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
Higher education in health plays a fundamental role in society because the graduates of the courses offered in this area will be the future providers of care to the population. This study aimed to analyze publications in the literature regarding undergraduate work in health, the methodology of which was a narrative review, with 51 stories selected in the Virtual Library in Health database (focused on undergraduate education, teaching methods, and the theory-practice relation). The results showed the importance of connecting theory and practice, the differences in teaching methodologies - which must be analyzed critically -, and the weaknesses in the pedagogical training of teachers. It was concluded that the dissent with regard to the teaching methodologies and concern with the training of teachers and students shows the need for discussions to socialize experiences and ideas in this important field of knowledge and to meet social needs.
Article
By establishing itself as a public policy based on the ethical-aesthetic-political paradigm, the National Humanization Policy introduces a new sense to the proposal of humanizing health: A counter-hegemonic sense, coupled with the understanding of life as openness and multiplicity. Given the challenge of operating such an innovative concept, which is contrary to traditional practices, this study sought to discuss the understanding and experience that institutional supporters trained under the National Humanization Policy had of the ethical and political dimension of the proposal. The subject of this research project was investigated in the light of a qualitative methodological approach, exploratory and descriptive in nature, having as subjects the graduates of an institutional supporter training process held in 2009, in Santa Catarina, Brazil. Through interviews and documentary research, the results were the obtained of an understanding of the scale based on the valuation of subjects and democratization of relations. The experiences and tests, however, were marked by obstacles and challenges, such as the concentration of power at the institutions and the fragility of the health care model, still guided by management and biomedical rationales. Also challenging were the difficulties related to the understanding of a few of the concepts of the Policy and the ways in which it has been organized both in health services and inter-federatively.
Article
The process of training in health faces a challenge of transformation and is being guided to meet the needs of the National Health System. This article analyzes how undergraduate courses in pharmacy have addressed the national curriculum guidelines, with a focus on training directed to pharmaceutical assistance, as well as on faculty and student participation in practices aiming to bring together teaching and the reality of working in the National Health System. A documentary analysis was made of the curricula and political-pedagogical projects of Pharmacy courses at public and private higher education institutions in Rio Grande do Sul, Santa Catarina, and Paraná, Brazil. Semi-structured interviews with students and professors of courses in Santa Catarina were also conducted. The National Curriculum Guidelines have been adopted at different times since 2002, and the theoretical bases, as evidenced by the offer of subjects, also showed quite substantial differences among the courses. Internships were the most common strategy to draw teaching and service closer together; in courses with the Program of Education through Work in Health, it was noted there was a better understanding of the NHS among students. The study points to the need to critically rethink the National Curriculum Guidelines and how they have been implemented by the Pharmacy courses.
Article
This article presents and discusses the results of research that discusses the potentiality of the praxis and public/collective health involving professionals and knowledge in the construction of knowledge in health in the school environment. The study was conducted during the 2012 school year in a public school in the city of Rio de Janeiro, Brazil with the participation of teachers, high school students, and undergraduate interns. The research action methodology involves collective action guided based on the resolution of problems identified from a diagnosis of the situation prepared by the participants. The diagnosis was made through questions made to the teachers and trainees, and an essay directed to students. The results obtained from teachers reveal that public health is understood as a duty of the State in the provision of prevention and health care services. Collective health, meanwhile, is associated with the population's physical, mental, and social well-being. Both professors and trainees, who have participated in interdisciplinary projects, recognize the experience as positive. Students recognized that education is prioritized in relation to the school's physical and sanitary conditions, but identified in such conditions risk factors for learning and, consequently, health and quality of life.
Article
This paper presents the results of a study carried out to evaluate the development of teaching and learning, supported by a problem-based participatory approach, from the perspective of professors and students of the Escola Tocantinense do Sistema Único de Gismar Gomes, in training National Health System workers and those seeking to enter this labor market. We opted for the ‘research itinerary’ approach set forth by educator Paulo Freire, adopting ‘crop circles’ as data collection framework, in three stages: Construction of generating themes; encoding and decoding of the issues, and critical unveiling. These themes were identified: Problematization as a methodological option; application of the investigative methodology; challenges in the teaching-learning process, and factors that hinder or facilitate the teaching-learning process. This process enabled closer relations among the various participants and allowed discussions on aspects of the school teaching-learning process, affording a better understanding of this reality, allowing it to be re-contextualized with new possibilities, progress, and means to overcome.
