Socio-environmental approach in nursing: focusing on rural labor and the use of pesticides. / Abordagem socioambiental na enfermagem: focalizando o trabalho rural e uso de agrotóxicos.

OBJECTIVE:: to apply a socio-environmental approach to the relationship between human health and rural labor through a link verification/association between health disorders and the use of pesticides. METHOD:: this is a quantitative, cross-sectional, observational and exploratory study with 331 inhabitants of two cities in the state of Rio Grande do Sul, Brazil. Data analysis was conducted by Poisson regression. RESULTS:: reported health disorders included: mental (62.2%); circulatory (49.8%); dermatologic (45%); respiratory (41%); and gastric (36.2%). Workers who apply pesticides showed a 90% higher prevalence of dermatological alterations when compared to those who did not. CONCLUSION:: the socio-environmental approach, comprising elements of the rural environment, of workers, and of the use of pesticides in the work process in connection/association with potential health disorders has shown that rural workers who apply pesticides present a higher prevalence of dermatological alterations.

Abordagem socioambiental na enfermagem: focalizando o trabalho rural e uso de agrotóxicos / Abordaje socioambiental en enfermería: haciendo foco en el trabajo rural y el uso de agrotóxicos / Socio-environmental approach in nursing: focusing on rural labor and the use of pesticides

RESUMO Objetivo: aplicar uma abordagem socioambiental na relação entre saúde humana e trabalho rural por meio da verificação de nexo/associação entre distúrbios de saúde e uso de agrotóxicos. Método: estudo quantitativo, transversal, observacional e exploratório, realizado com 331 trabalhadores rurais de dois municípios do estado do Rio Grande do Sul, Brasil. Realizou-se análise dos dados por regressão de Poisson. Resultados: os distúrbios de saúde referidos incluíram: distúrbios mentais (62,2%), circulatórios (49,8%), dermatológicos (45%), respiratórios (41%) e gástricos (36,2%). Trabalhadores que aplicam agrotóxicos apresentam prevalência 90% maior de alterações dermatológicas quando comparados aos que não aplicam. Conclusão: o uso da abordagem socioambiental constituída por elementos do ambiente rural, do trabalhador e do uso de agrotóxicos no processo de trabalho no potencial nexo/associação com os distúrbios de saúde permitiu verificar que os trabalhadores rurais que aplicam agrotóxicos apresentam maior prevalência de alterações dermatológicas.

RESUMEN Objetivo: aplicar un abordaje socioambiental en la relación entre salud humana y trabajo rural mediante verificación del nexo/asociación entre disturbios de la salud y uso de agrotóxicos. Método: estudio cuantitativo, transversal, observacional y exploratorio, realizado con 331 trabajadores rurales de dos municipios de Rio Grande do Sul, Brasil. Datos analizados por regresión de Poisson. Resultados: los referidos disturbios de salud incluyeron: disturbios mentales (62,2%), circulatorios (49,8%), dermatológicos (45%), respiratorios (41%) y gástricos (36,2%). Los trabajadores que aplican los agrotóxicos presentan una prevalencia 90% mayor de alteraciones dermatológicas en comparación con los que no los aplican. Conclusión: el uso del abordaje socioambiental constituido por elementos del ámbito rural, del trabajador y del uso de agrotóxicos en el proceso laboral buscando el potencial nexo/asociación con los disturbios de salud permitió verificar que los trabajadores rurales que aplican agrotóxicos presentan mayor prevalencia de alteraciones dermatológicas.

ABSTRACT Objective: to apply a socio-environmental approach to the relationship between human health and rural labor through a link verification/association between health disorders and the use of pesticides. Method: this is a quantitative, cross-sectional, observational and exploratory study with 331 inhabitants of two cities in the state of Rio Grande do Sul, Brazil. Data analysis was conducted by Poisson regression. Results: reported health disorders included: mental (62.2%); circulatory (49.8%); dermatologic (45%); respiratory (41%); and gastric (36.2%). Workers who apply pesticides showed a 90% higher prevalence of dermatological alterations when compared to those who did not. Conclusion: the socio-environmental approach, comprising elements of the rural environment, of workers, and of the use of pesticides in the work process in connection/association with potential health disorders has shown that rural workers who apply pesticides present a higher prevalence of dermatological alterations.

Social Ecology of Adherence to Hypertension Treatment in Latino Migrant and Seasonal Farmworkers.

PURPOSE: This study explored Latino migrant/seasonal farmworkers' (MSFWs') adherence to hypertension treatment. DESIGN: A cross-sectional correlational study was conducted. METHOD: Forty-five Latino MSFWs from two farmworker health clinics completed Spanish versions of the Morisky Medication Adherence Scale, the Blood Pressure Knowledge Scale and Blood Pressure Self-Care Scale, the Perceived Stress Scale, the Acculturation Rating Scale for Mexican Americans-II, the Short Assessment of Health Literacy for Spanish-Speaking Adults, health care access questions, and blood pressure measurements. RESULTS: MSFWs had poor medication adherence (51%). Blood pressure knowledge, perceived stress, acculturation, health literacy, and health care access accounted for 49% of the variance in blood pressure self-care. Higher acculturation level and health literacy were associated with better blood pressure control (p = .01). DISCUSSION: MSFWs had poor medication adherence and blood pressure control. Blood pressure knowledge and acculturation played a role in blood pressure self-care. IMPLICATIONS: Culturally appropriate educational programs are needed to help MSFWs' adherence to hypertension treatment.

Developing positive deviants as change agents.

In nearly every quagmire, one or more individuals surpass the issue being faced. Knowledge gained from these positive deviants-who fall outside the norm-leads to a six-step approach to problem solving that is fundamentally different than reductionistic approaches. Professional development educators can train leaders to this technique.

