Condiciones psicosociales de las enfermeras en el desempeño de sus funciones dentro del territorio español

Introducción Los riesgos laborales han acompañado a los trabajadores a lo largo de la historia. En ciertas profesiones como es el caso de la de las enfermeras, están expuestas en el ejercicio de sus funciones a multitud de riesgos y condiciones laborales adversas, como pueden ser la escasez de personal, las cargas excesivas de trabajo, el trabajo nocturno, los largos turnos de trabajo, un elevado número de horas trabajadas a la semana, una elevada frecuencia de rotación entre servicios y una elevada carga psicológica debida al manejo de situaciones de carácter crítico, entre otras. Todas estas condiciones laborales hacen que el trabajo que realizan las enfermeras sea particularmente estresante y diverso, en el que coexisten riesgos de diversa índole donde los factores de riesgo de tipo psicosocial son los más frecuentes que, si no se toman las medidas oportunas ni existen los recursos laborales adecuados, pueden generar manifestaciones de desgaste, una pérdida de compromiso laboral y una repercusión negativa sobre la propia salud del trabajador, especialmente en servicios donde la sobrecarga laboral es superior, como en el caso de los servicios de Urgencias. Objetivos El objetivo de este estudio fue describir el compromiso laboral, los riesgos psicosociales y el bienestar psicológico de una muestra de enfermeras españolas pertenecientes a distintas áreas asistenciales, analizando las relaciones existentes entre estas variables y sus efectos sobre la salud mental de las enfermeras. Hipótesis Las enfermeras que sufren sobrecarga laboral excesiva ofrecen niveles altos de burnout y moderados de compromiso laboral, por lo que aquellas que tienen una percepción de la salud regular o pésima un tienen mayor riesgo de desarrollar síntomas subjetivos de distrés psicológico. Así mismo, las demandas laborales elevadas aumentan la probabilidad de desgaste laboral, mientras que la existencia de recursos laborales aumenta el compromiso laboral de las enfermeras, especialmente en situaciones con una gran sobrecarga laboral como es el caso de la situación provocada por el SARS-CoV-2.Metodología Se realizó un estudio observacional, descriptivo, de corte transversal y de aproximación cuantitativa. Para su consecución se dividió en 2 fases: • Fase 1. Descripción e identificación de la evidencia disponible a través de un análisis bibliográfico. • Fase 2. Estudio de campo. Para la primera fase, se realizó un análisis bibliográfico de la evidencia disponible a través de 3 revisiones sistemáticas. Para la segunda fase, se realizó un estudio observacional, descriptivo, de corte transversal y de aproximación cuantitativa, con una muestra de 1704 enfermeras españolas entre enero de 2019 y enero de 2020, utilizando un cuestionario autoadministrado que contenía variables sociodemográficas, la versión española del Copenhagen Psychosocial Questionnaire (CoPsoQ-istas21) para la evaluación de riesgos psicosociales, la Utrecht Work Engagement Scale (UWES-9) para analizar el compromiso laboral y el General Health Questionnaire (GHQ 12) para hacer un cribado de posibles problemas psiquiátricos no psicóticos de la población objetivo. Resultados Más del 50% de las enfermeras perciben un nivel de riesgo alto en el ejercicio de sus funciones; salvo en la dimensión Compensaciones, en la que presentaron un nivel medio-alto. Además, se observó una prevalencia superior en los servicios de Urgencias para las cinco dimensiones, sobre todo en las dimensiones Exigencias psicológicas y Apoyo social a las empresas con 80’5% y 79’2% respectivamente. En contraposición, las enfermeras de Atención Primaria presentaron una menor percepción de riesgo, con respecto al resto de servicios, siendo la prevalencia inferior al 50% en las dimensiones Trabajo activo y desarrollo de habilidades (39’3%), Compensaciones (33’1%) y Doble presencia (48’7%) donde se pudo afirmar que el riesgo es medio-alto. Por otro lado, más del 75% de las enfermeras de Atención Primaria obtuvieron un porcentaje promedio de 5 o 6 en todas las subescalas y en el puntaje total para la escala UWES 9. En lo que respecta a las enfermeras de Urgencias, los porcentajes asociados a promedios de 5 o 6 fueron del 57’72% en vigor, 71’14% en dedicación y 62’42% en absorción; mientras que, para el Resto de áreas los porcentajes fueron 58’46%, 69’61% y 69’81% respectivamente y en ambos servicios este porcentaje del total fue ligeramente superior al 62%. Concretamente, en todas las áreas bajo estudio, más del 30% reportó que experimenta estos sentimientos todos los días. Respecto a la evaluación del binestar psicológico, un 41’14% de las enfermeras puntúan el test GHQ-12 con valores superiores a 3, siendo inferior en el caso de las enfermeras de Atención Primaria (30’52%), ligeramente superior para las enfermeras de Urgencias (47’65%) y muy similar en el Resto de áreas (42’98%). En los tres modelos, enfermeras de Atención Primaria, enfermeras de Urgencias y Resto de áreas, las variables salud percibida y subescala vigor del test UWES presentaron carácter predictor. La edad fue significativa en los grupos de enfermeras de Atención Primaria y Resto de áreas; mientras que el sexo y la subescala dedicación del test UWES únicamente fueron significativas en el último grupo. La subescala absorción y la escala total del test UWES no fueron