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
Official documents intended to reorient the training provided to health professionals in Brazil were used as a source to a survey conducted to determine what such documents report as innovative educational principles. This survey aimed to clarify the connection between these principles and a certain educational line, problematizing the theoretical and methodological origins of the current framework for vocational education at the undergraduate level in the area. The reorientation of health training is expressed in different official initiatives: the National Curriculum Guidelines for undergraduate courses, the National Policy for Continuing Education in the Health, and in the Pro-Health program. The educational principles widely cited in the documents were analyzed: meaningful learning, the facilitator teacher, learning to learn, and active methodologies. Based on the study of the Brazilian theoretical production on the theoretical and practical educational lines, we compared the educational principles from those documents. In conclusion, the educational principles presented are connected to theoretical and methodological benchmarks ofnon-directive pedagogies, which, when contextualized, are inserted, temporally, into in the early years of the twentieth century, focusing on the proposals for child education.
Article
This is an exploratory and descriptive study that aimed to evaluate the quality standards in health in 13 Brazilian public neonatal and pediatric intensive care units in periods prior (situational diagnosis) and subsequent (reassessment) to the development of the Program for Support for the Institutional Development of the Unified Health System. A diagnostic assessment tool was prepared based on decree n. 3432, of August 12, 1998. Training was planned based on the situational diagnosis. Ten assessment criteria were measured and, in the diagnostic phase, five had a 40 percent compliance rate. The training program was structured with on-the-job training (12 hours), which added up to 290 hours, and on a course with guided visits (30 hours), totaling 810 man hours and with an average of 180 man hours. During the reassessment, it was noted that there was an increase in nine of the ten criteria evaluated. The methodology that was adopted enabled the development of an educational program based on situational analysis, with satisfactory training indicators, considering the peculiarity of the public health sector. The participation of professionals from the hospital of excellence was relevant to the achievement of the results, as this provided space for discussion and for the exchange of experiences.
Article
This article presents reflections based on the experience and on research conducted with peasant women currently tied to the Peasant Women Movement and also on the interaction with different groups, movements, coordinations, and collective popular health education practices in operation in all Brazilian regions. We identified the base of the context and of everyday life, of the resistance and struggle of these women peasants, their interfaces with the health and illness processes, as well as the identification of the political contributions and educational practices that emerge in the popular health care, promotion and educational practices of these social players.
Article
In several countries, and in Brazil in particular, the adoption of primary care as a factor to reorder health systems has been consolidated by highlighting the community worker, who is called a community health agent in the Sistema Único de Saúde (SUS, Unified Health System). Understanding that this fact has ancient roots, this paper, with a historical perspective, is developed based on a review of documents and literature, guided by the mapping of projects put into dispute. In the analysis, tensions that permeated the configuration of healthcare proposals with these characteristics were distinguished: continuous action and linkage to the territory; health education as a relevant strategy, and the connection between health services and local populations, mediated by a worker who has this role as his or her primary social role. Also analyzed were features that constitute the work of the community health worker in the SUS, which represent challenges to the qualifications of these workers, having the rights associated with the work, and the complexity of the healthcare work and its technical and political role as a parameter.
Article
This study assesses on the early training of nurses and its relationship with the ethical-humanistic paradigm, especially to interpersonal relationships. A descriptive-exploratory qualitative research approach was used. The subjects were graduates and professors in nursing in the city of Curitiba, southern Brazil. The data were collected in 2009, using documentary analysis techniques for the undergraduate nursing program's educational project, the application of a questionnaire among graduates of the college of nursing, and semi-structured interviews conducted among nursing professors at a private college. The data collected were subjected to content analysis, from which three categories emerged: totality/multidimensionality; interdisciplinarity/disciplinarity/dichotomy between theory and practice, interpersonal relations/ interpersonal skills. The results show that both faculty and students realize that the academic training provided is still focused on technical and scientific references, but with a real intent to provide training in skills aimed at human relations. This study allowed the influence of the ethical and humanistic paradigm proposed by the curricular guidelines in the nursing education process to be noted, and reinforced the need for new possibilities to develop ideas capable of serving as the base for educational principles aimed at the totality of being in training and of the person assisted by a health professional.
Article
This article focuses on understanding the outsourcing of teaching in private higher education, carried out by means of labor cooperatives, under the light of the social responsibility of higher education. It conceptualizes social responsibility by focusing on two approaches: normative, which is legal in nature, and the ethical, which is directed to human development. The author examines the ethical coherence there must be in the university management process when addressing the requirements of maximizing resources aimed at gains in competitiveness, with the principles and values that should guide the educational endeavors within a scenario marked by the requirements and demands of the State and of society for the increased social responsibility of higher education, especially in the private sector.
