The Open Nursing Journal




ISSN: 1874-4346 ― Volume 13, 2019
RESEARCH ARTICLE

Correlation Between Stress and Quality of Life Experienced by Caregivers: Perception of a Group of Healthcare Professionals



Bhárbara Karolline Rodrigues Silva1, *, Fernando Rodrigues Peixoto Quaresma2, Erika da Silva Maciel3, Francisco Winter dos Santos Figueiredo4, Jonathan Souza Sarraf5, Fernando Adami6
1 Epidemiology and Data Analysis Laboratory, Faculdade de Medicina do ABC (FMABC) - Santo André-SP, Brazil.
2 Faculdade de Medicina do ABC (FMABC), Lutheran University Center of Palmas -TO and Federal University of the State of Tocantins (UFT) - Palmas-TO, Brazil.
3 Department of Medical Sciences, at the University of São Paulo (USP), Federal University of the Tocantins (UFT) - Miracema-TO, Brazil.
4 Faculdade de Medicina do ABC (FMABC), Epidemiology and Data Analysis Laboratory, Faculdade de Medicina do ABC (FMABC) - Santo André-SP, Brazil.
5 Federal University of the State of Pará (UFPA) - Belém-PA, Brazil.
6 Faculty of Public Health at the University of São Paulo (USP), Faculdade de Medicina do ABC (FMABC), Laboratory of Epidemiology and Data Analysis, Faculdade de Medicina do ABC (FMABC) - Santo André-SP, Brazil.

Abstract

Aim:

This study aims to evaluate the relationship between perceived level of stress and quality of life of professionals working in Prompt Service Units in the city of Palmas, Tocantins.

Methods:

A cross-sectional study was performed among 164 professionals from Prompt Service Units. Stress levels were evaluated using the Perceived Stress Scale. The WHOQOL-bref was used to evaluate the perception of quality of life. Quantitative variables distribution was evaluated using Shapiro-Wilk's test. For the analyses of correlations among perceived level of stress, total quality of life score, and the physical health domain of the WHOQOL-bref, Pearson's correlation test was applied. The significance level adopted for this trial was 95%. The study was approved by the Committee of Ethics in Research with Human Beings.

Results:

When assessing the perceived level of stress with the total quality of life score, there was no significant correlation between those variables. However, there was an association between the perceived level of stress and the physical health domain of quality of life.

Conclusion:

Perceived quality of life was correlated with the physical health domain, and this result reinforces the importance of the facets that make up this area.

Keywords: Quality of life, Stress, Healthcare professional, Self-perception, Prompt service units.


Article Information


Identifiers and Pagination:

Year: 2017
Volume: 11
First Page: 135
Last Page: 141
Publisher Id: TONURSJ-11-135
DOI: 10.2174/1874434601711010135

Article History:

Received Date: 31/05/2017
Revision Received Date: 5/06/2017
Acceptance Date: 10/06/2017
Electronic publication date: 27/09/2017
Collection year: 2017

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© 2017 Silva et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author at the Epidemiology and Data Analysis Laboratory, Faculty of Medicine of ABC (FMABC) – Santo André-SP, Brazil; Tel: +55 63 98415-3287; E-mail: bharbarakarolline@gmail.com




1. INTRODUCTION

Stress among healthcare professionals has been observed as an occupational risk factor in Brazilian and American professional sectors [1Ribeiro RP, Martins JT, Marziale MH, Robazzi ML. O adoecer pelo trabalho na enfermagem: uma revisão integrativa. Rev Esc Enferm USP 2012; 46(2): 495-504.
[http://dx.doi.org/10.1590/S0080-62342012000200031] [PMID: 22576557]
].

Faced with stressors, an individual experiences increasing stress. This process may become a risk if the body does not reestablish homeostasis as a mechanism to adapt to such stressors [2Rosario CAR, Lopes AM, Pereira FF, da Costa FM. Avaliação do estresse entre enfermeiros que atuam na Estratégia Saúde da Família de Montes Claros. Renome 2015; 4(1): 3-14.]. Emotional exhaustion, general fatigue, and physical waste are consequences that may lead to Burnout Syndrome or Occupational Burnout Syndrome [3Gouveia VV, Oliveira GF, Mendes LA, Souza LE, Cavalcanti TM, Melo RL. Escala de avaliação da fadiga: adaptação para profissionais da saúde. Revista Psicologia Organizações e Trabalho 2015; 15(3): 246-56.
[http://dx.doi.org/10.17652/rpot/2015.3.594]
, 4Almeida LA, de Souza Medeiros ID, de Barros AG, Martins CC, Santos VE. Fatores geradores da Síndrome de Burnout em profissionais da saúde Generating factors of Burnout Syndrome in health professionals. Revista de Pesquisa: Cuidado é Fundamental Online 2016; 8(3): 4623-31.
[http://dx.doi.org/10.9789/2175-5361.2016.v8i3.4623-4628]
].

