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01-01-2016
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(1):206-206
Abstract
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(1):206-206
DOI 10.1590/0034-7167.20166901e02
Views0In the article “Conceptions of mid-level nursing professionals facing those with a chemical dependency”, with the number of DOI: 10.1590/0034-7167.2015680610i, published in the journal Revista Brasileira de Enfermagem, v68(6):755-60, page 760 that read: “8. Vargas D, Soares J. Knowledge and attitudes of nurses towards alcohol and related problems: the impact of an educational intervention. Rev […]See more -
01-01-2016
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(1):205-205
Abstract
ERRATUM
Revista Brasileira de Enfermagem. 2016;69(1):205-205
DOI 10.1590/0034-7167.20166901e01
Views0In the article “Using the theory of meaningful learning in nursing education”, with the number of DOI: 10.1590/0034-7167.2015680420i, published in the journal Revista Brasileira de Enfermagem, v68(4):626-35, page 627 that read:“Ausubel was descended from Jewish, born in New York in 1918 and died in 1994 at the age of 75. He thought and wrote until […]See more -
01-01-2016
Nursing process documentation: rationale and methods of analytical study
Revista Brasileira de Enfermagem. 2016;69(1):197-204
Abstract
Nursing process documentation: rationale and methods of analytical study
Revista Brasileira de Enfermagem. 2016;69(1):197-204
DOI 10.1590/0034-7167.2016690126i
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Objective:
to describe the methods used to analyze the associations between variables of service, nursing and the nursing process documentation in institutions of the Department of Health of the State of São Paulo.
Method:
multilevel analytical study with data obtained in the domains of institution, units of the institution and nursing professionals who work there, using standardized instruments. The analyses had as axis the degree of completeness of the nursing process documentation in units or institutions and their association with variables of nursing personnel, of units and of institutions.
Conclusion:
This study will provide important empirical evidence on the factors involved in the nursing process documentation.
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01-01-2016
Qualitative methodologies in health research: interpretive referential of Patricia Benner
Revista Brasileira de Enfermagem. 2016;69(1):192-196
Abstract
Qualitative methodologies in health research: interpretive referential of Patricia Benner
Revista Brasileira de Enfermagem. 2016;69(1):192-196
DOI 10.1590/0034-7167.2016690125i
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Objective:
this article reports on the experience of using the interpretive phenomenological framework of Patricia Benner in a Brazilian context. Benner’s interpretive phenomenology, based on existential and interpretative philosophy, aims to understand human experiences in the particular worlds of research participants. Data were collected through interviews with nine nurses in November and December 2014.
Results:
data analysis process according to Benner’s framework consisted of: transcription, coding, thematic analysis, and search for paradigmatic cases and examples. Therefore, the prior knowledge of the researcher is an important part of the study, consisting in manners of the research conduction.
Conclusion:
The use of this methodological framework entailed a great challenge for the researcher, however, it also enabled a unique opportunity to illuminate important existential phenomena related to the daily lives of research participants.
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01-01-2016
Nurses’ performance on primary care in the National Health Service in England
Revista Brasileira de Enfermagem. 2016;69(1):182-191
Abstract
Nurses’ performance on primary care in the National Health Service in England
Revista Brasileira de Enfermagem. 2016;69(1):182-191
DOI 10.1590/0034-7167.2016690124i
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Objective:
To analyze the expansion of nursing roles in primary care in the English National Health Service and the implications for professional practice.
Method:
qualitative research in case study format, held in London, England, in six primary care units. Data were obtained through interviews with nine nurses. After the thematic data analysis, two units emerged: the nurses’ performance characteristics and effects of the expansion of nursing roles.
Results:
expansion of nurses’ roles: consultation, diagnosis and drug therapy, case management and monitoring of chronic conditions. Repercussions: for the user, there was improved access, communication and comprehensive care, increased duration of consultations, resulting in greater adherence; for nurses, there was the expansion of professional skills, knowledge and professional recognition; to the health care system, it resulted in cost savings.
Conclusion:
benefits in expanding nursing roles, were visible, contributing to primary care quality.
