APPENDIX A: RAW DATA COLLECTED FROM SELECTED STUDIES

APPENDIX A: RAW DATA COLLECTED FROM SELECTED STUDIE

Comparison of wearable measurement systems for estimating trunk postures in manual material handling, A

2017 Fall.Includes bibliographical references.Epidemiologic studies have established that awkward trunk postures during manual materials handling are associated with an increased risk of developing occupational low back disorders. With recent advances in motion capture technology, emerging wearable measurement systems have been designed to quantify trunk postures for exposure assessments. Wearable measurement systems integrate portable microelectromechanical sensors, real-time processing algorithms, and large memory capacity to effectively quantify trunk postures. Wearable measurement systems have been available primarily as research tools, but are now quickly becoming accessible to health and safety professionals for industrial application. Although some of these systems can be highly complex and deter health and safety professionals from using them, other systems can serve as a simpler, more user-friendly alternative. These simple wearable measurement systems are designed to be less intricate, allowing health and safety professionals to be more willing to utilize them in occupational posture assessments. Unfortunately, concerns regarding the comparability and agreement between simple and complex wearable measurement systems for estimating trunk postures are yet to be fully addressed. Furthermore, application of wearable measurement systems has been affected by the lack of adaptability of sensor placement to work around obstructive equipment and bulky gear workers often wear on the job. The aims of the present study were to 1) compare the Bioharness™3, a simple wearable measurement system, to Xsens™, a complex wearable measurement system, for estimating trunk postures during simulated manual material handling tasks and 2) to explore the effects of Xsens sensor placement on assessing trunk postures. Thirty participants wore the two systems simultaneously during simulated tasks in the laboratory that involved reaching, lifting, lowering, and pushing a load for ten minutes. Results indicated that the Bioharness 3 and Xsens systems are comparable for strictly estimating trunk postures that involved flexion and extension of 30° or less. Although limited to a short range of trunk postures, the Bioharness also exhibited moderate to strong agreement and correlations with the Xsens system for measuring key metrics commonly used in exposure assessments, including amplitude probability distribution functions and percent time spent in specific trunk posture categories or bins. The Bioharness is suggested to be an a more intuitive alternative to the Xsens system for posture analysis, but industrial use of the device should be warranted in the context of the exposure assessment goals. In addition, a single motion sensor from the Xsens system placed on the sternum yielded comparable and consistent estimates to a sensor secured on the sternum relative to a motion sensor on the sacrum. Estimates included descriptive measures of trunk flexion and extension and percent time spent in specific trunk posture categories. Using one motion sensor instead of two may serve as an alternative for sensor placement configuration in situations where worker portable equipment or personal preference prevents preferred sensor placement

Efeito da simulação clínica de alta fidelidade na ansiedade e no estresse do discente de graduação em enfermagem