Prompt Service Units (PSU) are health centers designed to deal with diseases of intermediate complexity, hierarchically allocated in between the Basic Health Unit and the Hospital Network. They are characterized by a closed environment and keeping close contact with human suffering, pain, and death, its constant attention leading, inevitably, to quality of life repercussions [5BRASIL Ministério da Saúde portaria nº 342 de 4 de março de 2013 Redefine as diretrizes para implantação do componente Unidade de Pronto Atendimento (UPA 24h) em Conformidadecom a Polílica Nacional de Atenção às Urgências, e dispõe sobre incentivo financeiro de investimento para novas UPA 24h (UPA Nova) e UPA 24h ampliadas (UPA Ampliada) e respectivo incentivo financeiro de custeio mensal Diário oficial [da] União, Brasília, DF. 2013., 6Freire CB, Dias RF, Schwingel PA, et al. Quality of life and physical activity in intensive care professionals from middle São Francisco. Rev Bras Enferm 2015; 68(1): 21-26, 26-31.
[PMID: 25946491]
].

On health evaluations, the identification of perceived stress has become an important variable considered for occupational health diagnosis [7Cohen S, Kamarck T, Mermelstein R. Stress Global Measure Perceived. J health Soc Behav 1983; 24(4): 385-96., 8Reis RS, Petroski EL, Lopes AS. Measures of the physical activity: revision of methods. RevBras cineantropom Desempenho Hum 2000; 2(1): 89-96.] and presents itself as a point for feasibly elaborating more efficient interventional strategies [9Maciel ES, Kimiesavay-Da-Silva L, Galvão JA, et al. Availability of fish in Brazilian households: Analysis of data from the 2008-2009 survey of family budgets. Int J Appl 2014; 4(4): 102-10.].

Besides, health professions occupy a prominent place when evaluating stress regarding labor dynamics [10Barroso ML, de Oliveira GF, de Carvalho AC, Batista HM, de Menezes Silveira GB. Estresse e uso de álcool em enfermeiros que trabalham em urgência e emergência. Cadernos de Cultura e Ciência 2015; 13(2): 60-75., 11Silva B, Zica M, Barbosa T, Quaresma F, Sonati J, Maciel E. Percepção da qualidade de vida, estresse, nível de atividade física e cronotipo em grupo de enfermeiros das Unidades de Pronto Atendimento do Brazil. Revista da UIIPS 2016; 4(2): 103-13.]. There are negative repercussions for employees’ health and for the quality of assistance provided [12Oliveira FP, Mazzaia MC, Marcolan JF. Symptoms of depression and intervening factors among nurses of emergency hospital services. Acta Paul Enferm 2015; 28(3): 209-15.
[http://dx.doi.org/10.1590/1982-0194201500036]
].

In this context, one must consider the fact that the lifestyle has become renowned as one of the most important determinants of health and quality of life of individuals and communities [13Malta DC, Szwarcwald CL. Lifestyles and chronic non-transmissible diseases of the Brazilian population according to the National Health Survey: balance of the main results. Sao Paulo Med J 2015; 133(4): 286-9.
[http://dx.doi.org/10.1590/1516-3180.2015.13340308] [PMID: 26517145]
], so the relevance of this work is clear as stressors in the work of these professionals are the main precursor of a negative perception of one's quality of life.

Thus, the present article aims to discuss the relationship between the perceived amount of stress and the quality of life of PSU working professionals in the city of Palmas, Tocantins.

2. MATERIALS AND METHODS

A cross-sectional study performed with a team of 164 multidisciplinary participants present at the PSU of the city of Palmas, Tocantins' capital, was approved by the Committee of Ethics in Research with Human Beings, under the identification of do CAAE 07564412.0.00005516.