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01-01-2016
Meleis’ Nursing Theories Evaluation: integrative review
Revista Brasileira de Enfermagem. 2016;69(1):174-181
Abstract
Meleis’ Nursing Theories Evaluation: integrative review
Revista Brasileira de Enfermagem. 2016;69(1):174-181
DOI 10.1590/0034-7167.2016690123i
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Objective:
to analyze the application of the theory evaluation model proposed by Meleis in Brazilian studies.
Method:
integrative review of online articles published from 2002 to 2012 in the databases LILACS and BDENF.
Results:
the 16 selected studies confirmed the use of only three of the five stages proposed for Meleis’ theories analysis: Description of the Theory, Criticism of the Theory and Analysis of the Theory, with a predominance of a single unit of analysis in each.
Conclusion:
the analysis of nursing theories provides support to nurses in the practice, research, education and administration of the different dimensions of care. Meleis’ model figures as very important by contributing to the development of knowledge of nursing discipline, considering that its use as a method allows several reflections on theories in order that they be revalidated to support a more theoretical and practical applicability.
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01-01-2016
Clinical indicators of sexual dysfunction in pregnant women: integrative literature review
Revista Brasileira de Enfermagem. 2016;69(1):165-173
Abstract
Clinical indicators of sexual dysfunction in pregnant women: integrative literature review
Revista Brasileira de Enfermagem. 2016;69(1):165-173
DOI 10.1590/0034-7167.2016690122i
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Objective:
to identify the nursing diagnosis clinical indicators of sexual dysfunction in pregnant women.
Method:
it is an integrative literature review, with research in databases using the keywords “sexual*”, “pregnan*” and “function*”. Studies included had an abstract available for analysis, referring to pregnant women over 18 years old, written in Portuguese, French, Spanish and English, with publication date between 2010 and 2014. Studies that reporting pregnant women with an associated pathology were excluded.
Results:
sexual dysfunction in pregnant women is consistent in the literature. Nine defining characteristics were identified and 16 related factors, some not classified in NANDA International.
Conclusion:
clinical indicators can be added to the nursing diagnosis to favor an accurate diagnosis and effective interventions in the surveillance of pregnancy as a period of healthy sexual experience.
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01-01-2016
Conditions of functional health literacy of an elderly diabetics group
Revista Brasileira de Enfermagem. 2016;69(1):156-164
Abstract
Conditions of functional health literacy of an elderly diabetics group
Revista Brasileira de Enfermagem. 2016;69(1):156-164
DOI 10.1590/0034-7167.2016690121i
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Objective:
to evaluate the conditions of functional health literacy of an elderly diabetics group.
Method:
cross-sectional and descriptive study, with diabetic’s elderly assisted in the SUS (N = 114). The social and health conditions were evaluated as well as functional health literacy by S-TOFHLA test (short version); the simple proportions, average, standard deviation and Pearson’s Chi-square were described by SPSS software (20.0) with α = 5% value.
Results:
the mean age was 67.4 years, 74.0% of the elderly were women, had up to four years of schooling; 29.8% had a long-standing illness, 64.0% reported having high blood pressure, 47.4% smoke or were smokers, 73.7% had low functional health literacy, which was associated with schooling p = 0.001.
Conclusions:
the low functional health literacy could be a self-care conditioning and can be influenced by low schooling because it implies to have skills to understand and make decisions aimed at self-management of health.
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01-01-2015
Women’s temporality after cardiac surgery: contributions to nursing care
Revista Brasileira de Enfermagem. 2015;68(6):1056-1062
Abstract
Women’s temporality after cardiac surgery: contributions to nursing care
Revista Brasileira de Enfermagem. 2015;68(6):1056-1062
DOI 10.1590/0034-7167.2015680609i
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Objective:
to unveil women’s existential movement after cardiac surgery.
Method:
qualitative phenomenological study. The research setting was a hospital in Minas Gerais, in which ten women were interviewed between December 2011 and January 2012.
Results:
after hospital discharge, the women experienced physical, social and emotional impairments, and expressed the desire to go back to the time before their diagnosis, because they felt as though they still had heart disease. This vague and average understanding led to three units of meaning that, from a Heideggerian hermeneutic point of view, revealed the phenomenon of cardiac surgery as a present circumstance that limited the participants’ daily lives.
