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
In this article we analyze the main aspects that contribute to increase the workloads of nurse technicians working in primary health care in Brazil, we identify the type of loads and rank the most prevalent aspects of this occupational group. It is based on a multicenter study with 24 professionals from the South, Center-west and North regions of Brazil, from 2011 to 2013, using data from semi-structured interviews. The data were systematized in Atlas.ti software and submitted to thematic analysis. The aspects that contribute to increasing workloads are low monthly remuneration, lack of material resources, work overload, wear and illness, relationship with the user, and lack of human resources, prevailing psychological and physiological loads. Adequacy of the conditions and organization of work are shown paramount to ease the workload on the primary health care setting, and to promote the health, wellbeing and quality of life in the nurse technicians working environment.
Article
We present part of the research on the precariousness of teaching in Brazil. It is an in-depth discussion about teaching in higher education, in the present context. The hypothesis is that these teachers are submitted to the alienation and precariousness of labor by means of the recruiting, selection, hiring and evaluation policies, that deprives them of control over their work. Taking historical and dialectical materialism as reference, we utilized documental analysis to study the case of a state university. We identified as indications of the precariousness of teaching: the application of institutional evaluations for the management of the teaching staff; staff cuts; the substitution of disciplines for internships and teaching practice; e-learning; the lack of retirement recognition policies; and the policies that impose a productivist logic to the teachers in activity.
Article
The theme of collective organization is an important dimension imbricated in health work management and occupational health. In this article we analyze the trajectory of workers of municipal health services in Cascavel, Paraná, Brazil, in addressing issues related to work and work management. We used the qualitative methodology, with the application of semi-structured interviews and snowball technique for defining the sample. The results show that workers organized collectively through regular meetings, the foundation of a union and conducting strikes and mobilizations. However, before the clashes with the municipal administration, some got sick and others opted for individual forms of resistance. The union of municipal health servers, founded in 1988, turned from a combative stance to cooperation with the management in the 2000s. We conclude that, based on the difficulties described, it is up to the Cascavel public health sector workers the challenge to reflect on the past and continue trying to build collective strategies for organizing to defend their interests facing the management.
Article
The Oral Health National Policy emphasizes the importance of the training of assistant personnel for its consolidation. This study evaluated the inclusion of Oral Health Technicians, trained by Escola de Saúde Pública do Ceará, Brazil, in the Unified Health System. This is a descriptive study with a qualitative approach, developed in two stages. In the first one, the professional profile of 573 oral health technicians was outlined. In the second stage, we used focal groups, as well as the technique of content analysis, thematic modality. The orienting question was: which aspects influence the inclusion of the oral health technician in the Unified Health System? It was found that 73.3% of technicians were in the National Health Facilities Register. Out of these, 20.7% were registered as oral health technician, and 67.9% as oral health assistant. In the focal groups, three thematic categories were identified: manager's interests; type of employment relationship; and professional appreciation. It was concluded that the majority was included in the Unified Health System, but as oral health assistant. From the graduates" point of view, managers lack interest in hiring oral health technicians, and there is lack of more stable employment relationships and of greater professional appreciation.
Article
The study aimed to describe and analyze possible differences in the activities of health education performed by community health workers during a home visit. Data of two transversal studies were analyzed in the context of Family Health Units in the municipalities of Campina Grande (2010) and Queimadas (2011), in the state of Paraíba, Brazil. In Campina Grande, women whose children were younger than one year old were eligible, selected by systematic lottery, from 30% of the health units (n=508). In Queimadas, all women whose children were born within the year of 2009, those who resided in the municipality and those who were treated in any of the 16 health units (n=204) were eligible. The mothers were questioned about the educational activities developed by the agents during the home visits. A larger proportion of women indicated not to receive home visits in the municipality of Campina Grande, and deficiencies were found related to orientation on how to care for children's health in the two municipalities, and there was a higher frequency of educational activities in the agents from Queimadas. The differences related to the work of community health workers may involve elements such as professional devaluation and precarious work conditions. It must be emphasized the importance of the training and preparation of nurses for the supervision of the health workers.
Article
This study aimed to describe the sociodemographic and economic profile of teachers and analyze their professional characteristics, working conditions and workloads. This is a cross-sectional study of the Pro-Master project. We interviewed 978 primary school and high school teachers of the twenty state schools with more teachers of the city of Londrina/PR, between August 2012 and July 2013. Most of the teachers surveyed were female (68.5%) with mean age of 41.5 years (SD 10). As for professional features, 42.9% worked in up to two places and 64.2% teach at least two shifts. Issues such as remuneration, amount of students per class and infrastructure were reported as negative (bad/regular). In relation to workloads, physical, physiological and mental burdens, for more than half of them, greatly affect their health and working conditions. These factors signaled the working conditions and health of state teachers of Paraná, and can be useful to support the development of public policies to improve these aspects.