The initial sample included all the professionals of the Palmas Pronto Care Units, approximately 250 professionals. However, among the exclusion criteria were those who were on vacation, who did not respond correctly to the questionnaires, who refused to sign the Free and Informed Consent Term, and/or who were not found within the data collection period stipulated by the researchers. A total of 164 professionals participated in the study.

The city has 39 Primary Healthcare Units and 2 PSUs, one of which is located in the northern region and the other in the southern region. All participants were multidisciplinary professionals with Higher Educational Level (Physician, Nurse, Dentist, Social Assistant, and Pharmacist), Technical Level (Nursing Technician, Dental Assistant, Laboratory Technician, and X-Ray Technician), and Medium Level (Security Guard, Administrative Assistant, General Services Assistant, and Stretcher Bearer). Professionals who answered less than 20% of the questions asked or who refused to take part in the trial were excluded from the research.

The professionals were invited to participate in the study, which took the form of an interview, in the workplace after explaining the objective and asking them to sign the Free and Informed Consent Form.

Sociodemographic variables evaluated were sex, profession, PSU, employment relationship, working hours, service time, number of workplaces, and income.

The Perceived Stress Scale - The Stress Perception Scale has demonstrated reliability and evidence of validity regarding actions of risk and health perception. It was proposed to evaluate stress from thoughts and feelings related to the events occurring in the last 30 days as a global measure. Composed of 10 multiple choice questions, it was to evaluate individual general stress [14Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983; 24(4): 385-96.
[http://dx.doi.org/10.2307/2136404] [PMID: 6668417]
].

To evaluate perceived quality of life, an instrument validated by the World Health Organization (WHO), the WHOQOL-bref, was used [15WHO Qol Group. The development of the World Health Organization quality of life assessment instrument (the WHOQOL) InQuality of life assessment: International perspectives. Springer Berlin Heidelberg 1994; pp. 41-57., 16Group TW. The World Health Organization quality of life assessment (WHOQOL): development and general psychometric properties. Soc Sci Med 1998; 46(12): 1569-85.
[http://dx.doi.org/10.1016/S0277-9536(98)00009-4] [PMID: 9672396]
]. It is composed of 26 items, 2 questions of which are broad and the other 24 are divided into 4 different domains: 1-physical health, 2-psychological health, 3-social relationships, and 4-environment [17Fleck MP, Louzada S, Xavier M, et al. Aplicação da versão em português do instrumento abreviado de avaliação da qualidade de vida “WHOQOL-bref”. Rev Saude Publica 2000; 34(2): 178-83.
[http://dx.doi.org/10.1590/S0034-89102000000200012] [PMID: 10881154]
]. The results were stratified for each domain with the understanding that the original division is a characterization of various aspects of one's quality of life.

Qualitative variables were described by absolute and relative frequency. The distribution of quantitative variables was evaluated using the Shapiro-Wilk test. For the domains that did not present normal distribution, score cubic transformation was used; quadratic transformation was used for total quality of life score.

Aiming to analyze correlation between the perceived level of stress, total quality of life score, and the physical health domain of the WHOQOL-bref, Pearson's correlation test was applied. The significance level adopted for this trial was 95%. The statistical software utilized was Stata 11.0.

3. RESULTS

In this study, 164 participants took part in the trial. The mean age was 38.13 years (SD = 9.97). Sociodemographic characteristics, profession, PSU in which the participant works, employee relationship, service time, number of places worked, income, and professional level are available in (Table 1).

Table 1
Characterization regarding sex, PSU unity of work, employee relationship, service time, number of places worked, income and educational level.


Regarding perceived quality of life (Table 2), the Psychological domain obtained a higher score 14.4 (SD = 1.9). Regarding perceived stress, the average score was 16.7 (SD = 6.7).

Table 2
Evaluation of stress, quality of life by domain and general score of quality of life.


According to the WHOQOL-bref, no association could be identified between the level of perceived stress and the domains of quality of life (Fig. 1).

Fig. (1)
Correlation between the level of perceived stress and the domains of quality of life (cubed).


4. DISCUSSION

When assessing the relationship between the perceived level of stress and the quality of life of professionals working in Emergency Care Units, no significant relationship was found.

To understand the observed relationship in our trial, it is crucial to consider that the WHOQOL-bref physical health domain is made up by facets that have some type of relationship with basic human needs—for instance, physical pain and discomfort, energy and fatigue, sleep and rest, daily life activities, dependence on medications or treatment, and work capacity [18Mascarenhas CH, Prado FO, Fernandes MH, Boery EN, da Silva Sena EL. Qualidade de vida em trabalhadores da área de saúde: uma revisão sistemática. Espaço para a Saúde-Revista de Saúde Pública do Paraná 2013; 14(1/2): 72-81.].

