ENFERMERAS DE SALUD OCUPACIONAL EN LA PROMOCIÓN DE LA SALUD: UNA REVISIÓN NARRATIVA

A enfermagem do trabalho vem se consolidando como uma especialidade na área da enfermagem, sendo uma das principais profissões existentes, atuando não somente nos serviços de saúde, como também em vários espaços que contemplam o processo de trabalho atualmente. O enfermeiro do trabalho exerce uma função importante na medicina ocupacional, pois vem atuando cada vez mais na prevenção de patologias laborais e de acidentes dentro das empresas. Dessa forma, o presente artigo identificou na literatura cientifica as competências do Enfermeiro do Trabalho na promoção da saúde do trabalhador. Para a produção do trabalho viabilizou-se a pesquisa narrativa. Como resultados, somente 06 artigos deram embasamento à pergunta de pesquisa e fica evidente a importância do profissional da enfermagem do trabalho agindo diretamente nas organizações, na intenção não somente de prevenir acidentes de trabalho e patologias ocupacionais, mas desenvolvendo uma função significativa na promoção da saúde do trabalhador, representando assim, um grande benefício para toda a coletividade da organização.Occupational health nursing has been consolidating itself as a specialty in the field of nursing, being one of the main existing professions, working not only in health services, but also in various spaces that currently contemplate the work process. Occupational health nurses play an important role in occupational medicine, as they have been working more and more in the prevention of occupational pathologies and accidents within companies. Thus, the present article identified in the scientific literature the competencies of occupational health nurses in the promotion of workers' health. To produce the work, narrative research was made possible. As a result, only 06 articles supported the research question and the importance of occupational nursing professionals acting directly in organizations is evident, with the intention not only of preventing work accidents and occupational pathologies, but also developing a significant role in the promotion of workers' health, thus representing a great benefit for the entire community of the organization.A enfermagem do trabalho vem se consolidando como uma especialidade na área da enfermagem, sendo uma das principais profissões existentes, atuando não somente nos serviços de saúde, como também em vários espaços que contemplam o processo de trabalho atualmente. O enfermeiro do trabalho exerce uma função importante na medicina ocupacional, pois vem atuando cada vez mais na prevenção de patologias laborais e de acidentes dentro das empresas. Dessa forma, o presente artigo identificou na literatura cientifica as competências do Enfermeiro do Trabalho na promoção da saúde do trabalhador. Para a produção do trabalho viabilizou-se a pesquisa narrativa. Como resultados, somente 06 artigos deram embasamento à pergunta de pesquisa e fica evidente a importância do profissional da enfermagem do trabalho agindo diretamente nas organizações, na intenção não somente de prevenir acidentes de trabalho e patologias ocupacionais, mas desenvolvendo uma função significativa na promoção da saúde do trabalhador, representando assim, um grande benefício para toda a coletividade da organização.La enfermería de salud ocupacional se ha ido consolidando como una especialidad en el ámbito de la enfermería, siendo una de las principales profesiones existentes, actuando no solo en los servicios de salud, sino también en diversos espacios que actualmente contemplan el proceso de trabajo. Las enfermeras de salud laboral juegan un papel importante en la medicina del trabajo, ya que vienen trabajando cada vez más en la prevención de patologías y accidentes laborales dentro de las empresas. Así, el presente artículo identificó en la literatura científica las competencias de los enfermeros de salud ocupacional en la promoción de la salud de los trabajadores. Para la producción de la obra se posibilitó la investigación narrativa. Como resultado, solo 06 artículos apoyaron la pregunta de investigación y se evidencia la importancia de que los profesionales de enfermería ocupacional actúen directamente en las organizaciones, con la intención no solo de prevenir accidentes de trabajo y patologías ocupacionales, sino también de desarrollar un papel significativo en la promoción de la salud de los trabajadores, representando así un gran beneficio para toda la comunidad de la organización

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Capacitação para cuidadores de idosos na Associação Promocional do Ancião (ASPAN) na cidade de João Pessoa – PB

O presente texto relara o desenvolvimento de um projeto de extensão que teve como objetivo geral proporcionar capacitação técnica/profissional a cuidadores de idosos de uma de Instituições de Longa Permanência para Idosos (ILPIs), na cidade de João Pessoa – PB, com foco nos aspectos biopsicossociais, dando sentido ao cuidado exercido. O projeto teve o formato de curso livre, tendo como parceiro social a Associação Promocional do Ancião (ASPAN). Primeiro entrou-se em contato com os cuidadores, através da ASPAN, e posteriormente foi dado início a capacitação. O curso teve a participação de 16 cuidadores de idosos da instituição parceira e foi executado por professores e um discente do Instituto Federal de Educação Ciência e Tecnologia do IFPB Campus Avançado Mangabeira. Ao longo das oficinas pode-se perceber que a equipe de cuidadores que a princípio se apresentou resistente a participar do curso aos poucos foram cedendo e participando das aulas, foram se identificando com os conteúdos que estavam sendo ministrados e foram participando das discussões e atividades propostas nas oficinas

