Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Continuing education in health proposes the creation of collective spaces to lead health workers to reflect on and evaluate their actions in daily life in order to seek the transformation of health and education practices. This article proposes a discussion on continuing education based on the considerations made by the Family Health Strategy workers with regard to the processes of their professional activity. A qualitative study using the focal group technique was developed for the discussion. As a result, it was found that the health professionals' reflection about the reality of their own daily work allowed for a discussion on continuing education and, thus, the onset of a process of changing their practices.

Undergraduate studies in the fields of health are currently being debated regarding the need for change in their syllabuses concerning the principles of the Brazilian Unified Health System, among other topics. Overcoming the operational and technicist education and expanding the critical thinking abilities of the students about the historical and political determinations of health are among the challenges highlighted. The article analyzes the teaching/learning process with a critical perspective based on the Historical and Political Education Course for Undergraduate Health Students, an extension semi-virtual course offered nationally, and supported by the National Policy for Popular Education in Health within the Unified Health System. In the present article, we analyzed the experiences brought about by the course, which took place between March and December 2014. The development of the course was based on the theoretical and methodological conceptions of the construction of shared knowledge, guided by the field of Popular Education and Health. The article presents: the history and the process of development of the course, the political and pedagogical project, the educational and pedagogical materials, and the contributions and questions, with notes on the potential future implications in educational processes in the field of health.

The main goal of the present study was to analyze the politics of human resources in health in state hospitals managed by health social organizations in the state of Espírito Santo, Brazil. We conducted a qualitative research, choosing as the field of investigation the social organizations that manage public hospitals in the state. During the data collection process, we sought the regulations and management contracts signed between 2008 and 2016, and performed individual interviews with the human resources managers of the participating institutions. During the analysis of the fieldwork materials, we used the content analysis technique, and chose five empirical categories of analysis of the contracts: the employment relationship model, the permission to hire legal entities, the percentage of expenses with staff, the procedure used to hire staff, and the goals regarding people management. The interviews were analyzed through the units of meaning proposed by Kvale. The results showed that the contracts omit legally-required information and have too many amendments. The people management practices are typical of private companies, and follow some guidelines of the work in health, but without reference to the Brazilian Unified Health System (Sistema Único de Saúde, SUS, in the Portuguese acronym). They adopt methods that are different from the rules of the public service entrance exams and the non-precarization of labor.

The article opens a methodological discussion on health research prompted by discomfort caused by dominant directrix for which there is a reality ready to be unveiled, and the expectation is that the researcher will access it. We describe a cultivation of an investigative process by means of the return of results of an epidemiological research in Rio de Janeiro, Brazil, between 2010 and 2013. The return prioritized dialogue with the nursing teams, framed by the concept of restitution, from French Institutional Analysis. We discussion groups on findings and meetings on nursing workers’ health that brought together hospital managers and workers to agree measures on worker’s health field. Participation by all stakeholders changed manners of researching and intervening, on the basis that health practices are produced in encounters among subjects. Drawing on tools commonly used only to report fin-dings, we walked from the merely informative return to participative restitution. In shaping the return process collectively, the intention was to challenge researches such as those that consider a dichotomy between researchers and researched, since we consider that methodologies and instruments arise in process of co-engenderment. In that respect, it comes to transform health researchers ’ ethical concerns into a health researchers’ ethos, from the understanding that research happens in the collective, which includes researchers and researched in the production of a common.

Interdisciplinarity and its practical correlation, interprofessionality, are essential to the work in the Family Health Strategy. The objective was to characterize the interdisciplinary perspective of Family Health Strategy workers in a Brazilian capital, linking it to interprofessionality. Transversal, exploratory and descriptive study, developed from the qualitative and quantitative approaches. Data were collected from june to november 2014 through questionnaires and participant observation. The results of the questionnaire were converted into scores, allowing to classify the level of interdisciplinarity. The observation findings, recorded in the field diary, were submitted to content analysis and discussed in parallel with the quantitative findings. It was verified, in the questionnaires, that the dimension ‘reception’ was the only one that presented medium availability for practices that can make interdisciplinarity feasible. The results indicate that the health professionals’ perception about interdisciplinarity was positive, however, contradictions of these findings with the ones observed locus . In the participant observation, it was verified that the professionals need to follow some paths in the sense of materializing the interdisciplinarity in collaborative interprofessional practices. It is important to emphasize the need for management-level actions that favor these practices; Permanent education as a strategy for coping with integration difficulties; And the subjective investment of workers in the same direction.

