805
FACTORS DERI VED FROM THE I NTRAHOSPI TABLE LABORATORI ES THAT
CAUSE STRESS I N I NFI RMARY STUDENTS
Liliana Basso Musso1 Bár bar a Ar diles Var gas2 Milenca Ber nal Tor r es2 Mar ía José Canov as del Cant o2 Cat h er in Gon zález Melén dez2 Mar ía Fr ancisca Kr off Balloqui2 Angélica Sot o Cor nej o2
Basso Musso L, Ardiles Vargas B, Bernal Torres M, Canovas del Cant o MJ, González Meléndez C, Kroff Balloqui MF, Sot o Cornej o A. Fact ors derived from t he int rahospit able laborat ories t hat cause st ress in infirm ary st udent s. Rev Lat ino- am Enfer m agem 2 0 0 8 set em br o- out ubr o; 1 6 ( 5 ) : 8 0 5 - 1 1 .
Qu an t it at iv e, cor r elat ion cr oss- sect ion al st u dy w it h descr ipt iv e an aly sis, w h ose obj ect iv e w as t o assess t h e fact or s der iv ed fr om t he int r a- hospit able labor at or ies t hat affect t he st r ess appear ance in I nfir m ar y st udent s. The sam ple consist ed of 129 st udent s, w hich volunt arily acceded t o answ er quest ionnaires Evaluat ive Scale de Ham ilt on for t h e An x iet y , v alidat ed in 2 0 0 3 , an d Qu est ion n air e KEZKAK, bot h adapt ed by t h e in v est igat in g group. The obt ained dat a was processed t hrough Microsoft Excel program , appearing: t he 100% of t he st udent s p r esen t ed St r ess. Fr om t h e m an if est at ion s of St r ess, t h e t en sion al an x iet y an d in som n ia ap p ear w it h t h e biggest per cent ages. Fr om t he St r ess pr oducing Fact or s, in St udent ’s com pet it ions: “ having er r or s on it s w or k and har m ing t he pat ient ” , and in t he Educat ional “ r eceiv ing cont r adict or y or der s” ar e t he ones t hat pr esent great er frequency of int ensit y, being t he Educat ional fact or t he preponderant in t he appearance of st ress. One con clu des t h at is n ecessar y t o adapt t h e edu cat ion al posit ion s of a gu ar dian in t h e clin ical pr act ices giv en great er em phasis t o t he support t hat will have t o be lend t o st udent , wit h t he purpose of dim inishing st ress an fav or ing t he lear ning.
DESCRI PTORS: st r ess; st udent s, nur sing; labor at or ies, hospit al
FACTORES DERI VADOS DE LOS LABORATORI OS I NTRAHOSPI TALARI OS QUE
PROVOCAN ESTRÉS EN LOS ESTUDI ANTES DE ENFERMERÍ A
Est udio t r ansv er sal, cuant it at iv o, cor r elacional con análisis descr ipt iv o, cuy o obj et iv o fue conocer los fact or es der iv ados de los labor at or ios int r ahospit alar ios que inciden en la apar ición de est r és en 1 2 9 est udiant es de Enfer m er ía, que cont est ar on los cuest ionar ios Escala Ham ilt on y KEZKAK. Los dat os fuer on pr ocesados con el p r og r am a Micr osof t Ex cel, seg ú n los r esu lt ad os: el 1 0 0 % p r esen t a Est r és. An sied ad , t en sión e in som n io, apar ecen con m ay or por cen t aj e. Los Fact or es Com pet en cias del alu m n o: “ com et er er r or es en su t r abaj o y perj udicar al pacient e” , y en Docent e: “ recibir ordenes cont radict orias” son los que present an m ayor frecuencia, siendo el Docent e el predom inant e en la aparición de est rés. Se concluye que es necesario adecuar las t ut orías docent es en las práct icas clínicas, dando m ayor énfasis al apoyo que deberá prest arse al alum no, con el fin de dism inuir el est r és y fav or ecer el apr endizaj e.
DESCRI PTORES: est r és; est udiant es de enfer m er ía; labor at or ios de hospit al
FATORES DERI VADOS DOS LABORATÓRI OS I NTRA-HOSPI TALARES QUE PROVOCAM
ESTRESSE NOS ESTUDANTES DE ENFERMAGEM
Est u do t r an sv er sal, qu an t it at iv o, de cor r elação com an álise descr it iv a, qu e t ev e com o obj et iv o con h ecer os fat or es der iv ados dos labor at ór ios int r a- hospit alar es que incidem na apar ição de est r esse em 129 est udant es de Enfer m agem , que r esponder am os quest ionár ios Escala Ham ilt on e KEZKAK. Os dados for am pr ocessados n o pr ogr am a Micr osof t Ex cel, apar ecen do: qu e 1 0 0 % apr esen t am est r esse. A an siedade, t en são e in sôn ia ap ar ecem com m aior p er cen t agem . Os Fat or es Com p et ên cias d o alu n o: “ com et er er r os n o seu t r ab alh o e prej udicar o pacient e” , e em Docent e: “ receber ordens cont radit órias” são os que apresent am m aior freqüência, sendo o Docent e o pr eponder ant e na apar ição do est r esse. Conclui- se que é necessár io adequar as t ut or ias docent es às prát icas clínicas, dando m aior ênfase ao apoio que deverá ser oferecido ao aluno, com a finalidade de dim inuir o est r esse e fav or ecer o apr endizado.
