Avaliação da estratégia saúde da família na capital potiguar

This research aimed to evaluate the Family Health Strategy (FHS) in Natal, Rio Grande do Norte, through its managers, professionals and users, having as its support the Theory of Belief and the Cognitive-Behavioral Theory. This is a multimethod research and is divided into three sub-studies. In the first study, nine managers answered to a semi-structured interview, to verify the knowledge and beliefs on SUS; the quantitative data were analyzed with descriptive statistics with the aid of SPSS software and the qualitative data were submitted to lexical analysis with support of ALCESTE software. In the second study, we have a descriptive correlational research in which the antecedent variables are related to working conditions in the family health units (FHUs) and to the professionals‟ profile; the corresponding variables refer to the evaluations of the FHS; a stratified probabilistic sample with 475 professionals, who answered to two scales, both consisting of three factors: Physical infrastructure, Material resources, and Treatment effectiveness, and data were analyzed using descriptive, bivariate and multivariate statistics, with the aid of SPSS. The third study is a descriptive correlational research in which the antecedent variables refer to the treatment in the FHUs and to the users‟ profile, and the corresponding variables refer to the evaluations of the FHS, with a stratified non-probabilistic sample with 390 users, who contributed to the construction of a new scale with a factor, effectiveness in treatment, analyzed through descriptive, bivariate and multivariate statistics, with the aid of SPSS. The results showed problems which start from management, under the shape of admission due to political indication and lack of knowledge on SUS and the FHS; they pass through the low tenure of professionals and insufficient professional; and they end up spreading all over the analyzed items: infrastructure of FHUs, material resources, professionals‟ training, accessibility and referral system. One concludes that, despite following an ideal model, the FHS is in need of changes with regard to the barriers to its operational reality

O Psicólogo no campo do Bem-Estar: cartografias de práticas na saúde e assistência social

The study focuses on the psychology and Social Well-being Policy encounters. The objective is to understand how the psychologists in the health services of Natal, RN, specifically in the Basic Health Units and social assistance, experience their daily practices. The methodology included observation and interviews of 13 psychologists regarding their daily activities and forms of practice in these services. We utilized an interview protocol directed at the affective memory and the professional life history of these technicians. Field notes were used to produce a cartography of the encounter intensities experienced by the researcher in the investigated context. The data analysis enabled the construction of the following analytic axes: 1) Work processes and proximity/ distancing points between these fields; 2) Forms of government and life management in the well-being context; 3) Experiments of self in the daily services. The first axis showed the precariousness of working conditions (remuneration issues, lack of structure, of training and autonomy for the activities). In the second axis the identified care forms produced in these fields indicated an adherence to the production of ideal subjects characterized as autonomous, productive, healthy and aware of own rights . These were considered normative insofar as they express attempts to break with the established patterns. In the third axis, many technicians experienced constraint with the daily activities because they found themselves in contexts that were adverse to the habitual forms of action. This situation provoked two distinct forms of positioning: a) action expressed by compassion, pity and resentment; b) investment in the practices themselves, so as to overcome its limits and to respond innovatively to the difficulties and/or challenges that these contexts provoke

Agente penitenciário: trabalho no cárcere

Behind the high walls of a prison, there is suffering! Suffering from those who atone to their punishment, from those who work on behalf of an alleged regeneration, suffering that has remained for over two centuries. For those who had their conducts characterized as a crime, many studies have been developed. On the other hand, little is known about the prison servants. This research focused mainly on the identification, from the perspective of the correctional officers from two prisons in different states of Brazil, of the negative influence that their jobs have on them, on the factors that serve as protection, as well as the ones that offer them risk. It was observed that hygiene and security conditions are precarious in both prisons. From the reports, scabies, tuberculosis, hepatitis, H1N1, constant violence, politicization of the working environment, doubled working hours, lack of career planning and salaries emerge as evidence of the place where the bodies who work there are subdued, not taking the differences into account. From the above, and as of the many things that still need to be said about this category, it is reiterated the importance in developing studies about the conditions and the work organization and its implications on the mental health of those workers, who lack of public policies committed to their working realities

O Serviço Social nas operadoras de planos privados de assistência à saúde: demandas, atribuições e respostas profissionais

