Ett byggprojekt använder idag cirka 21% av den tid som finns tillgänglig och står under den övriga tiden stilla. Samtidigt beräknas ungefär en tredjedel av arbetsdagens timmar försvinna som slöseri. En optimal situation hade inneburit ett 100% nyttjande av den tillgängliga tiden vilket i sig kunnat innebära en ökad effektivitet. Tidsanvändningen inom ett projekt påverkar resursanvändningen, där resursen arbetskraft idag motsvarar mellan 10–60% av den totala projektkostnaden. Planeringen av den tillgängliga tiden görs med hjälp av tidplaner och arbetsplatsens arbetstider blir styrande vid upprättandet av en tidplan. Genom att förändra arbetstiderna så förändras nyttjandegraden av den tillgängliga arbetstiden vilket möjliggör för en ökad effektivitet inom ett byggprojekt. Syftet med den genomförda studien har varit att undersöka vilka hinder och drivkrafter som finns för en förändring av de nuvarande arbetstiderna vid ett byggprojekt. Fokus har varit ett valt ombyggnadsprojekt i Stockholm. Målet med studien var att genom en kartläggning och identifiering av faktorerna bidra till en ökad förståelse och kunskap inom området samt redogöra för de interna förutsättningarna som bör finnas för en förändring av arbetstiderna. För att besvara syftet genomfördes en utforskande abduktiv fallstudie. Genom workshopar och intervjuer inhämtades primärdata direkt från fallprojektet, samtidigt som en litteraturstudie genomfördes med utgångspunkt i vad som framkommit av studiens inledande del. I slutskedet genomfördes en simulering av fallprojektets tidplan för två valda aktiviteter där den ordinarie arbetstiden ersattes av skiftarbete och en utökad arbetstid i form av en 7-dagarsvecka, med syftet att teoretiskt testa en arbetstidsförändring. Förändringen visade på en minskning om 43% respektive 19% av den totala kalendertiden. Resultatet från studien visar att det finns 15 stycken faktorer som påverkar eller påverkas av att arbetstiderna skulle förändras vid byggprojektet. Faktorerna kan ses som antingen drivkrafter eller hinder, där de interna drivkrafterna antingen kan ses som incitament till en förändring eller som resultat av förändringen. De interna drivkrafter som identifieras i studien är kontraktshandlingar, förseningar, arbetsmetoder, projektets utgifter samt produktionstid/tid för färdigställande. Interna hinder som identifieras ses som svårigheter och hindrande faktorer. Dessa faktorer identifieras som projektorganisationen, informationsöverföring, personalutrymmen, säkerhet, administrativa arbetsuppgifter samt arbetsplatslogistik. Som externa hinder identifieras arbetstid och arbetstidslagen, kollektivavtal, lönemodeller och lokala regler inom Stockholm stad. De interna förutsättningarna som bör finnas för en implementering av förändrade arbetstider är en tidig förankring mellan delaktiga parter, att arbetsplatsens kapacitet fastställs med avseende på resurserbehovet samt att implementeringen regelbundet följs upp. Studien indikerar på att man genom dessa tre insatser kan ge ett projekt de rätta förutsättningarna till en framgångsrik implementering av förändrade arbetstider. Slutligen rekommenderas fallföretaget att fortsatt utvärdera behovet av dagens arbetstider samt hur behovet av en arbetstidsförändring ser ut, eftersom studien indikerar på att det finns fördelar för ett projekt med helt eller delvis förändrade arbetstider i produktionen. / A construction project today uses about 21% of the time that is available and stands still for the rest of the time. At the same time, it is estimated that about a third of the working day's hours will disappear as waste. An optimal situation would be a 100% utilization of the available time, which could mean increased efficiency. The use of time within a project affects the use of resources, where the labor costs today corresponds to between 10–60% of the total project cost. The planning of the available time is done with schedules and the workplace's working hours become governing when establishing a schedule. By changing working hours, the utilization rate of the available working hours changes, which enables increased efficiency within a construction project. The purpose of the completed study has been to investigate the obstacles and driving forces that exist for a change in the current working hours of a construction project. The focus has been on a redevelopment project in Stockholm. The aim of the study was to contribute to an increased understanding and knowledge in the area through a mapping and identification of the factors and to account for the internal conditions that should exist for a change in working hours.  To answer the purpose, an exploratory abductive case study was conducted. Through workshops and interviews, primary data were obtained directly from the case project. Meanwhile a literature study was carried out based on the introductory part of the study. In the final phase, a simulation of the case project's schedule was carried out for two selected activities where the regular working hours were replaced by shift work and an extended working hours in the form of a 7-day week, with the aim of theoretically testing a change in working hours. The change resulted in a reduction of 43% and 19% of the total calendar time.  