Orientador: Dagmar de Paula Queluz / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-26T07:43:17Z (GMT). No. of bitstreams: 1 Rodrigues_Danilo_M.pdf: 933631 bytes, checksum: 12069295906092891897c457c333c9ed (MD5) Previous issue date: 2014 / Resumo: Trabalhos que exigem grande responsabilidade podem trazer sérios prejuízos ao organismo do indivíduo como o estresse. O estresse é um dos fatores desencadeantes de doenças, produzindo alterações sistêmicas e bucais em diferentes profissionais. O presente estudo propôs associar a presença de estresse emocional com as alterações sistêmicas e bucais em enfermeiros de um hospital público de referência na região de Piracicaba-SP. Foram convidados a participar todos os 60 enfermeiros de ambos os gêneros, de diferentes idades e etnias, com nível de formação superior. Os enfermeiros responderam ao questionário de Sintomas de Estresse (ISSL) e, junto a esse, responderam ao questionário de doenças/sintomas psicossomáticos. Em seguida passaram por avaliação estomatológica da cavidade bucal, de acordo com os critérios de Boraks (1996). A variável estresse foi associada com as variáveis psicossomáticas e bucais de maior destaque através de teste exato de Fisher para cálculo do valor de p (0,05). O nível de estresse nas fases II e III foi observado em 51,3% dos enfermeiros. Os sintomas de dor de cabeça e ter engordado ultimamente estiveram presente em 48,6% dos enfermeiros. Em relação às alterações bucais 32,4% relataram afta às vezes e 59,5% apresentaram mucosa mordiscada sempre. Não foi significativa a associação entre a variável estresse com as variáveis psicossomáticas e bucais. Baseado nos resultados desse estudo conclui-se que a profissão enfermagem pode levar ao estresse emocional, embora não encontrada associação significativa entre estresse e doenças/sintomas psicossomáticos e bucais. Estudos futuros deverão ser realizados para avaliar essa associação / Abstract: Jobs that require great responsibility can cause serious damage to the body of the individual as stress. Stress is one of the triggers of disease, producing the appearance of systemic and oral diseases in different professionals. This study aimed to associate the presence of emotional stress with the systemic and oral alterations on nurses in a public referral hospital in the Piracicaba-SP region. Were invited to attend all 60 nurses of both genders, of different ethnicity and ages with higher education. Nurses responded to Stress Symptoms (ISSL) questionnaire and, next to that, answered the questionnaire diseases/psychosomatic symptoms. Then passed through stomatological evaluation of oral cavity, according to the criteria Boraks (1996) . The variable stress was associated with psychosomatic and oral variables most outstanding through Fisher's exact test for calculating the p value (0.05). The level of stress in phase II and III was observed in 51.3% of the nurses. Symptoms of headache and have put on weight lately were present in 48.6% of the nurses. With regard to oral alterations 32.4% reported sore sometimes and 59.5% had nibbled mucosa always. There was no significant association between the variable stress with psychosomatic and oral variables. Based on the results of this study it is concluded that the nursing profession can lead to emotional stress, although no significant association between stress and disease / psychosomatic and oral symptoms. Future studies should be performed to evaluate this association / Mestrado / Odontologia em Saude Coletiva / Mestre em Odontologia em Saúde Coletiva

