Validation of a constraint questionnaire against work incident by biological fluid among the nursing staff of a public hospital, São Paulo, Brazil

INTRODUCTION:  French-speaking ergonomists conceive constraint as a work situation in which the worker has his power of acting, thinking and deciding reduced or hampered. This may facilitate the occurrence of work incidents or accidents, being an important issue among nursing staff due to the risk of biological fluid exposure. This study aimed at validating a constraint questionnaire among nursing staff.

METHODS:  From February to September 2013, a nursing staff census was carried out in a public hospital in São Paulo, Brazil. Four items composed the constraint questionnaire: if the nurse in emergency situation can carry out his/hers tasks according to technical guidelines; if the nurse's production is delayed by his/hers execution of the assigned tasks with the necessary care according to technical guidelines; if personal protection equipment (PPE) hampers the execution of a good job; and how often the nurse stopped using PPE. The first question was dichotomous and the others included a likert scale, never (zero score) up to always (four scores). Work incident by biological fluid was the gold standard, and its frequency was categorized as: always, frequently, sometimes, seldom, never. Zero value was assigned to the seldom and never categories, and one to the others. R software was used to analyze the validity, using logistic regression, gold standard versus the total sum of the four questions. Cutoff, sensitivity and specificity were also analyzed.

RESULTS:  Approximately 92%(N=1648) of nurses were interviewed. Incident’s prevalence was 35%(CI95%:33%-37%). The mean for the constraint questionnaire was 3,25(CI95%:3,14-3,36). OR was 1,20(CI95%:1,15-1,26), a one increase in the score of feeling constraint was associated with an increase of  20% in the chance of the nurse suffering an incident. Cutoff was seven scores, sensibility 14% and specificity 93%.

CONCLUSIONS:  Constraint questionnaire for nursing staff was valid, but its sharpness was better to identify nurses with low constraint that the inverse.