significativas en ninguno de los tres modelos. Discusión En este estudio se ha constatado, en una muestra de 1704 enfermeras españolas, cómo los riesgos psicológicos, el nivel de engagement o el bienestar psicológico presentaron diferencias significativas entre los diferentes tipos de servicios: Urgencias, Atención Primaria y resto de áreas. En lo referente a la evaluación de los riesgos psicosociales, en cuatro de las cinco las dimensiones (CoPsoQ-istas21: Exigencias psicológicas, Trabajo activo y desarrollo de habilidades, Apoyo social a las empresas y Doble presencia) predomina una prevalencia con nivel alto en los tres grupos bajo estudio. Los niveles de compromiso laboral fueron altos en una cantidad considerable de los sanitarios bajo estudio, superando puntuaciones medias superiores a 4 sobre 6 en las tres dimensiones, con más de un 30% de las enfermeras que afirmaron haber experimentado sentimientos de compromiso laboral a diario. Según los datos que arroja nuestro estudio, se observa que cuatro de cada diez profesionales sanitarios pueden presentar deterioro en su salud mental (GHQ>3). La variabilidad encontrada entre servicios podría ser explicada por ciertas variables que pueden aumentar la percepción de riesgo como ser mujer joven, tener una percepción de salud regular o pésima, tener un bajo compromiso laboral y trabajar en servicios con un alto nivel de estrés como en el caso de los servicios de Urgencias. Conclusiones La probabilidad que tiene una enfermera de desarrollar desgaste ocupacional y los niveles que ofrece de compromiso laboral van a depender de multitud de factores. Entre ellos, ciertas condiciones laborales como la sobrecarga laboral, el tipo de turno, el tipo de servicio, entre otros; y la presencia o no de ciertos recursos personales, situacionales y organizacionales como el capital psicológico del individuo, la percepción de apoyo social o ciertos valores personales, pueden ser factores especialmente influyentes. Así mismo, una situación como la provocada por la COVID-19, afecta a la salud mental de enfermeras en el ejercicio de sus funciones, especialmente en aquéllas que se encuentran en trabajando en primera línea de batalla contra el virus, debido al tiempo de trabajo, el miedo de poder contagiarse y contagiar a seres queridos y/o a pacientes, la preocupación en el control de la epidemia, entre otros. Por servicios, la mitad de las enfermeras de Atención Primaria experimentaron sentimientos de compromiso laboral a diario, presentando niveles más altos de compromiso laboral y más bajos de percepción de riesgos psicosociales que las enfermeras de Urgencias y del Resto de áreas. Además, 4 de cada 10 enfermeras ofrecieron puntuaciones por encima del punto de corte para para comenzar a padecer problemas de salud mental, siendo superior en las enfermeras de Urgencias e inferior en las enfermeras de Atención Primaria. La implantación de una figura como la Enfermera de Práctica Avanzada (EPA) podría ofrecer ventajas muy importantes para la mejora del sistema sanitario público, tanto en términos de costo-eficiencia como en términos de mejora de la accesibilidad y la calidad de los servicios prestados al ciudadano, especialmente en servicios como los Servicios de Urgencias.Introduction Occupational hazards have accompanied workers throughout history. In certain professions, such as nursing, professionals are exposed to a multitude of adverse risks and working conditions in the exercise of their duties, such as staff shortages, excessive workloads, night shifts, long work shifts, a high number of hours worked per week, a high frequency of rotation between services, and high psychological burden due to the management of critical situations, among others. All these working conditions make the work carried out by nurses particularly stressful and diverse, in which risks of various kinds coexist where psychosocial risk factors are the most frequent and, if appropriate measures are not taken or adequate work resources do not exist, can thus lead to manifestations of exhaustion, loss of work engagement, and a negative impact on the worker's own health, especially in services where work overload is higher, as in the case of emergency services. Objectives The objective of this study was to describe the work engagement, psychosocial risks, and psychological well-being of a sample of Spanish nurses belonging to different areas of care, analysing the relationships between these variables and their effects on the mental health of nurses. Hypothesis Nurses who suffer excessive work overload show high levels of burnout and moderate work engagement, so those who have a mediocre or poor perception of health are at increased risk of developing subjective symptoms of psychological distress. Likewise, high labour demands increase the likelihood of job burnout, while the existence of work resources increases the engagement of nurses, especially in situations with a high work overload such as the situation caused by SARS-CoV-2. Methodology An observational, descriptive, cross-sectional, and quantitative approximation study was carried out. To achieve this, it was divided into 2 phases: • Phase 1. Description and identification of the evidence available through a bibliographic analysis.