O processo de trabalho e a composição técnica do trabalho do enfermeiro no cuidado à saúde da criança em unidades de saúde da familia

With the trajectory that the problems related to child health are taking in our society, particularly with regard to infant mortality, beyond the process of decentralization of health and the implementation of the Family Health Strategy in the cities, where it has increased considerably performance of nursing staff in Primary Health Care, they can be considered essential factors for reflections on the care of nurse dispenses the health of these children. In order to check how it is organized the working process of the nurse in caring for these children in USFs as well as the difficulties found in the dynamics of this work, this research aimed to analyze the work processes of nurses in care Child Health in USFs, with emphasis on technologies used in producing care. This is a research exploratory and descriptive with qualitative approach, based on the theoretical reference in about Work Process and Composition Technique of Work. The data were collected through semi-structured interviews of 11 nurses who, at the moment, perform their functions for more than 01 year at USF. The guiding questions were based at theoretical reference. To analyze the results, was used the referential of content analysis, and was refer to thematic analysis. In situations that were involved closed questions of the interview, was used the aid of SPSS 15.0 program for Windows. The results indicated that the process of nurse work in health care of children, focuses on the preventive character, whose focus of the actions are healthy children, following the routines and protocols established by the Ministry of Health with a view to maintaining health them. When analyzing the data through theoretical references of Composition Technique of Work found that the core technologies of daily tasks of the nurse are directed for the use of technology soft-hard and hard, and the reason established between the Dead Working and Alive Working, there is prevalence of the first against the second in the production of this care. These situations contribute to the explanation of the emergence problems related to adhesion of mothers / caregivers to monitoring the CD, due to character prescriptive and normalizer of actions. The results also suggested the presence of "vanishing lines" in the make of nurses, confirming the self-governance of health professionals in daily work. These "vanishing lines" express the own execution of the Work Live in action, guided by the use of soft technologies, however, was not characterized as a process of technology transition. So, to get a better resolution to the problems related to child health, the nurse has reorganize your work process by focusing on the execution of work live in action.

O trabalho em saúde como espaço pedagógico: desafios e possibilidades

The ongoing transformations in brazilian society, arising from technical and organizational changes in the working world, are making, with much emphasis, heated debates resurge related to themes and issues that refer to the relationship between work, skills and education. Thus, this study is inserted in the link between education and work, pointing to the work as an educational principle according to Antonio Gramsci. This paper aims to discuss the interfaces between education and work in the everyday health care teams and learn about the activities developed by health teams related to the learning processes in and with the work to analyze the opportunities and challenges of transforming spaces of health work in an environment of lifelong learning. This is a descriptive, exploratory with a qualitative approach case study developed from semi-structured interviews with the health staff professionals of the Unidade de Terapia Intensiva da Casa de Saúde Dix-Sept Rosado in Mossoró / RN , who answered open questions about the relationship between education and work. The interviews were conducted during the month of January 2010, the same being recorded, transcribed and analyzed, culminating in the production of new knowledge on the subject. It is understood that work and education activities are eminently human, therefore only the human being works and educates. Given the statements of participants, it is noticed that all work processes in health are learning moments. This happens through new demands imposed by the everyday of the services, by interaction with a multidisciplinary team, participation in educational activities and individual study. It was noticed that the institution in this case does not promote study courses related to Intensive Care and that there are obstacles to the realization of educational activities on and with the work, such as: excessive workload, inability to release staff to participate in events, low pay, which leads the worker to have more than one employment, rejection of new knowledge by some workers and lack of physical infrastructure and incentives for the activities. The daily situations must be transformed in learning, selfanalyzing the problems of practice and valuing the work process itself in its intrinsic context. We conclude that dealing with the web of relationships between educational processes and production processes of health services, unraveling the intricacies of the world of work and education requirements in this sector are increasingly on the agenda of Sistema Único de Saúde workers and managers. The continuing consideration of this issue becomes an essential condition for the proper discharge of their responsibilities. We consider that bringing the education to everyday life is the result of recognition of the educational potential of the work situation

A precarização do trabalho do enfermeiro na estratégia saúde da família: contribuição ao debate

