Odontologia do Trabalho: o estado da arte, indicando trilhas para a promoção da saúde em contextos contemporâneos de labor - revisão de escopo / Occupational Dentistry: the state of the art, indicating paths for health promotion in contemporary work contexts - scoping review

Resumo O campo da Odontologia do Trabalho tem considerado lastro teórico-científico. Esta revisão de escopo objetiva desvelar o estado da arte acerca do tema em sete bases de pesquisas indexadas, considerando quase 100 anos de publicações (1921-2020). Das 337 produções inicialmente identificadas, realizou-se recorte para os últimos seis anos (2015-2021/janeiro), aplicando-se metodologia proposta pela extensão do Prisma para revisões de escopo (Prisma-ScR). Contudo, plataformas de revisões rápidas usadas para tomada de decisões em formulações de políticas públicas ou em aperfeiçoamentos de sistemas de saúde responderam por apenas 20 publicações, enquanto a amostra de 34 produções revelou peculiaridades: pesquisas privilegiam regimes de trabalho; associam o campo de estudo e prática ao modelo stricto sensu da saúde ocupacional; desconsideram concepções amplas e humanizantes do campo da Saúde do Trabalhador; tendem a priorizar a própria saúde ocupacional odontológica e parecem reduzir o conceito do acidente de trabalho a doenças. Tais questões precisam ser superadas se a perspectiva for manter-se em vanguarda, promovendo saúd e e segurança em contextos contemporâneos de trabalho, pois, embora seja evidente a transversalidade desse campo de saberes e práticas, é necessário mais, é preciso ousar para retirá-la da invisibilidade, seja em organizações privadas ou públicas de trabalho.

Abstract The field of Occupational Dentistry has considered theoretical-scientific ballast. This scoping review aims to reveal the state of the art on the subject in seven indexed research bases, considering almost 100 years of publications (1921-2020). Of the 337 productions initially identified, a cut was made for the last six years (2015-2021/January), applying the methodology proposed by the PRISMA extension for scope reviews (PRISMA-ScR). However, rapid review platforms used for decision making in formulating public policies or in improving health systems accounted for only 20 publications, whereas the sample of 34 productions revealed peculiarities: research favors work regimes; associates the field of study and practice with the stricto sensu model of occupational health; disregards broad and humanizing concepts in the field of Worker's Health; tends to prioritize its own occupational dental health, and seems to reduce the concept of work accidents to illnesses. Such issues need to be overcome if the perspective is to remain at the forefront, promoting health and safety in contemporary work contexts, since, although the transversality of this field of knowledge and practices is evident, more is needed, daring to remove it from invisibility whether in private or public work organizations is necessary.

Violência no trabalho na perspectiva dos enfermeiros do atendimento pré-hospitalar móvel / Workplace violence from the perspective of nurses in mobile pre-hospital care

Resumo Objetivou-se compreender a violência no trabalho na perspectiva dos enfermeiros do atendimento pré-hospitalar móvel. Estudo transversal, com 67 enfermeiros do atendimento pré-hospitalar móvel. Realizado a partir de duas perguntas: "O que você entende por violência no trabalho?" e "Como você percebe a ocorrência da violência no trabalho no ambiente do pré-hospitalar". Análise dos dados através da técnica de análise temática. Emergiram duas categorias: o que os enfermeiros entendem por violência no trabalho no ambiente pré-hospitalar móvel; e como os enfermeiros percebem a ocorrência da violência no trabalho no ambiente pré-hospitalar móvel. Destacaram-se ações de violência física, verbal, psicológica, comportamental, sexual, assim como advindas das características do processo de trabalho, praticada por pacientes, populares, profissionais da instituição de trabalho, profissionais de saúde dos hospitais de referência e profissionais com postos hierarquicamente superiores, nos locais de atendimento, de recebimento dos pacientes e na organização de trabalho, provocando queixas físicas, mentais e psicológicas, desprazer em realizar as atividades laborais e afastamento do trabalho. O estudo aponta a necessidade de discutir os fatores desencadeantes da violência contra os profissionais do atendimento pré-hospitalar e políticas públicas específicas à prevenção da violência no trabalho, visando a saúde dos trabalhadores.

