Worker´s health education in nursing graduation: a bibliographical research

Marcela Costa Fernandes^I; Norma Valéria Dantas de Oliveira Souza^II; Caroline Fonseca Marques^III
IMaster in Nursing by the Post-graduation Programo f the  Nursing University of Rio de Janeiro State. Specialist Nurse in Nursing at work. Rio de Janeiro, Brazil. E-mail: marcelacostafernandes@yahoo.com.br.
^IIDoctorate in Nursing. Vice-Director of the Nursing College and Permanent Teacher of the Master Program of the University of Rio de Janeiro State. Pro-scientist. Rio de Janeiro, Brasil. E-mail: norval_souza@yahoo.com.br.
^IIIPublic health nurse. Specialist in public health by the National School of Public health. Oswaldo Cruz Fundation. Rio de Janeiro, Brazil. E-mail: carolwellerson@yahoo.com.br.

ABSTRACT: Bibliographical research, integrative, descriptive and quantitative, which investigated the scientific production of nursing education on workers' health in undergraduate courses. Objectives: To raise the amount of articles produced by nursing on the issue of Occupational Health, focused on undergraduate courses, published in journals and national and international and Discuss the contributions of these items for teaching, nursing care and research, considering its importance to training of nurses. It was held in scientific databases on health, national and international. Tables and graphs are designed to highlight the absolute frequency of the data. It was confirmed that the production of the articles on the teaching of Nursing Occupational Health at graduation presents its incipient, particularly with regard to national publications. It is therefore recommended that it be systematically encouraged the scientific student in the area of ​​Occupational Health.

Keywords: Nursing baccalaureate; Health worker Teaching; Occupational health.

INTRODUCTION

This article emerged from discussions arising from a discipline of master's degree offered by the School of Nursing at the University of the State of Rio de Janeiro, entitled work, Training,  process and management in nursing. Throughout the course, we make reflections on the importance of the students develop theoretical and practical lessons about workers ' health related content. It was considered that the relevance of lessons was to awaken, in future nurses, interest in the area, enabling an attitude of caution about their own health and creating a critical and vindicatory conduct on better working conditions.

The object of study is the scientific production of nursing on the teaching of occupational health Nursing Graduate Courses, being prepared the following problem: how many research papers published by nursing, in scientific journals, presented issues related to worker's health education in nursing degree and what contributions have brought to the training of nurses?

The health of the worker is under the public health and, through its own methods and procedures, aims to preserve, promote and protect the health of people involved in the work, implementing measures collective range¹.

With this in mind, we have to consider the daily nursing work and its relation with the content relating to worker's health, paying attention to the many situations that require specific knowledge on this issue, since the context of the work of nursing has been often adverse, with unhealthy and dangerous working conditions, that just emphasizes the subjectivity of nursing professionals^2,3. Therefore, it is necessary to reflect, discuss and build strategies for the transformation of those adverse situations and which have strong potential for illness of nursing collective.

The responsibilities are of all nursing professionals to raise awareness of health issues and the commitment to the promotion and maintenance of physical, mental and social integrity of workers. And as for the field of research, specifically, the nurse adopt the theoretical framework of occupational health in conducting research in the area of work and health, in order to build and/or strengthen knowledge enabling the change of context⁴.

From the exposed, it is reflected on the importance of scientific production and development of targeted health line nurses, with the understanding that these professionals have particular potential to bring contributions to this field of knowledge. Therefore, the workers ' health must be part of the curriculum of nursing schools and needs to be more widely discussed in scientific circles and professional training spaces⁴.

With this in mind, we propose the following goals: to rise the amount of articles produced by nursing on the theme of worker's health, aimed to graduate courses and published in international and national journal, to discuss their contributions to teaching, service and research in nursing, considering their importance to the training of nurses.

This study presents its relevance based on the ability to recognize what has been researched on this topic, as well as gather information related to the training of professionals focused on health at work. It is also envisioned to contribute to the quality of life of workers in nursing, because as it is investigated, discusses and disseminates the labor context specific knowledge of nursing, it can help in the formation of a collective critical and trained professional to identify and modify adverse situations in the work.

