The influence of job rotation in the job satisfaction of nurses in a surgical service =

Theoretical framework: Job satisfaction is associated with better performance, leading to an optimisation of healthcare. Objectives: To understand the influence of job rotation between units of the same service in the nurses’ job satisfaction. Methodology: Observational, analytic, cross-sectional and quantitative study using a questionnaire and subsequent bivariate descriptive statistical analysis. Results: Statistically significant results were found in the variables related to the nurse’s service, satisfaction with the number of shifts, pace of work, and technicality. The nurses who were very dissatisfied with the job rotation were professionally satisfied. On the other hand, the nurses who were very satisfied with the job rotation were somewhat professionally satisfied. Although no association was found between satisfaction and rotation, nurses informally expressed their dissatisfaction. Thus, a qualitative or mixed study should have been developed. Conclusion: The engagement of nurses in the decision-making process, particularly regarding the rotation system, should be continuously valued as it allows nurses to expand their field of action and achieve better results. Enquadramento: A satisfação profissional está associada a melhores resultados no trabalho permitindo uma otimização dos cuidados de saúde. Objectivos: Compreender a influência da rotação no trabalho, entre secções do mesmo serviço, na satisfação profissional dos enfermeiros. Metodologia: Estudo quantitativo, observacional, analítico e transversal, com recurso a 1 questionário e posterior análise estatística descritiva e bivariada dos dados. Resultados: Resultados referentes à proveniência do enfermeiro, satisfação com o número de turnos, ritmo de trabalho e tecnicidade, foram estatisticamente significativos. Os enfermeiros muito insatisfeitos com a rotação estavam profissionalmente satisfeitos. Por outro lado, os enfermeiros muito satisfeitos com a rotação estavam profissionalmente bastante satisfeitos. Não se verificou associação entre satisfação e rotação, mas denotou-se uma verbalização informal de insatisfação por parte dos enfermeiros, tornando-se ideal a realização de um estudo qualitativo ou misto. Conclusão: A participação dos enfermeiros no processo de tomada de decisão, nomeadamente quanto ao sistema de rotação, deve ser continuamente valorizada, uma vez que permite ao trabalhador expandir o seu campo de ação e atingir melhores resultados.publishersversionpublishe

Understanding nurses' dual practice: A scoping review of what we know and what we still need to ask on nurses holding multiple jobs

© 2018 The Author(s). Background: Mounting evidence suggests that holding multiple concurrent jobs in public and private (dual practice) is common among health workers in low- as well as high-income countries. Nurses are world's largest health professional workforce and a critical resource for achieving Universal Health Coverage. Nonetheless, little is known about nurses' engagement with dual practice. Methods: We conducted a scoping review of the literature on nurses' dual practice with the objective of generating hypotheses on its nature and consequences, and define a research agenda on the phenomenon. The Arksey and O'Malley's methodological steps were followed to develop the research questions, identify relevant studies, include/exclude studies, extract the data, and report the findings. PRISMA guidelines were additionally used to conduct the review and report on results. Results: Of the initial 194 records identified, a total of 35 met the inclusion criteria for nurses' dual practice; the vast majority (65%) were peer-reviewed publications, followed by nursing magazine publications (19%), reports, and doctoral dissertations. Twenty publications focused on high-income countries, 16 on low- or middle-income ones, and two had a multi country perspective. Although holding multiple jobs not always amounted to dual practice, several ways were found for public-sector nurses to engage concomitantly in public and private employments, in regulated as well as in informal, casual fashions. Some of these forms were reported as particularly prevalent, from over 50% in Australia, Canada, and the UK, to 28% in South Africa. The opportunity to increase a meagre salary, but also a dissatisfaction with the main job and the flexibility offered by multiple job-holding arrangements, were among the reported reasons for engaging in these practices. Discussion and conclusions: Limited and mostly circumstantial evidence exists on nurses' dual practice, with the few existing studies suggesting that the phenomenon is likely to be very common and carry implications for health systems and nurses' welfare worldwide. We offer an agenda for future research to consolidate the existing evidence and to further explore nurses' motivation; without a better understanding of nurse dual practice, thiswill continue to be a largely 'hidden' element in nursing workforce policy and practice, with an unclear impact on the delivery of care

