Violência laboral em enfermeiras: explicações e estratégias de enfrentamento

This study explored part of the experience of occupational harassment, experienced by thirteen Chilean nurses, analyzing the relationship between the explanations and their coping strategies, to formulate a comprehensive model that includes the involved elements and that can be used to develop preventive strategies. Data were collected through semi-structured interviews, using theoretical saturation as the ending criterion and were analyzed according to the procedures of Grounded Theory. The relational analysis shows the influence of factors that perpetuate the phenomenon, both the organizational factors and the ones related to the execution of professional roles. According to the comprehensive model, this kind of violence is a circular phenomenon, in which the involved elements influence each other and are related to the narrative constructions of the phenomenon and to contextual elements, which can also be considered as part of the most probable cause of it.El objetivo del estudio fue explorar parte de la experiencia de hostigamiento laboral vivida por trece enfermeras chilenas, analizando la relación entre sus explicaciones y sus estrategias de afrontamiento, para luego formular un modelo comprensivo que contenga los elementos involucrados y que pueda utilizarse para desarrollar estrategias preventivas. Los datos se recolectaron a través de entrevistas semi estructuradas utilizando como criterio de finalización la saturación teórica y se analizaron según los procedimientos de la Grounded Theory. El análisis relacional muestra la influencia de factores que perpetuán el fenómeno, tanto los organizacionales como los relativos a la ejecución del rol profesional; utilizando el modelo comprensivo se postula que este tipo de violencia es un fenómeno circular, en el cual los elementos intervinientes se influyen mutuamente relacionándose con las construcciones narrativas del fenómeno y con los elementos contextuales, los cuales también pueden considerarse como parte de la causalidad más próxima del mismo.O objetivo do estudo foi explorar parte da experiência do assédio laboral, vivenciado por treze enfermeiras chilenas, analisando a relação entre as explicações e as estratégias de enfrentamento, para formular um modelo compreensivo que inclua os elementos envolvidos e que possa ser utilizado para desenvolver estratégias preventivas. Os dados foram coletados através de entrevistas semiestruturadas, utilizando como critério de finalização a saturação teórica e analisados segundo os procedimentos da Grounded Theory. A análise relacional mostra a influência de fatores perpetuantes do fenômeno, também dos fatores organizacionais e dos relacionados à execução do papel profissional. A partir do modelo compreensivo se postula que esse tipo de violência é fenômeno circular, no qual os elementos envolvidos se influenciariam e se relacionariam com as construções narrativas do fenômeno e com elementos contextuais, todos podem, também, ser considerados como parte da causalidade mais provável do mesmo

Hostigamiento Laboral: amenaza permanente para enfermería

Harassment in the workplace is defined as a situation where a person is repeatedly the object of negative acts in the workplace from which he/she cannot defend, with potential consequences being so serious to him/her that they have been catalogued as one of the most severe forms of social stress that it is possible to face.International evidence suggests that a quarter of violence in the workplace is directed towards health workers, especially against nurses. In Chile, there is little evidence to account for the harassment of nurses. For that reason the aim of this research is to describe using qualitative methodology the factors involved in the occurrence this phenomenon and support for the nurses who have been victims of it.The results show that the factors that directly influence the development of the cycle of violence are the characteristics of the organization and the form of development in the professional role. On the other hand, the ways in which the nurses describe the facts, the consequences and the reactions of the witnesses would prolong the harassment.El hostigamiento laboral es definido como una situación donde una persona es, repetidamente en el tiempo, objeto de actos negativos en el trabajo y de los cuales no puede defenderse, siendo tan graves sus consecuencias potenciales que se lo ha catalogado como una de las formas de estrés social más severo que se puede enfrentar. La evidencia internacional sugiere que la cuarta parte de la violencia laboral se dirige contra trabajadores del sector salud y en especial contra las enfermeras. En Chile existe escasa evidencia que de cuenta de la realidad del hostigamiento laboral en enfermería, razón por la cual el objetivo de esta investigación es describir, usando metodología cualitativa, los factores involucrados en la ocurrencia y mantención de este fenómeno a partir de las experiencias de enfermeras que han sido víctimas de él. Los principales resultados muestran que tanto elementos organizacionales como relativos a la ejecución del rol profesional actuarían como agentes favorecedores del hostigamiento laboral e influirían directamente en el desarrollo del ciclo de violencia. Por otro lado, las formas en que las enfermeras describen los hechos, las consecuencias en las mismas y las reacciones de los testigos influirían en la mantención del hostigamiento en el tiempo

Occupational Violence in Nursing: Explanations and Coping Strategies 1 Violência laboral em enfermeiras: explicações e estratégias de enfrentamento