Orientador: Satoshi Kitamura / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-20T19:15:33Z (GMT). No. of bitstreams: 1 Gonzalez_LuizRicardo_D.pdf: 1852973 bytes, checksum: fe261b80338f57f34b13efff35148a9f (MD5) Previous issue date: 2012 / Resumo: Justificativa e Objetivos: Neutropenia étnica benigna é uma condição caracterizada por uma redução da contagem dos neutrófilos abaixo de 1.500/mm³ na circulação sanguínea, estando ausentes as causas secundárias, adquiridas ou congênitas.Ocorre, principalmente, em populações negras e seus descendentes, não apresentando problemas recorrentes de infecção. Diversos trabalhos realizados, ao redor do tema em outros Países, em que a etnia negra é importante na composição populacional, como no Brasil, mostra à importância do conhecimento da neutropenia étnica.A proposta do presente estudo foi investigar a prevalência de neutropenia étnica benigna,no meio de uma população trabalhadora, aparentemente saudável, sendo realizado em um Hospital de grande porte na cidade de São Paulo-Brasil. Método: Trata-se de um estudo transversal, envolvendo 347 voluntários, que estavam dentro dos critérios de inclusão do estudo. Resultados: Os dados deste trabalho demonstram que entre os trabalhadores estudados, 9 (2,59%) apresentaram critérios diagnósticos para neutropenia étnica benigna. Relativamente em relação aos brancos participantes, os negros, pardos e amarelos apresentaram menor contagem de neutrófilos.Conclusão: Levando-se em consideração o aspecto racial, este estudo mostra que pessoas negras e seus descendentes podem apresentar uma diminuição na contagem de neutrófilos, sem predisposição a infecções / Abstract: Background and Objectives: Benign ethnic neutropenia is a condition characterized by a neutrophil count reduction under 1.500/mm³ in blood circulation, with absence of acquired or congenital secondary causes. It occurs mainly among afro populations or their descendants not presenting problems with recurrent infections. Different papers performed in other countries, in which the Black ethnicity is important in the population composition, such as in Brazil, discuss the importance of knowing about ethnic neutropenia. The aim of this study was to investigate the prevalence of benign ethnic neutropenia in an apparently healthy working population of a large hospital in the city of Sao Paulo, Brazil. Method: This transversal study comprised 347 volunteers who met the inclusion criteria. Results: According to this study, nine (2.59%) among the studied employees met the diagnostic criteria for benign ethnic neutropenia. Compared to Caucasian participants, Black, Brown and Yellow people presented a lower neutrophil count. Conclusion: Considering the racial aspect, this study showed that afro people and their descendants may present a neutrophil count reduction, without predisposition to infections / Doutorado / Epidemiologia / Doutor em Saude Coletiva

Orientador: Neusa Maria Costa Alexandre / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-04T15:33:31Z (GMT). No. of bitstreams: 1 Miguez_SymoneAntunes_M.pdf: 5979789 bytes, checksum: 8b9012992c1bdae7995eac106cc68749 (MD5) Previous issue date: 2005 / Resumo: As intervenções ergonômicas têm sido realizadas para minimizar os problemas dos distúrbios osteomusculares relacionados ao trabalho. Neste contexto, esta pesquisa teve por objetivo realizar uma intervenção ergonômica em uma indústria química da região metropolitana de Campinas, São Paulo e avaliar os índices de absenteísmo geral, os sintomas osteomusculares e a qualidade de vida dos trabalhadores. O presente estudo é do tipo transversal, de caráter descritivo, realizado com 76 trabalhadores do sexo masculino, da área operacional da indústria. Na coleta de dados foi utilizado um questionário de dados gerais e ocupacionais, o instrumento Nordic Questionnaire (Questionário Nórdico) sobre sintomas músculo esqueléticos com uma adaptação para o desenho metodológico deste estudo e o Short Form Health Survey (SF-36) para qualidade de vida. Verificou-se os índices de absenteísmo geral dos últimos três meses que antecederam a intervenção junto ao ambulatório médico da empresa. A análise das atividades baseou-se em um formulário para registro de soluções ergonômicas. As participações foram voluntárias e os trabalhadores receberam informações da pesquisadora sobre a intervenção ergonômica e assinaram o Termo de Consentimento Livre e Esclarecido. No tratamento dos resultados realizou-se análises descritivas das variáveis dos três instrumentos. Para a análise da relação entre os sintomas osteomusculares nos últimos três meses e os dados gerais e ocupacionais utilizouse a Regressão Logística Múltipla.A média de idade geral dos participantes foi de 35 anos, com escolaridade predominante do ensino médio (58,7%). A