DESCRI TORES: est r esse; est udant es de enfer m agem ; labor at ór ios de hospit al
Valparaíso Universit y, Chile:
1 RN, M.Sc. in Philosophy, Adj unct Professor, e- m ail: Liliana.basso@uv.cl; 2 Doct oral st udent s in Nursing, e- m ail: t esisenferm eras@gm ail.com .
Disponible en castellano/ Disponível em língua portuguesa SciELO Brasil w w w .scielo.br/ rlae Rev Lat ino- am Enferm agem 2008 set em bro- out ubro; 16( 5) : 805- 11
FOREW ORDS
T
he out line of t he social funct ioning is based in assum ing responsibilit ies and reach goals, however, t her e ar e per sons t hat hav e difficult ies t o be able t o adapt t o t hem , arising a condit ion known as “ St ress“ . Th e st r ess is u sef u l as a m ot iv at ion t o ov er com in g obst acles, however, a const ant ly presence o fan st ress m ay finish t he energies of a person, m aking him feeling ov er dem an ded, in t er fer in g h is life an d h is goals( 1 ). Th e st r ess in colleg e lif e can b e d ef in ed as w h en p h y si ca l a n d e m o t i o n a l r e a ct i o n s a p p e a r s w h e n c u r r i c u l u m d e m a n d s o v e r e x c e e d c a p a c i t i e s ,r esour ces and needs of t he st udent .
I n som e of t he st ress t hat st ands out in t he univ er sit y cur r iculum sy st em w e can m ent ion am ong o t h e r s : t e a c h e r s , e x a m s , c u r r i c u l u m s y s t e m , a ca d e m i c d e m a n d s a n d p r a ct i ce o r l a b o r a t o r i e s act iv it ies.
The universit y st udent s generally have st ress, and it is increased in cert ain periods, such as exam s and t est s, and in cert ain sit uat ions, like being t est ed by a t eacher wit h such charact erist ics t hat m akes t he st u d en t t o b e u n d er p r essu r e or n er v ou s( 2 ). Un d er
t hese sit uat ions we can not ice a great deal of st ress, especially w hen t he st udent , besides st udy ing, m ust w or k , or p r esen t p er son al st r essin g f act s, su ch as dir ect or indir ect pr essur e fr om his fam ily r egar ding success or failur e( 3).
I t is said t h at ar ou n d a 2 5 % of u n iv er sit y people has st ress. I n t he universit y young people are confront ed t o a new world, wit h increasing dem ands. This sit uat ion becom es obvious due t o recent st udies
in our count ry, where psychology’s at t ent ion has been increased from 20% t o 58% in som e universit y cent ers.
I t is rem arkable t hat st ress appears m ost ly in healt h careers, according t o a research in Universidad Aust ral de Chile in t he year 2004. Result s shows t hat I nfirm ary Car eer pr esent s t he higher lev el in st r ess( 4).
Clinic pr act ices ar e basic in t he for m at ion of n u r se st u den t s, in w h ich t h ey ar e allow ed t o apply t heorical knowledge, and t o develop skills t o pat ient s ca r e. Ho w ev er, st u d en t s b esi d es f a ci n g a ca d em i c sit u at ion s sim ilar t o ot h er gr ou ps of st u den t s, t h ey
h av e an ex t r a st r ess, sin ce t h ey ar e im m er sed in sit uat ions w or k ing w it h hum an beings, im ply ing lot s of r isk and r esponsibilit ies.
The pressure of t est s and exam inat ions, lack of t im e, r esponsibilit y of being in char ge of per sons, and t he pr essur e inside hospit al pr act ices, could be som e of t he reasons t hat explain t his phenom enon in nurse st udent s( 5). I n spit e t hat t here are no st at ist ics,
n u m b er s of sev er al u n iv er sit ies, sh ow s t h at st r ess a n d o t h e r p sy ch o l o g i ca l d i se a se s b e t w e e n t h e se st udent s has been incr eased in r ecent y ear s( 6- 7).
I n accordance wit h st udies done in Sant iago, Chile, in m edical schools of Univ er sidad de Sant iago de Chile and Univer sidad de Chile, in healt h car eer s, nur se car eer s has t he higher lev el of st r ess. I n t he sam e st u dy, it r ef er s abou t t h e dispar it y of r esu lt s bet w een w hat per ceived by nur se st udent s and fact s g i v e n b y s u r v e y s a p p l i e d , d e n o t i n g t h a t w h a t g e n e r a t e s m o r e st r e ss i s a l l co n n e ct e d w i t h t h e academ ic spher e ( t im e pr essur e, ov er w or k , lim it ed t i m e t o s t u d y, a n d h o u r s o f w o r k a n d s t u d y ) .
Nevert heless, st udent ’s point of view gives m ore st ress t o t e a c h i n g ( c o n t i n u o u s e v a l u a t i o n s , e v e r y d a y r epr oaches, and unj ust cr it icism )( 8).
Th i s i s i m p o r t an t an d r em ar k ab l e, d u e t o t hese ar e t he pr incipal com plains giv en by st udent s, however, in t he m om ent of evaluat ing t hem , t hey are not not ed so st r essing by t he st udent s. I t is k now n t hat if pr essur e is incr eased, it is pr obable t hat t he cognit ive evaluat ion done in t his kind of st ress becom es sm aller an d v ice v er sa, sit u at ion t h at ex plain s t h is r esult( 9).
