Brazil is the first country in the world to have broad coverage standard (NR-32) focused on protecting health workers exposed to biological risks. This study evaluated the degree of knowledge of the NR-32 Standard and the level of knowledge and compliance with the standard precautions. A cross-sectional study was conducted with 208 randomly selected health professionals; 93 of them were residents and 115 were physicians at a Brazilian Clinical Hospital. To collect information, the participants were interviewed and/or they completed semi-structured questionnaires divided into three domains: knowledge of the standard, knowledge of biosafety, and compliance with standard precautions. Cronbach's alpha was used to assess internal consistency of the scales of knowledge and compliance with values above +0.75 indicating excellent agreement. Multivariate linear regression was used to evaluate the predictors for compliance with NR-32, biosafety, and standard precautions. Mean knowledge of the NR-32 Standard was 2.2 (± 2.02) points (minimum 0 and maximum 7 points). The minimum expected mean was 5.25 points. The mean knowledge of biosafety was 12.31 (± 2.10) points (minimum 4 and maximum 16 points). The minimum expected mean was 12.75 points. The mean compliance with standard precautions was 12.79 (± 2.6) points (minimum 6 and maximum 18 points). The minimum expected mean was 13.5 points. The individual means for using gloves, masks and goggles during procedures and for not recapping needles were 2.69, 2.27, 1.20 and 2.14, respectively. The factors associated with knowledge of the NR-32 were: greater knowledge amongst those who studied at a public university and who had knowledge of biosafety. The knowledge of the NR-32 Standard was low, but there was a good level of knowledge of biosafety issues. The compliance with standard precautions was acceptable in general, but was low for some of the evaluated precautions.

Resumo Fizemos estudo transversal para iniciar coorte em dois Hospitais Universitários de dois países - Brasil e Colômbia - para avaliar a prevalência de acidentes com material biológico (AT-MB), o nível de adesão às Precauções Padrão (PP) e o conhecimento sobre patógenos transmissíveis pelo sangue e fatores associados entre trabalhadores e estudantes da saúde, no marco da implementação da norma NR-32. Criamos escalas para estimar conhecimento e adesão baseadas em 12 e 11 perguntas respectivamente. Utilizamos Regressão de Poisson-Tweedie para avaliar a associação do conhecimento e da adesão às PP com sofrer AT-MB. Avaliamos 965 indivíduos (348 estudantes e 617 profissionais). O conhecimento teve média de 10,98 com mediana de 11 (10, 12) e α-Cr de 0,625. A média de adesão foi de 30,74 com mediana de 31 (28, 34) e α-Cr de 0,745, associando-se a País, grupo (estudantes) e percepção de risco. Entre os fatores associadas ao relato de AT-MB encontraram-se o conhecimento, a adesão às PP, País de origem e ter tomado o esquema completo de vacinação contra Hepatites B. Concluímos que o nível de conhecimento e adesão foram adequados, ainda melhores entre os participantes do Brasil e associaram-se ao relato AT-MB.

BackgroundSeveral diseases may lead to the need for liver transplantation due to progressive organ damage until the onset of cirrhosis, resulting in changes in interpersonal relationships. Social Support for transplant candidates is an important variable, providing them with psychological and social well-being. This study aims to assess social support in chronic hepatic patients, waiting for liver transplantation.MethodsA cross-sectional study was conducted with 119 patients, for convenience sampling, from the liver transplant waiting list at a Brazilian University Hospital Outpatients. The information was collected through semistructured questionnaires, in four stages: 1) socioeconomic and demographic information 2) clinical aspects 3) feelings 4) Social Support Network Inventory (SSNI), to Brazilian Portuguese. The statistical analysis was conducted using ANOVA and multivariate linear regression analysis to evaluate the relationship between the scales of social support and the collected co-variables.ResultsAverage age was 50.2 ± 11.6, and 87 (73.1%) were men. Patients with alcohol and virus liver disease etiology had the same frequency of 28%. The MELD, without extrapoints, was 16.7 ± 4.9. Global social support family score was 3.72 ± 0.39, and Cronbach’s alpha = 0.79. The multivariate analysis presented the following associations, age = [− 0.010 (95% CI = − 0.010 - -0.010); P = 0.001], etiology of hepatic disease = [− 0.212 (95% CI = − 0.37 - -0.05); P = 0.009], happiness = [− 0.214(95% CI = − 0.33 - -0.09) P = 0.001) and aggressiveness = [0.172 (95% CI = 0.040–0.030); P = 0.010).ConclusionsThe social support was greater when the patients were younger (18 to 30 years). Patients with alcoholic cirrhosis, regardless of whether or not they were associated with virus, had less social support. As for feelings, the absence of happiness and the presence of aggressiveness showed a negative effect on social support.

