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01-01-2016
Perfil dos pacientes com tumores cerebrais e o papel do enfermeiro
Revista Brasileira de Enfermagem. 2016;69(1):150-155
Abstract
Perfil dos pacientes com tumores cerebrais e o papel do enfermeiro
Revista Brasileira de Enfermagem. 2016;69(1):150-155
DOI 10.1590/0034-7167.2016690120i
Views0See moreRESUMEN
Objetivo:
describir el perfil de los 200 pacientes con tumores del sistema nervioso central (TSNC) y el papel de la enfermería.
Método:
análisis prospectivo, cuantitativo y descriptivo de los registros médicos de 200 pacientes con TSNC.
Resultados:
61% de los pacientes tenían TSNC benignos y 39% tumores malignos. El grado de la dependencia de los pacientes según la Escala de Karnofsky fue significativamente mayor en los pacientes con tumores malignos (P <0,05), lo que indica que estos pacientes necesitan más apoyo en las actividades diarias.
Conclusión:
los pacientes con tumores cerebrales requieren atención especializada, con directrices específicas sobre su enfermedad y aspectos de la vida diaria después del tratamiento. Por lo tanto, los enfermeros pueden ser un elemento clave para la eficacia de la atención prestada a los pacientes y sus familias con el objetivo de mejorar la calidad de vida de las personas afectadas por la enfermedad.
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01-01-2016
Profile of patients with brain tumors and the role of nursing care
Revista Brasileira de Enfermagem. 2016;69(1):150-155
Abstract
Profile of patients with brain tumors and the role of nursing care
Revista Brasileira de Enfermagem. 2016;69(1):150-155
DOI 10.1590/0034-7167.2016690120i
Views0See moreABSTRACT
Objective:
to describe the profile of 200 patients with central nervous system tumors (CNST), and the role of the nursing care.
Method:
prospective, quantitative and descriptive analysis of medical records of 200 patients with TSNC.
Results:
a total of 61% of our patients had benign CNST and 39% had malignant tumors. The extent of patient dependence, according to the Karnofsky Performance Status scale, was significantly greater for patients with malignant CNST (p < .05), indicating that these patients needed more support with their activities of daily living.
Conclusion:
patients with CNST need specialized care, with specific guidance regarding their disease and aspects of daily living after treatment. Thus, the nurse can function as a key element for the effectiveness of care provided to patients and family members with the aim of enhancing the quality of life of all those affected, directly or indirectly, by the disease.
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01-01-2016
Clinical competences of nursing assistants: a strategy for people management
Revista Brasileira de Enfermagem. 2016;69(1):142-149
Abstract
Clinical competences of nursing assistants: a strategy for people management
Revista Brasileira de Enfermagem. 2016;69(1):142-149
DOI 10.1590/0034-7167.2016690119i
Views0See moreABSTRACT
Objective:
to identify the clinical competences of nursing assistants in a hospital organization and to understand how professional acquired these competences.
Method:
an exploratory study of a qualitative approach, performed at a private hospital in southern Brazil, through a semi-structured interview, in May and June 2013 with 20 nursing assistants.
Results:
the nursing assistantswho worked longer in the same work unit had a higher list of clinical competences. The acquisition of clinical competences occurred through interaction with other professionals; in daily nursing practice; in previous experiences and in formal learning.
Final considerations:
the identification of clinical competences and the way nursing assistants acquire these competences can be important resources for managing people, which can be used by nurse managers to better allocate these professionals and provide th e opportunity for their professional development.
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01-01-2016
Quality of life and accession to the pharmacological treatment among elderly hypertensive
Revista Brasileira de Enfermagem. 2016;69(1):134-141
Abstract
Quality of life and accession to the pharmacological treatment among elderly hypertensive
Revista Brasileira de Enfermagem. 2016;69(1):134-141
DOI 10.1590/0034-7167.2016690118i
Views0See moreABSTRACT
Objective:
to compare variables obtained in adherence and non-adherence to drug treatment for hypertension, according to socioeconomic situation, time of diagnosis, self-reported morbidities, indicative of depression and quality of life.
Method:
cross-sectional analytical study of 524 elderly with adherence and 505 non-adherence to the treatment. A descriptive analysis, Chi-square test and Student t test (p < 0.05) were held.
