Trabalho, Educação e Saúde - TES (Work, Education and Health) is an open access scientific journal, edited by the Joaquim Venâncio Polytechnic School of Health, from Oswaldo Cruz Foundation.
Editorial
Article
The research presented in this article aims to investigate the ‘expression’ of certain dominant ‘logic’ in medical education by analyzing the expectancies of students of a medical teaching institution in relation to a discipline focused on topics/questions of social sciences in health and coordinated by social scientists. The material analyzed comprises expectations of 72 students collected by an invitation to write freely about what they expect from the discipline. The result shows the dominance of discourses and pedagogical experience that contribute to production of an ‘instrumental’ and ‘colonial’ conception of the medical practice and allows us to understand some difficulties to the critical-reflexive exercise of social science in the medical education. Identifying the need to deconstruct this ‘logic’, the article concludes not with a concrete pedagogical proposal, but with the indication of the need for a process of deinstitutionalization/ institutionalization oriented to epistemic ‘decompression’ of the field of health in general and medical education in particular, an opening to other agents, other epistemologies and to the possibility of new productive connections in the field of health and medicine.
Article
The expression ‘work management in healthcare’ began to be used in Brazil after the 12a National Conference of Health, replacing ‘human resource’. The aim was analyze the meanings attributed to the use of the term ‘work management in healthcare’ based on the Brazilian historical context. This research developed a scoping review in the Lilacs database, between 1990 and 2010. Among 436 eligible studies, 34 were included. These publications presented numerical growth especially after the 3rd National Conference of Work Management and Education in Healthcare at 2006. The content was synthetized in five main topics: conceptualizing of work management in healthcare, policy formulation, and participation of workers in the work process, labor precarization and new challenges. Despite the consensus about the complexity of the expression, distinct aspects are explored by the authors depending of political, social and economic contexts during the construction of thought. The theoretical discussions should support changes on practices of management and on culture of production modeling, but practical changes are scarce, generating a question that was not completely answered: does work management in healthcare represent a simple terminology exchange or paradigm shift?
Article
This article discusses the relationship between the insertion of youth in the labor market and their passage through middle school. The central argument is that the recent middle education counter-reform will not guarantee universal opportunities for the completion of basic education, rather promote precarious training in public schools and reinforce the precariousness of youth labor. Methodologically, data were analyzed regarding the passage of youth through the schooling process and their insertion in the labor market. As basic primary sources, analyses were made of data provided by the Brazilian Institute of Geography and Statistics, in its National Household Sample Survey and Census; of surveys carried out by the Ministry of Labor, specifically data from the General Register of Employed and Unemployed persons and of the Annual Report of Social Information, and of data provided by the Anísio Teixeira National Institute of Educational Studies and Research.
Article
To rescue and systematize the different positions that shaped the path of the construction of the permanent education in health concept, the article aims to review the discussions carried out by the Pan American Health Organization in the period ranging from 1974 to 2002 with regard to health education practices to understand the lines of force, intentionalities, and power games involved in this debate. Documental and bibliographical research was carried out using the conceptual matrix notion as an analytical reference. The results present the elements that comprise these matrices and their respective emergency contexts, which corroborate the existence of two conceptual matrices in the production of the Pan American Health Organization, namely continuing education in health and permanent health education, respectively, from 1974 to 1984 and from 1985 to 2002. It is argued that the expansion and reconfiguration of the conceptual plan provided by the second matrix, largely centered on the pedagogical method, faces limitations that we can correlate not only with the redirection of the institution's agenda, but also with the experience of implementing the National Policy for Permanent Education in Health and the contradictions that marked the path followed by the management of the work of the Unified Health System.
Article
This paper analyzes the mediation between the school and the employment market in the mid-level technical training in Brazilian teaching institutions belonging to the Rede Federal de Educação Profissional, Científica e Tecnológica that materializes mainly through supervised internship activities. The paper's goal is to explain to what extent the mediation between school and employment market has been perverted by market logic, shifting the supervised internship activities of the teaching field to the field of workforce intermediation, giving it precarious job character. This is a basic research, developed by qualitative analysis, pointing as a result the distinction of conceptions and practices internship supervised in two categories. The first categorie is inserted in the pragmatic training perspective and another which is inserted in the omnilateral training perspective. The author points out the predominance of the pragmatic prospect of training in actions and conceptions of mediation between school and the employment market, which corrupts the internship activities supervised, giving it characteristics of precarious work.