It is a fact that painful and/or uncomfortable situations may negatively reflect on one's quality of life, increasing stress levels. Besides, nursing professionals (majority in this trial n = 96) often experience back pain and musculoskeletal injuries, often due to the posture adopted during the work activity [1Ribeiro RP, Martins JT, Marziale MH, Robazzi ML. O adoecer pelo trabalho na enfermagem: uma revisão integrativa. Rev Esc Enferm USP 2012; 46(2): 495-504.
[http://dx.doi.org/10.1590/S0080-62342012000200031] [PMID: 22576557]
].

Regarding energy and fatigue, it has been observed that most of the stressors of healthcare professionals originate with characteristics of the work environment, especially overcrowding, poor working conditions, lack of materials, and work overload [18Mascarenhas CH, Prado FO, Fernandes MH, Boery EN, da Silva Sena EL. Qualidade de vida em trabalhadores da área de saúde: uma revisão sistemática. Espaço para a Saúde-Revista de Saúde Pública do Paraná 2013; 14(1/2): 72-81., 19Woodhead E L, Northrop L, Edelstein B. Stress, social support, and burnout among long-term care nursing staff. J Appl Gerontol 2016; 35(1): 54-105.].

These circumstances, along with working in shifts, which leads to a decline in performance [20Marcolino AV, Siqueira JC, de Lima Barroso BI. Efeitos do trabalho em turnos nos controladores de tráfego aéreo: uma revisão sistemática baseada no método PRISMA/Effects of shift work in air traffic controllers: a systematic review based on the Prisma method. Cad Ter Ocup UFSCar 2015; 23(2): 393-402.], and the practice of accumulating more than one job [21Aquino RL. Impacto do trabalho noturno na qualidade de vida profissional de enfermagem do gênero masculino Dissertação de Mestrado em Saúde Ambiental e Saúde do Trabalhador) Universidade Federal de Uberlândia 2016.] to increase the income, create overwork, tiredness, lack of adequate rest, musculoskeletal pain [22Girondoli YM. Associação entre dores musculoesqueléticas, estado nutricional e trabalho em turnos em profissionais de enfermagem Dissertação de Mestrado em Ciência da NutriçãoUniversidade Federal de Viçosa 2013.], and, inevitably, decreased energy and increased fatigue as a consequence of stress.

During a considerable part of his or her life, the employee who works in shifts goes in the opposite direction of the “daytime society,” not only during night shifts but also in the daytime and on weekends and holidays [20Marcolino AV, Siqueira JC, de Lima Barroso BI. Efeitos do trabalho em turnos nos controladores de tráfego aéreo: uma revisão sistemática baseada no método PRISMA/Effects of shift work in air traffic controllers: a systematic review based on the Prisma method. Cad Ter Ocup UFSCar 2015; 23(2): 393-402.]. This affects one's energy level, working capacity, and daily life activities [21Aquino RL. Impacto do trabalho noturno na qualidade de vida profissional de enfermagem do gênero masculino Dissertação de Mestrado em Saúde Ambiental e Saúde do Trabalhador) Universidade Federal de Uberlândia 2016.].

Furthermore, impairment of the quality of life of healthcare professionals can influence the quality of service delivery, bringing losses across organizational dynamics, including to the patients [18Mascarenhas CH, Prado FO, Fernandes MH, Boery EN, da Silva Sena EL. Qualidade de vida em trabalhadores da área de saúde: uma revisão sistemática. Espaço para a Saúde-Revista de Saúde Pública do Paraná 2013; 14(1/2): 72-81.].

In an integrative review study, it was observed that physical exercise, massage therapy, music, and relaxation have been used as coping strategies against labor-related stressors in healthcare professionals [1Ribeiro RP, Martins JT, Marziale MH, Robazzi ML. O adoecer pelo trabalho na enfermagem: uma revisão integrativa. Rev Esc Enferm USP 2012; 46(2): 495-504.
[http://dx.doi.org/10.1590/S0080-62342012000200031] [PMID: 22576557]
].