The present study deals with the exercise of professional social workers in private health care plans registered with the Regional Council of Medicine/RN, in the city of Natal/RN, with regards to the demands/tasks, work conditions, and the professional response, given the climate of restructuring the capital. The set of socio-historical transformations, as a results of the dynamic capitalist, is a process of new configurations in relation to state and society that interfere directly in relation to working conditions, social rights historically won by workers. In this context, the operator of health plans arises as a possibilities to provide services in health, through the logic of the market, in which the subjects of law, become consumers contributing to the displacement of the responsibilities of the State. Obligating workers to lessen the burden with the reproduction of their workforce. This involves changing societal context for social service, since it is one of the professions that are active in terms of the immediate social issue, and come as part of the collective worker. From qualitative research based on a theoretical and methodological perspective and critical dialectics, it was possible to unveil some features and trends of the exercise of(a) social operators in private health care plans. The survey results indicated that : a) the demands and duties for certain social service, are associated with the redevelopment of the capital, whose requirements and responsibilities professionals have with their needs, particularly the guarantee of profit, services rendered; b) in the conditions of work there is a trend of insecurity uncertainty and dismantling of professionals; c) the answers professionals suffer the limits and contradictions present in the daily training, mainly depending one the characteristics of management and operation of the operators, which has professional relative autonomy

Processo de trabalho em saúde: uma análise das condições de trabalho dos assistentes sociais no âmbito hospitalar

This paper presents the survey results: PROCEDURE FOR WORK IN HEALTH: an analysis of working conditions of social workers in hospitals. Analyzes the inclusion of social workers in work processes in healthcare, specifically in the public hospital, from the objective conditions of work, according to which materializes professional action. The aim is to understand them from the point of view of its relationship with users and other health professionals through the privatization of health, which prevents the Unified Health System (SUS), limiting the operation of the services and the guarantee of rights. The approach to the reality studied was through theoretical and methodological procedures based on the qualitative and quantitative research, focusing on documentary research, observation, semi-structured interview and the theoretical foundation. It is observed that the inclusion of social workers in this context arises from the demands derived from expressions of social issues, "raw material" of professional work, and the gaps resulting from contradictions in the process of rationalization / reorganization of the SUS, meaning that the needs the population are confronted with the content and form of organization of services. At the hospital, the professional actions are developed through the shift, space contradictory clash between the collective and individual, in which individual activities are prioritized and ad hoc unplanned and reduced to the solution of "problems" of users, through actions assistance in an emergency and bureaucratic. These findings emphasize the inadequacy of space and lack of minimum conditions of service to users, which undertakes the professional with regard to ethical and political principles of the profession, since it is the responsibility and duty of the social guarantee the secrecy and privacy of users what is revealed during the process of professional intervention. The professional social workers is permeated by the diversity of skills and competence; lack of planning activities, by incorporating the institutional discourse at the expense of professional goals, by knowing the Code of Professional Ethics, for small number of professionals, the increasing number informality; by poor working conditions and wages; by discouraging research and participation in social policy councils, as well as professional training

As condições de trabalho na área de saúde e o processo de adoecimento da (o) assistente social

The requirements in the world of work in the contemporary impact on quality of life, health workers in their relations with users and other professionals of the healthcare team. Given this reality, this study discusses the working conditions in health and disease process of (a) having social goals as analyze the implications of working conditions in the disease (the) social workers in state hospitals Metropolitan Region Christmas (NMR); identify the main diseases affecting social workers in hospitals in the SESAP NMR and reveal the relationship between the disease processes of social and working conditions in hospitals in the state NMR. The research was guiding questions to reveal how to configure the work, conditions of work and of the disease process (the) social worker. To grasp the socioeconomic profile of (the) social workers, the characterization of the work, duties and responsibilities in the sociooccupational, factors that interfere with the disease process of (the) social workers of RMN, and actions and investments Policy on Occupational Health RN correlating to illness today is that we set for the unveiling of the movement of the object of study through the methodological approach with documentary research aimed at literature review; extensive direct observation correlated to real life observation and application of 66 (sixty-six) questionnaires. The data from the closed questions were treated using the Statistical Package for the Social Sciences (SPSS). The open questions were transcribed and then analyzed the light of theoretical work on the subject. The research reveals that social workers are subject to conditions and labor relations precarious illness causing health problems because some of these professionals, among them are: stress, allergies and skin conditions or, Read / WMSD among other diseases. Thus, we understand the need for debates about the relationship work (the) social worker and worker health before the contradictions of capital also present in public health services

