Intensidad y frecuencia del sufrimiento moral en enfermeros de salud mental en Brasil

Bruggmann, Mario Sergio; Schneider, Dulcinéia Ghizoni; Ramos, Flávia Regina Souza; Dalmolin, Graziele de Lima; Rodrigues, Jeferson; Bhering, Ácmon

Acessibilidade / Reportar erro

Brasil

Revista da Escola de Enfermagem da USP

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLE • Rev. esc. enferm. USP 57 • 2023 • https://doi.org/10.1590/1980-220X-REEUSP-2023-0122en copiar

Intensidad y frecuencia del sufrimiento moral en enfermeros de salud mental en Brasil

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Evaluar la intensidad y frecuencia del sufrimiento moral en enfermeros de salud mental en Brasil.

Método:

Estudio transversal con 173 enfermeros de la Red de Atención Psicosocial del territorio brasileño. Se utilizó la Escala Brasileña de Sufrimiento Moral en Enfermeros adaptada para el contexto de la salud mental. Se utilizó análisis estadístico descriptivo e inferencial para el procesamiento de datos.

Resultados:

Se observó, en su mayoría, niveles moderados de intensidad y frecuencia de sufrimiento moral (medianas entre 2,25 – 3,73 y 2,00 – 3,22, respectivamente), con énfasis en los factores condiciones de trabajo y conflictos sociales.

Conclusión:

El nivel de sufrimiento moral evidenciado en enfermeros de salud mental en Brasil refleja la dimensión y amplitud del fenómeno en los diferentes puntos de la Red de Atención Psicosocial. Se destaca la relevancia de las discusiones sobre estrategias de enfrentamiento del sufrimiento moral, articulando elementos como la sensibilidad, la resiliencia y el coraje moral, para que la deliberación ética sea aplicada en contextos de cuidado y gestión.

DESCRIPTORES
Distrés Psicológico; Salud Mental; Ética en Enfermería; Condiciones de Trabajo

Variables	Median (Q1-Q3)
Variables	Intensity	Frequency
F1 – Working conditions	3.33 (1.88–5.44)	3.22 (1.78–5.22)
F2 – Defense of values and rights	1.60 (0.20–3.60)	1.40 (0.20–2.80)
F3 – Professional safety and autonomy	3.00 (1.57–5.29)	2.86 (1.57–4.86)
F4 – Ethical violations	2.50 (0.50–4.50)	2.00 (1.00–3.50)
F5 – Social conflicts	3.20 (1.60–5.20)	3.00 (1.60–4.80)
F6 – Professional ethical competence	3.00 (1.33–5.00)	3.00 (1.67–5.00)
F7 – Conflicts with management	2.25 (0.75–5.00)	2.00 (0.75–3.75)