Abstract The objective was to understand violence in the workplace from the perspective of nurses in mobile pre-hospital care. This is a cross-sectional study with 67 nurses of mobile pre-hospital care guided by two questions: "What do you understand by violence in the workplace?" and "How do you perceive the occurrence of violence at work in the pre-hospital environment". Data analysis was performed through the thematic analysis technique. Two categories emerged: what nurses understand by violence at work in the mobile pre-hospital environment; and how nurses perceive the occurrence of violence at work in the mobile pre-hospital environment. Actions of physical, verbal, psychological, behavioral, sexual violence were highlighted, as well as those arising from the characteristics of the work process, practiced by patients, people, professionals of the work institution, health professionals of reference hospitals and professionals with hierarchically superior positions, in the places of care, reception of patients and in the work organization, causing physical, mental and psychological complaints, displeasure in carrying out work activities and leave from work. The study points out the need to discuss the triggers of violence against professionals in pre-hospital care and specific public policies to prevent violence at work, aiming at the health of workers.

Secondary trauma amongst administrative support staff working with traumatic incident dockets within the South African Police Service in Johannesburg, South Africa

Background: Secondary trauma is trauma experienced by those in close contact with the victims of trauma. Research shows that some individuals exposed to photographs or video presentations of traumatic events may experience secondary trauma. This includes administrative staff within the South African Police Service (SAPS), who work with trauma dockets. Objectives: We explored the effects of secondary trauma on administrative support staff within the SAPS, their access to psychological support in the SAPS, and their use of the employee health and wellness (EHW) services in the SAPS. Methods: An exploratory qualitative study was conducted among administrative support staff from one of the four Johannesburg clusters of the SAPS. In-depth interviews took place with seven staff members. The data were analysed using Atlas.ti. Results: Administrative support staff are exposed to trauma through incident dockets, victim statements, and gruesome images. The study participants indicated that they experienced trauma daily, and symptoms of trauma such as flashbacks, anxiety, sadness, nightmares, paranoia, avoidance, recurrent thoughts, and fear of death. They were overprotective of their loved ones and paranoid. They were not utilising the EHW services due to lack of access to appropriate services, or the stigma attached to seeking help from mental health professionals. Conclusion: The SAPS needs to develop and implement a strategy to mitigate the impact of secondary trauma on its personnel, which include administrative support staff. Evidence-based interventions, such as resilience training, should be considered as part of the strategy

Ammonia levels during broiler rearing cycle

The evaluated ammonia volatilization rates and its association with humidity, temperature, and pH in broiler litter in conventional and dark house rearing systems. Evaluations were performed at 0.01, 1.00, and 1.50 m high, using a completely randomized design, at a weekly frequency for 12 weeks­from the sanitary void to the end of the 42-day cycle. Litter temperature had no significant difference for different types of house. Humidity and pH levels varied according to houses and evaluation periods. No ammonia volatilization was detected during initial periods. However, up from the 21st day of rearing, rates started to increase, showing higher concentrations at 0.01 m height. At 1.00 and 1.50 m, values around 20 mL·m­3, were obtained and considered an acceptable exposure level for the broilers and employees directly working in this sector. Yet, broiler breeders should target lower levels due to environmental impacts.

Workplace Employees' Annual Physical Checkup and During Hire on the Job to Increase Health-care Awareness Perception to Prevent Disease Risk: A Work for Policy-Implementable Option Globally

BACKGROUND: Increasing workplace health-care perception has become a major issue in the world. Most of the health-related problems are faced because of the lack of health management instruments. The level of health care can be improved through workplace health well-being regulations. The aim of the present study is to formulate a conceptual model of physical checkup. METHODS: This study applied conceptual theories and figures and used secondary data from articles and relevant websites for evaluating the validity of the study. RESULTS: Annual health checkup increases health-care awareness perception of states, organizations, employees, and their families and manages the annual health record of employees, organizations, and states. CONCLUSIONS: Health care and awareness perception of states, organizations, employees, and families improves with annual health checkup, and annual health checkup also prevents unhealthy acts.

Resilience as a Protective Factor for Depressive Mood and Anxiety among Korean Employees

BACKGROUND: This study aimed to investigate resilience as a protective factor for depressive mood and anxiety among Korean employees. METHODS: Participants were employees of eight private and local government organizations in Korea, aged 19 to 65 years. A self-report questionnaire that included items on resilience, job stress, levels of depression and anxiety, and socio-demographic factors, was administered to 1,079 Korean employees, with 1,076 valid responses. We performed hierarchical linear regression analyses with the levels of depression and anxiety scores as dependent variables. RESULTS: Being women and having a high level of job stress were associated with greater depressive mood and anxiety. In contrast, resilience was negatively related to depressive mood and anxiety, after adjusting for demographic variables and the level of job stress. Among the five factors for resilience, “support” and “hardiness” were protective factors for depressive mood and anxiety after adjusting for demographic variables and the level of job stress. CONCLUSION: Based on the results of the current study, we suggest that focusing on the resilience of employees, especially on “support” and “hardiness,” factors as well as developing and engaging in interventions that increase resilience in the workplace, can protect against depressive mood and anxiety, especially for those with high levels of job stress.