Results:
there was higher proportion of older subjects, indicative of morbidity and depression among those with adherence. Non-adherence subjects had lower scores in all domains and quality of life facets.
Conclusion:
actions favoring the adherence to pharmacological treatment should be recommended, to minimize the impact of comorbidities and improve quality of life.
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01-01-2016
Exposure and sun protection practices of university students
Revista Brasileira de Enfermagem. 2016;69(1):126-133
Abstract
Exposure and sun protection practices of university students
Revista Brasileira de Enfermagem. 2016;69(1):126-133
DOI 10.1590/0034-7167.2016690117i
Views0See moreABSTRACT
Objective:
to learn exposure and sun protection practices for university students.
Method:
a descriptive, cross-sectional study performed at a university in São Paulo.
Results:
the sample consisted of 385 young and data collection conducted through a form. Of the total, 239 (62%) young people were classified as skin type III and IV and 69 (17.9%) affirmed to have a history of skin cancer in the family. Most affirmed exposure to the sun between 10 a.m and 04 p.m and for more than one hour; 112 (29.1%) informed not employ safeguards. Among those who use sunscreen, the minority does so regularly.
Conclusion:
although the sample was made up of people with greater access to information, it was found exposure and sunscreen improperly. Education, individual and collective actions should be strengthened and prioritized given the incidence of skin cancer in the country.
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01-01-2016
Hospitalizations sensitive to primary health care at a regional hospital in the Federal District
Revista Brasileira de Enfermagem. 2016;69(1):118-125
Abstract
Hospitalizations sensitive to primary health care at a regional hospital in the Federal District
Revista Brasileira de Enfermagem. 2016;69(1):118-125
DOI 10.1590/0034-7167.2016690116i
Views0See moreABSTRACT
Objective:
to characterize hospitalizations for sensitive conditions to primary care of a regional hospital in the Federal District.
Method:
this is a descriptive study, such as case series that considered users admitted between 2008 and 2012 in the Regional Hospital of Ceilândia. The selection of hospitalizations was based on the Brazilian List, and the data were obtained from the Hospital information System. The descriptive statistics was used in the data processing and analysis.
Results:
ACSC (Ambulatory Care Sensitive Conditions) showed a growth tendency, mainly due to cerebrovascular diseases, lung diseases and infections in the kidney and urinary tract. Female and elderly patients showed a higher frequency of hospitalizations.
Conclusion:
the results may help managers and health professionals to implement actions that aim higher solvability of primary care, and contribute to the systematization of nursing care and improved health care.
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01-01-2016
Significations of being the caregiver of the companion with cancer: an existential look
Revista Brasileira de Enfermagem. 2016;69(1):110-117
Abstract
Significations of being the caregiver of the companion with cancer: an existential look
Revista Brasileira de Enfermagem. 2016;69(1):110-117
DOI 10.1590/0034-7167.2016690115i
Views0See moreABSTRACT
Objective:
to unveil the significances of women who experience being the caregiver of their companion with cancer.
Method:
a Heidegger’s phenomenological research, performed with ten women who are caregivers of their companions with cancer in a town in the northwest of the state of Paraná, Brazil, from December 2013 to February 2014. The following guiding question was used: “How has it been for you to care for your companion with cancer?”.
Results:
from the analysis of the speeches the following ontological themes emerged: “Taking responsibility of caring for the companion with cancer”, “Learning to live with the intimacy changes” and “Learning to live with the feelings related to care”. The data revealed the wives’ sense of responsibilities for caring and the influence of feelings in the act of caring, including the impact on the couple’s intimacy.
Conclusion:
in the midst of difficulties, the feelings of affection are the driving force behind these women to continue their actions as wife-caregivers.
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01-01-2016
Defining characteristics of the nursing diagnosis “ineffective airway clearance”
Revista Brasileira de Enfermagem. 2016;69(1):102-109
Abstract
Defining characteristics of the nursing diagnosis “ineffective airway clearance”
Revista Brasileira de Enfermagem. 2016;69(1):102-109
DOI 10.1590/0034-7167.2016690114i
Views1See moreABSTRACT
Objective:
to analyze the defining characteristics of the nursing diagnosis “ineffective airway clearance” in children with acute respiratory infection.
