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BACKGROUND: Women's artistic gymnastics (WAG) is a complex aesthetic sport in which athletes start at a young age and are exposed to high loads during their careers. Little is known about the external and internal training load characteristics among elite young gymnasts. HYPOTHESIS: High training loads, with variations over the weeks, are expected. There is a relationship between external and internal load variables. STUDY DESIGN: Cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: Seven elite-level Brazilian youth artistic gymnasts (age, 11.3 ± 0.4 years; mass, 33.0 ± 7.0 kg; height, 137.7 ± 10.6 cm; experience, 4.0 ± 1.2 years) participated in this study. Five nonconsecutive microcycles were monitored. Both external and internal training loads were quantified by counting the number of elements in video recordings of training sessions and by the session rating of perceived exertion method. RESULTS: A total of 168 individual training sessions were monitored. The microcycle that succeeded the main competition showed a significantly lower training load than ≥3 of the other 4 microcycles for all training load variables, except for vault elements, of which microcycle 4 was inferior only to the microcycle before the competition. Significant correlations were found between weekly internal training load and the total of elements and elements performed on uneven bars. CONCLUSION: Youth women's artistic gymnasts present fluctuations in external and internal training load variables over the weeks close to a major competition. Training load management in this sport must consider the specificity of each apparatus, as they have different demands and training load behaviors. CLINICAL RELEVANCE: A better comprehension of external and internal training loads in youth WAG and its apparatuses can benefit coaches and support staff and provide more information to overcome the challenge of training load management in gymnastics.

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BACKGROUND: Previous studies have shown that women farmers are particularly vulnerable to mental health disorders such as depression and anxiety. AIMS: This study aimed to investigate the prevalence of anxiety and depression in women farmers from Ecuador Coastal and Highlands regions. METHOD: General Anxiety Disorder­7 (GAD­7) and Patient Health Questionnaire­9 (PHQ­9) were applied. In addition, self-reported number of children, days off, hours of work, pesticide use, sleep habits and years of work in agriculture, were also collected. This cross-sectional study occurred during 2023 with 443 women, for Coastal (197) and Highlands (246), respectively. Multivariable binary logistic regression models were performed to obtained adjusted odds ratios (aOR) and their 95% confidence intervals (95% CI). RESULTS: 34.5% of Coastal women had depression, while 27.2% of Highlands women had depression. 20.3% of coastal women farmers had anxiety, while in the Highlands 24.8% had anxiety. Coastal mestizo and montubio women exhibited lower probability of depression, but this was not significant in the Highlands. Coastal women farmers that did not have children showed lower odds of depression (aOR 0.05, 95% CI [0.01, 0.34]). A lower likelihood of depression was observed in coastal women that worked more than 8 hours (aOR 0.22, 95% CI [0.07, 0.72]). Women from the Highlands that had shortened sleep duration exhibited lower odds of depression and anxiety. CONCLUSIONS: A higher proportion of depressed women farmers was observed in the Coast region and slightly higher numbers of anxiety cases in the Highlands. The number of children may cause workload and is correlated with depression in Coastal women.

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This letter offers a constructive review of the article 'Influence of the time-task constraint on ocular metrics of semi-elite soccer' by Luis-del Campo et al. (2023), focusing on methodological considerations and avenues for future research enhancement. The study investigates the impact of task constraints on eye-tracking metrics among semi-elite soccer players, aiming to gauge mental workload during training sessions. While the study presents valuable insights, there are opportunities for methodological refinement. Suggestions include emphasizing sample size determination, randomization of the experimental conditions, and employing robust statistical analyses to mitigate potential biases. Moreover, future studies could benefit from integrating external load measures alongside heart rate monitoring to comprehensively assess training task variations. Despite these considerations, the study underscores the promising application of eye-tracking techniques in evaluating mental workload during soccer training, paving the way for further exploration and refinement of methodologies to enhance player performance assessment and training optimization in the field.

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BACKGROUND: Efficient planning of the oral health workforce in Primary Health Care (PHC) is paramount to ensure equitable community access to services. This requires a meticulous examination of the population's needs, strategic distribution of oral health professionals, and effective human resource management. In this context, the average time spent on care to meet the needs of users/families/communities is the central variable in healthcare professional workforce planning methods. However, many time measures are solely based on professional judgment or experience. OBJECTIVE: Calculate the average time parameters for the activities carried out by the oral health team in primary health care. METHOD: This is a descriptive observational study using the time-motion method carried out in five Primary Health Care Units in the city of São Paulo, SP, Brazil. Direct and continuous observation of oral health team members occurred for 40 h spread over five days of a typical work week. RESULTS: A total of 696.05 h of observation were conducted with 12 Dentists, three Oral Health Assistants, and five Oral Health Technicians. The Dentists' main activity was consultation with an average duration of 24.39 min, which took up 42.36% of their working time, followed by documentation with 12.15%. Oral Health Assistants spent 31.57% of their time on infection control, while Oral Health Technicians spent 22.37% on documentation. CONCLUSION: The study establishes time standards for the activities performed by the dental care team and provides support for the application of workforce planning methods that allow for review and optimization of the work process and public policies.