a quasi-experimental study

Funding Information: This study was elaborated based on the work of Miguelhete Lisboa doctoral program, a Fundação Calouste Gulbenkian scholarship holder, and used grants obtained from The Special Programme for Research and Training in Tropical Diseases (TDR) and co-sponsored by the United Nations Children’s Fund (UNICEF), United Nations Development Programme (UNDP), World Bank, and World Health Organization (WHO)—award ID number: B40151/ 2014. The FCG and WHO/TDR were not involved in the design of the study and collection; analysis and interpretation of data; and writing the manuscript; therefore, the authors are responsible for all information. Publisher Copyright: © 2020 The Author(s).Background In-hospital logistic management barriers (LMB) are considered to be important risk factors for delays in TB diagnosis and treatment initiation (TB-dt), which perpetuates TB transmission and the development of TB morbidity and mortality. We assessed the contribution of hospital auxiliary workers (HAWs) and 24-h TB laboratory services using Xpert (24h-Xpert) on the delays in TB-dt and TB mortality at Beira Central Hospital, Mozambique. Methods A quasi-experimental design was used. Implementation strategy—HAWs and laboratory technicians were selected and trained, accordingly. Interventions—having trained HAW and TB laboratory technicians as expediters of TB LMB issues and assurer of 24h-Xpert, respectively. Implementation outcomes—time from hospital admission to sputum examination results, time from hospital admission to treatment initiation, proportion of same-day TB cases diagnosed, initiated TB treatment, and TB patient with unfavorable outcome after hospitalization (hospital TB mortality). A nonparametric test was used to test the differences between groups and adjusted OR (95% CI) were computed using multivariate logistic regression. Results We recruited 522 TB patients. Median (IQR) age was 34 (16) years, and 52% were from intervention site, 58% males, 60% new case of TB, 12% MDR-TB, 72% TB/HIV co-infected, and 43% on HIV treatment at admission. In the intervention hospital, 93% of patients had same-day TB-dt in comparison with a median (IQR) time of 15 (2) days in the control hospital. TB mortality in the intervention hospital was lower than that in the control hospital (13% vs 49%). TB patients admitted to the intervention hospital were nine times more likely to obtain an early laboratory diagnosis of TB, six times more likely to reduce delays in TB treatment initiation, and eight times less likely to die, when compared to those who were admitted to the control hospital, adjusting for other factors. Conclusion In-hospital delays in TB-dt and high TB mortality in Mozambique are common and probably due, in part, to LMB amenable to poor-quality TB care. Task shifting of TB logistic management services to HAWs and lower laboratory technicians, to ensure 24h-Xpert through “on-the-spot strategy,” may contribute to timely TB detection, proper treatment, and reduction of TB mortality.publishersversionpublishe

