ORIGINAL RESEARCH

Workers' health: student nurses' conceptions

Rejane Silva Rocha^I; Rosangela Maria Greco^II; Denise Cristina Alves de Moura^III; Marluce Rodrigues Godinho^IV

^I Nurse. Master, Federal University of Juiz de Fora. Minas Gerais Brazil. E-mail: rejanesvrocha@gmail.com
^II Nurse. PhD. Full Professor, Federal University of Juiz de Fora. Minas Gerais Brazil. E-mail: romagreco@gmail.com
^III Nurse. Master. PhD student. Federal University of Juiz de Fora. Minas Gerais Brazil. E-mail: denisematipo@yahoo.com.br
^IV Nurse. PhD, Substitute Professor. Federal University of Juiz de Fora. Minas Gerais Brazil. E-mail: marlucerodriguesenf@gmail.com

DOI: http://dx.doi.org/10.12957/reuerj.2017.16143

ABSTRACT

Objective: to discuss conceptions of occupational health held by students at the School of Nursing, Juiz de Fora Federal University. Method : in this qualitative study, data were collected in 2014, by written questionnaires, from 19 5th and 9th term nursing students, and treated by content analysis. The study was approved by the research ethics committee (CAAE 33361214.2,0000.5147). Results: the participants were 20 to 28 years of age, and predominantly female. Although the subject was being studied on the undergraduate course, a broader approach was needed, with this content introduced early in the course so as to prompt students' thinking about, and understanding of, workers' health. Conclusion: students need to be encouraged to think critically about their own health, workforce health, and the health of workers in their care.

Keywords: Nursing; work; occupational health; students.

INTRODUCTION

The concretization of work is consolidated through a process that includes the objective conditions, which are the instruments and materials used, and the subjective conditions, which are the desires of the workers according to the meaning that the work has in their lives^1,2.

Therefore, work is understood as the set of activities that human beings perform daily, for which they receive a remuneration to reach life goals. Work is also a form of expression and a social environment. It is through it that individuals demonstrate initiatives, expand and perfect their abilities and, at the same time, learn to live with their peers, and thus, with differences and individualities².

Depending on the conditions under which it is performed, work can be a stimulus for the development of physical and mental capacities of the human being, and therefore a producer of health, or even a cause of illness. Thus, it is important to analyze the attention that is given to the workers' health³.

According to the Ministry of Health, occupational health is a field of knowledge that aims to understand the relationships between work and the health/disease process. In Brazil, it is carried out through collective health and seeks to know and intervene in work and health/illness relations^4,5.

Today, worker health is approached in a multiprofessional way, with the joint participation of professionals of the health, human and exact areas^6,7.

Nurses are also professionals who face several situations in their work routine related to worker health. Thus, it is essential to focus of this theme during the training of generalist nurses, since teaching plays a primary role for students who learn particular questions of the profession such as the exclusive activities of nurses, developed in the course under the teacher's supervision. Likewise, the articulation between professional training and practice, especially with the tendencies of occupational nursing, stimulates the development of promising professionals⁸.

The interest in investigating this theme comes from the academic experience during the undergraduate nursing course, with topics related to worker health and working conditions that led to the perception of the need to discuss, study, understand and know the field of occupational health. Nurses can play a crucial role in this field, since this area has implications for their quality of life, as well as for other workers and, consequently, for the work environment in which they are inserted.

In view of this context, the purpose of this study was to discuss the conceptions of the nursing faculty of the Federal University of Juiz de Fora (FACENF - UFJF) on the theme of occupational health.

LITERATURE REVIEW

Work plays several roles, such as productive space, source of income and social environment, and is an essential part of human life, occupying a central place in society^1,2.

The relationship between health/illness and work has been observed since the beginning of labor activities. Since its creation in 1919, the International Labor Organization (ILO) has proposed standards for the prevention of injuries and improvement of working conditions meeting relevant issues to the protection of workers' health^6,9.