O Serviço Social e a exclusão/inclusão social dos portadores de HIV/AIDS :demandas e desafios nos hospitais públicos

This research presents the labors developed by the Social Service unto socially excluded HIV/Aids positives at public hospitals in Rio Grande do Norte (RN). It purposes to identify and to analyze the demands brought by the holder onto the Social Service professional as well as the challenges the latter face to minister to the former. It privileges, from the methodological viewpoint, the qualitative and quantitative analysis with the application of questionnaires, direct observation, semi-structured interviews and bibliographic references. Data were collected from 12 (twelve) social assistants who work at Giselda Trigueiro Hospital in Natal (7) and Rafael Fernandes Hospital in Mossoró (5). The central hypothesis that guided this study is that the social inclusion/exclusion process experienced by the HIV/Aids positive on society implies a demand for the Social Service that is inserted in the public health context (specially in HIV-referred public hospitals), whose agents, however, when attempting to answer those demands, meet obstacles due to both the precariousness of public health services and the social complexity that concerns the HIV/Aids epidemic. Results point out that, de facto, the HIV/Aids epidemic, because of the social exclusion/inclusion process to which the holder is subject results a demand for the social agents at hospitals. Demands rise principally from the patient s life condition, considering the increasing pauperization in the epidemic context. As to what it is concerned, social assistants, responding to the needs, come across concrete twofold challenges: the illness in itself, for all social, negative aspects that make part of quotidian life of holders; and the precarious state of the public health service in RN State, since that working conditions are unsatisfactory

A mineração artesanal e de pequena escala em pegmatitos e cerâmica no município de Parelhas, região do Seridó/Rio Grande do Norte

The working conditions, occupational health, occupational illness and workers quality of life, usually referring to the artisanal activities and the workers with a poor professional support. Because this reality is still present in locals without good infrastructure of social and economic attention, there is a need for a broad knowledge of problems related to the productive processes that include features of unsanitary and unhealthy. Despite the intense process of industrialization promoted by globalization and the growth of developing nations like Brazil, the activities of artisanal and small-scale mining are still suffering from the marginalization of their production processes and their workers. This dissertation deals with the description of mineral-based activities (MBA), especially the activities related to production processes of extraction and processing of red pottery and minerals in pegmatites in Parelhas city, Seridó, Rio Grande do Norte, which are conducted by small mining companies or artisanal miners. The study of the work process was based on direct observation, photographic documentation, ergonomics, health and occupational safety analysis, interviews and structured questionnaire with workers of the two activities. The results indicate the need for improvement in both workplaces (red pottery and pegmatites), adaptation of workers to safety standards specific to the workplace, more attention and care related to ergonomics and occupational safety, greater importance to economic and social relations among performed activities, workers and firms of mineral branch and better and greater integration of social policies, supported by different sectors of society with the intention of transforming the current social, cultural, labor and education situation

Tragedy on grade crossing: driver failure or systemic fragility?

In 2010, an accident occurred in Americana-SP, Brazil, involving two trains and one bus on a Grade Crossing, when 10 people died and 17 were injured including workers. This paper aims to analyze the accident using the Model of Analysis and Prevention of Work Accidents (MAPA). The method provides observation of work, interviews and analysis of documents to understand precedents of the event in the following stages: to understand the usual work from the involved people, the changes occurred in the system, the operation of barriers, managerial and organizational aspects. By the end, measures are suggested to avoid new occurrences. The accident took place at night in a site with insufficient lighting. The working conditions of bus drivers, train operators and watchmen are inadequate. There were only symbolic barriers (visual and acoustic signals) triggered manually by watchman upon train operator radio communication. The fragility of the barrier system associated to poor lighting and short time to trigger the signaling seem to play a critical role in the event. Contrary to the official report which resulted in guilt of the bus driver, the conclusion of the paper emphasizes the fragility of the safety system and the need of level crossing reproject.