• Phase 2. Field study. For the first phase, a bibliographic analysis of the available evidence was performed through 3 reviews (one narrative and two systematic). For the second phase, an observational, descriptive, cross-sectional, and quantitative approximation study was carried out on a sample of 1704 Spanish nurses between January 2019 and January 2020, using a self-administered questionnaire containing sociodemographic variables, the Spanish version of the Copenhagen Psychosocial Questionnaire (CoPsoQ-istas21) for the assessment of psychosocial risks, the Utrecht Work Engagement Scale (UWES-9) to analyse work engagement, and the General Health Questionnaire (GHQ-12) to screen potential psychiatric, not psychotic, problems of the target population. Results More than 50% of nurses perceived a high level of risk in the exercise of their duties, except in the Compensations dimension, in which they showed an intermediate-high level. In addition, a higher prevalence was observed in the Emergency Services for the five dimensions, especially in the Psychological requirements and Social support for companies dimensions, with 80’5% and 79’2%, respectively. As opposed, Primary Care nurses had a lower perception of risk as compared to those from other services, with the prevalence being less than 50% in the dimensions: Active work and skills development (39'3%), Compensation (33'1%), and Double Presence (48’7%), where it could be said that the risk is intermediate-high. On the other hand, more than 75% of Primary Care nurses achieved a mean percentage of 5 or 6 in all subscales and in the total score for the UWES-9 scale. For Emergency nurses, the percentages associated with means of 5 or 6 were 57’72% in the Vigour dimension, 71’14% in Dedication, and 62’42% in Absorption. However, for the rest of the areas, the percentages were 58’46%, 69’61%, and 69’81%, respectively, and in both services this percentage of the total was slightly higher than 62%. Specifically, in all areas under study, more than 30% reported experiencing these feelings daily. With regard to the assessment of psychological well-being, 41’14% of nurses scored values above 3 in the GHQ-12 test, being these figures lower for Primary Care nurses (30’52%), slightly higher for Emergency nurses (47’65%), and very similar in the rest of areas (42’98%). In all three models, Primary Care nurses, Emergency nurses, and other areas, the perceived and subscale health variables of the UWES test were predictive. Age was significant in the Primary Care and Other areas nurses groups, while sex and the dedication subscale of the UWES test were only significant in the last group. The absorption subscale and the total scale of the UWES test were not significant in any of the three models.Discussion This study found, in a sample of 1704 Spanish nurses, how psychological risks, the level of engagement, or psychological well-being showed significant differences between the different types of services: Emergency Services, Primary Care, and other areas. With regard to the assessment of psychosocial risks, in four of the five dimensions (CoPsoQ-istas21: Psychological requirements, Active work and skills development, Social support for companies, and Double presence), a prevalence of high level predominates in the three groups under study. Work engagementlevels were high for a considerable number of health workers under study, exceeding mean scores above 4 out of 6 in all three dimensions, with more than 30% of nurses claiming to have experienced feelings of work engagement daily. According to the data presented by our study, it is observed that four out of ten healthcare professionals may have impaired mental health (GHQ>3). The variability found between services could be explained by certain variables that can increase the perception of risk such as being a young woman, having a mediocre or poor perception of health, low work engagement, and being working in services with a high level of stress as in the case of Emergency services. Conclusions A nurse's likelihood of developing job burnout and the levels of work engagement shown will depend on a multitude of factors. These include certain working conditions such as work overload, shift type, type of service, among others, and the presence or not of certain personal, situational and organisational resources such as the psychological skills of the individual, the perception of social support, or certain personal values, that can be particularly influential factors. Likewise, a situation such as that caused by COVID-19 affects the mental health of nurses in the exercise of their functions, especially of those who are working on the front line against the virus, due to working hours, the fear of being able to spread the virus and infect loved ones and/or patients, concern about controlling the epidemic, among others. As for services, half of Primary Care nurses experienced feelings of daily work engagement, presenting higher levels of work engagement and lower perception of psychosocial risks than Emergency nurses and those from other areas. In addition, 4 out of 10 nurses showed above-cut-off scores to develop mental health problems, being higher among Emergency nurses and lower in Primary Care nurses. The implementation of a figure such as the Advanced Practice Nurse (APN) could offer very important advantages for improving the public health system, both in terms of cost-efficiency and in terms of improving the accessibility and quality of the services provided to citizens, especially in services such as Emergency ones

