Occupational health nursing: realities and challenges.

BACKGROUND: Designing and enhancing resilient occupational health and safety systems is a challenge. This fact makes it clear that occupational health professionals must be able to develop their full range of competencies. From this premise, it is appropriate to define and deepen the strengths and weaknesses of occupational health nursing (OHN), as well as to point out the opportunities and realities that address its performance. SOURCES OF EVIDENCE: In the history of the professionalization of this speciality, different circumstances have conditioned its projection: the absence of its own body of doctrine, the lack of professional recognition, limited autonomy, and the definition of a clear regulatory framework. In addition to an epistemological limitation and the absence of clear leadership. DISCUSSION: In the consolidation of this speciality, there is a limited capacity to implement its own competencies, the invisibility of nursing care, the absence of leadership that incorporates research findings and difficulties in the application of scientific evidence, in addition to the influence of regulatory provisions and the idiosyncrasies of the company. CONCLUSIONS AND IMPLICATIONS FOR NURSING AND HEALTH POLICY: The analysis of classical models with a transformative approach invites a more fluid and coordinated communication between occupational health, occupational risk prevention, primary care and public health, a proposal that induces collaboration and a more holistic approach to care for workers.

Undergraduate Occupational Health Nursing Education in Chile, Colombia, Brazil, and Mexico.

BACKGROUND: Occupational health nursing plays a fundamental role in addressing the health of the working population; however, training in this area differs around the world in terms of levels, duration, content, and requirements, and the current situation in Latin American countries is unknown. The objective of this study was to analyze undergraduate nursing education in occupational health from an international perspective considering Chile, Colombia, Brazil, and Mexico. METHODS: We conducted a multicenter, descriptive study, based on bibliographic methodology, whose sample was documentary, consulting government databases in Chile, Colombia, Brazil, and Mexico. FINDINGS: Heterogeneity was identified within the training in the countries analyzed, with a small number of courses in the course structures; in most cases, the courses were taught in the last years of training and predominantly as elective courses. CONCLUSIONS: The authors recommend that training centers develop programs associated with occupational nursing, which is considered an imperative to strengthen public health in developing countries and an ethical and equitable response to the working population.

Interprofessional Field Experiences in Occupational Safety and Health.

Field trips are beneficial to students, because they provide experiences outside of the traditional classroom. Incorporating field trips into graduate programs can increase students' exposures to real world experiences so that they can incorporate that knowledge as they complete their program. The purpose of the project was to collect and analyze graduate student feedback on 13 in-person interprofessional field trips focused on occupational safety and health. Data were collected through post-field trip structured discussions. Content analysis was used to determine themes. Five themes emerged from the data: Personal Value, Networking and Meeting, Health and Safety Planning and Policy, Environment, and Logistics and Planning. Field trips are valuable learning experiences for graduate students. The field trips in this study offered concrete experiences in occupational safety and health. Post-field trip, students provided feedback through structured discussions, which allowed for reflective observation. Overall, students found personal value in the field trips, observed health and safety procedures and policies in action, learned about various work environments, and provided input on the logistics and planning of field trips.

Facilidades e dificuldades autorreferidas por trabalhadores de enfermagem para retorno ao trabalho após o diagnóstico de câncer / Self-reported facilities and difficulties by nursing workers for return to work after cancer diagnosis / Facilidades y dificultades autodeclaradas por trabajadores de enfermería para el regreso al trabajo después del diagnóstico de cáncer

Objetivo: analisar fatores facilitadores e dificultadores autorreferidos por trabalhadores da saúde para o retorno ao trabalho após o diagnóstico de câncer. Método: estudo descritivo transversal realizado com trabalhadores de enfermagem submetidos a tratamento de câncer, de dois hospitais públicos entre março e dezembro de 2019. Coletara-se dados sociodemográficos, do Índice para Capacidade de Trabalho e do Functional Assessment of Cancer Illness Therapy ­ General, analisados por estatística descritiva. Protocolo aprovado pelo Comitê de Ética em Pesquisa. Resultados: entre os participantes, 81,9% eram do sexo feminino e 54,6% técnicos de enfermagem. A dor foi o principal dificultador (81,9%) e, para todos, o apoio de chefes e colegas de trabalho o principal facilitador. Identificou-se excelente capacidade para o trabalho em 45,5% e qualidade de vida média de 56. Conclusão: para o retorno ao trabalho ser possível, é necessário oferecer suporte ao trabalhador, tanto em função dos efeitos do tratamento do câncer quanto da necessidade de apoio.