Work-related musculoskeletal disorders in senior farmers: safety and health considerations.

Aging farmers are at high risk musculoskeletal disorders due to occupational exposures. The development of musculoskeletal conditions can increase older farmers' risk for additional injuries because many older farmers continue to work past typical retirement age. Occupational health nurses with agricultural expertise can assist farmers by evaluating their health and safety needs. Possible interventions include ergonomic improvements in farm equipment, safety improvements in farm environment, and referrals to programs that assist older farmers in modifying their farms to improve safety.

Industrialized farm animal production: health concerns.

Modern livestock farming industry practice continues to cause concern about hazardous exposures among workers and nearby residents. Occupational and environmental health nurses can join other advocates and encourage policies that protect workers, communities, and the environment from confined animal feeding operations health hazards.

Caring for migrant farm workers on medical-surgical units.

Over 3 million migrant farm workers are employed in the United States. Many factors place them at risk for work-related disease and injury. Knowledge of workers' health issues can prepare medical-surgical nurses to anticipate and meet the needs of this underserved population.

Using problem-based learning for occupational and environmental health nursing education: pesticide exposures among migrant agricultural workers.

Problem-based learning, which emphasizes group collaboration to solve real-world case scenarios, is an instructional approach that is well suited to occupational and environmental health nursing education. Learners actively work through case studies rather than passively receive information presented through lectures. Problem-based learning methods promote critical thinking skills and motivate learning, preparing learners for professional practice in complex, ever-changing environments. Despite these advantages, problem-based learning is under-utilized in nursing education compared to more traditional lecture methods. This article presents key concepts of problem-based learning, discusses problem-based learning in educating occupational and environmental health nurses, and describes the development of a problem-based learning case aimed at increasing occupational and environmental health nurses capacity to address pesticide exposure among migrant and seasonal agricultural workers.

Preventing heat-related illness among Hispanic farmworkers.

Hispanic and Latino farmworkers are at risk for negative occupational health and safety outcomes due to issues such as their extreme work conditions, their reliance on employer beneficence, and cultural barriers. The purpose of this article is to explain the unique characteristics of heat-related illness in the Hispanic agricultural work force and to provide an overview of the problems of poor hydration and heat exposure in this population. Culturally appropriate preventive strategies are discussed because industrial-type solutions may not work in a crop production environment where language and beliefs may interfere with adaptation.

Agricultural-related injury and illness in The Gambia: a descriptive survey of a rural nursing service and area farmers.

This is an exploratory, descriptive study based on a convenience sample from a rural nursing service and in-country area farmers from The Gambia. The purpose of the study was to provide descriptive information about agricultural-related injury and illness from area farmers and to obtain data from rural nurses about the time they spent caring for and treating farmers. Employees of the nursing service could read and write English fluently and thus completed a written questionnaire; the area farmers were unable to read and write English so they were interviewed by farm extension workers in their own tribal language. The most alarming findings were the nursing respondents' report of farm workers using pesticides in their homes, the poor condition of pesticide sprayers, and the lack of personal protective equipment. Despite their claim of following pesticide instructions, farm workers reported a surprisingly high number of respiratory and neurological signs and symptoms.

Primary prevention of agricultural injuries. Use of standardized nursing diagnosis, interventions, and outcomes.

1. The use of standardized nursing language is important to the advancement of nursing knowledge and practice. The standardization of nursing diagnoses, interventions, and outcomes provides a means for collecting and analyzing large clinical databases. 2. The occupational health nurse has a clear role in developing health and safety programs. Standardized language using North American Nursing Diagnosis Association diagnoses, nursing outcomes classification, and nursing intervention classification can be incorporated into these programs. 3. The use of standardized taxonomies in the primary prevention of cumulative trauma disorders demonstrates how these systems are integrated into the documentation of the nursing process in a nursing care plan.

Agricultural health nurses. Job analysis of functions and competencies.

Agricultural health nurses address the health and safety issues of farmers, agricultural workers, and farm families. This nurse role incorporates both public health and occupational health nurse specialty practice. The purpose of this study was to describe agricultural health nurse job functions and competencies used in providing services to agricultural populations. A two round modified Delphi technique was used to attain a consensus among participants related to agricultural health nurse functions and competencies. In Round I, a mailed survey assessing demographic characteristics, and job functions and competencies was sent to an identified list of 61 nurses. A second mailed survey, with categorized job function and competency responses elicited through Round I, was sent to the 32 Round I respondents to assess the importance of the job functions and competencies and the frequency of performing each job function. Twenty four Round II surveys were returned. Job functions rated highest were: Serve as a liaison for the agricultural, health and medical, and nonfarm communities. Promote agricultural health and safety issues through the media. Implement educational courses for various groups. Conduct follow up assessment of injury, illness, or disease occurring as a result of an agricultural exposure. Function as a resource for information to victims of agricultural injury and illness and their families. The competencies of greatest importance were interpersonal communication skills, knowledge of injury prevention principles and measures, ability to recognize potential hazards within the work and home environment, and demonstrate a strong sense of self. This study adds to the body of knowledge needed to define the agricultural health nurse role.

Neurotoxins: a neuroscience nursing challenge.

Societal awareness of toxins in general has been heightened in the past few decades with the increased focus on environmental concerns. The medical profession has been aware of the effects of some toxins such as lead and mercury for centuries, while other toxins have more recently been identified. Neuroscience nurses are challenged to be aware of the neurological effects of lesser known toxins, such as ciguatera and methyl bromide, and to meet the complex needs of patients who are suffering from the effects of toxic levels of these substances.