Creation through the Google Classroom platform of activities on animal welfare aimed at early childhood education

Oral session 1[EN] Google Classroom is an educational platform developed by Google, specifically designed to facilitate the organization of virtual classes which allows for collaborative classroom management through the Internet

Suicidal ideation and suicide attempts in healthcare professionals during the COVID-19 pandemic: A systematic review

Background: COVID-19 has caused a series of economic, social, personal, and occupational consequences that may affect the mental health of healthcare workers (HCWs), with the consequent risk of developing suicidal ideation and behaviors. Objectives: The aim of this study was to identify the main risk factors that may predispose HCWs to suicidal ideation and suicide attempts during the COVID-19 pandemic. Methods: A systematic review of studies published between January 2020 and August 2022 was conducted following the PRISMA guidelines in the following electronic databases: Pubmed, Scopus, Web of Science, CINAHL, and PsycINFO. Methodological quality was assessed using the critical appraisal tools for non-randomized studies of the Joanna Briggs Institute (JBI). The followed protocol is listed in the International Prospective Register of Systematic Reviews (PROSPERO) with code CRD42022340732.ResultsA total of 34 studies were included in this review. There are a number of underlying factors such as higher rates of depression, anxiety, pre-pandemic lifetime mental disorders or previous lifetime suicide attempt, living alone, having problems with alcohol and/or other drugs, etc. that favor the emergence of suicidal tendencies and ideation in times of COVID-19. Similarly, the pandemic may have precipitated a series of factors such as economic concerns, assessing one's working conditions as poor, having family members or friends infected, changes in services or functions, and feeling discriminated against or stigmatized by society. Other factors such as age, sex, or type of healthcare worker show differences between studies. Conclusion: Organizations should ensure the adoption of strategies and programmes for early detection of suicides as well as increased attention to the mental health of professions with a high workload.Universidad de Huelva/CBU

Enfermería de práctica avanzada en la atención urgente, una propuesta de cambio : revisión sistemática