METHODOLOGY

Bibliographical search was made, integrative and descriptive in nature, with a quantitative approach. The review of integrative nature contributes to the process of synthesis and analysis of several studies, creating an Association of understandable literature. The descriptive and quantitative study outlines and documents features with a selected position, using numerical information, resulting from formal measurement, which will be analyzed by means of statistical methodology⁵.

The bibliographical research is not mere repetition of what has already been said or written about a certain subject. Before that, it provides an examination of a topic under new focus or approach, coming to conclusions. When doing a review of what has been produced, it can see things that otherwise would pass unnoticed, as dark spots or knowledge gaps⁶.

The literature search was performed in December 2011, without designation of period of time, in order to carry out a survey of all papers published by nursing on the subject. The investigated databases were the Virtual Health Library (VHL), subdivided into: Latin American literature and Caribbean Health Sciences (LILACS), Online Search System and analysis of medical literature (MEDLINE), Spanish bibliographic index in Health Sciences (IBECS), Cochrane Library, Scientific Electronic Library Online (SciELO); international organizations: Pan American Health Organization (PAHO), World Health Organization Library and information networks for knowledge database (WHOLIS); and Public Medline (Pubmed), which is an international base of biomedical citations, MEDLINE indexed.
In the search field, it was the standardization of selected descriptors from the portal of descriptors in health, namely: education, occupational health, Bachelor of nursing/nursing education, occupational health and teaching and health worker and education nursing baccalaureate. This selection was based to contemplate the problem presented by the research study.

34 articles were identified on the investigated object, being the oldest published in 1950 and the latest in the year 2008. The whole was indexed in the international database Pubmed and two also in national database of Health Virtual Library.

The articles were analyzed quantitatively, however, were enjoyed only the summaries, since only two were available in full, in accordance with the same procedure of analysis for all texts as methodological principle.

Considering the rules for the publication of this magazine, which limits the amount of referenced bibliographies, it was decided by quoting articles from 1985 to 2008 period. So, it was used to support the discussion of the most recent period works.

Descriptive statistics were applied in order to highlight the absolute frequency of production examined – and then they were referred to the discussion of the contributions with the support of specialized literature^7-26.

RESULTS AND DISCUSSION

Production profile of nursing on workers ' health education on graduation
           
The identification of articles published in scientific journals for nursing made the classification and presentation of data through figures, on which were displayed the information relating to the number of articles produced in the year; the title; the scientific journal, in addition to the distribution of production by decade of publication.

The articles published on the subject, during the period of 1950 to 1983, are presented in Figure 1. The 80 predominated with six publications.

The scientific literature on the subject^7-22, published in the most recent period, from 1985 to 2008, is listed in Figure 2. During this period, the years were 80 with eight products.

The scientific production of nursing on the workers ' health education had its beginning in 1950, being the latest survey found in the year 2008. Accordingly, in order to demonstrate the amount of articles produced by nursing on the subject, in that period, Figure 3 was drawn up.

The production in the first three decades, 1950, 1960, 1970 and presented the same quantitative with four articles each, totaling in 12 scientific articles on the teaching of occupational health with a focus on nursing degrees, as shown in Figure 3. This information demonstrates a concern already in those decades with the training of nurses facing the world of work, encouraging the development of workers ' health at the University level, that may have been well founded and justified by certain historical events.

From the Decade of 1950, laws have been edited creating single regulation for institutes of retirement and pensions. In 1966, the institutes were gathered in a city called Union National Social Security Institute (INPS). As a result, in 1977, in an overhaul of Social Security, the Government created two districts-National Institute of Social Security Medical Assistance (INAMPS) and the Institute of Financial Administration of Social Assistance and Welfare (IAPAS), and the first medical assistance for workers governed by the Consolidation of Labor Laws (CLT), being the own services or by agreements⁴.