Variables	Median (Q1-Q3)
Variables	Intensity	Frequency
F1 - Working conditions
Recognize that permanent materials are insufficient	3.00 (2.00–5.00)	3.00 (2.00–5.00)
Recognize that consumables are insufficient	3.00 (2.00–6.00)	3.00 (2.00–5.00)
Recognize that consumables are inadequate	3.00 (2.00–5.00)	3.00 (2.00–5.00)
Recognize that permanent materials are inadequate	3.00 (1.00–5.00)	3.00 (1.00–5.00)
Recognize that the lack of permanent education support impairs the work process	4.00 (2.00–6.00)	4.00 (2.00–6.00)
Recognize that disarticulations in the Psychosocial Care Network impair access and care for users and/or family members	5.00 (2.00–6.00)	4.00 (2.00–6.00)
Work with an incomplete multidisciplinary health team	3.00 (2.00–5.00)	3.00 (2.00–5.00)
Work with an insufficient number of nursing professionals due to the service demands	3.00 (2.00–5.00)	3.00 (1.00–5.00)
Experience situations of work overload	3.00 (2.00–6.00)	3.00 (2.00–5.00)
F2 – Defense of values and rights
Recognize situations of disrespect for the user’s right to confidentiality/secrecy	2.00 (0.00–3.00)	1.00 (0.00–3.00)
Recognize situations of disrespect for the right of users and family members to information	1.00 (0.00–3.00)	1.00 (0.00–2.00)
Recognize situations of disrespect for the user’s right to privacy/intimacy	2.00 (0.00–4.00)	2.00 (0.00–3.00)
Recognize situations of mistreatment by professionals in relation to the user	1.00 (0.00–4.00)	1.00 (0.00–3.00)
Experience professional behaviors that disregard users’ beliefs and culture	2.00 (1.00–4.00)	2.00 (1.00–3.00)
F3 – Professional safety and autonomy
Feel undervalued compared to other professionals	3.00 (1.00–5.00)	3.00 (1.00–5.00)
Perform actions that are not inherent to the role	3.00 (1.00–5.00)	3.00 (1.00–5.00)
Recognize that the physical structure of the service is inadequate	3.00 (2.00–6.00)	3.00 (2.00–5.00)
Experience routines and practices that are inappropriate for professional safety	3.00 (2.00–5.00)	3.00 (2.00–5.00)
Recognize that the physical structure of the service is insufficient	3.00 (2.00–5.00)	3.00 (2.00–5.00)
Experience conflicts related to the attributions of members of the multidisciplinary team	3.00 (2.00–5.00)	3.00 (2.00–5.00)
Have limited professional autonomy in decision-making processes	3.00 (1.00–5.00)	2.00 (1.00–4.00)
F4 - Ethical violations
Recognize acts of negligence by nurses	2.00 (0.00–4.00)	2.00 (1.00–3.00)
Recognize acts of recklessness by nurses	2.00 (0.00–4.00)	2.00 (1.00–3.00)
Recognize acts of recklessness by other team professionals	3.00 (1.00–5.00)	2.00 (1.00–4.00)
Recognize acts of recklessness by other team professionals	3.00 (1.00–5.00)	2.00 (1.00–4.00)
F5 - Social conflicts
Feel pressured by the user/family member in a situation they cannot intervene in	2.00 (1.00–4.00)	2.00 (1.00–4.00)
Feel powerless to defend the user/family member in situations of social vulnerability	3.00 (1.00–6.00)	3.00 (1.00–5.00)
Recognize that situations of family abandonment negatively interfere with the adherence and resolution of the user’s treatment	5.00 (3.00–6.00)	5.00 (3.00–6.00)
Recognize that ineffective communication between members of the multidisciplinary team leads to harm to care	3.00 (2.00–6.00)	3.00 (2.00–5.00)
Experience situations of physical and/or verbal aggression by the user/family member in relation to professionals	3.00 (1.00–4.00)	2.00 (1.00–4.00)
F6 - Professional ethical competence
Work with nursing assistants/technicians with an inadequate profile and/or technical preparation for the area	3.00 (1.00–5.00)	3.00 (2.00–5.00)
Work with nurses with an inadequate profile and/or technical preparation for the area	3.00 (1.00–5.00)	3.00 (1.00–5.00)
Work with professionals from other categories with an inadequate profile and/or technical preparation for the area	3.00 (2.00–5.00)	3.00 (2.00–5.00)
F7 - Conflicts with management
Feel disrespected by service managers	2.00 (1.00–5.00)	2.00 (1.00–4.00)
Recognize ethically inadequate attitudes from managers	3.00 (1.00–5.00)	2.00 (1.00–4.00)
Feel pressured to compromise or remain silent in the face of irregularities committed for the benefit of the institution	2.00 (0.00–5.00)	2.00 (0.00–3.00)
Feel impotent to defend the user’s autonomy in care decisions	2.00 (1.00–5.00)	2.00 (1.00–4.00)

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author: Mario Sergio Bruggmann, Rua Esteves Júnior, 160, Centro, 88015-130 – Florianópolis, SC, Brazil, mariobrugg@gmail.com