Processo de trabalho na estratégia saúde da família: potencialidades e fragilidades da atuação do enfermeiro

The present study aims to analyze the nurse s work process at Family Health Strategy, considering its basic elements and dynamic, and searching to identify aspects that may constitute strengths and weaknesses in its development. This is an analytical case study, with qualitative approach and theoretical-conceptual mark grounded in Dialectic Hermeneutics. Empirical research fields were the Family Health Units of Natal, RN, Brazil. The subjects are nurses working in this Strategy. Data collection was conducted through semi-structured individual interviews combined with field observation. The research was initiated after approval by the Ethics Committee of Universidade Federal do Rio Grande do Norte, according to the guidelines and rules for research involving humans (Resolution 466/12), ensuring proper ethical precepts. The project was approved by register number 398.929, CAAE 19588813.7.0000.5537. From the 9 interviewed nurses, 8 were female and 1 male, average age of 52 years, average graduation time of 27 years and average time they stayed at the same Family Health territory of 7 years. It was found that it is up to the professional nurse in the Family Health care the important role of taking care of human beings in their life, family and community contexts, producing conditions to meet their needs through therapeutic act in health, using for such purpose both materials and immaterial instruments. It was possible to relate aspects that characterize strengths and weaknesses in the work process of nurses in the ESF, according to the speech of the interviewed workers, including the meanings and contradictions. Among the potentialities observed, it was possible to highlight the wide role of the nurse at Family Health; the perception of nurses about teamwork; the relative autonomy of nurses; the commitment of professionals to work; Humanization as a technology; the presence of other agents at work, such as directors and officers at the primary health units; the professional s experience time and contract type in the case studied. As weaknesses in the work process of nurses at Family Health Strategy, were highlighted the limited skills of the workforce; the difficulty in 10 identifying specific limits of the work of nurses in this scenario; the disturbances that occur in the process, the existing gaps in multiprofessional teams; Structural deficits of the units in the studied case, the low coverage of the Family Health in the county, and the political vulnerability of the work conditions. It is considered necessary to understand the dilemmas experienced in everyday life of nurses at Family Health Strategy as part of multiprofessional teams, facing actual achievement of changes in work processes necessary for the reorientation of health care in Brazil. In accordance, it is necessary to promote proper working conditions and welfare of labor agents which are protagonists the work at the United Health System

Saúde psíquica e condições de trabalho dos profissionais de saúde nos hospitais da Universidade Federal do Rio Grande do Norte

A tese se propôs a avaliar a relação entre saúde psíquica e condições de trabalho em dois hospitais da Universidade Federal do Rio Grande do Norte, a saber: Hospital Universitário Onofre Lopes e Hospital Universitário Ana Bezerra. Adotou como ponto de partida epistemológico a abordagem psicossociológica, considerando que a compreensão sócio-histórica do contexto é indispensável para entender os fenômenos em análise. As condições de trabalho e a saúde psíquica foram abordadas interdisciplinarmente, fundamentando a construção de um modelo compreensivo de saúde psíquica que orientou a investigação. O caminho metodológico utilizado foi a pesquisação. Essa foi desenvolvida, utilizando técnicas como análise documental, observação participante, entrevistas não estruturadas, grupo focal e aplicação de um protocolo de pesquisa composto pelo questionário de condições de trabalho, pelo Questionário de Saúde Geral (QSG-60), pela Escala de Bem-Estar Afetivo no Trabalho (JAWS-12) e por questões sociodemográficas. A análise dos resultados mostrou que os escores sintomáticos de saúde psíquica variam por hospitais e que a saúde psíquica sofre influência das condições de trabalho, sobretudo em aspectos referentes a três dimensões: condições físicas e materiais; processos e características do trabalho e o ambiente sociogerencial. Em referência à primeira dessas dimensões, destacaram-se a exposição aos riscos psicobiológicos e de acidentes, bem como as exigências de esforço físico. Na segunda dimensão, a complexidade das atividades e a responsabilidade implicada nas mesmas. E, na última, os fatores de organização da atividade, violência e ambiente conflitivo. Como a relação do indivíduo com seu contexto é dialética, os resultados encontrados corroboraram que quanto mais as condições de trabalho são desfavoráveis, maior a afetação da saúde psíquica e dos afetos com relação ao trabalho, repercutindo novamente no ambiente de trabalho. Portanto, ações de melhoria das condições de trabalho precisam ser estabelecidas para resultar, no efeito inverso, proporcionando o aumento dos afetos positivos e a redução dos sintomas psíquicos