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Background: Musculoskeletal disorders (MSDs) pose a pervasive concern among nursing professionals due to the high physical workload. Simultaneously, the complex relationship between MSDs and mental health outcomes in this population remains an area of significant interest and importance. Objective: This study aimed to investigate the occurrence of MSDs and their relationships with burnout and psychological suffering within the nursing workforce. Methods: A cross-sectional study was conducted in 2020 involving 291 nursing professionals in Brazil. Standardized questionnaires were employed to gather information on MSDs, mental health outcomes, and pertinent work-related factors. Robust statistical analyses were conducted to ascertain the prevalence of MSDs, establish associations between MSDs and mental health outcomes, and delineate the influence of work-related factors on these associations. Statistical analysis was performed using the R software. Results: The study revealed a significant prevalence of musculoskeletal injuries (MSIs) among nursing workers, focusing on regions that include the lower back, upper back, neck, and shoulders. Individuals with MSIs in the lower back showed a marked increase in emotional exhaustion (p = 0.02), as did those with MSIs in the upper back (p <0.01) and depersonalization (p = 0.07). On the other hand, nursing professionals who reported MSIs in the neck and shoulders had considerably higher scores in emotional exhaustion (p <0.01 and p = 0.01, respectively) and depersonalization (p = 0.05 and p = 0.05, respectively). However, no significant correlations emerged between MSIs and depression or work-related factors. Conclusions: This study highlights the urgency of implementing proactive measures to prevent and manage MSDs within the nursing profession. Moreover, it emphasizes the critical need to enhance working conditions and provide robust support mechanisms to safeguard the mental health of nursing professionals.Open AccessOpen Access.

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Eye tracking has become increasingly applied in medical education research for studying the cognitive processes that occur during the performance of a task, such as image interpretation and surgical skills development. However, analysis and interpretation of the large amount of data obtained by eye tracking can be confusing. In this article, our intention is to clarify the analysis and interpretation of the data obtained from eye tracking. Understanding the relationship between eye tracking metrics (such as gaze, pupil and blink rate) and cognitive processes (such as visual attention, perception, memory and cognitive workload) is essential. The importance of calibration and how the limitations of eye tracking can be overcome is also highlighted.

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OBJECTIVE: To identify predictive factors for the length of physiotherapy sessions for adult intensive care unit (ICU) patients. DESIGN: Longitudinal panel study. SETTING: ICU of a secondary-care public teaching hospital, the University Hospital at the University of Sao Paulo, Brazil. PARTICIPANTS: Medical and surgical patients who received physiotherapy (N=181) assessed in 339 physiotherapy sessions. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The study investigator followed physiotherapists during their work shift and timed the physiotherapy session's length with a stopwatch. The association between session length and patient, physiotherapist, and service-related factors was evaluated by a mixed model. RESULTS: Assessed in this study were 339 physiotherapy sessions during 79 periods of observation that involved 181 patients and 19 physiotherapists. Median session length was 29 (interquartile range: 22.6-38.9) minutes; median number of patients assisted per physiotherapist per 6-hour shift was 5 (4-5). Physiotherapist's median age was 35 (26-39) years old, and median ICU experience was 13.0 (0.4-16.0) years. Patients were mostly older adults who were post surgery and had been at the ICU for 5 (2-9) days. Factors associated with physiotherapy session length (min) were the following: performing both motor- and respiratory-related physiotherapy procedures during the session (ß=6.5; 95% confidence interval [CI], 3.8-9.2), altered chest x-ray (ß=2.8; 95% CI, 0.3-5.3), ICU mobility scale (IMS) (ß=1.2; 95% CI, 0.4-2.0), contraindication to any level of out-of-bed mobilization (ß=-6.9; 95% CI, -10.5 to -3.3), afternoon shift (ß=-4.0; 95% CI, -6.7 to -1.4), and Barthel index (ß=-0.2; 95% CI, -0.3 to -0.1). CONCLUSIONS: The factors associated with longer session lengths were performing both motor- and respiratory-related physiotherapy procedures during the session, altered chest x-ray, and the IMS. Contraindication to any level of out-of-bed mobilization and sessions performed during the afternoon shift (vs the morning shift) were associated with shorter session lengths.

