Risk Perception and Fatigue in Port Workers: A Pilot Study.

INTRODUCTION AND OBJECTIVES: The aims of this study were to assess fatigue in port workers; analyze the association between fatigue and levels of trust in organizations, as well as the association between authorities and risk perception; and examine the official documents governing the studied port, along with the current health and communication status of the port workers. MATERIALS AND METHODS: This was a descriptive and cross-sectional pilot study, which presented quantitative and qualitative data, and it was carried out among port workers in the city of Pelotas, Rio Grande do Sul, Brazil. Thirty-nine port workers responded to quantitative questionnaires, which collected their socio-demographic data, as well as a risk perception questionnaire, the Chalder Fatigue Scale, and the Checklist of Individual Strength. Five documents from the port regiment were studied and qualitatively analyzed. The health communications consisted of presenting infographics with research data and providing information for reducing fatigue. RESULTS: Fifteen workers (38.5%) were considered fatigued. There was a reduction in fatigue associated with trust in the unions and the labor management body, and there was an agreement that the precarious environment was completely unacceptable. The qualitative data in the documents indicated that it was possible to identify the infrastructure of the port environment, the legislation, the strategies to be adopted in cases of natural disasters, emergency plans, plans for the protection and promotion of workers' health, individual and collective protection plans, the division of the sectors and those responsible for them, and documents detailing the hierarchy within the ports. The qualitative analysis culminated in graphic representations (infographics) created to communicate the research results to port workers, specifically in relation to fatigue, and we presented the ways to prevent fatigue at work. Discussion/Limitations: Studying the risk perceptions and fatigue levels of port workers through research with the active participation of these workers presented their lived experiences, which promoted discussion and perhaps more effective proposals to change their work conditions.

Grupo de apoio diante das necessidades da família do dependente químico / Support group for the needs of the chemical dependent's family

Objetivou-se identificar as necessidades dos participantes de um Grupo de Apoio à Família no tocante à convivência com o familiar dependente químico. Tratou-se de um estudo qualitativo, desenvolvido com seis familiares que frequentam o Grupo de Apoio à Família em um Centro de Atenção Psicossocial para usuários de Álcool e outras Drogas, em uma cidade do Sul do Brasil. Os dados foram coletados em junho de 2020, mediante entrevista semiestruturada; e, posteriormente, foram analisados por meio de análise temática de conteúdo. Após a observação, emergiram três categorias: Necessidades dos familiares em relação às perspectivas do Grupo de Apoio à Família; Vivência dos familiares em relação ao suporte do Grupo de Apoio à Família e Aspectos a serem reconsiderados no Grupo de Apoio à Família. Nesse contexto, o estudo possibilitou reflexões sobre a elaboração de estratégias mais efetivas a fim de proporcionar um processo terapêutico mais eficaz e resultados mais positivos.

The objective was to identify the needs of participants of a Family Support Group regarding coexistence with the family member who is chemically dependent. This was a qualitative study, developed with six family members who attend the Family Support Group in a Psychosocial Care Center for users of Alcohol and other Drugs in a city in southern Brazil. The data were collected in June 2020 in a semi-structured interview and subsequently analyzed through thematic content analysis. After observation, three categories emerged: Needs of family members in relation to the perspectives of the Family Support Group; Experience of family members in relation to the support of the Family Support Group; and Aspects to be reconsidered in the Family Support Group. In this context, the study enabled reflections on the development of more effective strategies in order to provide a more effective therapeutic process and more positive results.

Hospital sustainability indicators and reduction of socio-environmental impacts: a scoping review.

OBJECTIVE: To synthesize knowledge about hospital sustainability indicators and evidence of reduced socio-environmental impact. METHOD: Literature scoping review using Pubmed, Science Direct, Scielo and Lilacs databases. Studies in a time frame of 10 years, addressing hospital sustainability indicators and evidence of reduced socio-environmental impact published in any language were included. RESULTS: A total of 28 articles were included, most were applied research, published in 2012, in English. Studies showed ways to save water and energy, as well as ways to monitor and mitigate the impact of activities related to effluents, waste and emissions. All studies had nursing work directly or indirectly involved in hospital sustainability. CONCLUSION: The possibilities of generating less impact on the environment and increasing the economy/efficiency of a hospital are countless. The particularities of each hospital must be taken into account and workers, especially nurses, should be involved.

Musculoskeletal Pain in the Neck and Lower Back Regions among PHC Workers: Association between Workload, Mental Disorders, and Strategies to Manage Pain.

Scientific evidence indicates that workers in the health sector are commonly exposed to work-related musculoskeletal pain. OBJECTIVES: We aimed to identify the relationship between the presence and intensity of musculoskeletal pain in the neck and lumbar regions reported by Primary Health Care (PHC) workers with workloads and occupational risks, analyze musculoskeletal pain in the presence and absence of self-reported mental disorders based on a medical diagnosis, and identify workers' strategies to manage pain. METHOD: This cross-sectional study addressed 338 health professionals working in PHC outpatient services in the extreme South of Brazil. One questionnaire addressed sociodemographic questions concerning occupation, occupational risks, and mental disorders. The Nordic Musculoskeletal Questionnaire was used to assess self-reported musculoskeletal pain. The National Aeronautics and Space Administration Task Load Index (NASA-TLX) measured the workload. A descriptive and inferential analysis was performed using SPSS version 21.0. RESULTS: Most (55.3%) participants reported neck and (64.5%) lower back pain in the previous 12 months, and 22.5% and 30.5% reported intense neck and lower back pain, respectively, in the previous 12 months. The results showed different independent associations with increased musculoskeletal pain among health workers. Dentists presented the highest prevalence of neck pain, while female workers presented the highest prevalence of lower back pain. Furthermore, the perception of ergonomic risk and virtually all self-reported mental disorders (except panic syndrome for neck pain) were associated with pain in the neck and lower back regions and a higher frustration level (mental demand). Additionally, professionals with graduate degrees, nurses, and professionals working the longest in PHC services reported seeking complementary therapies more frequently, while physicians and those with self-reported mental disorders self-medicated more frequently.