The following decade presented the highest production-14 articles, comparing with the other decades, being published one or two articles per year in the period from 1980 to 1989. There are texts with content necessary for the training of nurses on health at work. These publications presented and discussed some curricular experiences, and encourage the incorporation of these contents in nursing degree.

It is considered that, with the Brazilian Federal Constitution of 1988, health assistance, including assistance to the employee, it is the responsibility of the Ministry of health, it has been determined that the unified Health System (SUS) to execute actions of worker's health, blaming himself for his service on the condition that the victim of an accident or work-related disease carrier occupational exercise, in addition to providing care in the case of common diseases that also affect this population⁴.

In late 1990, there was a reduction in the production of articles from nursing on the employee's health education program, with only publications in the years 1991 and 1996, a total of only three articles. However, it was noticed the continuation of discussions on the importance of content relating to approach health and work in the training of nurse undergraduate teaching level.

In 2000, the nursing publications about the employee's health education graduate overcame the previous decade, totaling five articles, and it was the only decade in which national study was carried out on this issue.

Of the total of five nursing publications in this period, three were foreign productions, two of which published in 2002 and, a most current, in 2008; these articles have kept discussions on the importance of inclusion of content relating to worker's health in graduate nursing education as in previous decades. It should be noted that the other two productions, both of 2007, were national and were shaped as also present. A part about teaching for health surveillance of workers in nursing degree and another on the conceptions of nursing students on the relation health and work.

As for publication in journals, it was identified a prevalence of publication in international journals, with a predominance of Occupational Health Nursing magazine, with seven publications, followed by the magazine the American Association of Occupational Health Nurses Journal, with six articles published by nursing. The most current article, 2008, was in charge of the journal International Nursing Review and brought a study of nursing in Turkey. In relation to the Brazilian publication, the Journal of the School of Nursing at the University of São Paulo was the only national scientific journal that published an article on this topic.

The prevalent was the international basis (PubMed), composing a total of 34 publications. This is justified by the fact that most publications, 32 (94%), being international and for the reason of national database investigated (BVS) does not cover the predominant international organism in this study. However, as stated earlier, the national database (BVS) included two of the most recent publications on the subject.

The knowledge produced and contributions to nursing

Analyzing the articles listed, they can be grouped into three main themes, involving the worker's health education: education in nursing and the health of the worker^7-17;  workers ' health in the curriculum of nursing^18-21; and workers ' health in nursing practice²².

Thus, the first eleven thematic articles, which turned on the teaching methodologies for the approach of the worker's health in undergraduate courses; the contents that are developed in the course of graduation in nursing; and the teaching-learning experiences related to the field of occupational health^7-17. The four articles, which fit into the second theme, discuss the philosophies of the health of the worker; the load time for such content; and its objectives for the training of nurses^18-21. The last issue relates to an article that relates to the need to link theory and practice, in order to better empower the nurses for a comprehensive and integral action, including the world of work as an influencer of the health-disease process of people²².

The analysis of the scientific literature on the health education of undergraduate nursing worker elucidated the importance of inserting content pertaining to this field of knowledge as a key element for the training of nurses, whereas a singular achievement for the nursing profession, and emphasized the need of acquisition and/or maintenance of this subject in the curriculum, with the presentation of recommendations to the scientific and theoretical-practical enhancement of professional collective^8,9.

The development of theoretical and practical content of occupational health nursing undergraduate courses has benefited the working relationships with health professionals, students and the teacher¹². In this sense, it is recommended that the undergraduate nursing courses to develop comprehensive concepts on occupational health, so that future nurses can develop knowledge about the relationship between work and health, both in terms of community and individual^14,19.

The teaching of health vigilance of the worker was described in activities developed in the nursing degree, being regarded by students as very good or excellent by about 80% of them; 71.5% already considered the experience gained in the discipline as very good or excellent, showing a satisfactory academic use and about the development of this content in nursing degree. The importance of workers ' health vigilance theme is discussed as an aid for the development of actions to the health of workers, which imposes the need for inclusion of content on the subject in the training of nurses, including through the development of skills in the construction and management of information systems¹⁶.

