Resiliência e estresse ocupacional em profissionais de enfermagem num hospital público da Bahia-Brasil: contributos para a gestão em serviços de saúde
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2016-07-29
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Numa instituição hospitalar, os profissionais de enfermagem representam a maior e mais complexa força de trabalho, tanto pelo seu contingente numérico como pela heterogeneidade de sua composição (auxiliares de enfermagem, técnicos de enfermagem e enfermeiros). O ambiente de trabalho da profissão de enfermagem integra elementos considerados estressores, o que pode comprometer a saúde e a qualidade de vida dos trabalhadores. No setor público, Stacciarini e Tróccoli (2001) afirmam que a enfermagem é classificada pela Health Education Authority como a quarta profissão mais estressante.
Considerando o estresse ocupacional uma adversidade para os profissionais de enfermagem, é plausível que desenvolvam defesas psicológicas, atualmente chamadas pelas ciências sociais de resiliência, como sendo a capacidade do indivíduo de superar e crescer, aprender com as adversidades, promovendo, dessa forma, a saúde e a qualidade de vida.
Assim, neste estudo pretendeu-se avaliar a resiliência e estresse ocupacional em profissionais de enfermagem de um hospital público da Bahia – Brasil e dar contributos para a gestão da instituição, que se concretiza nos seguintes objetivos: caracterizar os profissionais de enfermagem, nas suas variáveis sociodemográficas e laborais; determinar o escore de resiliência dos profissionais de enfermagem; determinar o escore de estresse dos profissionais de enfermagem; relacionar o escore de resiliência com as variáveis sociodemográficas e laborais dos profissionais de enfermagem; relacionar o escore de estresse com as variáveis sociodemográficas e laborais dos profissionais de enfermagem; correlacionar o escore de resiliência com o escore de estresse dos profissionais de enfermagem.
Metodologicamente, desenvolvemos um estudo de caráter descritivo, correlacional, de abordagem quantitativa e transversal. Os dados foram coletados por meio de um questionário que integra variáveis sociodemográficas, a Escala de Resiliência de Wagnild e Young e a Job Stress Scale.
De um total de 505 profissionais de enfermagem, 238 (47,13%) responderam ao instrumento de coleta de dados, sendo 214 (89,9%) do sexo feminino e 24 (10,1%) do sexo masculino, com idade média de 39,9 anos. A maior parte (52,1%) dos sujeitos encontra-se na situação de “casado/união estável”. Quanto à habilitação acadêmica, 57,6% são técnicos de enfermagem (nível médio) e 97,9% ocupa a função assistencial.
No que se refere às variáveis laborais, 38,2% exerce funções nas unidades de terapia intensiva (adulto e infantil), 8,4% na emergência, 15,5% na ginecologia/obstetrícia, 9,2% na clínica médica, 13,4% na clínica cirúrgica, 7,1% no centro cirúrgico e 8,0% na neonatologia. Os técnicos de enfermagem representam 57,1% da categoria profissional, com o tempo médio de 13,1 anos na profissão, sendo o mínimo de 1 ano e o máximo de 38 anos, e o tempo médio de trabalho nesta instituição era de
aproximadamente sete anos e meio. O tipo de horário predominante é o regime diurno (55,9%) que compreende os turnos, matutino e vespertino, sendo a função assistencial exercida por 97,9% dos participantes. As ausências ao trabalho são pouco expressivas, sendo que apenas 2,9% faltou mais de 11 dias.
Relativamente à resiliência, cuja média foi de 136,63 (dp=19,66), não se verificaram diferenças no escore de resiliência em função do estado civil, da idade, do tempo de experiência, da presença versus ausência ao trabalho e do sexo, sendo, no entanto, superior para o sexo feminino. Constata-se, relações estatisticamente significativas em função de algumas variáveis: foram os técnicos de enfermagem os que apresentaram escore de resiliência acima da média (138,7); os enfermeiros com habilitação acadêmica de bacharel eram mais resilientes que os auxiliares de enfermagem; e foi a categoria profissional de enfermeiro que apresentou um escore de resiliência com valor superior em relação às outras categorias profissionais.