Method:
cross-sectional descriptive study, developed in two hospitals specialized in care for children. It was held a detailed respiratory evaluation of the child to identify the defining characteristics of the diagnosis under study.
Results:
a total of 249 children were evaluated, 55.8% were male and the median age was 13.76 months. Ineffective airway clearance was identified in 222 children (89.2%). The following defining characteristics presented statistically significant associations: dyspnea, expectoration, orthopnea, respiratory adventitious sounds, decreased breath sounds and ineffective cough. Decreased breath sounds, ineffective cough and respiratory adventitious sounds composed the logistic regression model.
Conclusion:
the characteristics decreased breath sounds, ineffective cough and respiratory adventitious sounds have better predictive capacity for the diagnosis “ineffective airway clearance” in children with acute respiratory infection.
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ORIGINAL ARTICLE02-26-2024
Technological prospecting of patents related to monitoring accidents due to falls in hospitals
Revista Brasileira de Enfermagem. 2024;77(1):e20230084
Abstract
ORIGINAL ARTICLETechnological prospecting of patents related to monitoring accidents due to falls in hospitals
Revista Brasileira de Enfermagem. 2024;77(1):e20230084
DOI 10.1590/0034-7167-2023-0084
Views0See moreABSTRACT
Objectives:
to map the production of technologies aimed at monitoring falls in a hospital environment protected by registered patents.
Methods:
a technological prospecting of international patents, with a quantitative approach, with search carried out between February and March 2022 in the Derwent Innovations Index database with descriptors fall, hospital, monitoring.
Results:
212 patents were found, with the majority filed and published since 2010, by Tran B (9) and Cerner Innovation Inc (9), focused on health technology. Universities were responsible for 13% of deposits. There was a predominance of records from the United States (43.4%), China (21.7%) and Japan (12.3%), in addition to technological strategies classified as devices for the environment (80.7%) and for preventing falls (66.5%) as well as trend towards resources with multiple functionalities in the same technology.
Conclusions:
the plurality of functions in the same device reflects the search for optimizing resources and the concern with comprehensive care.
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ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20230045
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20230045
DOI 10.1590/0034-7167.20247701e04
Views0In the article “Coping strategies for chronically ill children and adolescents facing the COVID-19 pandemic”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(Suppl 2):e20230045, in the author:Where it read:[…]See more -
ERRATUM02-26-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20160061
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e20160061
DOI 10.1590/0034-7167.20247701e03
Views0In the article “Nurses in the labor market: professional insertion, competencies and skills”, with DOI number: , published in Revista Brasileira de Enfermagem, 2017;70(6):1220-6, on page 1225:Include before REFERENCES:[…]See more -
ORIGINAL ARTICLE01-24-2019
Active teaching model to promote critical thinking
- Fábio da Costa Carbogim
, - Larissa Bertacchini de Oliveira ,
- Melina Mafra Toledo ,
- Flávia Batista Barbosa de Sá Diaz ,
- Greicy Kelly Gouveia Dias Bittencourt , [ … ],
- Vilanice Alves de Araújo Püschel
Abstract
ORIGINAL ARTICLEActive teaching model to promote critical thinking
Revista Brasileira de Enfermagem. 2019;72(1):293-298
DOI 10.1590/0034-7167-2018-0002
- Fábio da Costa Carbogim ,
- Larissa Bertacchini de Oliveira ,
- Melina Mafra Toledo ,
- Flávia Batista Barbosa de Sá Diaz ,
- Greicy Kelly Gouveia Dias Bittencourt ,
- Vilanice Alves de Araújo Püschel
Views0See moreABSTRACT
Objective:
To present the experience of elaboration and implementation of the Active Teaching Model to Promote Critical Thinking (MEAPC), associated to Problem-Based Learning (PBL), for undergraduate students in Nursing.
Method:
Case report on the experience of the educational intervention (MEAPC + PBL) with undergraduate students in Nursing, in a 20-hour course on Basic Life Support (BLS). The MEAPC was validated by judges to guide the analysis of clinical cases. Critical Thinking (CT) skills were assessed using the California Critical Thinking Skills Test.
