomic nervous system, with the incremented levels of cathecholamines. In the last years, increasing interests about the algae Chlorella vulgaris (CV) has been demonstrated by the scientific community, due to its modulatory effects on the defenses of the immunosuppressed host. In previous studies we demonstrated that the reestablishment of the generation of granulocytes and macrophages in bone marrow and, the activation of effectors functions of phagocytes and lymphocytes, are crucial features about the immunomodulatory activity from the algae. However, nothing is known about the activity of CV in the central nervous system. Thus, pioneer investigation was made in this work about the effect of treatment with the CV on: 1) neuronal activation (c-fos) in pre-frontal cortex, lateral septum, Rafe nucleus and locus coeruleus; 2) activation of the HPA axis by analysis of expression of the gen to hnCRF in the parvocelular region from the paraventricular nucleus of the hypothalamus -mpdPVN and the release of ACTH and corticosterone) and, 3) glucose levels, as an indirect indicator of autonomic nervous system activity. Considering that the bone marrow is the site of origin from pluripotent cells from which all cells from the hematopoietic system are originated, and also that this system is vulnerable to the neuroendocrine control, we evaluated the effects of the treatment with CV on the hematopoiesis of stressed animals through 4) growing and differentiation of precursors to granulocytes and macrophages (CFU-GM); 5) colony stimulating activity from the serum (CSA); 6) quantification of population of mature and immature populations and 7) cell death. The interaction between stromal cells and hematopoietic progenitors in stressed mice was evaluated by the technique of long term bone marrow culture (LTBMC). In the culture we evaluated 8) the CFU-GM, levels of IL-1? / IL-6 and quantification of mature and immature population. The application of the stressor produced an increase in the expression of c-fos in all brain areas evaluated and in the expression of the gen to hnCRF in mpdPVN. Increased levels of ACTH, corticosterone and glucose found in stressed animals corroborate these findings. Reduced numbers of CFU-GM in the bone marrow and increase in plasma CSA, increased cell death in stem cell population (LSK) and decreased numbers of hematopoietic precursors and of mature cells was also observed in stressed group. In LTBMC we observed impairment on the functional activity from medullar stroma, which was observed by reduction of: CFU-GM, IL-1? / IL-6 levels and number of immature and mature cells. Treatment with CV partially prevented increase in c-fos activation caused by stress in the brain except in the magnocelular region from PVN. The more accentuated result from treatment with CV of stressed animals was observed in the expression of c-fos in the Raphe nucleus and in the expression of the gen to hnCRF in mpdPVN, where levels were similar to that observed in control group. All hematopoietic alterations observed after stress were prevented by the treatment with CV. Taken together, our results demonstrate that the protective effect of the treatment with CV on hematopoiesis of stressed animals may be due to a prevention of the neuronal activation in areas related to the decodification of the emotional stressful stimuli, reducing the amplitude of HPA axis and autonomic nervous system activity / Doutorado / Farmacologia / Doutora em Farmacologia