This study makes an analysis of the work of nurse of the, uncovering the meaning of work and of precarious work for the nurse. aims to analyze the forms of precariousness of work of the nurse of Family Health Strategy the municipality of Pau dos Ferros-RN, Brazil. This is a qualitative study with analysis of the categories that emerged from search through dialog with the authors studied in theoretical framework of the sense of human work, the world of work actual and the precariousness of work in health. Used if the methodology of thematic oral history and semi-structured interview as an instrument for data collection and information. Participated 07 nurses of. There was predominance of females, with civil state married, with age between 29 and 47 years, inserted as nurses in Family Health Strategy 1 to 9 years. All referred satisfaction with work. Emerged 02 main meanings of work, whichever the design of work as a source of human and practical transforming of reality, with the sense of perform an action by the individual facilitator and suffers change. Include the precarious work not only as the absence of links labor and social protection, unlike the thought of the Ministry of Health, similar to the design of the study, the precariousness understood yet as the absence of participation of workers in the spaces work management and running of the work and the absence of structural conditions and infra-structural where the work process takes place. evidenced the totality of nurses inserted in Family Health Strategy by public tender. Refer have labor rights guaranteed. Don´t include under which legal arrangements are governed. The researched reality does not have a policy desprecarização nursing work of Family Health Strategy. Concluded the municipality presents progress and setbacks for the precariousness of work of the nurse of Family Health Strategy. The collective work in health is a challenge in researched reality and the policy of desprecarização of the work of the management of education and work was not evidenced. Despite the implementation of the public tender these professionals have a degree of precariousness of work, with the accumulation gradient of responsibilities, some lack of working conditions in structural aspects, infra-structural and means and instruments

Trajetória do hospital dia Dr. Elger nunes: um recorte histórico da psiquiatria e saúde mental no Rio Grande do Norte

In Brazil, the mental health network proposed by the Psychiatric Reform inserts the intermediate and replacement services in the pursuit of alignment or resocialization of patients with mental and behavioral disorder in the community. Was adopted, among other services, the Center for Psychosocial Care, Home Therapy, Sheltered Home, Day Hospital and psychiatric beds in general hospital. In this context, the State of Rio Grande do Norte implanted the Day Hospital Dr. Elger Nunes (HDEN) in Natal / RN in 1996, linked to State Department of Public Health. At HDEN happened a multi and interdisciplinary therapeutic work, besides being the scene of disciplinary practices, and extension projects for graduate courses in Higher Education Institutions in the city. However, with the process of decentralization of local services, the hospital was terminated by an administrative state act in 2006, leaving damage to the activities provided to users, disciplinary practices and extension activities. From this breakdown, the objective was to narrate the trajectory of HDEN through a multidisciplinary team of professionals and teachers who used it as a field of disciplinary practices. It is characterized as a documental and qualitative, backed in the technique of thematic oral history, following the phases: authorization of the interviewee, interview recording, transcription, textualization and transcreation of the material obtained. We used documents, ordinances, general reports of activities, among others, plus interviews to fifteen employees who used this service, being thirteen part of the multidisciplinary team of professionals and two graduation professors of health care area, nursing and medicine. The stories collected were organized according to the technique chosen, respecting its steps. In preparing the body subjected to ALCESTE computer program, priority was given to the vital tone for the formation of categories and classes elected by the program, structured in three thematic areas. In the first axis, called Trajectory of HDEN, were recalled the beginning of its activities, the steps of that time, their activities, and its actors - users, families, professionals, and teaching practices. The second axis has dealt with the process of extinction of HDEN, rescuing the feelings of employees, the main reasons given at the time and immediate postextinction scenario. And the third axis revealed in an articulated form the situation of mental health in Natal / RN, listing to the challenges and prospects for the psychosocial care, starting from the trajectory of HDEN with emphasis on activities. Moreover, the trajectory of HDEN provides recognition of the historical basis outlined in the constitution of the network of substitute services present in the current scenario of psychosocial care in the city of Natal and in RN.