Th e cu r r i cu l u m sy st em o f n u r se car eer i n Un i v e r s i d a d d e Va l p a r a ís o h a s t h e o b t a i n i n g o f k now ledge t hr ough a pr act ical/ t heor ical for m at ion( 10). Th i s a l s o i n c l u d e s t h e d e v e l o p m e n t o f h o s p i t a l laborat ories, and according t o t he st udent ’s percept ion t h r o u g h g en er a t i o n s o f t h ese l a b o r a t o r i es m a i n l y com es t he fact s t hat gener at e st r ess on t hem .
Due t o t he increasing im port ance t hat nursing is ob t ain in g in h ealt h an d d isease p r ev en t ion , an d
a cce p t i n g t h a t st r e ss i s a r i sk f a ct o r i n se v e r a l diseases, it is im port ant t o m ake a pract ical st udy of
fact ors t hat generat e st ress and t heir signs in nursing st udent s, since t hey can be considered a risk group( 11). We p r e t e n d t h r o u g h a r e s e a r c h o f q u a n t i t a t i v e , co r r e l a t i v e t y p e , w i t h a d e scr i p t i v e an aly sis, of a t r an sv er se cu t , in v est igat e t h e st r ess ap p ear an ce, it s m or e f r eq u en t m an if est at ion s, an d fact s t hat induce it s appearance in universit y st udent s of 2nd and 3rd year of nurse career of t he Universidad de Valpar aíso, dur ing hospit al pr act ice and adult and
senile subj ect s I I and I I I .
807
i d e n t i f y t h e h i g h e r p e r c e n t a g e i n e a c h o f t h e dim ensions of com pet it iv e and t eaching bet w een t he v ar iable oper at ion s.
The dependent v ar iable w as t he st r ess, and i n d e p e n d e n t v a r i a b l e s w e r e t h e f a ct s o f h o sp i t a l p r act ices t h at cou ld in f lu en ce in st r ess ap p ear an ce du r in g pr act ices.
METHOD AND MATERI AL
Research of quant it at ive t ype, correlat ive, wit h descript ive analysis, which purpose is t o describe t he
ex ist ence of st r ess and fact or s der iv ed fr om hospit al pr act ices t hat pr oduce it , in 145 st udent s of second an d t h ir d y ear t h at ar e st u dy in g pr of ession al n u r se car eer s in Un iv er sidad de Valparaíso. I n t h e ch oice select ion of t he whole, was considered t hat t his group of st u d en t s w as t h e m ost v u ln er ab le of p r esen t in g st r ess, due t o t hey ar e in t he fir st hospit al pr act ices of t he car eer, for t he st age of t heir liv es and by t he over work dem anded by t heir st udies. As a viewpoint o f e x c l u s i o n a p p e a r s : s t u d e n t s n o t w a n t i n g t o p ar t icip at e in t h is r esear ch , st u d en t s ab sen t w h en
r esear ch w as done, st udent s st udy ing for second or t h ir d t im e t h e cou r se, an d st u den t s w it h n o st r ess, according t o Ham ilt on Scale for Anxiet y. The select ion was finally of 129 st udent s, 65 of second year, and 64 of 3 t hird year.
Th e d e p e n d e n t v a r i a b l e w a s : t h e s t r e s s d ef in ed as t h e g en er al an sw er or a sp ecif ic of t h e organism t o a st ress fact or or a st ress sit uat ion causing s t r e s s , c o n s i d e r i n g t h e s u b d i m e n t i o n s : a n x i e t y,
st r a i n s, f e a r s, i n so m n i a , l o w m o o d , a n d so m a t i c s y m p t o m s : m u s c u l a r, s e n s o r s , h e a r t b r e a t h i n g ,
g ast r i cs, u r i n ar y an d au t o n o m o u s act i o n s. I t w as c o n s i d e r e d a s a n i n d i c a t o r, t h e f r e q u e n c y o f o ccu r r e n ce o f t h e se si t u a t i o n s, m e a su r e d i n t h e follow ing int ensit y r ange: v oid: 0, low : 1, m oder at e: 2, int ense: 3, very int ense: 4.
Th e i n d e p e n d e n t v a r i a b l e s : t h e h o s p i t a l p r act ices t h at cou ld in f lu en ce in st r ess ap p ear an ce d u r i n g p r a c t i c e s w h i c h s i z e s w e r e : s t u d e n t s concerning, wit h t he frequent indicat or of t he following
s i t u a t i o n s : < Qu e s t i o n 1 > t o m a k e a m i s t a k e , < Quest ion2 > feeling useless, < Quest ion 3 > t o aut o p u n ct u r e w i t h i n f e ct e d n e e d l e , < Qu e st i o n 4 > t o d a m a g e a p a t i e n t , < Qu e s t i o n 5 > t o m a k e a p sy ch o l o g i ca l d a m a g e , < Qu e st i o n 6 > t o co n f u se m edicat ion, < Quest ion 7> ignorance of what t o do in som e sit uat ion, < Quest ion 8> don’t know what t o do i n an u r g en t si t u at i o n , < Qu est i o n 9 > af f ect ed b y
pat ient s em ot ions, < Quest ion 10> hav e t o t alk w it h pat ient of his sufferings, < Quest ion 11> m alt reat m ent from t he pat ient , < Quest ion 12> not knowing how t o
answ er t o pat ient s hopes, < Quest ion 13> int er act ion difficult y, < Quest ion14> bad relat ionship wit h a pat ient , < Qu e s t i o n 1 5 > t o c a u s e p a i n t o a p a t i e n t , < Quest ion16> t o be engaged em ot ionally.