Quanto ao estresse, com a média do escore de 31,0 (dp=3,90), não se verificaram diferenças estatisticamente significativas em função do sexo, embora a média mais alta fosse para o sexo masculino, da idade, do estado civil, da categoria profissional, cuja média é inferior para os enfermeiros, do tempo de experiência na profissão e da habilitação acadêmica. Nas variáveis tipo de horário e presença versus ausência do trabalho, verificou-se uma relação estatisticamente significativa, sendo que os profissionais de enfermagem que trabalhavam no regime de plantão 24 horas foram os que apresentaram maior escore de estresse (34,28), bem como os profissionais que tiveram ausências ao trabalho (31,81).
Quanto à relação entre o escore de resiliência e o escore de estresse, fundamental para as políticas de gestão de recursos humanos e de modo particular para as instituições de saúde, verificou-se que quanto mais elevado era o escore de resiliência, menor era o escore de estresse.
Partindo destes resultados, é importante que os processos de gestão hospitalar possam contribuir para diminuir o estresse nos profissionais de enfermagem, considerando que a integração social entre os profissionais se dá tanto pela dimensão de subsistência como pela dimensão simbólica, na dinâmica do investimento afetivo, do apoio social, proporcionando saúde e bem-estar.
In hospitals, nursing professionals represent the largest and most complex workforce, both by its numerical contingent as the heterogeneity of its composition (nursing assistants, technicians and nurses). The working environment of the nursing profession integrates elements considered stressors, which might jeopardize the health and quality of life of workers. In the public sector, Stacciarini and Tróccoli (2001) state that nursing is classified by the Health Education Authority as the fourth most stressful profession. Considering the adversity occupational stress for nurses, it is plausible to develop psychological defenses, now called the social sciences resilience, as the capacity of the individual to overcome and grow, learn from adversity, promoting thereby the health and quality of life. Thus, this study sought to assess the resilience and occupational stress in nurses in a public hospital of Bahia - Brazil and provide input to the management of the institution, which is realized in the following objectives: to characterize nursing professionals in their variables sociodemographic and labor; determine the score resilience of nursing professionals; determine the stress score of nursing professionals; score resilience relate to sociodemographic and labor variables of nursing professionals; relate the stress score and sociodemographic and labor variables of nursing professionals; score resilience correlate with stress score of nursing professionals. Methodologically, we develop a study of descriptive, correlational nature of quantitative and transversal approach. Data were collected through a questionnaire that integrates sociodemographic variables, the Resilience Scale for Wagnild and Young and the Job Stress Scale. A total of 505 nurses, 238 (47.13%) responded to the instrument of data collection, 214 (89.9%) females and 24 (10.1%) male, mean age 39.9 years. The majority (52.1%) of the subjects is in the situation of "married/common-law marriage". Regarding academic qualification, 57.6% are nursing technicians (medium level) and 97.9% occupies the welfare function. With regard to the labor variables, 38.2% perform duties in intensive care units (adult and child), 8.4% emergence, 15.5% in obstetrics/gynecology, 9.2% in the medical clinic, 13 4% in the surgical clinic, surgical center at 7.1% and 8.0% in neonatology. Nursing staff represent 57.1% of the professional category, with the average time of 13.1 years in the profession, with a minimum of 1 year and maximum 38 years, and the average working time in this institution was approximately seven half years. The predominant type of schedule is the daytime (55.9%) comprising the morning and afternoon shifts, with the assistance function performed by 97.9% of participants. The absence from work is negligible, with only 2.9% missed more than 11 days. Regarding resilience, with an average of 136.63 (sd = 19.66), there were no differences in the scores for resilience on account of civil status, age, length of experience, the presence versus absence from work and sex being, however, higher for females. There has been, statistically significant relationships because of several variables were nursing technicians who showed resilience score above average (138.7); nurses with bachelor's academic qualification were more resilient than nursing assistants; and was the professional category of nurse who had a score of resilience with superior value compared to other professions. As for stress, with the mean score of 31.0 (sd = 3.90), there were no statistically significant differences by gender, although the highest average was for males, age, marital status, the professional category, whose average is lower for nurses, the length of experience in the profession and academic qualification. In the kind of time and presence versus absence of labor variables, we found a statistically significant relationship, and nursing professionals working in night shifts 24 hours were those with the highest stress score (34.28) as well as professionals who have had absences from work (31,81). Regarding the relationship between the score of resilience and stress score, crucial for the political management of human resources and institutions particularly for health so, it was found that the higher was the score resilience, the lower the score stress. From these results, it is important that the processes of hospital management can help reduce stress in nurses, whereas the social integration among professionals occurs both by the size of subsistence as the symbolic dimension, the dynamics of affective investment, social support, providing health and wellness.