Aid and social support have also been associated with reduced levels of stress in health professionals, especially the support of supervisors [19Woodhead E L, Northrop L, Edelstein B. Stress, social support, and burnout among long-term care nursing staff. J Appl Gerontol 2016; 35(1): 54-105.]. Another alternative that has been reported is the possibility of reducing working time for healthcare professionals [23Liang YW, Hsieh Y, Lin YH, Chen WY. The impact of job stressors on health-related quality of life of nursing assistants in long-term care settings. Geriatr Nurs 2014; 35(2): 114-9.
[http://dx.doi.org/10.1016/j.gerinurse.2013.11.001] [PMID: 24321836]
], one action that, in Brazil, can encourage adherence to more than a working relationship and have a reverse effect on the indicators assessed.

Among the interventions, emphasis is being given to physical exercise programs because they contribute strategies for improving quality of life and mental health and reducing stress and anxiety in the short term and for reducing depression and mood alternations and improving self-esteem in the long term [24Ministério da Saúde Secretaria de Políticas de Saúde. Programa Nacional de Promoção da Atividade Física” Agita Brasil”: atividade física e sua contribuição para a qualidade de vida. Rev Saude Publica 2002; 36(2): 254-6.].

In a review study that evaluated studies whose aim was to draw a relationship between physical activity and a positive perception of quality of life, it was observed that there is a positive association between these variables and that this relationship is independent of the domains of Quality of Life analyzed [25Pucci GC, Rech CR, Fermino RC, Reis RS. Associação entre atividade física e qualidade de vida em adultos. Rev Saude Publica 2012; 46(1): 166-79.
[http://dx.doi.org/10.1590/S0034-89102012000100021] [PMID: 22249758]
].

Regular physical activity appears to be related to lower stress levels in workers [26Souza MC, Guimarães AC, Marinho A, et al. Atividade fisica relacionada ao estresse no trabalho de professores universitários. Revista Brasileira de Ciência e Movimento 2014; 22(4): 68-76.
[http://dx.doi.org/10.18511/0103-1716/rbcm.v22n4p68-76]
, 27Farah BQ, de Barros MV, de Farias Júnior JC, et al. Percepção de estresse: associação com a prática de atividades físicas no lazer e comportamentos sedentários em trabalhadores da indústria. Rev Bras Educ Fís Esporte 2013; 27(2): 225-34.
[http://dx.doi.org/10.1590/S1807-55092013000200007]
] and healthcare professionals working in the emergency care network [6Freire CB, Dias RF, Schwingel PA, et al. Quality of life and physical activity in intensive care professionals from middle São Francisco. Rev Bras Enferm 2015; 68(1): 21-26, 26-31.
[PMID: 25946491]
].

Thus, since the physical health domain has been the most affected by healthcare professionals’ working conditions [22Girondoli YM. Associação entre dores musculoesqueléticas, estado nutricional e trabalho em turnos em profissionais de enfermagem Dissertação de Mestrado em Ciência da NutriçãoUniversidade Federal de Viçosa 2013.], it is understood that an alternative would be to encourage the practice of regular physical activity to improve perceived quality of life.

However, it is important to highlight some limitations related to this study, regarding sample selection, data related to the practice of physical activity, amount of absences from work by stress, factors such as salary income of professionals can significantly alter the quality of life of these professionals, while physicians claim to have a higher total income than nurses, taking into account Since most of the time the workload of nurses is greater than that of physicians, has more employment ties and is more susceptible to emotional discharges, due to the fact that they receive less than other professionals because of the work done, consequently, altering the quality of life [18Mascarenhas CH, Prado FO, Fernandes MH, Boery EN, da Silva Sena EL. Qualidade de vida em trabalhadores da área de saúde: uma revisão sistemática. Espaço para a Saúde-Revista de Saúde Pública do Paraná 2013; 14(1/2): 72-81., 28Martins MB, Araújo TP, Ferreira LB, Peixoto HM. Qualidade de vida de enfermeiros da atenção primária em saúde. Gestão e Saúde 2013; 4(2): 2165-74.].

CONCLUSION

Results indicate an association between physical health and the stress perception regarding healthcare professionals. As the scores of the physical domain facets diminish, the perceived stress levels increase, which leads to the conclusion that investing in actions considering the items that make up the facets of the physical domain can favor the promotion of health professionals; in this context, regular physical activity can be an interesting measure.

