a balance between science and art?

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Prevalence of COVID-19 in health professionals and occupational psychosocial risks

Introduction: Health professionals who provide clinical care are exposed to patients potentially infected by the severe acute respiratory syndrome coronavirus 2 SARS-CoV-2), namely physicians and nurses; consequently, these professionals face higher risks of infection. Objectives: This study aimed to describe the prevalence of coronavirus disease 19 (COVID-19) cases among health professionals and the frequencies of risk factors and psychosocial risk. Methods: This is a cross-sectional study targeted at health professionals working in Portugal during the current COVID-19 pandemic. Data were obtained through a self-administered questionnaire available online at the websites of medical and nursing boards, among other sources. We performed a univariate analysis, calculating absolute and relative frequencies, and a bivariate analysis with a Pearson's chi-squared test. Results: We studied 4,212 health professionals, of which 36.7% (n = 1,514) worked in areas dedicated to the treatment of sick or suspected COVID-19 patients. Of these, 2.11% tested positive for SARS-CoV-2. Among all participants, 76.7% and 79.1% presented moderate to severe levels of fatigue and anxiety, respectively. Fatigue levels were significantly higher in professionals working in areas dedicated to the treatment of patients with COVID-19 (80.5% p = 0.01), but this difference was not observed regarding anxiety (79.5% p = 0.681). Conclusions: The percentage of health professionals who tested positive for SARS-CoV-2 was 2.11%. The reported high levels of fatigue and anxiety should determine a better protection of the health and safety of those who provide health care in the current pandemic.info:eu-repo/semantics/publishedVersio

a retrospective cohort study

Objective: To analyse the variation in the rate of adverse events (AEs) between acute hospitals and explore the extent to which some patients and hospital characteristics influence the differences in the rates of AEs. Design: Retrospective cohort study. Chi-square test for independence and binary logistic regression models were used to identify the potential association of some patients and hospital characteristics with AEs. Setting: Nine acute Portuguese public hospital centres. Participants: A random sample of 4250 charts, representative of around 180 000 hospital admissions in 2013, was analysed. Intervention: To measure adverse events based on chart review. Main Outcome Measure: Rate of AEs. Results: Main results: (i) AE incidence was 12.5%; (ii) 66.4% of all AEs were related to Hospital-Acquired Infection and surgical procedures; (iii) patient characteristics such as sex (female 11%; male 14.4%), age (≥65 y 16.4%; <65 y 8.5%), admission coded as elective vs. urgent (8.6% vs. 14.6%) and medical vs. surgical Diagnosis Related Group code (13.4% vs. 11.7%), all with p < 0.001, were associated with a greater occurrence of AEs. (iv) hospital characteristics such as use of reporting system (13.2% vs. 7.1%), being accredited (13.7% vs. non-accredited 11.2%), university status (15.9% vs. non-university 10.9%) and hospital size (small 12.9%; medium 9.3%; large 14.3%), all with p < 0.001, seem to be associated with a higher rate of AEs. Conclusions: We identified some patient and hospital characteristics that might influence the rate of AEs. Based on these results, more adequate solutions to improve patient safety can be defined.publishe

is health and safety at work a real occupational health and safety policy concern or just a political topic?

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Telework during the COVID-19 epidemic in Portugal and determinants of job satisfaction: a cross-sectional study