Result:
The educational intervention took place in two phases: elaboration and implementation, allowing not only the production of knowledge about BLS, but also the development of CT and exchange of experiences for teaching-learning.
Conclusion:
The association of the MEAPC to the PBL in the course of BLS organized the learning, gave opportunity to acquire knowledge and to stimulate the skills of the CT.
- Fábio da Costa Carbogim
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RESEARCH01-24-2017
Nurses in the labor market: professional insertion, competencies and skills
Revista Brasileira de Enfermagem. 2017;70(6):1220-1226
Abstract
RESEARCHNurses in the labor market: professional insertion, competencies and skills
Revista Brasileira de Enfermagem. 2017;70(6):1220-1226
DOI 10.1590/0034-7167-2016-0061
Views0See moreABSTRACT
Objective:
to characterize nurses graduated from the School of Nursing of the University of São Paulo, from 2006 to 2012; verify their entry, facilitating factors and difficulties of these graduates in the labor market and to consider their skills and competences in the world of work.
Method:
an exploratory, descriptive study with a qualitative approach.
Results:
out of 505 graduates, 172 (34.1%) participated in the research. Entry into the labor market was mainly via public hospital institutions, in the SE of Brazil, in the caregiving sectors. The greater part remained from one to two years in their first job. Most agreed that they were prepared to meet the health needs of the population. Furthermore, they had been encouraged to seek systematic and continuous improvement in a critical, reflexive and creative way, while combining technical-scientific knowledge and personal skills.
Conclusion:
the results show that the University of São Paulo has been preparing nurses for work in the labor market, in accordance with the provisions of the National Curricular Guidelines.
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01-15-2024
ERRATA
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
Abstract
ERRATA
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
DOI 10.1590/0034-7167.20247701e01
Views0En el artículo “La ética del cuidado de enfermería para personas transgénero”, con número DOI: , publicado en la Revista Brasileira de Enfermagem, 2023;76( Suppl 3):e20220797, en autoría:Onde se lia:[…]See more -
ERRATUM01-15-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(1):e2024n1e01
DOI 10.1590/0034-7167.20247701e01
Views1In the article “The ethics of nursing care for transgender people”, with DOI number: , published in Revista Brasileira de Enfermagem, 2023;76(Suppl 3):e20220797, in authorship:Where it read:[…]See more -
12-08-2024
Contexto ibero-americano da enfermagem: construindo e compartilhando conhecimento
Revista Brasileira de Enfermagem. 2024;77(1):e770101
Abstract
Contexto ibero-americano da enfermagem: construindo e compartilhando conhecimento
Revista Brasileira de Enfermagem. 2024;77(1):e770101
DOI 10.1590/0034-7167.2024770101pt
Views0Na próxima semana, acontecerão dois grandes eventos científicos em Madri e Granada (Espanha). Serão atividades internacionais, específicas e de forma muito especial, embora não exclusivas do campo ibero-americano, organizadas e desenvolvidas por duas sociedades científicas de enfermagem muito importantes, como a Associação de Enfermagem Comunitária (AEC) e a Associação Latino-Americana de Escolas e Faculdades de […]See more
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01-01-2016
Prevalence and factors associated with traffic accidents involving motorcycle taxis
Revista Brasileira de Enfermagem. 2016;69(2):382-388
Abstract
Prevalence and factors associated with traffic accidents involving motorcycle taxis
Revista Brasileira de Enfermagem. 2016;69(2):382-388
DOI 10.1590/0034-7167.2016690223i
Views0See moreABSTRACT
Objective:
to determine the prevalence of motorcycle accidents involving motorcycle taxi drivers and associated factors.
Method:
this is a cross-sectional and exploratory study, with application of questionnaires to motorcycle taxi drivers of 32 regions of Caicó, Rio Grande do Norte, Brazil (N=420).
Results:
motorcycle taxi drivers have a high level of daily working hours (12 hours on average), and it was found that 63.6% were involved in at least one motorcycling accident. The occurence of motorcycling accidents was significantly associated only to level of education (p<0.001), with no significant association with the other variables, such as age (p=0.132), time of service (p=0.744) and working hours (p=0.830).