Terapia comunitária integrativa: construção de um espaço de escuta para os trabalhadores na atenção básica da saúde

This research, which appears in the form of a dissertation, entitled: Integrative Therapy Community: construction of a listening space to health care workers in primary care, addresses the Integrative Community Therapy (ICT) as a tool to create meeting spaces between health professionals where they can be receptive among one another. With the completion of this study aimed to analyze the ICT as a therapeutic approach and space of listening and speaking for health professionals cited here in order to identify their anxieties, doubts, worries and uncertainties arising from the context of labor relations and the impact of therapeutic experiences under the view of the participants. It was developed as an action-science research, involving several steps. The field of research was the ICT meetings of workers from the units under the Family Health Strategy of Northern Health Districts I and II of the city of Natal, using a qualitative approach. The interpretation of data collected was based on content analysis proposed by Bardin. Finally, this study showed the ICT as a space for dialogue and sharing, with repercussions on labor relations and expansions beyond the ICT meetings, reaching out to family and social relationships, contributing to creating bonds and solidarity networks. Under the view of the participants it was recognized as an experience that optimized the socialization, promoting the alleviation of suffering and increasing the well-being. Based on the study findings, it is inferred that ICT can be considered a viable tool for the receptiveness and humanized care of health care workers.

Carga de trabalho de enfermagem e infecções relacionadas à assistência à saúde na unidade de terapia intensiva

In recent decades, the search for quality care has been widely discussed by the institutions and health professionals. In this context, it is the nurse coordinator of the process of providing nursing staff, reflecting the commitment to quality of care. In this process, it is the appearance of Infections Related to health care and its potential association with the workload in nursing as a valuable indicator of quality of care. Thus, this research contributes to studies to characterize the demand of nursing work to promote a safe healthcare practice. This study aimed to identify the association of nursing workload with the number of cases of Ventilator-Associated Pneumonia, urinary tract infection and central venous catheter infection in the intensive care unit. This is a quantitative research approach, descriptive, cross-sectional and prospective, held at Unimed Hospital in Natal-RN. The study population consisted of all patients treated in the Intensive Care Unit, Hospital for a period of 90 consecutive days in 2011. The convenience sample was compostapelos patients admitted to the ICU during the period of data collection, a total sample of 286 patients. To perform the data analysis software were used: Statistica 6.0, SPPS (Statistical Package for Social Sciences) version 17.0 (2004) and Excel 2007. In the descriptive analysis, we used Measures of Central Tendency and Measures of Dispersion or Variability and the use of nonparametric tests. Of the 286 patients, 88 were from the ICU and 198 ICU II II. Males predominated in the ICU I (51.1%) and female ICU II (57.6%) patients in the ICU I were aged 61-80 years (39.8%) followed by greater than 80 years (39.8%). In the ICU II, most of the patients were aged 61-80 years (38.9%) and then from 41 to 60 years (24.2%). In relation to the class of TISS inlet predominant class II in the two ICUs (59.1%), followed by Class III also in the two units (34.6%). Most patients (70.6%) out of the ICUs belonging to class II TISS. In the ICU I, the average number of forms of the TISS 28 was 6, has in ICU II this value drops to 3.2 forms. The overall mean was 19.9 TISS points in ICU patients I and ICU II.the 17 points in the average hours required to provide adequate nursing care to patients in the ICU I found that is 10 , 7 hours, and the ICU II 9.2 hours. It was found that the time provided by the nursing staff were higher in ICU II, with an average of 19 hours available for nurses in this sector. In the ICU I, which showed higher need of available hours, it was found that the mean value of 12.7 available hours. It was found that only 2.4% of patients had these units Ventilator-Associated Pneumonia, 1.0% were infected central venous catheter and 1.4% of patients had urinary tract infection. Infection associated with health care occurs, on average, on the tenth day of hospitalization. In the ICU II, this average value extends to the twelfth day with an excess of 2.7 hours of nursing care while in ICU I value decays to the ninth day of hospitalization with a deficiency of 12-hour assistance. It is concluded that patients generally showed a need for classification of semi-intensive care and has been assisted in their need to load. As for his association with the Related Infections Health will assist this analysis could not be performed due to the small number of notifications in this period. It is suggested further study how other factors related to infections me a longer period of analysis

Modelagem de arranjos institucionais para implementação da diretriz de sistema de gestão de segurança e saúde ocupacional da organização internacional do trabalho ILO/OSH 2001 no brasil

The commitment assumed by Brazil to ILO in order to pursue actions toward the ILO/OSH-2001 adoption in the country poses the issue of modeling the institutional arrangement the set roles and relationship between government, standards organizations, health and safety organizations, professionals and other institutions to deploy the ILO/OSH-2001. This Thesis develop institutional arrangement models based on the current model and also in the ISO 9000 scheme and others. It is studied the US case with OSHA and VPP, the OHSAS 18001 and ANSI/AIHA Z-10, in addition to actual context of the regulating norms NR s. The scenarios developed are put to evaluation on feasibility, potential changes and effects on current MTE auditors work scheme. The main results are five scenarios developed and that the MTE auditors tend to be reactive to the change toward the ILO/OSH-2001.