Relationship between head posture and lumbar curve in a sitting position: a biomechanical study / Relação entre a postura da cabeça e a curvatura lombar na posição sentada: um estudo biomecânico

Abstract Introduction: The sitting position routinely used for a wide variety of tasks increases the potential of developing forward head posture, which can seriously compromise the health of different systems in the human body. Objective: A static equilibrium analysis was conducted, comparing the position of the head with the lumbar curve in three different sitting positions. Methods: The approximate force and flexion moment of the head extensor muscles in static equilibrium was calculated in each of the following positions: (A) without a backrest; (B) using a backrest with a 100° tilt angle; (C) using a 100° tilted backrest associated with a cylindrical lumbar support cushion at the level of the L3 vertebra. Results: The C7-tragus angles were 43°, 50° and 52°; Frankfort horizontal plane (FH) angles were 5°, 9° and 9°; force of the head extensor muscles was 53.0N, 59.7N and 43.5N and flexion moments were 2.60Nm, 2.05Nm and 1.78Nm, in positions A, B and C, respectively. Conclusion: The results revealed that the sitting position using a 100° tilted backrest and lumbar support with the smallest L3-tragus horizontal distance required less effort by the head and neck extensor muscles to retain the head in equilibrium. This study demonstrated the need to preserve the physiology of the lumbar spine, characterized by the position of the L3 vertebra, in order to ensure good head position.

Resumo Introdução: A postura do indivíduo sentado, utilizada rotineiramente na execução de grande variedade de tarefas, constitui-se num potencial aumentado para o desenvolvimento da postura de projeção da cabeça, a qual pode ocasionar sérios comprometimentos à saúde de vários sistemas no corpo humano. Objetivo: Um estudo do equilíbrio estático foi realizado, relacionando a posição da cabeça com a curvatura da coluna lombar em três diferentes posturas do indivíduo sentado. Métodos: Foi realizado o cálculo do valor aproximado de força e momento fletor dos músculos extensores da cabeça na manutenção do equilíbrio estático em cada uma das seguintes posturas: (A) sem uso de encosto para as costas; (B) com uso de encosto de 100° de inclinação; (C) com uso de encosto de 100° associado a um suporte lombar cilíndrico em nível da vértebra L3. Resultados: Os ângulos tragus-C7 foram 43°, 50° e 52°; os ângulos de Frankfort foram 5°, 9° e 9°; as forças musculares extensoras da cabeça foram 53,0N, 59,7N e 43,5N e os momentos fletores foram 2,60N.m, 2,05N.m e 1,78N.m, nas posturas A, B e C, respectivamente. Conclusão: Os resultados revelaram que a postura sentada com encosto inclinado a 100° e calço lombar, onde houve a menor distância horizontal tragus-L3, apresentou menor esforço para a musculatura cervical extensora na manutenção do equilíbrio da cabeça. Este estudo demonstrou a necessidade da preservação do eixo lombar fisiológico, caracterizado pelo posicionamento da vértebra L3, para garantir o bom posicionamento da cabeça.

Health Inequalities Among Korean Employees

BACKGROUND: Social status might be a determinant of occupational health inequalities. This study analyzed the effects of social status on both work environments and health outcomes. METHODS: The study sample consisted of 27,598 wage employees aged 15 years and older from among the Korean Working Condition Survey participants in 2011. Work environments included atypical work, physical risks, ergonomic risks, work demands, work autonomy, social supports, and job rewards. Health outcomes comprised general health, health and safety at risk because of work, the World Health Organization-5 Well-being Index, work-related musculoskeletal disease, and work-related injury. Multivariable logistic-regression models were used to identify the associations between social status and work environments and health outcomes. RESULTS: Employees in the demographically vulnerable group had lower occupational status compared with their counterparts. Low social status was largely related to adverse work environments. Especially, precarious employment and manual labor occupation were associated with both adverse work environments and poor health outcomes. CONCLUSION: Precarious and manual workers should take precedence in occupational health equity policies and interventions. Their cumulative vulnerability, which is connected to demographics, occupational status, adverse work environments, or poor health outcomes, can be improved through a multilevel approach such as labor market, organizations, and individual goals.

