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This study aimed to analyse the relationship between the organisational culture and feelings of pleasure and suffering among working nursing professionals. This was a cross-sectional correlational study conducted in a tertiary hospital with 214 nursing staff over 3 months using three instruments: professional characterisation, the Brazilian Instrument for Assessment of Organisational Culture, and the Scale of Pleasure and Suffering at Work. The analysis included descriptive statistics and the Spearman correlation test. The external integration practice was the domain most frequently found in the organisational culture and the feeling of pleasure–gratification predominated among the workers. Values of cooperative professionalism and wellbeing, and practices of external integration and relationship promotion, were related to increased pleasure and decreased suffering at work. These aspects depend on the organisational culture of the institution. Investigating organisational culture facilitates the understanding of potential collective coping strategies and the organisational changes that favour good mental health in nurses.

OBJECTIVE: To systematically review literature on priorities in nursing research on health systems and services in the Region of the Americas as a step toward developing a nursing research agenda that will advance the Regional Strategy for Universal Access to Health and Universal Health Coverage. METHOD: This was a systematic review of the literature available from the following databases: Web of Science, PubMed, LILACS, and Google. Documents considered were published in 2008-2014; in English, Spanish, or Portuguese; and addressed the topic in the Region of the Americas. The documents selected had their priority-setting process evaluated according to the "nine common themes for good practice in health research priorities." A content analysis collected all study questions and topics, and sorted them by category and subcategory. RESULTS: Of 185 full-text articles/documents that were assessed for eligibility, 23 were selected: 12 were from peer-reviewed journals; 6 from nursing publications; 4 from Ministries of Health; and 1 from an international organization. Journal publications had stronger methodological rigor; the majority did not present a clear implementation or evaluation plan. After compiling the 444 documents' study questions and topics, the content analysis resulted in a document with 5 categories and 16 subcategories regarding nursing research priorities on health systems and services. CONCLUSIONS: Research priority-setting is a highly important process for health services improvement and resources optimization, but implementation and evaluation plans are rarely included. The resulting document will serve as basis for the development of a new nursing research agenda focused on health systems and services, and shaped to advance universal health coverage and universal access to health.

Patient frailty is associated with adverse health outcomes and increased risk of mortality. This ARISTOPHANES study subgroup analysis used multiple data sources to evaluate stroke/systemic embolism (S/SE) and major bleeding (MB) among frail nonvalvular atrial fibrillation (NVAF) patients prescribed

Obesity has an important impact on general health outcomes and is prevalent in nonvalvular atrial fibrillation (NVAF) patients. This study evaluated stroke/systemic embolism (SE) and major bleeding (MB) among obese NVAF patients using non-vitamin K antagonist oral anticoagulants (NOACs) in the

The prevalence of obesity in nonvalvular atrial fibrillation (NVAF) patients is apparent in trials and real-world studies; however, there is limited data on the effectiveness and safety of anticoagulation specific to this population. This study evaluated stroke/systemic embolism (SE) and major

Patients with non-valvular atrial fibrillation (NVAF) and chronic kidney disease (CKD) are at increased risk of adverse outcomes. This study evaluated treatment patterns and outcomes in elderly NVAF patients across CKD stages. All patients ≥65 enrolled in US Medicare fee-for-service (FFS) with

Patient frailty is associated with adverse health outcomes and increased risk of mortality. This subgroup analysis of the ARISTOPHANES study used multiple data sources to evaluate stroke/systemic embolism (S/SE) and major bleeding (MB) among frail non-valvular atrial fibrillation (NVAF) patients