Participação e ação política dos psicólogos frente à política de saúde mental no Piauí

It is intended to problematize forms of participation and political action of psychologists toward mental health policy in Piauí. The study was motivated through challenges faced by the local Psychiatric Reform movement, and the one underway in the country, which needs support technical-assistence and sociopolitical to guarantee accomplishments and to move on with the complete reversion of the asylum to psychosocial model. The method was based on institutional analysis and counted with three insertion moments for the field research: a) to identify historical and political events that configure the local Psychiatric Reform (documental research/oral memory) and to identify psychologists that act in Mental Health; b) to realize participant observation and semi-structured interview with 33 psychologists which act in Mental Health in Teresina; c) to follow the sociopolitical contexts/events of the local Psychiatric Reform (participant observation and conversation circles). The data were analyzed considering four discussion axes, achieved through categorization of the collected material: 1) ways of professional insertion of psychologists in mental health; 2) knowledge and practices used to act in this work context of the profession; 3) political professional movements of workers of the reformist local process; 4) political action of psychologists toward the course of Piauí mental health policy. We concluded identifying that the participation of psychologists in Piauí mental health finds strength by the conduction of its macro and micropolitical professional action. The first one follows oriented by the lemma of social commitment, despite this movement doesn t have equivalence in the transformation of practices and political-professional postures of psychologists in the daily of services. The second is constituted in the every day of work, standing to the political action of the profession implicated with the preservation of the classic modus operandi of being psychologist. Therefore, it is about the actions that give little sustainability technicalassistance to the Psychiatric Reform underway in the State, and why not say in the country

Motivação para o trabalho: um estudo com os profissionais de saúde das unidades básicas de saúde do município de Natal RN

This thesis studied the motivation to work among health professionals of the Basic Unities (BUH) in the health network of the city of Natal (RN). It was understood that the work motivation is a process. Then, the expectation theory was applied and motivation components (results of work, expectative, valence, instrumentality, and motivational force) were used to analyses. It s understanding the motivation as multifaceted phenomenon, the psycho sociological perspective was adopted. The research was developed in two phases: one with application of Work Motivation and Meaning Inventory (WMMI), and another with interview. In the first phases, the analysis of results revealed that the major factors contributing to increase the motivational force to health professionals in the BUH´s are: in valence, Self Expression and Personal Realization (VF2), Personal and Family Survival (VF3); in expectative, Self Expression and Work Justice (EF1), Safety and Dignity (EF2) and Responsibility (EF4); in instrumentality, Involvement (IF1) and Recognition and Economic Independence (IF4). In opposition, the factors that more contribute to reduce the motivational force are Wear and Dehumanization factors in valence (VF4), in expectative (EF3), and in instrumentality (IF4), behind the Work Justice Factor (IF2). Basing in content analysis of interviews, it was possible to associate by equivalence, the senses presented by health professionals with obtained results of first phase, indicating that the results of second phase corroborated and complemented those of first one. This possibility broadened the comprehension of the studied phenomenon. In speaking of the respondents, it was visible the presence of contents showing that they perceive the Health System and BUH´s in degradation. In the first phase, the participants´ instruction also predict the results in motivation, and in the interviews can be saw that the instruction is associated with the opportunities in outside of system. As work motivation is a process, the impact of personal and occupational characteristics tend to interact with contextual aspects. It was concluded the majority of health professionals present the moderated motivational force, but it was falling because they experience and perceive a degrading context with work condition increasingly unfavorable.