Barriers preventing phc services from meeting mental health demands in cabo verde / Barreras para atender la demanda de salud mental en los servicios de atención primaria a la salud de cabo verde / Barreiras para atendimento da demanda em saúde mental nos serviços atenção primária à saúde caboverdiana

ABSTRACT Objective: this study aimed to identify among Cape Verdean professionals working in Primary Health Care services the barriers impeding care from being provided to people with mental disorders in this context. Method: data in this qualitative study was collected between February and March 2020 using semi-structured interviews with 43 workers from five Health Centers in the urban areas of Cape Verde/Africa. The interviews were treated with content analysis. Results: the barriers included: the professionals' perception regarding people with mental disorders concerning a feeling of being threatened by these patients, such as a fear of having their physical integrity at risk; lack of coordination between the team and the services; lack of knowledge of protocols; and distancing from care in the mental health field. Conclusion: the barriers identified here show a need to qualify PHC professionals. In this sense, matrix support is an alternative for continuing education to leveraging existing resources.

RESUMEN Objetivo: este estudio tiene como objetivo identificar - en los profesionales de Cabo Verde que actúan en la Atención Primaria a la Salud - las barreras que en ese contexto dificultan la atención de personas con trastorno mental. Método: estudio cualitativo; los datos fueron recogidos entre febrero y marzo de 2020, por medio de entrevistas semiestructuradas, realizadas en 43 profesionales que trabajaban en cinco Centros de Salud, localizados en regiones urbanas de Cabo Verde, en África; posteriormente los datos fueron sometidos al análisis de contenido temático. Resultados: las barreras referidas fueron: la visión de los profesionales acerca de la persona con un trastorno mental que representa el sentimiento amenaza que coloca en riesgo su integridad física; la desarticulación entre el equipo y los servicios; el desconocimiento de los protocolos de atención; y, el distanciamiento en relación a los cuidados en el área de la salud mental. Conclusión: las barreras identificadas evidenciaron la necesidad de aumentar la calificación de los profesionales de la Atención Primaria; en ese sentido, una organización matricial puede ser un medio para la formación continuada, con el objetivo de potencializar los recursos existentes.

RESUMO Objetivo: este estudo tem como objetivo identificar junto aos profissionais caboverdianos, que atuam na Atenção Primária à Saúde as barreiras que, nesse contexto, dificultam o atendimento das pessoas com transtorno mental. Método: estudo qualitativo, cujos dados foram coletados entre fevereiro e março de 2020, por meio de entrevistas semiestruturadas, realizadas com 43 profissionais que trabalham em cinco Centros de Saúde localizados em regiões urbanas de Cabo Verde/África, e posteriormente submetidos à análise de conteúdo temática. Resultados: as barreiras referidas foram: a visão dos profissionais acerca da pessoa com transtorno mental representativa de sentimento de ameaça que coloca em risco a sua integridade física; a desarticulação entre a equipe e os serviços; o desconhecimento dos protocolos de atendimento e o distanciamento em relação aos cuidados na área de saúde mental. Conclusão: as barreiras identificadas evidenciam a necessidade de qualificação dos profissionais da Atenção Primária e, nesse sentido, o matriciamento pode ser uma via para a formação continuada, com vista a potencializar os recursos existentes.

Hospital sustainability indicators and reduction of socio-environmental impacts: a scoping review / Indicadores de sostenibilidad hospitalaria y reducción de impactos socioambientales: una scoping review / Indicadores de sustentabilidade hospitalar e redução de impactos socioambientais: uma revisão de escopo

ABSTRACT Objective: To synthesize knowledge about hospital sustainability indicators and evidence of reduced socio-environmental impact. Method: Literature scoping review using Pubmed, Science Direct, Scielo and Lilacs databases. Studies in a time frame of 10 years, addressing hospital sustainability indicators and evidence of reduced socio-environmental impact published in any language were included. Results: A total of 28 articles were included, most were applied research, published in 2012, in English. Studies showed ways to save water and energy, as well as ways to monitor and mitigate the impact of activities related to effluents, waste and emissions. All studies had nursing work directly or indirectly involved in hospital sustainability. Conclusion: The possibilities of generating less impact on the environment and increasing the economy/efficiency of a hospital are countless. The particularities of each hospital must be taken into account and workers, especially nurses, should be involved.

RESUMEN Objetivo: Sintetizar conocimientos sobre indicadores de sostenibilidad hospitalaria y evidencias de reducción del impacto socioambiental. Método: Revisión de literatura, scoping review, utilizando las bases de datos Pubmed, Science Direct, Scielo y Lilacs. Se incluyeron estudios con un horizonte temporal de 10 años, publicados en cualquier idioma, que abordaran indicadores de sostenibilidad hospitalaria y evidencias de reducción del impacto socioambiental. Resultados: Se incluyeron un total de 28 artículos, la mayoría de investigación aplicada, publicados en 2012, en inglés. Los estudios mostraron formas de ahorrar agua y energía, así como formas de monitorear y mitigar el impacto de las actividades relacionadas con efluentes, desechos y emisiones. Todos los estudios tenían trabajo de enfermería involucrado directa o indirectamente en la sostenibilidad del hospital. Conclusión: Las posibilidades de generar un menor impacto en el medio ambiente y aumentar la economía/eficiencia de un hospital son innumerables. Hay que tener en cuenta las particularidades de cada hospital y se debe involucrar a los trabajadores, especialmente a los enfermeros.

