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RESEARCH01-01-2018
Ineffective health management in hemodialysis patients: content analysis
Revista Brasileira de Enfermagem. 2018;71(4):1825-1831
Abstract
RESEARCHIneffective health management in hemodialysis patients: content analysis
Revista Brasileira de Enfermagem. 2018;71(4):1825-1831
DOI 10.1590/0034-7167-2016-0682
Views1See moreABSTRACT
Objective:
To analyze the content of the nursing diagnosis Ineffective Health Management in hemodialysis patients.
Method:
The Nursing Diagnoses Validation Model by Lopes, Silva and Auraújo was used in this research. A semi-structured questionnaire and evaluated the definition, location, defining characteristics, and related factors of the diagnosis Ineffective Health Management was answered by 22 experts in nursing diagnosis. The analysis was conducted from August 2014 to January 2015.
Results:
Experts considered the proposed definition and the current location in the taxonomy II by the NANDA-I, Domain 1 Health Promotion, Class 2 Health Control, adequate to the diagnosis. The adequacy level adopted at 85% or p > 0.05 were above 10 defining characteristics and 24 related factors. Experts also suggested that one defining characteristic should become a related factor and that three factors should turn into defining characteristics.
Conclusion:
A new proposal was developed for the diagnosis under study after the analysis of experts.
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RESEARCH01-01-2018
Myocardial revascularization: factors intervening in the reference and counter-reference in the hospital setting
Revista Brasileira de Enfermagem. 2018;71(4):1817-1824
Abstract
RESEARCHMyocardial revascularization: factors intervening in the reference and counter-reference in the hospital setting
Revista Brasileira de Enfermagem. 2018;71(4):1817-1824
DOI 10.1590/0034-7167-2017-0218
Views0ABSTRACT
Objective:
To understand the intervening factors in the process of reference and counter-reference of the individual with heart disease in the scenario of high complexity in the health care network.
Method:
Research anchored in the Grounded Theory (Teoria Fundamentada nos Dados). It totaled 21 participants. The data collection scenario was a cardiovascular reference hospital in the south of Brazil and occurred between March and June 2014.
Results:
The intervening factors in the reference process were the difficulty to access the points of the network and telemedicine and the central to manage the flow of patients in the network. In the counter-reference, there was a link with the hospital and the lack of communication among network professionals.
Conclusion:
It reveals the need to reorganize the service flow in HCN, enhancing PHC, expanding the performance of medium complexity and increasing the capacity of high complexity in order to carry out the process of reference and counter-reference.
Keywords:Access to Health ServicesHealth ManagementIntegrality in HealthMyocardial RevascularizationNursingSee more -
EDITORIAL01-01-2018
Importância da prática clínica sustentada por instrumentos de avaliação em saúde
Revista Brasileira de Enfermagem. 2018;71(4):1815-1816
Abstract
EDITORIALImportância da prática clínica sustentada por instrumentos de avaliação em saúde
Revista Brasileira de Enfermagem. 2018;71(4):1815-1816
DOI 10.1590/0034-7167-2018710401
Views0Instrumentos de avaliação na prática clínica são recursos com capacidade de identificar, de maneira objetiva, importantes alterações físico-psíquico e espirituais, de aferir fenômenos subjetivos, de acompanhar de forma regular a progressão, retrocesso ou estagnação de um estado de saúde-doença além de criar um mecanismo de direção ao examinador e à equipe assistencial.Esses instrumentos ainda são […]See more -
EDITORIAL01-01-2018
The importance of clinical practice supported by health assessment tools
Revista Brasileira de Enfermagem. 2018;71(4):1815-1816
Abstract
EDITORIALThe importance of clinical practice supported by health assessment tools
Revista Brasileira de Enfermagem. 2018;71(4):1815-1816
DOI 10.1590/0034-7167-2018710401
Views0The tools of assessment in clinical practice are tools capable of objectively identifying important physical and psychic and spiritual changes, examining subjective phenomena and regularly monitoring the progression, regression or stagnation of a health-disease state. Moreover, of creating a steering mechanism for the examiner and the care team. These tools are still capable of standardizing […]See more -
EXPERIENCE REPORT01-01-2018
Constructing a logical model in school health: experience on the Lower Amazon region
Revista Brasileira de Enfermagem. 2018;71(3):1198-1202
Abstract
EXPERIENCE REPORTConstructing a logical model in school health: experience on the Lower Amazon region
Revista Brasileira de Enfermagem. 2018;71(3):1198-1202
DOI 10.1590/0034-7167-2016-0389
Views0See moreABSTRACT
Objective:
This experience report presents the construction of the theoretical and logic model for intervention to promote physical activity and healthy eating habits of the public schools students in the city of Parintins, Amazonas, Brazil.