Trabalho e saúde na sociedade capitalista: uma relação inversamente proporciona

It is a dissertation which has the Area of Concentration: Social Services, Vocational Training, Labour and Social Protection. Research Line: Social Services, Labor, Social Protection and Citizenship. Brings an approach to health and worker safety, approached on the organization of work in their processes of worker exploitation, analyzed from the critical perspective and all. Its central objective of uncovering how the organization of work affects the health of their workers, considering the working process in the capitalist mode of production, the health-disease relationship. Displays the worker, as determined by the work process, emphasizing, along the lines of capitalism, the consequences for the physical well-being, mental and social workers. To this end, we make a documentary and bibliographic research, whose point of analysis is based on the perspective of the centrality of work, recovering their sense of ontological Marx, through which the transformations are discussed in the working world, listed based on context productive restructuring of capital, which occurs along the imperialist stage of capitalist mode of production. It is problematized, though, worker health, analyzed from the wider definition of health as a field of public health, considering the work process in health-disease relationship. Finally, the research developed raised between 2006 and 2010, the Graduate Programs UFRN that address the range of issues studied in this dissertation. The scientific outputs are problematized as a way to reveal the theoretical trends (critical or conservative) which facilitate the thematic area

Percepções das relações entre trabalho remunerado e trabalho voluntário: um estudo com voluntários da pastoral da criança

O trabalho é uma atividade de fundamental importância na vida do homem porque é uma condição essencial para sua existência social. Ao longo do tempo o trabalho teve diversas definições e significados, mas na atualidade pode-se dizer que ele sintetiza e satisfaz três necessidades essenciais da natureza humana, a necessidade de subsistir (função econômica), a de criar (função psicológica) e a de colaborar (função social). Nesse contexto a presente pesquisa objetivou compreender as relações estabelecidas entre os trabalhos remunerado e voluntário, na perspectiva de identificar os aspectos convergentes e divergentes dessas atividades, que possam explicar a permanência dos sujeitos nas duas dimensões laborais e ao mesmo tempo entender qual a importância e reflexo que ambas as atividades têm na vida dos entrevistados. Como instrumento de coleta de dados foi utilizado a entrevista semi-estruturada do tipo focalizada. Foram entrevistados nove líderes da Pastoral da Criança no mês de dezembro de 2009 na cidade de Natal/RN. Os dados foram interpretados à luz da análise de conteúdo, proposta por Bardin. Os principais resultados encontrados quanto aos aspectos convergentes do trabalho remunerado foram a importância do salário para prover a sobrevivência, convivência com as pessoas e troca de experiência além do valor do trabalho para manter a dignidade do homem. Os pontos divergentes enquadraram: trabalho como obrigação, competitividade no ambiente laboral e baixa remuneração. Quanto ao trabalho voluntário, os aspectos convergentes emergidos foram a realização pessoal, a solidariedade, o envolvimento com a causa da Pastoral, valorização das coisas que possui diante de outras realidades mais difíceis, reconhecimento e prestígio dos voluntários pelas famílias assistidas, e por fim a visão do trabalho voluntário como complementação da vida. Com relação aos pontos divergentes foram citados a falta de comprometimento de alguns voluntários, bem como a necessidade de adesão de novas pessoas à este tipo de trabalho, limitação de querer fazer mais e não poder, exigências do público assistido e imagem distorcida da missão da Pastoral da Criança por parte das famílias, além da constatação dos níveis de pobreza e injustiça social que geram desigualdades as mais diversas. Sobre os aspectos marcantes para a permanência dos sujeitos nas duas esferas de trabalho, o amor, a dedicação, a realização pessoal foram os motivos mais apontados. Nas relações entre os dois trabalhos, as transferências de valores aparecem como recíprocas e naturais, sendo aproveitados para estabelecê-las o que cada atividade laboral apresenta de melhor. Conclui-se que o altruísmo, a solidariedade, a generosidade, o acolhimento, a paz espiritual, o bem-estar e sobretudo o amor, são sentimentos que sustentam e confortam o homem, cujas relações aparecem de forma expressiva nas falas dos entrevistados e permeando todo o decorrer da pesquisa.