It is important to emphasize the need for continuity of studies about quality of life in this population. Moreover, interventions to improve quality of life prevent future expenses with professionals removed from work because of disease and, consequently, improve patient care. Therefore, the quality of life at work corresponds to the values of a more humane and healthy life.

ETHICS APPROVAL AND CONSENT TO PARTICIPATE

Not applicable.

HUMAN AND ANIMAL RIGHTS

No Animals/Humans were used for studies that are base of this research.

CONSENT FOR PUBLICATION

Not applicable.

CONFLICT OF INTEREST

The authors declare no conflict of interest, financial or otherwise.

ACKNOWLEDGEMENTS

Declared none.

REFERENCES

[1] Ribeiro RP, Martins JT, Marziale MH, Robazzi ML. O adoecer pelo trabalho na enfermagem: uma revisão integrativa. Rev Esc Enferm USP 2012; 46(2): 495-504.
[http://dx.doi.org/10.1590/S0080-62342012000200031] [PMID: 22576557]
[2] Rosario CAR, Lopes AM, Pereira FF, da Costa FM. Avaliação do estresse entre enfermeiros que atuam na Estratégia Saúde da Família de Montes Claros. Renome 2015; 4(1): 3-14.
[3] Gouveia VV, Oliveira GF, Mendes LA, Souza LE, Cavalcanti TM, Melo RL. Escala de avaliação da fadiga: adaptação para profissionais da saúde. Revista Psicologia Organizações e Trabalho 2015; 15(3): 246-56.
[http://dx.doi.org/10.17652/rpot/2015.3.594]
[4] Almeida LA, de Souza Medeiros ID, de Barros AG, Martins CC, Santos VE. Fatores geradores da Síndrome de Burnout em profissionais da saúde Generating factors of Burnout Syndrome in health professionals. Revista de Pesquisa: Cuidado é Fundamental Online 2016; 8(3): 4623-31.
[http://dx.doi.org/10.9789/2175-5361.2016.v8i3.4623-4628]
[5] BRASIL Ministério da Saúde portaria nº 342 de 4 de março de 2013 Redefine as diretrizes para implantação do componente Unidade de Pronto Atendimento (UPA 24h) em Conformidadecom a Polílica Nacional de Atenção às Urgências, e dispõe sobre incentivo financeiro de investimento para novas UPA 24h (UPA Nova) e UPA 24h ampliadas (UPA Ampliada) e respectivo incentivo financeiro de custeio mensal Diário oficial [da] União, Brasília, DF. 2013.
[6] Freire CB, Dias RF, Schwingel PA, et al. Quality of life and physical activity in intensive care professionals from middle São Francisco. Rev Bras Enferm 2015; 68(1): 21-26, 26-31.
[PMID: 25946491]
[7] Cohen S, Kamarck T, Mermelstein R. Stress Global Measure Perceived. J health Soc Behav 1983; 24(4): 385-96.
[8] Reis RS, Petroski EL, Lopes AS. Measures of the physical activity: revision of methods. RevBras cineantropom Desempenho Hum 2000; 2(1): 89-96.
[9] Maciel ES, Kimiesavay-Da-Silva L, Galvão JA, et al. Availability of fish in Brazilian households: Analysis of data from the 2008-2009 survey of family budgets. Int J Appl 2014; 4(4): 102-10.
[10] Barroso ML, de Oliveira GF, de Carvalho AC, Batista HM, de Menezes Silveira GB. Estresse e uso de álcool em enfermeiros que trabalham em urgência e emergência. Cadernos de Cultura e Ciência 2015; 13(2): 60-75.
[11] Silva B, Zica M, Barbosa T, Quaresma F, Sonati J, Maciel E. Percepção da qualidade de vida, estresse, nível de atividade física e cronotipo em grupo de enfermeiros das Unidades de Pronto Atendimento do Brazil. Revista da UIIPS 2016; 4(2): 103-13.
[12] Oliveira FP, Mazzaia MC, Marcolan JF. Symptoms of depression and intervening factors among nurses of emergency hospital services. Acta Paul Enferm 2015; 28(3): 209-15.
[http://dx.doi.org/10.1590/1982-0194201500036]
[13] Malta DC, Szwarcwald CL. Lifestyles and chronic non-transmissible diseases of the Brazilian population according to the National Health Survey: balance of the main results. Sao Paulo Med J 2015; 133(4): 286-9.
[http://dx.doi.org/10.1590/1516-3180.2015.13340308] [PMID: 26517145]
[14] Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983; 24(4): 385-96.