RESUMO Objetivo: Sintetizar o conhecimento acerca dos indicadores de sustentabilidade hospitalar e evidências de redução do impacto socioambiental. Método: Revisão de literatura, do tipo scoping review, utilizando as bases de dados Pubmed, Science Direct, Scielo e Lilacs. Foram incluídos estudos com recorte temporal de 10 anos, publicados em qualquer idioma, que abordassem indicadores de sustentabilidade hospitalar e evidências de redução do impacto socioambiental. Resultados: Um total de 28 artigos foram incluídos, a maioria teve como tipo de estudo a pesquisa aplicada, publicados em 2012, no idioma inglês. Os estudos demonstraram maneiras de economizar água e energia, bem como, formas de monitorar e mitigar o impacto de atividades relacionadas a efluentes, resíduos e emissões. Todos os estudos tinham o trabalho da enfermagem envolvido de forma direta ou indireta na sustentabilidade hospitalar. Conclusão: As possibilidades de gerar menos impacto ao meio ambiente e aumentar a economia/eficiência de um hospital são inúmeras. Há de se levar em consideração as particularidades de cada hospital e envolver os trabalhadores, em especial a enfermagem.

Occupational Well-Being of Multidisciplinary PHC Teams: Barriers/Facilitators and Negotiations to Improve Working Conditions.

Well-being at work is one of the factors determining healthy work conditions and is perceived by workers as a positive psychological state. In this study, the concept of well-being at work was used together with occupational functionality (i.e., current health state, current work environment, and barriers/facilitators to implementing well-being at work), occupational risk perception, and proactivity/negotiations held by workers to improve working conditions. In this context, the objectives were to identify the socio-demographic and occupational characteristics independently associated with levels of well-being at work of the multidisciplinary PHC health team; detect barriers or facilitators resulting from the attitudes of colleagues, community members, and managers that influence the well-being at work of the multidisciplinary health team; and identify with whom and what reasons led health workers to become proactive and negotiate improved working conditions. This cross-sectional study addressed 338 health workers from the multidisciplinary teams of PHC outpatient services in the extreme south of Brazil. Multivariate linear regression models were adopted to analyze data. The results show various independent associations with levels of well-being at work. Nursing workers (technicians and nurses) more frequently expressed job commitment and job satisfaction. Difficulties in solving problems and performing work routines, and co-workers' attitudes directly influence the well-being of the PHC team members. Risk perception (physical and chemical) also influences well-being. Negotiations in which PHC managers engaged to improve working conditions appeared as a significant predictor of job commitment, job satisfaction, and job involvement. The results reveal that well-being at work is an important indicator of the potential of workers' proactivity in negotiating improved working conditions.

Domains of Physical and Mental Workload in Health Work and Unpaid Domestic Work by Gender Division: A Study with Primary Health Care Workers in Brazil.

Various studies indicate that workload metrics can be used to assess inequities in the division of labor according to gender and in the mental health of health care professionals. In most studies, the workload is portrayed in a way that does not integrate the different fields of work, that is, work in health services and unpaid domestic work. The objective was to determine the effects of the workload domains of health work and unpaid domestic work according to the gender division of health professionals working in primary health care (PHC), and to analyze the workload as an inducer of anxiety disorders and episodes of depression. This cross-sectional study consisted of 342 health care professionals recruited for interview at primary health care units in the extreme south of Rio Grande do Sul, Brazil. Sociodemographic and occupational variables, workload in PHC and unpaid domestic work, and dichotomies of anxiety disorders and episodes of depression were considered. Poisson and multivariate linear regression models were used for data analysis. Cohen's standardized effect size was used to assess the magnitude of the difference between women and men in terms of workload. The female professionals presented higher scores in terms of PHC work and unpaid domestic work and higher proportions of episodes of depression and anxiety disorders compared to males. The male professionals showed that anxiety disorders presented a medium standardized effect size on domestic workload and the level of frustration with family involvement was higher in those with episodes of depression. The results illustrate that the workload metric is an important indicator of female vulnerability to working conditions in PHC and in the family environment.

Fatores de risco cardiovascular, saberes e práticas de cuidado de mulheres: possibilidade para rever hábitos / Factores de riesgo cardiovascular, conocimientos y prácticas de cuidado de las mujeres: posibilidad de revisar hábitos / Cardiovascular risk factors, knowledge and care practices of women: possibility to review habits

Resumo Objetivo investigar fatores de risco para doenças cardiovasculares e compreender as práticas de cuidado de mulheres. Método paralelo convergente misto. A etapa quantitativa foi transversal descritiva com formulário abordando características demográficas, socioeconômicas, fatores de risco cardiovascular, hábitos de vida e saúde, participaram 289 mulheres e aplicou-se estatística descritiva. A etapa qualitativa foi fundamentada na pesquisa participativa, exploratória descritiva, mediante entrevista semiestruturada, técnica de criatividade e sensibilidade e narrativas, com 30 mulheres. Resultados identificaram-se fatores como sedentarismo (60,9%), uso do anticoncepcional (57,9%), estresse (60,6%), depressão (40,1%), obesidade (38,8%), hipertensão arterial (33,6%), consumo de bebida alcoólica (29,8%), cigarro (16,6%), dislipidemia (25,6%) e diabetes (10,0%). Quanto aos saberes e práticas de cuidado, as participantes mencionaram os fatores, porém algumas relataram realizar os cuidados, e outras não, mesmo reconhecendo os riscos. Assim, compartilharam a falta de tempo para realizar exercícios físicos, dificuldades para cuidar da alimentação e aderir ao tratamento anti-hipertensivo e, ainda, relataram sentirem-se estressadas. Conclusão e implicações para a prática identificaram-se fatores modificáveis e as mulheres possuíam conhecimento acerca destes, entretanto divergiam sobre os cuidados, demonstrando a importância de ações voltadas a essa população.