Were m easured in int ensit y range: Never: 0, Som et im es: 1, Fr equent ly : 2, Alw ay s: 3.
G u i d i n g t e a c h e r w i t h s u b d i m e n t i o n s : 1 - S u p e r v i s i o n t h a t c o n s i d e r t h e i n d i c a t o r s : < Qu est ion 1 7 > Ov er load of act iv it ies g iv en t o t h e st udent , < Quest ion 18> Judgm ent of t he t eacher when
a s s i g n i n g p a t i e n t s , < Qu e s t i o n 1 9 > To g i v e c o n t r a d i c t o r y o r d e r s , < Qu e s t i o n 2 1 > Ef f i c i e n c y d em an d i n g , < Qu est i o n 2 2 > Co n st an t su p er v i si o n . 2 - Availabilit y w it h indicat or: < Quest ion 20> Teacher ab sen t . Beh av i o r, w i t h i n d i cat o r s: < Qu est i o n 2 3 > Pe r s o n a l b e h a v i o r, < Qu e s t i o n 2 4 > Or a l a n s w e r, < Quest ion 25> Way of calling at t ent ion, and < Quest ion 26> Way of expressing an opinion of t he st udent .
Th ey w er e m easu r ed as p er t h e f r eq u en cy o f o ccu r r e n ce i n t h e f o l l o w i n g r a n g e : Ne v e r : 0 , Som et im es: 1, Fr equent ly : 2, Alw ay s: 3.
Tw o in st r u m en t s f or collect in g f igu r es w er e u sed :
Th e Ev a l u a t i o n S c a l e o f H a m i l t o n f o r Anx iet y( 12) v alidat ed in 2003, allow ed m easur ing t he st r e ss l e v e l s p r e se n t e d b y st u d e n t s d u r i n g t h e i r hospit al pract ices. I t was m odified by t he researchers in t he w ay of applicat ion, since t he figur es w er e not ask ed in an int er v iew , but by a quest ionnair e.
Th e bilin gu al qu est ion n air e of st r essor s f or
n u r se st u d en t s in clin ic p r act ice, KEZ KAK, ad ap t ed by r esear cher s for t he inv est igat ion, t hat allow ed t o
ev aluat e t he et iology of st r ess in st udent s, based in t w o f a c t o r s t h a t p r o d u c e s t r e s s , w h i c h a r e : Co m p e t e n c e a n d Te a c h i n g( 1 3 ). I t c o n s i s t s i n a q u est ion n air e of 5 5 q u est ion s w it h f ou r op t ion s of a n s w e r s , w h i c h w e r e g a t h e r e d i n o r d e r o f t h e in v est ig at ion in t h e f ollow in g n in e it em s: I t em 1 : con n ect ed w it h t h e fear t o dam age, or can n ot h elp t he pat ient or t o be dam aged, it em s t hat are connect ed w it h lack of com pet ence. I t em 2: it refers t o cont act
sit uat ions w it h suffer ing. I t em 3: has t o be w it h t he r e l a t i o n s w i t h t e a c h e r s a n d p a r t n e r s . I t e m 4 : connect ed w it h t he im pot ence and uncer t ainly. I t em 5: connect ed wit h no cont rolling relat ion wit h pat ient . I t em 6: r efer s w it h t he em ot ional involvem ent eit her wit h pat ient and work. I t em 7: it refers wit h not being well t reat ed by pat ient and result ing dam aged in t hat relat ion. I t em 8: in connect ion wit h pat ient s behavior Rev Lat ino- am Enferm agem 2008 set em bro- out ubro; 16( 5) : 805- 11
w w w .eer p.usp.br / r lae
Factors derived from the intrahospitable laboratories…
looking for an int im at e relat ion wit h st udent . I t em 9: r efer s t o sur char ge sit uat ions for t he st udent .
For t his invest igat ion, t he KEZKAK inst rum ent
has been m odified and r eor ganized, consider ing t he n in e it em s, bu t t ak in g f r om t h em on ly t h ose m or e relevant quest ions and in accordance w it h t he realit y of t h e h ospit al pr act ices of t h e su bj ect s Adu lt s an d Senile I I and I I I of Nur se Car eer of t he Univ er sidad de Valparaíso, choosing 26 quest ions t hat were shown in v ar iable definit ions.
The questionnaires were given by the researchers to each of the group’s class ( 2nd and 3rd year) during the third week after they start their practices, in a m eeting
specially assigned for this purpose.
Re g a r d i n g t h e r e l i a n c e o f i n s t r u m e n t s follow ing is obt ained:
H a m i l t o n Ev a l u a t i o n S c a l e f o r A n x i e t y, m odified, gives a Cronbach Alfa of 0,812. This result s m eans, t hat t he int ernal consist ence of t he inst rum ent i s h i g h r el i ab l e, w h er e t h e coef f i ci en t cou n t i n g of Cr o n b ach Al f a g o es f r o m 0 t o 1 , m ean i n g 0 v o i d r eliabilit y and 1 com plet e r eliabilit y.