This study explored part of the experience of occupational harassment, experienced by thirteen Chilean nurses, analyzing the relationship between the explanations and their coping strategies, to formulate a comprehensive model that includes the involved elements and that can be used to develop preventive strategies. Data were collected through semistructured interviews, using theoretical saturation as the ending criterion and were analyzed according to the procedures of Grounded Theory. The relational analysis shows the influence of factors that perpetuate the phenomenon, both the organizational factors and the ones related to the execution of professional roles. According to the comprehensive model, this kind of violence is a circular phenomenon, in which the involved elements influence each other and are related to the narrative constructions of the phenomenon and to contextual elements, which can also be considered as part of the most probable cause of it. Descriptors: Adaptation, Psychological; Nurses, Male; Occupational Health. Violencia laboral en enfermeras: explicaciones y estrategias de afrontamiento El objetivo del estudio fue explorar parte de la experiencia de hostigamiento laboral vivida por trece enfermeras chilenas, analizando la relación entre sus explicaciones y sus estrategias de afrontamiento, para luego formular un modelo comprensivo que contenga los elementos involucrados y que pueda utilizarse para desarrollar estrategias preventivas. Los datos se recolectaron a través de entrevistas semi estructuradas utilizando como criterio de finalización la saturación teórica y se analizaron según los procedimientos de la Grounded Theory. El análisis relacional muestra la influencia de factores que perpetuán el fenómeno, tanto los organizacionales como los relativos a la ejecución del rol profesional; utilizando el modelo comprensivo se postula que este tipo de violencia es un fenómeno circular, en el cual los elementos intervinientes se influyen mutuamente relacionándose con las construcciones narrativas del fenómeno y con los elementos contextuales, los cuales también pueden considerarse como parte de la causalidad más próxima del mismo. Descriptores: Adaptación Psicológica; Enfermeros; Salud Laboral. Introduction Mobbing is an occupational situation in which someone is the object of negative, intentional, persistent and repetitive actions, characterized by the asymmetry of the relationship, the relative difference of power between victim and harasser and the absence of visible sequelae, except for the psychological deterioration of the victim International evidence suggest high rates of mobbing against nurses Among its consequences, higher rates of accidents, long medical leaves, isolation, alterations in physical and mental health, changes in social relationships and in the attention needed to execute 158 Rev. Latino-Am. Enfermagem 2011 Jan-Feb;19(1):156-63. www.eerp.usp.br/rlae the job are described Thus, this study explores a part of the phenomenon and analyzes the explanations regarding harassment given by nurses who were victims of it and how they are related to their coping strategies, in order to formulate a comprehensive model that accounts for the elements involved and that can be used to develop prevention strategies. Methods This is a retrospective, relational-analytic and qualitative study, based on Grounded Theory (12) . This method is useful to explore new study fields or In light of these codifications, modifications were made to the interview guide to deepen some themes, a procedure which was repeated with the analysis of the following interviews. The criteria to end the interview was theoretical saturation (12) . The organization and analysis was done manually according to the procedures of Grounded Theory. Open codification was used to identify the emerging concepts, their properties and dimensions. For the relational analytic analysis, two axial codifications were carried out in related categories and subcategories into agglutinating axis and one selective codification to integrate the main categories into a wider theoretical scheme that permitted formulating an explicative model (12) . To decrease researcher's bias, the relevant categories were determined according to the results brought by the interviews, the bibliographical background and triangulation by experts. The confidentiality of information, the autonomy of the participants and the protection of their dignity was assured by getting free and informed consent, approved for the Research Project n o 0702005010 (Purdue University Institutional Review Board). Results The participants, at the time they were victims of mobbing, were aged between 23 and 56 years. Most were single, worked in public and private services, outpatient clinics and hospitals. The average performance on the job was 3.9 years (from 6 months to 14 years) and the average duration of harassment was 19 months (2 to 84 months). Among the harassers, 11 were nurses, of which 9 worked as chief nurses. According to the coordination of these elements, the professional role of nurses is performed following different standards that are able to deal with the concrete reality of building the role and the paradigms that they recognize as theirs and that distinguish the profession. They also distinguish personal characteristics that influence the execution of the role and the occupational relationship styles: it is possible to differentiate those that highlight subordination or authoritarianism and the two patterns to develop the work, the first establishing horizontal teamwork relationships with closeness and the second one that highlights the vertical feature of the relationships, keeping them apart from their partners. In this kind of work relationship, hostile actions are characterized as being hidden, reiterated, persistent over time and comprising the personal and professional aspects of the victim, being the object of intimidating and threatening actions, mostly related to verbal insults and rumors about their personal life. In the professional area, the actions try to make the performance and development of work difficult, hide relevant information and threaten the professional status of the victim. It was as if you felt that they were talking about you, that they are trying to cause you harm, but you do not see anybody… (Nurse 5). Due to the ceaselessness and reiteration over time of the attacks, the victims use coping strategies that try to end with harassment by confronting or revealing it (active), or decreasing the contacts with the harasser and abandoning the conduct (passive). It is observed that many times they change from active to passive and vice versa, due to the unfruitful results of the first trials of resolution