The research presented in this article aims to investigate the ‘expression’ of certain dominant ‘logic’ in medical education by analyzing the expectancies of students of a medical teaching institution in relation to a discipline focused on topics/questions of social sciences in health and coordinated by social scientists. The material analyzed comprises expectations of 72 students collected by an invitation to write freely about what they expect from the discipline. The result shows the dominance of discourses and pedagogical experience that contribute to production of an ‘instrumental’ and ‘colonial’ conception of the medical practice and allows us to understand some difficulties to the critical-reflexive exercise of social science in the medical education. Identifying the need to deconstruct this ‘logic’, the article concludes not with a concrete pedagogical proposal, but with the indication of the need for a process of deinstitutionalization/ institutionalization oriented to epistemic ‘decompression’ of the field of health in general and medical education in particular, an opening to other agents, other epistemologies and to the possibility of new productive connections in the field of health and medicine.

The research had the goal of analyzing the perception regarding the work on the Family Health Strategy. We conducted a case study in the city of João Pessoa, in the state of Paraíba, Brazil, in 2014, with a questionnaire applied to a sample of workers with higher education (n = 342), interviews with managers (n = 6), professionals (n = 12), and a simple in loco observation. The data were treated by means of an analysis of the content and by descriptive statistics. The most evident qualitative goal of the work performed by the Family Health Strategy was improving the health conditions of the users. It was put into effect though the prevention, promotion, education and treatment of diseases, incorporating the expanded concept of health and autonomy of the population. However, according to the quantitative data, little time was devoted to these activities when compared to the time devoted to the spontaneous demands, generating a significant number of individual consultations. Activities regarding education, prevention, promotion and group approaches must be stimulated and incorporated into the everyday activities of the Family Health Strategy in a manner that intersects all of the actions, in which the expanded medical practice is a powerful tool. More involvement on the part of the professionals in these activities will enhance the quality of the assistance though interprofessionality, and will help break free from curative practices.

Ethical problems in public health – especially those concerning primary health care – require a specific and adequate approach. The factor analysis of quantitative data about ethical problems in primary health care pointed to management, longitudinality, team experience, professional profile, secrecy and privacy as specific topics. In the subsequent qualitative stage, we searched for examples and solutions through a focal discussion with primary health care teams in the cities of Porto Alegre and Sapucaia do Sul, in the state of Rio Grande do Sul, Brazil. The adopted methodological approach was the Grounded Theory. The analysis of the results had as reference points the causal and intervening conditions and the strategies for action when facing these problems. The fragmentation of care and the lack of prominence, caused by insufficient planning and permanent education, weaken the users and the professionals. The refinement of these results through selective codification reached the nuclear category of programmatic vulnerability as an explanatory category for the occurrence of ethical problems in primary health care.

This study aimed at analyzing the work process in the daily life of the community health agents and the strategies used to deal with the common adversities to the work process within the scope of the Family Health Strategies) of a District Health Management Center in the municipality of Porto Alegre, Rio Grande do Sul, Brazil. This is a qualitative study, carried out from August 2015 to February 2016, by means of focal groups and semi-structured interviews. The analysis of the data was done by thematic categorization. The results emerged from four main themes: Administrative work and the decharacterization of the Community Health Agents work; The daily life in a team and their working conditions; The attention networks and their discontinuity in health care; and Coping strategies between difficulties and potency. By considering the interfaces between actual and prescribed work of the community health agents, it is not possible to deny the need for dialogue between social control, professionals and managers to deal with situations that cause suffering to users and professionals.

This paper analyzes the mediation between the school and the employment market in the mid-level technical training in Brazilian teaching institutions belonging to the Rede Federal de Educação Profissional, Científica e Tecnológica that materializes mainly through supervised internship activities. The paper's goal is to explain to what extent the mediation between school and employment market has been perverted by market logic, shifting the supervised internship activities of the teaching field to the field of workforce intermediation, giving it precarious job character. This is a basic research, developed by qualitative analysis, pointing as a result the distinction of conceptions and practices internship supervised in two categories. The first categorie is inserted in the pragmatic training perspective and another which is inserted in the omnilateral training perspective. The author points out the predominance of the pragmatic prospect of training in actions and conceptions of mediation between school and the employment market, which corrupts the internship activities supervised, giving it characteristics of precarious work.