Resumen Objetivo investigar los factores de riesgo para enfermedades cardiovasculares y comprender las prácticas de atención brindadas a las mujeres. Método paralelo convergente mixto. La etapa cuantitativa fue transversal transcriptiva con formulario abordando características demográficas, socioeconómicas, factores de riesgo cardiovascular, hábitos de vida y salud. Participaron 289 mujeres y se aplicó estadística descriptiva. La etapa cualitativa fue fundamentada en la investigación participativa, exploratoria descriptiva, mediante entrevista semiestructurada, técnica de creatividad y sensibilidad y narrativas, con 30 mujeres. Resultados se identificaron factores como sedentarismo (60,9%), uso de anticonceptivos (57,9%), estrés (60,6%), depresión (40,1%), obesidad (38,8%), hipertensión arterial (33,6%), consumo de bebidas alcohólicas (29,8%), tabaquismo (16,6%), dislipidemia (25,6%) y diabetes (10,0%). En cuanto a los conocimientos y prácticas de cuidado, las participantes mencionaron los factores, sin embargo, algunas reportaron realizar el cuidado y otras no, inclusive reconociendo los riesgos. Así, compartieron la falta de tiempo para la realización de actividades físicas, dificultades para cuidar su alimentación y la adherencia al tratamiento antihipertensivo e, inclusive, refirieron sentirse estresadas. Conclusión e implicaciones para la práctica se identificaron factores modificables y las mujeres tenían conocimiento sobre ellos, sin embargo, divergieron sobre el cuidado, demostrando la importancia de las acciones dirigidas a esta población.

Abstract Objective to investigate risk factors for cardiovascular disease and understand the care practices of women. Method mixed convergent parallel. The quantitative stage was descriptive transversal with a form addressing demographic characteristics, socioeconomic, cardiovascular risk factors, lifestyle and health habits; 289 women participated and descriptive statistics were applied. The qualitative step was based on participatory research, exploratory descriptive, through semi-structured interviews, creativity and sensitivity technique and narratives, with 30 women. Results factors were identified as sedentarism (60.9%), use of contraceptives (57.9%), stress (60.6%), depression (40.1%), obesity (38.8%), high blood pressure (33.6%), alcohol consumption (29.8%), smoking (16.6%), dyslipidemia (25.6%), and diabetes (10.0%). As for knowledge and care practices, the participants mentioned the factors, but some reported performing the care, and others did not, even though they recognized the risks. Thus, they shared the lack of time to perform physical exercises, difficulties to take care of the diet and adhere to antihypertensive treatment, and also reported feeling stressed. Conclusion and implications for practice modifiable factors were identified and women had knowledge about these, however, they differed on the care, demonstrating the importance of actions aimed at this population.

Absenteeism and associated factors: a study addressing the workers from a footwear manufacturer.

OBJECTIVES: To characterize absenteeism among the workers of a footwear manufacturer and analyze associated factors. METHOD: This quantitative and cross-sectional study addressed 572 workers from a footwear company located in southern Brazil, totaling 1,902 sick leaves in 2017. Analyses considered absolute and relative frequencies, and univariate and multivariate Poisson regression models were performed. RESULTS: Most workers taking a leave from work were women with a job position in the operational sector to accompany a family member to attend a medical appointment or take exams. In the multivariate analysis, the following variables appeared associated with leaves longer than three days: being ≥ 50 years older, working in the Production Support sector, working in the company from 16 to 20 years, and nine groups of diseases (ICD-10). CONCLUSION: The findings contribute to understanding this industry's absenteeism profile, supporting strategies to promote positive economic and social impact, and promote adequate occupational health and safety.

Work conditions and their repercussions on the quality of life of rural workers.

OBJECTIVE: To assess the context of work and analyze their repercussions on the quality of life of rural workers in soybean agribusiness. METHOD: Cross-sectional study, with an intentional sample of rural workers, conducted between the months of October and December 2019, with the application of the instruments World Health Organization Quality Life-bref and Scales of Assessment of Context and Human Cost of Work. The data were analyzed through bivariate and multivariate descriptive statistics. RESULTS: The participants amounted to 299 rural workers. The scores of Work Conditions and Socioprofessional Relations were satisfactory and Organization of Work was critical. The scores of Physical and Cognitive costs were considered critical and of the Affective Cost was satisfactory. The Socioprofessional Relations have negatively impacted the overall quality of life and the Physical and Psychological, the Social Relations and the Environmental Domains, whereas Cognitive Cost positively impacted the Physical and the Environmental Domain and the Affective Cost positively impacted the Social Relations Domain. CONCLUSION: Although the Work Context and Human Cost indicated adverse conditions, only the Socioprofessional Relations exerted negative influences on the quality of life of rural workers.

Communication in health and inter-professional collaboration in the care for children with chronic conditions.

