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
Given the scarcity of studies on workforce turnover rates in the public health care industry in Brazil, the purpose of this study was to assess this rate in the municipal health care network of Belo Horizonte, Minas Gerais. Based on the acknowledged inclusion of a turnover rate parameter for the hospital area in the literature and on the frequency distribution noticed in this study, a new parameter for the outpatient network and values for the cutoff points were made formal to classify turnover on the qualiquantitative levels. These values are the base for the analysis of the turnover rate concerning these variables: employment contracts, sanitary districts, health care services, professional categories and primary and secondary health care. The overall turnover rate in the municipal network in the studied period (July 2008 to June 2009) was 8.35% which, even considering the difficulties faced to build the database which derived from distinct sources of information has internal validity in statistical terms.
Article
The Brazilian experience of training and working with Community Health Workers was the basis for the implementation of the Community Health Workers Program by the Provincial Health Directorate in Luanda, Angola. This article reports on an exploratory visit carried out in 2009 to the municipalities of Cacuaco, Cazenga, Kilamba-Kiaxi, Samba, Sambizanga and Viana, with a view to understanding the health perceptions and practices of community health workers in Angola. This visit aimed to gather information that would engender a discussion on technical cooperation between Brazilian institutions and the coordination of the Program of Community Health Workers to strengthen the professional education of the Program. We have found similarities and differences between the Angolan experience and the Brazilian one, and we believe that the main challenges to be faced in Angola are the institutionalization of the program, the regularization of employment relationships and the professional qualifications of the community health workers.
Article
In this article, we aim to report on and analyze the relationship between health and work of small farmers of the Landless Workers Movement (MST). So far as the methodology is concerned, we used participatory research and the basics of popular education. The study allowed for an understanding of health and work based on the workers' narratives, stories relating to collective struggles against exclusion and violence in the countryside. Important aspects related to this population group as were discovered, such as, for example, the sense of conquest of land ownership, the conflicts arising from 'activism,' and the differences of gender and generations. From the reports that were provided, we also examined the accidents and risks related to work in the rural settlement, particularly exposure to pesticides. It was also found that solidarity and cooperation are important values, basic elements for new relations and a distinctive mode of social organization of collective.
Article
This article presents an integrative review about studies that address the relationships between health professionals and users in health care practices. It aimed to identify aspects that were researched on the daily life of the services concerning such relationships. Data were collected from the Lilacs and Pubmed databases based on these descriptors: user embracement; professionalfamily relations; professionalpatient relations; humanization of the care; and the bonding word associated to the Single Health System descriptor. Two hundred and ninety studies, published from 1990 to 2010, were selected. Through thematic analyses, five meaning cores were created: the relevance of the confidence in the professionaluser relationship; feelings and senses in the health care practice; the importance of communications in health care services; ways to organize health care practices and (de)colonialism. It was found that relationships established in health care practices have a transformative dimension. However, the challenge to humanize health care services remains. Nursing stands out in the production of knowledge on such theme.
Article
The purpose of this study was to understand the contributions made by the 'nurse being' in the daily life of the 'manager being' in the hospital context. This is a descriptive, exploratory and qualitative study. The subjects of the study were nine nurses holding managerial positions in three hospitals. The data were collected through semistructured interviews and submitted to content analyses. It was shown that the academic background in nursing gave the nurses the knowledge and the skills for the professional role they were to play and for the adoption of an administrative vision of their work. The 'nurse being' experience is described as one that facilitates the managerial roles. Deficiencies were noted in the educational background relating to the administrative roles. It can thus be concluded that undergraduate nursing courses must be reoriented, seeking to train professionals who are in tune with the quick pace of change in modern society.
Article
*
Article
This article attempts to rescue [resume] the positivity of the concept of risk as a tool to analyze human activity. To achieve this, an analysis is made of the use of the concept of risk during the history of the Aids epidemic, seeking to show the reasons that led it to be partially overcome with the use of the concept of vulnerability, which allows one to learn the social dynamics of this syndrome. An analysis is also made of how the concept of risk is learned in the public health field, showing the positive dimensions of this concept, which is frequently ignored in its use. Based on the concept of health of Canguilhem, one of the main pillars to elucidate this positive dimension on risk, and by analyzing the concept of the society of risk, in which this concept is learned in modernity as a mechanism of power and as a strategy to govern the populations, one arrives at the explanation provided by Nouroudine regarding the positive dimension of risk as one focused on activity. The article concludes suggesting that using this positive dimension of risk can assist both in understanding and in intervening with several social phenomena that the field of public health has difficulties apprehending.
Article
The National Policy for Permanent Education in Health (Pneps) aims at achieving changes in pedagogical and health practices and, thus, the improvement of the professionals, emphasizing the link between social control, management, health care and schools. This study aims at examining the experiences of permanent education in Brazilian health services according to Pneps, the areas and the actors involved, the methodology used and the funding. It is characterized as an integrative study and proposes to critically analyze the stages of the studies that were found. Methodology: survey of the literature at Bireme, Capes, and BDTD for the period ranging from 2004 to 2010. The experiences published are in accordance with Pnps in some aspects and at different periods of time, demonstrating that it is essential to debate work practices, bringing together the four components of training in health: management, attention, social control and education. This study may not only encourage the publication of other experiences, but also turn health services into a space for production of knowledge.
Article
Community health agents (CHAs) are considered important for the implementation of the SUS (Sistema Único de Saúde/Single Health System), especially for reinforcing primary health care. Their work may lead to situations that generate realization and/or experiences that are determining for motivation. This study aims to characterize the labor process of the CHAs in an area of Teresina, State of Piauí, Brazil, describing their perceptions about work and their motivations. Thirty-one CHAs took part in the study. This is an exploratory and descriptive qualitative review. In order to collect data, we used the focus group method. Six focus groups were held, one per family health team belonging to the territory. The discussions were based on three guiding questions, recorded in MP4, and then transcribed and categorized. Five categories were created to present and discuss the results. It was noticed that the CHAs have an understanding of the importance of their work, but they feel discouraged for not getting support and recognition, in certain situations, from the community, the team itself, and from the city's management. There is a desire for the appreciation of their work.
Ensaio
This essay analyzes the Integrative and Complementary Practices (PICs) and seeks to show the germinal (and potential) experiences of training professionals in this area with a profile to work in the Single Health System (SUS). The state of the art in courses offered in the PIC area is presented seeking their interface with Collective Health. Authors writing about the PIC areas and the Ministry of Health's National Policy on Integrative and Complementary Practices were used. A conceptual survey was carried out on courses that offer such practices and contacts made with associations and coordinators of courses taught on them. It can be stated that the PICs can be considered revitalization strategies for the health system and can change the biologizing and medicalizing standard to care for and promote health. However, the health professionals' lack of political and technical preparedness to work with PICs in the SUS is noticeable. Thus, it is considered essential to form an educational process that trains PIC professionals in tune with the SUS guidelines and with the principles of Collective Health.