O fenômeno da corrupção na esfera pública brasileira

This work aims to understand the phenomenon of corruption in the Brazilian public sphere and its implications for society. It has brought concepts of corruption, and has referred to its highest incidence in the public sphere in the three levels of government (despite its infiltration also in the privative sector) and has called attention to two subjects which intertwine public administration (as a means of ordering social life) and corruption (as a form of denial to the collective welfare). Through literature search whose analysis shows that the phenomenon contains the entire country history, from discovery to present day it was found to be common several dictatorial and democratic political regimes. Finally, it has emphasized the importance and necessity of citizen participation in process, as well as the organization of civil society and media, in addition to highlighting the relevance of autonomy and independence of Powers set for its effective confrontation and fighting

Diagnóstico da cultura organizacional em hospitais da rede privada de Natal/RN

As peculiaridades presentes no ser humano são observadas a partir da manifestação de sua cultura. Estas manifestações podem ser influenciadas pelo contexto social do indivíduo. A cultura nacional é uma destas influências. A brasileira, por exemplo, possui alguns traços nacionais peculiares ao seu povo que amenizam a sua complexidade e pluralidade. Estes traços podem se tornar influentes na cultura organizacional, através da manifestação das práticas e dos valores utilizados pela organização. Diante disso, o presente trabalho teve como objetivo diagnosticar a cultura organizacional dos hospitais, enfatizando as práticas e os valores organizacionais e a percepção dos colaboradores sobre a cultura organizacional. A metodologia utilizada na pesquisa foi de caráter descritivo e explicativo. A pesquisa ocorreu através da aplicação do Instrumento Brasileiro para a Avaliação da Cultura Organizacional IBACO, com 283 sujeitos distribuídos em três hospitais da rede privada de Natal/RN. As evidências encontradas pelo estudo foram analisadas através do software estatístico SPSS, com as técnicas multivariadas de análise fatorial, análise de aglomerados e análise discriminante. A partir dessas análises, foram obtidos cinco fatores distribuídos entre práticas e valores apresentados pelo IBACO, que foram: as práticas de recompensa e treinamento; integração externa e promoção do relacionamento interpessoal; e, os valores de satisfação, bem-estar e cooperação dos empregados e profissionalismo competitivo. Os grupos encontrados na análise apresentaram divergências de opinião quanto às práticas e os valores utilizados nos hospitais. Concluiu-se, portanto, que o Hospital A apresentou uma cultura mais proativa e voltada mais para a satisfação e bem-estar dos funcionários. Já os outros dois hospitais apresentaram culturas semelhantes, com limitações quanto à valorização do bem-estar e da cooperação entre os colaboradores, porém com uma boa prática do relacionamento interpessoal

O idoso e as ações sociais em prol desse grupo etário: um estudo sobre a qualidade de vida na Terceira Idade e o Projeto Saúde e Cidadania na Melhor Idade

The present study regards an applied qualitative social research (descriptive) which approaches the matter between old age and Brazilian social actions performed in social projects, aiming a qualified life and citizenship for this group of age. The objective of the study is to evaluate the contribution of Project Health and Citizenship in Old Age regarding social actions from the government directed to old age individual treatment for life quality improvement. The theoretical fundamentals of this work is, in a first moment, about old age and certain existing theories about aging process, as well as the differences and perspectives that come up throughout this process. In a second moment, some reflections are developed about the relation between life quality and leisure regarding old age, with the conception and historical rescue about these questions, as well as the evidence of leisure as an instrument of well-being feasibility and a better life quality in old age. Then the study contextualizes Brazilian government treatment to old age individuals, cutting off the Constitution of Republic from 1988 and some social attitudes taken by the government in a try to reach this specific group. Finally, the study presents the Project Health and Citizenship in Old Age , as a social program which belongs to extension activities from Federal Center of Technological Education of Rio Grande do Norte (CEFET-RN), which aims old age treatment and their citizenship and life quality. After the application of a semi-structured interview using the technique of Analysis of content for the Analysis and Discussion of Results, it is possible to conclude that the Project Health and Citizenship in Old Age fulfils its objective regarding contribution, through offered leisure activities, for old age well-being and life quality improvement. Hence, on this regard, it is possible to observe the importance and value of government actions, social projects and programs assisting old age individuals, for they are able to provide this group the opportunity to live out activities that allow their citizenship and socialization, regarding well-being and life quality improvement.