Orientador: Prof. Dr. Jorge Vínicius Cestari FélixCoorientadora: Profª Drª Maria de Fátima MantovaniDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação Mestrado Profissional em Enfermagem. Defesa: Curitiba, 14/02/2017Inclui referências : f.84-98Resumo: A simulação clínica de alta fidelidade é uma metodologia ativa que permite a vivência de situações quase reais de atendimento a pacientes, mediante a utilização de manequins com respostas fisiológicas. Ela favorece o desenvolvimento de habilidades e competências em estudantes da área da saúde, antes que estes tenham contato com pacientes reais. Nesta pesquisa objetivou-se avaliar o efeito do uso da simulação clínica de alta fidelidade na ansiedade e na percepção dos fatores estressores do discente de graduação em enfermagem. Desenvolveu-se um ensaio clínico randomizado com estudantes do quarto período do curso de graduação em enfermagem de uma universidade pública da Região Sul do Brasil. Os participantes foram alocados em dois grupos: grupo controle (GC) - realizou aula convencional de laboratório seguida de prática clínica em ambiente hospitalar; grupo experimental (GE) - realizou simulação clínica de alta fidelidade seguida de prática clínica em ambiente hospitalar. Os participantes foram avaliados quanto aos fatores estressores, mediante o Kezkak, e a ansiedade, pelo Inventário de Ansiedade Traço-Estado, nos momentos antes e depois do laboratório e da primeira prática clínica em ambiente hospitalar. A amostra foi de 52 participantes, dos quais 25 no GC e 27 no GE. Houve predomínio de adultos jovens, do sexo feminino. O GC apresentou redução na percepção dos fatores estressores após a aula convencional de laboratório e após o contato com o paciente, enquanto no GE houve aumento depois da simulação e diminuição após o contato com o paciente. Além disso, antes do laboratório, a maioria do GC considerou quatro itens, relacionados à falta de competência e à relação com os professores e colegas, como muitíssimo estressante, enquanto o GE apontou apenas dois, ambos referentes à falta de competência. Os dois grupos apresentaram redução na percepção desses itens como estressores após o contato com o paciente. O GC apresentou aumento significativo da ansiedade antes do hospital, que se manteve após o hospital. Já o GE teve aumento significativo depois do laboratório e diminuição significativa depois do primeiro contato com o paciente. Assim, conclui-se que a estratégia de ensino com simulação de alta fidelidade provocou um aumento na percepção dos fatores estressores do discente de enfermagem e uma diminuição na ansiedade frente ao primeiro contato com o paciente real. O aumento da percepção dos fatores estressores dos alunos esteve relacionado ao aumento da sua capacidade de auto avaliação e reflexão crítica frente a sua responsabilidade com o aprendizado e com o paciente. Palavras-chaves: Simulação de alta fidelidade. Estudantes de Enfermagem. Ansiedade. Estresse Psicológico.Abstract: The high fidelity clinical simulation is an active methodology that allows the experience of almost actual situations of patient care, using mannequin with physiological responses. It favors the development of skills and competencies of students in health area before they have contact with actual patients. The objective of this research was to evaluate the effect of high fidelity clinical simulation on anxiety and on the perception of the stressors of undergraduate students in nursing. A randomized clinical trial was carried out with undergraduate students in nursing of fourth period from a public university in the southern region of Brazil. Participants were allocated into two groups: (a) control group (CG), which performed a conventional laboratory practice class, followed by clinical practice in a hospital environment; and (b) experimental group (EG), which performed clinical simulation of high fidelity, followed by clinical practice in a hospital environment. Participants were evaluated for stress factors through Kezkak, and for anxiety, by the Trait-State Anxiety Inventory at the moments before and after the laboratory practice, and at the first clinical practice in a hospital environment. The sample consisted of 52 participants, of whom 25 were in the CG and 27 in the EG. There was predominance of female young adults. The CG presented a reduction in the perception of the stressors after the conventional laboratory practice class and after the contact with patient, while in the EG there was increase in the perception of the stressors after the simulation and decrease after the contact with patient. Also, before the lab practice, most the CG participants considered four items, related to lack of competence and the relationship with teachers and classmates as very stressful, while the EG pointed only two, both regarding to the lack of competence. Both groups presented a reduction in the perception of these items as stressors after contact with patient. CG had a significant increase in anxiety before the hospital environment, and it was maintained after that. The EG had a significant increase after the laboratory practice and a significant decrease after the first contact with patient. Thus, it was concluded that the strategy of teaching with simulation of high fidelity provoked an increase in the perception of the stressors factors by the nursing student and a decrease in anxiety before the first contact with the actual patient. The increase in the perception of the stressors by the students was related to the increase of their capacity for self-evaluation and critical reflection regarding their responsibility to the learning and to the patient. Keywords: High fidelity simulation. Students, nursing. Anxiety. Stress, psychological

Preliminary Analysis of Physiological Changes of Nursing Students during Training

Abstract — Long-term exposure to stress has been associated with chronic diseases, depression, and immune disorders. The precise detection and assessment of stress depends on personalized physiological monitoring and assessment of influence of personal and workplace factors We monitored nursing students during training on a high fidelity simulator in the Real-time Physiological Monitoring Lab at the University of Alabama in Huntsville. In this paper we present the preliminary results of this pilot study. A total of 14 participants were recorded: 12 female and 2 male subjects, 23-46 years old with an average age of 32.8 years. We analyzed heart rate, Heart Rate Variability (HRV), respiration, and physical activity. The results indicate significant strain on subjects during simulation: heart rate increased 16.7%, from 82.8 to 96.6 bpm (p<0.001), falling to a slightly increased level after the training session (84.9 bpm); Root Mean Square of Successive RR Differences (RMSSD) decreased from 38.9 ms to 37.7 ms; the breathing rate increased during the simulation from 16.9 to 17.7 breaths/min. Distractions also significantly influenced physiological parameters: the first telephone call increased heart rate on average 9 bpm (p<0.001), while the second call increased heart rate 8.6 bpm (p<0.001). The simulated patient-related events created even more prominent response; the average heart rate increased 17.4 bpm (p<0.001) at the onset of “patient in crisis” event. Real-time wearable monitoring may provide assessment of occupational stress. I