Strategies for Worksite Health Interventions to Employees with Elevated Risk of Chronic Diseases

Chronic disease rates have become more prevalent in the modern American workforce, which has negative implications for workplace productivity and healthcare costs. Offering workplace health interventions is recognized as an effective strategy to reduce chronic disease progression, absenteeism, and healthcare costs as well as improve population health. This review documents intervention and evaluation strategies used for health promotion programs delivered in workplaces. Using predetermined search terms in five online databases, we identified 1,131 published items from 1995 to 2014. Of these items, 27 peer-reviewed articles met the inclusion criteria; reporting data from completed United States-based workplace interventions that recruited at-risk employees based on their disease or disease-related risk factors. A content rubric was developed and used to catalogue these 27 published field studies. Selected workplace interventions targeted obesity (n=13), cardiovascular diseases (n=8), and diabetes (n=6). Intervention strategies included instructional education/counseling (n=20), workplace environmental change (n=6), physical activity (n=10), use of technology (n=10), and incentives (n=13). Self-reported data (n=21), anthropometric measurements (n=17), and laboratory tests (n=14) were used most often in studies with outcome evaluation. This is the first literature review to focus on interventions for employees with elevated risk for chronic diseases. The review has the potential to inform future workplace health interventions by presenting strategies related to implementation and evaluation strategies in workplace settings. These strategies can help determine optimal worksite health programs based on the unique characteristics of work settings and the health risk factors of their employee populations.

Occupational health systems across selected public healthcare facilities in the Philippines

OBJECTIVE: The study aimed to collect data on the occupational health systems implemented across selected healthcare facilities in the Philippines, including: (1) governance system for occupational health and safety (OHS), (2) OHS information systems, (3) OHS financing systems, (4) technology and related systems for OHS, (5) the OHS workforce, and (6) the delivery of OHS services.METHODS: The data were collected through a walkthrough survey of the selected facilities as well as through the review of records and relevant documents found in the facilities.RESULTS: Governance and financing systems for OHS are not present in any of the facilities. 3 out of the 13 hospitals studied have employee medical records, accident/incident reports while none of the 19 facilities have Workplace Environment Monitoring Reports (WEM), implying the lack of OHS information systems. Due to the lack of a financing mechanism for occupational health services, there is a lack of OHS technology in the facilities which include but are not limited to the presence of an Immunization and Post-Exposure Program (present in 7 out of 13 hospitals and none of the 6 RHUs studied). 1 out of 19 facilities reported to having personnel delegated for OHS activities in their facility. Lastly, 1 out of 19 facilities have emergency treatment and medical facilities for their employees, indicating inadequate OHS service delivery in the facilities studied.CONCLUSIONS: Standards and laws such as the Philippine OHS Standards and Department of Health (DOH) Administrative Order (AO) 2012-0020 have provisions with regard to OHS in these facilities, and stricter implementation of these provisions could help in filling in the gaps in the OHS systems in these facilities. This will provide a healthy workforce capable of giving better healthcare services to the general population.

AIDS e discriminação, a enfermidade no ambiente laboral / AIDS and discrimination, the disease in the contextual labour environment / SIDA y la discriminación, la enfermedad en el medio ambiente del trabajo

A presente reflexão aborda algumas questões políticas e sociais relacionando o ambiente laboral e a Síndrome da Imunodeficiência Adquirida (AIDS). O objetivo deste estudo é refletir sobre o uso do poder diretivo do empregador ao despedir arbitrariamente um empregado portador do HIV. Tal fato ofende a dignidade da pessoa, motivo pelo qual referido trabalhador faz jus a uma recompensa seja ela reintegração ao labor ou indenização. Metodologicamente, foram feitas buscas bibliográficas em bancos de dados nacionais e análise de seus conteúdos, traçado uma linha de reflexão sobre a temática. Como resultado observou-se que o dano moral, que o empregado soro positivo pode sofrer no decorrer do contrato laboral, inclusive pela própria despedida arbitrária, leva à observância do caminho tortuoso em busca de justiça pelo qual passa o empregado que sofre discriminação. Desse modo considera-se, que o a busca não é pelo dever de reintegração pelo fato de ser portador de determinado vírus, mas o respeito ao trabalhador capaz de integrar a sociedade economicamente ativa, valorizando inclusive a sua dignidade como pessoa, fato este explícito na Constituição da República bem como nas premissas do Sistema Único de Saúde.

