Este estudo tem como objeto a carga de trabalho de enfermeiros que trabalham em unidades de cuidados semi-intensivos. Seu objetivo geral foi identificar e analisar a percepção dos enfermeiros de uma unidade semi-intensiva acerca do instrumento Nursing Activities Score - NAS, tendo como foco o conceito de carga de trabalho. Os objetivos específicos foram: identificar domínios do NAS considerados pelos enfermeiros como capazes de avaliar a carga de trabalho; identificar os itens que os enfermeiros consideram relevantes e manteriam no instrumento, os itens que excluiriam e os que acrescentariam; identificar itens que os enfermeiros consideram subdimensionados, para os quais aumentariam a pontuação, os superdimensionados, para os quais diminuiriam a pontuação; e, ao final, discutir implicações dessa avaliação para a organização do trabalho e seus impactos na saúde do trabalhador de enfermagem. Estudo de abordagem quantitativa do tipo descritivo exploratória, com breve aporte qualitativo, utilizando a triangulação metodológica. O local de estudo foi uma unidade de média complexidade com 35 leitos em um hospital privado do Rio de Janeiro. Participaram do estudo 28 enfermeiros e os dados foram coletados por meio de um questionário com perguntas fechadas e abertas no período de abril a maio de 2008. O tratamento dos dados foi realizado com apoio do software Excel, utilizando estatística descritiva. O material qualitativo foi organizado em categorias, usando elementos da Análise de Conteúdo Temática. Entre os domínios, verificou-se que os enfermeiros consideram o que mais avalia a carga real de trabalho o Suporte Ventilatório, com 89%, e o domínio que não avalia a carga de trabalho foi o Suporte Neurológico, com 25%. Os três domínios mais citados para serem acrescidos de atividades foram o Suporte Renal, com 25%, seguido Intervenção Especificas, com 21%, e Suporte Metabólico, respectivamente. Quanto à exclusão de atividades, só dois domínios foram mencionados: Suporte Ventilatório, com 25%, e Atividade Básica, com 21%. Os enfermeiros acham que 69% da pontuação era adequada aos itens e 31% acreditam não estar adequada. No grupo, 27% aumentariam a pontuação em alguns itens e 4% diminuiriam a pontuação. Sobre a mensuração da carga de trabalho, acreditam que essa colabora no processo de trabalho, 79%, e 57% acham que mensurar a carga de trabalho através do NAS pode auxiliar na preservação de sua saúde. Concluímos que esse instrumento mensura a carga de trabalho na opinião dos enfermeiros, mas precisa ser adaptado à realidade da unidade onde está sendo aplicada. Além disso, os enfermeiros alteraram mais os itens relacionados à carga física sem identificar a carga psíquica de trabalho como relevante, evidenciando que o trabalho de enfermagem precisa ser mais bem conhecido pelos enfermeiros no que se refere às dimensões de impacto na sua saúde. / The objective of this study was identify and analyze the perception of nurses from a Unit Semi Intensity on the instrument Nursing Activities Score (NAS) concerning the concept of work burden. Specific targets were: identify NAS domains that nurses considerate that can measure work burden ; identify the items they considerate relevant and they would keep in the instrument, the items they would exclude, and items they evaluate must be added; identify sub and super dimensioned items, adequating their punctuation; discuss implications of this assessment for work organization and the impacts on workers health. Quantitative, exploratory and descriptive study, including a brief qualitative contribution. Locus was a medium complexity health unit with 35 beds in a private hospital of Rio de Janeiro City. Subjects were 28 nurses, and data collection used a structured questionnaire, in the period from April to May, 2008. Data organization was accomplished with support of an electronic database in the software Excel, using descriptive statistical tests. Qualitative material was organized in categories, according to Thematic Analysis of Content methodology. Results showed that nurses considered that the domains can assess work burden in a range from 25% to Neurological Support to 98% for Ventilatory Support. The three domains nurses would increase punctuation were Renal Support Specific Interventions and Metabolic Support. They would exclude items of two domains: Respiratory Support (25%) and Basic Activities (21%), and 69% of nurses considered punctuation correct, and 31%, incorrect. In the samplo, 27% would increase punctuation in some items, and 4% would diminish. About work burden assessment, nurses think NAS collaborates in work process (79%), and 57% think that measure work burden through NAS helps to preserve their health. We concluded that this instrument measures work burden in the nurses' opinion, but needs to be adapted to the unit care reality where is being applied. Besides, nurses altered more the items related to physical burden, without identifying the psychic work burden as relevant, evidencing that nursing work needs to be known better by nurses concerning the impact dimensions in their health.

