cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.14327364.v1
title: FAMILY HEALTH SUPPORT CENTERS: CONCEPTIONS, IMPLICATIONS AND CHALLENGES FOR THE MATRIX SUPPORT

description: Abstract This study intended to analyze the assigned meaning and the contributions of the work of the Family Health Support Centers, as well as the barriers and challenges to the daily practice of matrix support. This is a qualitative study involving multiple cases, which was performed in six cities in Bahia, Brazil. Semi-structured interviews were conducted with 43 professionals from the support centers and 40 from the family health teams. We used the theoretical reference of the matrix support in the pedagogical, therapeutic and institutional dimensions. The results were grouped into three categories: (Mis) Understandings about the work of the support centers; Infrastructure and working conditions; Appreciation and management of work. Our study has unveiled divergent understandings among supporters and family health teams about the role of the matrix support process, with conflicting expectations and implications for work. The current infrastructure has proved to be insufficient and inappropriate for the work of matrix support. The little appreciation of the support centers was also highlighted through the low adherence of the community to the collective activities, unsatisfactory wages and excessive workload. Misunderstandings about the innovative nature of matrix support and structural difficulties indicate outstanding challenges for achieving the supportive function.
DOI: 10.6084/m9.figshare.7101842
title: HUMAN RESOURCES IN STATE HOSPITALS MANAGED BY HEALTH SOCIAL ORGANIZATIONS: THE LOGIC OF THE PRIVATE

description: Abstract 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.
DOI: 10.6084/m9.figshare.14327365
title: PROFESSIONAL EDUCATION IN COMPLEMENTARY AND ALTERNATIVE MEDICINE: CHALLENGES FOR THE PUBLIC UNIVERSITIES

description: Abstract Legitimated by the World Health Organization, Complementary and Alternative Medicine have shown an increasing demand in the Western world. Professional training is considered one of it’s biggest challenges to its advance in the Brazilian National Health System. The descriptive quantitative study presents the availability of modules of Complementary and Alternative Medicine in six public institutions of higher education at the state of Rio de Janeiro, 2014, identified on these respective websites and secretariat, and classified according to the variables: institutions of higher education, health subarea, level of education (undergraduate and graduate), subtopics of Complementary and Alternative Medicine (Homeopathy, Acupuncture, Meditation etc.); Format (mandatory, elective or optional) and content (informative or formative). The results shows an offer of 56 modules distributed in almost all sub-areas of health care, mainly in Medicine, Pharmacy and Nursing, with a predominantly optional and informative approach. The main themes are Homeopathy, Meditation and Body Practices. The analysis of this offer, based on the perspective of integral care and referenced in national and international literature, points out challenges for the expansion and qualification of the teaching of Integrative and Complementary Practices, among them the integrated insertion in health courses aiming at the interaction and complementarity between knowledge.
DOI: 10.6084/m9.figshare.14327365.v1
title: PROFESSIONAL EDUCATION IN COMPLEMENTARY AND ALTERNATIVE MEDICINE: CHALLENGES FOR THE PUBLIC UNIVERSITIES

description: Abstract Legitimated by the World Health Organization, Complementary and Alternative Medicine have shown an increasing demand in the Western world. Professional training is considered one of it’s biggest challenges to its advance in the Brazilian National Health System. The descriptive quantitative study presents the availability of modules of Complementary and Alternative Medicine in six public institutions of higher education at the state of Rio de Janeiro, 2014, identified on these respective websites and secretariat, and classified according to the variables: institutions of higher education, health subarea, level of education (undergraduate and graduate), subtopics of Complementary and Alternative Medicine (Homeopathy, Acupuncture, Meditation etc.); Format (mandatory, elective or optional) and content (informative or formative). The results shows an offer of 56 modules distributed in almost all sub-areas of health care, mainly in Medicine, Pharmacy and Nursing, with a predominantly optional and informative approach. The main themes are Homeopathy, Meditation and Body Practices. The analysis of this offer, based on the perspective of integral care and referenced in national and international literature, points out challenges for the expansion and qualification of the teaching of Integrative and Complementary Practices, among them the integrated insertion in health courses aiming at the interaction and complementarity between knowledge.
DOI: 10.6084/m9.figshare.7101842.v1
title: HUMAN RESOURCES IN STATE HOSPITALS MANAGED BY HEALTH SOCIAL ORGANIZATIONS: THE LOGIC OF THE PRIVATE

description: Abstract 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.
DOI: 10.6084/m9.figshare.7101482
title: ASSESSMENT OF LEARNING IN THE SUPERVISED INTERNSHIP IN NURSING IN COLLECTIVE HEALTH