maioria dos trabalhadores (77,6%) relatou não praticar nenhuma atividade física. Observou-se um elevado percentual de trabalhadores que referiu fazer horas extras (73%). Constatou-se que o maior índice de absenteísmo nos últimos três meses foi causado por problemas osteomusculares (48%). Em relação aos sintomas osteomusculares, observou-se que 53% dos trabalhadores apresentaram sintomas em pelo menos uma área corporal nos últimos três meses.Verificouse o comprometimento de diversas regiões corporais, sendo que a mais acometida foi a coluna lombar (19,7%), que ficou também em primeiro lugar (6,6%) na justificativa por auxílio de profissional da área de saúde. Notou-se uma distribuição diferenciada de sintomas osteomusculares por prédio, sugerindo relação com as atividades ocupacionais do trabalhador. Os trabalhadores com faixas etárias mais elevadas apresentaram menos chance de desenvolver distúrbios músculo-esquelético, em qualquer região corporal. O tempo na atividade foi significativo, indicando que trabalhadores com mais de 36 meses têm quatro vezes mais chance de apresentar problemas osteomusculares. Comparando-se os participantes com e sem sintomas osteomusculares, verificou-se que todos os domínios do questionário de qualidade de vida (SF36) apresentaram índices menores nos sujeitos que referiram algum sintoma. Diante dos resultados, sugestões como ações educativas junto aos trabalhadores, a implantação do Comitê de Ergonomia e o desenvolvimento de um dispositivo para o corte de sacarias fizeram parte das primeiras melhorias ergonômicas implantadas. Concluiu-se que é de extrema importância dar continuidade a esta intervenção ergonômica validando as recomendações sugeridas e mensurando a contribuição para a saúde do trabalhador / Abstract: The ergonomic interventions have been performed to minimize the work related musculoskeletal disorders. Given such background, this research had as target the performance of an ergonomic intervention at a chemical factory from the Campinas metropolitan area, state of São Paulo, evaluation of the general absenteeism indexes, the musculoskeletal symptoms and the workers quality of life. The present study is of the transversal type, descriptive in character, executed with 76 workers of the male gender, from the operational area of the factory. A general and occupational data questionnaire was utilized during the gathering of data, the instrument, Nordic Questionnaire, regarding musculoskeletal symptoms with an adaptation for the methodological drawing of this study and the Short Form Health Survey (SF-36) for quality of life. There were verified along with the factory's medicar clinic general absenteeism indexes frem the last 3 months prior to the intervention. The activities analysis was based on a form for the registration of ergonomic solutions. The participations were voluntary and the workers received information from the researcher regarding the ergonomic intervention and signed the Free and Clarified Consent Term. Descriptive analyses of the variables from the 3 instruments were performed at the treatment of the results. For the analysis of the relation between the musculoskeletal symptoms at the last 3 months and the general and occupational data the Multiple Logistic Regression was utilized. The general participants age average was that of 35 years old, with schooling at the secondary education levei being predominant (58,7%). The majority of workers (77,6%) reported not practicing any physical activity. It was observed a high percentage of workers, which reported working overtime (73%). It was found that the highest absenteeism índex in the last 3 months was caused by musculoskeletal problems (48%). Conceming the musculoskeletal symptoms it was observed that 53% of workers presented symptoms in at least one bodily area in the last 3 months. It was verified the compremising of various bodily regions, with the most stricken being the lumbar spine (19,7%), which also ranked first (6,6%) at the supporting cause for the aid of professional help from the health field. A differentiated distribution of musculoskeletal symptoms by building was noted, suggesting relationship