Objective: to identify the current state of advanced practice nursing regulation, education and practice in Latin America and the Caribbean and the perception of nursing leaders in the region toward an advanced practice nursing role in primary health care to support Universal Access to Health and Universal Health Coverage initiatives. Method: a descriptive cross-sectional design utilizing a web-based survey of 173 nursing leaders about their perceptions of the state of nursing practice and potential development of advanced practice nursing in their countries, including definition, work environment, regulation, education, nursing practice, nursing culture, and perceived receptiveness to an expanded role in primary health care. Result: the participants were largely familiar with the advanced practice nursing role, but most were unaware of or reported no current existing legislation for the advanced practice nursing role in their countries. Participants reported the need for increased faculty preparation and promotion of curricula reforms to emphasize primary health care programs to train advanced practice nurses. The vast majority of participants believed their countries' populations could benefit from an advanced practice nursing role in primary health care. Conclusion: strong legislative support and a solid educational framework are critical to the successful development of advanced practice nursing programs and practitioners to support Universal Access to Health and Universal Health Coverage initiatives. Resumo Objetivo: identificar o estado atual da regulação, educação e prática do enfermeiro de prática avançada na América Latina e no Caribe e a percepção de líderes de enfermagem na região quanto ao papel da enfermagem de prática avançada na atenção primaria à saúde em apoio às iniciativas de Acesso Universal à Saúde e Cobertura Universal de Saúde. Método: o estudo descritivo transversal utilizou um survey online com 173 líderes de enfermagem questionando suas percepções sobre o estado atual da prática de enfermagem e o potencial desenvolvimento da enfermagem de prática avançada em seus países, incluindo a definição do termo, o ambiente de trabalho, a regulação, educação, prática, cultura de enfermagem e receptividade percebida de um papel mais amplo deste profissional na atenção primaria à saúde. Resultado: os participantes referiram estar familiarizados com o papel do enfermeiro de prática avançada, mas a maioria não sabia ou não relatou a legislação vigente para o papel da prática avançada em seus países. Os participantes relataram a necessidade de aumentar a preparação do corpo docente e promover reformas curriculares com enfase na atenção primária à saúde para formar enfermeiros de prática avançada. A grande maioria dos participantes acredita que as populações de seus países se beneficiará com o papel do enfermeiro de prática avançada na atenção primária à saúde. Conclusão: forte apoio em termos de legislação e uma estrutura educacional sólida de formação contínua são fundamentais para o êxito do desenvolvimento de programas de enfermagem de prática avançada em apoio às iniciativas de Acesso Universal à Saúde e Cobertura Universal de Saúde. Resume Objetivo: identificar el estado actual de la regulación, educación y práctica de la enfermera de práctica avanzada en Latinoamérica y el Caribe y la percepción de los líderes de enfermería en la región hacia un rol de práctica avanzada de enfermería dentro de la atención primaria de salud para apoyar las iniciativas de Acceso Universal a la Salud y la Cobertura Universal de Salud. Método: un diseño transversal descriptivo que utilizó una encuesta basada en la web a 173 líderes de enfermería acerca de sus percepciones sobre el estado de la enfermería y el desarrollo potencial de la práctica avanzada de enfermería en sus países, incluyendo definición, ambiente laboral, regulación, educación, práctica de enfermería, cultura de enfermería y la receptividad percibida a un papel más amplio en atención primaria de salud. Resultado: los participantes estaban ampliamente familiarizados con el rol de la enfermera de práctica avanzada, pero la mayoría desconocía la legislación o reportaba no existencia actual de legislación para el rol de práctica avanzada en sus países. Los participantes reportaron la necesidad de aumentar la preparación docente y reformas curriculares para apoyar programas de atención primaria de salud para capacitar las enfermeras de práctica avanzada. La gran mayoría de los participantes creían que las poblaciones de sus países se podrían beneficiar de un rol de práctica avanzada de enfermería en atención primaria de salud. Conclusión: un fuerte apoyo legislativo y un marco educacional sólido que continúen informándose entre sí, son críticos para el desarrollo exitoso de programas de práctica avanzada y de nurse practitioners para apoyar las iniciativas de Acceso Universal a la Salud y Cobertura Universal de Salud.