Conclusion:
it is necessary to implement preventive and educational actions with motorcycle taxi drivers and users of this service concerning accidents and emergency measures, due to constant exposure to accidents during work routine.
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01-01-2016
Characterization of undergraduate nursing courses according to the National Student Performance Exam
Revista Brasileira de Enfermagem. 2016;69(2):375-381
Abstract
Characterization of undergraduate nursing courses according to the National Student Performance Exam
Revista Brasileira de Enfermagem. 2016;69(2):375-381
DOI 10.1590/0034-7167.2016690222i
Views0See moreABSTRACT
Objective:
to characterize undergraduate nursing courses according to Enade (National Student Performance Exam) in 2010 and 2013.
Method:
a quantitative documental study was performed and descriptive statistics was used for data organization and analysis.
Results:
Enade report analysis enabled the identification of a reduction in the total number of institutions providing undergraduate nursing courses that passed the evaluation process. The Southeastern, Northeastern and Southern regions of Brazil included the highest numbers of courses assessed and showed the best results in the two evaluation cycles. Additionally, the courses characterized as “without a ranking” were mainly held at private institutions.
Conclusion:
the results of these evaluation cycles are important to support investigative and intervention processes about and with undergraduate nursing courses.
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01-01-2016
Teaching airway management with laryngeal mask: randomized controlled trial
Revista Brasileira de Enfermagem. 2016;69(2):368-374
Abstract
Teaching airway management with laryngeal mask: randomized controlled trial
Revista Brasileira de Enfermagem. 2016;69(2):368-374
DOI 10.1590/0034-7167.2016690221i
Views0See moreABSTRACT
Objective:
to teach airway management with laryngeal mask to nursing students through dialogic lectures along with laboratory activities or exclusively through simulation class.
Method:
randomized controlled trial. Population: eighth semester bachelor’s degree students. Sample: 17 students randomized in the intervention group (IG: simulation class) or control group (CG: dialogic lecture along with laboratory activities). Elaborated and validated instruments: written test, simulation scenario, objective structured clinical examination (checklist). Data collected from workshop. Structured clinical examination in simulation scenario filmed and evaluated by 3 experts, and written tests were applied.
Results:
24.4±4.2 years old. Right answers percentage: CG: pre-test 66±10%; post-test 84±8%. IG: pre-test 65±5%; post-test 86±11%. Scenario: CG 78±5.2%; IG 84±8.9%.
Conclusion:
strategies allowed the development of knowledge, skills and decision-making, which are essential to achieve the scenario objectives. Knowledge was incorporated in airway management with laryngeal mask, shown by the increase in the scenario and written tests scores.
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01-01-2016
Influence of the São Paulo State innovative models on Brazil’s mental health policy
Revista Brasileira de Enfermagem. 2016;69(2):360-367
Abstract
Influence of the São Paulo State innovative models on Brazil’s mental health policy
Revista Brasileira de Enfermagem. 2016;69(2):360-367
DOI 10.1590/0034-7167.2016690220i
Views0See moreABSTRACT
Objective:
to analyze the influence of two São Paulo State experiences in the choice of psychosocial care centers as guiding service providers for the national mental health policy.
Method:
qualitative, exploratory, and descriptive study using oral history as a methodology and theoretical reference.
Results:
eight professionals involved in the deployment of the mental health policy in the cities of Santos and São Paulo between the years 1989 and 1992 were interviewed. Data were analyzed after treating the narratives and grouping the most significant content. Two central themes emerged: development of the local-regional model, and the model’s influence on the choice of the psychosocial care center.
Conclusion:
due to greater insertion of the Santos experience group in the spheres of the federal government, its influence on the choice of the substitute model was higher in ideological terms, whereas the São Paulo model had its influence restricted for political reasons.
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01-01-2016
Stress and cardiovascular risk: multi-professional intervention in health education
Revista Brasileira de Enfermagem. 2016;69(2):351-359
Abstract
Stress and cardiovascular risk: multi-professional intervention in health education
Revista Brasileira de Enfermagem. 2016;69(2):351-359
DOI 10.1590/0034-7167.2016690219i
Views0See moreABSTRACT
Objective:
to identify cardiovascular risk in educators (administrators and teachers) from the South region of Brazil, evaluated before and after intervention with stress management activities and health education.