Article
The suffering of medical residents caused by their working conditions is broadly described in the literature. The conditions imposed on this type of work, often unacceptable, are object of scientific investigations, and are fully aware of those who work in health and medical education. This study was conducted in 2010 in order to describe the main aspects of these conditions in two public hospitals in Curitiba (Brazil) and reflect on the reasons and mechanisms reproduction of most of them. We conducted a cross-sectional study from the application of questionnaires, for the explanation of the protective critical processes and destructive ones in health of medical residents. Of the 100 medical residents in his or her first year in activity in the hospitals studied, 58 participated in the survey. The results show high weekly working hours, high number of continuous working hours, lack of supervision and high load stress. The working process is characterized by the subordination of teaching and learning to the exploitation of the labor force of residents, becoming more like destructive than as a protector of his or her health.
Article
In this article, we identify the political and social determinations that underlie the work of management in the Brazilian Unified Health System during the 2000s and discuss the configurations of the qualification of nurse technicians based on official documents of the period. The work on the National Health System, in the last two decades, was permeated by two central movements: management ideas adopted by the State related to the paradigm of public administration management; and articulation of the specificities of the health work, at the same time, with the principles and guidelines defined by the Federal Constitution of 1988 and with the ways of organizing work characteristic of flexible accumulation pattern. The shape of these elements, in turn, is expressed in the actions and the Ministry of Health programs as new demands for health work, which give emphasis to the subjective, emotional and relational aspects of activity.
Article
The article addresses the changes taking place in work organization under the Brazilian Oral Health Policy, considering the changes occurring in the organization of labor in the global scenario of productive restructuring. This phenomenon, first observed in the organization of industrial work, has been described also in the service sector, being visible some of its effects in the health field. In Brazil, since the 1995 State Reform, flexible contractual models were implemented, which allowed the legal institution of precarious labor ties in the public and private healthcare services. This study is descriptive, with its own components of quantitative and qualitative approaches. The field study was conducted in 13 Specialized Dental Clinics (SDCs) of the Metropolitan Region of Recife and aimed to investigate the phenomenon of precariousness and its manifestations in oral health care. The material studied evidenced a precarious context of work in investigation services, with repercussions on the quality of care provided to the population user of the centers, a condition that consists one of the challenges to be faced by the National Oral Health Policy.
Article
The research aimed to know the conceptions of health, disease, quality of life and other topics in teachers of a public school in Florianópolis, Santa Catarina, Brazil, 2013. A qualitative and descriptive study was carried out with data collected in focus group and semi-structured interviews. The focal group strategy was oriented on the approach of the ‘circle of culture’, in which the participants expressed their concepts on the studied themes and reflected on how to contribute to health promotion strategies in the school context through education on health. The research universe included 16 teachers from state schools; eight teachers confirmed their participation in the focus group and, of these, only six attended the first to the last meeting. At the end, the data revealed that teachers perceive a close relationship between health and quality of life and that a healthy life is possible in the presence of disease. They emphasized the need for greater participation of parents and health professionals in the health education process and also a systematic and continuing preparation on issues involving health in the school context. Conceptions of teachers reaffirm that the social dimension exceeds the biological one and that knowledge and appreciation of these aspects, in teaching practice, can broaden health actions.
Ensaio
This essay presents some reflections on outsourcing in the public service inspired by the sociology of work. It takes as reference the implementation of social organizations, which became strong reality in public health over the past 15 years and, from 2015. After the decision of the Brazilian Supreme Court in 2015, it has been considered constitutional, denying the request for direct unconstitutionality action. Thus, released to outsourcing for all essential services under state responsibility. It is also the subject of discussion the implementation of the Brazilian Hospital Services Company (Empresa Brasileira de Serviços Hospitalares), which, although more recent than social organizations, already has such harmful results as them. The argument put forward is that the outsourcing of public service in Brazil is one of the most efficient mechanisms to remove the social content of the state and its privatization, which occurs through various forms of precarious work as outsourcing - through social organizations, civil society organizations of public interest, private companies, public companies under private rules, partnerships, among others - is the main way that neoliberal political forces found to attack the heart of a social and democratic state: the workers who are civil servants.