Article
Interdisciplinarity and its practical correlation, interprofessionality, are essential to the work in the Family Health Strategy. The objective was to characterize the interdisciplinary perspective of Family Health Strategy workers in a Brazilian capital, linking it to interprofessionality. Transversal, exploratory and descriptive study, developed from the qualitative and quantitative approaches. Data were collected from june to november 2014 through questionnaires and participant observation. The results of the questionnaire were converted into scores, allowing to classify the level of interdisciplinarity. The observation findings, recorded in the field diary, were submitted to content analysis and discussed in parallel with the quantitative findings. It was verified, in the questionnaires, that the dimension ‘reception’ was the only one that presented medium availability for practices that can make interdisciplinarity feasible. The results indicate that the health professionals’ perception about interdisciplinarity was positive, however, contradictions of these findings with the ones observed locus . In the participant observation, it was verified that the professionals need to follow some paths in the sense of materializing the interdisciplinarity in collaborative interprofessional practices. It is important to emphasize the need for management-level actions that favor these practices; Permanent education as a strategy for coping with integration difficulties; And the subjective investment of workers in the same direction.
Article
This study aimed at analyzing the work process in the daily life of the community health agents and the strategies used to deal with the common adversities to the work process within the scope of the Family Health Strategies) of a District Health Management Center in the municipality of Porto Alegre, Rio Grande do Sul, Brazil. This is a qualitative study, carried out from August 2015 to February 2016, by means of focal groups and semi-structured interviews. The analysis of the data was done by thematic categorization. The results emerged from four main themes: Administrative work and the decharacterization of the Community Health Agents work; The daily life in a team and their working conditions; The attention networks and their discontinuity in health care; and Coping strategies between difficulties and potency. By considering the interfaces between actual and prescribed work of the community health agents, it is not possible to deny the need for dialogue between social control, professionals and managers to deal with situations that cause suffering to users and professionals.
Article
This paper aims to describe and to analyze the foundation of Forums of the services composing the Network for Psychosocial Care in the territory of a Management District of Porto Alegre, Rio Grande do Sul, Brazil. It is a qualitative study performed with intervention-research from March 2014 to March 2015. To analyze this process, we used field diary as a tool to record the Forums and assessment reports of trainings seminars in mental health, performed with primary healthcare professionals. The Forum arrangement, with professionals of several services, defines a process that aims to join different points in the Network for Psychosocial Care, promoting interlocution among the services and co-responsibility for management-execution of the territory healthcare. From the relations emerged in the Forums, we propose to rethink work processes, questioning the practices and knowledges in health, alluding to Permanent Education in Health as an important strategy in this setting. As initial results, we think the monthly meetings provided reflection spaces and proposed construction of flows and connections among work, management, and Permanent Education, aspects considered inseparable in the public health filed.
Article
This research aims to examine the practice of matrix support in mental health from the case study of the experience of the city of Belo Horizonte, Minas Gerais, Brazil, between the years 2013-2014. From a qualitative approach, there were semi-structured and individual type of interviews with five psychologists and two representatives of management involved with this in mental health in the city, as well as participant observation in matricial meetings. Data were analyzed using the methodology of content analysis. In the final reflections, it is clear that the support matrix has transformed the employment relationship in basic health units in the sense of co-responsibility and integrated work between the teams. Nevertheless, we still need to move forward with regard to the construction of the treatment plan, expanding the scope of interventions beyond the clinical and individual care, including the prospect of working with groups and in the territory.
Article
This article aims to meet the work and health of public universities teachers under the Trade Union point of view. To this end, qualitative oriented research was done with the participation of members of the regional direction of the National Union of Teachers of higher education institutions of Rio de Janeiro (Brazil). Individual interviews were conducted with open-ended questions through a script of semi-structured questions. Regarding the analysis of the interview's material, was used the technique of ‘content analysis’, more specifically the thematic analysis, being identified five empirical discussion axes, which are: changes in the role of the university and the relationship with the state model; precariousness work in public universities; teaching work intensification and productivity academic; trade union action and workers’ health and necessary changes at work. At the end, a health conception was set, under the trade union point of view, which is interpreted as permanent collective emancipation movement, moving away from the meanings centered on individuals and in strictly biomedical approaches. It is a dialectical conception of health which comprises the life and work as a process, in constant transformation in history.
Article
This study focused the association between common mental disorders and situations of imbalance between efforts and rewards in primary health care workers held in sanitary district, municipality of Salvador, Bahia, Brazil. The study included workers who were active in the district’s health in 2012. A cross-sectional study, with 400 out of 509 workers, was conducted. Effort-Reward Imbalance was used to evaluate effort and reward at work and the Self-Reporting Questionnaire measured common mental disorders. The prevalence of common mental disorders was 21%, 46.2% of studied workers experienced situations of work-reward imbalance at work. The highest prevalence of common mental disorders was observed in the effort-reward imbalance (26.9%) and in the operational workers group (33.8%). Correspondence analysis indicated a relationship between effort and reward imbalance and common mental disorders in the first dimension. The log-binomial logistic regression model showed a positive association between effort and reward imbalance and common mental disorders (adjusted prevalence ratio=1.91). Workers exposed to situations of effort-reward imbalance at work showed a higher frequency of mental illness. It is necessary to intervene in the management and organization of the work regarding the demands of the services, precarious work conditions and forms of reward or recognition.