Method:
We carried out a theoretical research and also a documentary research on the School Health Program (PSE – Programa Saúde na Escola) on the national and local level, in addition to meetings with the PSE management committee for strategic planning of the actions.
Result:
The municipality had no systematic structure of health practices at school. A theoretical and logical model that involved prerogatives of practice from the management of the municipality in PSE was developed. Actions to promote physical activity and healthy nutrition of primary and secondary school students were planned and promoted in schools of the PSE.
Final considerations:
Thus, the collective construction of this proposal contributed to the research of multi-sectoral practices related to the PSE principles and strategies, considering the particularities of the Lower Amazon context.
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EXPERIENCE REPORT01-01-2018
Multiple case study applied in nursing research: a case report
Revista Brasileira de Enfermagem. 2018;71(3):1194-1197
Abstract
EXPERIENCE REPORTMultiple case study applied in nursing research: a case report
Revista Brasileira de Enfermagem. 2018;71(3):1194-1197
DOI 10.1590/0034-7167-2017-0066
Views0See moreABSTRACT
Objective:
To report the experience of using the method of multiple case study.
Method:
We used the method of multiple case study, conducted with children and adolescents assisted in the pediatric oncology inpatient unit.
Results:
The steps used for the development of a multiple case study were: Step 1 – Define and design; Step 2 – Prepare, collect and analyze; Step 3 – Analyze and complete. The steps included the development of a research project with the definition of its components, preparation of protocol for the case study, data collection, individual report of cases, data analysis and final report with data cross-referencing.
Conclusion:
The case study method can be used by nurses and contribute to the advancement in knowledge of nursing as a science and therefore contribute to a full care practice in the context in which the phenomenon happens.
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REVIEW01-01-2018
Hand hygiene: nurses’ adherence after training
Revista Brasileira de Enfermagem. 2018;71(3):1189-1193
Abstract
REVIEWHand hygiene: nurses’ adherence after training
Revista Brasileira de Enfermagem. 2018;71(3):1189-1193
DOI 10.1590/0034-7167-2017-0239
Views0See moreABSTRACT
Objective:
Hand hygiene plays a key role in the prevention of healthcare-associated infections. Therefore, this study aims to analyze nurses’ adherence to hand hygiene and identify intervention strategies to improve this procedure.
Method:
Integrative literature review, using the Cochrane methodology, to answer the following question: “What is the level of effectiveness of training in improving nurses’ adherence to hand hygiene?”.
Results:
Studies show that nurses’ adherence to hand hygiene has increased from 42.9% to 61.4% (p<0.001), or even from 63% to 76% (p<0.005) after a specific training intervention.
Conclusion:
After training, nurses’ adherence to hand hygiene improved, particularly when compared to the other professionals involved. Despite its simplicity, the implementation of a training program and its subsequent follow-up have a positive on nurses’ attitudes and adherence to hand hygiene.
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REVIEW01-01-2018
Integrative literature review: access to primary healthcare services
Revista Brasileira de Enfermagem. 2018;71(3):1178-1188
Abstract
REVIEWIntegrative literature review: access to primary healthcare services
Revista Brasileira de Enfermagem. 2018;71(3):1178-1188
DOI 10.1590/0034-7167-2017-0441
Views0See moreABSTRACT
Objective:
Analyze the scientific production that describes the type of access to primary healthcare services and identify specific populations that have differentiated access to health services.
Method:
An integrative review. For study selection, the following databases were used: PubMed, Scopus, Bireme, and Cinahl. The sample included 22 national and international articles.
Results:
The results describe the access of specific populations to health services, the access to primary care through health plans and proposed improvements to the access to primary care.
Conclusion:
The access to services is a challenge in many countries and some strategies and policies are implemented to solve and improve primary health care.
