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- Validation of the comprehensiveness of an instrument on ethical problems in primary carePublication . Junges, José Roque; Zóboli, Elma Lourdes Campos Pavone; Schaefer, Rafaela; Nora, Carlise Rigon Dalla; Basso, MikaelaThe study aimed to validate the comprehensiveness of an instrument on the occurrence of ethical problems in primary health care and discuss their results. This is a methodological research. The technique used was Delphi, which seeks to obtain a consensus on a subject by experts, using structured questionnaires that are modified to obtain consensus on the comprehensibility of content. The sample was composed by nine professionals with expertise in primary health care in São Leopoldo. Data collection was in March and April 2011. In the first round, the professional was asked to respond whether the described situation has represented an ethical problem, whether the statement was clear and whether there was any suggestion to rewriting the problem. Were presented thirty-six statements, and to twenty was suggested new rewrite. After the review and systematization the proposed amendments, has begun the second round to seek consensus among all the statements that its writing had changed. In the second round, the consensus required by the method was obtained. Using the method supported significantly to build the instrument in its initial stage, what makes it appropriated and comprehensive for the subsequent steps of the validation.
- Psychic and moral exhaustion in primary care workersPublication . Pegoraro, Priscilla Brandão Bacci; Schaefer, Rafaela; Zoboli, Elma Lourdes Campos PavoneObjective: To report the experience of developing a workshop proposal to assist local managers with the identification, management and prevention of primary care workers' psychic and moral exhaustion. Method: The workshop was developed through a literature review performed between November 2014 and June 2015. The temporal cut considered studies of the ten previous years. The selection included studies describing collective interventions for situations generating psychic and moral exhaustion, preferably in primary care services. Results: Thirty-five articles were analyzed. The workshop provides five meetings with an average duration of one hour. The themes are: awareness; recognizing personal stress; dealing with personal stress; recognizing team stress; and dealing with team stress. The workshop is based on five key principles: detection and coping; attention to interpersonal relationships; communication; self-knowledge and mindfulness. Conclusion: Psychic and moral exhaustion may reflect negatively on workers' health, the care, and the organization. The proposal of measures to recognize, deal with and prevent psychic and moral exhaustion is relevant and strategic in the constant search for improvement of satisfaction and quality.
- Psychometric evaluation of the Moral Distress Risk Scale: a methodological studyPublication . Schaefer, Rafaela; Zoboli, Elma; Vieira, MargaridaBackground: Moral distress is a kind of suffering that nurses may experience when they act in ways that are considered inconsistent with moral values, leading to a perceived compromise of moral integrity. Consequences are mostly negative and include physical and psychological symptoms, in addition to organizational implications. Objective: To psychometrically test the Moral Distress Risk Scale. Research design: A methodological study was realized. Data were submitted to exploratory factorial analysis through the SPSS statistical program. Participants and research context: In total, 268 nurses from hospitals and primary healthcare settings participated in this research during the period of March to June of 2016. Ethical considerations: This research has ethics committee approval. Findings: The Moral Distress Risk Scale is composed of 7 factors and 30 items; it shows evidence of acceptable reliability and validity with a Cronbach’s α = 0.913, a total variance explained of 59%, a Kaiser–Meyer–Olkin = 0.896, and a significant Bartlett <0.001. Discussion: Concerns about moral distress should be beyond acute care settings, and a tool to help clarify critical points in other healthcare contexts may add value to moral distress speech. Conclusion:Psychometric results reveal that the Moral Distress Risk Scale can be applied in different healthcare contexts.