Economia solidária e relações de gênero na agricultura familiar: o caso do grupo produtivo mulheres decididas a vencer

The Women s experiences in the private sphere under the work s field changes the family relationship allowing them more freedom, autonomy and independence. The inequalities, socially built, homemade women s obligations results in discrimination, difficult to insert and recovery on female s job in a job s market, including low salary if compared with men s and difficult to services access in addiction a difficult daily life and in domestic sphere. The women s organisation in productive groups or economically solidary enterprises (ESE) torn possible the social economically organisations and politicians to promote deep changes in a domestically e socially relationship, positioning, for example, women s in publics areas and in the rout of emancipation. The objective of this search are understand men and women relationship in the family agriculture s field starts insert women in economically solidary enterprises (ESE) on Mulunguzinho s settlement (Mossoró/RN). The theoretical framework is inspirited Economical Solidary concept kind division s job and women s empowerment. This search had a qualitative character and exploration through case s study on Mulheres decididas a vencer s group. The secondary information was create through theoretical framework and information collected through semi-structured interviews based in interviews applied for women and yours respective husbands by criterion for women participation on productive activities of beekeeping culture of goat and sheep. This study turns possible conclude that the women s participations in productive groups in solidary economical change significantly their life and their family life. The group s organisations process, the training was received, the collective production, the marketing and the mobilized participation to move it all was fundamental for women share with their families partners some homemade and take care with the children. This finding confirm a different aspect not economical in solidary economy overcoming the monetary value in associative relationship observing principally individuals well-being and the concern with the form of reproduction this way of life in the associated

Natureza morta...edifício com vida: uma arquitetura sustentável para o Serviço de Verificação de Óbitos

Sustainability in buildings, while reducing the impact on the environment, contributes to the promotion of social welfare, to increase the health and productivity of occupants. The search for a way of build that meets the aspirations and development of humanity without, however, represent degradation of the environment, has become the great challenge of contemporary architecture. It is considered that the incorporation of principles that provide a sustainable building with careful choices of design solutions contribute to a better economic and thermal performance of the building, as well as functional and psychological comfort to its users. Based on this general understanding, this paper presents an architecture project aimed to health care whose the solutions adopted follow carefully the relevant legislation and sets his sights on the theme of sustainability. The methodology began with studies on the themes of verification service of deaths, sustainability and those application in construction developed through research in academic studies and analysis of architectural projects, using them like reference for the solutions adopted. Within the project analysis was performed a visit to the verification service of deaths in the city of Palmas in Tocantins, subsidizing information that, plus the relevant legislation, led to functional programming and pre-dimensional of the building to be designed. The result of this programming environments were individual records with information from environmental restrictions, space required for the development of activities, desirable flow and sustainability strategies, that can be considered as the first product of relevance of the professional master's degree. Finally we have outlined the basic design architecture of a Verification Service of Death SVO/RN (in portuguese), whose process of projecting defined as a guiding line of work four points: the use of bioclimatic architecture as the main feature projectual, the use of resources would provide minimal harm to the environment, the use of modulation and structure to the building as a form of rationalization and finally the search for solutions that ensure environmental and psychological comfort to users. Importantly to highlight that, besides owning a rare theme in literature that refers to architectural projects, the whole project was drawn up with foundations in projective criteria that contribute to environmental sustainability, with emphasis on thermal performance, energy efficiency and reuse of rainwater

A saúde psíquica de quem faz saúde: uma análise crítica sobre a humanização direcionada ao profissional de saúde