This review addresses several political and social issues related to the workplace and Acquired Immune Deficiency Syndrome (AIDS). Herein, we discuss an employer's directive power to arbitrarily dismiss an HIV positive employee. Such actions offend a worker's personal dignity, and the worker is justified in receiving compensation, either through reintegration into the workforce or severance. In our methodology, we searched national databases for relevant literature and then performed a content analysis based on this topic. We found that serum-positive employees can be harmed in their workplace, including harm caused by arbitrary dismissal, and seeking justice is difficult for the discriminated employee. Therefore, justice should be sought not only to reintegrate such individuals but to afford respect to workers as members of an economically active society that values individual dignity, which is explicitly stated in the Brazilian Constitution and the Unified Health System rules.

Esta reflexión aborda algunas cuestiones políticas y sociales relacionando el ambiente laboral y la Síndrome de la Inmunodeficiencia Adquirida (SIDA). El objetivo de este estudio es reflexionar sobre el uso del poder directivo del empleador al despedir arbitrariamente a un empleado portador del VIH. Tal hecho ofende la dignidad de la persona, motivo por el cual tal trabajador tiene derecho a una recompensa sea ella reintegración al trabajo o indemnización. Metodológicamente, se realizaron búsquedas bibliográficas en banco de datos nacionales y análisis de sus contenidos, trazando una línea de reflexión sobre el tema. Como resultados se observó que el daño moral, que el empleado seropositivo puede sufrir en el transcurso del contrato laboral, inclusive por la propia despedida arbitraria, lleva a la observancia del camino tortuoso en la busca de justicia por el cual pasa el empleado que sufre discriminación. De este modo se considera que la busca no es por el deber de reintegración por cuenta de ser portador de determinado virus, sino por el respeto al trabajador capaz de integrarse a la sociedad económicamente activa, valorando inclusive su dignidad como persona, hecho este explícito en la Constitución de la República, así como en las premisas del Sistema Único de Salud.

A study on the state of occupational safety and health in the Philippines

OBJECTIVES: This study looked into the state of occupational health and safety in the country. Specifically, the objectives were 1) to show to current condition of workers, both local and migrant, in terms of their workplace conditions and hazard exposures; and 2) to present occupational diseases and illnesses in various industries and occupational groupings in the Philippines. METHODS: Data were gathered using documentary research targeting agencies that deal with occupational safety and health in the Philippines in terms of occupational diseases, injuries, and accidents, and existing occupational health and safety policies. RESULTS: The study revealed occupational hazards and health and safety conditions in various industries, occupational settings, and job groupings such as in the industrial sector, manufacturing, mining, agriculture, fishing, and cement manufacturing. It also looked into small-scale and informal industries such as tanning, laundry work, and pyrotechnics manufacture. Special segments of the labor force including women workers, child laborers and migrant workers were also covered. CONCLUSION AND RECOMMENDATION: In all these sectors and industries, the stdy found attendant occupational diseases and injuries from occupational hazards. In general, OSH in the Philippines requires further improvements in data collection, coverage of industries and occupational sectors, and dissemination to both public and private sectors.

A pessoa estomizada e o processo de inclusão no trabalho: contribuição para a enfermagem / The person with stoma and the inclusion process at work: contribution to nursing

Estudo cujo objeto tratou da inclusão do cliente estomizado no mundo do trabalho. Os objetivos foram: identificar as dificuldades e facilidades dos clientes estomizados para inclusão no mundo do trabalho; analisar as possibilidades de inclusão no mundo do trabalho; discutir, a partir do ponto de vista do cliente estomizado, as orientações fornecidas pelos enfermeiros com vistas à inclusão no mundo do trabalho. O referencial teórico baseou-se no campo da Saúde do Trabalhador, enfocando a reabilitação profissional e o capítulo de bases conceituais abordou o conhecimento da estomaterapia, do mundo do trabalho, da deficiência física e aspectos legais que envolvem a reabilitação do estomizado no mundo laboral. O desenho metodológico foi de uma pesquisa descritiva, exploratória, de natureza qualitativa, realizada com 20 clientes estomizados definitivos, aos quais se aplicou uma entrevista semiestruturada. O método de análise dos dados foi a Análise Temática de Conteúdo, a qual fez emergir quatro categorias: a) Sentidos do Trabalho para o Ser Estomizado; b) O Estomizado e Sua Problemática Biopsicossocial; c) Contexto Social e Aspectos Legais Envolvendo a Inclusão do Estomizado no Mundo Laboral; d) O Enfermeiro e Sua Participação na Reabilitação do Cliente Estomizado. Os resultados revelaram que a maioria dos sujeitos trabalhava informalmente e recebia ao mesmo tempo algum auxílio governamental. Ressalta-se que eles reconheciam a ilegalidade desta situação, porém, julgavam-na necessária devido aos baixos valores dos benefícios, enfatizando-se a sensação de utilidade causada pelo fato de trabalharem. Referiram que o retorno ao trabalho era prejudicado devido a empecilhos encontrados nas dimensões psíquica, física e social, as quais estavam articuladas intimamente...