OBJECTIVE: to understand how health communication in the care of children with chronic conditions interferes with inter-professional collaboration. METHOD: a multicentric qualitative research. Data collection, carried out through interviews and observation, occurred from October 2017 to February 2018. For data organization, the NVivo software, version 12, was used. These data were analyzed from a dialectical perspective. RESULTS: a total of 79 professionals were interviewed, including physicians and nurses in the Family Health Strategy. Essential markers for inter-professionality stand out, such as multi-institutional communication; the historical and political context of the municipalities; the bond between staff and families with children with chronic conditions; and active and purposeful communication. CONCLUSION: inter-professional collaboration is strengthened when the therapeutic plan of the child with a chronic condition is coordinated by the Family Health Strategy, plus the intention of communicating with the secondary sector. It is considered that the research included important issues, contributing to planning the work process in the Family Health Strategy.

Obtaining tissues and organs: empowering actions of nurses in the light of ecosystem thinking.

OBJECTIVES: to analyze, in the light of ecosystem thinking, the actions of nurses that stimulate the potential to increase the rates of organ and tissue donation. METHODS: descriptive, exploratory, mixed method study, of the embedded type, with simultaneous realization and emphasis on the quantitative approach, including 125 nurses from the Intra-hospital Commission for Donation of Organs and Tissues for Transplants in the Southern Region of Brazil. Data were collected using an online survey questionnaire. Quantitative data were analyzed using the Statistical Package for the Social Sciences software; and qualitative, Bardin content analysis. RESULTS: the identified actions refer to the reception of the family, exclusive dedication and remunerated valorization of the nurses of the commission, media and dissemination campaigns for society in general and educational actions for the training of professionals. CONCLUSIONS: the results of the actions encourage the possibility of increasing the rates of organ and tissue donation for transplantation.

Workplace violence: legislation, public policies and possibility of advances for health workers.

OBJECTIVES: to discuss specific laws and public policies for workplace violence in the health sector, highlighting possibilities for the collective confrontation of this phenomenon in Brazil. METHODS: this is a reflective and argumentative study that refers to some previous experiences regarding the implementation of legal aspects to curb workplace violence directed at health professionals. RESULTS: there are experiences regarding the existence of legislation or public policies to specifically contain workplace violence in the health sector, but these are still restricted to some places or countries. The literature provides resources for developing specific strategies for managing this phenomenon, highlighting prevention programs and conducts for case management. FINAL CONSIDERATIONS: implementation of legal aspects or public policies at the municipal, regional, state and/or national level is a strategy with potential to confront workplace violence in health services in a collective and sustainable way.

Occupational health network: study of the nurses' work process / Rede de saúde do trabalhador: estudo do processo de trabalho de enfermeiros

INTRODUCTION: Nurses, professionals recognized in the health field for their competence to care, are part of the multiprofessional team of the occupational health network. Therefore, they are inserted in the Reference Centers in Occupational Health, in medium and high complexity services and in the managerial scope of this health area. OBJECTIVE: To establish the relationship between the elements of the nurses' work process in the occupational health network. METHODS: Field research carried out with 43 nurses who work in the occupational health network in the Western Border, Macro South and Central regions of Rio Grande do Sul, Brazil. RESULTS: The qualitative technique and the IRAMUTEQ software were used. The analysis of the data allowed to identify that the nurses' work process develops based on the guidelines of the public health policies of the employee. In addition, it was possible to identify that the elements of the work process of these professionals are directly related and organized to meet the workers' needs. CONCLUSION: This study demonstrates the relevance of the workforce of professional nurses in the occupational health network. Its performance permeates the field of care, health promotion and prevention of accidents at work and occupational diseases and has respective purposes.

INTRODUÇÃO: Os enfermeiros, profissionais reconhecidos no campo da saúde pela competência de cuidar, são parte da equipe multiprofissional da rede de saúde do trabalhador. Logo, estão inseridos nos Centros de Referência em Saúde do Trabalhador, nos serviços de média e alta complexidade e o âmbito gerencial desta área da saúde. OBJETIVO: Conhecer a relação entre os elementos do processo de trabalho de enfermeiros da rede de saúde do trabalhador. MÉTODOS: Pesquisa de campo realizada com 43 enfermeiros que atuam na rede de saúde do trabalhador das regiões Fronteira Oeste, Macrosul e Centro do Rio Grande do Sul. Analisada por meio da técnica qualitativa e com utilização do software IRAMUTEQ. RESULTADOS: A análise dos dados permitiu identificar que o processo de trabalho dos enfermeiros desenvolve-se com base nas orientações das políticas públicas de saúde do trabalhador. Além disso, foi possível identificar que os elementos do processo de trabalho destes profissionais estão diretamente relacionados e organizados com vistas a suprir as necessidades dos trabalhadores. CONCLUSÃO: Este estudo demonstra a relevância da atuação da força de trabalho dos profissionais enfermeiros da rede de saúde do trabalhador. Sua atuação permeia o campo do cuidado assistencial, da promoção da saúde e da prevenção de acidentes de trabalho e doenças ocupacionais e que possui as respectivas finalidades.

