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
This article presents the results of a survey that examined the experiences of professionals working in providing foster care at basic health units. The assumption was that the neoliberal logic is increasingly present in various social fields, including public health services, influencing their labor relations and organization and, thus, possibly hindering the practice of fostering the Ministry of Health recommends. Five reflexive interviews were carried out among professionals working with fostering at basic health units. The interviews were submitted to content analysis. The results indicate that formal employment, the need for flexibility, and the lack of resources are indicative aspects of precarious working conditions. Coupled with the prevalence of the doctor-centered care concept and over-medicalization, this undermines the fostering practice the Ministry of Health recommends. The interviewees showed they are aware of these contradictions in their daily work, but are powerless to change the situation. These aspects make up the subjective precariousness that these professionals are submitted to and generate mental strain that can result in suffering and illness.
Article
This qualitative exploratory study focused on the narrative of professionals working at Childhood and Adolescent Psychosocial Care Centers. The goal was to describe and analyze the backgrounds of the staff of these centers and their relationship to the process of insertion and practice in this field, as well as to understand how these backgrounds influence these professionals’ everyday work. A questionnaire with open questions and narrative interviews were used. The total study population comprised eight workers from different professional categories working at two childhood and adolescent psychosocial care centers in the city of São Paulo, state of São Paulo, Brazil, one managed directly by the city, while the other by a social health organization. It was shown that politics is not often cited by the organization's employees, while for city professionals is an important part of the meaning of their work. All respondents bear similarities, among which the assimilation of the treatment offered to children based on adult rules, having worked at hospitals and clinics, and the professional's focus on the disease, not the subject of the suffering. Captive of these representations, these professionals experience competencies, skills, and thoughts that give rise to improvisation and anguish.
Article
Throughout history, Psychiatry developed psychological theories and healing models that required specific organizational settings to be implemented. With the reform movements and the emergence of the field of psychosocial care, it was necessary to rethink human resources. The purpose of this study is to present the construction of the figure of the assistant in mental health in the historical context of the Brazilian psychiatric reform. The study was conducted from the perspective of the Oral History of the mental health policy in the city of Quixadá, state of Ceará, Brazil, due to its contributions related to organizing work in psychosocial care centers. Based on the results attained through a review of the literature, rules, documents and interviews, the creation of the figure of assistant in mental health, a job done by elementary and secondary level workers is considered a contribution. According to interviewees, this position favored the reduction of the stigma related to the mentally ill; the internal decrease in hierarchy among professionals; the establishment of all workers as care professionals, and closer links and more satisfaction with the job and other workers.
Article
This study aimed to investigate the view nursing professionals have of moral harassment and how to identify these situations as experienced by the professionals in this area, as well as their causes and consequences for these workers’ health. This is a qualitative exploratory research study in which 15 nursing professionals working at family health facilities in the city of João Pessoa, state of Paraíba, Brazil took part. Data collection took place between April and May 2013 by means of a recorded interview. The data were analyzed using the content analysis technique. The analysis of the material revealed three categories: Moral harassment: Concept and characteristics from the nursing professionals’ viewpoint; Moral harassment behaviors experienced by nursing professionals, and Consequences of the moral harassment. We conclude that moral harassment is widespread among nurses and nursing technicians, although some professionals understand the concept of this practice, and the prevalence of the descending type is notorious.
Article
This study aimed to determine if the views the staff working at shelters for youth have about the hurdles they face at work are related to deficient selection, capacity building and training. A qualitative survey was carried out at two shelters located in Rio de Janeiro, Brazil, between 2008 and 2010. The 47 interviews conducted with shelter professionals and field observations at group workshops were transcribed. The analysis of the data identified hot spots that can lead to violence, interfere in task management and worsen psychosocial risks, compromising the mental health of both caregivers and of the youth being assisted. Their accounts were compared with the recommendations featured in the Technical Guidelines for foster care for children and adolescents, and we concluded that although this document allows the mapping of the actions to be taken by the professionals and provides guidance on the best ways to accomplish the fostering task, it needs to be assimilated and experienced in order to reduce the gap between what is prescribed and the actual reality.
Article
This article is a prospective, descriptive study using a qualitative approach that investigated, through focus groups, the views that the employees of a Psychosocial Care Center for Children and Adolescents, CAPSi, in the interior of the state of Rio Grande do Sul, Brazil, have on health and mental health. The theoretical framework is based on Christophe Dejours’ work psychodynamics, on the policies and guidelines of the Ministry of Health, and on the concepts of health and mental health proposed by the World Health Organization. The material was analyzed using theme coding based on approach made of the structure. The main results include the ability to resolve conflict situations and to undertake some bodily activity as strategies to maintain health and mental health, in addition to the integrated understanding of health, including physical, psychological, and social aspects.
