Nursing, environment and health conceptions: an ecosystemic approach of the collective health production in the primary care

Sustainability in nursing: a concept analysis

AIM

The aim of this study was to describe, explore and explain the concept of sustainability in nursing.

BACKGROUND

Although researchers in nursing and medicine have emphasised the issue of sustainability and health, the concept of sustainability in nursing is undefined and poorly researched. A need exists for theoretical and empirical studies of sustainability in nursing.

DESIGN

Concept analysis as developed by Walker and Avant.

METHOD

Data were derived from dictionaries, international healthcare organisations and literature searches in the CINAHL and MEDLINE databases. Inclusive years for the search ranged from 1990 to 2012. A total of fourteen articles were found that referred to sustainability in nursing.

RESULTS

Sustainability in nursing involves six defining attributes: ecology, environment, future, globalism, holism and maintenance. Antecedents of sustainability require climate change, environmental impact and awareness, confidence in the future, responsibility and a willingness to change. Consequences of sustainability in nursing include education in the areas of ecology, environment and sustainable development as well as sustainability as a part of nursing academic programs and in the description of the academic subject of nursing. Sustainability should also be part of national and international healthcare organisations. The concept was clarified herein by giving it a definition.

CONCLUSION

Sustainability in nursing was explored and found to contribute to sustainable development, with the ultimate goal of maintaining an environment that does not harm current and future generations' opportunities for good health. This concept analysis provides recommendations for the healthcare sector to incorporate sustainability and provides recommendations for future research.

Comunidade: objeto coletivo do trabalho das enfermeiras da Estratégia Saúde da Família

OBJETIVO: Compreender no que concerne a constituição da interação da enfermeira com a comunidade, considerando o(s) sujeito(s) e a(s) finalidade(s) com base na percepção de enfermeiras atuantes na Saúde da Família. MÉTODOS: Estudo exploratório-descritivo utilizando entrevista semiestruturada com análise qualitativa temática com 65 enfermeiras atuantes na Estratégia Saúde da Família, no extremo sul do Brasil, no período de janeiro a julho de 2006. RESULTADOS: Duas abordagens da interação foram evidenciadas: imediata nas entidades coletivas; e mediata, com os demais trabalhadores da equipe. Nas finalidades, emergiram dois objetos de ação: a população na resolutividade e integralidade com enfoque na qualidade da ação, formação de vínculo, prevenção de doenças e promoção da saúde direcionada à autonomia com corresponsabilização; e a equipe na organização do trabalho direcionada à resolutividade da atenção. CONCLUSÕES: Enfatiza-se a importância da interação enfermeira-comunidade visando às ações que fortaleçam potencialidades dos indivíduos/grupos e integralidade e resolutividade da assistência pela organização do trabalho.

Multiple Relationships of Nursing Care: the Emergence of Care "of the us"

The aim of this qualitative study was to comprehend the relationships of the care of the self, of care of the other, and of care "of the us" in the different dimensions of care, through an educational/reflexive/interpretative process with nursing professionals in a University Hospital, using the complexity perspective. The data were collected through workshops and submitted to content analysis. The following categories emerged: reflecting upon the meaning of care of the self, care of the other, and "of the us" for the "I - human being", and for the "I - nursing professional"; and reflecting and (re)constructing the meanings of the relationships of care for the self, care for the other, and care "for the us". The care "for the us" is an emerging theme, in construction, and impels a concern for the collective, as well as remits to the comprehension of the multiple and unending phenomenon of constant movement among the beings and between them and their environment, modifying, altering, and causing to be altered the networks of existent relationships.

Reflexivity, knowledge and ecological awareness: premises for responsible action in the hospital work environment

The article aims to analyze the interface of reflexivity, knowledge and ecologic awareness in the context of hospital work, based on data collected in a qualitative case study carried out at a public hospital. Field observation data and interviews are discussed in the light of sociologic and philosophic references. Workers expressed the interface between knowledge and action, in which there is a cycle of lack of knowledge, automatism in the actions and lack of environmental awareness, posing limits to individual awareness and to responsibility towards environmental preservation. Increased debate and education, including the environmental issue, are needed in the context of hospital work. Although hospital work is reflexively affected by the environmental problem, that does not guarantee the reorientation of practices and responsible action towards the environment.

Risk perception in family health work: study with workers in Southern Brazil

This analytical and qualitative study aimed to identify how workers in the Family Health Strategy perceive the risks they are exposed to at work. Thematic analysis and the reference framework of the work process were used to examine the contents of interviews with 48 subjects (community health agents, nurses, nursing auxiliaries and physicians). The workers noticed the following risks: physical and moral violence, typical work accident, emotional exhaustion, lack of problem-solving ability and occupational disease. The results predominantly show the connection with the object / subject of the work and the social environmental characteristics of the related communities. The study adds to the body of knowledge and can systemize collective and individual technological processes for occupational health risk management in primary health care.