healthcare workers’ perspective from Beira, Mozambique

Funding Information: This study was elaborated based on the work of first Miguelhete Lisboa?s doctoral program, a Funda??o Calouste Gulbenkian (FCG) scholarship holder (ID: P-135647/SBG/2014) and, used grants obtained from World Health Organization, The Special Programme for Research and Training in Tropical Diseases (WHO/TDR) and co-sponsored by the United Nations Children?s Fund, United Nations Development Programme, World Bank and WHO ? award ID number: B40151/2014. The FCG and WHO/TDR were neither involved in the design of the study and collection, analysis, interpretation of data, nor in the writing of manuscript or decision to publish. Therefore, the authors are responsible for all information. The authors acknowledge the Tutorial Commission of the doctoral program of Miguelhete Lisboa (Professors Sonia Dias and Miguel Viveiros at Instituto de Higiene e Medicina Tropical Universidade Nova de Lisboa, Portugal); people who helped in the collection and data management: Marques Nhamonga, Joaquim Lequechane and Estefano Colove; the Centro de Investiga??o Operacional da Beira directorate and all colleagues, the Beira Central Hospital directorate and all healthcare workers. Publisher Copyright: © 2020 Lisboa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Background: Mozambique is one of the countries with the deadly implementation gaps in the tuberculosis (TB) care and services delivery. In-hospital delays in TB diagnosis and treatment, transmission and mortality still persist, in part, due to poor-quality of TB care cascade. Objective: We aimed to assess, from the healthcare workers’ (HCW) perspective, factors associated with poor-quality TB care cascade and explore local sustainable suggestions to improve in-hospital TB management. Methods: In-depth interviews and focus group discussions were conducted with different categories of HCW. Audio-recording and written notes were taken, and content analysis was performed through atlas.ti7. Results: Bottlenecks within hospital TB care cascade, lack of TB staff and task shifting, centralized and limited time of TB laboratory services, and fear of healthcare workers getting infected by TB were mentioned to be the main factors associated with implementation gaps. Interviewees believe that task shifting from nurses to hospital auxiliary workers, and from higher and well-trained to lower HCW are accepted and feasible. The expansion and use of molecular TB diagnostic tools are seen by the interviewees as a proper way to fight effectively against both sensitive and MDR TB. Ensuring provision of N95 respiratory masks is believed to be an essential requirement for effective engagement of the HCW on high-quality in-hospital TB care. For monitoring and evaluation, TB quality improvement teams in each health facility are considered to be an added value. Conclusion: Shortage of resources within the national TB control programme is one of the potential factors for poor-quality of the TB care cascade. Task shifting of TB care and services delivery, decentralization of the molecular TB diagnostic tools, and regular provision of N95 respiratory masks should contribute not just to reduce the impact of resource scarceness, but also to ensure proper TB diagnosis and treatment to both sensitive and MDR TB.publishersversionpublishe

A scoping review

Objective: to map scientific evidence on the extent of tuberculosis in migrants from the international borders between Brazil and the countries of South America. Design: Scoping review of quantitative, qualitative and mixed studies. The research was conducted between February and April 2021. The terms “migrants”, “tuberculosis”, “Brazil”, “Uruguay”, “Paraguay”, “Bolivia”, “Peru”, “British Guiana” “English Guiana”, “French Guiana”, “Suriname”, “Venezuela”, “Argentina”, “Colombia” combined with Boolean operators “AND” and “OR” to identified relevant documents. Studies addressing tuberculosis on migrants from international borders of Brazil were included. Pubmed Central (PMC), LILACS (Scientific and technical literature of Latin America and the Caribbean/BVS), Scopus (Elsevier), Scielo (Scientific Electronic Library Online) and gray literature CAPES thesis database were searched. The study was carried out in three stages where the data was selected and extracted by two independent reviewers for full reading. Results: A total of 705 articles were extracted from the databases chosen for the search, 04 master's dissertations and 01 doctoral thesis. Of these 456 were excluded because they did not meet at least one of the eligibility criteria for this SR and 4 were further excluded because they were duplicates who had not been previously identified. A total of 58 documents were, thus, selected for assessment of the full text. Of these, 40 were further excluded for not meeting at least one of the eligibility criteria. A total of 18 studies were included for data collection: 15 articles, 2 master's dissertations and 1 doctoral thesis, produced between 2002 and 2021. Conclusion: This scoping review mapped the existing evidence on tuberculosis at the international borders of Brazil and on access of immigrants with tuberculosis to health services in Brazil. Descriptors: tuberculosis; immigrants; public health surveillance; epidemiological surveillance; sanitary control of borders; health services accessibility.publishersversionpublishe

