Objective: to analyze the frequency and intensity of moral distress experienced by nursing personnel in southern Brazil, covering elements of their professional practice. Method: a survey was undertaken in two hospitals in Rio Grande do Sul, Brazil, with 247 nurses. Data was collected by means of the adapted Moral Distress Scale. Results: the perception of situations that lead to moral distress is enhanced in nurses and in nursing staff working in institutions with greater openness to dialogue, which hold team meetings, with fewer working hours and a greater ratio of professionals to patients. Conclusion: understanding moral distress allows us to go beyond solving the problems of the workers themselves, enabling the development of an ethics of active individuals and wide opportunities, defined mainly by the relationship with oneself.Descriptors: Nursing; Nursing Ethics; Burnout. Sufrimiento moral en trabajadores de enfermeríaObjetivo: analizar la frecuencia e intensidad del sufrimiento moral vivido por los profesionales de enfermería del sur de Brasil, abarcando los elementos de su rutina profesional. Método:investigación survey en dos hospitales, con 247 profesionales de enfermería. Los datos fueron recolectados mediante aplicación de la adaptación del Moral Distress Scale. Resultados: la percepción de situaciones que conducen al sufrimiento moral es intensificada en enfermeros; en trabajadores de enfermería que actúan en instituciones con mayor apertura al dialogo, que realizan reuniones de equipo, con menos horas de trabajo y mayor relación del número de profesionales por paciente. Conclusión: entender el sufrimiento moral permite ir más allá de la resolución de los problemas de los propios trabajadores, lo que posibilita la elaboración de una ética de sujetos activos y de amplias posibilidades, definidas principalmente por la relación consigo mismo.

Realizou-se uma revisão integrativa, com o objetivo de identificar as implicações do sofrimento moral para os(as) enfermeiros(as), aproximações entre sofrimento moral e burnout, e estratégias de enfrentamento do sofrimento moral, na literatura científica nacional e internacional publicada nos últimos 10 anos. As bases de dados foram CINAHL, MEDLINE e SAGE, e as palavras-chave, sofrimento moral, burnout e enfermagem. Obtiveram-se 21 artigos para análise, realizada em quatro etapas: redução, visualização e comparação dos dados, e verificação e esboço da conclusão. Identificou-se que o sofrimento moral vivenciado pelos(as) enfermeiros(as) manifesta-se na dimensão pessoal, com alterações emocionais e físicas, e na dimensão profissional, com insatisfação no trabalho, burnout e abandono da profissão. Constataram-se estratégias de enfrentamento em três dimensões: educativa, comunicativa e organizacional. Considera-se necessário maior exploração dessa temática, contribuindo para a prevenção do sofrimento moral.

Objetivando conhecer a percepção do sofrimento moral vivenciado, relacionando frequência e intensidade, realizou-se pesquisa Survey, utilizando escala Likert variando de 0 a 6 pontos, com 124 enfermeiras em hospitais do sul do Brasil, no ano de 2008. Mediante questionário autoaplicável e análise fatorial, foram identificados e validados quatro constructos. Os resultados finais foram obtidos através de três diferentes análises: 1) estatística descritiva; 2) análises de variância 3) regressão múltipla. O constructo que apresentou maior intensidade de percepção de vivência do sofrimento moral foi a falta de competência na equipe de trabalho (4,55), seguido pela negação do papel da enfermeira como advogada do paciente (4,30), obstinação terapêutica (3,60) e desrespeito à autonomia do paciente (3,57). Em relação à percepção da frequência do sofrimento moral, destacou-se, novamente, o constructo falta de competência na equipe de trabalho (2,42), seguido da obstinação terapêutica (2,26), negação do papel da enfermeira como advogada do paciente (1,71) e desrespeito à autonomia do paciente (1,42).

Objective to identify relationships between moral distress and Burnout in the professional performance from the perceptions of the experiences of nursing workers. Methods this is a survey type study with 375 nursing workers working in three different hospitals of southern Rio Grande do Sul, with the application of adaptations of the Moral Distress Scale and the Maslach Burnout Inventory, validated and standardized for use in Brazil. Data validation occurred through factor analysis and Cronbach's alpha. For the data analysis bivariate analysis using Pearson's correlation and multivariate analysis using multiple regression were performed. Results the existence of a weak correlation between moral distress and Burnout was verified. A possible positive correlation between Burnout and therapeutic obstinacy, and a negative correlation between professional fulfillment and moral distress were identified. Conclusion the need was identified for further studies that include mediating and moderating variables that may explain more clearly the models studied.