Resumo Considerando a dispersão de sentidos que constitui a nomeação da área ‘Saúde do Trabalhador’, buscou-se compreender o que está em jogo nas constantes mudanças da nomenclatura nesse campo. Essas alterações ocorrem em uma linha do tempo, mas concomitantemente. Seu marco inaugural foi encontrado na estabilidade do nome ‘medicina do trabalho’, nome institucionalizado pela Organização Internacional do Trabalho, no início da segunda metade do século XX. Desse primeiro gesto de nomeação, seguem outros, estabelecidos em relações tensas e contraditórias de substituição, recobrimento e concorrência como: saúde ocupacional, saúde e segurança no trabalho, e, mais contemporaneamente, em meio a estas variações, encontrou-se o acréscimo do termo ‘Saúde do Trabalhador’. O penúltimo nome é o mais estável e acionado pelas instâncias internacionais e empresariais.

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PSYChOSOCIAL IMPACT OF PATIENTS WAITING FOR LIvER TRANSPLANTAbSTRACT: The psychosocial impact (PI) of familial caregivers (FC) on liver pre-transplant patients is assessed by a transversal and quantitative study undertaken at the HC of the UFMG, Brazil. Three tools were employed, namely, demographic and clinical characteristics and Zarit Inventory for PI. Data were analyzed by descriptive and comparative statistics with Shapiro-Wilk, χ 2 and Kruskal-Wallis tests. Further, 73% of the 119 participants were males, aged 50 ± 12; 70% were married; 60% had basic schooling and 13% were employed. Highest percentage of FCs was made up of patients´ children, with α at 0.81. Relationship between males (0.018), schooling (0.014), encephalopathy (0.039), number of drugs (0.029) and happiness (0.028) with PI was reported. Highest schooling rate meant more happiness and, with less concomitant diseases, the lower was PI in FCs. Highest PI rate in FCs occurrred in male patients, with low schooling, with encephalopathy, when a concomitant disease and greater number of drugs occurred.

Nas últimas décadas, estudos sobre o impacto psicossocial e transplante de  órgãos e tecidos têm sido realizados; porém pode-se perceber que são escassas as pesquisas que avaliam os aspectos psicossociais ou o impacto psicossocial no processo do transplante hepático, principalmente entre adultos. O objetivo deste estudo foi apresentar e discutir os achados na literatura referentes aos impactos psicossociais presentes no transplante de fígado. Realizou-se revisão da literatura que compreendeu o período entre 2010 e outubro de 2016, nas bases de dados Medline e Lilacs/Bireme, e nas bibliotecas eletrônicas Scielo e Google Acadêmico, utilizando-se como descritores: impacto psicossocial, transplante de fígado e psicologia. Foram selecionadas onze publicações por cumprirem os critérios de inclusão, tendo sido identificados que oito pesquisavam o impacto ou aspectos psicossociais em crianças e adolescentes candidatos a transplante e transplantados e/ou as reações parentais, e somente três artigos em pacientes adultos. Conclui-se que os estudos que avaliam impacto psicossocial em pacientes adultos (que evoluem com doenças crônicas hepáticas em estágio avançado e que requerem transplante hepático), assim como em seus familiares são poucos, considerando-se a grande necessidade de melhorar a avaliação e o atendimento psicológico dessa clientela.