evolução entre 2007 e 2016

Introdução: O contexto de formação dos médicos e as suas expetativas em relação à vida profissional são fundamentais para planear a distribuição, retenção e motivação da força de trabalho em saúde. Neste estudo, comparámos a evolução das expetativas profissionais dos alunos de medicina da Guiné-Bissau entre 2007 e 2016. Material e métodos: Comparámos os resultados de dois estudos trans-versais descritivos, obtidos através de um questionário. Procedeu-se a análise estatística e análise de conteúdo dos dados .Resultados: Em ambos os anos, os alunos eram maioritariamente homens, tinham familiares profissionais de saúde, tinham realizado o percurso escolar em Bissau, tencionavam trabalhar no hospital e no sector público. Em 2016, a proporção daqueles dispostos a trabalhar fora de Bissau aumentou. Ainda não se tinham decidido acerca da especialização e tinham expetativas elevadas relativamente aos rendimentos. Discussão: Apesar da forte orientação para o setor hospitalar, houve um aumento da disponibilidade para trabalhar na periferia, o que pode constituir uma oportunidade de adequação entre aquilo que são as necessidades dos sistemas de saúde e as expetativas dos futuros profissionais. As ambições salariais devem ser trabalhadas a nível da formação e das instituições responsáveis pela política de recursos humanos, com possíveis efeitos nefastos para os jovens profissionais caso tal não aconteça. A decisão mais tardia por uma especialidade representa uma oportunidade de convergência com as prioridades da estratégia nacional de saúde. Conclusão: Não se verificaram grandes alterações nas expetativas profissionais dos jovens estudantes de medicina da Guiné-Bissau entre 2007 e 2016 Background: The context where medical students are trained and their expectations towards professional life are paramount to plan the distribution, retention and motivation of the health workforce. In this study we compare the evolution of professional expectations of medical students of Guinea-Bissau, between 2007 and 2016.Material and Methods: We compare the results of two descriptive, cross-sectional studies where we applied a questionnaire. We conducted descriptive statistical analysis and content analysis. Results: In both years, most students were men, had family members who were health professionals, had attended school in Bissau, intended to work in the hospital and in the public sector. In 2016, the proportion of those willing to work outside Bissau had increased. They had not yet decided on the area of specialization and had high expectations towards futures earnings. Discussion: Despite the strong orientation towards hospital among, there was an increase in the proportion of students willing to work outside Bissau which presents an opportunity to bridge the gap between the needs of the health system and the expectations of future doctors. The expectations on future earnings should be worked at training level and in the institutions responsible for the planning of the health workforce to avoid detrimental effects on young doctors. The postponement of a decision on the area of specialization might present an opportunity of convergence with the national health strategy. Conclusion: No major changes occurred in the professional expectations of medical students of Guinea Bissau, between 2007 and 2016.publishersversionpublishe

Digital health literacy and online information queries in Portuguese university students

Supplement to the European Journal of Public Health which contains the abstracts of presentations at the 14th European Public Health (EPH) Conference «Public health futures in a changing world», held online 10-12 November 2021. Section: 1.G. Workshop: COVID-HL: A global survey on digital health literacy in university students during the pandemicBackground Worldwide there is an overwhelming amount of information about COVID-19 circulating online, also named infodemic. Misinformation (the unintentional) and disinformation (the intentional) spreading of false information have proven to be very dangerous to public health. Hence, more than ever, people need skills for searching, evaluating and integrating information related to health in daily life, i.e., health literacy. Until now, little is known about the digital health literacy of university students and their information-seeking behaviour. Hence, this study aimed to analyse the associations between university students' digital health literacy and online information queries during the beginning of the COVID-19 pandemic (and infodemic) in Portugal. Methods A cross-sectional study of 3.084 Portuguese university students (75.7% females), with an average age of 24.2 (SD = 7.5), was conducted using an online survey. We used sociodemographic data (sex, age, subjective social status) and the digital health literacy questionnaire adapted to the specific COVID-19 context. Online information queries included the topics related to SARS-CoV-2 and COVID-19 searched by students. Logistic regression models were performed. Results Online information queries (e.g., individual measures to protect against infection, current spread of the virus, current situation assessments and recommendations) were associated with an increased odds of achieving sufficient digital health literacy. Conclusions Online information queries related to epidemiological and public health topics are significantly associated with digital health literacy in times of COVID-19. Further studies are needed, including programs that improve digital health literacy among university students and increase the availability of high-quality content information.publishersversionpublishe

comparação dos perfis dos alunos de diferentes cursos (medicina, enfermagem e TDT), em diferentes níveis de ensino (básico, médio e superior)