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BACKGROUND: A high workload has been associated with musculoskeletal pain in public school teachers. However, the hypothesis of the present study was that physical activity (PA) practice is able to attenuate this association. OBJECTIVE: To analyze the associations between high workload with musculoskeletal pain according to PA levels in public school teachers. METHODS: Teachers (n = 239) from 13 public schools were evaluated. Workload was assessed using a Likert scale in which teachers reported their perception of their work routine as: very low, low, regular, high, and very high. Musculoskeletal pain and PA were assessed using questionnaires. Multivariate logistic regression models were used to investigate the association of high workload with PA levels and musculoskeletal pain in different body regions, compared to participants with normal workload, adjusted by sex, age, and socioeconomic status. RESULTS: A high workload was associated with higher chances of reporting pain in the wrists and hands (OR = 3.55; 95% CI = 1.27-9.89), knee (OR = 3.09; 95CI%  = 1.09-8.82), and feet and ankles (OR = 3.16; 95% CI = 1.03-9.76) in less active teachers. However, these associations were not observed in teachers considered more active. CONCLUSION: PA practice is able to act as a good protector against musculoskeletal pain in teachers, even in individuals with a high workload.

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OBJECTIVE: To synthesise scientific evidence on interprofessional practice in hospital care and the effects on nursing workload. METHODS: Systematic mixed method review, registered in PROSPERO (CRD42021225627) and conducted in the following databases: CINAHL, Medline, Web of Science and Scopus, with no restrictions on the publication period of the studies. Primary studies were recruited on nurses' interprofessional practice (actions and interactions with other professional categories) in hospitals and the effects on one or more dimensions of nursing workload (quantitative, qualitative, physical, cognitive, emotional, time and variation). Scientific articles available in open access, in English, Spanish or Portuguese, were included. The searches were carried out in January 2021. The studies were evaluated by pairs of independent researchers to verify methodological quality, through the Mixed Method Appraisal Tool, and data extraction. To summarise the studies, thematic analysis was adopted. RESULTS: A total of 1774 publications were assessed for eligibility and 17 studies were included. Of these, two were mixed methods, four were qualitative, and 11 were quantitative, published between 2011 and 2020. The main scenarios investigated were Intensive Care Units and/or Inpatient Units. During data analysis, three thematic categories emerged: Interprofessional practice in coping with emotional overload; Time dedicated by nurses to professional communication; and Working conditions and patient care. The third category consisted of three subthemes: Conflict and flexibility in the context of practice; Working conditions and interprofessional practice; and Effects on patient care. CONCLUSIONS: The evidence points to the emotional overload of nurses in the face of uncooperative practices. Interprofessional actions, especially communicative ones, demand nurses' time and impact the care provided. The results contribute to political decisions and health work management.

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The present study aims to explore and compare psychosocial risks and work overload among nursing professionals in the field mental health and psychiatry in Chile. Quantitative, observational and cross-sectional research was designed for this purpose. Nurses from community, ambulatory, hospital and emergency units in mental health and psychiatry in Chile were recruited between January and May 2022. Instruments of psychosocial variables and an occupational psychosocial risk scale based on the Copenhagen Psychosocial Questionnaire were used. Descriptive and correlational statistics were used, as well as independent samples t-tests, Factorial Anova and post-hoc analysis with Bonferroni correction. As a result, 174 nursing professionals were recruited, 79.3% female, average age 33.9 years. One-third belonged to the Metropolitan Region of Chile. The highest psychosocial risk was obtained by nurses over 30 years of age, from the Metropolitan Region, with more than 16 patients under their care, at the hospital or psychiatric emergency level. Significant differences were observed in work overload and psychosocial risks according to personal and work characteristics of the professionals, as well as of the users and health services. The levels of psychosocial risk and work overload of mental health and psychiatric nurses were reported, as well as the comparison of these according to personal, sociodemographic, and work characteristics. In order to improve the quality of work life of these professionals and the quality of these services, it is essential to develop interventions focused on the dimensions addressed, as well as to define norms and policies that ensure a workload in accordance with international standards.

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This study aimed to analyze the effects of contextual variables (i.e., match location and match outcome) and season periods on match load (i.e., internal and external load) in professional Brazilian soccer players. Thirty-six professional players from the same soccer team participated in this study. The season was split into four phases: matches 1-16 (i.e., Phase 1 = P1); matches 17-32 (i.e., Phase 2 = P2); matches 33-48, (i.e., Phase 3 = P3); matches 49-65 (i.e., Phase 4 = P4). Considering match outcome, when the team wins, Cognitive load, Emotional load, and Affective load were significantly higher in away vs. home matches (p < 0.05). Considering season phases, in P3, Mental Fatigue was significantly higher in drawing than in losing matches (p < 0.05). Additionally, considering the match outcome, when the team lost, Total Distance (TD)/min and TD > 19 km·h-1/min were significantly lower in P1 than P2 (p < 0.001), P3 (p < 0.001), and P4 (p < 0.001). These results suggest to strength and conditioning coaches the need to consider the outcome and location of the previous game when planning the week, as well as the phase of the season they are in to reduce fatigue and injury risk.