Objective: to analyze facilitating and hindering factors self-reported by health workers in returning to work after a cancer diagnosis. Method: cross-sectional descriptive study carried out with nursing workers undergoing cancer treatment in two public hospitals between March and December 2019. Sociodemographic data were collected, from the Work Capacity Index and the Functional Assessment of Cancer Illness Therapy ­ General, analyzed by descriptive statistics. Protocol approved by the Research Ethics Committee. Results: among the participants, 81.9% were female and 54.6% were nursing technicians. Pain was the main obstacle (81.9%) and, for everyone, support from bosses and co-workers was the main facilitator. Excellent work capacity was identified in 45.5% and an average quality of life of 56. Conclusion: for a return to work to be possible, it is necessary to offer support to the worker, both due to the effects of cancer treatment and the need of support.

Objetivo: analizar los factores facilitadores y obstaculizadores autodeclarados por trabajadores de la salud en el regreso al trabajo después de un diagnóstico de cáncer. Método: estudio descriptivo transversal realizado con trabajadores de enfermería en tratamiento oncológico, en dos hospitales públicos, entre marzo y diciembre de 2019. Se recolectaron datos sociodemográficos, del Functional Assessment of Cancer Illness Therapy ­ General (Evaluación Funcional de la Terapia para Enfermedad Oncológica), analizados mediante estadística descriptiva. El Comité de Ética en Investigación aprobó el Protocolo. Resultados: entre los participantes, el 81,9% consistía en mujeres y el 54,6% en técnicos de enfermería. El dolor fue el principal obstáculo (81,9%) y, para todos, el apoyo de jefes y compañeros de trabajo fue el principal facilitador. Se identificó una excelente capacidad de trabajo en un 45,5% y una calidad de vida promedio de 56. Conclusión: para que el retorno al trabajo sea posible, es necesario ofrecer soporte al trabajador, tanto por los efectos del tratamiento del cáncer como por la necesidad de apoyo.

Facilitators and barriers for using outdoor areas in the primary work tasks of eldercare workers in nursing homes.

BACKGROUND: Eldercare workers in nursing homes report high musculoskeletal disorders, stressful work, and sickness absence. Initiatives that can accommodate these issues are needed. Current studies point out that nature contact may offer a range of human health benefits, potentially promoting healthier work among eldercare workers. Therefore, this study aimed to investigate facilitators and barriers for using outdoor areas as part of the daily work among eldercare workers in Danish nursing homes. METHODS: In this multiple case study, we collected data from three nursing homes, conducting three semi-structured focus group interviews with eldercare workers and three individual interviews with nursing home managers. Furthermore, we conducted observations of the daily work and mappings of the nursing homes' outdoor environments to gain in-depth knowledge of eldercare workers' and managers' perspectives on using outdoor areas in their daily work. The data was thematically analysed using 'The Behaviour Change Wheel' (BCW), more specifically the COM-B model, as a theoretical foundation for exploring facilitators and barriers for the use of outdoor areas. RESULTS: Frequently mentioned facilitators were facilities, traditions or repetitive events, positive experiences with residents ('star moments'), and knowledge about the residents. Frequently mentioned barriers were insufficient staffing, hierarchy in the work tasks, professional identity, and lack of ideas. CONCLUSIONS: The identified facilitators and barriers should be considered when designing initiatives for increased use of outdoor areas or activities of eldercare workers. TRIAL REGISTRATION: According to the Danish ethics committee (Law of committee, (komitéloven) paragraph 14, Sect. 2), qualitative interviews, which do not include human biological materials, do not need neither approval by ethical and scientific committee or informed consent (The Danish National Centre for Ethics).