Introdução: Descrevemos a evolução da formação de técnicos de saúde (TdS) em Angola e verificamos que o Plano de Desenvolvimento de Recursos Humanos (PDRH) 1997-2007 teve um profundo impacto no desenvolvimento da formação da força de trabalho em saúde em Angola. Este artigo relata um estudo feito no âmbito da elaboração do segundo PDRH 2013-2025 tendo por objetivo obter dados comparáveis sobre o perfil dos estudantes que frequentavam os diferentes cursos de ciências da saúde em Angola. Métodos: A metodologia foi baseada na utlizada em estudos semelhantes noutros países lusófonos e em Angola em 2007. O estudo decorreu no primeiro quadrimestre de 2014 subcontratado a uma empresa especializada. Os dados foram inseridos em SPSS v.20 em 2014 e estatísticas descritivas (contagem, frequência relativa, média e desvio padrão e medianas) foram calculadas com SPSS v 25 durante 2020. Resultados: Os resultados do estudo revelam uma mensagem positiva. Os alunos foram recrutados com uma ampla base geográfica; estavam satisfeitos com a escolha da formação e o seu desempenho era, em geral, satisfatório, embora a percentagem de estudantes de técnicas de diagnóstico e terapêutica (TDT) com disciplinas em atraso mereça atenção. Após a formação pretendiam estabelecer-se em Angola, de preferência numa prática hospitalar, de preferência na rede pública. Como o setor público não tem capacidade para absorver todos os alunos, é gratificante constatar que muitos estavam abertos à prática no setor privado, principalmente nas capitais provinciais ou nacionais, preferencialmente em acumulação com trabalhos do setor público. Discussão e conclusões: Em fim de ciclo do Plano Nacional de Formação de Quadros 2013-2020, este estudo destaca algumas das questões que terão de ser abordadas pelas instituições de formação a fim de contribuir para uma força de trabalho de saúde equilibrada em Angola, com TdS em quantidade com a qualidade e distribuição necessárias para dar reposta às necessidades do sistema de saúde e da população. Introduction: We describe the evolution of the training of health technicians (HT) in Angola and find that the Human Resources Development Plan (HRDP) 1997-2007 had a profound impact on the development of the training of the health workforce in Angola. This article reports on a study carried out within the scope of the preparation of the second HRDP 2013-2025 with the objective of obtaining comparable data on the profile of students who attended the different health sciences courses in Angola. Methods: The methodology was based on that used in similar studies in other Portuguese-speaking countries and in Angola in 2007. The study took place in the first four months of 2014, subcontracted to a specialized company. Data were entered in SPSS v.20 in 2014 and descriptive statistics (count, relative frequency, mean and standard deviation and medians) were calculated with SPSS v 25 during 2020. Results: The study results reveal a positive message. The students were recruited with a wide geographic base; they were satisfied with the choice of training and their performance was, in general, satisfactory, although the percentage of students in the Allied Health Sciences (AHS) with over-due subjects deserves attention. After training, they intended to settle in Angola, preferably in a hospital practice, preferably in the public network. As the public sector does not have the capacity to absorb all students, it is gratifying to note that many were open to practice in the private sector, mainly in provincial or national capitals, preferably in accumulation with public sector work. Discussion and conclusions: At the end of the cycle of the National Staff Training Plan 2013-2020, this study highlights some of the issues that will have to be addressed by training institutions in order to contribute to a balanced health workforce in Angola, with HT in quantity with the quality and distribution needed to respond to the needs of the health system and the populationpublishersversionpublishe