Objective: To assess the prevalence and factors associated with musculoskeletal pain in undergraduate health students. Method: A cross-sectional study was conducted with undergraduate students from a university in the south of Brazil between April and July 2017. The Brazilian version of the Standardized Nordic Questionnaire and a questionnaire for the characterization of students were used. Descriptive statistics, the chi-square test and Poisson regression were used for the analysis. Results: Participation of 792 undergraduate health students. The region of the vertebral column had a higher prevalence (74.9%) of musculoskeletal pain. The variables of female sex, age between 18 and 20 years, overweight, not having time for leisure, six or more daily hours of mobile phone use, having a clinical condition with medical diagnosis and attending the intermediate or final semesters of the course were associated with musculoskeletal pain. Conclusion: The high prevalence of musculoskeletal pain demonstrates the need for strategies aimed at preventing this aggravation still in the academic setting.

Objective: to adapt culturally and validate the Protective Nursing Advocacy Scale for Brazilian nurses. Method: methodological study carried out with 153 nurses from two hospitals in the South region of Brazil, one public and the other philanthropic. The cross-cultural adaptation of the Protective Nursing Advocacy Scale was performed according to international standards, and its validation was carried out for use in the Brazilian context, by means of factor analysis and Cronbach's alpha as measure of internal consistency. Results: by means of evaluation by a committee of experts and application of pre-test, face validity and content validity of the instrument were considered satisfactory. From the factor analysis, five constructs were identified: negative implications of the advocacy practice, advocacy actions, facilitators of the advocacy practice, perceptions that favor practice advocacy and barriers to advocacy practice. The instrument showed satisfactory internal consistency, with Cronbach's alpha values ranging from 0.70 to 0.87. Conclusion: it was concluded that the Protective Nursing Advocacy Scale - Brazilian version, is a valid and reliable instrument for use in the evaluation of beliefs and actions of health advocacy, performed by Brazilian nurses in their professional practice environment.

Rev Esc Enferm USP2014; 48(3):519-26 www.ee.usp.br/reeusp/ RESUMEN Objetivo: Identificar la frecuencia e intensidad del sufrimiento moral experimentado por enfermeros, técnicos y auxiliares de enfermería que trabajan en los hospitales del sur del estado de Rio Grande do Sul. Método: Se realizó una investigación encuesta con 334 trabajadores de enfermería, pertenecientes a tres instituciones, a través de la aplicación del cuestionario de sufrimiento moral. Por medio del análisis factorial y el Alfa de Cronbach, se validaron los constructos: falta de competencia en el equipo de trabajo, falta de respeto a la autonomía del paciente, condiciones de trabajo insuficientes y obstinación terapéu-tica. Resultados: A través de la estadística descriptiva y el análisis de la varianza, se constató que los enfermeros y auxiliares de enfermería poseen una mayor percepción del sufrimiento moral comparados a los técnicos de enfermería. Los aspectos organizacionales y las formas de comunicación influyen en la menor percepción del sufrimiento moral. Conclusión: Se recomienda la implementación de acciones que favorezcan los enfrentamientos, las tomas de decisiones y el ejercicio de la autonomía de esos trabajadores. DESCRIPTORES

Background: Moral distress is considered to be the negative feelings that arise when one knows the morally correct response to a situation but cannot act because of institutional or hierarchal constraints. Objectives: To analyze moral distress and its relation with sociodemographic and academic variables in undergraduate students from different universities in Brazil. Method: Quantitative study with a cross-sectional design. Data were collected through the Moral Distress Scale for Nursing Students, with 499 nursing students from three universities in the extreme south of Brazil answering the scale. The data were analyzed in the statistical software SPSS version 22.0, through descriptive statistical analysis, association tests (t-test and analysis of variance), and linear regression models. Ethical considerations: Approval for the study was obtained from the Research Ethics Committee at Universidade Federal do Rio Grande. Findings: The mean intensity of moral distress in the constructs ranged from 1.60 to 2.55. As to the occurrence of situations leading to moral distress in the constructs, the frequencies ranged from 1.21 to 2.43. The intensity level of moral distress showed higher averages in the more advanced grades of the undergraduate nursing course, when compared to the early grades of this course (between 5 and 10 grade, average = 2.60–3.14, p = 0.000). Conclusion: The demographic and academic characteristics of the undergraduate nursing students who referred higher levels of moral distress were being enrolled in the final course semesters, were at a federal university, and had no prior degree as an auxiliary nurse/nursing technician.