This is a study which considered the inclusion of the colostomy clients into the labor world. The objectives were: to identify the difficulties and also the facilities of these clients for the inclusion in job field; to analyze such possibilities of inclusion, to discuss, from the point of view of the client the orientation provided by the nurses who aim to inclusion their clients into the job world. The theoretical reference was based on the field of Employee Health, focusing o the professional rehabilitation and the chapter for supporting the theory has approached the knowledge of colostomy , job- or employment world, physical handicap and the legal aspects which involve the rehabilitation of colostomyzed client in labor world. The methodology drawing was a qualitative descriptive, exploratory survey accomplished with 20 definitive colostomyzed clients, to whom were prepared semi-structured interviews. The data analysis method was the Thematic Content Analysis, which emerged four categories: a)Meanings of the Work for the Colostomyzed Being; b) The Colostomy patient and his/her Biopsychosocial problem; c) Social Context and Legal Aspects Involving his/her the Inclusion in Labor World; d) The Nurse and the Participation in the Rehabilitation of Such Client. The results have shown that most subjects worked informally and at the same time they had been receiving some type of government aid. It is also important to highlight that they recognized such illegal situation, however, they considered it important due to the poor payment of the aid, emphasizing the sensation of usefulness emerging from job opportunities. They have referred to the return to work as an impaired opportunity due to the obstacles set in psychic, physical and social dimensions which were close articulated...

O sofrimento psíquico do profissional de enfermagem da unidade hospitalar / Suffering of Psychic Training Nursing Unit Hospital / El sufrimiento psíquico del profesional de enfermería de centros hospitalarios

A equipe de enfermagem muitas vezes não percebe os problemas de saúde ao qual esta exposta. O objetivo do trabalho foi identificar as condições de trabalho que levam o profissional de enfermagem da unidade hospitalar ao sofrimento psíquico, para que a partir desta, possam surgir estratégias de mudanças a fim de obtermos melhoria nas condições de trabalho e consequentemente na saúde física e mental do profissional. Esta pesquisa configura-se descritiva explicativa exploratória, com uma abordagem qualiquantitativa, realizada através de pesquisa de campo, no Hospital e Maternidade Luiz Palmier, onde entrevistamos profissionais técnicos de enfermagem e enfermeiros do setor hospitalar, através de um questionário com questões abertas e fechadas. Na análise de dados, os resultados nos mostraram que o profissional em questão está satisfeito, realizado, com um a relação interpessoal satisfatória com a Chefia. O resultado, apesar da satisfação, aponta que a visão do profissional técnico mediante a teu superior é de maneira inadequada. Apesar dos resultados, da visão distorcida, forjada pela inexistência de conceitos como Gerência e Chefia, os profissionais atuam com o espírito da Enfermagem: o cuidar....

The nursing staff often does not realize the dangers to which it is exposed. The objective of this study is to help identify elements in the work environment at hospitals that can cause psychological problems for nursing professionals and, on that basis, to facilitate strategies for changes to improve working conditions in the interest of better physical and mental health. This is an exploratory and explanatory study of a descriptive nature, with a qualitative- quantitative approach. It was conducted through field work at the Luiz Palmier Maternity Hospital, where nursing professionals were interviewed and asked to complete a standard form with open and closed questions. An analysis of the collected data showed the professionals who were interviewed are satisfied, to some degree, with the general conditions and with their superiors. However, in spite of that satisfaction, the results show technical personnel have a poor view of their superiors. Regardless of the results and the distorted view, forged by the lack of concepts such as management and leadership, professional nurses perform in keeping with the spirit of nursing, which is based on care...