SAMMANFATTNING   Bakgrund: Trygghet kan beskrivas som en säkerhet som varje person kan lita på och som medför en skyddande känsla. Patientens upplevelse från ambulansen har en stor påverkan på välbefinnande och livskvalitet efter vårdtidens slut. Hur patienten känner är en av de största informationskällorna för att kunna avgöra hur upplevelsen har varit i ambulansen. Varje vårdsituation i den prehospitala vårdmiljön är unik, vårdmiljöns utformning har en direkt koppling till patientens hälsa.    Syfte: Syftet var att beskriva patientens upplevelse av trygghet i prehospital miljö.   Metod: Den valda metoden var en allmän litteraturöversikt med induktiv ansats där både kvalitativ och kvantitativ forskning använts. En strukturerad sökning genomfördes i databaserna PubMed och Cinahl. 15 vetenskapliga artiklar inkluderades efter att de analyserats och genomgått kvalitetsgranskning. Resultatet är främst baserat på kvalitativ forskning.     Resultat: Resultatet i studien syntetiserades till två huvudkategorier som beskrev patienters upplevelse av trygghet; mellanmänskliga faktorer och yttre faktorer. De mellanmänskliga faktorerna innefattar underkategorierna ambulanspersonalens yrkesskicklighet, deras förmåga till att ge information, skapa förtroende och bedriva en personcentrerad vård. De yttre faktorerna innefattar underkategorierna den prehospitala miljön i sig, patientens exponering av smärta och värme.   Slutsats: Litteraturstudiens resultat visade på patientens upplevelse av trygghet i prehospital miljö via huvudfynden mellanmänskliga faktorer och yttre faktorer. De mellanmänskliga faktorerna beskrivs i större omfattning med direkt påverkan på upplevelsen av trygghet genom ambulanspersonalens uppträdande. De yttre faktorerna beskrivs indirekt påverka upplevelsen av trygghet via frihet från lidande. Upplevelsen från ambulansen har påverkan på hur patienten upplever välbefinnande och livskvalitet efter vårdtidens slut. Hur patienten känner är en av de största informationskällorna för att kunna avgöra hur upplevelsen har varit i ambulansen. Hälso- och sjukvårdsbarometern ges ut årligen i Sverige för att inventera förtroendet för somatisk slutenvård, primärvård eller somatiska specialiserade mottagningar. Förtroende har i litteraturstudien identifierats som ett huvudfynd när det gäller upplevelse av trygghet. / Background: Safety can be described as a security that every person can rely on and that brings a protective feeling. The patient's experience from the ambulance has a major impact on well-being and quality of life after the end of the care period. How the patient feels are one of the biggest sources of information in order to determine how the experience has been in the ambulance. Every care situation in the prehospital care environment is unique, the design of the care environment has a direct link to the patient's health.   Purpose: The purpose was to describe the patient's experience of safety in the prehospital environment.   Method: The method chosen was a general literature review with inductive approach where both qualitative and quantitative research was used. A structured search was performed in the PubMed and Cinahl databases. 15 scientific articles were included after being analyzed and subjected to quality review. The result is mainly based on qualitative research.   Results: The results of the study were synthesized into two main categories that described the patient's experience of safety; interpersonal factors and external factors. The interpersonal factors include the subcategories of the ambulance staff's professional skills, their ability to provide information, create confidence and conduct a person-centered care. The external factors include the subcategories of the prehospital environment itself, the patient's exposure to pain and heat.   Conclusion: The results of the literature study showed the patient's experience of safety in the prehospital environment via the main findings of interpersonal factors and external factors. The interpersonal factors are described to a greater extent with direct impact on the experience of security through the behaviour of ambulance personnel. The external factors are described indirectly affecting the experience of safety through freedom from suffering. The experience from the ambulance has an impact on how the patient experiences well-being and quality of life after the end of care. How the patient feels are one of the biggest sources of information in order to determine how the experience has been in the ambulance. The health barometer is issued annually in Sweden to inventory confidence in somatic inpatient care, primary care or somatic specialized clinics. In the literature study, confidence has been identified as a key finding when it comes to experiencing safety.

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Although much research has been conducted on the association between poverty and happiness, little is known about its mediators and moderators. Thus, our understanding of how – and the conditions under which -- poverty affects happiness is imprecise. This study assessed stress as a mediator of the negative association between poverty and happiness using a sample of 345 farmers and fish farmers living in Ghana. Further, Psychological Capital (PsyCap, consisting of hope, optimism, resilience, and self-confidence) was examined as a two-stage moderator of the poverty-happiness relationship, as mediated by stress. There was no support for the stage 1 moderation, and while there was support for stage 2 moderation, it was in a direction opposite from what was hypothesized (for overall PsyCap and PsyCapF2). The negative moderation at stage 2 suggests that PsyCap (overall and PsyCap2) is associated with a weakening of an unexpected positive association between stress and happiness. PsyCapF2, appears to reflect agency or general self-efficacy. Although the hypothesized model was not supported this study has provided insights into how future research of Ghanaians might be better designed. It also has shown that the positive PsyCap-happiness relationship found in several Western samples is replicable among Ghanaian farmers, a collectivist and highly religious community. / Thesis / Doctor of Philosophy (PhD)