Article
This study assesses how popular organizations discuss public health policies based on the analysis of popular participation and on the construction of citizenship in the city of Florianópolis, southern Brazil. It was carried out with social control institutions and organizations. The methodological strategy used was qualitative surveys, with the collective subject discourse as technical analysis. The discourses show that the subjects have an understanding of health with elements that refer to a biological concept, but also advance to an expanded concept. It was observed that citizenship is not limited merely to ensuring rights; rather it extends to the struggle to achieve it. In this sense, participation emerges as a duty to be exercised collectively.
Article
This study discusses how the professionals on the family health team interpret and represent the health education and educational practice they perform. The subjects (n=248) - physicians, nurses, nurse aides, and community health workers from 20 basic health units in Belo Horizonte (southeastern Brazil) - were interviewed using the free recall technique and the theory of social representations. Subjects were asked to verbalize five words that came to their minds immediately when thinking about health education, rating them as positive or negative. The Evoc software was used and the simple frequency of occurrence, the weighted average of occurrence based on the order of recall, and the weighted average of all the terms mentioned were calculated. The four decimal frame comprising the central core and contrast and peripheral elements of representation was constructed. Physicians and nurses shared representational content among themselves, expressing similar social representations when presenting the possible central core of 'empowerment' and 'prevention.' Nursing aides and community health workers resemble each other through the possible central elements of 'education' and 'prevention.' The focus is on the conveyance of guidelines aimed at persuading individuals to adopt healthy lifestyles.
Article
The aim of this study was to understand the views and approaches community caregivers use to provide care to children aged fewer than three years. This is an exploratory, descriptive study with qualitative data analysis. Study subjects were defined by mapping possible community caregivers assisting children under three years old. Semi structured interviews were conducted among 18 community caregivers, in their homes. A thematic categorial data analysis was performed, which allowed two categories to be identified: care from the caregiver's viewpoint and ways of caring. The first category showed that caring for children aged fewer than three years is a task that requires responsibility and commitment. The second category showed that caregivers prioritize the children's nutrition, hygiene and safety, and that they consider playing important to drive the kids' learning and socialization process. This study showed the need to provide more opportunities for dialog among mothers, fathers, other family members, caregivers, and community professionals who deal with childhood with the aim to increase knowledge about child care.
Review
Review
Ensaio
This essay discusses the new scenarios for the training of health professionals for the Sistema Único de Saúde (SUS, Unified Health System) and how they are related the proposals made in the report entitled "Health Professionals for a New Century: Transforming Education to Strengthen Health Systems in an Interdependent World". It was drafted by an independent committee made up of 18 professionals and academics from several countries, led by physicians and professors Julio Frenk and Lincoln Chen and created in January 2010, in the United States, by the health sector to honor the centennial of the Flexner Report. The purpose of the report was to lay down recommendations for the adoption of educational and institutional innovations aimed at training a new generation of professionals in order for them to be best equipped to deal with the area's present and future challenges in a comprehensive perspective of health promotion. The discussion resulted in the perception that, despite governmental policies and programs created in Brazil since 2001 and of timely institutional initiatives, health area professionals still get training that is strongly guided by a hospital-centric educational conception, categorizes illnesses based on biological criteria, and dissociates clinic practice and politics, something that is not suitable to help strengthen the SUS.
Interview
The psychoanalyst Christian Ingo Lenz Dunker is a lecturer professor at the Institute of Psychology of the University of São Paulo (USP). A Jaboti Award Winner in the Psychology and Psychoanalysis category with the book titled Estrutura e constituição da clínica psicanalítica: uma arqueologia das práticas de cura, psicoterapia e tratamento (Structure and constitution of the psychoanalytic clinic: an archeology of the practices of cure, psychotherapy and treatment) (Annablume, 2011), he has done important work in these two areas, publishing articles and a section in the Mente e Cérebro and Cult magazines. In this interview,1 Dunker discusses issues such as the current moment of psychoanalysis, its interface with dialectical thinking, the issue of ideology, as well as other topics that contribute to understanding the current malaise, especially in countries where there is hyper late capitalism such as Brazil.
Experience Report
The Brazilian initiatives that propose to contribute to redirecting training and the care model led us to describe the experience of deploying of the Education for Work Program (PET) - Health/Health Surveillance (HS) in Sobral, northeastern Brazil. This is a descriptive, experience-reporting study, experienced by nursing students at the Vale do Acaraú State University (UVA) and medicine and dentistry students at the Federal University of Ceará (UFC), tutors, and PET-Health/HS preceptors. The information was recorded by the tutors and preceptors during the activities undertaken ever since the program was deployed (July 2010). The work process performed under PET-Health/HS comprises three intercommunicating structural axes, consisting of theoretical and conceptual experiences, experiences in service, and research experiences. To ensure the interface between teaching and service and integration between health surveillance and primary care, we built an educational 'technology' we call a permanent education in health surveillance technology. The experience afforded the students a broader view about the population's health conditions and on the importance of understanding local issues for health surveillance in order to provide qualified care targeted at the reality at each territory.