with the worker's occupational activities. The workers at a higher age group presented less chance of developing musculoskeletal troubles, in any region of the body. The time at the activity was significant, indicating that workers with more than 36 months are 4 times more susceptible of presenting musculoskeletal problems. Comparing participants possessing and not possessing musculoskeletal symptoms, it was verified that ali the domains of the quality of life questionnaire (SF36) presented lower levels in the subjects that referred some symptom. In face of the results, suggestions such as educational actions combined with the workers, the implementation of the Ergonomics Committee and the development of a device for the sectioning of sacks were part of the first ergonomic improvements implemented. In conclusion, it is of utmost importance the continuance of such ergonomic intervention validating the suggested recommendations and measuring the contribution for the worker's health / Mestrado / Enfermagem e Trabalho / Mestre em Enfermagem

Sammanfattning Syfte och frågeställningar Syftet med uppsatsen var att undersöka genom ett test-retest, reliabiliteten hos fem stycken specifika fys- och styrketester för de muskelgrupper, som är mest utsatta i en ambulanssjukvårdares arbete. - Är det en god reliabilitet i ett bellybacktest utan motstånd? - Är det en god reliabilitet i ett balanstest? - Är det en god reliabilitet i ett handstyrketest? - Är det en god reliabilitet i ett aerobiskt steptest? - Är det en god reliabilitet i ett marklyft i dragmaskin? Metod Ett test och retest utfördes på fem tester, bellybacktest utan motstånd, handstyrketest, aerobiskt steptest, marklyft i drargmaskin och balanstest. Försökspersonerna var 14 stycken, 11 män och 3 kvinnor, samtliga var studenter vid GIH i Stockholm. Resultat Varken bellybacktestet utan motstånd, handstyrketestet (höger samt vänster hand), aerobiska steptestet eller marklyftet i dragmaskinen visar några slumpmässiga eller systematiska statistisk signifikanta skillnader. Balanstestet däremot har bra värden på t-testet (p=0,89), som visar att det inte finns några systematiska signifikanta skillnader, men låga värden på övriga uträkningar som visar på de slumpmässiga skillnaderna. Slutsats Samtliga tester med undantag från balanstestet har hög reliabilitet. Balanstestet visar mindre tillförlitlighet än de övriga fyra testerna, vilket även tidigare forskning visar. Det är därför vår tanke att bellybacktestet, handstyrketesterna, aerobiska steptestet och marklyftet i dragmaskinen är tester som kan byggas vidare på inom arbetet att testa ambulanssjukvårdare. Balansen är fortfarande en viktig faktor att testa, men ett bättre test är nödvändigt för att få tillförlitliga resultat.

This study focuses on computer workers with repetitive strain injury (RSI) that lead to chronic pain, interference with daily activities (work and leisure), getting a night's sleep, and pain-related mental health issues (e.g., anxiety and depression). People take their hands for granted, and when they suddenly lose the use of them and are unable to perform basic daily activities (bathing, dressing, feeding ourselves), may develop anxiety and depression. This research examines how physical pain caused by RSI affects computer workers as a whole, and how workers use exercise/physical activity participation and health professionals use exercise/physical activity prescription to alleviate the accompanying pain, anxiety and depression, interviews were conducted with eight RSI-injured computer workers from the public service and eight health professionals who treat this type of injury. The results show that regular exercise/physical activity is seen to be a weapon in combating pain and pain-related mental health issues in RSI-injured computer workers. An improved understanding of the benefits of exercise/physical activity for RSI-injured computer workers living with chronic pain and pain-related mental health issues will provide them with more effective coping strategies, ameliorate their emotional/psychological recovery, facilitate their active return to the workforce, and enhance their overall quality of life.