Obtaining tissues and organs: empowering actions of nurses in the light of ecosystem thinking / Obtención de tejidos y órganos: acciones potenciadoras del enfermero a la luz del pensamiento ecosistémico / Obtenção de tecidos e órgãos: ações potencializadoras do enfermeiro à luz do pensamento ecossistêmico

ABSTRACT Objectives: to analyze, in the light of ecosystem thinking, the actions of nurses that stimulate the potential to increase the rates of organ and tissue donation. Methods: descriptive, exploratory, mixed method study, of the embedded type, with simultaneous realization and emphasis on the quantitative approach, including 125 nurses from the Intra-hospital Commission for Donation of Organs and Tissues for Transplants in the Southern Region of Brazil. Data were collected using an online survey questionnaire. Quantitative data were analyzed using the Statistical Package for the Social Sciences software; and qualitative, Bardin content analysis. Results: the identified actions refer to the reception of the family, exclusive dedication and remunerated valorization of the nurses of the commission, media and dissemination campaigns for society in general and educational actions for the training of professionals. Conclusions: the results of the actions encourage the possibility of increasing the rates of organ and tissue donation for transplantation.

RESUMEN Objetivos: analizar, de acuerdo al pensamiento ecosistémico, las acciones del enfermero que estimulan la potencialidad de aumentar las tasas de donación de órganos y tejidos. Métodos: estudio descriptivo, exploratorio, de método misto, del tipo incorporado, con realización simultánea y énfasis en abordaje cuantitativo, incluyendo 125 enfermeros de Comisión Intra-hospitalaria de Donación de Órganos y Tejidos para Trasplantes de la Región Sur de Brasil. Los datos recogidos por medio de cuestionario tipo survey on-line. Datos cuantitativos analizados utilizando el software Statistical Package for the Social Sciences; y los cualitativos, análisis de contenido de Bardin. Resultados: acciones identificadas refieren a la recepción del familiar, dedicación exclusiva y valoración remunerada de los enfermeros de la comisión, campañas mediáticas y divulgación para la sociedad en general y acciones educativas para capacitación de los profesionales. Conclusiones: resultados de las acciones estimulan la posibilidad de aumentar los índices de donación de órganos y tejidos para trasplante.

RESUMO Objetivos: analisar, à luz do pensamento ecossistêmico, as ações do enfermeiro que estimulam a potencialidade de aumentar as taxas de doação de órgãos e tecidos. Métodos: estudo descritivo, exploratório, de método misto, do tipo incorporado, com realização simultânea e ênfase na abordagem quantitativa, incluindo 125 enfermeiros de Comissão Intra-hospitalar de Doação de Órgãos e Tecidos para Transplantes da Região Sul do Brasil. Os dados foram coletados por meio de questionário tipo survey on-line. Os dados quantitativos foram analisados utilizando o software Statistical Package for the Social Sciences; e os qualitativos, análise de conteúdo de Bardin. Resultados: as ações identificadas referem-se ao acolhimento do familiar, dedicação exclusiva e valorização remunerada dos enfermeiros da comissão, campanhas de mídia e divulgação para a sociedade em geral e ações educativas para capacitação dos profissionais. Conclusões: os resultados das ações estimulam a possibilidade de aumentar os índices de doação de órgãos e tecidos para transplante.

Absenteeism and associated factors: a study addressing the workers from a footwear manufacturer / Ausentismo y factores asociados: estudio con trabajadores en una industria del calzado / Absenteísmo e fatores associados: estudo com trabalhadores de uma indústria calçadista

ABSTRACT Objectives: To characterize absenteeism among the workers of a footwear manufacturer and analyze associated factors. Method: This quantitative and cross-sectional study addressed 572 workers from a footwear company located in southern Brazil, totaling 1,902 sick leaves in 2017. Analyses considered absolute and relative frequencies, and univariate and multivariate Poisson regression models were performed. Results: Most workers taking a leave from work were women with a job position in the operational sector to accompany a family member to attend a medical appointment or take exams. In the multivariate analysis, the following variables appeared associated with leaves longer than three days: being ≥ 50 years older, working in the Production Support sector, working in the company from 16 to 20 years, and nine groups of diseases (ICD-10). Conclusion: The findings contribute to understanding this industry's absenteeism profile, supporting strategies to promote positive economic and social impact, and promote adequate occupational health and safety.

RESUMEN Objetivos: Caracterizar el absentismo de los trabajadores en una industria en el sector del calzado y analizar los factores asociados con el tiempo de ausencia de los trabajadores. Método: Se trata de un estudio cuantitativo y transversal realizado con572 trabajadores del calzado en el sur de Brasil que tuvieron 1902 eventos de abandono en 2017. Los análisis se realizaron tanto por frecuencias absolutas como relativas y utilizando el modelo de regresión de Poisson univariado y multivariado. Resultados: Predominio femenino; sector operativo y cargo; certificados médicos y motivos de ausencia por seguimiento familiar, consultas y reconocimientos. En el análisis multivariado, mantuvieron asociación con más de tres días de ausencia: edad ≥ 50 años, sector de Apoyo a la Producción y tiempo de trabajo en la empresa de 16 a 20 años, además de nueve grupos de enfermedades de la ICD-10. Conclusión: Tales hallazgos contribuyen a la comprensión del perfil de absentismo de la industria, favoreciendo la planificación de estrategias asertivas a los impactos económicos y sociales y la asistencia adecuada a la salud y seguridad de los trabajadores.

RESUMO Objetivos: Caracterizar o absenteísmo de trabalhadores de uma indústria do setor calçadista e analisar fatores associados com o tempo de afastamento dos trabalhadores. Método: Trata-se de um estudo quantitativo e transversal com 572 trabalhadores calçadistas do Sul do Brasil que tiveram 1902 eventos de afastamento no ano de 2017. As analises foram realizadas tanto por frequências absolutas e relativas, quanto usando o modelo de Regressão de Poisson univariada e multivariada. Resultados: Predomínio do sexo feminino; de setor e cargo operacionais; de atestados médicos e de motivos de afastamento por acompanhamento familiar, consultas e exames. Na análise multivariada, mantiveram associação com mais de três dias de afastamento: idade ≥ 50 anos, setor Apoio à Produção e tempo de trabalho na empresa de 16 a 20 anos, além de nove grupos de doenças do CID-10. Conclusão: Os achados contribuem na compreensão do perfil de absenteísmo da indústria, favorecendo o planejamento de estratégias assertivas aos impactos econômicos e sociais e adequada assistência à saúde e segurança do trabalhador.