Article
The article traces a first profile of the production and circulation of educational materials produced and distributed by municipal health surveillance offices in the State of Rio de Janeiro, Brazil, focusing on the food theme, in 2008-2010 period. For mapping, we consulted databases and health surveillance coordinator collections from the 92 municipalities in the state. The health surveillance teams received a letter of invitation to participate in the survey. They were asked to submit physical or scanned versions of their educational materials and to fill out a questionnaire concerning issues of interest to the research: Theme of the materials, year of production and circulation, circulation, institutional origin, forms of cooperation and circulation, justification for the production. Thirty coordinators responded, and only nine sent materials rated as relevant to the food theme. This made it clear that investments in this area are very low, despite its importance to public health. The analysis pointed out that most information in the materials had been written in a technical-scientific language the population is unlikely to understand as intended; that there are great differences in production resources, with high-and low-quality materials, that there is a circumstantial circulation effort that is subject to the administrative political process, and that there are recurrent cases of action discontinuity.
Article
The aim was to evaluate the level of performance of the teaching nurse in core competencies in adult education from the andragogical perspective. This descriptive, comparative, cross-sectional, quantitative study was carried out with 226 teacher nurses working at twenty undergraduate nursing courses. Descriptive statistics, nonparametric tests and the Minitab® 16 software were used. The population's age ranged, predominantly, from 46 to 55 years, they were mostly female, had graduated from public schools and attended specialization and master's degree courses; fewer than half held doctorates. The professors considered themselves below the level they should be at for adult education, distant from the ideal for the skills they sought to achieve, and stated they had more control to facilitate learning than to develop and manage adult education programs. It was concluded that the professors’ performance levels were homogeneous, with no significant differences when comparing the results with the population's characteristics.
Article
This article analyzes the relationship between work and subjectivity in the Family Health Strategy in the state of Amazonas, Brazil, from the perspective of the psychodynamics of work, pursuant to which work is what imposes demands, in addition to know-how, the engagement of the body and mobilization of intelligence, the ability to reflect, create, and invent. From there, it was proposed an analysis of those things that are invisible at work, based on the statements of 75 health professionals working in the Family Health Strategy at four municipalities in the state of Amazonas (Coari, Manacapuru, Parintins, and São Gabriel da Cachoeira), obtained via individual interviews, focus groups, and participant observation. Different types of significant labor content have been identified, i.e., the symbolic sense that it introduces in one's work activity, in addition to defensive strategies for the mediation of suffering, including the rationalization and the relationship of trust and cooperation found in the team. The Family Health Strategy workers in Amazonas showed they come up against unique issues in the provision of health services at these locations. Through this qualitative survey, we give voice to the workers, considering them as the main managers of their own work, allowing, through reflection, them to envision their potential to create change from their daily work.
Article
The aim of this paper is to discuss the transformations that have taken place in work, the demands of training, and new skills in the primary health policy, with particular emphasis on the impacts on the work of physicians in the family health units in Portugal. The qualitative survey was carried out by querying documentary sources: Decrees, laws, action plans, and reports on the policies and organizational structure in health facilities, adopting content analysis to process data. It recommends that the commitment to the renewal process entails new instituting movements, which empower the (re)construction of the medical identity, understood not only as individuation/identification, rather constituted as an ongoing process linked to personal identity, enabling the construction, deconstruction, and reconstruction of something that gives meaning to the work done. For work in health, we value a new professional profile provided with highly qualified, integrating, inseparably, theory, technical, practical, and social knowledge. ‘Service provision’ and ‘health care’ have a subjective and individual dimension; however, at the same time they are expressed in groups and populations, and are guided by cultural values and clinical standards recognized by science.
Article
The current discussion on education and health has shown the need for greater integration between health services and the academy. The National Policy of Permanent Health Education proposed the dissemination of pedagogical capacity in the National Health System, so that the public health system would become a teaching and learning space while one performs his or her work. The goal was to get to know the process of integration between education and health services in Primary Health Care, from the actions of professors in the training process of students in the undergraduate courses in health care at the Federal University Rio Grande do Norte. Semi-structured interviews and direct observation were the techniques chosen, and data analysis, based on the hermeneutic-dialectic approach, showed that the professor's performance is an important strategy to facilitate integration between teaching and service. The conclusion points to the realization that the professionals involved in teaching are educated while they educate, and that the educational process is permeated by heterogeneous knowledge and experience, a highly favorable factor for the training of students and professionals.
Article
Research shows that, today, spirituality is an important aspect of human life. The achievements made by the biomechanical model of teaching and practice of medicine were unable to overshadow the role that spirituality plays in the health-disease process. Following a trend occurring in medical schools throughout the world, the authors introduced at the Federal University of São Paulo the optional Spirituality and Medicine class, aimed at medical and nursing students and to promote the recognition of the spiritual dimension of the patient and, thus, afford more humane care. After four years of the course being offered, a qualitative study was carried out to determine the profile of the students who chose to take the class, their perception concerning the spirituality and health topic, and the importance attributed to the course when it comes to their personal, professional, and humanistic development. The texts produced by the students during the course were the main source of data. The data were interpreted through a hermeneutic phenomenology focus and highlighted the following issues: The search for the meaning of life; independence of views about God and spirituality and the importance given to the discipline; Spirituality and humanization, and spirituality, self-care and self-knowledge.