Desarrollo de funciones de la enfermería del trabajo en la vigilancia de la salud laboral por exposición a tóxicos: el tolueno como ejemplo / Occupational Health Nurses' Role in the Occupational Health Surveillance of Exposure to Toxics: Toluene as a Case Study

Introducción: El tolueno, hidrocarburo aromático presente en varios productos, se absorbe principalmente por vía respiratoria y afecta diferentes sistemas corporales. Los enfermeros/as del trabajo son clave para detectar exposiciones agudas y crónicas. Además, son responsables de recolectar y procesar las muestras para su biomonitorización. Sin embar-go, la información sobre los requisitos de recogida y manipulación, así como de intervencio-nes enfermeras es escasa y heterogénea. Objetivo: Revisar la bibliografía disponible sobre el tolueno y la enfermería del trabajo, iden-tificar requisitos de recogida y procesamiento de muestras, así como los signos y síntomas de exposición y relacionarlos con diagnósticos e intervenciones enfermeras.Métodos: Se realizó una revisión bibliográfica aplicando la estrategia PICO, no limitada por tipo de documento, fecha o idioma en PubMed, Web of Science y Scopus. Se clasificaron los signos y síntomas según sistema y prueba de enfermería realizada durante el examen de salud, identificando diagnósticos e intervenciones enfermeras.Resultados: No se encontraron estudios sobre tolueno y enfermería del trabajo. De 60 citas identificadas, 6 artículos señalaban requisitos de recogida de muestras. Se identificaron signos y síntomas de acuerdo a las pruebas de enfermería y se relacionaron con diagnósti-cos e intervenciones de enfermería.Conclusiones: La presencia de la enfermería del trabajo en la literatura científica sobre to-lueno es escasa. Los criterios de recogida de muestras son heterogéneos y limitados. No se han encontrado estudios que relacionen signos y síntomas de exposición al tolueno con diagnósticos e intervenciones enfermeras. Se propone un cuadro relacional novedoso. Son necesarios estudios de toxicología laboral desde la perspectiva de la enfermería del trabajo (AU)

ntroduction: Toluene, an aromatic hydrocarbon present in various products, is primarily absorbed through the respiratory tract and can affect different body organs. Occupational health nurses play a key role in detecting acute and chronic exposures. They are also re-sponsible for collecting and processing samples for biomonitoring. However, information on the collection and handling requirements, as well as nursing interventions, is scarce and heterogeneous.Aims: We reviewed the existing literature linking toluene and occupational health nursing, identified sample collection and processing requirements, as well as signs and symptoms of exposure, and related them to diagnoses and nursing interventions.Methods: We conducted a literature search using the PICO strategy, without limitations on document type, date, or language, in PubMed, Web of Science, and Scopus databases. Signs and symptoms were classified according to the system and nursing test performed during the health examination, identifying possible diagnoses and nursing interventions.Results: We found no studies linking toluene and occupational health nursing. Seven out of 60 identified documents were selected, which provided information on sample collection requirements. Signs and symptoms were identified based on nursing tests and related to diagnoses and nursing interventions.Conclusions: The presence of occupational health nursing in studies on toluene is scarce. Sample collection criteria are heterogeneous and limited. There were no studies relating signs and symptoms of toluene exposure to diagnoses and nursing interventions. Further studies on occupational toxicology are needed from a nursing perspective. (AU)

A Systematic Review of the Impact of Remote Working Referenced to the Concept of Work-Life Flow on Physical and Psychological Health.

BACKGROUND: COVID-19 accelerated the adoption of remote working in which employers' obligations for employees' health and well-being extended into the home. This paper reports on a systematic review of the health impacts of remote working within the context of COVID-19 and discusses the implications of these impacts for the future role of the occupational health nurse. METHOD: The review protocol was registered with PROSPERO (CRD42021258517) and followed the PRISMA guidelines. The review covered 2020-2021 to capture empirical studies of remote working during the COVID-19 pandemic, their physical and psychological impacts and mediating factors. RESULTS: Eight hundred and thirty articles were identified. After applying the inclusion criteria, a total of 34 studies were reviewed. Most studies showed low to very low strength of evidence using the GRADE approach. A minority of studies had high strength of evidence. These focused on the reduced risk of infection and negative effects in terms of reduced physical activity, increased sedentary activity, and increased screen time. CONCLUSION/APPLICATION TO PRACTICE: The synergy of work and personal well-being with the accelerated expansion of remote working suggests a more active role in the lives of workers within the home setting on the part of occupational health nurses. That role relates to how employees organize their relationship to work and home life, promoting positive lifestyles while mitigating adverse impacts of remote working on personal well-being.