Communication in health and inter-professional collaboration in the care for children with chronic conditions / Comunicación de salud y colaboración interprofesional en la atención de niños con afecciones crónicas / Comunicação em saúde e colaboração interprofissional na atenção a crianças com condições crônicas

Objective: to understand how health communication in the care of children with chronic conditions interferes with inter-professional collaboration. Method: a multicentric qualitative research. Data collection, carried out through interviews and observation, occurred from October 2017 to February 2018. For data organization, the NVivo software, version 12, was used. These data were analyzed from a dialectical perspective. Results: a total of 79 professionals were interviewed, including physicians and nurses in the Family Health Strategy. Essential markers for inter-professionality stand out, such as multi-institutional communication; the historical and political context of the municipalities; the bond between staff and families with children with chronic conditions; and active and purposeful communication. Conclusion: inter-professional collaboration is strengthened when the therapeutic plan of the child with a chronic condition is coordinated by the Family Health Strategy, plus the intention of communicating with the secondary sector. It is considered that the research included important issues, contributing to planning the work process in the Family Health Strategy.

Objetivo: comprender cómo la comunicación sanitaria en el cuidado de niños con afecciones crónicas interfiere en la colaboración interprofesional. Método: investigación multicéntrica, cualitativa. La recopilación de datos, realizada a través de entrevistas y observaciones, se llevó a cabo entre octubre de 2017 y febrero de 2018. En la organización de los datos, se utilizó el software NVivo versión 12. Los datos fueron analizados desde una perspectiva dialéctica. Resultados: fueron entrevistados 79 profesionales, incluidos médicos y enfermeros del programa Estrategia de Salud de la Familia. Se destacan marcadores esenciales para la interprofesionalidad, como la comunicación multiinstitucional; el contexto histórico y político de los municipios; el vínculo entre el equipo de profesionales y las familias con niños con afecciones crónicas y la comunicación activa y resolutiva. Conclusión: la colaboración interprofesional se fortalece cuando se coordina el plan terapéutico para niños con enfermedades crónicas a través del programa Estrategia de Salud de la Familia, y se verifica la intención de establecer comunicación con el sector secundario. Se considera que la investigación integró temas importantes y contribuyó a la planificación del proceso de trabajo en el programa Estrategia de Salud de la Familia.

Objetivo: compreender como a comunicação em saúde na atenção de crianças com condições crônicas interfere na colaboração interprofissional. Método: pesquisa multicêntrica, qualitativa. A coleta de dados, realizada por meio de entrevista e observação, ocorreu de outubro de 2017 a fevereiro de 2018. Para a organização dos dados, utilizou-se o software NVivo versão 12. Esses dados foram analisados pela perspectiva dialética. Resultados: foram entrevistados 79 profissionais, entre médicos e enfermeiros na Estratégia Saúde da Família. Destacam-se marcadores essenciais para a interprofissionalidade, como a comunicação plurinstitucional; o contexto histórico e político dos municípios; o vínculo entre equipe e famílias com crianças com condições crônicas e a comunicação ativa e propositiva. Conclusão: a colaboração interprofissional é fortalecida quando o plano terapêutico da criança com condição crônica é coordenado pela Saúde da Família, acrescida da intencionalidade de comunicação com o setor secundário. Considera-se que a pesquisa integrou importantes temas, contribuindo para o planejamento do processo de trabalho na Estratégia Saúde da Família.

Work conditions and their repercussions on the quality of life of rural workers / Las condiciones de trabajo y su repercusión en la calidad de vida de los trabajadores rurales / As condições de trabalho e suas repercussões na qualidade de vida de trabalhadores rurais

ABSTRACT Objective: To assess the context of work and analyze their repercussions on the quality of life of rural workers in soybean agribusiness. Method: Cross-sectional study, with an intentional sample of rural workers, conducted between the months of October and December 2019, with the application of the instruments World Health Organization Quality Life-bref and Scales of Assessment of Context and Human Cost of Work. The data were analyzed through bivariate and multivariate descriptive statistics. Results: The participants amounted to 299 rural workers. The scores of Work Conditions and Socioprofessional Relations were satisfactory and Organization of Work was critical. The scores of Physical and Cognitive costs were considered critical and of the Affective Cost was satisfactory. The Socioprofessional Relations have negatively impacted the overall quality of life and the Physical and Psychological, the Social Relations and the Environmental Domains, whereas Cognitive Cost positively impacted the Physical and the Environmental Domain and the Affective Cost positively impacted the Social Relations Domain. Conclusion: Although the Work Context and Human Cost indicated adverse conditions, only the Socioprofessional Relations exerted negative influences on the quality of life of rural workers.