Article
Professors are exposed to increased tension at work on account of the fragmentation of their activities and of the responsibilities demanded of them without, in many cases, their having the conditions they need in order to respond adequately. Such a situation may represent stressful conditions, which increase the risk of mental disorders. We investigated the association between common mental disorders and stress factors at work among professors teaching in nine health courses at a private university in Minas Gerais, Brazil. The dependent variable was the presence of mental disorders, as measured by General Health Questionnaire 12. Stress factors at work were evaluated based on the Effort-Reward and Excessive Commitment model. The other variables were sociodemographic, occupational background, behavioral, and related to general health. The data were submitted to descriptive analyses, bivariate analyses, and Poisson regression. A total of 175 professors participated (80.0%), of whom 19.5% had mental disorders. These disorders were more prevalent among professors making the most effort at work (PR= 1.8, 95% CI= 1.01-3.46) and less prevalent among those with higher quality of life in their physical domain (PR= 0.95, 95% CI= 0.93 to 0.97). It can be concluded that there is a considerable prevalence of common mental disorders among university professors, which were higher among those who put more effort into their work and had lower quality of life in their physical domains.
Article
The article presents the different positions the current Brazilian public policies have on alcohol and drug abuse and discusses the possible effects such differences could have on the healthcare worker's performance. It is the outcome of documentary research on these policies, such as ordinances, laws, and decrees from 1938 to those currently in effect. We chose to list them chronologically, considering the two main political positions: 1. Focus on public security and justice; 2. focus on public health. We found that in this period there was a clear attempt to make a paradigm shift in order to include use prevention and treatment. However, the policies and the common sense still bear strong signs of idealistic views of a world free of drugs which are derived from moralistic, intolerant, and authoritarian concepts such as the war on drugs, repression, and reductions in supply. It is in this context that public health professionals, especially those working in psychosocial alcohol and drug abuse care centers, face the challenge and experience the subjective effects of everyday work at the face of so many differences and contradictions.
Article
The environmental characteristics and the way work is organized in specialized health centers can lead to stressful situations and have negative effects on the workers’ health. The aim of the study was to evaluate the mental health of health professionals working at the specialized network of Aracaju, state of Sergipe, Brazil, and situations of occupational stress based on the effort-reward model. It is a cross-sectional study conducted in 2011 among 94 health professionals working at two specialized care centers. A questionnaire containing demographic and economic variables, the situation and working environment, occupational stress assessments (using Effort-Reward Imbalance) and a Self-Reporting Questionnaire were used to measure common mental disorders. There was a high prevalence of common mental disorders (50.6%), which were more frequent among speech therapists, psychologists, occupational therapists and physical therapists, and among those who reported being dissatisfied with their pay and work conditions. All professionals who mentioned imbalance between their efforts and their rewards at work presented common mental disorders. In sum, working characteristics unfavorable to the professionals and to the performance of their duties were identified, as was a high prevalence of common mental disorders. Programs aimed at the protection, enhancement and promotion of the workers’ health must be implemented in order to improve their quality of life at work.
Article
The article addresses the phenomenon of stress and its relationship with the worker and his system. The methodology used was exploratory research with a qualitative approach. A review of the literature was conducted for the years ranging from 2001 to 2012, searching for articles published in Portuguese and English in the Virtual Health Library, SciELO, and MEDLINE databases. These descriptors were used: occupational health, occupational stress, psychological stress, work, intervention and worker health surveillance. After reading the abstracts of 362 articles that were found, 18 were selected and submitted to content analysis. The need to identify, remedy or mitigate the factors that cause this phenomenon was emphasized in order for health promotion activities to be proposed within the workplace aiming to turn it into a source of pleasure for the worker.
Ensaio
This paper aims to contribute with analytical reflections on awareness and alienation in the context of the Brazilian psychiatric reform movement, pointing out the peculiarities of this process in a capitalist society. It seeks to present initial elements that problematize the political and social direction that is being built and consolidated by the psychiatric reform movement, which does not rely on transforming societal order and, as such, is limited to attaining political emancipation. It starts with the hypothesis that it is essential to locate the importance and contribution of the dialectical historical materialism in analyzing not only the context, but to guide it in everyday actions and in the search for critical awareness in order to build a new social order.