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ERRATUM01-13-2024
ERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
Abstract
ERRATUMERRATUM
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e08
DOI 10.1590/0034-7167.20247706e08
Views0In the article “Brazilian nursing specific situation, middle and micro-range theories: a bibliometric study”, with DOI number: , published in Revista Brasileira de Enfermagem, 2024;77(4):e20230520, Chart 1:Where it read:[…]See more -
ERRATUM01-13-2024
ERRATA
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e07
Abstract
ERRATUMERRATA
Revista Brasileira de Enfermagem. 2024;77(6):e2024n6e07
DOI 10.1590/0034-7167.20247706e06pt
Views0No artigo “Crenças e atitudes de pais ou responsáveis legais sobre a vacinação infantil: revisão de escopo”, com número DOI: , publicado no periódico Revista Brasileira de Enfermagem, 2024;77(4):e20240126, página 5:Onde se lia:[…]See more -
ORIGINAL ARTICLE01-13-2024
Indicators associated with severity and mortality in hospitalized people with HIV: A retrospective cohort
Revista Brasileira de Enfermagem. 2024;77(6):e20240204
Abstract
ORIGINAL ARTICLEIndicators associated with severity and mortality in hospitalized people with HIV: A retrospective cohort
Revista Brasileira de Enfermagem. 2024;77(6):e20240204
DOI 10.1590/0034-7167-2024-0204
Views0See moreABSTRACT
Objectives:
to compare the sociodemographic and clinical severity indicators of hospitalized people with HIV in relation to clinical outcomes and urgent hospital admission.
Methods:
a retrospective cohort study was conducted with 102 medical records of HIV-infected individuals hospitalized in a hospital in southern Brazil. In addition to descriptive analysis, Fisher’s exact test, Pearson’s Chi-square, and logistic regression were used.
Results:
the data showed a significant direct effect on severity indicators in the following variables: male sex (p=0.013), skin color (p=0.023), level of education (p=0.000), urgent admissions (p=0.000), late diagnosis (p=0.001), diabetes mellitus (p=0.001), hypertension (p=0.004), kidney disease (p=0.002), high viral load (p=0.006), CD4+ count below 200 (p=0.005), fever (p=0.016), weight loss (p=0.013), co-infection with hepatitis C (p=0.004), and mortality (p=0.007).
Conclusions:
three sociodemographic and thirteen clinical markers were identified as being associated with the risk of clinical deterioration in hospitalized people with HIV.
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ORIGINAL ARTICLE01-13-2024
Nurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
Abstract
ORIGINAL ARTICLENurses’ perspectives on the use of telemonitoring in the management of people with diabetes and hypertension
Revista Brasileira de Enfermagem. 2024;77(6):e20230481
DOI 10.1590/0034-7167-2023-0481
Views1See moreABSTRACT
Objectives:
to understand the perspective of nurses on the use of telemonitoring in the management of people with type 2 diabetes mellitus and arterial hypertension in primary care.
Methods:
this qualitative research involved sixteen nurses from eight municipalities in Paraná. Data were collected between November 2022 and January 2023 through inperson or remote interviews, which were audio-recorded and subjected to content analysis.
Results:
according to the nurses, telemonitoring enhances users’ knowledge about these conditions, communication and connection with the team, and productivity. However, the lack of electronic resources and equipment, high staff turnover, low user adherence, and the limited availability of professional time present significant challenges.
Final Considerations:
the effective implementation and operation of telemonitoring in the management of people with diabetes and hypertension involve both potential benefits and barriers. It is essential to have the availability of human and technological resources, managerial support, and the commitment of professionals and users.
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ORIGINAL ARTICLE01-13-2024
Knowledge, Attitudes, and Practices of nurses regarding blood culture collection
Revista Brasileira de Enfermagem. 2024;77(6):e20230424
Abstract
ORIGINAL ARTICLEKnowledge, Attitudes, and Practices of nurses regarding blood culture collection
Revista Brasileira de Enfermagem. 2024;77(6):e20230424
DOI 10.1590/0034-7167-2023-0424
Views0ABSTRACT
Objectives:
to investigate the knowledge, attitudes, and practices of nurses regarding blood culture collection.