It is noticeable that pressure, tension and overwork are frequent in health professionals routine. The work related to the ward area demands deep attention and surveillance. Because of that, it is essential to have a specific look at the humanization directed at health professionals, considering that taking care of other human beings is the essence of their job. This study has analyzed the psychic health levels, as well as the stress health professionals are submitted to, providing a debate about the humanization in 06 public hospitals (03 of them awarded by actions of humanization, and 03 not awarded) in Rio Grande do Norte state, Brazil. A study with 126 active health professionals (doctors, nurses, psychologists, nutritionists and social workers) in ward areas in their respective institutions was carried out. The thesis presented, with multi-disciplinary characteristic, counted on the support of statisticians (to calculate samples and data analysis), psychologists, social workers and administrators (linked to the human resources sector in each hospital). A cross-sectional study was performed, taking into consideration both quantitative and qualitative factors. The tools used for that were a semistructured questionnaire with socio-demographic characteristics, work and humanization; Lipp's Stress Symptoms Inventory for Adults (ISSL), and the Goldberg s General Health Questionnaire (QSG). The workers are predominantly women (84,9%), married (54,8%), between 46 and 55 years old (40,5%), working in the same institution for more than 20 years (22,2%), and between 16 and 20 years (20,6%), respectively. They work 40 hours a week (71,4%) and have multiple jobs (61,9%). Although most of these individuals global psychic health is in a good level, there are a significant number of people that is gradually getting worse concerning psychic stress (F1) showed by QSG (54,7%), and stress showed by ISSL(42,1%). Observing the categories, nurses (41,5%). Nutritionists (20,8%), doctors and social workers (18,9%), were among the most affected. About general health (F6), 63% of the awarded hospitals and 70% of the not awarded ones, presented good health levels (ranging from 5 to 50%). It was also noticed that, in the groups mentioned above, 25 and 20% respectively, were inserted in scores between 55 to 90%, what means that they are in worsening phase. The fact that the hospital is awarded or well recognized doesn t interfere in health professionals stress level and in their psychic health. Through what was heard from these individuals, it was possible to verify that they know little about humanization, once few of them identify or know that the service they offer is in an adoption process by Ministerial Policies. It was also detected the necessity of developing actions aimed at worker s health. Such results showed the importance of have more investments in programs that are directed to workers well-being, because they deal with other people s health and it is known that it is difficult for them to offer high-quality assistance if there are not suitable physical, psychological and material conditions to help them develop their jobs. As a warning, it is fair to say that investments in actions that provide humanized care to health professionals, mainly concerning preventive care for their health and life quality in their work

Representações sociais dos trabalhadores de saúde da atenção básica sobre envelhecimento e o atendimento ao idoso

This study aims to identify the social representations built on senior care health workers of Primary Care. This is an exploratory research within the subsidized social representations held in 100 Basic Health Units in the city of João Pessoa-PB, with a sample of n= 204 workers of both sexes, who agreed to participate. To collect the data used to set an interview in two parts: the first looked at the Test of Free Association of Words using the inductive stimulus "senior care". The interviews were analyzed with the help of a software for quantitative analysis of textual data ALCESTE (version 2010). The results were interpreted from the theoretical framework of social representations. The study included 178 women (87.25%) and 26 men (12.75%), working in Family Health Units in the city of João Pessoa, the majority are aged between 40-49 years of age ( 28.92%), and have higher education with 81.86%. The results of Alceste link to the term inducer six (6) where the hierarchical classes representing senior care workers as synonymous with care and attention, showing situations neglect of the elderly, for that patience is required to promote the increase of disease prevention and living with the elderly to generate humanization in health services. It is considered that the social representations of health workers on assistance to the elderly may support modeling of strategic actions in health services with health promotion programs for large groups, able to modify practices and behavior in elder care and strengthening the policy was directed at the elderly

Cuidado formal em saúde bucal: percepção de senescentes

Ações promotoras de saúde e independência para pessoas idosas são indispensáveis. Compreender essa construção no cotidiano da provisão dos cuidados talvez estimule o desenvolvimento de capacitações ao bem estar nesta população. O objetivo deste estudo foi Identificar a repercussão da provisão do cuidado formal em saúde bucal na percepção de senescentes. Desenvolvemos uma pesquisa de base qualitativa com abordagem fenomenológica, onde realizamos entrevistas semiestruturadas e individuais com 30 pessoas de idade superior a 50 anos (22 mulheres e 08 homens), em um Centro de Convivência na cidade de Natal/Rio Grande do Norte, no nordeste do Brasil. Os relatos obtidos foram analisados em cinco estágios: transcrição dos discursos sem preocupação interpretativa; limpeza de erros linguísticos e repetições; leitura repetitiva e exaustiva para apreensão do sentido das informações coletadas; seleção das unidades significativas dos discursos, correspondendo aos trechos relevantes no horizonte do fenômeno em estudo; e compreensão da ideografia elaborada pelos participantes por grupos temáticos simbólicos. Assim, identificamos as essências temáticas de: determinante social e iniquidade em saúde bucal; e provisão de cuidados de saúde bucal e mal-estar físico, mental e social. Concluímos que a prestação de cuidados agregando abordagem humanístico-ética pode levar a vivências dignificantes no processo de envelhecimento, destacadamente quando estimula a promoção da segurança pessoal. O âmago desse trabalho descortina uma vertente multidisciplinar que perpassa a saúde, a educação e a ética

