The objective of the present study was to perform the cultural adaptation of The Environmental Stressor Questionnaire -ESQ for the Brazilian Portuguese, as well as to verify its reliability and validity. In order to ensure the equivalence between the original instrument and the Brazilian version, all methodological steps recommended in the literature regarding cultural adaptation were followed. The Brazilian version of the ESQ was applied to 106 ICU patients in two hospitals (public and private) in the interior of São Paulo State. Reliability was evaluated in relation to internal consistency and stability (test e retest) and the convergent validity was determined by the correlation between ESQ and generic questions about ICU stress. Reliability was satisfactory with Cronbach's Alfa = 0,94 and stability (ICC=0,861; IC95% 0,723; 0,933). ESQ total score displayed strong correlation with the generic questions about stress (r=0,70; p<0,0001), thus confirming the convergent validity. The conclusion was that the ESQ adapted for Brazilian culture is a reliable instrument for evaluation of stressors in the ICU. KEY WORDS RESUMENEste estudio tuvo como objetivo realizar la adaptación cultural del Environmental Stressor Questionnaire (ESQ) a la lengua portuguesa de Brasil y verificar su confiabilidad y validez. Fueron empleadas las etapas metodológicas recomendadas por la bibliografía para la adaptación cultural. La versión brasileña del ESQ fue aplicada a 106 pacientes de Unidad de Terapia Intensiva (UTI) de dos hospitales, público y privado, del interior del estado de San Pablo, Brasil. La confiabilidad fue evaluada respecto de la consistencia interna y la estabilidad (test y retest); la validez convergente fue verificada a través de la correlación entre el ESQ y pregunta genérica acerca de estrés en UTI. La confiabilidad fue satisfactoria, con Alfa de Cronbach = 0,94 y Coeficiente de Relación Intraclase = 0,861 (IC 95%; 0,723; 0,933). Se constató correlación entre el puntaje total del ESQ y la pregunta genérica sobre estrés (r = 0,70), confirmado la validez convergente. La versión brasileña del ESQ se mostró como una herramienta confiable y válida para la evaluación de estresores en UTI. DESCRIPTORES
Social work, like other professions, has undergone changes in its structural basis, as well as a re-dimensioning of the professional work, which cannot be dissociated from the inevitable administrative reforms of the State and of the social policies themselves. In this research we sought to understand how the state administrative reforms, namely the managerial model of New Public Management have influenced the professional intervention of social workers in the public sector. We did so through the perceptions of the social workers about the implications of managerialism in their professional practices. It is a qualitative research, with exploratory characteristics and was carried out in a municipality in a district of Portugal. It was conducted a semi-structured interview with six social workers in the public sector, from four different sectors: Justice, Local Power, Health and Social Security. After the interviews were collected, a Characterization Grid of the sample and a SWOT Analysis Grid were used for each of the participants to assist the researcher in the Content Analysis of this investigation. The data we analyzed revealed that in all services and intervention areas there was a prevalence of characteristics of managerialism influences, which necessarily induced changes in professional practices. The collected data revealed that there are characteristics of managerialism perceived as beneficial and positive for the professional exercise and other characteristics that have brought constraints.
RESUMOObjetivo: Comparar estressores em unidade de terapia intensiva na percepção dos familiares do paciente em hospital particular e público. Métodos: Foi feito um estudo prospectivo, observacional entre março e agosto de 2014. O estudo foi desenvolvido em duas UTIs, uma da rede pública e outro da privada. Fizeram parte deste estudo os 65 familiares dos pacientes internados na UTI privada e 57 de UTI pública. Foi utilizado um Instrumento de Caracterização do paciente, do familiar do paciente e outro para a Avaliação dos Estressores (EAEUTI). Para análise estatística foram usados os testes: Mann-Whitney; Qui quadrado; exato de fisher e coeficiente de correlação de Spearman 10, 11 .0020. Resultados: Houve predominância do gênero feminino nas duas instituições e a maioria possui companheiro. A idade, escolaridade, renda e doenças associadas na instituição privada foi maior do que na pública. Dor, a falta de comunicação, imobilização, falta de esclarecimento sobre o tratamento e falta do companheiro foram, para os familiares de ambas instituições, os maiores estressores percebidos. A média de cada item da escala foi maior no hospital privado e o escore total foi maior na instituição privada 142,4( 31,5) e 101,8(39,2) na pública. Conclusão: a dor, a falta de comunicação, imobilização, falta de esclarecimento sobre o tratamento e falta do companheiro, foram para os familiares da instituição pública e privada, os maiores estressores percebidos. A média de cada item da escala foi maior no hospital privado e o escore total foi alto, e maior na instituição privada. Unitermos: estressores, cuidados intensivo, família, humanização na assistência, unidade de terapia intensiva, enfermagem
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