RESUMO Objetivo Avaliar os valores e as práticas que caracterizam a cultura organizacional de um hospital privado do interior do Estado de São Paulo na perspectiva dos trabalhadores de enfermagem. Métodos Estudo quantitativo, descritivo e transversal cuja coleta de dados ocorreu de janeiro a março de 2013, utilizando-se o Instrumento Brasileiro para Avaliação da Cultura Organizacional. Participaram 21 enfermeiros e 62 técnicos e auxiliares de enfermagem. As respostas dos participantes foram codificadas em categorias numéricas, constituindo uma base de dados eletrônica, sendo analisada pelo programa Statistical Package for the Social Sciences. Resultados Escores de valores de profissionalismo cooperativo (3,24); valores de rigidez hierárquica (2,83); valores de profissionalismo individual (2,69); valores de bem-estar (2,71); práticas de integração externa (3,73); práticas de recompensa e treinamento (2,56) e práticas de promoção do relacionamento (2,83). Conclusão Na percepção dos trabalhadores, existe cooperação no trabalho, a instituição busca a satisfação do cliente e um bom relacionamento interpessoal, apesar de haver rigidez hierárquica. RESUMEN Objetivo Evaluar los valores y prácticas que caracterizan a la cultura organizacional de un hospital privado en el estado de São Paulo en la perspectiva de la enfermería. Métodos Estudio cuantitativo, descriptivo y transversal, donde la recolección de datos se realizó de enero a marzo de 2013, se utilizó el Instrumento Brasileño para Evaluación de la Cultura Organizacional. 21 enfermeras y 62 técnicos y auxiliares de enfermería participaron. Las respuestas se codificaron en categorías numéricas, lo que constituye una base de datos electrónica, analizada por el programa Statistical Package for the Social Sciences. Resultados Puntuaciones de los valores cooperativos de profesionalidad (3,24); valores de rigidez jerárquicos (2,83); valores individuales de profesionalidad (2,69); valores de bienestar (2,71); prácticas de integración externa (3,73); prácticas de recompensa y entrenamiento (2,56) y las prácticas de promoción de la relación (2.83). Conclusión En la percepción de los trabajadores, existe cooperación en el lugar de trabajo, la institución busca la satisfacción del cliente y la buena relación interpersonal, aunque hay rigidez jerárquica. ABSTRACT Objective To assess the values and practices that characterize the organizational culture of a private hospital in the state of São Paulo in the perspective of nursing professionals. Methods Quantitative, descriptive, cross-sectional study. Data collection was conducted between January and March 2013 using the Brazilian Instrument for Assessing Organizational Culture. Twenty-one nurses and sixty-two nursing aides and technicians participated in the study. The responses of the participants were coded into numerical categories, generating an electronic database to be analyzed by means of the software Statistical Package for the Social Sciences. Results Scores of cooperative professionalism values (3.24); hierarchical strictness values (2.83); individual professionalism values (2.69); well-being values (2.71); external integration practices (3.73); reward and training practices (2.56); and relationship promotion practices (2.83). Conclusion In the perception of workers, despite the existence of hierarchical strictness there is cooperation at work and the institution pursues customer satisfaction and good interpersonal relationships.

Este estudo objetivou revelar os principais aspectos do processo de trabalho e os sentimentos de prazer vivenciados por técnicos de enfermagem que trabalham em um pronto-socorro do Paraná, Brasil. A psicodinâmica do trabalho sustenta teoricamente a pesquisa. Estudo descritivo, qualitativo, coleta de dados por entrevista semiestruturada e análise utilizando-se a técnica de análise de conteúdo. Para a seleção dos sujeitos, utilizou-se a técnica bola de neve. Surgiram aspectos importantes do processo de trabalho, como a imprevisibilidade do pronto-socorro, o trabalho em equipe e o modelo de cuidados integrais como precursor da humanização ao paciente. Os sentimentos de prazer originam-se do reconhecimento do trabalho pelo próprio sujeito que trabalha, pelo paciente ou pela sociedade, e do trabalho em equipe, percebido pela cooperação entre profissionais. Os sentimentos de prazer estão ligados ao reconhecimento do trabalho, havendo necessidade de valorizá-lo, pois o prazer no trabalho colabora para a saúde psíquica do trabalhador. This study aimed to reveal the main aspects of the work process and feelings of pleasure experienced by nursing technicians who work at an emergency unit in Paraná, Brazil. The theoretical basis is the psychodynamics of work. This is a qualitative and descriptive study. Data were collected and analyzed using a semi-structured interview and the content analysis technique. Subjects were selected using a snowball sampling. Important aspects of the work process were revealed, such as the unpredictability of working in an emergency unit, the impact of team work, and the comprehensive care model as a precursor to humanized care. Pleasure originates from the acknowledgement of their work either by the working subject him/herself, by patients or society; and from the team work, realized by the cooperation among professionals. Feelings of pleasure are linked to the acknowledgment of their work, which should be valued, since gratification contributes to the psychological health of workers. Este estudio objetivó revelar los principales aspectos del proceso de trabajo y sentimientos de placer vividos por técnicos de enfermería de una unidad de emergencia de Paraná, Brasil. Se fundamenta en la psicodinámica del trabajo. Estudio descriptivo de carácter cualitativo; se utilizó entrevista semiestructurada para recolección de datos, la técnica de análisis de contenido y la técnica bola de nieve para la selección de los sujetos. Surgieron importantes aspectos del proceso de trabajo, como la imprevisibilidad de esta unidad, el impacto del trabajo en equipo y el modelo de cuidados integrales como precursor de la humanización. El origen del placer estaba en el reconocimiento del trabajo por el propio sujeto que trabaja, paciente o sociedad; y en el trabajo en equipo, percibido por la cooperación entre profesionales. Los sentimientos de placer son vinculados al reconocimiento del trabajo, así hay necesidad de valorarlo, pues el placer laboral contribuye para la salud psíquica del trabajador.