Avaliação das condições de trabalho dos servidores braçais de instituição pública

Descrevem-se as condições de trabalho dos servidores braçais da Prefeitura Municipal de Botucatu (PMB), Brasil, procurando identificar as condições mais freqüentes e mais graves de riscos ocupacionais. Foi analisada a morbidade registrada no ambulatório dos servidores municipais, no período de 17 de julho a 4 de dezembro de 1987; foram analisados os acidentes de trabalho sofridos e registrados pelos servidores municipais nos anos de 1984, 1985,1986 e 1987. A descrição dos setores braçais revelou que as tarefas executadas na PMB são, majoritariamente, executadas manualmente, sem tecnologia, evidenciando condições potenciais para gerar acidentes de trabalho e posições antiergonômicas como as condições de risco mais freqüentes. Os coeficientes de gravidade desses mesmos acidentes elevaram-se desde 1984, sendo o de 1987, 1,85 vezes maior que o de 1984. A análise da causa externa e natureza da lesão decorrentes dos ATs validam a descrição do processo de trabalho e das condições de risco ocupacionais observadas. Os agravos mais freqüentes registrados no ambulatório foram: hipertensão arterial, outras circunstâncias familiares não especificadas (problemas pessoais), lombalgia, gripe, alcoolismo crônico e gastroenterocolite aguda, sendo que todas essas doenças (exceto problemas pessoais) foram mais freqüentes nos servidores braçais do que nos administrativos. Propõe-se a implantação de um programa de saúde ocupacional voltado aos servidores municipais da PMB.

A implementação da sistematização da assistência de enfermagem no serviço de saúde hospitalar do Brasil

Trata-se de uma pesquisa bibliográfica que objetivou analisar como tem ocorrido a implantação da Sistematização da Assistência de Enfermagem no serviço de saúde hospitalar do Brasil no período de 1986 a 2005. Utilizou-se como fonte de busca as bases de consulta LILACS, BDENF e SciELO. Foram incluídos 30 artigos (15 relatos de experiência, 14 pesquisas de campo e uma reflexão teórica), tendo como critério a implementação da Sistematização da Assistência de Enfermagem no Brasil, na área hospitalar. Realizou-se a análise de conteúdo, modalidade temática. Na análise dos artigos se percebe que a finalidade de implantar a sistematização é organizar o cuidado a partir da adoção de um método sistemático, proporcionando ao enfermeiro a (re)definição da sua ação. Dependendo da escolha do referencial teórico de gestão e das estratégias utilizadas, isso se reflete sobre as condições de trabalho e o modo de agir, havendo interferência no processo de implantação.

Influências das condições e organização do trabalho de uma indústria de transformação de cana-de-açúcar na ocorrência de acidentes de trabalho

Este estudo discute a relação entre as condições e a organização do trabalho como elementos que contribuem para a ocorrência de acidentes do trabalho. Os dados foram coletados em uma indústria produtora de açúcar, álcool e derivados, situada no Estado de São Paulo. Para a coleta dos dados utilizamos a observação direta do trabalho e realizamos entrevistas semidirigidas individuais como 22 trabalhadores do setor de produção de açúcar. A produção de açúcar foi indicada pela Equipe de Segurança e Higiene no Trabalho como o setor em que havia a maior ocorrência de acidentes. Por destacar o papel que a relação homem-trabalho desempenha na saúde física e psíquica dos trabalhadores, utilizamos a Psicodinâmica do Trabalho (Dejours, 1994) como referencial teórico para a análise dos dados obtidos nas entrevistas. A análise das entrevistas envolveu três aspectos: condições e organização do trabalho e insatisfação. Os resultados revelaram que o ambiente estudado apresenta fatores físicos, químicos e biológicos desfavoráveis à saúde dos trabalhadores. Quanto à organização do trabalho, os dados revelaram que a divisão do trabalho bem como o conteúdo das tarefas determinavam sobrecarga aos trabalhadores. O relato sobre a insatisfação envolveu: ausência de perspectiva para progressão profissional, falta de treinamento técnico, dificuldade em manejar equipamentos e inadequação dos equipamentos de proteção. Destaca-se também no discurso dos trabalhadores a ineficiência das ações organizacionais para a eliminação ou a neutralização dos riscos de acidentes do trabalho e a predominância da teoria do Ato inseguro na apuração da causalidade dos acidentes do trabalho.