Harassment in the workplace: A permanent threat for nursing

El hostigamiento laboral es definido como una situación donde una persona es, repetidamente en el tiempo, objeto de actos negativos en el trabajo y de los cuales no puede defenderse, siendo tan graves sus consecuencias potenciales que se lo ha catalogado como una de las formas de estrés social más severo que se puede enfrentar. La evidencia internacional sugiere que la cuarta parte de la violencia laboral se dirige contra trabajadores del sector salud y en especial contra las enfermeras. En Chile existe escasa evidencia que dé cuenta de la realidad del hostigamiento laboral en enfermería, razón por la cual el objetivo de esta investigación es describir, usando metodología cualitativa, los factores involucrados en la ocurrencia y mantención de este fenómeno a partir de las experiencias de enfermeras que han sido víctimas de él. Los principales resultados muestran que tanto elementos organizacionales como relativos a la ejecución del rol profesional actuarían como agentes favorecedores del hostigamiento laboral e influirían directamente en el desarrollo del ciclo de violencia. Por otro lado, las formas en que las enfermeras describen los hechos, las consecuencias en las mismas y las reacciones de los testigos influirían en la mantención del hostigamiento en el tiempo.Harassment in the workplace is defined as a situation where a person is repeatedly the object of negative acts in the workplace from which he/she cannot defend, with potential consequences being so serious to him/her that they have been catalogued as one of the most severe forms of social stress that it is possible to face. International evidence suggests that a quarter of violence in the workplace is directed towards health workers, especially against nurses. In Chile, there is little evidence to account for the harassment of nurses. For that reason the aim of this research is to describe using qualitative methodology the factors involved in the occurrence this phenomenon and support for the nurses who have been victims of it. The results show that the factors that directly influence the development of the cycle of violence are the characteristics of the organization and the form of development in the professional role. On the other hand, the ways in which the nurses describe the facts, the consequences and the reactions of the witnesses would prolong the harassment

Occupational violence in nursing: explanations and coping strategies

This study explored part of the experience of occupational harassment, experienced by thirteen Chilean nurses, analyzing the relationship between the explanations and their coping strategies, to formulate a comprehensive model that includes the involved elements and that can be used to develop preventive strategies. Data were collected through semi-structured interviews, using theoretical saturation as the ending criterion and were analyzed according to the procedures of Grounded Theory. The relational analysis shows the influence of factors that perpetuate the phenomenon, both the organizational factors and the ones related to the execution of professional roles. According to the comprehensive model, this kind of violence is a circular phenomenon, in which the involved elements influence each other and are related to the narrative constructions of the phenomenon and to contextual elements, which can also be considered as part of the most probable cause of it

Comunicación entre equipo de enfermería y pacientes con ventilación mecánica invasiva en una unidad de paciente crítico