A previdência rural universalista e a sua relevância na economia dos municípios do Rio Grande do Norte

This study deals with the rural social security Universalist established by the Constitution of 1988 and its importance in the economy of the municipalities of Rio Grande do Norte. In this context, the study seeks to satisfy two important criteria that guide the selection of objects of social science research: a consideration of issues that have relevance to the real world and the intention to make the contribution to the scholarly literature on theoretical and empirical aspects. The research seeks to reveal what is the economic importance of the subsystem of social security for rural municipalities in RN. The hypothesis is that the transfer of income received by beneficiaries from the rural social security tax exceeds the explicit mechanisms for most municipalities in RN, in many cases significantly, proving the importance of this policy as a mechanism for combating poverty and reducing social inequality, especially before the fragility of the federal system on the national political entity hall. The study presents theoretical cores - chapters 1-3 - and empirical - Chapter 4. The first core is about the evolution of social protection as a state policy, addressing the influential theories and typologies of the State of Social Welfare and the characteristics of the Brazilian social security model, but mainly, its rural social security subsystem, its history until universalistic model inaugurated by the Federal Constitution of 1988. The second begins with an overview of studies that have emphasized the impact of Social Security on the local economy of small municipalities, then passing data and statistics in order to gauge the socioeconomic importance of pension income in the rural municipalities of Rio Grande do Norte. To this end, the final chapter provides a comparison of the monetary value transferred by the payment of social security benefits - rural and urban - to each of the 167 municipalities in RN with the equally important sources of income in the budget of municipal entities. Apart from their own tax revenues, are objects of comparison with the value of pension benefits awarded in RN, transfer quota state relating to the municipality on the federal ICMS and the transfer on the FPM

O choque das culturas da ordem

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Paradigma constitucional brasileiro da livre concorrência e da defesa do consumidor face às estruturas de poder no mercado

The Federal Constitution of 1988, when taking care of the economical order, denotes special concern in the abuses of the economical power and the disloyal competition. The mark to mediate of all this is, in fact, the defense and the consumer's protection, once this is final addressee of whatever if it puts at the consumption market. The coming of the Law 8.078/90, Code of Protection and Defense of the Consumer, inaugurates a time of effective concern with the homogeneous individual interests originating from of the consumption relationships. In this point, the focus of main to face of the present work lives, in other words, the protection of the right to the individual property, especially manifests in the exercise of the trade freedom that keeps direct relationship with the respective social function the one that is destined. The code of the consumer's defense doesn't just take care of this, but also of the other star of the relationships of the consumption. When affirming in the interruption VI of the art. 4th that the national politics of those relationships, finds ballast in the prohibition and repression efficient of all of the abuses committed in the consumption relationships, keeping inherent relationship-causality in the economical order, sculpted for the article 170 in the Constitution of 1988. In the generic plan, the mark of the present work is to question concerning the limits of the trade freedom and previsible collisions with protection norms and the consumer's defense, as well as factual convergences of those small systems, especially in what he/she refers to the innate interests to the suppliers. In the specific plan, we aspirated to identify the protection device-commands to the actors of the trade relationship, capable to guarantee the free competition in a global economy of market, seeking especially the Well-being, for soon afterwards, in an analytical perspective, to discover the possible applications that it holds the Federal Constitution, in headquarters of economical freedoms. It was observed that the consumer today doesn't need only of laws that their needs, fruit of the vulnerability that it is him/her meditate innate. He/she lacks, yes, of effective mechanisms that prevent lesions that can be them impinged by the suppliers at the time in that you/they are useful to repair the damages when happened, punishing the author of the damage