Methods:
a cross-sectional study was conducted in five Brazilian public hospitals with 112 nurses. Data were collected using an adapted questionnaire and analyzed through descriptive and inferential statistics.
Results:
nurses who did not consider themselves capable of collecting blood cultures had a 72% lower chance of performing the collection at the recommended site and an 83% lower chance of using the same needle for blood inoculation into the vials. Nurses working in the emergency department had a 75% lower chance of knowing the international benchmark for blood culture contamination rates, and those with less than 5 years in the position decreased their chance of accuracy in this matter by 79%.
Conclusions:
there are gaps in the knowledge, attitudes, and practices of nurses regarding blood culture collection. Standardization of the technique, periodic education, supervision and guidance of the collection team, and process auditing are recommended coping strategies.
Keywords:Blood CultureBlood Specimen CollectionHealth Knowledge, Attitudes, PracticeNursing CareQuality of Health CareSee more -
ORIGINAL ARTICLE01-13-2024
Evaluation of care for people with HIV in Primary Health Care: construct validation
Revista Brasileira de Enfermagem. 2024;77(6):e20230190
Abstract
ORIGINAL ARTICLEEvaluation of care for people with HIV in Primary Health Care: construct validation
Revista Brasileira de Enfermagem. 2024;77(6):e20230190
DOI 10.1590/0034-7167-2023-0190
Views0ABSTRACT
Objectives:
to verify the construct validation of an instrument for evaluating care for people living with HIV in Primary Health Care.
Methods:
methodological study carried out in 2021 with 260 health professionals in Recife, PE. Validation based on the internal structure was carried out at this stage using exploratory and confirmatory factor analysis, and validity based on item response theory.
Results:
the validation determined the retention of five factors and 63 items. The instrument’s internal consistency and quality of fit was 0.90, the Tukey-Lewis index was 0.915 and the comparative fit index was 0.918 in the confirmatory factor analysis. The indication for the absolute majority of items is adequate fit.
Conclusions:
the instrument has construct validity, making it possible to use it to evaluate the decentralization process and care for People Living with HIV in Primary Health Care.
Keywords:Acquired Immunodeficiency SyndromeComprehensive Health CareHIVPrimary Health CareProgram EvaluationSee more -
ORIGINAL ARTICLE01-10-2024
Inventory of ethical problems in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77:e20230539
Abstract
ORIGINAL ARTICLEInventory of ethical problems in mobile pre-hospital care
Revista Brasileira de Enfermagem. 2024;77:e20230539
DOI 10.1590/0034-7167-2023-0539
Views0See moreABSTRACT
Objective:
to construct and validate the content of an inventory of ethical problems experienced by nurses in mobile pre-hospital care.
Method:
a psychometric approach study, developed with the following stages: (1) instrument construction through a theoretical matrix based on deliberative bioethics, scoping review and online qualitative research; (2) content validity by judges; (3) pre-testing with Mobile Emergency Care Service nurses in various Brazilian states. For content validity analysis, the Content Validity Ratio was calculated (CVR>0.45 for judges and CVR>0.35 for the target population).
Results:
the instrument had 44 items, distributed across four dimensions.
Final considerations:
the constructed instrument presented sources of evidence of content validity, providing good psychometric measurements and constituting a useful tool for nurses’ practice in the pre-hospital setting.
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REVIEW01-01-2015
Adverse events and safety in nursing care
Revista Brasileira de Enfermagem. 2015;68(1):144-154
Abstract
REVIEWAdverse events and safety in nursing care
Revista Brasileira de Enfermagem. 2015;68(1):144-154
DOI 10.1590/0034-7167.2015680120i
Views0See moreObjective:
to identify the scientific publications about adverse events in nursing care in adult hospitalized patients and discuss the main adverse events in nursing care.
Method:
Integrative revision with a qualitative approach. The data were collected at LILACS, MEDLINE, BDENF and the library SCIELO and were submitted to thematic analysis.
Results:
three categories were developed: Adverse events in nursing care; The main causes of the adverse events in nursing care; Attitude of nursing professionals in face of errors. The main events were identified in nursing care with emphasis on the medication error, the failure to perform dressings and falls of patients. The importance of instruments was emphasized for notification of adverse events in the institutions. However the fear of punishment on professionals stimulates the underreporting of events.