Outcomes from elective colorectal cancer surgery during the SARS‐CoV‐2 pandemic

Aim This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic. Method This was an international cohort study of patients undergoing elective resection of colon or rectal cancer without preoperative suspicion of SARS-CoV-2. Centres entered data from their first recorded case of COVID-19 until 19 April 2020. The primary outcome was 30-day mortality. Secondary outcomes included anastomotic leak, postoperative SARS-CoV-2 and a comparison with prepandemic European Society of Coloproctology cohort data. Results From 2073 patients in 40 countries, 1.3% (27/2073) had a defunctioning stoma and 3.0% (63/2073) had an end stoma instead of an anastomosis only. Thirty-day mortality was 1.8% (38/2073), the incidence of postoperative SARS-CoV-2 was 3.8% (78/2073) and the anastomotic leak rate was 4.9% (86/1738). Mortality was lowest in patients without a leak or SARS-CoV-2 (14/1601, 0.9%) and highest in patients with both a leak and SARS-CoV-2 (5/13, 38.5%). Mortality was independently associated with anastomotic leak (adjusted odds ratio 6.01, 95% confidence interval 2.58–14.06), postoperative SARS-CoV-2 (16.90, 7.86–36.38), male sex (2.46, 1.01–5.93), age >70 years (2.87, 1.32–6.20) and advanced cancer stage (3.43, 1.16–10.21). Compared with prepandemic data, there were fewer anastomotic leaks (4.9% versus 7.7%) and an overall shorter length of stay (6 versus 7 days) but higher mortality (1.7% versus 1.1%). Conclusion Surgeons need to further mitigate against both SARS-CoV-2 and anastomotic leak when offering surgery during current and future COVID-19 waves based on patient, operative and organizational risks

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

Aim: This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic. Method: This was an international cohort study of patients undergoing elective resection of colon or rectal cancer without preoperative suspicion of SARS-CoV-2. Centres entered data from their first recorded case of COVID-19 until 19 April 2020. The primary outcome was 30-day mortality. Secondary outcomes included anastomotic leak, postoperative SARS-CoV-2 and a comparison with prepandemic European Society of Coloproctology cohort data. Results: From 2073 patients in 40 countries, 1.3% (27/2073) had a defunctioning stoma and 3.0% (63/2073) had an end stoma instead of an anastomosis only. Thirty-day mortality was 1.8% (38/2073), the incidence of postoperative SARS-CoV-2 was 3.8% (78/2073) and the anastomotic leak rate was 4.9% (86/1738). Mortality was lowest in patients without a leak or SARS-CoV-2 (14/1601, 0.9%) and highest in patients with both a leak and SARS-CoV-2 (5/13, 38.5%). Mortality was independently associated with anastomotic leak (adjusted odds ratio 6.01, 95% confidence interval 2.58–14.06), postoperative SARS-CoV-2 (16.90, 7.86–36.38), male sex (2.46, 1.01–5.93), age &gt;70&nbsp;years (2.87, 1.32–6.20) and advanced cancer stage (3.43, 1.16–10.21). Compared with prepandemic data, there were fewer anastomotic leaks (4.9% versus 7.7%) and an overall shorter length of stay (6 versus 7&nbsp;days) but higher mortality (1.7% versus 1.1%). Conclusion: Surgeons need to further mitigate against both SARS-CoV-2 and anastomotic leak when offering surgery during current and future COVID-19 waves based on patient, operative and organizational risks

Head and neck cancer surgery during the COVID-19 pandemic: An international, multicenter, observational cohort study

Background: The aims of this study were to provide data on the safety of head and neck cancer surgery currently being undertaken during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This international, observational cohort study comprised 1137 consecutive patients with head and neck cancer undergoing primary surgery with curative intent in 26 countries. Factors associated with severe pulmonary complications in COVID-19–positive patients and infections in the surgical team were determined by univariate analysis. Results: Among the 1137 patients, the commonest sites were the oral cavity (38%) and the thyroid (21%). For oropharynx and larynx tumors, nonsurgical therapy was favored in most cases. There was evidence of surgical de-escalation of neck management and reconstruction. Overall 30-day mortality was 1.2%. Twenty-nine patients (3%) tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within 30 days of surgery; 13 of these patients (44.8%) developed severe respiratory complications, and 3.51 (10.3%) died. There were significant correlations with an advanced tumor stage and admission to critical care. Members of the surgical team tested positive within 30 days of surgery in 40 cases (3%). There were significant associations with operations in which the patients also tested positive for SARS-CoV-2 within 30 days, with a high community incidence of SARS-CoV-2, with screened patients, with oral tumor sites, and with tracheostomy. Conclusions: Head and neck cancer surgery in the COVID-19 era appears safe even when surgery is prolonged and complex. The overlap in COVID-19 between patients and members of the surgical team raises the suspicion of failures in cross-infection measures or the use of personal protective equipment. Lay Summary: Head and neck surgery is safe for patients during the coronavirus disease 2019 pandemic even when it is lengthy and complex. This is significant because concerns over patient safety raised in many guidelines appear not to be reflected by outcomes, even for those who have other serious illnesses or require complex reconstructions. Patients subjected to suboptimal or nonstandard treatments should be carefully followed up to optimize their cancer outcomes. The overlap between patients and surgeons testing positive for severe acute respiratory syndrome coronavirus 2 is notable and emphasizes the need for fastidious cross-infection controls and effective personal protective equipment

Delaying surgery for patients with a previous SARS-CoV-2 infection

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