The results show that there are 15 factors that affect or are affected by the fact that working hours would change during the construction project. The factors are either driving forces or obstacles, where the internal driving forces can either be incentives for a change or as a result of the change. The internal driving forces identified in the study are contract documents, delays, working methods, project expenses and production time/time for completion. Internal barriers that are identified are difficulties and hindering factors. These factors are identified as the project organization, information transfer, staff spaces, security, administrative tasks and workplace logistics. Working hours and the Working Hours Act, collective agreements, wage models and local rules within the City of Stockholm are identified as external obstacles. The internal preconditions that should exist for an implementation of changed working hours are an early anchoring between the parties involved, that the workplace's capacity is determined regarding the need for resources and that the implementation is followed up regularly. The study indicates that through these three initiatives one can give a project the right conditions for a successful implementation of changed working hours.  Finally, the company is recommended to continue evaluating the need for current working hours and what the need for a change in working hours looks like, as the study indicates that there are benefits with completely or partially changed working hours in production.

Hållbar konsumtion och produktion är viktiga delar i omställningen till ett klimatanpassat samhälle, där livsstilsförändringar kan spela en avgörande roll. Syftet med denna studie är att kvalitativt bedöma huruvida minskad arbetstid och inkomst kan ge effekter på personers miljöpåverkan från konsumtion, samt upplevda välbefinnande. För att uppnå detta utförs kvalitativa intervjuer med fem deltidsarbetande anställda på en svensk arbetsplats inom miljöfältet. Studien visar att de studerade personernas konsumtionsvanor i hög grad präglats av ett miljötänk, både innan och efter deltidsövergången, och vissa har sedan länge levt en sparsam livsstil. Minskad inkomst visade sig ha mindre betydelse för de studerade personernas konsumtionsval, men vissa hade minskat sitt sparande vilket kan tolkas som att konsumtion undviks i framtiden. Samtidigt har Covid-19 påverkat hela samhällets konsumtionsmönster, och studien pekar på att flera intervjupersoner förmodligen spenderar mindre pengar till följd av pandemin. Resultatet visar att minskad arbetstid och inkomst kan ge upphov till konsumtionsminskande effekter såsom ett minskat behov av att kompensera tidsbrist med konsumtion, samt ett mer rationellt och medvetet tänk kring privatekonomin. Det står också klart att en övergång till deltid, med motsvarande inkomstminskning, inte nödvändigtvis innebär att den totala inkomsten minskar i praktiken eftersom sidoinkomster och befordringar kan kompensera för inkomstförlusten. Tidsanvändningen är central för intervjupersonernas konsumtionsval. Mycket av deras tid läggs på aktiviteter med låg miljöbelastning, såsom utbildning, ideellt arbete, motion, vila och sociala relationer. Hur tid spenderas är också det mest centrala för hur intervjupersonernas upplevda välbefinnande påverkas, eftersom inkomstminskningen har en nästintill obefintlig negativ påverkan på dem. Mer tid till återhämtning, familj, vänner, vardagsbestyr och fritidsaktiviteter gynnar deras upplevda välbefinnande. Samtliga intervjuade upplever därtill en bättre balans mellan jobb och fritid, även om deltiden för med sig begränsningar i arbetet och fortsatta utmaningar med att anpassa arbetsbördan till den minskade arbetstiden. En arbetstidsminskning kan således leda till att personers miljöavtryck från konsumtion reduceras samtidigt som välbefinnandet ökar, men det kräver att ny fritid spenderas på rätt aktiviteter och att konsumtion minskar och/eller blir mindre miljöbelastande. Om tid i större mån skulle värderas högre än pengar genom minskad arbetstid och inkomst, skulle det kunna ändra konsumtionsnormen, minska konsumtion och produktion på samhällsnivå och därmed dess miljöpåverkan. / Sustainable consumption and production are important elements in the transition into a climate-adapted society, where lifestyle changes could play a crucial role. The purpose of this study is to qualitatively assess whether reduced working hours and income can have effects on people's environmental impact from consumption, as well as perceived well-being. To achieve this, qualitative interviews are conducted with five part-time employees at a Swedish workplace in the environmental field. The study shows that the interviewees’ consumption habits were largely characterized by environmental thinking, both before and after the part- time transition, and some already live a sufficient lifestyle. Reduced income proved to be less important for the interviewees' choice of consumption, however, some had reduced their savings, which can be interpreted as avoiding consumption in the future. At the same time, Covid-19 has affected the consumption patterns of society as a whole, and