In hospitals, nursing professionals represent the largest and most complex workforce, both by its numerical contingent as the heterogeneity of its composition (nursing assistants, technicians and nurses). The working environment of the nursing profession integrates elements considered stressors, which might jeopardize the health and quality of life of workers. In the public sector, Stacciarini and Tróccoli (2001) state that nursing is classified by the Health Education Authority as the fourth most stressful profession. Considering the adversity occupational stress for nurses, it is plausible to develop psychological defenses, now called the social sciences resilience, as the capacity of the individual to overcome and grow, learn from adversity, promoting thereby the health and quality of life. Thus, this study sought to assess the resilience and occupational stress in nurses in a public hospital of Bahia - Brazil and provide input to the management of the institution, which is realized in the following objectives: to characterize nursing professionals in their variables sociodemographic and labor; determine the score resilience of nursing professionals; determine the stress score of nursing professionals; score resilience relate to sociodemographic and labor variables of nursing professionals; relate the stress score and sociodemographic and labor variables of nursing professionals; score resilience correlate with stress score of nursing professionals. Methodologically, we develop a study of descriptive, correlational nature of quantitative and transversal approach. Data were collected through a questionnaire that integrates sociodemographic variables, the Resilience Scale for Wagnild and Young and the Job Stress Scale. A total of 505 nurses, 238 (47.13%) responded to the instrument of data collection, 214 (89.9%) females and 24 (10.1%) male, mean age 39.9 years. The majority (52.1%) of the subjects is in the situation of "married/common-law marriage". Regarding academic qualification, 57.6% are nursing technicians (medium level) and 97.9% occupies the welfare function. With regard to the labor variables, 38.2% perform duties in intensive care units (adult and child), 8.4% emergence, 15.5% in obstetrics/gynecology, 9.2% in the medical clinic, 13 4% in the surgical clinic, surgical center at 7.1% and 8.0% in neonatology. Nursing staff represent 57.1% of the professional category, with the average time of 13.1 years in the profession, with a minimum of 1 year and maximum 38 years, and the average working time in this institution was approximately seven half years. The predominant type of schedule is the daytime (55.9%) comprising the morning and afternoon shifts, with the assistance function performed by 97.9% of participants. The absence from work is negligible, with only 2.9% missed more than 11 days. Regarding resilience, with an average of 136.63 (sd = 19.66), there were no differences in the scores for resilience on account of civil status, age, length of experience, the presence versus absence from work and sex being, however, higher for females. There has been, statistically significant relationships because of several variables were nursing technicians who showed resilience score above average (138.7); nurses with bachelor's academic qualification were more resilient than nursing assistants; and was the professional category of nurse who had a score of resilience with superior value compared to other professions. As for stress, with the mean score of 31.0 (sd = 3.90), there were no statistically significant differences by gender, although the highest average was for males, age, marital status, the professional category, whose average is lower for nurses, the length of experience in the profession and academic qualification. In the kind of time and presence versus absence of labor variables, we found a statistically significant relationship, and nursing professionals working in night shifts 24 hours were those with the highest stress score (34.28) as well as professionals who have had absences from work (31,81). Regarding the relationship between the score of resilience and stress score, crucial for the political management of human resources and institutions particularly for health so, it was found that the higher was the score resilience, the lower the score stress. From these results, it is important that the processes of hospital management can help reduce stress in nurses, whereas the social integration among professionals occurs both by the size of subsistence as the symbolic dimension, the dynamics of affective investment, social support, providing health and wellness.
Descrição
Dissertação de Mestrado em Gestão dos Serviços de Saúde
Palavras-chave
Papel do profissional de enfermagem , Resiliência psicológica , Esgotamento profissional , Gestão hospitalar