description: Abstract In this thoughtful theoretical essay, we developed a discussion regarding the assessment of learning in the process of training for care in Nursing in Collective Health throughout the supervised internship. We had conversations with the authors of Collective Health and of the assessment of learning by competencies, mainly those involved in medicine, who were pioneers in this debate, using the hierarchical-conceptual model of assessment by competencies proposed by George Miller. We sought to make a contribution by presenting the possibilities of methods, tools and procedures for the assessment of learning in summative or formative contexts, and the perspectives and tendencies of the assessment of the teaching-learning process in the field of Nursing. We verified that the assessment by competencies needs to be more discussed in order to be in line with the ongoing syllabus changes and the demands for the training of professional profiles that is in accordance with the needs and principles of the Unified Health System (Sistema Único de Saúde, SUS, in the Portuguese acronym).
DOI: 10.6084/m9.figshare.7101482.v1
title: ASSESSMENT OF LEARNING IN THE SUPERVISED INTERNSHIP IN NURSING IN COLLECTIVE HEALTH

description: Abstract In this thoughtful theoretical essay, we developed a discussion regarding the assessment of learning in the process of training for care in Nursing in Collective Health throughout the supervised internship. We had conversations with the authors of Collective Health and of the assessment of learning by competencies, mainly those involved in medicine, who were pioneers in this debate, using the hierarchical-conceptual model of assessment by competencies proposed by George Miller. We sought to make a contribution by presenting the possibilities of methods, tools and procedures for the assessment of learning in summative or formative contexts, and the perspectives and tendencies of the assessment of the teaching-learning process in the field of Nursing. We verified that the assessment by competencies needs to be more discussed in order to be in line with the ongoing syllabus changes and the demands for the training of professional profiles that is in accordance with the needs and principles of the Unified Health System (Sistema Único de Saúde, SUS, in the Portuguese acronym).
DOI: 10.6084/m9.figshare.7103054
title: WORK PROCESS CONFIGURATIONS IN FAMILY HEALTH SUPPORT CENTERS AND COMPREHENSIVE CARE

description: Abstract The aim of this study was to systematize the configurations of Family Health Support Centers. A qualitative study was conducted in three municipalities of metropolitan Recife, in the state of Pernambuco, Brazil, and considered data collected from focus groups in three Family Health Support Centers and analyzed through the meaning condensation technique. The study’s findings allowed the systematizing of three types of configurations: the assistive-curative, which shows great distancing from the family health support center’s goals; the semi-matrical, considered to be an intermediary configuration, and the matrical, which stays closer to the ideal model, recommended by the Ministry of Health. In conclusion, there is, on all three municipalities, a recent and fragile family health proposal that, despite its potentialities, is permeated with conflicts, contestations and uncertainties. The findings of the present study can assist in the planning and execution of actions that seek to break from various hegemonic concepts regarding the work of primary healthcare professionals.
DOI: 10.6084/m9.figshare.7103054.v1
title: WORK PROCESS CONFIGURATIONS IN FAMILY HEALTH SUPPORT CENTERS AND COMPREHENSIVE CARE

description: Abstract The aim of this study was to systematize the configurations of Family Health Support Centers. A qualitative study was conducted in three municipalities of metropolitan Recife, in the state of Pernambuco, Brazil, and considered data collected from focus groups in three Family Health Support Centers and analyzed through the meaning condensation technique. The study’s findings allowed the systematizing of three types of configurations: the assistive-curative, which shows great distancing from the family health support center’s goals; the semi-matrical, considered to be an intermediary configuration, and the matrical, which stays closer to the ideal model, recommended by the Ministry of Health. In conclusion, there is, on all three municipalities, a recent and fragile family health proposal that, despite its potentialities, is permeated with conflicts, contestations and uncertainties. The findings of the present study can assist in the planning and execution of actions that seek to break from various hegemonic concepts regarding the work of primary healthcare professionals.
DOI: 10.6084/m9.figshare.7101659.v1
title: THE PARTICIPATION OF PRIVATE HIGHER EDUCATION INSTITUTIONS IN HEALTH TRAINING IN BRAZIL

description: Abstract Brazilian higher education has been historically marked by the presence of private institutions. During the unhindered expansion that took place over the past two decades, the private sector presented a growth in the number of enrollments and in the percentage of participation. This article describes the private participation in the undergraduate courses in health in the period between 1993 and 2013. The review of the literature on Brazilian higher education and the descriptive analysis of the secondary data evinced that the participation of the private sector in the training in health, in many aspects, has been compatible with the dynamics of the higher education sector. In the 1990s, the growth of the private sector was a trend in all undergraduate courses in health, and, in most courses, the growth rates were higher than the national average. In the period between 2003 and 2013, the courses of Medicine, Odontology and Social Services presented growth rates that were higher than those of the preceding period, and the other courses presented a decrease in the growth rates; as for the courses of Biology, Speech and Language Therapy and Occupational Therapy, a decrease in the number of enrollments in private institutions was observed.
DOI: 10.6084/m9.figshare.7101659
title: THE PARTICIPATION OF PRIVATE HIGHER EDUCATION INSTITUTIONS IN HEALTH TRAINING IN BRAZIL