In relation to the development of educational activities, in addition to the workers ' health vigilance, the contents covered in nursing degree related to this area know contemplated themes: Epidemiology applied to worker's health, accidents at work, investigation of accidents at work, occupational diseases and occupational health in the Unique Health System¹⁶.

So, it turns out the relevance of the undergraduate nursing courses adopt the theoretical referential about worker´s health; inserting and/or improving the contents about health and work with the prospect of students ' awareness about the process of illness as a result of the work^17,20,21.

Are still discussed, among other issues, that the vast majority of nursing publications on worker's health has been the assessment of occupational risks, pointing as relevant the intensification of studies with targeted approach to the teaching of this area of knowledge in the formation of the nurse^10,16.

The working conditions and the physiological, psychological and social well-being are characterized as relevant content related to learning about the employee's health, because it makes a more secure environment in work and make an instrument for the future nurses for the promotion and protection of health of workers – and the health team^16-17.  Corroborating the above stated that the actions taken on the basis of the theoretical framework of occupational health are committed to the worker, with the maintenance of their physical and mental integrity. They should strengthen their participation in decisions about the work process that develops and on the adequacy of the working environment⁴.

As for the aspects that make up the nursing role focused on worker's health, the themes treated were: health education; the prevention of accidents at work; direct assistance to workers; the formation of support groups and the concern with working conditions^16,23.

The nursing courses, in their vast majority, are included in an educational model in which all opportunities that arise to the building of knowledge should be added to the critical conscience and questioning of the apprentice²³. Thus, the undergraduate program must enable the future nurse their exploitation for the intervention in reality, promoting the Organization and reorganization of work^11,12,24.

In this sense, an important point evidenced was the participation of nursing students as co-authors of the research¹⁶.This observation confirms the importance of stimulating production of articles still on graduation, allowing the construction of an expanded and consistent knowledge, based on scientific studies and focused on the knowledge of nursing, specifically, concerning the health of the worker.

The production of quality knowledge demand permanent research achievement. The education in nursing, graduate students while driving this production of knowledge related to research, can provide future professionals the very best and most current for their training²⁵. In this way, it is important that the training institutions to include in their educational plans to develop expertise to scientific research in nursing, enabling the construction of skills directed to the production of scientific knowledge²⁶.

CONCLUSION

The study was relevant as evidenced nursing research on worker's health education carried out in the course of graduation, having as basis the scientific production of nurses and students, which promotes the growth and the development of new knowledge inherent in professional training on the requirements and complexities of the world of work.

However, the analysis confirmed that the production of nursing articles on the teaching of workers ' health in the graduate is starting, especially with regard to national publications. In this sense, it can be seen as relevant research problem to investigate why this issue is still being studied.

This research also highlighted the importance of partnerships students and teachers in the development of research, with enrichment of scientific production, because it is from the student scientific curiosity well directed and guided the future professionals will have critical awareness of occupational risks that are running and will be able to create strategies to neutralize them or minimize them.

Thus, it is recommended that greater incentive for the production of articles, with dissemination of curricular experiences and teaching strategies used by teachers for the development of educational content related to the field of occupational health in undergraduate program.

Therefore, the production of this research contributed to the understanding of what content related to the field of occupational health are being developed in the degree in nursing, in conjunction with the tasks and roles of the nurses. Thus, it was found that the occupational risks, epidemiological vigilance, occupational diseases, accidents at work and working conditions are matters dealt with in the training of nursing professionals.

In this sense, it is suggested that additional research be carried out in order to add new themes and/or reaffirm its relevance in the training of nurses. This suggestion is based on the dynamism of the labor market, health services and epidemiological profile of the population, which demands a rewatching constant for the teaching-learning process, to curriculum and pedagogical political projects of educational institutions.

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