El personal de enfermería a menudo no es consciente de los problemas de salud a que está expuesto. El objetivo del trabajo fue identificar las condiciones laborales en los centros hospitalarios que llevan al profesional de enfermería a sufrir enfermedades psíquicas, para que a partir de ahí, puedan surgir estrategias de cambio para mejorar las condiciones de trabajo y, en consecuencia mejorar la salud física y mental del profesional. Este estudio es descriptivo explicativo exploratorio, con un enfoque de cualicuantitativo, realizado a través de la investigación de campo en el hospital y la maternidad Luiz Palmier, donde se ha entrevistado técnicos de enfermería, enfermeros del sector hospitalário , a través de un cuestionario con cuestiones abiertas y cerradas. En el análisis de datos, los resultados mostraron que el profesional afectado está satisfecho, realizado con una relación interpersonal satisfactoria con el liderazgo. El resultado, a pesar de los puntos de satisfacción, apunta que la visión profesional técnica mediante su superior es inadecuada. A pesar de los resultados, de la visión distorsionada, forjada por la falta de conceptos tales como la gestión y liderazgo, los profesionales trabajan con el espíritu de enfermería: el cuidado...

Occupational health and safety training of personnel from eleven Department of Health hospitals in Metro Manila

OBJECTIVE. This study was conducted to describe areas of concern with respect to occupational health and safety (OHS) program administration at eleven (11) Metro Manila hospitals, particularly: level of OHS knowledge and skill of personnel, the nature of occupational hazards perceived to exist in the hospitals, and how these relate to OHS program staffing and implementation.METHODS. Participants were surveyed on OHS knowledge and skills, as well as perceived occupational hazards, during the pilot of the "Occupational Health and Safety for Hospital Workers" training course held last April 2009.RESULTS AND DISCUSSION. The participants needed improvement in many of the OHS knowledge and ability items assessed. Familiarity and mastery of some items were demonstrated, but for effectiveness to be assured, it is necessary for other areas to be improved. Occupational hazards from all categories (chemical, ergonomic, physical, biological, and safety-related) are observed in the hospitals, with the most frequently cited being chemical and ergonomic in nature. Health and safety committees and OHS programs exist, but staff abilities limit their operation and effectiveness.CONCLUSION AND RECOMMENDATIONS. Improvement of certain OHS personnel abilities in the hospitals surveyed is suggested, and may help improve administration of OHS programs.

A adesão ao protocolo de monitoramento biológico entre trabalhadores de saúde / La adhesión al protocolo de monitoreo biológico entre trabajadores de salud / The adhesion to the protocol of biologyc monitoring between health workers

O objetivo deste estudo foi avaliar a adesão dos trabalhadores expostos aos fluidos biológicos frente ao protocolo de monitoramento e acompanhamento na Unidade Saúde do Trabalhador durante o ano de 2005. Tratase de uma pesquisa transversal descritiva-retrospectiva, realizada no Hospital do Trabalhador em Curitiba, sul do Brasil. Foram analisados 450 boletins de emergência que adentraram no Pronto Socorro e analisados 114 prontuários dos pacientes que retornaram para a continuidade do atendimento no ano 2005. Dos 450 prontuários analisados verificou-se a maior exposição entre as mulheres 345 (76,6 por cento). Em relação ao protocolo preconizado pelo Ministério da Saúde do Brasil, os registros mostraram que 114 trabalhadores (25,3 por cento) fizeram o monitoramento e retornaram em 30 dias e apenas uma minoria 42(9,3 por cento) fez o monitoramento completo. Comprovou-se que esta adesão ainda é insuficiente para o monitoramento da saúde desta população exposta. Estes resultados podem subsidiar a reflexão dos administradores e trabalhadores para o desenvolvimento de estratégias que possibilitem o monitoramento completo. Algumas estratégias já foram implantadas para melhorar a adesão destes trabalhadores, mas na prática estas estratégias não dependem apenas do serviço, dependem, também, de outras medidas que possibilitem a conscientização de seu processo de saúde, sejam por parte dos próprios trabalhadores, bem como nos seus locais de trabalho. Sugere-se a realização de estudos futuros com outras metodologias para evidenciar as crenças e valores destes trabalhadores em relação a exposição e o monitoramento completo.