Fatores determinantes da carga de trabalho em uma unidade básica de saúde

As doenças decorrentes do exercício pro-fissional, sejam de ordem física ou emocional, têm apresentado aumento crescente na sociedade atual, nos diferentes segmentos laborativos, com projeção significativa junto aos profissionais da saúde como médicos, dentistas, enfermeiros, auxiliares de enfermagem e auxiliares administrativos envolvidos com a prestação de serviços nas unidades de saúde. Este estudo teve por objetivo conhecer a carga de trabalho e seus fatores determinantes, buscando identificar possíveis relações entre as condições de trabalho e o possível impacto para a saúde dos trabalhadores. Participaram da amostra 31 indivíduos: 12 médicos, 3 dentistas, 1 enfermeira, 9 auxiliares de enfermagem, 3 auxiliares odontológicos e 3 auxiliares administrativos de uma Unidade Básica de Saúde (UBS) no interior de São Paulo. Para a coleta dos dados foi elaborado um roteiro de entrevista estruturado e realizadas reuniões com os grupos específicos para uma descrição detalhada das atividades realizadas em cada setor e o levantamento de problemas e de características desejáveis. Os resultados indicam a presença de carga física, carga cognitiva e carga psíquica; processo de comunicação inadequado; equipamentos obsoletos; número excessivo de usuários e estrutura frágil para lidar com absenteísmo.

Diagnostic de sécurité d’une entreprise brésilienne à partir de l’analyse des accidents du travail par la méthode de l’arbre des causes

We present here the results of a study of 21 work-related accidents that occurred in a Brazilian manufacturing company. The aim was to assess the safety level of the company to improve its work accident prevention policy. In the last 6 months of 1992 and 1993, all accidents resulting in 15 days' absence from work, reported for social security purposes, were analyzed using the INRS causal tree method (ADC) and a questionnaire completed on site. Potential risk factors for accidents were identified based on the specific factors highlighted by the ADC. More universal trees were also compiled for the safety assessment. Three hundred and thirty specific accident factors were recorded (mean of 15.71 per accident). This is consistent with there being multiple causes of accidents rather than the assertion of Brazilian business safety departments that accidents are due to dangerous or unsafe behavior. Introducing the idea of culpability into accidents prevents the implementation of an appropriate information feedback process, essential for effective prevention. However, the large number of accidents related to material (78%) and environment (70%) indicates that working conditions are poor. This shows that the technical risks, mostly due to unsafe machinery and equipment are not being dealt with. Seventy-five potential accident factors were identified. Of these, 35% were organizational, a high proportion for the company studied. Improvisation occurs at all levels, particularly at the organizational level. This is thus a major determinant for entire series of, if not most, accident situations. The poor condition of equipment also plays a major role in accidents. The effects of poor equipment on safety exacerbate the organizational shortcomings. The company's safety intervention policy should improve the management of human resources (rules designating particular workers for particular workstations; instructions for the safe operation of machines and equipment; training of operators, etc.) and introduce programs to detect risks and to improve the safety of machines and equipment. We also recommend the establishment of a program to follow the results of any preventive measures adopted.

Stressful life events and occupational accidents

Objective: The purpose of this study was to examine the association between stressful life events and occupational accidents. Methods: This was a population-based case-control study, carried out in the city of Botucatu, in southeast Brazil. The cases consisted of 108 workers who had recently experienced occupational accidents. Each case was matched with three controls. The cases and controls answered a questionnaire about recent exposure to stressful life events. Results: Reporting of environmental problems, being a victim of assault, not having enough food at home and nonoccupational fatigue were found to be risk factors for work-related accidents with estimated incidence rate ratios of 1.4 [95% confidence interval (95% CI) 1.1-1.7], 1.3 (95% CI 1.1 1-1.7), 1.3 (95% CI 1.1-1.6), and 1.4 (95% CI 1.2-1.7) respectively. Conclusions: The findings of the study suggested that nonwork variables contribute to occupational accidents, thus broadening the understanding of these phenomena, which can support new approaches to the prevention of occupational accidents.