the study suggests that several interviewees probably spend less money as a consequence of the pandemic. The results show that reduced working hours and income can give rise to consumption-reducing effects such as a reduced need to compensate for lack of time with consumption, as well as more rationality and awareness regarding personal finances. It is also clear that a transition to part-time work, with a corresponding decrease in income, does not necessarily mean that total income decreases in practice, as side incomes and promotions can compensate for the loss of income. The use of time is central to the interviewees' consumption choices. A lot of their time is spent on activities with a low environmental impact, such as education, voluntary work, exercise, rest, and social relationships. How time is spent is also the most important factor in how the interviewees’ perceived well-being is affected, as the reduction in income has an almost non-existent negative impact on them. More time for recovery, family, friends, daily chores, and leisure activities benefit their perceived well-being. In addition, all interviewees experience a better work-life balance, even if part-time work entails limitations in work and continued challenges in adapting the workload to the reduced working hours. Hence, a reduction in working hours might lead to a reduction in people's environmental footprint from consumption while increasing well-being, given that the new leisure time is spent on the right activities and that consumption decreases and/or becomes less environmentally damaging. If time to a greater extent were to be valued over money through reduced working hours and income, it could change the consumption norm and reduce consumption and production at a societal level and thus, its environmental impact.

Bakgrund: Barnmorskor larmar världen över om en ohållbar och ansträngd arbetssituation. I Sverige är det brist på barnmorskor i 19 av 21 regioner. Forskning visar att arbetsmiljö och bristande bemanning är bidragande orsaker till att barnmorskor inte orkar arbeta kvar i förlossningsvården.  Motiv: Bemanningssituationen inom förlossningsvården har varit ett omdiskuterat ämne under lång tid. Barnmorskor uppskattar sitt yrke men arbetsvillkoren möter inte upp förväntningarna om ett hållbart yrkesliv.  Syfte: Syftet med denna studie var att belysa barnmorskors upplevelse av vad som bidrar till en hållbar arbetsplats inom svensk förlossningsvård.  Metod: En kvalitativ metod med åtta semistrukturerade intervjuer genomfördes. Materialet analyserades med tematisk analysmetod.   Resultat: Analysen resulterade i två huvudteman med tre respektive två underteman. Det första huvudtemat var ”Barnmorskeprofessionens Betydelse” med underteman ”Att trivas med sin yrkesroll som barnmorska” och “Att kollegor bidrar till teamkänsla och trygghet”. Det andra huvudtemat var ”Ledningens ansvar för en hållbar arbetsmiljö” med underteman ”Att chefer och organisation har ett stort ansvar för en hållbar arbetsmiljö”, ”Stabil bemanning gör skillnad i verksamheten” och ”vidareutveckling bidrar till en hållbar arbetsplats”.  Konklusion: Barnmorskor uppskattar sitt yrke och har en drivkraft att bidra till vidareutveckling vilket är gynnsamt både för verksamheten och för den enskilda barnmorskan. Om hållbara förutsättningar skulle finnas i verksamheten skulle barnmorskor stanna inom förlossningsvården i större omfattning än de gör idag. / Background: Midwives are raising the alarm worldwide about an unsustainable and strained work situation. In Sweden, there is a shortage of midwives in 19 out of 21 regions. Research shows that the work environment and lack of staffing are contributing factors to midwives not being able to continue working in delivery care.  Motive: The staffing situation in delivery care has been a topic of discussion for a long time. Midwives appreciate their profession, but the working conditions do not meet the expectations of a sustainable working life.  Aim: The aim of this study was to investigate midwives' experience of what contributes to a sustainable workplace within delivery care in Sweden.  Method: A qualitative method with eight semi-structured interviews was conducted. The material was analyzed using the thematic analysis method.  Result: The analysis resulted in two main themes with five sub-themes. The first main theme was "The Significance of the Midwifery Profession" with the subthemes "Enjoying your professional role as a midwife" and “Colleagues contribute to teamspirit and safety”. The second main theme was "Management's responsibility for a sustainable work environment" with sub-themes "That managers and organization have a great responsibility for a sustainable work environment", "A trustable staffing makes a difference for the workplace” and "Development contributes to a sustainable workplace".  Conclusion: Midwives appreciate their profession and want to contribute to the development of their workplace, which is beneficial both for the organization and for the midwife as an individual. Prerequisite to achieve sustainable working conditions is required to make midwives continue working in delivery care to a greater extent than they do today.