Method:
longitudinal study of the before and after type. The sample consisted of 49 participants. Variables studied were socio-demographic, morbidity antecedents and lifestyle habits. Measured risk factors for cardiovascular disease were arterial blood pressure, body mass index, ratio of waist to hip size, lipid profile and capillary blood glucose. Stress levels were evaluated using the Lipp Stress Symptoms Inventory (LSSI). The study ran for four months, with weekly meetings of a multidisciplinary team.
Results:
after intervention, the study observed a statistically significant reduction of the investigated variables, except for blood glucose levels in the administrators group.
Conclusion:
stress management activities are potential tools in the identification and control of the risk factors studied, particularly in those involving multi- and trans-disciplinary focus.
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01-01-2016
Social representations of nursing students about hospital assistance and primary health care
Revista Brasileira de Enfermagem. 2016;69(2):343-350
Abstract
Social representations of nursing students about hospital assistance and primary health care
Revista Brasileira de Enfermagem. 2016;69(2):343-350
DOI 10.1590/0034-7167.2016690218i
Views0See moreABSTRACT
Objective:
To analyze how social representations of hospital and community care are structured in two groups of nursing students – 1st and 4th years.
Method:
Qualitative research oriented by the Theory of Social Representations. We used a questionnaire with Free Association of Words. Data were analyzed in the Software IRaMuTeQ 0.6 alpha 3.
Results:
We applied the method of Descending Hierarchical Classification and obtained four classes. Class 4 has the largest social representation (30.41%) within the corpus. The two organizational axes are nurse and disease/patient in the central core. On the periphery are the care and help related to the nurse and the treatment and prevention associated with the disease.
Conclusion:
Social representations focus on disease/patient and on the role of nurses in the treatment, prevention, and care. Health promotion and the social determinants of health are absent from the social representations of students.
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01-01-2016
Prevalence of medication therapy adherence in the elderly and related factors
Revista Brasileira de Enfermagem. 2016;69(2):335-342
Abstract
Prevalence of medication therapy adherence in the elderly and related factors
Revista Brasileira de Enfermagem. 2016;69(2):335-342
DOI 10.1590/0034-7167.2016690217i
Views0See moreABSTRACT
Objective:
to determine the prevalence of adherence to medication therapy in elderly outpatients; to verify whether there is an association between medication therapy adherence and demographic and socioeconomic factors, health conditions.
Method:
a quantitative, exploratory, descriptive, cross-sectional study, performed in outpatient clinics of a university hospital in Rio Grande do Sul, Brazil. Three data collection instruments were answered by a convenience sample of 107 elders. A descriptive and inferential statistical analysis was conducted.
Results:
the prevalence of adherence was 86.9%. A statistically significant association was identified between the adherence variable and receiving medical guidelines on how to take medications, and having adverse reactions. Conclusion: Nurses must know the prevalence of medication adherence and related factors in order to plan interventions that promote therapeutic success.
Conclusion:
Nurses must know the prevalence of medication adherence and related factors in order to plan interventions that promote therapeutic success.
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01-01-2016
Family farming and human and environmental health conservation
Revista Brasileira de Enfermagem. 2016;69(2):326-334
Abstract
Family farming and human and environmental health conservation
Revista Brasileira de Enfermagem. 2016;69(2):326-334
DOI 10.1590/0034-7167.2016690216i
Views0See moreABSTRACT
Objective:
understand how farmers identify positive and negative impacts of family farming work on the environment and conserve the environmental health.
Method:
a qualitative study with 129 farmers from Ilha dos Marinheiros, Rio Grande, Brazil. Secondary data and recorded interviews were used in this study, with subsequent analysis performed by Bardin and NVivo10, both based on Enrique Leff’s cultural rationality.
Results:
the positive impacts included food production with responsibility, work appreciation, and the correct, minimum or inexistent insertion of agrochemicals. The negative aspects included excessive and incorrect use of agrochemicals and absent farming knowledge.
Conclusion:
environmental conservation consisted in reducing impacts that could have a negative effect on health, while performing work activities.
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