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

The study aimed to evaluate the role played by the Unified Health System’s position, career, and wage plan in Guarulhos municipality, in the state of São Paulo, Brazil, as a possible tool to improve labor relations, as recommended by the Ministry of Health. The research carried out between 2013 and 2014 was based on the collection and the analysis of the content of interviews conducted with managers and health worker focus groups. It was noted that the position, career, and wage plan has a strong technical and administrative bias, being seen as a tool for organizing workers in positions/jobs at health service locations. It is emphasized that initiatives that could promote professional fixation and development towards a career were affected budgetary restrictions that have compromised their application under the law. Hiring under it, which takes place via a public contest, included only direct administration employees, and the hiring of human resources through non-state partnerships was concomitant with its implementation. It was concluded that the position, career and wage plan is an important, albeit limited tool to improve work in the Unified Health System, and it is necessary to expand discussions on the effects of the State’s Administrative Reform in health and its impacts on the organization of the workforce and on the concept of precarious work, linked only to the observance of labor and social rights.

The study that originated this article aimed to understand the representations of Family Health Strategy professionals and users about education in health. It was an study carried out using a qualitative approach and participant observation and interview techniques through content analysis. It was conducted in 2008 and 2009. The group's representation denoted ‘education’ and ‘health’ as assets of social, cultural, and historical value that should be preserved in the family and in society at large, anchoring health care on strategies that overlap the prescription of procedures and behaviors. However, health service professionals and users associate ‘health education’ to the conveyance of technical knowledge, which should be done by trained professionals. Prevailing in health education practices were prescribing healthy habits in the individual dimension; thematic groups focused on specific diseases or health conditions; the users' passive behavior; difficulties in adherence, and mandatory actions. All study subjects viewed the conveyance of knowledge and the prescribing of habits for individual self-care the prevalent ways of representing health education. Observed health education practices can be characterized as traditional health care practices.

This study aimed to compare the evaluation of the working environment and the rates of alcohol abuse, depression and Burnout Syndrome among health care workers from a public and a private hospital of the metropolitan region of Porto Alegre, Rio Grande do Sul, Brazil, between January 2009 and January 2010. It is a quantitative study of descriptive and comparative type. Participants were 182 health workers, which 92 from public hospital and 90 from private hospital. Participants answered five instruments individually: sociodemographic and labor questionnaire, Alcohol Use Disorders Identification Test, Beck Depression Inventory, Maslach Burnout Inventory and Work Context Assessment Scale. Data were analyzed by descriptive statistical analysis and Student t test for comparison of means between groups of the two hospital types. Results indicated that the work context was rated significantly more negative by workers of the public hospital. The data also showed higher rates of illness in professionals working in this type of institution. It was concluded that mental illness of health workers is more related to the type of working environment (public or private) than professional category.

The study aimed to describe the views nursing students had on the psychosocial impacts and on the coping strategies of a population made vulnerable in the context of the construction of the Petrochemical Complex in Rio de Janeiro, Brazil. It was a descriptive research action using a qualitative approach and including 18 nursing students by means of the application of photovoice techniques and focus groups during the month of May 2015. The data were subjected to analytical content treatment. As consequences of the plant's construction process, participants only highlighted drug consumption and trafficking, sexual violence, and the availability of health services as social impacts with great potential to lead to psychological issues in the population, such as anxiety and depression. Only two participants problematized strategies to cope with environmental stressors focused on collective action. It was concluded that including a cross-section mode of the socio-environmental theme – and its relation to the mental health of populations made vulnerable by the industrial project construction contexts in the country, in undergraduate courses and other academic spaces – is essential to encourage the critical, reflective, and political skills of future nurses on the relationship between development projects, environmental degradation, equity and psychological impact on the population.

This study examined the coordination of care based on data from the National Program for the Improvement of Quality and Access to Primary Care. It was a descriptive study based on questionnaires answered by 1,313 users and 324 primary care teams in the city of Rio de Janeiro (Brazil), in 2012. Dimensions such as the organization of the gateway, resolution and continuity of care, horizontal integration, organization of flows and access to the referral network, informational continuity, and communication among professionals were analyzed. The results indicated that primary health care has established itself as the preferred gateway. Users reported that primary care teams sought to solve their health issues, the electronic medical record was available, although it had not been integrated into the other levels, and the professionals stated they held weekly meetings and got matrix support. However, there was a long waiting time for specialized care and a lack of communication among professionals, a fact that not only hindered the users in their pursuit for care, but also revealed networking weaknesses. There was progress in the process of strengthening primary care and challenges to the establishment of the Health Care Network that minimized the possibilities for care coordination by the primary care teams.