Working time is a constantly discussed topic. In Sweden working time is largely controlled by collective agreements. About 90% of all workers are covered by a collective agreement. For those who are parts of a collective agreement, it is important to consider the regulations in both the Swedish Arbetstidslagen (ATL) and the Working Time Directive (the Directive) when making a collective agreement. The purpose of this thesis is to examine various aspects of working time regulation in the form of directives, law and collective agreements. The thesis intends to contribute to knowledge of how the regulations regarding working hours in Sweden meet the requirements of the Directive by the EU. Further, the purpose is to examine how deviations from ATL can be regulated by collective agreements. The legal dogmatic method has been used in combination with an EU legal method. Directive, law, preparatory acts, case law, doctrine and literature were studied to investigate the legal situation. Collective agreements have been used as a source of law as well as empirical material. When studying implementation of the Directive to Swedish law, certain contradictions can be identified. The Swedish model collides with the Directive and the Swedish legislators as well as the Labour court choose to safeguard the Swedish model. Another contradiction is the purpose of the directive, protection of worker's health and safety, it is important and the Court of Justice of EU returns to it in many cases. A counterpart is lacking in ATL, instead, a connection is made to AML. Furthermore, the definition of working time is an issue where differences can be noticed between the Directive and Swedish law. Interpretations of the Court of Justice of EU and ATL defines different interpretations of call time and a new case may affect the travel time. The Court of Justice of EU calls the member countries to have equivalent definitions of working time and it should originate from the Directive. Regarding deviations through collective agreements the study shows that there are difficulties to interpret 3 § ATL, which is giving contradictory instructions regarding deviations. The paragraph and the EU-lock puts a great responsibility on the parties of the labour market to be familiar with both the Swedish law and the Directive. Some regulations are better for workers in ATL than the Directive at first glance, but this can be settled by collective agreements. Practice shows that there may be errors in the preparation of collective agreements.

Les inégalités de revenus et la polarisation de l'emploi ont augmenté dans plusieurs pays au cours des dernières décennies, suscitant des préoccupations d'équité ainsi que des interrogations concernant les politiques de redistribution. Cette thèse répond à deux questions primordiales. La première concerne le rôle des heures travaillées et de leur dispersion pour expliquer les inégalités de revenu; la seconde porte sur le rôle de l'offre de travail des femmes dans l'explication de la polarisation de l'emploi. Le premier chapitre utilise des données pour les États-Unis, le Royaume-Uni, l'Allemagne et la France et examine comment les inégalités de revenu sont affectées par la dispersion des heures de travail. Le principal enseignement de cette approche est que la dispersion des heures de travail peut expliquer plus d'un tiers des inégalités de revenu dans certains pays et que la corrélation entre le salaire horaire et les heures travaillées s'est accrue au fil du temps. Le second chapitre s'appuie sur les résultats du précédent et explore les mécanismes qui expliquent la tendance à la hausse de la corrélation entre salaires et heures travaillées. Nous constatons qu'une plus grande volatilité de la production agrégée et une réglementation plus stricte du marché du travail ont tendance à réduire l'élasticité, alors qu'une augmentation du commerce dans un secteur les augmente. Enfin, le troisième chapitre met l'accent sur le rôle des femmes hautement qualifiées dans l'évolution du marché des substituts de la production domestique et montre que, lorsque les femmes hautement qualifiées travaillent plus d'heures, les femmes moins qualifiées sont plus susceptibles d'être employées. / Earnings inequality and job polarization have increased in a number of countries during the last decades, raising concerns of fairness and fostering debates on the implications for redistributive policies. This thesis asks two main questions. The first concerns the relevance of hours worked and their dispersion for earnings inequality, while the second question investigates the role of female labour supply in explaining the increase in job polarization. The first chapter uses data for the USA, the UK, Germany, and France and examines how earnings inequality is affected by the dispersion of working hours. The main result of this exercise is that hours dispersion can account for over a third of earnings inequality in some countries and that the relevance of the correlation between wages and working hours has been growing over time. The second chapter builds on the results of the previous one and explores the forces behind the upward trend of the correlation between wages and working hours. We find that greater aggregate output volatility and stricter labour market regulation tend to reduce the elasticity, while a greater trade share in an industry raises it. Finally, the third chapter investigates the relevance of female employment for job polarization in Germany. The analysis focuses on the role of high-skilled females in the evolution of a market for home production substitutes and finds that when top-employed females work more hours, low-skilled women are more likely to be employed.