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

O trabalho docente em psicólogo e o enfrentamento da violência contra crianças e adolescentes: uma experiência teresinense

In this thesis I discuss the role of the psychologist as a university professor and as intellectual from a specific context and also from a specific query. The context is the city of Teresina, capital city of Piauí state, which is peripheral in Brazil s northeast region. The defiance here is to build a critical psychological tradition that will deal with the challenges imposed by the reality of poverty and socio-economic backwardness of the region. The greatest difficulty is the lack of a public institution of learning that carries out instruction, research and extension with commitment to social transformation, and with the production of a psychological knowledge that is able to understand local reality. I take it that the undergraduate course in Psychology at UESPI [State University of Piauí] is the only one in Teresina that can take over such mission. The query is confronting violence against children and adolescents that defies us to ethically and politically commit to solidarity toward fragile human beings in need of adult involvement in order to survive this daily inhumanity. The involvement of psychologists from Teresina in this must result from a social commitment and a technical competence to deal with prevention and therapeutic consideration toward the victims. This dissertation is divided into three parts: the first is a study on the curriculum and the performance of psychologists, which revises the academic output in Brazil and envisages new queries to the theme, such as the role of teaching inside the curriculum, and presents social security (including Medicare) as the privileged field in which Brazilian psychologists perform. The second part contains a study on the concepts of childhood, adolescence and violence, which presents a consideration on the strategies to confront violence against children and adolescents. In the last part I discuss the role of the psychologist as teacher and intellectual in the context undergraduate course in Psychology at UESPI [State University of Piauí] from the commitment to the protection of children and adolescents

Os profissionais de saúde diante da violência :mapeando o processo de implantaçãoda notificação na rede básica de saúde em Natal/RN

Violence is a complex and multifarious phenomenon that has convoked the government to think about strategies to face the question. This work is about one of these strategies proposed by brazilian Health Minister: the Individual notification/investigation Card - Domestic Violence, Sexual and/or others Interpersonal Violences . This instrument is a notification protocol which is been implanted in all of the country. This process is in course in Natal/RN. This work is a report of one research realized in five units of basic health care network of Natal/RN concerning this process about the implementation of the violence notification card. The study aims to cartography all the process of card implantation, discussing the used strategies, the drawn course, difficulties and possibilities as well as how the researcher intended to map subjective process involved at health professional acting at violence case and the propose to use the card. Meetings were held at each unit and a daily fieldwork report was used as research instrument. In this investigation it was observed that notifying violence involves a complexity that is not present in other kinds of notification as consequence of the phenomenon characteristic and health workers are invited to act in different perspective that knowledge and instruments of traditional health fieldwork available does not work. It was observed that the notification card, as a possible instrument of intervention, are considered important detectors from process of work at health basic care and health policies. Depending the way the instrument is used, it may incentive different discussions and manners to offer health care or in other way it can reproduce control and vigilance logics. Consequently it is necessary to consider some factors pointed out at this experience, implanting instruments like this, thinking about these limits and possibilities

A Psicologia do trabalho e das organizações na formação do psicólogo no Brasil

This research has aimed to analyze the presence of the Work and Organizational Psychology (WOP) at the psychologist s undergraduate education after 2004 s National Curricular Guidelines in Brazil. It has investigated in 43 Brazilian undergraduate courses of Psychology how their Course Pedagogical Projects (CPPs) approach the WOP issues. For that investigation, the CPPs, the subjects programmes related to the WOP and the curriculum grid have been accurately read and analyzed. Categories created by similar studies have also been used. The studied knowledge field has been cited by 41 courses, mainly on the definition of the egress s professional profile, on the expected competences and on the psychologist s formation process lines. Moreover, 28 courses have disposed curricular emphasis on the WOP and 12 have provided professional practices on that Psychology s field. All the courses have displayed, at least, one subject related to the WOP and in 29 cases there have been found between two and six subjects concerned to that field of Psychology, occupying nearby 10% of the whole courses credit hours. It has been verified that the Work and Organizational Psychology is allied to discussions about Quality of Life and Health of the Worker, bonded to work prescriptions at the Personnel Management departments and in other places such as syndicates. Additionally, 37% (147) of the WOP s subjects concerns to the contents of the Work Psychology, 21% (81) relates to the Organizational Psychology, 18% (71) are about Industrial Psychology s topics and 14% (55) debates the field generically. The most often issues are: Recruitment and Selection (25 courses); Training, Development, Learning and Education (24); and Work and Mental Health (24). Those topics have assumed three functions: providing principles for the acting at the WOP field; tutoring psychologists to analyze their own workplaces; and offering a comprehension of the human being mediated by the Work. It has been concluded that the WOP is incorporated on the psychologist s undergraduate education by considering the increasing of its presence and the occurrence of its traditional and emergent topics