Background:Telework satisfaction is a Public Health concern, intensified by the COVID-19 pandemic, and its determinant factors may be related with the negative health effects of teleworking. However, there is still little research exploring this issue. This study aimed to characterize telework during the first wave of the COVID-19 epidemic in Portugal and to identify the major predictors of telework satisfaction. Methods: This is a cross-sectional study aimed at all teleworkers working in Portugal, during the first wave of the COVID-19 epidemic. Data were collected through a Google Forms platform online questionnaire distributed by a snowball method on social networks. Descriptive statistics included crude and relative frequency data. The associations between sociodemographic characteristics, self-perceived health, organization of working time, concentration at work, work-life balance, work disconnection, working conditions, and organizational demands (flexibility and organizational trust based on E-work Life Scale) with telework satisfaction were estimated through logistic regression. Results: This study included 1004 participants. Teleworkers satisfaction levels were high (69%). Better concentration at work (OR = 1.54; 95%CI 1.01–2.34); the satisfaction with the balance between work life and extra work when teleworking (OR = 1.79; 95%CI 1.17–2.74); and higher work flexibility (OR = 2.26; 95%CI 1.46–3.49) were good predictors of greater levels of satisfaction with telework. However, its major predictors were the company’s trust in teleworkers (OR = 4.50; 95%CI 2.89–7.02) and feeling good in the workspace at home (OR = 3.72; 95%CI 1.46–9.49). Conclusions: Our findings point that work environment and organizational culture play a crucial role in affecting telework satisfaction. More studies are needed to monitor telework satisfaction and its effects on physical and mental health, so that Public and Occupational Health (and Safety) can be able to identify and implement the best interventions that allow promoting individual health and foster a healthy work environment for teleworkers.Fundação Ciência e Tecnologia, IP national support through CHRC (UIDP/04923/2020)info:eu-repo/semantics/publishedVersio

do we need a more proactive approach?

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a contribution to strengthen assessment towards quality improvement in interventional cardiology

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Saúde ocupacional e assédio moral no local de trabalho

Comunicação apresentada na Conferência "O assédio moral no local de trabalho : emergência de uma nova realidade", 29 e 30 de Novembro de 2007As influências (negativas e positivas) do trabalho sobre a saúde envolvem uma enorme complexidade e exigem, para o seu conhecimento, uma (também) complexa matriz de saberes e de competências em inúmeras áreas de conhecimento. De facto, a Saúde e Segurança do Trabalho (ou a Saúde Ocupacional se for preferível ou até mesmo a Segurança, Higiene e Saúde dos trabalhadores nos Locais de Trabalho) abrangem uma profusa pluralidade disciplinar, mesmo na estrita abordagem das denominadas “doenças ligadas ao trabalho”. O conceito de “doenças ligadas ao trabalho” engloba todas as formas em que o trabalho pode interferir na saúde, em termos de efeitos adversos, independentemente da sua influência se situar na etiologia, na evolução, no desfecho ou no agravamento de lesões ou doenças (Uva; Graça, 2004). Independentemente da natureza das inter-relações entre o ambiente de trabalho (no seu sentido mais amplo) e a saúde, as condições de ocorrência de efeitos negativos para a saúde pertence essencialmente ao mundo do trabalho, designadamente aos factores de risco de natureza profissional (agora também designados perigos), ainda que existam, certamente, factores de natureza individual (do trabalhador) que podem estar implicados. Em qualquer situação de assédio moral existe um determinado contexto (profissional), um assediador e um assediado. Qualquer processo que tenha como finalidade o desenho, a implementação e a manutenção de medidas de redução (ou eliminação) desse risco deve abordar sistemicamente todos os aspectos correlacionados, independentemente da adopção de estratégias centradas em cada um daqueles agentes e respectivo contexto. A gestão (ou controlo) dos riscos profissionais baseia-se muito em metodologias de diagnóstico e gestão de riscos de natureza física e química que, para além de incluir uma boa avaliação das situações de risco, necessitam de acções de comunicação desses mesmos riscos, de modo a que se tornem compreensíveis para os diversos intervenientes do mundo do trabalho (Uva, 2006)