This mixed-methods study examines factors determining employees' desire to reduce worktime. The results of a binary logit regression model, based on data from the Austrian Microcencus 2012, suggest that employees who prefer shorter weekly working hours are older, higher educated and work longer hours in white-collar positions, compared to those who do not wish to change their hours. Gender differences are greatest in terms of household and family characteristics, supporting the 'male breadwinner & part-time' model. Qualitative interviews have been conducted among employees who had the possibility to choose between a pay increase and equivalent leisure time via a new worktime policy ("Freizeitoption") implemented in 2013. The results suggest that employees with higher education tend to reduce worktime. The fact that money is valued from a long-term, security perspective, as well as the tendency of assessing work performances by output indicators can be regarded as major obstacles for worktime reductions. / Series: WWWforEurope

Made available in DSpace on 2016-04-29T14:16:13Z (GMT). No. of bitstreams: 1 Fernanda de Jesus Carriel.pdf: 2444964 bytes, checksum: 9b26aec45ff10cb27bd80d4e11d0707a (MD5) Previous issue date: 2012-06-15 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This present dissertation seeks to understand the processes of struggles of the social workers of Municipality of Campinas for the conquest of the journey with 30 hours per week and the relations with its labor union. The study was based on analysis of Marx about the work as a basic category of human sociability and the ideas of Engels and Marx on the trade union movement as an instrument of struggle for workers with structural limitation, but with an important contribution to the process of class-consciousness. From the conquest of the Federal Law 12.317/2010, which reduced the working hours of social workers to 30 hours, without loss of wages, there were different legal interpretations of this law. Social workers public employees, contracting with statutory regime, in some localities and spheres, as in the case of Municipality of Campinas, encountered obstacles created by public managers to recognize such a right, which ordered the resumption of the organization of workers in their union. Thus, the research was conducted with social workers of Municipality of Campinas who participated in the struggle for 30 hours, using focus groups as an instrument to collect data with the active participation of the subjects and ability to gather different views about the subject. It also appealed to the documentary sources of the file built by social workers, e-mail messages and news media. The conclusions, however provisional, indicate that the struggle for 30 hours in Municipality of Campinas called the category for a significant corporate struggle, which created the accumulation of political forces that can be sent to the struggles of the broader group of municipal workers in the context of struggles of the Brazilian working class / A presente dissertação busca compreender os processos de luta das assistentes sociais da Prefeitura Municipal de Campinas (PMC) pela conquista da jornada de 30 horas semanais e as relações com a sua entidade sindical. O estudo baseou-se nas análises de Marx sobre o trabalho como categoria fundante da sociabilidade humana e nas concepções de Engels e Marx sobre o movimento sindical como instrumento de luta dos trabalhadores com limitações estruturais, mas com importante contribuição no processo de consciência de classe. A partir da conquista da Lei Federal 12.317/2010, que reduziu a jornada de trabalho dos assistentes sociais para 30 horas semanais, sem redução salarial, surgiram diferentes interpretações jurídicas. Os assistentes sociais servidores públicos, com contratação por regime estatutário, em algumas localidades e esferas, como no caso da PMC, se depararam com os obstáculos criados pelos gestores públicos em reconhecer tal direito, o que requisitou na retomada da organização dos trabalhadores em seu sindicato. Desta forma, a pesquisa foi realizada com assistentes sociais da PMC que participaram da luta pelas 30 horas, utilizando o grupo focal como instrumento de coleta dos dados com participação ativa dos sujeitos e possibilidade de reunir diferentes concepções sobre o tema. Recorreu-se também às fontes documentais do arquivo construído pelas assistentes sociais, mensagens de correio eletrônico e notícias da mídia. As conclusões, ainda que provisórias, indicam que a luta pelas 30 horas na PMC convocou a categoria para uma luta corporativa significativa, que criou acúmulo de forças políticas que podem ser remetidas às lutas mais gerais do conjunto dos trabalhadores públicos municipais, no contexto das lutas da classe trabalhadora brasileira