RESUMEN Objetivo: Evaluar el contexto de trabajo y analizar sus repercusiones en la calidad de vida de los trabajadores rurales de la agroindustria de la soja. Método: Estudio transversal con una muestra intencional de trabajadores rurales, realizado entre los meses de octubre y diciembre de 2019, con aplicación de los instrumentos World Health Organization Quality Life-bref y Escalas de Evaluación del Contexto y Costo Humano del Trabajo. Los datos se analizaron mediante estadísticas descriptivas, bivariadas y multivariadas. Resultados: Participaron un total de 299 trabajadores rurales. Las puntuaciones de las Condiciones de Trabajo y las Relaciones Socioprofesionales fueron satisfactorias y la de la Organización del Trabajo fue crítica. Las puntuaciones de los Costos Físico y Cognitivo fueron consideradas críticas y la del Costo Afectivo fue satisfactoria. Las Relaciones Socioprofesionales impactaron negativamente la calidad de vida global y los Dominios Físico y Psicológico, Relaciones Sociales y Entorno, mientras que el Costo Cognitivo impactó positivamente los Dominios Físico y Entorno y el Costo Afectivo impactó positivamente el Dominio de Relaciones Sociales. Conclusión: Aunque el Contexto y el Costo Humano del Trabajo indican condiciones adversas, sólo las Relaciones Socioprofesionales ejercieron influencias negativas en la calidad de vida de los trabajadores rurales.

RESUMO Objetivo: Avaliar o contexto de trabalho e analisar suas repercussões na qualidade de vida de trabalhadores rurais do agronegócio da soja. Método: Estudo transversal, com amostra intencional de trabalhadores rurais, realizado entre os meses de outubro e dezembro de 2019, com aplicação dos instrumentos World Health Organization Quality Life-bref e Escalas de Avaliação do Contexto e Custo Humano do Trabalho. Os dados foram analisados por meio de estatística descritiva, bivariada e multivariada. Resultados: Participaram 299 trabalhadores rurais. Os escores das Condições de Trabalho e das Relações Socioprofissionais foram satisfatórios e o da Organização do Trabalho foi crítico. Os escores dos Custos Físico e Cognitivo foram considerados críticos e o do Custo Afetivo, satisfatório. As Relações Socioprofissionais repercutiram negativamente na qualidade de vida geral e nos Domínios Físico e Psicológico, nas Relações Sociais e no Meio Ambiente, enquanto o Custo Cognitivo repercutiu positivamente nos Domínios Físico e no Meio Ambiente e o Custo Afetivo repercutiu positivamente no Domínio das Relações Sociais. Conclusão: Apesar de o Contexto e o Custo Humano do Trabalho indicarem condições adversas, somente as Relações Socioprofissionais exerceram influências negativas na qualidade de vida dos trabalhadores rurais.

Riscos ocupacionais no trabalho agrícola e a negociação para a saúde do trabalhador rural' / Riesgos laborales en el trabajo agrícola y la negociación para la salud del trabajador rural / Occupational risks in agricultural work and the negotiation for the health of rural workers

Objetivo: apreender a relação entre riscos ocupacionais no trabalho agrícola e a negociação para a saúde do trabalhador rural. Método: estudo misto concorrente aninhado, combinado por integração (QUAN + QUAL) igualitária. Realizado com 351 agricultores, entre 2014/2015, por meio de formulário e entrevista semiestruturada. Para a análise, utilizou-se a estatística descritiva e inferencial e a classificação hierárquica descendente e a nuvem de palavras. Resultados: na fase QUAN, obteve-se idade média de 50,58 anos e predomínio de sintomas de adoecimento nos sistemas muscular, endócrino e urinário. Na fase QUAL, evidenciou-se que a negociação dos produtos agrícolas amplia a exposição dos trabalhadores a riscos físico, químico e ergonômico. O lucro representa o objetivo e permite o custeio de equipamentos, assistência à saúde e terapêutica medicamentosa, mediante o adoecimento. Conclusão: os riscos ocupacionais estão presentes no trabalho agrícola. A negociação reduz-se ao consumo de serviços e produtos de saúde em presença do adoecimento.

Objective: to understand the relationship between occupational risks in agricultural work and the negotiation for the health of rural workers. Method: mixed nested concurrent study, combined with equal integration (QUAN + QUAL). It was conducted with 351 farmers, between 2014/2015, using a form and semi-structured interview. For the analysis, descriptive and inferential statistics and the descending hierarchical classification, and the word cloud were used. Results: in the QUAN phase, the average age of 50.58 years old was obtained and a predominance of symptoms of illness in the muscular, endocrine, and urinary systems. In the QUAL phase, it became evident that the negotiation of agricultural products increases the exposure of workers to physical, chemical, and ergonomic risks. Profit represents the goal and allows for the cost of equipment, health care, and drug therapy, through illness. Conclusion: occupational risks are present in agricultural work. Negotiation is reduced to the consumption of health services and products in the presence of illness.

Objetivo: comprender la relación entre riesgos laborales en el trabajo agrícola y la negociación para la salud del trabajador rural. Método: estudio mixto concurrente anidado, combinado por integración (QUAN + QUAL) igualitaria. Fue realizado con 351 agricultores, entre 2014/2015, por medio de un formulario y una entrevista semi-estructurada. Para el análisis, se utilizó la estadística descriptiva e inferencial y la clasificación jerárquica descendiente y la nube de palabras. Resultados: en la fase QUAN, se obtuvo una edad media de 50,58 años y predominio de síntomas de enfermedades en los sistemas muscular, endócrino y urinario. En la fase QUAL, se observó que la negociación de los productos agrícolas amplia la exposición de los trabajadores a riesgos físico, químico y ergonómico. El lucro representa el objetivo y permite el costeo de equipamientos, asistencia a la salud y terapéutica medicamentosa, mediante la enfermedad. Conclusión: los riesgos laborales están presentes en el trabajo agrícola. La negociación se reduce al consumo de servicios y productos de salud en la presencia de la enfermedad.