This thesis deals with the stressful situations in the profession of the nursing staff. The occupation of the nurse belongs to the most demanding ones. In this occupation, the nurse is permanently affected by many stressors of different types. She faces death, the suffering, dying and incurably ill people very often. She is there in times of pain, agony and suffering. Personal encounters with these difficult situations require highly professional approach but most of all, they present immense work stress for the nurse. The theory section describes mainly the stressful situations that are the most common and most difficult in the work of the nursing staff. The next part of the theory section describes possible consequences of the stressful situations and methods of managing them including the support by the management. This thesis has two objectives. The first objective was to map the manners used by the nursing personnel to cope with the stressful situations brought by their profession. The second objective was to find out the difference in the coping with the stressful situations between the hospital staff and hospice staff. The research section of this thesis contains the quantitative research done using the technique of an anonymous questionnaire with 20 question prepared by ourselves. The questionnaire was distributed to the nursing staff of all categories in the hospital and hospice care. It was completed by 269 respondents in total. The data was statistically processed using systems Microsoft Excel 2010 and Software R, version 3.0.2 (Chi-squared test, Fisher´s exact test, and Wilcoxon test). We determined four hypotheses. H1: Manners of coping with the stressful situations depend on the qualification of the nursing staff reached; not confirmed. H2: Manners of coping with the stressful situations are influenced by the length of practice of the staff; not confirmed. H3: Manners of coping with the stressful situations differ between the hospital staff and hospice staff; confirmed. H4: The nursing staff views their own mental hygiene as more efficient than the support from the management concerning the coping with the stressful situations; confirmed. The research results show that the nursing staff faces the stressful situations very often. They see as the heaviest stress the care of the suffering and aggressive patient, conflicts with the patient´s family, conflicts at work and workload. The manners of coping with the work burden which proved as the best for them are relax, rest and sleep. There were no differences proved in the manners of coping with the stress among respective members of the nursing team. Nevertheless, the coping with the work burden of the nursing staff in the hospital and hospice care is different. A minimum of the respondents notices any support during the stressful situations from the employer. On the other hand, certain support by the management could be viewed in the form of trainings, supervision or contribution to a "recovery" which are granted to the respondents from the employer according to their answers. However, the respondents would prefer, as the support by the management, the increase in pay or more days off. The respondents view as insufficient the preparation of the graduates for the future stressful situations in their profession, as well. They would recommend mainly various trainings dealing with the stress and its management. A good solution to alleviate the work burden of the nursing staff and quality enhancement of the services provided could be investments into better work conditions, both in terms of sufficient human and material resources and the very organization of the work processes.