KESKAK Quest ionnaire. I n t his inst rum ent , by m easu r e r easo n s, t h e q u est i o n s h ad t o b e j o i n ed
accor ding t o Com pet ences and Teaching dim ensions, est ablished in t he funct ioning v ar iable, Com pet ence: quest ions 1 t o 16, gives a Cronbach Alfa of 0,847 and Teaching: quest ions 17 t o 26 giv es a Cr onbach Alfa of 0,847.
I n conclusion, t he inst r um ent s used for t his r esear ch , p r esen t s a h ig h lev el of r eliab ilit y w h ich i m p l i e s t h a t t h e y h a v e a n i n t e r n a l co n si st e n ce , t her efor e ar e highly r eliable.
The figure analysis obt ained was done put t ing t h e m f i r st i n a d a t a b a se , a n d a f t e r w a r d s b e i n g
pr ocessed t hr ough a Micr osoft Ex cel pr ogr am . The analysis of figures w as done for each of t he dim ensions of collect ing inst rum ent s. Besides, we t r ied t o est ablish som e t y pe of con n ect ion t o k n ow t he associat ion bet w een t he variable of t he research. The shown of figures was done t hrough com parat ives t ab l es i n p er cen t ag es, o r f r eq u en ci es o f i n t en si t y
ex pr essed in ar abic n u m ber s.
RESULTS
Valuat ion of par t icipat ion
From a t ot al of 145 st udent s at t ending Nurse Car eer Adult and Senile I I and I I I , t he quest ionnair e
w as answ er ed by a t ot al of 129 st udent s. 65 of 2nd
y ear and 64 of 3rd year. The 16 st udent s t o which was not possible t o apply t he inst rum ent s, t he m ain reason
w a s t h a t t h e y w e r e a b s e n t a t t h e m o m e n t o f ap p licat ion . How ev er, t h e r elat ion sh ip b et w een t h e
universe of t he research, and t he num ber of st udent s r e p r e se n t i n g t h e p o p u l a t i o n st u d y, 1 2 9 st u d e n t s
equivalent t o 88,96% is sat isfact ory t o com ply t o t he research obj ect ives. Of t hese st udent s, 50,4% belongs
t o second year and 49,6% t o t hird year.
The age r ange of second y ear w as bet w een
19 and 24 years wit h an average of 20,3 years; and for t he t hir d y ear, bet w een 20 and 26 year s w it h an
av er age of 2 1 , 3 y ear s.
As per sex, in second year is 78% of fem ales and 21,5 of m ales, and in t hird year, 93.8% fem ales
and 6,2% of m ales.
Table 1 - Dist ribut ion of st ress level in t he st udent s
The 1 0 0 % of polled pr esent s som e degr ees of st ress being t he light level t he m ost significant for
bot h classes.
Table 2 - Dist ribut ion of st ress signs in t he st udent s
s n g i S r a e y d n o c e
S Thirdyear
y c n e u c e r
F Frecuency
y t e i x n
A 2,3 2,5
s e s n e
T 2,2 2,5
s r a e
F 0,6 0,7
a i n m o s n
I 2,1 2,3
s n o it c n u f l a u t c e l e t n
I 1,9 2,1
d o o m d e s s e r p e
D 1,9 2,0
r a l u c s u M : c it a m o S .
S 1,8 2,2
c i r o s n e S : c it a m o S .
S 1,8 1,1
s r a l u c s a v o i d r a
C 1,0 1,1
s g n i h t a e r
B 0,8 0,8
s c i r t s a
G 1,5 1,8
s l a t i n e
G 0,6 0,7
s u o m o n o t u
A 1,5 1,9
To an al y ze d escr i b ab l y t h e f r eq u en ci es o f in t en sit y of t h e differ en t st r ess sign s, t h e follow in g
r an ges of lev el w er e u sed, f r om 0 Void, 1 Ligh t , 2 Moderat e, 3 I nt ense, 4 Ver y I nt ense, w hich belongs
t o ways used in Ham ilt on Evaluat ion Scale of Ham ilt on for Anx iet y, m odified.