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Chronic high stress levels related to work impact the quality of life (QoL). Although physical activity improves QoL, it is not clear whether this life study habit could attenuate possible relationships between QoL and stress in public school teachers. The sample for this study was made up of 231 teachers from public schools. QoL was assessed using the Short-Form Health Survey and physical activity via Baecke's questionnaire. A Likert scale assessed stress level perception. Poisson Regression analyzed the association between stress level and QoL domains adjusted for sex, age, and socioeconomic conditions (model 1). In model 2, physical activity level was inserted in addition to model 1. Seven out of eight domains of QoL, except the domain of pain, were associated with high levels of stress (all p < 0.05-model 1). However, in model 2, the associations of the high levels of stress with general health status (p = 0.052) and functional capacity (p = 0.081) domains of QoL were mitigated. Our results indicated that physical activity mitigated the relationship between higher levels of stress and lower perception of general health status and functional capacity domains in secondary public school teachers.

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PURPOSE: Growing complexity and demand for cancer care entail increased challenges for Medical Oncology (MO). The Spanish Society of Medical Oncology (SEOM) has promoted studies to provide updated data to estimate the need for medical oncologists in 2040 and to analyse current professional standing of young medical oncologists. METHODS: Two national, online surveys were conducted. The first (2021) targeted 146 Heads of MO Departments, and the second (2022), 775 young medical oncologists who had completed their MO residency between 2014 and 2021. Participants were contacted individually, and data were processed anonymously. RESULTS: Participation rates reached 78.8% and 48.8%, respectively. The updated data suggest that 87-110 new medical oncologist full-time equivalents (FTEs) should be recruited each year to achieve an optimal ratio of 110-130 new cases per medical oncologist FTE by 2040. The professional standing analysis reveals that 9.1% of medical oncologists trained in Spain do not work in clinical care in the country, with tremendous employment instability (only 15.2% have a permanent contract). A high percentage of young medical oncologists have contemplated career paths other than clinical care (64.5%) or working in other countries (51.7%). CONCLUSIONS: Optimal ratios of medical oncologists must be achieved to tackle the evolution of MO workloads and challenges in comprehensive cancer care. However, the incorporation and permanence of medical oncologists in the national healthcare system in Spain could be compromised by their current sub-optimal professional standing.

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BACKGROUND: People with long work hours, as evidenced by teachers, were more likely to present health problems that impact their quality of life (QoL). The reduced physical activity (PA) level or higher sedentary behavior in public school teachers was related to obesity. Although PA seems to improve the QoL in other professions, assessing whether the PA level could influence the relationship between workload and QoL in public school teachers is necessary. OBJECTIVE: To analyze whether the high workload was related to worse QoL in teachers considered less active and more active. METHODS: Two hundred forty-three teachers from public schools participated in this study. The domains of QoL and PA levels were assessed by SF-36 and Baecke questionnaires, respectively. Workload perception was assessed by a Likert scale. Binary logistic regression analyzed the association between high workload and QoL domains in teachers considering the PA level in a model adjusted by confounding factors (i.e., sex, age, and socioeconomic condition). RESULTS: Heavy workload was associated with less chances of having better physical limitation domain of both less and more physically active teachers. Less active teachers with heavy workloads were 53%, 61%, and 56% less likely to have better vitality, social functioning, and mental health, respectively. No such associations were observed in the more physically active teachers. CONCLUSION: Less active teachers with a heavy workload demonstrate lower QoL. Although the PA practice eliminated this relationship, both active and less active teachers with a heavy workload demonstrated lower QoL in physical limitation domain.

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BACKGROUND: Intensive care environments already required complex work, and, furthermore, the recent COVID-19 pandemic increased health care demands, disorganized work teams and limited resources. Nonetheless, the real workload of nursing workers in the care for critical patients during this period was seldom investigated. AIM: To compare the workload of nursing workers, estimated using the Nursing Activities Score (NAS), in patients with and without COVID-19 who had been hospitalized in an adult intensive care unit (ICU). STUDY DESIGN: This study was developed in the ICU of a public university hospital in the south of Brazil. The workload of nursing workers was estimated using the NAS, which was developed through a retrospective cohort using reports of the assistance registered in electronic records, including the first 10 days of hospitalization of all patients admitted into the ICU in 2020 and 2021, who had at least one NAS evaluation; then, the workload was compared between patients with and without COVID-19. Generalized estimating equations models were used. The project was approved by the research ethics committee of the institution where the study took place. RESULTS: The follow-up of 3485 patients resulted in 20 506 days of observation during the first 10 days of ICU hospitalization. The mean NAS score for the entire patient/day sample was 85.6 ± 18.1%, with 87.8 ± 17.8% in the COVID-19 group and 82.6 ± 18.2% in the non-COVID-19 group (p < .001). The use of mechanical ventilation, noradrenaline, sedation and neuromuscular blocking drugs, extracorporeal membrane oxygenation and haemodialysis increased the value of NAS for patients with or without COVID-19. CONCLUSIONS: The workload of nursing professionals was higher for COVID-19 patients than for patients who did not present the disease in the first 10 days of ICU hospitalization. RELEVANCE TO CLINICAL PRACTICE: This study presents the impact of COVID-19 on the ICU nursing workload in Brazil. The high workload found can support management decisions regarding quantity and quality of workforce composition.