[http://dx.doi.org/10.2307/2136404] [PMID: 6668417]
[15] WHO Qol Group. The development of the World Health Organization quality of life assessment instrument (the WHOQOL) InQuality of life assessment: International perspectives. Springer Berlin Heidelberg 1994; pp. 41-57.
[16] Group TW. The World Health Organization quality of life assessment (WHOQOL): development and general psychometric properties. Soc Sci Med 1998; 46(12): 1569-85.
[http://dx.doi.org/10.1016/S0277-9536(98)00009-4] [PMID: 9672396]
[17] Fleck MP, Louzada S, Xavier M, et al. Aplicação da versão em português do instrumento abreviado de avaliação da qualidade de vida “WHOQOL-bref”. Rev Saude Publica 2000; 34(2): 178-83.
[http://dx.doi.org/10.1590/S0034-89102000000200012] [PMID: 10881154]
[18] Mascarenhas CH, Prado FO, Fernandes MH, Boery EN, da Silva Sena EL. Qualidade de vida em trabalhadores da área de saúde: uma revisão sistemática. Espaço para a Saúde-Revista de Saúde Pública do Paraná 2013; 14(1/2): 72-81.
[19] Woodhead E L, Northrop L, Edelstein B. Stress, social support, and burnout among long-term care nursing staff. J Appl Gerontol 2016; 35(1): 54-105.
[20] Marcolino AV, Siqueira JC, de Lima Barroso BI. Efeitos do trabalho em turnos nos controladores de tráfego aéreo: uma revisão sistemática baseada no método PRISMA/Effects of shift work in air traffic controllers: a systematic review based on the Prisma method. Cad Ter Ocup UFSCar 2015; 23(2): 393-402.
[21] Aquino RL. Impacto do trabalho noturno na qualidade de vida profissional de enfermagem do gênero masculino Dissertação de Mestrado em Saúde Ambiental e Saúde do Trabalhador) Universidade Federal de Uberlândia 2016.
[22] Girondoli YM. Associação entre dores musculoesqueléticas, estado nutricional e trabalho em turnos em profissionais de enfermagem Dissertação de Mestrado em Ciência da NutriçãoUniversidade Federal de Viçosa 2013.
[23] Liang YW, Hsieh Y, Lin YH, Chen WY. The impact of job stressors on health-related quality of life of nursing assistants in long-term care settings. Geriatr Nurs 2014; 35(2): 114-9.
[http://dx.doi.org/10.1016/j.gerinurse.2013.11.001] [PMID: 24321836]
[24] Ministério da Saúde Secretaria de Políticas de Saúde. Programa Nacional de Promoção da Atividade Física” Agita Brasil”: atividade física e sua contribuição para a qualidade de vida. Rev Saude Publica 2002; 36(2): 254-6.
[25] Pucci GC, Rech CR, Fermino RC, Reis RS. Associação entre atividade física e qualidade de vida em adultos. Rev Saude Publica 2012; 46(1): 166-79.
[http://dx.doi.org/10.1590/S0034-89102012000100021] [PMID: 22249758]
[26] Souza MC, Guimarães AC, Marinho A, et al. Atividade fisica relacionada ao estresse no trabalho de professores universitários. Revista Brasileira de Ciência e Movimento 2014; 22(4): 68-76.
[http://dx.doi.org/10.18511/0103-1716/rbcm.v22n4p68-76]
[27] Farah BQ, de Barros MV, de Farias Júnior JC, et al. Percepção de estresse: associação com a prática de atividades físicas no lazer e comportamentos sedentários em trabalhadores da indústria. Rev Bras Educ Fís Esporte 2013; 27(2): 225-34.
[http://dx.doi.org/10.1590/S1807-55092013000200007]
[28] Martins MB, Araújo TP, Ferreira LB, Peixoto HM. Qualidade de vida de enfermeiros da atenção primária em saúde. Gestão e Saúde 2013; 4(2): 2165-74.

Endorsements



"Open access will revolutionize 21st century knowledge work and accelerate the diffusion of ideas and evidence that support just in time learning and the evolution of thinking in a number of disciplines."


Daniel Pesut
(Indiana University School of Nursing, USA)

"It is important that students and researchers from all over the world can have easy access to relevant, high-standard and timely scientific information. This is exactly what Open Access Journals provide and this is the reason why I support this endeavor."