l e v e L s s e r t S r a e y d n o c e
S Thirdyear
s n o s r e P º
N % NºPersons %
] s t n i o p 0 [ n w o h s t o
N 0 0,0 0 0,0
] s t n i o p 3 1 -1 [ t h g i
L 17 26,2 10 15,6
] s t n i o p 6 2 -4 1 [ e t a r e d o
M 30 46,2 37 57,8
] s t n i o p 9 3 -7 2 [ e r e v e
S 16 24,6 16 25,0
] s t n i o p 2 5 -9 3 [ e r e v e s y r e
V 2 3,1 1 1,6
l a t o
809
n o i s n e m iD Secondyear Thirdyear
y c n e u q e r
F Frequency
e c n e t e p m o
C 1,2 1,3
g n i h c a e
T 1,9 2,1
r e b m u n n o i t s e u
Q Secondyear Thirdyear
y c n e u q e r
F Frequency
1 º n n o it s e u
Q 1,9 2,0
2 º n n o it s e u
Q 1,4 1,5
3 º n n o it s e u
Q 1,4 1,4
4 º n n o it s e u
Q 1,4 1,6
5 º n n o it s e u
Q 1,1 1,3
6 º n n o it s e u
Q 1,7 1,8
7 º n n o it s e u
Q 1,8 1,9
8 º n n o it s e u
Q 1,5 1,8
9 º n n o it s e u
Q 1,0 1,0
0 1 º n n o it s e u
Q 0,8 0,9
1 1 º n n o it s e u
Q 1,0 1,0
2 1 º n n o it s e u
Q 0,9 1,2
3 1 º n n o it s e u
Q 0,7 1,0
4 1 º n n o it s e u
Q 0,9 1,0
5 1 º n n o it s e u
Q 1,2 1,2
6 1 º n n o it s e u
Q 0,7 0,8
When exam ining t his scale it is clearly not ed t hat signs t hat appear s m or e fr equent ly ar e in fir st
place t he Anxiet y, wit h a frequency in 2nd year of 2,3 an for 3r d y ear a fr equency of 2 , 5 ; w hich put t hem
bet ween range Moderat e and I nt ense. I n second place ar e t he t enses signs w it h a fr equency in 2nd y ear of
2,2 and for 3rd year a frequency of 2,5; which placed t hem bet ween ranges Moderat e and I nt ense. I n Third
place are I nsom nia Signs wit h a frequency in 2nd year of 2,1 and for 3rd year wit h a frequency of 2,3; which
put t hem bet w een r ange Moder at e and I nt ense
Table 3 – Dist ribut ion of Dim ensions Com pet ence and
Teach in g
Wh en an aly zin g descr ibable t h e fr equ en cies
o f d i m e n si o n s Co m p e t i t i v e n e ss a n d Te a ch i n g t h e following ranges of int ent ions were used, from 0 Void,
1 Som et im es, 2 Frequent ly, and 3 Always, t hat belongs t o f or m s u sed in Qu est ion n air e St r essin g Fact or in
Nur se st udent s on t heir Hospit al Pr act ices.
We ca n se e i n t h e t a b l e t h a t D i m e n si o n
Com pet ence, has an av er age fr equency for 2nd y ear of 1,2 , and for 3rd year 1,3 which put it bet ween ranges
So m e t i m e s a n d Fr e q u e n t l y. Re g a r d i n g d i m e n si o n Te a ch i n g i t i s n o t e d t h a t sh o w s a n i n cr e a si n g o f
frequency, being t his for 2nd year 1,9 placing it bet ween
ranges Som et im es and Frequent ly, and for 3rd year of 2,1 put t ing it bet ween ranges Frequent ly and Always.
Ta b l e 4 – D i st r i b u t i o n b y q u e st i o n o f D i m e n si o n
Com pet ence in quest ionnair e Fact s Generat ing St r ess
in St udent s
To analyze describably t he ranges of int ensit y
o f d i f f e r e n t i n d i ca t o r s o f D i m e n si o n Co m p e t e n ce
following ranges were used from 0 Void, 1 Som et im es,
2 Fr equ en t ly an d 3 Alw ay s, w h ich belon gs t o t h ose
u sed in q u est ion n air e St r essin g Fact or s of Nu r sin g
st udent s dur ing t heir Hospit al Pr act ices.
From analysis of Table N° 4 we can see t hat
t he quest ion t hat has t he higher level, for bot h classes,
b elon g s t o N° 1 t h at say s: “ To d o m ist ak es in m y
work and dam age t he pat ient ”, which present s a range
of 1, 9 for 2nd year and 2, 0 for 3r d year, t his m eans
t hat t he range of answers of t his quest ion is bet ween
lev els of Som et im es and Fr equent ly. I n second place
f ollow s q u est ion N° 7 t h at say s : “ To b e in som e
sit uat ion not k now ing w hat t o do”, w hich pr esent s a
range of 1,8 for 2nd year and 1.9 for 3rd year, put t ing
it bet ween ranges Som e t im es and Frequent ly. I n t hird
p lace is t h e q u est ion N° 6 t h at say s: “ To con f u se
t reat m ent ”, which present s a frequency of 1,7 for 2nd
and 1,8 for 3rd, placing it bet ween ranges Som et im es
and Fr equent ly.
Tab le 5 - Dist r ib u t ion b y q u est ion of in d icat or s of
Teaching Dim ension in quest ionnaire Fact ors of St ress
Gener at or s in Nur se St udent s
n o i t s e u Q r e b m u n n o i t n e m i d b u S g n i h c a e t r a e y d n o c e
S Thirdyear
y c n e u q e r
F Frequency
7 1 ° n n o it s e u
Q Supervision 2,1 2,2
8 1 º n n o it s e u
Q Supervision 1,8 2,2
9 1 º n n o it s e u
Q Supervision 2,3 2,4
0 2 º n n o it s e u
Q Avaliabiilty 1,7 2,0
1 2 º n n o it s e u
Q Supervision 1,9 2,2
2 2 º n n o it s e u
Q Supervision 1,4 1,8
3 2 º n n o it s e u
Q Conduct 1,7 1,9
4 2 º n n o it s e u
Q Conduct 1,8 2,0
5 2 º n n o it s e u
Q Conduct 2,2 2,3
6 2 º n n o it s e u
Q Conduct 1,8 2,1
Wit h t he pur pose of analy ze descr ibably t he
f r e q u e n c i e s o f t h e i n d i c a t o r s o f t h e Te a c h i n g
dim en sion , follow in g r an ges of in t en sit y w er e u sed,
from 0 Void, 1 Som et im es, 2 Frequent ly, and 3 Always,
w h ich belon gs t o appr oach es u sed in qu est ion n air e
St r essi n g Fa ct o r s o f Nu r se St u d en t s D u r i n g t h ei r
Hospit al Pr act ices.