Article
Interdisciplinarity is presented as a challenge and a need of the health sector, with a view to redirect the health care model. This study aimed to unveil the understanding the coordinators of undergraduate programs in Pharmacy in Midwestern Brazil have of interdisciplinarity in training pharmacists. A qualitative approach was used in the methodological fundamentals of the phenomenology, pursuant to the mode of the phenomenon. A total of 16 testimonials were collected between June 2011 and April 2012, which were then submitted to description, reduction, and phenomenological interpretation in order to reach knowledge on the phenomenon studied. Results were built based on ideographic and nomothetic analyses of the testimonials, from which 12 topics grouped into three main categories emerged: curriculum interdisciplinary, interdisciplinary in training the pharmacists, and interdisciplinarity in the pharmacist's role in the health system. Some of the results that were obtained point to the need to better understand how interdisciplinary converses with the Pharmacy curriculum and overcoming technical and political obstacles that prevent the practice of effective interdisciplinary in the training of pharmacists, including the lack of training for faculty and competition for power among areas.
Article
This study aimed to understand the relationship between oral health technicians and dental surgeons in work and the factors that may promote or hinder this relationship. To analyze the perception oral health technicians have regarding possible agreements and disagreements in their working relationship with dental surgeons, a focus group was held with eight of those workers from the National Health System working at the municipalities encompassed by the Vitória metro region, in Espírito Santo, Brazil. The thematic content analysis revealed three categories: Profile and labor market; Working and infrastructure conditions, and Vocational training, work processes, and interpersonal relationships. The complexity of the work was shown, within the field of interests, power and resistance, involving both the technicians and dental surgeons, in a behavior generator matrix. These workers' training system, the infrastructure, working conditions, and the professionals' profile also influence the oral health team's work process heavily. Communication was seen as a mediator in this, building new encounters. It is considered that there are many barriers to the relationship between oral health care technicians and dental surgeons at work, and mediation is seen to be possible through communication, building new meeting grounds, and representing alternatives to the desecration of what has been instituted, overcoming the challenges in the power relations.
Article
Integration between teaching and service affords better training to teachers, students, and to health service professionals, and, as such, ensures quality actions and services are provided to the population. This study aimed to refocus the training of professionals taking courses at the Health Sciences Center at Sagrado Coração University, in Bauru, state of São Paulo, Brazil, in line with the National Reorientation Program for Vocational Training in Health II. These courses' curricula were reorganized, including adjustments made to teaching in accordance with social and labor market demands and the incorporation of new educational technologies. Based on this analysis, we created a group of subjects common to all health courses taught at the institution, i.e., an identity that characterizes the profile of the professional graduating from the Health Sciences Center at Sagrado Coração University was developed. The results were the training of a professional competent to act as a manager and multiplier of the NHS principles, the improvement of the training process of the professionals in service, and the promotion of multidisciplinary work. For users, meanwhile, the results translate in improvements in the quality of the services received.
Ensaio
The April 25, 1974 military coup in Portugal required workers and intermediate sectors of society to come into the scene. There is a historical connection between the attaining of social rights and the development of the workers’ control in the revolutionary process from February 1975. The Government then implemented a series of social measures intended to prevent the uprising and that, broadly speaking, would build what has been called the social State, i.e., the allocation of resources for work through the social functions of the State (education, health, social security, leisure, sports, subsidized public transport, subsidized income, etc.), against, in fact, the orders of the military leadership itself, which had put an end to the dictatorship, the Armed Forces Movement. From March 1975, with the widespread establishment of worker and resident councils, the beginning of the agrarian reform, and the questioning of private property (a process taking place through the action of workers, often fighting against dismissals or disinvestments and the abandonment of companies, and not as a strategy of its main policy guidelines, the Portuguese Communist Party), the Portuguese revolution took a qualitative leap, becoming a ‘Soviet’-type revolutionary situation.
Interview
Domingos Sávio do Nascimento Alves is a neurologist and sanitarian, specialized in Social Psychiatry through the Sergio Arouca National School of Public Health, of the Oswaldo Cruz Foundation (ENSP/Fiocruz). Since the 1980s, as a physician, and twice as a director of the Juliano Moreira Colony, and during the 1990s, as the coordinator of the Ministry of Health's Mental Health Technical Area, he has been one of the main actors in the Psychiatric Reformation process in Brazil. From the 1990s, in addition to serving as an occasional consultant for the Ministry of Health, he also served as one of the directors and as the last chairman of the Franco Basaglia Institute, a Rio de Janeiro non-governmental organization that advocated the rights of people with mental disorders. In this interview,1 Domingos addresses the current, conflicting situation of the Minister of Health's appointment2 of an undeniable critic of the reformation, and makes a brief analysis of the progress that has been made and of the challenges of this process.