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ABSTRACT Objective: To evaluate the workload and severity of patients in the Intensive Care Unit (ICU) with COVID-19. Method: Cross-sectional, analytical study carried out in the ICU of a private hospital. All patients over the age of 18 with a diagnosis of COVID-19 admitted from September 2020 to June 2021 were included. Workload assessed by the Nursing Activities Score (NAS), and severity by the Sequential Organ Failure Assessment. Descriptive and inferential analyses were performed. Results: 217 patients were included, mostly men, mean age 62.41 years, white, obese, non-smokers and sedentary. The average NAS was 84.79. Staffing was in line with legislation and NAS. NAS was not associated with severity. Severity was associated with higher age, gender, comorbidities, sedentary lifestyle, time on mechanical ventilation, hospitalization and death. Conclusion: Workload was high and not associated with severity or outcomes. Severity was associated with demographic and clinical conditions. This study shows the importance of staff sizing, with a view to promoting safety and quality of care.

RESUMEN Objetivo: Evaluar la carga de trabajo y la gravedad de los pacientes de la Unidad de Cuidados Intensivos (UCI) con COVID-19. Método: Estudio transversal y analítico realizado en la UCI de un hospital privado. Se incluyeron todos los pacientes mayores de 18 años con diagnóstico de COVID-19 ingresados entre septiembre de 2020 y junio de 2021. Carga de trabajo evaluada mediante la Nursing Activities Score (NAS), y gravedad mediante la valoración secuencial de fallo orgánico. Se realizaron análisis descriptivos e inferenciales. Resultados: Se incluyeron 217 pacientes, en su mayoría hombres, edad media 62,41 años, raza blanca, obesos, no fumadores y sedentarios. El NAS medio era de 84,79. Los niveles de personal se ajustaban a la legislación y al NAS. El NAS no se asoció con la gravedad. La gravedad se asoció a mayor edad, sexo, comorbilidades, sedentarismo, tiempo de ventilación mecánica, hospitalización y muerte. Conclusión: La carga de trabajo fue elevada y no se asoció a la gravedad ni a los resultados. La gravedad se asoció a las condiciones demográficas y clínicas. Este estudio muestra la importancia del dimensionamiento del personal, con vistas a promover la seguridad y la calidad de los cuidados.

RESUMO Objetivos: Avaliar carga de trabalho e gravidade dos pacientes na Unidade de Terapia Intensiva (UTI) com COVID-19. Método: Estudo transversal, analítico realizado na UTI em hospital privado. Incluídos todos os pacientes maiores de 18 anos, com diagnóstico de COVID-19 admitidos de setembro de 2020 a junho de 2021. Carga de trabalho avaliado pelo Nursing Activities Score (NAS), e gravidade pelo Sequential Organ Failure Assessment. Realizado análises descritiva e inferencial. Resultados: Incluídos 217 pacientes, maioria homens, média de idade 62,41 anos, brancos, obesos, não tabagistas e sedentários. A média do NAS foi 84,79. O dimensionamento de pessoal estava em concordância com legislação e NAS. O NAS não foi associado a gravidade. Houve associação da gravidade com maior idade, sexo, comorbidades, sedentarismo, tempo de ventilação mecânica, internação e óbito. Conclusão: A carga de trabalho foi alta e não associada a gravidade e desfechos. A gravidade foi associada às condições demográficas e clínicas. Este estudo mostra a importância do dimensionamento de pessoal, com vistas à promoção da segurança e qualidade assistencial.

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ABSTRACT Objectives: To describe the historical series of admissions to the Intensive Care Unit of older adults with femoral fractures, and verify the association between age and injury characteristics and treatment, nursing workload, severity, and clinical evolution in the unit. Method: Retrospective cohort of 295 older adults (age ≥60 years) admitted to the Intensive Care Unit of a hospital in São Paulo, between 2013 and 2019, and who presented with a femur fracture as the main cause of hospitalization. Variables regarding demographic characteristics, cause, and type of fracture, treatment provided, severity, nursing workload, and medical outcome of patients were analyzed. The Shapiro-Wilk, Wilcoxon-Mann-Whitney, Kruskal-Wallis tests and Pearson correlation were applied. Results: There was an increase in older adults admission to the Intensive Care Unit from 2017 on. Female patients with distal femur fractures who died in the Intensive Care Unit had significantly (p < 0.05) higher median age than men, patients with shaft or proximal femur fractures, and survivors. Conclusion: The study findings highlight essential information for structuring care for older adults with femoral fractures who require intensive care.