It is worth noting that the occurrence of occupational diseases and/or work accidents causes a decrease in the capacity to perform work activities, and may also lead to temporary or permanent removal from work and, in some cases, from the daily life activities. In order to avoid work-related diseases, it is important that workers be aware of their rights, the risks they are exposed to, and also preventive measures¹⁰.

Companies, employers and health professionals known well that the exposure of workers to risks implied in the work environment prompts diseases and accidents. However, many of these problems can be avoided through counseling and prevention programs promoted by nurse practitioners ¹⁰.

It is necessary to emphasize that, despite the availability of nursing specialization in the area of ​​occupational health, all members of the nursing team, even those who are not specialists, have responsibilities regarding the promotion and maintenance of workers' physical and mental health¹¹.

As occupational health is one of the nursing specialties, non-specialists often believe they have no responsibility towards this issue, which is an incorrect idea. This is due to the need to approach the patients/users of the service in an integral manner. It is incumbent upon all nursing professionals to "raise awareness about worker health issues and to promote and maintain the physical and mental integrity of workers in general" ^11:104.

Thus, professionals must be able to provide assistance to the most diverse situations, promoting care and the health of the individuals and of the community.

Universities have social responsibilities in various fields, including when it comes to worker health. This role should be recognized and valued because discussions, studies in research groups and implementation of activities that benefit the population make dissemination of ideas in a network to take place¹².

METODOLOGHY

The approach used in this descriptive research was qualitative, through the content analysis of the students' testimonials. This method is used to study opinions and perceptions, providing an understanding of the context in which the problem is inserted¹³.

The research was carried out in the city of Juiz de Fora - MG at the FACENF-UFJF, in 2014, and the participants were the students of the institution, chosen by lot and drawn from the attendance list. The inclusion criteria were: to be enrolled in the Undergraduate Nursing Course and to be attending the 5th or 9th semester in the Institution where the data were collected. Academics from other semesters were excluded.

After the acceptance of the institution and approval by the Research Ethics Committee under Opinion number 780.596/2014, CAAE number 33361214.2.0000.5147, the academics were individually approached. Those who agreed participating in the study were requested to sign the Informed Consent Term. In order to maintain the anonymity of the participants, the questionnaires (Q) were numbered from 1 to 19 with the indication of the corresponding semester to which students were enrolled, 5^th or 9 ^th period.

Data were collected through a self-applied instrument with closed questions to characterize the participants and to present discursive questions, in order to verify the knowledge of the student about the topic in question.

The questions were written answers were provided by the students and, after transcription verbatim of each response, the content analysis was started. Initially, a systematic and in-depth reading of the testimonies was carried out. This made it possible to identify the most significant and sometimes repetitive answers, extracting data that corresponded to the objective of the research.

The nuclei of sense and determination of meanings were identified through the reading, and grouped according to similarities, giving rise to three categories that composed the results of the research, they are: biological conception of man and worker health centered on the work environment; self-care and worker health; contribution of nursing to worker health.

RESULTS AND DISCUSSION

Nine academics from the 5th semester and 10 from the 9th semester answered the questions. The general questions contained in the first part of the questionnaire made it possible to characterize the population.

Age ranged from 20 to 28 years, with a predominance of the age group from 23 to 25 years, of which only 1 (5.3%) person was male, corroborating the results of other studies performed with nursing students^14,15. When questioned about the paid activity, it was found that 11 (57.9%) participants have these activities. From these, 3 (27.3%) reported that there was no relation between these activities and graduation, and 8 (72.7%) emphasized those that the FACENF-UFJF offered, such as outreach projects and assistantship, noting that the academics assume extracurricular actions as work in order to support themselves during graduation in many cases.

The interpretation of the answers to the questions about the idea that nursing students have about occupational health allowed the creation of three categories which are presented below.

Biological conception of man and worker health centered on the work environment

Some research participants, especially those in the fifth semester, described the worker health in a restricted way, focused on the condition of working without harm, absence of occupational hazards, and a work environment in which the individual is inserted. They do not have an extensive comprehension of the worker health and restricted it to the concept of occupational hygiene.