Este estudo tem como objeto a carga de trabalho de enfermeiros que trabalham em unidades de cuidados semi-intensivos. Seu objetivo geral foi identificar e analisar a percepção dos enfermeiros de uma unidade semi-intensiva acerca do instrumento Nursing Activities Score - NAS, tendo como foco o conceito de carga de trabalho. Os objetivos específicos foram: identificar domínios do NAS considerados pelos enfermeiros como capazes de avaliar a carga de trabalho; identificar os itens que os enfermeiros consideram relevantes e manteriam no instrumento, os itens que excluiriam e os que acrescentariam; identificar itens que os enfermeiros consideram subdimensionados, para os quais aumentariam a pontuação, os superdimensionados, para os quais diminuiriam a pontuação; e, ao final, discutir implicações dessa avaliação para a organização do trabalho e seus impactos na saúde do trabalhador de enfermagem. Estudo de abordagem quantitativa do tipo descritivo exploratória, com breve aporte qualitativo, utilizando a triangulação metodológica. O local de estudo foi uma unidade de média complexidade com 35 leitos em um hospital privado do Rio de Janeiro. Participaram do estudo 28 enfermeiros e os dados foram coletados por meio de um questionário com perguntas fechadas e abertas no período de abril a maio de 2008. O tratamento dos dados foi realizado com apoio do software Excel, utilizando estatística descritiva. O material qualitativo foi organizado em categorias, usando elementos da Análise de Conteúdo Temática. Entre os domínios, verificou-se que os enfermeiros consideram o que mais avalia a carga real de trabalho o Suporte Ventilatório, com 89%, e o domínio que não avalia a carga de trabalho foi o Suporte Neurológico, com 25%. Os três domínios mais citados para serem acrescidos de atividades foram o Suporte Renal, com 25%, seguido Intervenção Especificas, com 21%, e Suporte Metabólico, respectivamente. Quanto à exclusão de atividades, só dois domínios foram mencionados: Suporte Ventilatório, com 25%, e Atividade Básica, com 21%. Os enfermeiros acham que 69% da pontuação era adequada aos itens e 31% acreditam não estar adequada. No grupo, 27% aumentariam a pontuação em alguns itens e 4% diminuiriam a pontuação. Sobre a mensuração da carga de trabalho, acreditam que essa colabora no processo de trabalho, 79%, e 57% acham que mensurar a carga de trabalho através do NAS pode auxiliar na preservação de sua saúde. Concluímos que esse instrumento mensura a carga de trabalho na opinião dos enfermeiros, mas precisa ser adaptado à realidade da unidade onde está sendo aplicada. Além disso, os enfermeiros alteraram mais os itens relacionados à carga física sem identificar a carga psíquica de trabalho como relevante, evidenciando que o trabalho de enfermagem precisa ser mais bem conhecido pelos enfermeiros no que se refere às dimensões de impacto na sua saúde. / The objective of this study was identify and analyze the perception of nurses from a Unit Semi Intensity on the instrument Nursing Activities Score (NAS) concerning the concept of work burden. Specific targets were: identify NAS domains that nurses considerate that can measure work burden ; identify the items they considerate relevant and they would keep in the instrument, the items they would exclude, and items they evaluate must be added; identify sub and super dimensioned items, adequating their punctuation; discuss implications of this assessment for work organization and the impacts on workers health. Quantitative, exploratory and descriptive study, including a brief qualitative contribution. Locus was a medium complexity health unit with 35 beds in a private hospital of Rio de Janeiro City. Subjects were 28 nurses, and data collection used a structured questionnaire, in the period from April to May, 2008. Data organization was accomplished with support of an electronic database in the software Excel, using descriptive statistical tests. Qualitative material was organized in categories, according to Thematic Analysis of Content methodology. Results showed that nurses considered that the domains can assess work burden in a range from 25% to Neurological Support to 98% for Ventilatory Support. The three domains nurses would increase punctuation were Renal Support Specific Interventions and Metabolic Support. They would exclude items of two domains: Respiratory Support (25%) and Basic Activities (21%), and 69% of nurses considered punctuation correct, and 31%, incorrect. In the samplo, 27% would increase punctuation in some items, and 4% would diminish. About work burden assessment, nurses think NAS collaborates in work process (79%), and 57% think that measure work burden through NAS helps to preserve their health. We concluded that this instrument measures work burden in the nurses' opinion, but needs to be adapted to the unit care reality where is being applied. Besides, nurses altered more the items related to physical burden, without identifying the psychic work burden as relevant, evidencing that nursing work needs to be known better by nurses concerning the impact dimensions in their health.

The diploma thesis concentrates on the stress that the vast majority of employees face today. The thesis analyzes the various types of stress, its indication and manifestation. Furthemore, the factors that contribute to stress, their identification and elimination are also discussed. The focus of the thesis is on the theoretical analyzis of the problems. Moreover, it measures the stressors on the workplace, too. Specifically, it evaluates the level of stress in P&L spol. s.r.o. In the conclusion, the recommendations that decrease the detected stress factors are given.