Article
Among the most prevalent occupational diseases are the Repetitive Strain Injury and Work-Related Musculoskeletal Disorders (RSI/WRMD), which are directly related to the organization of the work that ignores the limits of the body and the uniqueness of each worker. The study main focus was to investigate the significance of the body at work in individuals diagnosed with lesion/disturb. To achieve the proposed objective, a case study was held in a qualitative approach, which is based in the socio-historical theory of psychology. The means used to achieve the data was through individual open interviews with nine subjects whom had been diagnosed with RSI/WRMD and were accompanied at the Worker's Health Reference Center in Botucatu (São Paulo, Brazil). As a result, three meaning cores have been revealed: need to work - the ‘body’ in motion; body submission - lack of autonomy/power; and prevented body — ‘I caught, I stopped in my life’. In addition to these, meanings and explanatory material have composed the illustrator scheme of results of this research. The phrase that best defines the whole process of health/disease measured in the interviews according to the scenario reported by the individuals is ‘The extravagance of working sick’, and the product of this, is an uncertain future.
Article
Burnout syndrome results from a chronic process of exposure to labor stressors. It is characterized by emotional exhaustion dimensions, depersonalization and low personal accomplishment. Health professionals are prone to it by dealing directly with people and suffering, which harms their health and the care offered to society. The primary health care is the level of care that is most adjacent to the community, exposing professionals to their realities. This study aims to identify the prevalence of burnout in Primary Care professionals and associated factors. This is a cross-sectional study carried out with 153 health care professionals from the city of Juiz de Fora, Minas Gerais, Brazil, between 2013 and 2014. The Maslach Burnout Inventory was used to measure the outcome. The prevalence of the syndrome was 51%, highlighting that the prevalence was higher among nursing professionals. The variables associated with the outcome after multivariate analysis were: self-assessment of poor health status and job dissatisfaction. Work at the primary level of care is complex and demanding, which makes it relevant to care for the health and satisfaction of these professionals, in order to protect their well-being and the production of quality care for society.
Article
The objectives of the study were to understand the employability of the graduates from a Physical Education course with emphasis on health training from the perspective of the Unified Health System and to analyze the relationship between this insertion and the interdisciplinary and interprofessional training proposed by the institution – in this case, the Federal University of São Paulo – Baixada Santista Campus , São Paulo, Brazil. For that, in 2012, an exploratory qualitative research was developed, which analyzed part of the database of a study that aimed to evaluate the interprofessional education project in the health training program of the institution. From the total sample of this research (107 volunteers), 15 graduates from the Physical Education course, formed in the 1st and 2nd classes, were included in the study. Data analysis was performed by a posteriori categories. The results showed that the graduates were inserted in areas common to Physical Education (gymnastic academies, personal trainer, physical evaluation, among others), in postgraduation and, less frequently, in the Unified Health System environment. It is concluded that the employability of Physical Education professionals in the Unified Health System is still small, even for a course with this emphasis.
Article
The internship in nursing represents the consolidation of practice and theory applied in the reality of health services, and improving it is a constant target of curricular discussions. The purpose of this study was to describe the history of the internship in nursing at a public university in northern Paraná state, Brazil, and to publicize the achievements made and challenges faced in the training of nurses. This was a historical and documentary research project with a qualitative approach carried out in the year 2013. The internship in nursing was built based on the integration of national changes and the social and political influences faced by public universities. It should be emphasized that the university plays an important role as a trainer of professionals who, from the conception of the internships, are involved in discussions on and in the planning of the praxis to potentiate innovative methodologies and to value the internship fields. The internship in nursing in question underwent several challenges over the years in the pursuit of educational and health system precepts, and it reached effectiveness, as confirmed by the players involved.
Article
The objective was to analyze the conditions in which the libraries of the institutions of training of technical workers in health of the African countries of Portuguese official language within the framework of the International Network of Education of Health Technicians. Data collection was carried out through field research based on the application of questionnaires to workers responsible for libraries or educational institutions. The results showed that most of the workers in the libraries had no specific training for the activity; the available stock revealed a disparity in the types and quantities of materials, besides being presented in languages other than Portuguese; physical resources were insufficient, as were the space and location of libraries; technological resources lacked improvement, including access to the internet. It was concluded that the conditions of the libraries surveyed were insufficient to support the training of the workforce at a technical level, as well as to subsidize the teaching activity, since, in addition to insufficient and outdated works available, there was precariousness in facilities, furniture and equipments.
Ensaio
The objective of this essay is to argument the modern individuality is a particular category which mediates through men’s practical action, the relationship between concrete individuals and species-in-itself ( Gattungsmässigkeit ). The paper shows the modern individuality as the rational egoism exercitation, specially into economic categories. This tendential exercitation cohabits with countertendencies, which allows apprehend the concrete individuality in a constant tensioned putting with modern individuality tendencies as an effect of economic compulsion which rules the present sociability.
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