Objective To assess the values and practices that characterize the organizational culture of a private hospital in the state of São Paulo in the perspective of nursing professionals. Methods Quantitative, descriptive, cross-sectional study. Data collection was conducted between January and March 2013 using the Brazilian Instrument for Assessing Organizational Culture. Twenty-one nurses and sixty-two nursing aides and technicians participated in the study. The responses of the participants were coded into numerical categories, generating an electronic database to be analyzed by means of the software Statistical Package for the Social Sciences. Results Scores of cooperative professionalism values (3.24); hierarchical strictness values (2.83); individual professionalism values (2.69); well-being values (2.71); external integration practices (3.73); reward and training practices (2.56); and relationship promotion practices (2.83). Conclusion In the perception of workers, despite the existence of hierarchical strictness there is cooperation at work and the institution pursues customer satisfaction and good interpersonal relationships.

A cultura representa o conhecimento, a moral e as normas que regem o comportamento social. As organizações possuem os seus próprios sistemas culturais, compostos por uma estrutura de valores e práticas que condicionam o comportamento de seus membros, o que representa a cultura organizacional. O homem, inserido no ambiente de trabalho, não passa imune às imposições da cultura de uma organização, o que pode abalar sua saúde mental, principalmente quando o trabalho já envolve desgastes inerentes à profissão, como a de enfermagem. Considerando a relação entre sujeito e trabalho, compreende-se o trabalho como elemento central nos processos de subjetivação do homem, capaz de proporcionar prazer e sofrimento aos trabalhadores. Assim, o objetivo desta pesquisa foi analisar a relação entre a cultura organizacional e as vivências de prazer e de sofrimento no trabalho dos profissionais de enfermagem de um hospital filantrópico. Trata-se de um estudo descritivo correlacional, transversal, com abordagem quantitativa, baseado no referencial teórico da Psicodinâmica do Trabalho e da Cultura Organizacional. O estudo foi realizado em um hospital filantrópico de alta complexidade do interior de São Paulo. Participaram 26 enfermeiros e 188 técnicos e auxiliares de enfermagem. Os dados foram coletados nos meses de janeiro e fevereiro de 2013 por meio da aplicação de três instrumentos: instrumento de caracterização profissional, Instrumento Brasileiro para Avaliação da Cultura Organizacional e Escala de Indicadores de Prazer e Sofrimento no Trabalho. Os dados foram analisados por meio de estatística descritiva e foi realizado teste de Spearman para verificar a correlação entre as categorias da cultura organizacional e as categorias de prazer-sofrimento no trabalho. Os resultados mostraram que a prática de integração externa (PIE) foi a mais presente na cultura da organização e o sentimento de prazer-gratificação (PG) foi o sentimento que predominou entre os trabalhadores, o que não excluiu a presença de outros valores e práticas organizacionais ou de sentimentos de sofrimento, vivenciados em menor intensidade pelos trabalhadores. Na análise de correlações, os valores de profissionalismo cooperativo (VPC), valores de bem-estar do empregado (VBE), práticas de integração externa (PIE) e práticas de promoção do relacionamento (PPR) mostraram estar relacionados com o aumento do prazer e diminuição do sofrimento no trabalho. Neste contexto, quatro aspectos são de singular importância para que haja saúde mental no trabalho: o uso de faculdades intelectuais, a liberdade de organização, a cooperação coletiva e o reconhecimento no trabalho. Estes quatro aspectos dependem da organização do trabalho e, portanto, da sua cultura, incluindo valores e práticas. A pesquisa proporcionou subsídios que nos permitiram conhecer os valores e práticas da cultura de uma organização de saúde e sua relação com as vivências de prazer e sofrimento no trabalho em enfermagem, ampliando o conhecimento sobre a influência da cultura organizacional na saúde mental dos trabalhadores. Conclui-se que as organizações em saúde devem conservar valores e práticas em sua cultura que protejam a saúde mental de seus trabalhadores, pois assim o trabalho se tornará mais prazeroso, conferindo maior qualidade ao cuidado prestado Culture represents the knowledge, moral and rules that influence social behavior. Organizations have their own cultural systems, composed by a structure of values and practices that influence the behavior of its members, which is called organizational culture. Professionals within their work environment are affected by the burden of the organizational culture, which can undermine their mental health, especially when their sort of job already includes some inherent suffering, like in the nursing profession. Considering the subjective relationship between worker and their work, it is understood the work as a central element in the subjectivity of mankind, capable of generating pleasure and/or suffering to them. Thus, the objective of this research was to analyze the relationship between organizational culture and experiences of pleasure and suffering of nurses working in a public hospital. This is a cross-sectional, correlational descriptive study with a quantitative approach, based on two theoretical frameworks: Psychodynamics of Work and Organizational Culture. The study was conducted in a high complexity philanthropic hospital located in São Paulo State, Brazil. 26 nurses and 188 nursing technicians/assistants participated in the study. Data were collected between january and february of 2013 through the application of a characterization survey and two validated instruments: Brazilian Instrument to Assess Organizational Culture and Indicators Scale of Pleasure and Suffering at Work. Data were analyzed using descriptive statistics and Spearman\'s correlation test was applied to verify correlation between the organizational culture categories and the pleasure-suffering at work categories. The results have shown that the practice of external integration (PIE) was the most present in the culture of the organization and the feeling of pleasure-gratification (PG) was the most prevalent feeling amongst these nursing professionals, however, this did not exclude the presence of other organizational values and practices or the feelings of suffering, experienced at a lower intensity. The correlation analysis has shown that the values of cooperative professionalism (VPC), employee welfare (VBE), pratices of external integration (PIE) and relationship promotion (PPR) were found to be related with increased level of pleasure and decreased level of suffering at work. In this context and according to scientific literature, four aspects hold particular importance regarding occupational mental health: the use of intellectual capacities, freedom to organize your own work, cooperative teamwork and recognition at work. These four aspects depend on the organization of work and, therefore, the organizational culture, including its values and practices. This research has provided evidences that enabled us to know a healthcare organizational culture\'s values and practices and its relation to the pleasure and suffering experienced by nursing staff during their labor, broadening the expertise on the influence of organizational culture on the workers\' mental health. The conclusion is that healthcare organizations must retain values and practices in their culture that will protect the worker\'s mental health, turning the work into a more enjoyable one, and improving the quality of care