From Analysis of Table N° 5 we can see t hat
quest ions t hat pr esent s higher r anges of int ensit y in
t h ei r an sw er s, f o r b o t h cl asses, ar e i n f i r st p l ace
quest ion N° 19, w hich say s: “ To r eceive cont radict or y
orders from t eachers”, which present s a range of 2,3
for second, and 2 , 4 for t hir d y ear, t his im plies t hat
t he range of answers of t his quest ion is bet ween levels Rev Lat ino- am Enferm agem 2008 set em bro- out ubro; 16( 5) : 805- 11
w w w .eer p.usp.br / r lae
Factors derived from the intrahospitable laboratories…
of frequent ly and always. I n second place follows t he quest ion N° 2 5 t hat say s “ That t he guiding t eacher
call y our at t ent ion in fr ont of t he pat ient and healt h st aff”, w hich pr esent s a range of 2,2 for second and
2 , 3 f o r t h i r d ; w h i ch p l a ce t h e m b e t w e e n r a n g e s Frequent ly and Always. And last in t hird place, is t he
quest ion N° 17 t hat says: “ The ext ra work of act ivit ies assigned by t eacher in labor at or ies, by ex am ple: in
co n n e ct i o n t o N° o f p a t i e n t s a ssi g n e d a n d d a i l y operat ions”, which present s a range of 2,1 for second
a n d 2 , 2 f o r t h i r d ; p l a ci n g t h e m b e t w e e n r a n g e s Fr equent ly and Alw ay s.
We can deduce st ar t ing fr om t his t able t hat
t h e a v e r a g e f r e q u e n cy o f su b d i m e n si o n Co n d u ct correspond for 2nd year 1,9 , and for 3rd year 2,1 which
place it bet ween ranges Som e t im es and Always; t he subdim ension Av ailabilit y is for t he 2nd y ear 1,7 and
for t he 3rd year 2,0 which place it bet ween Som et im es and Frequent ly; and for t he subdim ension Supervision
t hey belongs t o 1,9 for t he 2nd and 2,2 for t he t hird,
w hich is bet w een r anges Som et im es and Alw ay s.
DI SCUSSI ON
According t o t he figures analysis, t he st udent s
of second and t hir d y ear of t he Nur se Car eer of t he Un i v e r si d a d d e Va l p a r a íso p r e se n t st r e ss d u r i n g
Pr a ct i ca l La b o r a t o r i e s. Th i s f i n d i n g m a t ch e s w i t h st u d ies d on e in Un iv er sid ad d e San t iag o d e Ch ile,
Univ er sidad de Chile and Univ er sidad de Los Andes,
w hich show s t hat t he Nur sing St udent s ar e ex posed during t heir educat ion t o a high st ress level.
I n connect ion t o t he st ress level, independent , in bot h classes t h e lev el of t h e Moder at e St r ess is
pr edom inant( 1 4 ).
Regar ding t o sy m pt om s der iv ed fr om st r ess,
t hese are num erous and varied, however, t he st udent s
ag r ee t h at t h e m o st f r eq u en t si g n s ar e: f i r st t h e
An x iet y, secon d Ten sion al Sign s an d t h ir d I n som n ia
Sig n s. Th ese f in d in g s ag r eed w it h f ig u r es ob t ain ed
f r om t h e r esear ch of st r ess in Nu r sin g st u d en t s of Un i v e r si d a d Au st r a l d e Ch i l e , w h e r e t h e se si g n s
present s t he higher score. Regarding t he rest of signs
it can be n ot ed t h at t h er e is a sim ilar t en den cy in
t heir appearance in each class, however, t he 3rd year
shows grades slight ly higher, which can be t o fact ors,
eit her from Hospit al Pract ices or derived from personal
pr oblem s. This last fact w as not appr oached in t his r esear ch , n ev er t h eless, w e con sider ed im por t an t t o
enclose it in fur t her r esear ches.
Reg a r d i n g t o d i m en si o n s Co m p et i t i v en ess
and Teaching, bot h classes agreed t hat t he fact or t hat
provokes m ore st ress during t heir m edical laborat ories
i s Te a c h i n g d i m e n s i o n , t h a t g a v e h i g h s c o r e s ,
s p e c i a l l y i n q u e s t i o n s r e f e r r e d a s “ To r e c e i v e
con t r adict or y or der s fr om t each er ”. I n secon d place
w e find t he quest ion t hat r efer s t o “ The t eacher call
t he at t ent ion in front of pat ient and/ or healt h st aff ”.