The objective of this study was evaluate the adhesion of workers exposed to biological fluids considering the monitoring and follow up protocol at the worker health unit during 2005. This is a descriptive, transversal and retrospective research, that took place at the Worker Hospital, in Curitiba, south of Brasil. From 450 emergency clinical records that got into the Emergency Room, that were analyzed, the biggest exposure among women was verified: 345 (76,6 percent). Regarding the protocol proposed by Ministry of Health, the records show that 114 workers (25,3 percent) made the monitoring and returned in 30 days and just the minority 42 (9,3 percent) made the complete monitoring. It has been confirmed that this adhesion still is insufficient to the health tracking of this exposed population. These results may support the reflection of administrators and workers to develop strategies that allow a complete monitoring. Some strategies have been already implanted to improve the adhesion of those workers, but in practice, these strategies do not depend solely on the service, but in other measures that permit the awareness of their health process, either by themselves as workers, or within their workplaces. The completion of future studies with others methodologies to demonstrate the belief and values of these workers regarding the exposure and the complete monitoring, is suggested.

El objetivo de este estudio fue evaluar la adhesión de los trabajadores expuestos a fluidos biológicos considerando el protocolo de monitoreo y seguimiento en la Unidad de Salud del Trabajador durante el año 2005. Se trata de una investigación transversal descriptiva-retrospectiva, realizada en Hospital del Trabajador en Curitiba, sur de Brasil. De las 450 fichas clínicas analizadas, se verificó mayor exposición entre mujeres: 345 (76,6 por ciento). Acerca del protocolo preconizado por el Ministerio de la Salud de Brasil, los registros mostraron que 114 trabajadores (25,3 por ciento) hicieron el monitoreo y volvieron en 30 días y sólo una minoría 42(9,3 por ciento) hizo el monitoreo completo. Se ha comprobado que esta adhesión es todavía insuficiente para el monitoreo de la salud de esta población expuesta. Estos resultados pueden apoyar la reflexión de los administradores y trabajadores para el desarrollo de estrategias que posibiliten el monitoreo completo. Algunas estrategias ya fueron implantadas para mejorar la adhesión de estos trabajadores, pero, en la práctica, estas estrategias no dependen sólo de los servicios, sino de otras medidas que posibiliten mejorar su proceso de salud, ya sea por parte de los propios trabajadores, o sus sitios de trabajo. Se sugiere la realización de estudios futuros con otras metodologías a fin de evidenciar las creencias y valores de estos trabajadores en relación a la exposición y el monitoreo completo.

Estudo descritivo sobre as condições de trabalho em um serviço de emergência médica e a ocorrência de sintomas psicossociais / Descriptive study on working conditions in an emergency department and the occurrence of psychosocial symptoms

Na prática do médico plantonista, o ambiente e as condições de trabalho podem apresentar influência no desempenho profissional e na satisfação do usuário. Esta pesquisa foi realizada com 10 médicos plantonistas e buscou descrever as condições de trabalho em um serviço de emergência médica e a ocorrência de sintomas psicossociais junto aos médicos plantonistas. Os resultados indicam que na prática do plantonista ocorrem situações que potencializam o surgimento de stress ocupacional, decorrentes da estrutura física precária, insuficiência de salas, insuficiência de medicamentos, equipamentos obsoletos, queixa no relacionamento com a equipe de apoio e conflito com os usuários. Salienta-se de maneira significativa a presença de sintomas psicossociais como: irritação/impaciência, esânimo/desmotivação, memória/falta de contato pessoal, falta de concentração/ insônia e prazer sexual diminuído. Assim, há necessidade de investigação detalhada do trabalho, elaborar estratégias de intervenção, repensar formas de organização e participação dos trabalhadores nas decisões para que o ambiente de trabalho não favoreça o surgimento de doenças ocupacionais.

Within the duty doctor’s practice, the environment and the working conditions can interfere with both, their professional performance, and their client’s satisfaction. This research was realized with 10 duty doctors it tried to describe the work conditions in emergency room doctors and the occurrence of symptoms psychosocial.The results indicated that the function of such practitioners involves situations that intensify the manifestation of occupational stress. Some of the mainsources can be the precarious physical structure, limited number of rooms, insufficient medication, obsolete equipment, lack of support from the team, and conflict with the patients. The major psychosocial symptoms presented by the practitioners were: irritability/impatience, withdraw/discouragement, memory/lack of personal contact, attention deficit/insomnia, and reduction of sexual pleasure. Therefore, there is a necessity of, not only a detailed investigation of the job, but also the creation of some different intervention strategies, as well as the revision of organizational arrangement. Finally, the employees participation in the administrative decisions, in order to avoid that the workplace leads to the manifestation of occupational diseases, is also fundamental.

Reform of Government Employee and Labor Health Insurance in China / 中国卫生经济

This paper deals with the process of the reform and development of the social medical insurance scheme in urban China and the reasons for reform. At the same time, the paper presents the model of financing new urban employees' medical insurance in China.