RESUMEN Objetivo: Describir la serie histórica de internaciones, en la Unidad de Cuidados Intensivos, de ancianos con fractura de fémur, y verificar la asociación entre la edad y las características y tratamiento de la lesión, carga de trabajo de enfermería, gravedad y evolución clínica en la unidad. Método: Cohorte retrospectiva de 295 ancianos (edad ≥60 años) ingresados en la Unidad de Cuidados Intensivos de un hospital de São Paulo, entre 2013 y 2019, y que presentaron fractura de fémur como principal causa de hospitalización. Se analizaron variables relativas a características demográficas, causa y tipo de fractura, tratamiento realizado, gravedad, carga de trabajo de enfermería y evolución clínica de los pacientes. Se aplicaron las pruebas de Shapiro-Wilk, Wilcoxon-Mann-Whitney, Kruskal-Wallis y correlación de Pearson. Resultados: Hubo aumento de hospitalizaciones de ancianos en Unidad de Cuidados Intensivos desde 2017. Las pacientes del sexo femenino con fracturas de fémur distal que murieron en la Unidad de Cuidados Intensivos tuvieron mediana de edad significativamente (p < 0,05) más alta que los hombres, los pacientes con fracturas de diáfisis o de fémur proximal y los supervivientes. Conclusión: Los hallazgos del estudio resaltan información esencial para estructurar la atención de los ancianos con fracturas femorales que requieren tratamiento intensivo.

RESUMO Objetivos: Descrever a série histórica das internações, na Unidade de Terapia Intensiva, de idosos com fratura de fêmur, e verificar a associação entre idade e as características e tratamento da lesão, carga de trabalho de enfermagem, gravidade e evolução clínica na unidade. Método: Coorte retrospectiva de 295 idosos (idade ≥60 anos) admitidos na Unidade de Terapia Intensiva de hospital em São Paulo, entre 2013 e 2019, e que apresentaram fratura de fêmur como causa principal da internação. Variáveis sobre características demográficas, causa e tipo da fratura, tratamento realizado, gravidade, carga de trabalho de enfermagem e desfecho clínico dos pacientes foram analisadas. Os testes de Shapiro-Wilk, Wilcoxon-Mann-Whitney, Kruskal-Wallis e correlação de Pearson foram aplicados. Resultados: Houve aumento das internações de idosos na Unidade de Terapia Intensiva a partir de 2017. Pacientes do sexo feminino, com fratura distal de fêmur e que morreram na Unidade de Terapia Intensiva apresentaram significativamente (p < 0,05) maior mediana de idade do que homens, pacientes com fratura de diáfise ou proximal do fêmur e sobreviventes. Conclusão: Os achados do estudo evidenciam informações essenciais para estruturação dos cuidados ao idoso com fratura de fêmur que necessita de tratamento intensivo.

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Objective: to describe the development of a predictive nursing workload classifier model, using artificial intelligence. Method: retrospective observational study, using secondary sources of electronic patient records, using machine learning. The convenience sample consisted of 43,871 assessments carried out by clinical nurses using the Perroca Patient Classification System, which served as the gold standard, and clinical data from the electronic medical records of 11,774 patients, which constituted the variables. In order to organize the data and carry out the analysis, the Dataiku® data science platform was used. Data analysis occurred in an exploratory, descriptive and predictive manner. The study was approved by the Ethics and Research Committee of the institution where the study was carried out. Results: the use of artificial intelligence enabled the development of the nursing workload assessment classifier model, identifying the variables that most contributed to its prediction. The algorithm correctly classified 72% of the variables and the area under the Receiver Operating Characteristic curve was 82%. Conclusion: a predictive model was developed, demonstrating that it is possible to train algorithms with data from the patient's electronic medical record to predict the nursing workload and that artificial intelligence tools can be effective in automating this activity.

Objetivo: describir el desarrollo de un modelo clasificador predictivo de la carga de trabajo de enfermería, utilizando inteligencia artificial. Método: estudio observacional retrospectivo, en fuentes secundarias de registros electrónicos de pacientes, con uso de aprendizaje automático. La muestra por conveniencia se constituyó de 43.871 evaluaciones realizadas por enfermeras asistenciales con el Sistema de Clasificación de Pacientes de Perroca, que sirvieron como patrón oro, y datos clínicos del expediente electrónico de 11.774 pacientes, que constituyeron las variables. Para la organización de los datos y la realización de los análisis se utilizó la plataforma de ciencia de datos Dataiku ® . El análisis de los datos ocurrió de forma exploratoria, descriptiva y predictiva. Estudio aprobado por el Comité de Ética e Investigación de la institución campo del estudio. Resultados: el uso de inteligencia artificial posibilitó el desarrollo del modelo clasificador de evaluación de la carga de trabajo de enfermería, identificando las variables que más contribuyeron para su predicción. El algoritmo clasificó correctamente el 72% de las variables y el área bajo la curva Receiver Operating Characteristic fue del 82%. Conclusión: hubo el desarrollo de un modelo predictivo, demostrando que es posible entrenar algoritmos con datos del expediente electrónico del paciente para predecir la carga de trabajo de enfermería y que las herramientas de inteligencia artificial pueden ser efectivas para la automatización de esta actividad.

