Carga laboral como causa de alteración del bienestar psicológico en el personal de enfermería

Los profesionales de Enfermería están expuestos a altos niveles de estrés laboral. Dependiendo del área donde trabajen, se generan diferentes estresores que afectan el equilibrio emocional y la salud mental. De acuerdo a varias investigaciones, se conoce que el personal que trabaja en áreas críticas en los hospitales poseen un mayor grado de estrés o desarrollan el síndrome de ‘burnout’ debido a que están en contacto con situaciones de dolor, sufrimiento y muerte. Objetivo: Evaluar el bienestar laboral del personal de enfermería en áreas críticas del Hospital José Carrasco Arteaga en la ciudad de Cuenca con el fin de diagnosticar el estado de su salud emocional y psicológica. Metodología: Se realizará un estudio descriptivo de corte transversal, no experimental. A su vez, se implementará la escala de Bienestar Psicológico de José Sánchez Cánova a miembros del personal de enfermería en las áreas de emergencia y cuidados intensivos del Hospital José Carrasco Arteaga. Seguido de esto, se procede a tabular la información obtenida en los test, mediante tablas y gráficos en el programa estadístico Infostat para exponer los resultados. Resultados: Descubrir la estabilidad del personal de enfermería proponer acciones donde se implementen estrategias de afrontamiento de acuerdo al grado de afectación que tenga el personal, que ayuden a mejorar el ambiente laboral y el manejo de los diferentes estresores a los que se enfrentan el personal profesional de enfermería

Switching TNF antagonists in patients with chronic arthritis: An observational study of 488 patients over a four-year period

The objective of this work is to analyze the survival of infliximab, etanercept and adalimumab in patients who have switched among tumor necrosis factor (TNF) antagonists for the treatment of chronic arthritis. BIOBADASER is a national registry of patients with different forms of chronic arthritis who are treated with biologics. Using this registry, we have analyzed patient switching of TNF antagonists. The cumulative discontinuation rate was calculated using the actuarial method. The log-rank test was used to compare survival curves, and Cox regression models were used to assess independent factors associated with discontinuing medication. Between February 2000 and September 2004, 4,706 patients were registered in BIOBADASER, of whom 68% had rheumatoid arthritis, 11% ankylosing spondylitis, 10% psoriatic arthritis, and 11% other forms of chronic arthritis. One- and two-year drug survival rates of the TNF antagonist were 0.83 and 0.75, respectively. There were 488 patients treated with more than one TNF antagonist. In this situation, survival of the second TNF antagonist decreased to 0.68 and 0.60 at 1 and 2 years, respectively. Survival was better in patients replacing the first TNF antagonist because of adverse events (hazard ratio (HR) for discontinuation 0.55 (95% confidence interval (CI), 0.34-0.84)), and worse in patients older than 60 years (HR 1.10 (95% CI 0.97-2.49)) or who were treated with infliximab (HR 3.22 (95% CI 2.13-4.87)). In summary, in patients who require continuous therapy and have failed to respond to a TNF antagonist, replacement with a different TNF antagonist may be of use under certain situations. This issue will deserve continuous reassessment with the arrival of new medications. © 2006 Gomez-Reino and Loreto Carmona; licensee BioMed Central Ltd