Thesis (MA)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Burnout levels have been found to be high among nurses in both public and private hospitals in South Africa. Burnout is defined within the human services as a syndrome of emotional exhaustion, depersonalisation, and reduced personal accomplishment that can occur among individuals who work with people in some capacity. High levels of burnout have been linked to nurses’ intention to leave the profession, which places additional strain on an already struggling public health system characterised by a shortage of nurses in South Africa. The primary aim of the present cross-sectional correlational study was to determine the proportion of the variance in burnout among nurses accounted for by the linear combination of certain demographic characteristics and occupational stress factors. Secondary aims were to determine the relationship between such factors and burnout levels and to determine the average level of burnout and occupational stress factors reported. A convenience sample of 110 nurses was recruited from a public hospital located in the Western Cape. An analytical survey design for the collection of quantitative data was used. The results of hierarchical multiple regression analyses indicated that workload, interpersonal conflict at work, job status, organisational constraints, and HIV/AIDS stigma by association significantly predicted burnout levels. The linear combination of these variables accounted for 38% of the variance in emotional exhaustion, 32% of the variance in depersonalisation, and 12% of the variance in personal accomplishment. Death and dying-related stress and age did not predict burnout levels. Age was also the only predictor variable not significantly associated with burnout levels. Although burnout levels were not found to be high on average, 34% of the sample reported high levels of emotional exhaustion. A high average level of workload was also reported. It is recommended that future research should focus on the development and evaluation of interventions to ameliorate burnout among South African nurses. / AFRIKAANSE OPSOMMING: Hoë vlakke van uitbranding is bevind onder verpleegkundiges in beide openbare en private hospitale in Suid-Afrika. Uitbranding word binne die menslike dienste gedefinieer as 'n sindroom van emosionele uitputting, depersonalisasie en verminderde persoonlike vervulling wat kan voorkom onder individue wat werk met mense in een of ander hoedanigheid. Hoë vlakke van uitbranding is gekoppel aan verpleegkundiges se voorneme om die professie te verlaat, wat bykomende druk plaas op 'n reeds sukkelende openbare gesondheidstelsel gekenmerk deur 'n tekort aan verpleegkundiges in Suid-Afrika. Die primêre doel van die huidige deursnee- korrelasionele studie was om te bepaal hoeveel van die variansie in uitbranding onder verpleegkundiges voorspel word deur die lineêre kombinasie van sekere demografiese eienskappe en beroepstresfaktore. Sekondêre doelwitte was om die verhouding tussen sodanige faktore en uitbrandingsvlakke te bepaal en om die gemiddelde vlak van uitbranding en beroepstresfaktore soos gerapporteer te bepaal. ’n Gerieflikheidsteekproef van 110 verpleegkundiges is gewerf uit 'n openbare hospitaal geleë in die Wes-Kaap. 'n Analitiese opname-ontwerp vir die insameling van kwantitatiewe data is gebruik. Die resultate van hiërargiese meervoudige regressie-ontledings het aangedui dat werkslading, interpersoonlike konflik by die werk, werkstatus, organisatoriese beperkinge , en MIV/VIGS stigma deur assosiasie uitbrandingsvlakke beduidend voorspel het. Die lineêre kombinasie van hierdie veranderlikes was verantwoordelik vir 38% van die variansie in emosionele uitputting, 32% van die variansie in depersonalisasie, en 12% van die variansie in persoonlike vervulling. Dood en sterfte-verwante stres en ouderdom het nie uitbrandingsvlakke voorspel nie. Ouderdom was ook die enigste veranderlike wat nie beduidend geassosieer was met uitbrandingsvlakke nie. Alhoewel dit bevind is dat gemiddelde vlakke van uitbranding nie hoog is nie, het 34% van die steekproef hoë vlakke van emosionele uitputting gerapporteer. 'n Hoë gemiddelde vlak van werkslading is ook aangemeld. Dit word aanbeveel dat toekomstige navorsing toegespits behoort te word op die ontwikkeling en evaluering van ingrypings om uitbranding onder Suid-Afrikaanse verpleegkundiges aan te spreek.

This diploma thesis deals with the psychical and physical stress of nurses working in anesthesiology and intensive medicine. In the theoretical part, the problems of psychical and physical stress are presented, as well as the role of nurses and their activities undertaken in the units of anesthesiology and intensive care. The practical part deals with a research that aims to obtain data revealing indicators of mental and physical stress of nurses working in anaesthesiology and intensive medicine. The research took place in four selected hospitals in their departments of anesthesiology and intensive care and intensive care units of neurosurgical clinics. Respondents were divided into two groups - respondents of anesthesiology and intensive care and respondents from department of neurosurgery. Groups were compared and results are presented in tables and graphs. Key words Anesteziology, intensit medicine, roles of nurses, physical stress, psychological stress, departemnt of ICU

Title: Significantly influence subjective psychological Stress perceived Factor Analysis. Objectives: The main Aim of this Work is subjective perceived psychological Stress changing comparation of professional Soldiers Group before and after psychological Stress, They receive every Day in their Job. Methods: The Method used in this Work is Research by standard Questionnaire consists of two Parts. One of Them was realised before psychological Stress and the second One was realised after the psychological Stress. Both Parts of Questionnaires was analyzed and statisticaly evaluated. Results: By the Research was found, that from researching Age, Education and Length of Service in Unit Factors, the most significant Influence on Changes of subjective perceived psychological Stress have the Age and the Length of Service Factors. After that was found, the subjective perceived psychological Stress at the End of all-day Duty have increased. Keywords: Stress, psychological Stress, Frustration, Trauma, Post-traumatic Stress Disorder, peacekeeping Operation, Soldier.