evidência de dois países da África Subsariana

Saúde Global e Doenças TropicaisResumo Introdução Na última década, em alguns dos Países Africanos de Língua Oficial Portuguesa, foi criado o grau de licenciado em enfermagem (4 anos de formação de nível superior) que passou a co-existir com a formação de nível médio (3 anos). Não existe evidência sobre as expectativas profissionais dos alunos de nível superior e se estas diferem das dos de nível médio. Contudo, quando as expectativas profissionais não são atingidas, os profissionais podem ficar insatisfeitos e desmotivados o que, em última análise, condiciona a qualidade dos cuidados prestados. Objetivos Identificar e comparar as expectativas profissionais futuras dos alunos de enfermagem de nível médio e de nível superior. Material e métodos Estudo observacional, transversal, multicêntrico, realizado em duas escolas de Enfermagem da Guiné Bissau e uma de SãoTomé e Príncipe, no ano letivo de 2010/2011.A população do estudo incluiu todos os alunos do último ano das escolas selecionadas. Foi aplicado um questionário de perguntas de resposta fechada utilizado anteriormente em estudos semelhantes. De modo a identificar grupos de alunos que partilhavam caraterísticas sociodemográficas e expectativas profissionais comuns, foi usada a análise de correspondência múltipla da Escola de Leiden do software SPSS v.20. Resultados Os alunos de enfermagem de nível médio não diferiam dos de nível universitário em termos de caraterísticas sociodemográficas, independentemente do país de origem. Os estudantes de enfermagem de nível universitário esperavam trabalhar no setor privado e no público (duplo emprego), na administração central do sistema de saúde e ter um salário de mais de 200 euros esperavam trabalhar no setor público, num hospital e ganhar menos de 200 euros mensais. Discussão: O aumento do número de anos de formação dos enfermeiros não pode ser dissociado das expectativas profissionais dos recém-formados e da capacidade dos sistemas de saúde para dar resposta a estas expectativas. Se o aumento do número de anos de formação de enfermeiros for dissociado de uma política de recursos humanos da saúde mais abrangente, pode dar lugar à insatisfação e desmotivação dos enfermeiros cujo desempenho pode ser inferior, podendo mesmo abandonar a profissão ou emigrar. Abstract Background In the last decade, in some of the Portuguese Speaking African Countries, a nursing degree with four years of training (graduate/university- -level) has been created along with the pre-existing middle level /diploma training (3 years). There is no evidence on what university level students course expect of their professional life and if their expectations differ from middle-level nursing students. Nevertheless, when professional expectations are not met, professionals might get dissatisfied and unmotivated which, ultimately, will influence the quality of care they provide. Aims To identify and compare the expectations of middle level and university level nursing students towards professional life. Material and methods Multicentric cross sectional study, conducted in two nursing schools in Guinea Bissau and one nursing school in Sao Tome and Principe in 2010/2011 school year. The population of the study comprised all last year students from selected schools. We used a close ended questionnaire previously used in similar studies to collect data. We used SPSS v.20 Leiden’s School optimal scaling multiple correspondence analysis to identify groups of students that shared common socio-demographic characteristics and expectations towards professional life Results Middle level nursing students did not differ significantly from university level nursing students in terms of socio-demographic characteristics, despite the country of origin. University level nursing students expected to work in both the private and the public setor (dual practice), in the central administration of the health system and to earn more than 200 euros per month. Middle level students from SaoTome and Principe and from Guinea Bissau, expected to work in the public setor, at the hospital level and to earn 200 or less euros. Discussion The skilling up of the training of nurses cannot be dissociated from the expectations of newly graduate and the capacity of the health system to address those expectations. If not part of a broader human resources for health policy, the isolated skilling-up of nursing training can lead to unsatisfied and demotivated nurses who ultimately will deliver poor quality services, leave their job and/or migrate.publishersversionpublishe

opinião e perceção dos agentes educativos

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