COVID-19 infection in nursing staff: A cohort study.

AIM: This study aims to identify the working conditions of Brazilian nursing professionals and the risk factors for these professionals to become infected by coronavirus disease. BACKGROUND: Understanding the factors that affected nursing professionals during the pandemic can support better nursing management. DESIGN: This is a quantitative, cross-sectional survey study. METHODS: Data collection was carried out between February and March 2022 in Brazil. All nursing professionals registered in the national database received by e-mail the study instrument with the data collection variables: professionals' sociodemographic and comorbid, professional and institutional characteristics, and professionals' health conditions and disease-related aspects for COVID-19. RESULTS: Four thousand eight hundred sixty-two nursing professionals reported a lack of personal protective equipment for patient care, and 4424 were infected by coronavirus disease. The risk factors to become infected were having cardiovascular disease, being under 60 years of age, living in the northern region, using public transportation, working in a hospital, an emergency department or reference institution for COVID-19, living with an infected person and lack of respirators or waterproof aprons. CONCLUSION: Multiple risk factors for infection with SARS-CoV-2 were demonstrated for the nursing professionals during the pandemic, highlighting current and future pandemics factors that are modifiable in a worthwhile time frame to minimize nurses' infection risks, such as inadequate working conditions associated with lack of essential personal protective equipment.

Riesgos psicosociales laborales: una propuesta de definición / A definition proposal for psychosocial risks at work

BACKGROUND: In 1984, the joint WHO/ILO committee, postulated a definition of psychosocial risks at work, responding to a need in a specific context. However, with the evolution of the working and personal conditions of workers, this definition is progressively considered to be insolvent, ambiguous, with false breadth and omissions. AIM: To analyze the concept of «psychosocial risk at work» and to establish a clear definition based on evidence from the existing literature. MATERIAL AND METHODS: An analysis of the concept, based on Walker and Avant's proposal was carried out. It encompasses eight steps, namely the selection of the concept, determination of the objectives or purposes of the analysis, identification of all possible uses of the concept, determination of defining attributes, identification of a model case, identification of borderline cases, identification of background and consequences and definition of empirical references. RESULTS: The defining attributes of the construct are quantity, rhythm, complexity, content, control, diversity, schedule, flexibility or meaning of the work, perceived as inappropriate by the worker. Also, preoccupation associated with domestic chores and attention to the needs of others, lack of clarity about the role in the job position, deficient personal and professional development of the worker, adverse work environment, organizational aspects that harm the worker, technological demands incompatible with the worker's capabilities and needs and finally, inadequate social relations at work. CONCLUSIONS: The construct background is grouped into elements attributed to the worker and attributed to the labor. The concept attributes were organized into eight dimensions, and the consequences were classified as the personal effects on the worker and those associated with the labor.

Construction and Validation of an Occupational Risks Scale for Intra-hospital Nursing Staff.

Objective: To construct and evaluate initial validity indicators of an instrument on occupational risks for hospital nursing staff. Methods: A methodological study was conducted in four Chilean hospitals. The study was carried out in three stages: (i) integrative literature review on risk assessment instruments for nursing; (ii) descriptive qualitative study on 113 health professionals to identify their work conditions and experiences regarding occupational risks and construct three instruments proposals for nursing managers, clinical nurses, and technicians; and (iii) validity and reliability study of the three instruments in 503 nurses and nursing technicians. To collect the data from the qualitative study, individual interviews, focal groups, and non-participant observation were conducted. The data were analyzed thematically into predefined risk categories. Content validation was performed through expert judgment, and exploratory factor analysis of principal components was conducted for the preliminary construct validity study. Cronbach's alpha was used as an indicator of internal consistency. Results: A total of 128 items were identified, distributed across 11 categories and 25 subcategories of occupational risks for the three instruments derived from the original proposal. After expert validation, pilot study, and instrument administration, Cronbach's alpha values between 0.88 and 0.93 were obtained. Exploratory factor analysis distinguished eight to eleven components, with unsatisfactory goodness-of-fit indicators. Conclusion: The instruments demonstrated good parameters of content validity and reliability, although their construct validity needs further improvement.

