Atividade de grupo como estratégia de educação em saúde auditiva de trabalhadores da manutenção hospitalar

Abstract

Hospital maintenance service features unhealthy environmental conditions, posing risks that may impair workers’ health and work safety, as well as the development of hearing pathologies and other occupational diseases. Noise-Induced Hearing Loss (NIHL) may result from the professional activity in noisy facilities, which most of the time, exceed the tolerance threshold established by law, hindering workers’ quality of life. Educational actions at work settings, which enhance workers’ knowledge on noise, hearing and preventive measures are important tools to make them aware of protection and hearing conservation facing aggressive agents. Therefore, a cross-sectional, intervention, quantitative-qualitative research study was carried out, objectifying to analyze group activity as an educational strategy on workers’ hearing health of the Hospital Maintenance Service at a teaching hospital from a Public Federal University in the municipality of Curitiba, Paraná State/Brazil. The studied population entailed 57 workers; 10 subjects of that group participated in the intervention group. For data collection, the following steps were carried out: the first step (quantitative) comprised two phases: Phase 1: situational analysis: questionnaire on hearing health and work conditions of the studied population; and Phase 2: assessment of the environmental noise; The second step (qualitative) comprised the educational actions and assessment of the results from the group activity. In the Quantitative Step, Phase 1, an adapted questionnaire was used based on the anamnesis of the noise-exposed workers. In Phase 2, a sound level pressure meter was used by the evaluator. The development of educational actions in the Qualitative Step followed the active teaching model, grounded in the problem-based learning model, and the group activity as the methodological device, following the phases proposed by Bordenave (1996): synchresis (reality observation), analysis (identification of the key points and theorization), and synthesis (hypotheses for solution). Five meetings were held once a week, lasting one hour each, mediated by a nurse and a speech-language therapist. Results from the first step showed that all participants in the study were male, average age between 30 and 59 years old (68.42%), average work length in the maintenance service of 8.9 years, 52% referred that noise level in the maintenance was medium, and it was high to 44%, and 45.76% did not know what could be done to reduce it. Measurement of noise levels from the machines in the sector evidenced average values (Leq) over 85 dB (A), being the Manual Circular Saw = 101.0 dB (A), and the Iron Multicutting Machine = 98.7 dB (A), the noisiest equipment. The results from the second step evidenced the contribution of the group activity for the adoption of preventive measures. The identified thematic categories were as follows: in the synchresis phase (reality analysis) 1 – My workplace is dangerous; 2- Noise - Steady machine noise; 3- Contact with different chemicals; 4- Weight, Height and Improper Place: Ergonomic Risk. In the analysis phase (from the theorization) 1- Steady environmental noise; 2- Impaired hearing, difficulty in communication; 3- Hearing care - Prevention. In the synthesis phase (hypotheses for solution) 1- Multiplying information, encouraging the use of hearing protectors. It is concluded that the obtained results enabled to identify and feature the workers of a hospital maintenance service, a scarcely studied sector in the literature, and meet the proposed goals in this study. Group activity, grounded in the problem-based learning model was an effective methodological approach for building knowledge on hearing health and for the generation and development of hospital maintenance workers’ critical awareness.