Introdução: Os recentes avanços no diagnóstico, tratamento e terapia de suporte têm melhorado o prognóstico e ampliado a sobrevida dos pacientes com câncer. No entanto, ao lado dos benefícios, complicações decorrentes da doença e dos tratamentos têm aumentado o tempo de internação desses pacientes em unidades de terapia intensiva (UTI) clínicas e cirúrgicas, com diferentes demandas de cuidados. Objetivo: Comparar a carga de trabalho de enfermagem entre os pacientes oncológicos clínicos e cirúrgicos admitidos em UTI. Método: Trata-se de um estudo transversal, descritivo e comparativo, realizado em duas UTIs de um instituto de alta complexidade em oncologia, sendo uma clínica e a outra cirúrgica, no período de abril a junho de 2014. Foram coletados dados demográficos e clínicos dos pacientes e a carga de trabalho de enfermagem, mensurada pelo Nursing Activities Score (NAS). Estatísticas descritivas, testes de associação e correlação foram realizadas para tratamento dos dados, considerando-se valores de p<0,05 para a significância estatística. Resultados: A casuística compôs-se de 766 pacientes adultos admitidos na UTI para tratamento clínico e cirúrgico, com permanência mínima de 24 horas na unidade. A maioria da amostra era do sexo masculino (56,4%), com média de idade 59,8 anos (dp=15,1) para pacientes clínicos e 60,8 anos (dp=13,9) para os pacientes cirúrgicos (p=0,626), cuja permanência na UTI foi em média de 7,2 dias e 4,1 dias respectivamente (p<0,001). Em Comparação com os cirúrgicos, houve predominância de pacientes oncológicos submetidos a tratamento clínico (p<0,001), que apresentaram, em média, maior comorbidade (p<0,001), maior gravidade(p<0,001), presença de metástases (p<0,001), maior tempo de permanência na Unidade (p<0,001) e maior mortalidade (p< 0,001). A média NAS dos pacientes clínicos (88,0%) foi maior que dos cirúrgicos (82,1%), com, (p<0,001). Nos dois tipos de tratamento, pacientes do gênero feminino (p=0,035), não sobreviventes (p< 0,001) e portadores de câncer hematológico e sarcomas/melanomas (p=0,414 e p=0,153, respectivamente) apresentaram carga de trabalho de enfermagem mais elevadas. Observou-se na admissão e saída da UTI, que pacientes não sobreviventes, apresentaram médias NAS maiores em relação aos sobreviventes (p<0,001). Também as intervenções de enfermagem no primeiro dia de internação foram diferentes entre os grupos em 11 (47,8%) dos 23 itens do instrumento do NAS. A carga de trabalho de enfermagem de pacientes clínicos apresentou correlação com a gravidade SAPS3 (p<0,001), enquanto a dos pacientes cirúrgicos correlacionou-se com o Índice de Comorbidade de Charlson e tempo de permanência (p=0,047 e p<0,001, respectivamente). Em todos os meses do estudo, as horas de cuidados requeridas pelos pacientes das UTIs clínica e cirúrgica foram maiores do que as disponíveis pela equipe de enfermagem. Conclusão: Pacientes oncológicos submetidos a tratamento clínico em UTI exigiram maior carga de trabalho comparativamente aos cirúrgicos. Observou-se déficit de horas de enfermagem tanto na UTI clínica como cirúrgica, durante o período do estudo. / Introduction: Recent advances in diagnosis, treatment and supportive therapy have improved prognosis and increased the survival of patients with cancer. However, along with the benefits, complications of the disease and treatments have increased the length of stay of these patients in clinical and surgical intensive care units (ICUs), with different demands of care. Objective: Compare the nursing workload required by clinical and surgical oncology patients admitted to the ICU. Method: This is a cross-sectional, descriptive and comparative study, carried out in two ICUs of a highly complex oncology institute, being one of them clinical and the other one surgical, from April to June 2014. We have collected demographic and clinical data of patients and the nursing workload, measured by the Nursing Activities Score (NAS). Descriptive statistics, association and correlation tests were performed for data treatment, considering p<0.05 for statistical significance. Results: The study was