El rol de la enfermería del trabajo, un debate abierto / The role of occupational health nursing, an open debate

En una realidad social y laboral variable, compleja e inestable, la presencia de la enfermería del trabajo en las organizaciones constituye un valor añadido por su trayectoria y atención especializada. El periodo de formación de la especialidad tiene como objetivo formar a profesionales que puedan realizar actividades dirigidas a prevenir, promover, proteger y restaurar la salud de la población trabajadora. El enfoque de su actuación será laboral con perspectiva de salud pública, integral con mirada holística, integrado en el servicio de prevención de riesgos laborales y basado en la mejor evidencia científica disponible. A su vez, el ejercicio de la actividad debe realizarse también de acuerdo con estándares profesionales y ajustada a principios éticos. Por tanto, esta disciplina debe considerar no sólo que su práctica clínica sea efectiva, sino también coste-eficiente (AU)

In a variable, complex and unstable social and labour reality, the presence of occupational health nursing in organ-isations is an added value due to its specialised care and experience. The training period of the speciality aims to train professionals who can carry out activities aimed at preventing, promoting, protecting and restoring the health of the working population. The focus of their action will be occupational with a public health perspective, compre-hensive with a holistic view, integrated in the occupational risk prevention service and based on the best scientific evidence available. At the same time, the exercise of the activity must also be carried out in accordance with profes-sional standards and in line with ethical principles. Therefore, this discipline must consider not only that its clinical practice is effective, but also cost-efficient (AU)

Uso de EPIs e seu impacto na saúde do cirurgião-dentista em tempos de Covid-19 / Use of PEES and its impact on the health of the dental surgeon in Covid-19 times

O objetivo do presente estudo foi identificar quais EPIs foram utilizados pelos cirurgiões-dentistas e a relação destes EPIs com a presença de dores osteomusculares em virtude do novo estilo de vida profissional ocasionado pelo SARS-CoV-2. Foram aplicados dois questionários com a temática por intermédio da plataforma Google Forms®. Os participantes da pesquisa (n= 110) tiveram acesso aos questionários via e-mail e através das redes sociais. A análise de dados foi realizada por meio de teste qui-quadrado com nível de confiança de 95%. Os resultados obtidos demonstraram predomínio de indivíduos do sexo masculino, com idade entre 21 a 29 anos, solteiros, entre 1 a 10 anos de formado, possuindo renda mensal de 1 a 5 salários-mínimos, especialistas, atuando em consultório particular, com atualizações para atendimento durante o período de pandemia. Observou-se relação estatisticamente significativa (p<0,05) na utilização de gorro durante os atendimentos odontológicos para os profissionais que realizaram atualizações para atendimento durante o período de pandemia da COVID-19. Em relação aos demais EPIs não houve relação estatisticamente significativa (p>0,05). No que diz respeito às dores osteomusculares, observou-se relação estatisticamente significativa (p<0,05) apenas entre a utilização de avental descartável e o relato de dores na região do pescoço, ombro e costas. Ademais, não foi possível observar relação estatisticamente significativa (p>0,05) entre EPIs e dores osteomusculares. Pôde-se concluir que uma grande parcela dos cirurgiões-dentistas adotou medidas de proteção contra o novo Coronavírus (SARS-CoV-2), utilizando os EPIs recomendados para executar atendimento durante o período pandêmico. Com relação às dores osteomusculares, os participantes relataram dor com ou sem a utilização de EPIs, porém ao utilizarem avental descartável, houve predominância de sintomatologia na região do pescoço, ombros e coluna(AU)