This study aimed to reveal the main aspects of the work process and feelings of pleasure experienced by nursing technicians who work at an emergency unit in Paraná, Brazil. The theoretical basis is the psychodynamics of work. This is a qualitative and descriptive study. Data were collected and analyzed using a semi-structured interview and the content analysis technique. Subjects were selected using a snowball sampling. Important aspects of the work process were revealed such as the unpredictability of working in an emergency unit, the impact of team work, and the comprehensive care model as a precursor to humanized care. Pleasure originates from the acknowledgement of their work either by the working subject him/herself by patients or society; and from the team work, realized by the cooperation among professionals. Feelings of pleasure are linked to the acknowledgment of their work, which should be valued since gratification contributes to the psychological health of workers.

Trata-se de uma pesquisa qualitativa que teve por objetivo revelar os sentimentos de sofrimento dos tecnicos de enfermagem que trabalhavam em um pronto-socorro, utilizando o referencial da psicodinâmica do trabalho. A coleta de dados ocorreu por meio de entrevista semiestruturada e a analise adotou a tecnica de analise de conteudo. Para a selecao dos sujeitos foi utilizada a tecnica bola de neve. As categorias que emergiram das falas ilustravam o sofrimento relacionado ao ambiente, a dinâmica de trabalho, a qualidade do cuidado prestado ao paciente, a falta de valorizacao e reconhecimento nas relacoes profissionais e aos conflitos internos e pessoais que influenciavam o processo de trabalho ou eram despertados por ele. Conclui-se que o sofrimento relaciona-se a varios aspectos do processo de trabalho, sendo primordial reconhece-lo para, entao, criar estrategias para enfrenta-lo.