Fundamentos: La Enfermería de Práctica Avanzada es un rol desconocido en nuestro país. El objetivo principal de esta revisión fue mostrar los resultados de este modelo en los servicios de urgencias para alcanzar su futura implementación dentro del ámbito sanitario español. Métodos: Revisión sistemática de las bases de datos de The Cochrane Controlled, Web Of Science, Cinahl, Cuiden, LILACS, Guía Salud y Cochrane Database of Systematic Reviews. Se utilizaron escalas validadas para la selección de 14 artículos finales, siguiendo el formato PRISMA. Resultados: Se apreciaron resultados favorables, con tiempos de espera máximos de 53 minutos y tiempo medio de estancia de 45 minutos, y menos de un 8% de casos de reingresos inesperados; así como en materia seguridad y satisfacción del paciente. Conclusiones: La implantación de esta figura ofrecería ventajas muy importantes para la mejora del sistema sanitario público, incrementando la calidad asistencial en términos de eficiencia.country. The aim of the study is to show the results of this model in emergency services for its future implementation in the Spanish health system. Methods: Systematic review with the Cochrane Controlled, Web Of Science, Cinahl, Cuiden, LILACS, Guía Salud and Cochrane Database of Systematic Reviews databases. Different validated scales were used for the selection of 14 final articles, following the PRISMA Statement. Results: Favourable results were observed, with maximum waiting times of 53 minutes and average time of stay of 45 minutes. There were less than 8% of cases of unexpected readmissions. Favourable results were also found regarding safety and patient satisfaction. Conclusions: The implementation of this figure could be beneficial for the improvement of the public health system, increasing the quality of care in terms of efficiency

Use of preventive measures, beliefs and information received about COVID-19 and their effects on mental health, in two stages of the pandemic in Colombia

Background: Several studies have highlighted the effects of the COVID-19 pandemic on both physical and mental health. The aim of this study is to analyse the effects on mental health in two phases of the COVID-19 pandemic (April 2020 and February 2021) in the population of Colombia. Methods: Observational, prospective, cross-sectional study along two periods, April 2020 and February 2021. The sample (N=1309) was extracted from the Colombian population, only including individuals over the age of 18 and residing in Colombia during the pandemic. The IMPACTCOVID-19 questionnaire was used, previously validated in Spain and cross-culturally adapted to the Colombian population, which included sociodemographic data, use of preventive measures, information received and the Goldberg General Health Questionnaire (GHQ-12) for psychological distress (PD). Participants had to sign an informed consent before taking part in the investigation. Results: A higher level of PD was observed among women (M=3.99, SD = 3.39) (p<.001), in those who lived without a partner (M=3.83, SD = 3.47) (p = .036), and in those with a worse perception of health (M=6.27, SD = 3.51) (p<.001). PD decreased in the second period from M=3.99 (SD = 3.36) to M=2.98 (SD = 3.30) (p<.001), coinciding with a higher use of preventive measures, less distress caused by COVID-19 and greater confidence in healthcare professionals and clinical structures. In the second period, the time spent in getting informed decreased, but the sources of information were the same, principally social media and official sources. Conclusions: Better information on the effects and preventive measures to prevent the pandemic improves confidence in the health system and its professionals, reducing the level of PD. There is a need for quality information on social networks and an adaptation of telemedicine to address the pandemic effects on mental health

Levels of Anxiety and Fear among Nurses During the COVID-19 Pandemic: A Systematic Review

[Abstract] Aim. The aim of this review is to find out what levels of anxiety and fear have been shown by nurses during the COVID-19 pandemic. Background. Health security crises affect not only physical health but also the mental health and wellbeing of healthcare professionals due to a higher level of exposure. Evaluation. A systematic review was carried out following the PRISMA statement. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools. The literature search was carried out in the PubMed, Scopus, and Web of Science (WoS) electronic databases based on the keywords that the research question yielded following the PECOT strategy. For the selection of articles, original articles, meta-analyses, systematic reviews, short communication articles, and case reports were included. Then, a series of inclusion and exclusion criteria were applied, screening the results to obtain a total of 18 articles, which were used to elaborate the study. Key Issues. Fear and anxiety levels were described in a total of 18 selected studies. The main fear-related concerns of the nurses were associated with the fear of infecting their family or friends and the fear of the death of a family member or friend. Conclusions. The main psychological impact on nurses during the COVID-19 pandemic was related to fear, anxiety, stress, and depression. Fear of infecting family members or of being infected were the main impacts perceived by nurses. Implications for Nursing Management. In general, high scores were found for levels of fear and anxiety, although the figures varied by country and time of data collection. Resilience was considered the main tool for coping with the loss and trauma experienced by nurses

Design of Fear and Anxiety of COVID-19 Assessment Tool in Spanish Adult Population