composed of 766 adult patients admitted to the ICU for clinical or surgical treatment, with a minimum stay of 24 hours at the unit. Most of the sample was composed of male patients (56.4%), with an average age of 59.8 years (standard deviation=15.1) for clinical patients and 60.8 years (standard deviation=13.9) for surgical patients (p=0.626), with an average ICU stay of 7.2 and 4.1 days, respectively (p<0.001). Compared to surgical patients, there was a predominance of oncology patients undergoing clinical treatment (p<0.001), which showed, on average, more comorbidity (p<0.001), greater severity (p<0.001), presence of metastases (p<0.001), increased length of stay at the ICU (p<0.001) and higher mortality rates (p< 0.001). The average NAS in clinical patients (88.0%) was higher than in surgical patients (82.1%), with (p<0.001). In both types of treatment, female patients (p=0.035), non-survivors (p< 0.001) with blood cancer and sarcomas/melanomas (p=0.414 and p=0.153, respectively), showed higher nursing workload. At ICU admission and discharge, we noticed that non-survivors showed higher average NAS when compared to survivors (p<0.001). In addition, nursing interventions on the first day of admission were different between the groups in 11 (47.8%) of the 23 items of the NAS tool. The nursing workload of clinical patients showed correlation with the SAPS3 severity (p<0.001), while the workload of surgical patients was correlated with the Charlson Comorbidity Index and the length of stay (p=0.047 and p<0.001, respectively). During all the months of study, the time of patient care required at the clinical and surgical ICUs was higher than the time available by the nursing team. Conclusion: Oncology patients undergoing clinical treatment at the ICU demanded more workload than surgical patients did. There was a deficit of nursing hours both in the clinical and in the surgical ICU during the study.

Introdução: Os recentes avanços no diagnóstico, tratamento e terapia de suporte têm melhorado o prognóstico e ampliado a sobrevida dos pacientes com câncer. No entanto, ao lado dos benefícios, complicações decorrentes da doença e dos tratamentos têm aumentado o tempo de internação desses pacientes em unidades de terapia intensiva (UTI) clínicas e cirúrgicas, com diferentes demandas de cuidados. Objetivo: Comparar a carga de trabalho de enfermagem entre os pacientes oncológicos clínicos e cirúrgicos admitidos em UTI. Método: Trata-se de um estudo transversal, descritivo e comparativo, realizado em duas UTIs de um instituto de alta complexidade em oncologia, sendo uma clínica e a outra cirúrgica, no período de abril a junho de 2014. Foram coletados dados demográficos e clínicos dos pacientes e a carga de trabalho de enfermagem, mensurada pelo Nursing Activities Score (NAS). Estatísticas descritivas, testes de associação e correlação foram realizadas para tratamento dos dados, considerando-se valores de p<0,05 para a significância estatística. Resultados: A casuística compôs-se de 766 pacientes adultos admitidos na UTI para tratamento clínico e cirúrgico, com permanência mínima de 24 horas na unidade. A maioria da amostra era do sexo masculino (56,4%), com média de idade 59,8 anos (dp=15,1) para pacientes clínicos e 60,8 anos (dp=13,9) para os pacientes cirúrgicos (p=0,626), cuja permanência na UTI foi em média de 7,2 dias e 4,1 dias respectivamente (p<0,001). Em Comparação com os cirúrgicos, houve predominância de pacientes oncológicos submetidos a tratamento clínico (p<0,001), que apresentaram, em média, maior comorbidade (p<0,001), maior gravidade(p<0,001), presença de metástases (p<0,001), maior tempo de permanência na Unidade (p<0,001) e maior mortalidade (p< 0,001). A média NAS dos pacientes clínicos (88,0%) foi maior que dos cirúrgicos (82,1%), com, (p<0,001). Nos dois tipos de tratamento, pacientes do gênero feminino (p=0,035), não sobreviventes (p< 0,001) e portadores de câncer hematológico e sarcomas/melanomas (p=0,414 e p=0,153, respectivamente) apresentaram carga de trabalho de enfermagem mais elevadas. Observou-se na admissão e saída da UTI, que pacientes não sobreviventes, apresentaram médias NAS maiores em relação aos sobreviventes (p<0,001). Também as intervenções de enfermagem no primeiro dia de internação foram diferentes entre os grupos em 11 (47,8%) dos 23 itens do instrumento do NAS. A carga de trabalho de enfermagem de pacientes clínicos apresentou correlação com a gravidade SAPS3 (p<0,001), enquanto a dos pacientes cirúrgicos correlacionou-se com o Índice de Comorbidade de Charlson e tempo de permanência (p=0,047 e p<0,001, respectivamente). Em todos os meses do estudo, as horas de cuidados requeridas pelos pacientes das UTIs clínica e cirúrgica foram maiores do que as disponíveis pela equipe de enfermagem. Conclusão: Pacientes oncológicos submetidos a tratamento clínico em UTI exigiram maior carga de trabalho comparativamente aos cirúrgicos. Observou-se déficit de horas de enfermagem tanto na UTI clínica como cirúrgica, durante o período do estudo. / Introduction: Recent advances in diagnosis, treatment and supportive therapy have improved prognosis and increased the survival of patients with cancer. However, along with the benefits, complications of the disease and treatments have increased the length of stay of these patients in clinical and surgical intensive care units (ICUs), with different demands of care. Objective: Compare the nursing workload required by clinical and surgical oncology patients admitted to the ICU. Method: This is a cross-sectional, descriptive and comparative study, carried out in two ICUs of a highly complex oncology institute, being one of them clinical and the other one surgical, from April to June 2014. We have collected demographic and clinical data of patients and the nursing workload, measured by the Nursing Activities Score (NAS). Descriptive statistics, association and correlation tests were performed for data treatment, considering p<0.05 for statistical significance. Results: The study was composed of 766 adult patients admitted to the ICU for clinical or surgical treatment, with a minimum stay of 24 hours at the unit. Most of the sample was composed of male patients (56.4%), with an average age of 59.8 years (standard deviation=15.1) for clinical patients and 60.8 years (standard deviation=13.9) for surgical patients (p=0.626), with an average ICU stay of 7.2 and 4.1 days, respectively (p<0.001). Compared to surgical patients, there was a predominance of oncology patients undergoing clinical treatment (p<0.001), which showed, on average, more comorbidity (p<0.001), greater severity (p<0.001), presence of metastases (p<0.001), increased length of stay at the ICU (p<0.001) and higher mortality rates (p< 0.001). The average NAS in clinical patients (88.0%) was higher than in surgical patients (82.1%), with (p<0.001). In both types of treatment, female patients (p=0.035), non-survivors (p< 0.001) with blood cancer and sarcomas/melanomas (p=0.414 and p=0.153, respectively), showed higher nursing workload. At ICU admission and discharge, we noticed that non-survivors showed higher average NAS when compared to survivors (p<0.001). In addition, nursing interventions on the first day of admission were different between the groups in 11 (47.8%) of the 23 items of the NAS tool. The nursing workload of clinical patients showed correlation with the SAPS3 severity (p<0.001), while the workload of surgical patients was correlated with the Charlson Comorbidity Index and the length of stay (p=0.047 and p<0.001, respectively). During all the months of study, the time of patient care required at the clinical and surgical ICUs was higher than the time available by the nursing team. Conclusion: Oncology patients undergoing clinical treatment at the ICU demanded more workload than surgical patients did. There was a deficit of nursing hours both in the clinical and in the surgical ICU during the study.

<p>Labour and its conditions is a subject constantly in focus. Therefore this study aims to shed some light on different factors which constitutes the basis for the definition of optimal labour conditions, as well as creating a need for change of labour conditions. In this case these factors are changes in society and cultures. The study describes how different levels of society - government, employer and employee – are affected by, or wishes to affect the labor conditions in terms of location, working hours and leisure. In brief this study concerns how different goals and interests results in different definitions of the optimum at the different levels. For instance the goal of the state is to increase its GNP to better compete with other nations. The goal of the employer is, among other things, to increase the company’s profits and conquer the market. The employee’s interest, on the other hand, is mainly to get resources for survival and better terms of life.</p>