Syfte: Syftet med den här uppsatsen är att undersöka om införandet av hälsobokslut fått några effekter på sjukfrånvaron. Frågeställningar: Hur redovisas sjukfrånvaron av företagen? Kommenteras vald redovisning av företagen och i så fall hur? Hur har sjukfrånvaron förändrats sedan införandet av obligatorisk redovisning av sjukfrånvaro? Metod: För att undersöka detta har årsredovisningar från 25 privata företag analyserats. Årsredovisningarna från 2003 har jämförts med motsvarande årsredovisningarna för 2004. Företagen kommer från fem av de största branscherna i Stockholms län. Företagen har 50-249 anställda vilket motsvarar medelstora företag i Stockholm. Urvalet har gjorts efter näringsgrenar och efter det som ett slumpmässigt urval i form av lottning. De sammanställningar som gjorts är den totala sjukfrånvarons förändring samt förändringen av sjukfrånvaron inom respektive undergrupp. Detta har gjorts både branschvis samt totalt. En sammanställning har även gjorts av den totala långtidssjukfrånvarons förändring för alla företag, både branschvis samt totalt. Resultat: Sjukfrånvaron redovisas av alla företag och i stort i enlighet med lagen. Beträffande långtidssjukfrånvaron har 7 av 25 företag förmodligen redovisat den totala långtidssjukfrånvaron som procentenheter av den totala sjukfrånvaron i stället för som procent av den totala sjukfrånvaron. Sjukfrånvaron visar en tendens till att sjunkit eller stått stilla i alla de redovisade kategorierna. Inget av företagen har kommenterat sjukfrånvaron i årsredovisningen utöver de kommentarer som beskriver siffrorna. 9 av de 25 företagen har valt att inte redovisa någonting för vissa grupper. Två av dessa företag har valt att kommentera detta. Slutsats: Hälsobokslutet har än så länge inte gett några större effekter på sjukfrånvaron. Den visar dock ingen tendens till att ha ökat vilket får ses som positivt. Då inget av företagen har kommenterat någonting utöver vad lagen säger antas att hälsobokslutet mottagits endast som ett extra tillägg i årsredovisningen. Då det finns en del osäkerhet kring hur rapporteringen ska gå till borde lagen förtydligas för att uppnå syftet med hälsobokslutet. Sammanfattningsvis kan sägas att hälsobokslutet är en bra tanke som än så länge endast får företagen att bli medvetna om sin sjukfrånvarosituation. För externa intressenter säger inte siffrorna mycket än. / Aim: The aim of this graduate essay is to study if the health statement has brought any consequences to the sickness absence. Questions: How do the companies report the sickness absence? Do the companies comment on their chosen reporting and if so, how? How has the sickness absence changed since the introduction of obligatory reporting of sickness absence? Method: To study this, annual reports from 25 private companies have been analysed. The annual reports from 2003 have been compared with the corresponding annual reports of 2004. The companies come from five of the largest line of businesses in the Stockholm region. The companies have 50-249 employees which correspond to medium sized companies in Stockholm. The selection has been done from branches of industry and after that as a random pick in terms of drawing lots. The compilation that has been made is the total change of the sickness absence and the change of sickness absence in respective subgroup. This has been made both in branches of industry and totally. There has also been a compilation of the change of the total long-term sickness absence for all the companies, both in branches of industry and totally. Results: The sickness absence is reported by all the companies and on average in accordance with the law. Concerning the long-term sickness absence, 7 of the 25 companies probably have reported the total long-term sickness absence as per cent units of the total sickness absence instead of per cent of the total sickness absence. The sickness absence shows a tendency to have decreased or been unchanged in all the reported categories. None of the companies have commented the sickness absence in the annual report besides the comments that describes the numbers. 9 of the 25 companies have chosen not to report anything concerning some of the categories. Two of these companies have chosen to comment this. Conclusions: The health statement does not seem to have given any larger effects on the sickness absence. Nevertheless it shows no tendency to have increased which will have to been seen as positive. Since none of the companies has commented anything besides what the law says, one can assume that the health statement only has been received as an extra addition in the annual report. Since there is some uncertainty how the reporting should be done, the law should be clarified so that the aim with the health statement is achieved. To sum up, the health statement is a good thought that yet only get the companies aware of their sickness absence situation. For external interests the numbers still do not say much.