Conclusion:
it is important to discuss effective prevention strategies that ensure patient safety in healthcare institutions.
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REVIEW01-01-2015
Staphylococcus aureus meticilino resistente adquirido na comunidade: um problema mundial
Revista Brasileira de Enfermagem. 2015;68(1):136-143
Abstract
REVIEWStaphylococcus aureus meticilino resistente adquirido na comunidade: um problema mundial
Revista Brasileira de Enfermagem. 2015;68(1):136-143
DOI 10.1590/0034-7167.2015680119p
Views0Objetivo:
descrever a epidemiologia dos casos de CA-MRSA no Brasil de forma a compreender sua ocorrência, fatores de risco associados e formas de manejo em relação à situação mundial.
Método:
revisão integrativa e para seleção dos estudos utilizou-se as bases de dados: Scopus, Science direct, Isi Web of Knowledge, PUBMED e BVS.
Resultados:
foram identificados dez artigos nacionais que descreveram 21 casos de CA-MRSA principalmente em crianças, adolescentes e adultos com quadro de infecção de pele e tecidos moles evoluindo para infecções graves relacionados ao clone Oceania Southwest Pacific Clone (OSPC) que resultaram em hospitalização.
Conclusão:
apesar do CA-MRSA ser considerado um micro-organismo de relevância mundial verificou-se a escassez de dados publicados sobre sua epidemiologia no Brasil, o que dificultam o delineamento da realidade do país frente ao CA-MRSA.
Keywords:Controle de InfecçõesFarmacorresistência BacterianaInfecções Comunitárias AdquiridasStaphylococcus Aureus Resistente à MeticilinaSee more -
REVIEW01-01-2015
Prevention and non-pharmacological management of pain in newborns
Revista Brasileira de Enfermagem. 2015;68(1):131-135
Abstract
REVIEWPrevention and non-pharmacological management of pain in newborns
Revista Brasileira de Enfermagem. 2015;68(1):131-135
DOI 10.1590/0034-7167.2015680118i
Views0See moreObjective:
to describe the main non-pharmacological interventions for pain relief in newborns available in Neonatal Intensive Care Unit.
Method:
an exploratory search of the MedLine, Lilacs and Scielo online databases was conducted to retrieve references of studies published from 2004 to 2013.
Results:
several non-pharmacological interventions were shown to be effective, to represent low risk for neonates and to have a low operational cost. The ones most often discussed in the literature were: oral administration of glucose/sucrose, non-nutritive sucking, breastfeeding, skin-to-skin contact, facilitated tucking and swaddling.
Conclusion:
healthcare teams should be familiar with these methods and use them more effectively in Neonatal Intensive Care Unit daily routines, so as to ensure that newborns receive qualified and more human care.
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BANFISA e (IN)DICA-SUS na graduação em saúde: o lúdico e a construção de aprendizados
Revista Brasileira de Enfermagem. 2015;68(1):124-130
Abstract
BANFISA e (IN)DICA-SUS na graduação em saúde: o lúdico e a construção de aprendizados
Revista Brasileira de Enfermagem. 2015;68(1):124-130
DOI 10.1590/0034-7167.2015680117i
Views0See moreObjectives:
to analyze the learning built during the matches of the games by students of the subject Gestão de Políticas Públicas em Saúde at the Universidade de Brasília.
Method:
exploratory, descriptive research, in a qualitative approach, with 26 students from various graduation courses in health, using a questionnaire and participant observation.
Results:
participants reinvented rules, related issues addressed in the games to the reality, interacted with colleagues and had fun throughout the match. Comparing the games in relation to ludicity, the BANFISA was more attractive than the (IN) DICA-SUS, although they are complementary.
Conclusions:
learning constructed by the students goes beyond the content of the subject; involve the active participation in group and creativity.
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Chinese auriculotherapy to improve quality of life of nursing team
Revista Brasileira de Enfermagem. 2015;68(1):117-123
Abstract
Chinese auriculotherapy to improve quality of life of nursing team
Revista Brasileira de Enfermagem. 2015;68(1):117-123
DOI 10.1590/0034-7167.2015680116p
Views0See moreObjective:
to evaluated the effi cacy of auriculotherapy for improving quality of life and reducing stress in nursing staff.