Conclusion:
nurses supporting women patients after cardiac surgery should promote health considering existential facets that are expressed during care. The bases for comprehensive care are revealed in singular and whole meetings of subjectivity.
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01-01-2015
Compliance of hand hygiene in maintaining the catheter for hemodialysis
Revista Brasileira de Enfermagem. 2015;68(6):1050-1055
Abstract
Compliance of hand hygiene in maintaining the catheter for hemodialysis
Revista Brasileira de Enfermagem. 2015;68(6):1050-1055
DOI 10.1590/0034-7167.2015680608i
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Objective:
to assess the compliance of the practice of hand hygiene in maintaining the temporary double-lumen catheter for hemodialysis, through the use of process indicator at the University Hospital of the University of São Paulo.
Method:
a quantitative, exploratory, descriptive, observational study. Sample consists of 155 observations of patients with catheter from March to November 2011, using the Maintenance Indicator Temporary Dual Lumen Catheter for Hemodialysis.
Results:
the overall compliance rate was 65.8%. Of the 13 specific components evaluated, 9 (69.2%) had 100% compliance. Hand hygiene by health professionals presented one of the worst rates (83.9%).
Conclusion:
it is necessary to implement strategies to reduce the rates of non-compliance, improve quality of care and safety of patients with catheter, and explore factors that affect the process, such as structural issues, and behavioral materials.
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01-01-2015
Replication of the training program in nonverbal communication in gerontology
Revista Brasileira de Enfermagem. 2015;68(6):1042-1049
Abstract
Replication of the training program in nonverbal communication in gerontology
Revista Brasileira de Enfermagem. 2015;68(6):1042-1049
DOI 10.1590/0034-7167.2015680607i
Views0See moreABSTRACT
Objective:
to measure the rate of assimilation of applied content at immediate and subsequent moments after a nonverbal communication in gerontology training program.
Method:
descriptive and exploratory fi eld study developed in three state administered hospitals, which attend Brazilian National Health Service (SUS) clients. The duration of the training was twelve hours, applied with 102 healthcare professionals.
Results:
the results revealed that the rate of assimilation of the content immediately after the program was satisfactory, as well as being satisfactory in the aspects concept of aging; strategies to foster the independence and autonomy of the elderly person; communication interferences linked to the elderly and the professional; recognition of non-verbal functions and dimensions. The exception was the professional perception faced with aspects that influence the success of communication.
Conclusion:
it was concluded that the replication of this program was relevant and current for the hospital context, remaining effi cient for healthcare professionals.
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01-01-2015
Physical and psychological violence against the elderly: prevalence and associated factors
Revista Brasileira de Enfermagem. 2015;68(6):1035-1041
Abstract
Physical and psychological violence against the elderly: prevalence and associated factors
Revista Brasileira de Enfermagem. 2015;68(6):1035-1041
DOI 10.1590/0034-7167.2015680606i
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Objective:
to verify the prevalence and associated factors to physical and psychological violence against elderlies and trace the sociodemographic and clinical indicators of this population.
Method:
household survey conducted in 729 elderlies Uberaba – MG. Data were analyzed by Chi-square test and logistic regression (p < 0,05).
Results:
the prevalence of elderly on violence was 20.9%, and 5.9% to 20.9% for physical and psychological. Among them prevailed women; with 60├80 years; no education; with income, with their partner as the primary aggressor; negative self-perception of health, hospitalization in the last year and presence of multimorbidities. The violence has been associated with have 60├80 years, living with your partner and dependence for instrumental activities of daily living.
Conclusion:
reinforces the need for early identification of domestic violence and invest in both the old protective actions and in maintaining functional capacity and social inclusion.
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01-01-2015
First civil service examination for nurses at the Administrative Department of Public Service
Revista Brasileira de Enfermagem. 2015;68(6):1027-1034
Abstract
First civil service examination for nurses at the Administrative Department of Public Service
Revista Brasileira de Enfermagem. 2015;68(6):1027-1034
DOI 10.1590/0034-7167.2015680605i
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Objective:
to describe the results of the first national public service examination for nurses conducted by the Administrative Department of Public Service between 1941 and 1942.
Method:
historical-documentary research with a quantitative approach.