The Occupational Safety and Health Administration estimates that each year, approximately 30 million people are occupationally exposed to hazardous noise. While many are aware of the noise exposure associated with industrial occupations, there has been little research conducted on bartenders who often work in environments that have high levels of noise. The majority of current published research on occupational noise exposure of bartenders has only evaluated noise levels on one night of business. Bartenders often work multiple days per week, which vary in the amount of patrons and entertainment provided, this variation in business leads to variation in the amount of noise to which they are exposed. The purpose of this research study was to gather occupational noise exposure data for bartenders during a workweek at a Tampa Bay bar establishment that hosts live music on weekends. Personal noise dosimeters were used to collect personal noise exposure data. Area noise level data were collected using a sound level meter. While several bar establishments were approached, one bar establishment part pated as the study site and noise data were collected for seven consecutive days (Thursday-Wednesday). Personal noise exposure data were collected for an entire 8-hour work shift for the Thursday-Sunday portion of the study, and for 6 hours for the Monday-Wednesday portion of the study. Area noise data were collected for the Thursday-Saturday portion of the study. Results of this study indicate that the highest noise exposure for either bartender occurred on Saturday (Bartender 1: 93.1 dBA; Bartender 2: 83.6 dBA) when a live band was performing in the establishment. Using the OSHA Hearing Conversation and OSHA PEL measurement methods, Bartender 1 was exposed to excessive noise levels (>85 dBA) on four (4) nights of the study, while Bartender 2 had no exposures over 85 dBA. However, using the ACGIH measurement method, Bartender 1 was exposed to excessive noise levels six (6) nights of the study, while Bartender 2 was exposed to excessive noise levels two (2) nights of the study.

Magister Curationis - MCur / Occupational health nursing (OHN) as a specialist area has become increasingly popular in South Africa for registered nurses. With developing legislation in South Africa regarding occupational health in the workplace, there is a growing need for occupational health nursing practitioners to be adequately prepared to practice according to the competencies set out by the South African Nursing Council on completion of their study programme. No significant research studies have been done on the perceived readiness of occupational health nursing practitioners to practice occupational health nursing in South Africa. The aim of the study was to explore the perceived readiness of the 2015 graduating OHN students to practice OHN. The study used a qualitative research approach, using an exploratory descriptive design. Purposive sampling was used to select participants who were enrolled in the occupational health nursing programme during their final year of study at a specific university in South Africa. Data were collected by means of in-depth interviews from participants and were analysed using thematic content analysis. Five major themes were identified: Perceived confidence to practice OHN; Readiness for the unique field of OHN; Readiness for professional and self development; Readiness for a leadership role in occupational health management; and Perceived readiness for a research role in OHN and future implications.The researcher concluded, on the basis of the findings, that occupational health nurse practitioners are generally ready to practice as competent and independent OHN professionals.

Abstract The aim of this study was to deepen the understanding of ageing nurses’ well-being at work. The study consists of the following phases: 1) a substantive theory of ageing hospital nurses’ well-being at work, 2) systematic literature review of nurses’ well-being at work, 3) developing a scale to measure ageing nurses’ well-being at work, 4) testing the substantive theory to serve as a theoretical model based on the survey study and 5) practical application of the theoretical model in Finnish hospitals. The substantive theory was created using Glaserian grounded theory methodology. The subjects of the study are nurses working at a university hospital, aged 45–55 years, with at least 10 years of hospital work experience and doing three-shift work in the specialities of internal medicine or surgery. The data (n = 21) analysed using constant comparison analysis consists of interviews, diaries and open data collection forms. Nurses’ well-being at work is investigated through a systematic literature review, consisted of data from 21 scientific original articles collected from