I n con n ect ion t o dim en sion Com pet en ce, it
g o t l o w er sco r es t o t h e f o r m er d i m en si o n , b u t i s
rem arkable for t he st udent s, since t hat also got high
scores. I n t his dim ension t he quest ions t hat got higher
st ore of int ensit y refers t hat t he st udent is confront ed
t o sit uat ions lik e “ Not t o do m ist ak es w hile w or k ing”
and “ To dam age t he pat ient ”, and follows “ To be in a
sit u at ion n ot k n ow in g w h at t o d o”, an d af t er w ar d s
“ Confuse t reat m ent ”. For t he 2nd year, in a lower level
of int ensit y we find “ To be in an urgent sit uat ion”. As
w e can not ice, t he int ensit y of scor es do not change
bet ween bot h classes, however, t he scores are slight ly
higher in 3rd year of t he career.
Wit h t his r esear ch w e have j oined t o r esult s
found in several st udies connect ed wit h st ress present
in n u r sin g st u d en t s, est ab lish in g t h at d u r in g t h eir
universit y educat ion t hey are under several sit uat ions
g en er at in g st r ess, esp ecially in Hosp it al p r act ices.
Ther efor e, w e conclude t hat t he obj ect iv es pr oposed
i n t h e p r esen t r esea r ch a r e f u l f i l l ed . Ho w ev er, i s
im por t ant t o em phasize t hat ot her fact or s w er e not
considered t hat could generat e st ress in t he st udent s.
Th e s e c o u l d b e c l a s s i f i e d a s n o t c o n c e r n i n g t o
labor at or y an d n ot depen din g of obj ect iv es def in ed
in subj ect s, t hat is t o say, t hey belong t o t hose fact ors
t h at ar e con n ect ed w it h t h e clin ic en v ir on m en t , as
ex am p le, t h e r elat ion w it h p r of ession als ( Doct or s,
Nurses, and ot her Therapist ) and wit h nurse assist ant s
and service st aff, t o which we can add t he charact erist ic
nat ur e of t he I nst it ut ion, t he com plex it y of pat ient s,
and t he personal charact er of each st udent , specially
wit h t heir capacit y of solving problem s.
As a co r o l l a r y o f t h i s r e se a r ch w e co u l d
dedu ce t h at if n u r ses h as an im por t an t par t in t h e
p r o m o t i o n o f b et t er st an d ar d s o f l i f e an d d i sease
pr ev ent ion, it is necessar y t o ex t r apolat e t hese r ole
t o t h e edu cat ion of n u r se pr ofession al, in a w ay of
convert ing t he nurse pract ice in a way of learning not
r e su l t i n g i n i n cr e a si n g t h e d a i l y st r e ss t o l e v e l s
m en t ion ed in t h is r esear ch , an d t o f av ou r a bet t er
d i sp o si t i o n o f t h e st u d e n t f o r h i s d e v e l o p m e n t ,
811
w ill per for m . Besides, w e t hink it is necessar y t o r
e-ex am in e of t h e per son al qu alit ies r equ est ed t o t h e
t each er t o p er f or m p ed ag og ic act iv it ies in n u r sin g .
Th e p er so n a l q u a l i t i es t h a t sh o u l d p o ssess t h o se
h o l d i n g n u r se r y t e a ch i n g a r e : a p e r so n a l i t y w e l l
b a l a n c e d a n d o p e n m i n d e d , s e n s i t i v e n e s s a n d
ex t r av er sion , opt im ist an d k in dn ess. Mu st h av e self
cont rol over his own react ions, t hat is t o say, t o have
an em ot ion al in t elligen ce t h at allow h im t o dev elop
affect ion and em pat hy t o t he persons t hat is working
and assist ing. He needs also t o be coherent and have
clear and defined pr inciples, beliefs and est eem s of
h i s o w n l i f e , t h e r e f o r e , sh o u l d b e a u t h e n t i c a n d
con g r u en t b et w een w h at h e say s an d d o, p ossess
defined est eem s based in self r espect and t o ot her s,
an d a h ig h sen se of com p r om ise in t r ain in g ot h er
nurses t hat includes t he st udent , t he inst it ut ion, person
and count ry. As educat or, it is necessary t o go t hrough
a period of t raining, w hich dem ands t o develop skills
su ch a s k n o w i n g t h e su b j e ct h e i s t e a ch i n g a n d
pedagogic capacit y t hat drive him t o be a supplier of
learning and developm ent of st udent s as persons and
pr ofessionals, cr eat ing an adequat e env ir onm ent for
t h e acqu isit ion of ex per ien ces an d lear n in g( 1 5 ). I t is
im por t ant t o have t echnical solvency t o allow him t o
a c t w i t h s e c u r i t y i n t h e a t t e n t i o n o f p e r s o n s ,
t ransm it t ing t hat securit y t o st udent s. And last , should
b e a cr it ical an d st im u lat in g p er son , en g ag ed w it h
t e a ch i n g , so t h a t k n o w l e d g e ’ s b e co h e r e n t w i t h
didact ic and m et hodological principles, facilit at ing t he
p r o ce ss, t e a ch i n g a n d l e a r n i n g . Th i s a p p e a r a n ce
d em an d s a p er m an en t t r ain in g , t og et h er w it h t h e
m e t h o d o l o g i ca l a d v a n ce s o f e d u ca t i o n a n d o f i t s
pr act ical w elfar e ar ea( 16- 17).
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Recebido em : 25.8.2007 Aprovado em : 8.8.2008
Rev Lat ino- am Enferm agem 2008 set em bro- out ubro; 16( 5) : 805- 11 w w w .eer p.usp.br / r lae
Factors derived from the intrahospitable laboratories…