The work presented here resulted from document research, semi-structured interviews, and focus groups with health teams, resident supporters, and primary care management on the joint experience between the matrix support and reference teams at family health units in the context of the reformulation of the care model being implemented in a municipality in the state of São Paulo in the first half of 2009. The authors reflected on the experience based on three dimensions: The initial understanding of the proposal, daily work, and the impact on the matrix support work process. It was found that there were proposal-understanding issues in the matrix support and that it came up against the predominance of biological healing practices and limits with regard to solving the population's problems. The integration among professionals enabled joint pacts, interdisciplinary work, and the construction of common therapeutic projects, allowing for promising prospects. We hope that these findings subsidize the current discussions on the planning and management of the matrix support in the local health system.

This study presents the educational concepts and practices in health of professionals in the Family Health strategy at a small city in the state of Rio Grande do Norte, Brazil. The survey was conducted among 18 high-level professionals, among whom physicians, nurses, and dentists, between October and December 2013. Semi-structured interviews and observation guided by ethnographic principles were used. Bardin content analysis supported the analysis of the material. The results show that the health education concepts and practices are guided by a ‘banking education’ that is based on the transmission and reproduction of knowledge. The educational activities are eminently aimed at disease prevention and conducted largely by nurses and graduate students taking internships at the Family Health Units. It was observed that the health education practiced does not instrumentalize users to develop autonomy and become the subjects of their lives and of their history.

The environmental characteristics and the way work is organized in specialized health centers can lead to stressful situations and have negative effects on the workers’ health. The aim of the study was to evaluate the mental health of health professionals working at the specialized network of Aracaju, state of Sergipe, Brazil, and situations of occupational stress based on the effort-reward model. It is a cross-sectional study conducted in 2011 among 94 health professionals working at two specialized care centers. A questionnaire containing demographic and economic variables, the situation and working environment, occupational stress assessments (using Effort-Reward Imbalance) and a Self-Reporting Questionnaire were used to measure common mental disorders. There was a high prevalence of common mental disorders (50.6%), which were more frequent among speech therapists, psychologists, occupational therapists and physical therapists, and among those who reported being dissatisfied with their pay and work conditions. All professionals who mentioned imbalance between their efforts and their rewards at work presented common mental disorders. In sum, working characteristics unfavorable to the professionals and to the performance of their duties were identified, as was a high prevalence of common mental disorders. Programs aimed at the protection, enhancement and promotion of the workers’ health must be implemented in order to improve their quality of life at work.

This study aimed to understand the limits and possibilities for intersectorality that were created in the process of structuring the Brazilian social protection system. It is justified on the account of the potential attributed to intersectorality to overcome the fragmentation of knowledge and structures of society, creating the sharing and dialog spaces needed to solve complex issues and the ability to understand the challenges faced with the dilemma of operating intersectoral issues in traditionally sectoral environments. The text is divided into three parts: First, the notion of 'intersectionality' is worked on; the authors then outline the construction and characteristics of the Brazilian social protection system; finally, they discuss how the institutional conformation resulting from its configuration interferes in the form of joint social policies. It was concluded that the development process and the history of the construction of the Brazilian social protection system were marked by elements that produced an environment that is little favorable to intersectorality. A first draft of the intersectoral coordination occurred under the scope of the discussion on 'social development,' which took place late in Brazil and seems to have tried to reverse the stigma of little efficient and effective social policies. However, little progress has been made in this direction, and the current way of designating the State's social intervention remains plural (social policies) and sectorally referenced.

The article presents the different positions the current Brazilian public policies have on alcohol and drug abuse and discusses the possible effects such differences could have on the healthcare worker's performance. It is the outcome of documentary research on these policies, such as ordinances, laws, and decrees from 1938 to those currently in effect. We chose to list them chronologically, considering the two main political positions: 1. Focus on public security and justice; 2. focus on public health. We found that in this period there was a clear attempt to make a paradigm shift in order to include use prevention and treatment. However, the policies and the common sense still bear strong signs of idealistic views of a world free of drugs which are derived from moralistic, intolerant, and authoritarian concepts such as the war on drugs, repression, and reductions in supply. It is in this context that public health professionals, especially those working in psychosocial alcohol and drug abuse care centers, face the challenge and experience the subjective effects of everyday work at the face of so many differences and contradictions.