Objetivo: descrever o desenvolvimento de um modelo classificador preditivo da carga de trabalho de enfermagem, utilizando inteligência artificial. Método: estudo observacional retrospectivo, em fontes secundárias de registros eletrônicos de pacientes, com uso de aprendizado de máquina. A amostra por conveniência constituiu-se de 43.871 avaliações realizadas por enfermeiras assistenciais com o Sistema de Classificação de Pacientes de Perroca, as quais serviram como padrão ouro, e os dados clínicos do prontuário eletrônico de 11.774 pacientes, que constituíram as variáveis. Para a organização dos dados e a realização das análises, utilizou-se a plataforma de ciência de dados Dataiku ® . A análise dos dados ocorreu de forma exploratória, descritiva e preditiva. Estudo aprovado pelo Comitê de Ética e Pesquisa da instituição campo do estudo. Resultados: o uso de inteligência artificial possibilitou o desenvolvimento do modelo classificador de avaliação da carga de trabalho de enfermagem, identificando as variáveis que mais contribuíram para a sua predição. O algoritmo classificou corretamente 72% das variáveis e a área sob a curva Receiver Operating Characteristic foi de 82%. Conclusão: houve o desenvolvimento de um modelo preditivo, demonstrando que é possível treinar algoritmos com dados do prontuário eletrônico do paciente para predizer a carga de trabalho de enfermagem e que as ferramentas da inteligência artificial podem ser efetivas para a automatização desta atividade.

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Objective: to examine the nursing team's view of the repercussions of moving patients (admissions, transfers and discharges) on the organization of work and the delivery of care. Method: this is a qualitative study using the focus group technique, conducted with 23 professionals - 12 nurses, eight nurse technicians and three nurse assistants working in three inpatient units at a teaching hospital in the countryside of Sao Paulo. Four meetings took place between November 2021 and March 2022. The reports were analyzed thematically using MAXQDA software. Results: two thematic categories emerged: the influence of structural factors and work organization on the intra-hospital moving of patients; it demands time, generates work overload and interferes with the delivery of care. Conclusion: the volume of moving patient associated with unforeseen demands, care complexity and insufficient staff and resources have a negative impact on the delivery of care, with clinical risks and work overload. The findings make it possible to improve the regulation of patients entering and leaving the units, work organization and care management, avoiding clinical risks, delays, omissions and work overload.

Objetivo: examinar la perspectiva del equipo de enfermería sobre las repercusiones del movimiento de pacientes (admisiones, traslados y altas) en la organización del trabajo y en la prestación de cuidados. Método: estudio cualitativo utilizando la técnica de grupo focal llevado a cabo con 23 profesionales, incluyendo 12 enfermeros, ocho técnicos y tres auxiliares de enfermería de tres unidades de internación de un hospital universitario del interior de São Paulo. Se realizaron cuatro encuentros entre noviembre de 2021 y marzo de 2022. Los relatos fueron analizados en la modalidad temática con la ayuda del software MAXQDA. Resultados: surgieron dos categorías temáticas: la influencia de factores estructurales y de la organización del trabajo en el movimiento intrahospitalario de pacientes; y, el movimiento de pacientes demanda tiempo, genera sobrecarga de trabajo e interfiere en la prestación de cuidados. Conclusión: el volumen de movimientos de pacientes asociado a demandas imprevistas, complejidad asistencial e insuficiencia de personal y de recursos repercute negativamente en la prestación del cuidado con riesgos clínicos y sobrecarga laboral. Los hallazgos permiten mejorar la regulación de las entradas y salidas de pacientes en las unidades, la organización del trabajo y la gestión del cuidado, evitando riesgos clínicos, retrasos, omisiones y sobrecarga laboral.