The aim of this study was to develop a specific scale to measure anxiety and fear levels in the general Spanish population. For this, a transcultural adaptation to Spanish of the fear of coronavirus disease 2019 (COVID-19) scale, in its original version of 10 items, was carried out. Then, the Anxiety and Fear of COVID-19 Assessment Scale (AMICO, for its acronym in Spanish) was designed by translating the tool and Delphi technique into three rounds. Ten experts participated voluntarily, and inter-observer match rates and the reliability study of the designed scale were calculated. A pilot study was carried out with the final version of the scale for the validity and reliability study. The instrument did not raise problems in semantic and cultural terms during the first and second rounds of the translation process, with an overall weighted Kappa value of 0.9. In the third round, eight new items were designed and consensual, obtaining a weighted overall value of 0.89. The pilot study sample was made up of 445 subjects, of which 60.3% were women with a mean age of 46.2 years. The final version consisted of 16 items, 2 factors, and a Cronbach’s alpha value of 0.92. The AMICO scale was developed to assess the level of anxiety and fear of COVID-19 and proved to be valid and reliable for its use in the adult Spanish population.Junta de Andalucía PI 036/2

Relationship Between Psychological Distress, Burnout and Work Engagement in Workers During the COVID-19 Pandemic: A Systematic Review

Objective: The psychological distress that the COVID-19 pandemic has produced has generated negative effects on workers, and in one way or another this has affected their work engagement within companies. The aim of this research was to assess the relationship between psychological distress, burnout and work engagement in workers during the COVID-19 pandemic. Methods: A systematic review was carried out following the PRISMA methodology, taking articles from the Scopus, Pubmed, and Web of Science databases from the beginning of the pandemic until November 2022. The methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools for non-randomised studies. Results: 24 articles were selected. All the articles found an association between psychological distress, burnout or other factors and work engagement. Conclusion: The COVID-19 pandemic has had an impact on work engagement and a negative relationship with psychological distress and burnout, hence the importance of companies taking measures to minimise levels of psychological distress and burnout

Sense of Coherence in Healthcare Workers During the COVID-19 Pandemic in Ecuador: Association With Work Engagement, Work Environment and Psychological Distress Factors

Objectives: The aim of this study was to test the association between the sense of coherence, work engagement, and psychological distress in healthcare workers in Ecuador during the first phase of the COVID-19 pandemic. Methods: A cross-sectional observational study in a sample of 803 healthcare professionals from all regions of Ecuador between 2 April and 17 May 2020. A self-administered questionnaire was used, which contained sociodemographic and work environment variables, the Utrecht Work Engagement Scale (UWES-9), the General Health Questionnaire (GHQ-12), and Sense of Coherence Scale (SOC-13). Results: The mean value of sense of coherence was M = 65.04; SD = 12.74; for work engagement, it was M = 39.36; SD = 10.53; and for psychological distress, M = 4.58; SD = 3.44. There is a positive correlation (p < 0.01) between the sense of coherence and work engagement, and a negative correlation with psychological distress. Conclusion: During the pandemic in Ecuador, healthcare professionals have suffered a major deterioration of their mental health. Sense of coherence has been associated with work engagement and psychological distress. They have perceived a worsening of the quality of care and working conditions compared to those existing before COVID-19

Risk Factors for Working Pregnant Women and Potential Adverse Consequences of Exposure: A Systematic Review

Objective: To assess the risk factors perceived as stressors by pregnant women in the work environment and the possible adverse consequences of such exposure for the normal development of pregnancy. Methods: Systematic review, guided by the PRISMA guidelines, and using Pubmed, Web of Science, Dialnet, SciELO, and REDIB databases. Methodological quality was assessed using the critical appraisal tools for non-randomised studies of the Joanna Briggs Institute. Results: A total of 38 studies were included. The main risk factors found in the work environment of pregnant women were chemical, psychosocial, physical-ergonomicmechanical factors, and other work-related factors. The main adverse consequences of exposure to these factors include low birth weight, preterm birth, miscarriage, hypertension and pre-eclampsia, as well as various obstetric complications. Conclusion: During pregnancy, working conditions that are considered acceptable in normal situations may not be so during this stage due to the major changes that occur during pregnancy. Many obstetric effects may have an important impact in the mother’s psychological status; therefore, it is important to optimise working conditions during this stage and to reduce or eliminate possible risksFunding for open access charge: Foundation for Science and Technology, Portugal (FCT)