Results:
155 candidates registered, aged between 21 and 35 years old, 141 (91%) of whom were female. A total of 120 candidates passed the practical exam. Of these, 116 took the written qualification exam. In the end, 107 were approved, 74 (69.1%) of whom were temporary public nurses, 59 (55.1%) Anna Nery Nursing School alumni, and 10 among the first 20 twenty became involved with the Brazilian Association of Nursing later.
Conclusion:
although the exam legitimized the meritbased culture in the staff selection in the area of Brazilian nursing, egalitarian criteria were mitigated, especially regarding the grades applied to different kinds of exams. This resulted in a significant number of temporary nurses approved.
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01-01-2015
Children and adolescents with chronic kidney disease in haemodialysis: perception of professionals
Revista Brasileira de Enfermagem. 2015;68(6):1020-1026
Abstract
Children and adolescents with chronic kidney disease in haemodialysis: perception of professionals
Revista Brasileira de Enfermagem. 2015;68(6):1020-1026
DOI 10.1590/0034-7167.2015680604i
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Objective:
to identify aspects impacting on quality of life for children and adolescents with chronic kidney disease on hemodialysis, from the perspective of health professionals, as an essential step for the construction of a specific module of the DISABKIDS® instrument.
Method:
methodological study. Data was collected between May and June 2012, through personal interviews with 12 participants, in two dialysis centers. The empirical material was analyzed according to the thematic content analysis, using the program MAXQDA – Qualitative Data Analysis Software.
Results:
we identifi ed seven themes: self-care, family support, impact of diagnosis, expectation of kidney transplant, truancy, socialization and stigma, grouped into three domains.
Conclusion:
the results showed aspects that impact the quality of life of these customers and, therefore, will be considered in the development of specifi c DISABKIDS® module. In addition, these aspects are relevant to the preparation and planning of actions directed towards children and adolescents with chronic kidney disease.
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01-01-2015
From frustration to coping with caring for death by nurse technicians
Revista Brasileira de Enfermagem. 2015;68(6):1013-1019
Abstract
From frustration to coping with caring for death by nurse technicians
Revista Brasileira de Enfermagem. 2015;68(6):1013-1019
DOI 10.1590/0034-7167.2015680603i
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Objective:
to understand nurse technicians’ experience with caring for the death of terminal patients in ICUs and to configure a theoretical model.
Method:
qualitative study with theoretical saturation when analyzing the 10th non-directive interview, having as reference Grounded Theory, Symbolic Interactionism and Bioethics.
Results:
the core category – from frustration to coping with dignified nursing care for finitude: the acceptance of death as a therapeutic and intervenient component – emerged from the comparison of the sub-processes: when the nurse does not feel prepared for caring for death, accepting death as a therapeutic phenomenon and developing coping strategies.
Conclusion:
according to Symbolic Interactionism, a novice professional’s frustration in caring for an individual for death is related to his/her interaction and interpretation of the situation as he/she feels prepared only to care for individuals for life.
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01-01-2015
Sedentary lifestyle in individuals with hypertension
Revista Brasileira de Enfermagem. 2015;68(6):1005-1012
Abstract
Sedentary lifestyle in individuals with hypertension
Revista Brasileira de Enfermagem. 2015;68(6):1005-1012
DOI 10.1590/0034-7167.2015680602i
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Objective:
to identify the prevalence of nursing diagnosis Sedentary lifestyle (SL) and to analyze its association with clinical indicators (CI) and related factors (RF) in patients with hypertension.
Method:
cross-sectional study with 285 patients with hypertension at a reference center for outpatient care in Northeastern Brazil. To collect data it was used an instrument based on operational defi nitions of the CI and RF previously validated. Four nurses rated SL as present or absent. To evaluate the association between CI and RF with the presence of SL it was applied the chi-square test. The prevalence ratio and confi dence interval was calculated to verify the magnitude of the effect between RF and SL. Results: SL was identifi ed in 55.8% of the sample. Five IC and six RF showed a signifi cant association with SL.
Conclusion:
the study identifi es main indicators for inference of SL as well as their possible causal factors among people with hypertension.
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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
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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
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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
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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
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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
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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
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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
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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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