The aim of this study was to identify which PPE was used by Dental Surgeons and the relationship of this PPE with the presence of musculoskeletal pain due to the new professional lifestyle caused by SARS-CoV-2. Two questionnaires with the theme were applied through the Google Forms® platform. Research participants (n = 110) had access to the questionnaires via e-mail and through social networks. Data analysis was performed using a chi-square test with a 95% confidence level. The results showed a predominance of male individuals, aged between 21 and 29 years old, single, between 1 and 10 years since graduation, having a monthly income of 1 to 5 minimum wages, specialists, working in private practice, with updates for care during the pandemic period. There was a statistically significant relationship (p<0.05) in the use of a cap during dental care for professionals who updated for care during the COVID-19 pandemic period. About the other PPE there was no statistically significant relationship (p>0.05). Regarding musculoskeletal pain, there was a statistically significant relationship (p<0.05) only between the use of a disposable apron and the report of pain in the neck, shoulder, and back. Furthermore, it was not possible to observe a statistically significant relationship (p>0.05) between PPE and musculoskeletal pain. It was concluded that a large portion of dentists adopted protective measures against the new Coronavirus (SARS-CoV-2), using the recommended PPE to perform care during the pandemic period. Regarding musculoskeletal pain, participants reported pain with or without the use of PPE, however, when using a disposable apron, there was a predominance of symptoms in the neck, shoulders, and back(AU)

Prazer e sofrimento dos profissionais de enfermagem decorrentes do trabalho em clínicas cirúrgicas / Pleasure and suffering of nursing professionals arising from work in surgical clinics / Placer y sufrimiento de profesionales de enfermería derivados del trabajo en clínicas quirúrgicas

Objetivo: identificar as situações geradoras de prazer e sofrimento na equipe de enfermagem em clínicas cirúrgicas. Método: estudo qualitativo realizado com 30 profissionais de enfermagem de clínicas cirúrgicas. A produção de dados se deu por meio de entrevista semiestruturada no período de abril a novembro de 2019. Os dados foram processados pelo software IRaMuTeQ, e foi feita análise lexical pela classificação hierárquica descendente. Resultados: duas classes foram formadas e intituladas de situações geradoras de prazer e sofrimento na equipe de enfermagem. Conclusão: as situações geradoras de sofrimento foram condições inadequadas de trabalho, lidar com o quadro clínico e morte dos pacientes, falta de lazer e necessidade de fazer escolhas entre trabalhar e cuidar da família. As situações geradoras de prazer foram reconhecimento por parte dos pacientes e equipe, alta dos pacientes e colaboração entre os membros da equipe.

Objective: to identify situations that generate pleasure and suffering in the nursing staff in surgical clinics. Method: qualitative study, carried out with 30 nursing professionals from surgical clinics in a hospital. Data was obtained by semi-structured interviews from April to November 2019. Data processed by the IRaMuTeQ software, and lexical analysis was performed by the descending hierarchical classification. Results: two classes were composed and entitled situations that generate pleasure and suffering in the nursing team. Conclusion: situations that generate suffering were inadequate working conditions, dealing with the clinical condition and death of patients, lack of leisure and the need to make choices between working and caring for the family; situations that generate pleasure were recognition by patients and the team, patient discharge and collaboration between team members.

Objetivo: identificar situaciones que generan placer y sufrimiento en el personal de enfermería de las clínicas quirúrgicas. Método: estudio cualitativo, realizado con 30 profesionales de enfermería de clínicas quirúrgicas de un hospital. Producción de datos a través de entrevistas semiestructuradas de abril a noviembre de 2019. Datos procesados por el software IRaMuTeQ, análisis léxico realizado por la clasificación jerárquica descendente. Resultados: se generaron dos clases y situaciones tituladas que generan placer y sufrimiento en el equipo de enfermería. Conclusión: las situaciones que generan sufrimiento fueron las condiciones laborales inadecuadas, el enfrentamiento de la condición clínica y la muerte de los pacientes, la falta de ocio y la necesidad de elegir entre trabajar y cuidar de la familia. Las situaciones que generan placer fueron el reconocimiento por parte de los pacientes y el equipo, el alta del paciente y la colaboración entre los miembros del equipo.