Communication, in this case, is based on the use of tools and involves reciprocal interaction between two parties. The use of mechanical ventilation in intensive care units generates patient-specific conditions that impede communication. A lack of communication between the nursing team and mechanically-ventilated patients is attributed to a variety of barriers and produces negative effects that can have an impact on the patient’s recovery and comfort. Objective: The study was conducted to become familiar with the characteristics of communication between mechanically-ventilated patients and the nursing team. Method: The elements of the grounded theory method were applied to the analytical process, and focus groups of nurses and nursing technicians who provide care directly to mechanically-ventilated patients in an ICU were used to gather the data. Results: The findings provide a description of the main features of communication with these patients by identifying the ways and means of communicating used by the nursing team, the moments when communication occurs, and the benefits and barriers perceived by the participant group. However, it was not possible to establish a central category with the structures and definitions of the process within it, which will require new research. Conclusion: The findings are expected to contribute to the body of nursing knowledge and to help reinforce the management of care provided by ICU nursing teams.A comunicação se baseia na utilização de ferramentas e envolve a interação recíproca de dois interlocutores. Nas Unidades de Tratamento Intensivo (UTI), a aplicação de ventilação mecânica invasiva (VMI), gera condições especiais no paciente que dificultam sua comunicação. A ausência de comunicação entre a equipe de enfermagem (EE) e os pacientes com VMI é atribuída a múltiplas barreiras e produz efeitos negativos que afetam a recuperação e o bem-estar. Objetivo: conhecer as características da comunicação com pacientes com VMI que aplica elementos da Teoria Fundada para o processo de análise e que utilizou como técnica de coleta de dados grupos focais de enfermeiras e técnicos de enfermagem que realizam cuidado direto a pacientes com VMI em uma UTI. Método: projeto de pesquisa qualitativa, orientada pela teoria fundamentada, para a análise e associação de conceitos, que utilizou grupos focais como técnica de coleta de dados. Resultados: embora as constatações permitam descrever as principais características da comunicação com esses pacientes, ao identificar os meios e as formas utilizados pela EE para fazer isso, os momentos em que ocorre a comunicação, os benefícios e as barreiras percebidas pelo grupo de participantes, não se chega a estabelecer uma categoria central com as estruturas e definições do processo dentro desta, para o qual se requereriam novas pesquisas. A partir dessas constatações, espera-se contribuir ao corpo de conhecimentos da disciplina de enfermagem e fortalecer a gestão do cuidado que realiza a EE nas UTI.La comunicación se basa en la utilización de herramientas e involucra la interacción recíproca de dos interlocutores. En las Unidades de Cuidados Intensivo (UCI), la aplicación de ventilación mecánica invasiva (VMI), genera condiciones especiales en el paciente que dificultan su comunicación. La ausencia de comunicación entre el equipo de enfermería (EE) y los pacientes con VMI es atribuida a múltiples barreras y produce efectos negativos que afectan la recuperación y el bienestar. Objetivo: conocer las características de la comunicación con pacientes con VMI que aplica elementos de la Teoría Fundada para el proceso de análisis y que utilizó como técnica de recolección de datos grupos focales de enfermeras y técnicos de enfermería que realizan cuidado directo a pacientes con VMI en una UCI. Método: Investigación de diseño cualitativo, orientada por la Teoría Fundada, para el análisis y la asociación de conceptos, que utilizó grupos focales como técnica de recolección de la información.  Resultados: si bien los hallazgos permiten describir las principales características de la comunicación con estos pacientes identificando los medios y las formas utilizados por el EE para hacerlo, los momentos en que ocurre la comunicación, los beneficios y las barreras percibidas por el grupo de participantes, no se llega a establecer una categoría central con las estructuras y definiciones del proceso dentro de la misma, para lo que se requerirían nuevas investigaciones. Conclusión: a partir de estos hallazgos se espera contribuir al cuerpo de conocimientos de la disciplina de enfermería y fortalecer la gestión del cuidado que realiza el EE en las UCI.

Enfermería para el auto cuidado en personas con problemas del sueño

The objective of this research is to know the perception of effectiveness of the Self Care Nursing Program in adults with sleep disorders treated in the Medical Sleep Center of the Catholic University of Chile (CEMS) between 1999 and 2000, in Santiago de Chile. It is a descriptive, exploratory, retrospective study, with a sample of 25 adults, constituted in a 72 % by women, 52% of people has between 20 and 39 years, 78% classify in a high and medium- high socio-economic level, the 100% have complete high school education, and the most frequently sleep problem is the conciliation insomnia. More of 80% consumes sleeping pills, 85 % of them refers to have diminished the doses during and after attending the Self-Care Nursing Program. 84% of the interviewed people at the moment uses some of the learned techniques: 36% sleep hygiene, 12% relaxation and imaginary and 36% both. 80% perceived as benefits of the nursing Program the improvement in the quality of the sleep and a sensation of serenity and tranquillity in their daily live, by that is better quality of life.El objetivo de la presente investigación es conocer la percepción de la eficacia del Programa de Enfermería para el Autocuidado de adultos con problemas del sueño atendidos en el Centro de Estudios Médicos del Sueño de la Universidad Católica de Chile (CEMS), entre los años 1999 y 2000, en Santiago de Chile. Es un estudio descriptivo, exploratorio, retrospectivo, en una muestra de 25 adultos, constituida en un 72% por mujeres. 52% de los entrevistados tiene entre 20 y 39 años, el 78% se clasifica en un nivel socio económico alto y medio-alto, el 100% tiene enseñanza secundaria completa y el problema de sueño más frecuente es el insomnio de conciliación. Más del 80% consume medicamentos para dormir, de ellos el 85% refiere haber disminuido las dosis durante y después de haber asistido al Programa de Enfermería para el Autocuidado. El 84% de los entrevistados usa actualmente alguna de las técnicas aprendidas: 36% higiene del sueño, 12% relajación e imaginería y otro 36%, ambas. El 80% percibió como beneficios del Programa la mejoría en la calidad del sueño y una sensación de mayor serenidad y tranquilidad en su diario vivir, por lo mismo una mejor calidad de vida