Objetivo: examinar o olhar da equipe de enfermagem quanto às repercussões da movimentação de pacientes (admissões, transferências e altas) na organização do trabalho e na entrega do cuidado. Método: estudo qualitativo utilizando técnica de grupo focal conduzido junto a vinte e três profissionais sendo doze enfermeiros, oito técnicos e três auxiliares de enfermagem lotados em três unidades de internação de um hospital de ensino do interior de São Paulo. Ocorreram quatro encontros, entre novembro de 2021 e março de 2022. Os relatos foram analisados na modalidade temática com o auxílio do software MAXQDA. Resultados: emergiram duas categorias temáticas: a influência de fatores estruturais e da organização do trabalho na movimentação intra-hospitalar de pacientes; e a movimentação de pacientes demanda tempo, gera sobrecarga de trabalho e interfere na entrega do cuidado. Conclusão: o volume de movimentações de pacientes associado às demandas imprevistas, complexidade assistencial e insuficiência de pessoal e de recursos repercutem negativamente na entrega do cuidar com riscos clínicos e sobrecarga laboral. Os achados possibilitam aprimorar a regulação das entradas e saídas de pacientes nas unidades, organização do trabalho e gestão do cuidado evitando-se riscos clínicos, atrasos, omissões e sobrecarga laboral.

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Objective: to evaluate the Nursing workload and its related factors in the assistance provided to hospitalized women with gynecological and breast cancers, according to the Nursing Activities Scores adapted for cancer patients. Method: a cross-sectional and epidemiological study. The participants were women with gynecological and/or breast cancer, over 18 years of age, and hospitalized for a minimum period of 24 hours. The following was collected from the medical records: sociodemographic and clinical data, Karnofsky Performance Status and workload, according to the adapted Nursing Activities Score. The factors related to workload were analyzed by means of multiple linear regression. Results: the mean Nursing Activities Scores was 29.3%, denoting seven hours of daily care per patient. The factors related to workload differed according to the breast or gynecological cancer diagnosis (β=-0.01; p<0.001), clinical or surgical treatment (β=-0.03; p<0.001) and functional capacity at admission (β=0.07; p<0.001), as per the Karnofsky Performance Status. Conclusion: there was greater workload for the care of women with gynecological cancer undergoing clinical treatment and with lower functional capacity at admission. The findings reveal directions for optimization of resources and improvements in work processes and flows, in order to promote a favorable work environment and good quality assistance.

Objetivo: evaluar la carga de trabajo de enfermería y los factores relacionados con la atención de mujeres hospitalizadas con cáncer ginecológico y de mama, según el Nursing Activities Scores adaptado para pacientes oncológicos. Método: estudio epidemiológico y transversal. Participaron mujeres con cáncer ginecológico y/o de mama, mayores de 18 años, hospitalizadas por un período mínimo de 24 horas. De las historias clínicas se recolectaron datos sociodemográficos y clínicos, Karnofsky Performance Status y carga de trabajo, según el Nursing Activity Score adaptado. Los factores relacionados con la carga de trabajo se analizaron mediante regresión lineal múltiple. Resultados: el puntaje promedio del Nursing Activity Scores fue del 29,3%, lo que indica que se brindan siete horas diarias de atención por paciente. Los factores relacionados con la carga de trabajo difirieron según diagnóstico de cáncer de mama o ginecológico (β=-0,01; p<0,001), tratamiento clínico o quirúrgico (β=-0,03; p<0,001) y capacidad funcional al momento del ingreso (β=0,07; p< 0,001), conforme a la escala Karnofsky Performance Status . Conclusión: hubo una mayor carga de trabajo en la atención a mujeres con cáncer ginecológico en tratamiento clínico y con menor capacidad funcional al momento del ingreso. Los hallazgos revelan información útil para optimizar recursos, mejorar procesos y flujos de trabajo, con el fin de promover un ambiente de trabajo favorable y una atención de calidad.

Objetivo: avaliar a carga de trabalho da enfermagem e seus fatores relacionados na assistência às mulheres hospitalizadas com cânceres ginecológicos e mamários, segundo o Nursing Activities Scores , adaptado a pacientes oncológicos. Método: estudo epidemiológico de corte transversal. Participaram mulheres com câncer ginecológico e/ou mamário, maiores de 18 anos, hospitalizadas por período mínimo de 24 horas. Coletados, do prontuário, dados sociodemográficos, clínicos, Karnofsky Performance Status e carga de trabalho, segundo Nursing Activities Score adaptado. Os fatores relacionados à carga de trabalho foram analisados por regressão linear múltipla. Resultados: pontuação média do Nursing Activities Scores foi 29,3%, denotando sete horas de assistência diária por paciente. Os fatores relacionados à carga de trabalho diferiram conforme diagnóstico de câncer de mama ou ginecológico (β= - 0,01; p<0,001), tratamento clínico ou cirúrgico (β= - 0,03; p<0,001) e capacidade funcional na admissão (β= 0,07; p<0,001), pelo Karnofsky Performance Status . Conclusão: evidenciou-se maior carga de trabalho para atendimento de mulheres com câncer ginecológico sob tratamento clínico e com menor capacidade funcional na admissão. Os achados revelam direcionamentos para otimização de recursos, melhorias em processos e fluxos de trabalho, a fim de promover ambiente laboral favorável e assistência de qualidade.

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