Health and disease are articulated and dynamic processes, linked to the way of life of the subjects as well as to their productive development. Thus, the insertion of individuals in work environments may contribute to the occurrence of damage to health⁴.

Some academics, especially in the 9^th semester, were able to expand the concept of worker health, subtly widening their view and understanding of the theme, as follows:

At the FACENF-UFJF, biosafety and accident prevention are taught in the 3 ^rd and 4^th semesters, during the courses Nursing Fundamentals I and II, and the specific content about the worker health is offered during the classes of the courses Administration in Nursing I and II, in the 6^th and 7^th semesters. In this way, it is noticeable that the way academics respond to the questions is closely linked to the semester and to the theoretical knowledge they possess. Therefore, a theoretical approach that goes beyond the disciplinary borders for the understanding of the several problems that will be seen and experienced by the academics becomes indispensable.

Self-care and worker health

When we analyzed the participants' answers to questions about the relationship between self-care and work, there were reports that confirmed that these dimensions are inseparable, since self-care is related to the individuals' responsibility to prevent and correctly perform their activities in order to avoid harm to themselves and to others.

Students also considered as self-care the following aspects: biosecurity, feeding, practice of physical activities and time for rest and to participate in relaxing activities with co-workers and employers. These questions are linked to the service of Basic Human Needs (BHN), a theory developed by Abraham Maslow¹⁷.

It is important at this moment to highlight the Self-Care Theory developed by Dorothea Orem, which argues that self-care is the practice of activities that individuals perform for their own benefit, aiming to maintain life, health and well- being¹⁸.

In this regard, it was also seen that academics relate self-care to prevention and to the safety of all individuals involved in the work process, thus conveying the importance of maintaining harmony, aimed at a healthy working environment¹⁹.

Nursing workers are exposed to risks every day during their working hours, being a profession considered to be a high risk for acquiring diseases and suffering accidents due to the constant manipulation of biological materials, work overload, precarious conditions of the environments labor, among other factors. Thus, self-care is a tool that contributes to the professional's commitment to take on and concretize individual and collective protection²⁰.

Contribution of nursing to worker health

The participants of the research mentioned confidence in the educational aspect for health promotion, since the answers to the questionnaire on the contribution of nursing to worker health point the nurses as the responsible for the health education of workers. This can be seen in the following reports:

Health promotion can occur, among other ways, through health education, which is a strategy aimed at influencing the acquisition of healthy lifestyles, and nurses are the main professionals that play this role of educators over of the life cycle of the person²¹.

The recognition by the student of the relevance of nursing professionals to get involved in the education of workers emphasizes the benefits of their early inclusion in the debate and the study of the questions about work environment and worker health, aiming at their intellectual and critical development during undergraduate training. Therefore, it is essential to invest in pedagogical proposals that allow the problematization of the subjects addressed in the classroom^22-25.

CONCLUSION

This study responded to the proposed objectives by allowing a reflection, on the part of the academics, about the theme occupational health. Considerations about self-care with health, as future professionals and workers, and the contribution of nursing to worker health are outstanding aspects of the study, with the exception of the categories that emerged from the study.

We identified the concern of the academics with actions planned to promote the worker health. However, the difficulty to exposing, in a more comprehensive and critical way, what was apprehended in their daily life as students was evident. This was evidenced by the restriction of statements to predetermined concepts, without reflexive critical thinking at the moment of responding to questions. A difference in terms of maturity was observed among the participants of the different semesters: the respondents of the 9^th semester presented their opinions in a more consistent and comprehensive way than those of the 5^th semester.

The analysis of the results made it possible to state that there is a need to deepen the discussions and teaching in the theme of worker health during undergraduate training, so that academics may be encouraged to think critically about their own health, the health of the team workers and of the population under their care, since they are, for the most part, workers.

Moreover, before the process of curricular restructuring, the data from this research may contribute to make teachers rethink the insertion of worker health in the curriculum of the institution.

As limitations of the study, we studied nursing students from a single teaching institution, not representing the universe of the phenomenon studied, which prevents the generalization of the findings. However, the results allow a reflection on the theme and its implications in a local reality.

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