international databases. A scale was developed based on the substantive theory whose validity and reliability was tested with the aid of survey data. The substantive theory was also tested using the scale and survey data. Survey data (n = 328) were collected from nurses born between the years 1948–1962 and working at hospitals all around Finland. Data were analysed using explorative factor analysis (principal component analysis). With the aid of a second survey data set (n = 285) the practical application of the theoretical model was studied in Finnish hospital organizations as seen in the work of ageing nurses. According to the theoretical model, the well-being at work of ageing nurses consists of nurse-nurse interaction, nurse-patient interaction and orientation towards nursing work. Nurse-nurse interaction consists of meaningfulness of work, helping, status at work, communality, freedom, working in pairs and being together. Nurse-patient interaction consists of patient satisfaction, well-conducted nursing and meeting and helping patients. Orientation towards nursing work includes provision of good care to patients, appreciation of nursing and putting the patient first. The theoretical model is well realized within the hospital organization: the strongest conflict can be seen in relation to the importance of well-conducted nursing and its quite poor realization in Finnish hospitals. The results of this study emphasize in a new way the key significance of reciprocity, dignity and respect to nurses’ well-being at work. The knowledge generated in this study can be exploited when promoting well-being at work of ageing nurses in responding to the challenges at both individual and organizational level. The results of this study can be utilized in nursing work, nursing leadership and education and in research related to well-being at work. / Tiivistelmä Tutkimuksen tarkoituksena on syventää ymmärrystä ikääntyvien sairaanhoitajien työhyvinvoinnista. Tutkimus rakentuu seuraavista vaiheista: 1) substantiivinen teoria ikääntyvien sairaanhoitajien työhyvinvoinnista, 2) systemaattinen kirjallisuuskatsaus hoitajien työhyvinvoinnista, 3) ikääntyvien sairaanhoitajien työhyvinvointia mittaavan mittarin kehittäminen, 4) substantiivisen teorian testaaminen teoreettiseksi malliksi empiirisen aineiston avulla ja 5) teoreettisen mallin toteutuminen suomalaisissa sairaaloissa. Substantiivinen teoria on luotu glaserilaisen grounded theory -metodologian avulla. Tutkimuksen kohteena ovat yliopistosairaalan sisätautien ja kirurgian klinikan 45–55-vuotiaat, yli 10 vuoden työkokemuksen omaavat ja kolmivuorotyötä tekevät sairaanhoitajat. Jatkuvan vertailun analyysilla analysoitu aineisto (n = 21) koostuu haastatteluista, päiväkirjoista ja avoimista tiedonkeruulomakkeista. Hoitajien työhyvinvointia on tarkasteltu systemaattisen kirjallisuuskatsauksen avulla, jonka aineisto koostui 21 kansainvälisestä tietokannoista kerätystä tieteellisestä alkuperäisjulkaisusta. Substantiivisen teorian perusteella on kehitetty mittari, jonka luotettavuutta testattiin empiirisen aineiston avulla. Mittarin ja kyselyaineiston avulla myös testattiin substantiivista teoriaa. Aineisto (n = 328) kerättiin vuosina 1948–1962 syntyneiltä ja eri puolella Suomea sairaaloissa työskenteleviltä sairaanhoitajilta. Aineisto analysoitiin eksploratiivisella faktorianalyysilla (pääkomponenttianalyysi). Toisen empiirisen kyselyaineiston (n = 285) avulla tarkasteltiin teoreettisen mallin toteutumista suomalaisissa sairaalaorganisaatioissa ikääntyvien sairaanhoitajien työssä. Teoreettisen mallin mukaan ikääntyvien sairaanhoitajien työhyvinvointi rakentuu hoitajavastavuoroisuudesta, potilasvastavuoroisuudesta ja hoitajien työn asenneperustasta. Hoitajavastavuoroisuus koostuu työn mielekkyydestä, auttamisesta, asemasta työssä, yhteisöllisyydestä, vapaudesta, parityöstä ja yhdessäolosta. Potilasvastavuoroisuus rakentuu potilaiden tyytyväisyydestä, hyvin tehdystä hoitotyöstä sekä potilaiden kohtaamisesta ja auttamisesta. Sairaanhoitajien työn asenneperusta sisältää potilaan hyvän hoitamisen, hoitajuuden arvostamisen ja potilaan ensisijaistamisen. Teoreettinen malli toteutuu sairaalaorganisaatioissa hyvin: merkittävin ristiriita on havaittavissa liittyen hyvin tehdyn hoitotyön tärkeyteen, mutta heikkoon toteutumiseen. Tutkimuksen tulokset nostavat uudella tavalla keskiöön arvostavan vastavuoroisuuden merkityksen sairaanhoitajien työhyvinvoinnille. Tutkimuksen tuottamaa tietoa voidaan hyödyntää ikääntyvien sairaanhoitajien työhyvinvoinnin edistämisessä sekä yksilö- että organisaatiotason haasteisiin vastaamisessa. Tutkimuksen tulokset ovat hyödynnettävissä käytännön hoitotyössä, hoitotyön johtamisessa ja koulutuksessa sekä työhyvinvoinnin tutkimuksessa.

M.Tech. (Public Health) / Please refer to full text to view abstract