apuntes diversos

RESUMO - El autor aborda algunos aspectos relativos a la Salud y Seguridad del Trabajo (SST) en Portugal llamando la atención para, esencialmente, intentar sostener la tesis de que, desde mediados de la década de los 90, se observaron importantes avances en la mejoría de las condiciones del trabajo en la perspectiva de la SST, aunque se mantuvieron algunos problemas en la práctica concreta de las normativas legales. Incluso con estas mejoras, las tasas de frecuencia de accidentes de trabajo y de enfermedades profesionales en Portugal todavía se mantienen muy elevadas necesitando, por tanto, estrategias más “agresivas” para concienciar la sociedad portuguesa en torno a las políticas públicas de SST efectivamente promotoras de prevención de riesgos profesionales y de la promoción de la salud de quien trabaja. Es por tanto indispensable que la protección de la salud y de la seguridad de los trabajadores en los puestos de trabajo sea encarada como un conjunto de actividades de indiscutible utilidad para todos los representantes del mundo del trabajo e que la agenda política pase a valorizar, aún más, la promoción de espacios de trabajo saludables y seguros, con la consecuente valorización de las variables individuales en la estrategia nacional de salud y seguridad.--------------------------ABSTRACT – In the present work, the author analyzes several aspects of Occupational Health and Safety (OHS) in Portugal. He provides evidence sustaining the assumption of an important progress, since the mid-nineties, in the improvement of the working conditions from an OHS perspective. Nevertheless, several problems still remain in the practical application of legal regulations. In addition, despite of these improvements, the frequency rates of working accidents and occupational diseases remain very high. Hence, more “aggressive” strategies are required to increase the awareness of the Portuguese society relative to the OHS public policies, whose effectiveness has been demonstrated either in terms of occupational risks prevention and workers health promotion. The protection of workers’ health and safety at the workplace must then be assumed as an activity of indisputable utility by all stakeholders. The political agenda must thus promote even more the promotion of healthy and safe workplaces. As a consequence, there would be also a higher development of individual aspects, and not only environmental data, in the national strategy of occupational health and safety.publishersversionpublishe

Patient safety research and innovation

R E S U M O - As questões relacionadas com a Segurança do Doente, e em particular, com a ocorrência de eventos adversos têm constituído, de há uns tempos a esta parte, uma crescente preocupação para as organizações de saúde, para os decisores políticos, para os profissionais de saúde e para os doentes/utentes e suas famílias. Mais recentemente, tem-se assistido a um movimento crescente no sentido de valorizar a investigação na área da segurança do doente e, também, na necessidade de desenvolver e avaliar o impacte de soluções inovadoras que possam acrescentar valor em termos de ganhos clínicos, sociais e económicos. De entre os temas prioritários na investigação em segurança do doente destacam-se: i) o conhecimento epidemiológico (frequência, causas, tipologia e impacte) dos eventos adversos e ii) o desenvolvimento, implementação e avaliação de soluções inovadoras. O objectivo subjacente a essas duas linhas de investigação consiste em obter conhecimento que possibilite a diminuição do risco e consequentemente potenciar a segurança do doente e, simultaneamente, com base na transferência desse conhecimento monitorizar acções de melhoria e apoiar as tomadas de decisão (política e clínica) a nível local, regional, nacional e internacional. Neste artigo são destacadas três questões que se afiguram essenciais para a investigação em segurança do doente: i) a organização das diversas iniciativas de investigação em segurança do doente; ii) a identificação das áreas/temas prioritários para a investigação em segurança do doente; e iii) as abordagens metodológicas (paradigmas; métodos e técnicas) que devem ser privilegiadas, bem como alguns dos critérios que devem estar nessa base de decisão. Paralelamente, pretende-se ainda fazer referência, de forma sucinta, a alguns exemplos de soluções inovadoras que têm sido desenvolvidos e aplicados na prática do dia-a-dia nos serviços de saúde.A B S T R A C T - Despite improvements in healthcare interventions, issues relating to Patient Safety, and in particular to the occurrence of adverse events have constituted, for some time, a growing concern for healthcare organizations, policy makers, health professionals and for patients and their families. More recently, there has been a growing movement towards enhancing research on patient safety and also the need to develop and evaluate the impact of innovative solutions that can add value in terms of clinical, social and economic gains. Among others the priority topics for research in patient safety are: i) knowledge of epidemiology (frequency, causes, types and impact) of adverse events and ii) the development, implementation and evaluation of innovative solutions. The purpose behind these two lines of research is to gain knowledge that enables the reduction of risk and therefore enhance patient safety, and simultaneously, based on the translation of this knowledge, improve and support decision-making (policy and clinical) locally, regionally, nationally and internationally. In this article three issues that are essential for patient safety research are highlighted: i) the organization of various patient safety research initiatives; ii) the identification of areas/priorities for research on patient safety, and iii) the methodological approaches (paradigms, methods and techniques) that should be privileged as well as some of the criteria which support that decision. In parallel, the intention is still to refer briefly to some examples of innovative solutions that have been developed and applied in the daily practice of health care services.info:eu-repo/semantics/publishedVersio