Jacques Descotes
(Centre Antipoison-Centre de Pharmacovigilance, France)

"Publishing research articles is the key for future scientific progress. Open Access publishing is therefore of utmost importance for wider dissemination of information, and will help serving the best interest of the scientific community."


Patrice Talaga
(UCB S.A., Belgium)

"Open access journals are a novel concept in the medical literature. They offer accessible information to a wide variety of individuals, including physicians, medical students, clinical investigators, and the general public. They are an outstanding source of medical and scientific information."


Jeffrey M. Weinberg
(St. Luke's-Roosevelt Hospital Center, USA)

"Open access journals are extremely useful for graduate students, investigators and all other interested persons to read important scientific articles and subscribe scientific journals. Indeed, the research articles span a wide range of area and of high quality. This is specially a must for researchers belonging to institutions with limited library facility and funding to subscribe scientific journals."


Debomoy K. Lahiri
(Indiana University School of Medicine, USA)

"Open access journals represent a major break-through in publishing. They provide easy access to the latest research on a wide variety of issues. Relevant and timely articles are made available in a fraction of the time taken by more conventional publishers. Articles are of uniformly high quality and written by the world's leading authorities."


Robert Looney
(Naval Postgraduate School, USA)

"Open access journals have transformed the way scientific data is published and disseminated: particularly, whilst ensuring a high quality standard and transparency in the editorial process, they have increased the access to the scientific literature by those researchers that have limited library support or that are working on small budgets."


Richard Reithinger
(Westat, USA)

"Not only do open access journals greatly improve the access to high quality information for scientists in the developing world, it also provides extra exposure for our papers."


J. Ferwerda
(University of Oxford, UK)

"Open Access 'Chemistry' Journals allow the dissemination of knowledge at your finger tips without paying for the scientific content."


Sean L. Kitson
(Almac Sciences, Northern Ireland)

"In principle, all scientific journals should have open access, as should be science itself. Open access journals are very helpful for students, researchers and the general public including people from institutions which do not have library or cannot afford to subscribe scientific journals. The articles are high standard and cover a wide area."


Hubert Wolterbeek
(Delft University of Technology, The Netherlands)

"The widest possible diffusion of information is critical for the advancement of science. In this perspective, open access journals are instrumental in fostering researches and achievements."


Alessandro Laviano
(Sapienza - University of Rome, Italy)

"Open access journals are very useful for all scientists as they can have quick information in the different fields of science."


Philippe Hernigou
(Paris University, France)

"There are many scientists who can not afford the rather expensive subscriptions to scientific journals. Open access journals offer a good alternative for free access to good quality scientific information."


Fidel Toldrá
(Instituto de Agroquimica y Tecnologia de Alimentos, Spain)

"Open access journals have become a fundamental tool for students, researchers, patients and the general public. Many people from institutions which do not have library or cannot afford to subscribe scientific journals benefit of them on a daily basis. The articles are among the best and cover most scientific areas."


M. Bendandi
(University Clinic of Navarre, Spain)

"These journals provide researchers with a platform for rapid, open access scientific communication. The articles are of high quality and broad scope."


Peter Chiba
(University of Vienna, Austria)

"Open access journals are probably one of the most important contributions to promote and diffuse science worldwide."


Jaime Sampaio
(University of Trás-os-Montes e Alto Douro, Portugal)

"Open access journals make up a new and rather revolutionary way to scientific publication. This option opens several quite interesting possibilities to disseminate openly and freely new knowledge and even to facilitate interpersonal communication among scientists."


Eduardo A. Castro
(INIFTA, Argentina)

"Open access journals are freely available online throughout the world, for you to read, download, copy, distribute, and use. The articles published in the open access journals are high quality and cover a wide range of fields."


Kenji Hashimoto
(Chiba University, Japan)

"Open Access journals offer an innovative and efficient way of publication for academics and professionals in a wide range of disciplines. The papers published are of high quality after rigorous peer review and they are Indexed in: major international databases. I read Open Access journals to keep abreast of the recent development in my field of study."


Daniel Shek
(Chinese University of Hong Kong, Hong Kong)

"It is a modern trend for publishers to establish open access journals. Researchers, faculty members, and students will be greatly benefited by the new journals of Bentham Science Publishers Ltd. in this category."


Jih Ru Hwu
(National Central University, Taiwan)


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