Method:
single-blind radomizad clinical trail envolving 175 subjects randomized in: Control (G1), Protocol Group (G2) and without Protocol Group (G3). They were evaluated by the Stress Symptoms List and SF36v2 at baseline, after 12 sessions and follow up (30 days), between January and July 2012.
Results:
both intervention groups reduced stress (p <0.05) with greater effect for G3 (d = 1.15). G3 was also higher for improving life quality especially the physical domain (p = 0.05).
Conclusion:
individualized auriculotherapy (G3) had greater effect compared to the protocol auriculotherapy (G2) for reducing stress and improving life quality.
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Adherence to foot self-care in diabetes mellitus patients
Revista Brasileira de Enfermagem. 2015;68(1):111-116
Abstract
Adherence to foot self-care in diabetes mellitus patients
Revista Brasileira de Enfermagem. 2015;68(1):111-116
DOI 10.1590/0034-7167.2015680115p
Views0See moreObjective:
to analyze the self-care of patients with type 2 diabetes mellitus in the Family Health Strategy in Teresina-PI.
Method:
search cross selected by simple random sampling, 331 people with diabetes mellitus. Data collection took place from August to December 2012 with the use of Self-Care Activities Questionnaire with Diabetes and structured instrument for recording information socioeconomic and guidance received by the professional nurse.
Results:
the data revealed that patients have poor adherence to blood glucose monitoring, the physical exercise and foot care, but with good adherence to the medication. Only 38.7% of the sample examined the feet of fi ve to seven days a week. Statistically signifi cant association between self-care activities with their feet and orientations of nurses (p < 0,05).
Conclusion:
that there is need to raise awareness with regard to the development of skills for self-care.
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Patients with disorders of consciousness: vital, facial and muscular responses to music or messages
Revista Brasileira de Enfermagem. 2015;68(1):102-110
Abstract
Patients with disorders of consciousness: vital, facial and muscular responses to music or messages
Revista Brasileira de Enfermagem. 2015;68(1):102-110
DOI 10.1590/0034-7167.2015680114p
Views1See morePurposes:
to compare vital signs, facial expression and basal electroneurographic signs with measures during stimuli music, message or “silence” in coma patients, vegetative status or sedated; and relating the score of Glasgow Results Scale with the intervention realized.
Method:
a Monoblind Transversal Controlled Clinical Trial to researcher. The distribution, among the three groups, was randomized (experiment with music, experiment with message or control). Two assessments (sessions) were performed with interval of 40 minutes on the same day.
Results:
most of the 76 patients were male, between 18 to 36 years old and hospitalized due to trauma. Statistically signifi cant changes were found in the variables referred to temperature, facial expression, electroneurography and Glasgow Results Scale; more frequent alterations in second session, in coma and vegetative patients, in frontal muscles and in experiment group.
Conclusions:
the facial expression and the electroneurography seem to be more trustworthy variables than vital signs to evaluate consciousness.
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Prevalence of minor psychiatric disorders in socio-educational agents in the state of Rio Grande do Sul
Revista Brasileira de Enfermagem. 2015;68(1):93-101
Abstract
Prevalence of minor psychiatric disorders in socio-educational agents in the state of Rio Grande do Sul
Revista Brasileira de Enfermagem. 2015;68(1):93-101
DOI 10.1590/0034-7167.2015680113p
Views0See moreObjective:
to determine the prevalence and factors associated with minor psychiatric disorders (MPD) in socio-educational agents.
Method:
it is a cross-sectional study with 381 socio-educational agents the Centers for Socio-Educational Services in the State of Rio Grande do Sul, Brazil. The Brazilian versions of the Scale of Demand-control-social support at work and the Self Reporting Questionnaire-20 have been applied.
Results:
the results showed a prevalence of suspicion MPD of 50.1%. They showed to be related to suspicion of MPD : being female (55.7%), having age up to 44 years old (58.5%), no physical activity (57.4%), do not have time for leisure (75%), make use of medication (61.4%), require medical attention (56.9%) and psychological counseling (72.7%), not being satisfied with the workplace (61.7%) and need for time off from work (65.6%).
Conclusion:
the study provides important data about the mental health of agents, showing the need for the involvement of managers and of the health service of worker’s health in planning actions to promote health of these workers.
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