description: Abstract Brazilian higher education has been historically marked by the presence of private institutions. During the unhindered expansion that took place over the past two decades, the private sector presented a growth in the number of enrollments and in the percentage of participation. This article describes the private participation in the undergraduate courses in health in the period between 1993 and 2013. The review of the literature on Brazilian higher education and the descriptive analysis of the secondary data evinced that the participation of the private sector in the training in health, in many aspects, has been compatible with the dynamics of the higher education sector. In the 1990s, the growth of the private sector was a trend in all undergraduate courses in health, and, in most courses, the growth rates were higher than the national average. In the period between 2003 and 2013, the courses of Medicine, Odontology and Social Services presented growth rates that were higher than those of the preceding period, and the other courses presented a decrease in the growth rates; as for the courses of Biology, Speech and Language Therapy and Occupational Therapy, a decrease in the number of enrollments in private institutions was observed.
DOI: 10.6084/m9.figshare.7101527
title: THE MEDICAL PRAXIS IN THE EMERGENCY CARE IN THE PRESENCE OF THE PATIENT WITH CHRONIC SEQUELAE: GUILT, FEAR AND COMPASSION

description: Abstract What is the relationship between urgencies and chronic care? This question, which is appa-rently paradoxical, was approached in an ethnography conducted at the largest emergency care hospital of a Brazilian metropolis; the ethnography investigated medical care from admission to the confirmation of the clinical and functional condition of the patient with severe sequelae. Between December 2012 and August 2013, we conducted interviews and participant observation with 43 physicians: 25 men and 18 women, aged between 28 and 69 years. The analysis, which was guided by the signs, meanings and actions model, led to the realization that the care varies according to the context: at the ‘gateway’ and at the ‘intensive therapy center’, the struggle to maintain life is intense; at the “chronic patient” sector, care is provided to people who survive, but who have a high degree of dependence. For the physician, ‘life’ means regaining previous function, while survival with dependence would mean a ‘living death.’ The physician refrains from dealing with a highly-limited human being, for he/she feels somehow guilty of the clinical picture, even though he/she feels compassion towards the patient who requires chronic care. The insufficiency of a long-term care network and the lack of palliative training on the part of the physicians cause suffering in those who care and in those who are cared for.
DOI: 10.6084/m9.figshare.7102376
title: WORKING CONDITIONS AND HEALTH IN THE CONTEXT OF SOCIAL SECURITY IN SANTA CATARINA, BRAZIL

description: Abstract The aim of this qualitative and quantitative research was to get to know and analyze the working conditions of the public servants who work at the National Institute of Social Security (from the Portuguese Instituto Nacional de Seguro Social) and have ties with the Social Security System in the south of the state of Santa Catarina, Brazil, focusing on the implications to their health. This exploratory research was performed between 2013 and 2017. The sample was composed of 165 workers from 11 agencies of the National Institute of Social Security in that region, who filled out a questionnaire with scales to rate working conditions and well-being in association with open questions. In a second moment, we adopted the narrative technique with the goal of complementing the data. The mean result of the working conditions scale (0-10) was 6.65 (SD = 1.39); as for the well-being, the mean result of the scale (0-7) was 4.99 (SD = 1.13). We observed ethical dilemmas deriving from the quality of the work, with the prioritization of the fulfillment of quantitative goals due to the introduction of the logic of the private sector within the management of the work in the public sphere. We concluded that the working conditions and well-being have negative repercussions on the health of the workers.
DOI: 10.6084/m9.figshare.7102376.v1
title: WORKING CONDITIONS AND HEALTH IN THE CONTEXT OF SOCIAL SECURITY IN SANTA CATARINA, BRAZIL

description: Abstract The aim of this qualitative and quantitative research was to get to know and analyze the working conditions of the public servants who work at the National Institute of Social Security (from the Portuguese Instituto Nacional de Seguro Social) and have ties with the Social Security System in the south of the state of Santa Catarina, Brazil, focusing on the implications to their health. This exploratory research was performed between 2013 and 2017. The sample was composed of 165 workers from 11 agencies of the National Institute of Social Security in that region, who filled out a questionnaire with scales to rate working conditions and well-being in association with open questions. In a second moment, we adopted the narrative technique with the goal of complementing the data. The mean result of the working conditions scale (0-10) was 6.65 (SD = 1.39); as for the well-being, the mean result of the scale (0-7) was 4.99 (SD = 1.13). We observed ethical dilemmas deriving from the quality of the work, with the prioritization of the fulfillment of quantitative goals due to the introduction of the logic of the private sector within the management of the work in the public sphere. We concluded that the working conditions and well-being have negative repercussions on the health of the workers.
DOI: 10.6084/m9.figshare.7101527.v1
title: THE MEDICAL PRAXIS IN THE EMERGENCY CARE IN THE PRESENCE OF THE PATIENT WITH CHRONIC SEQUELAE: GUILT, FEAR AND COMPASSION

description: Abstract What is the relationship between urgencies and chronic care? This question, which is appa-rently paradoxical, was approached in an ethnography conducted at the largest emergency care hospital of a Brazilian metropolis; the ethnography investigated medical care from admission to the confirmation of the clinical and functional condition of the patient with severe sequelae. Between December 2012 and August 2013, we conducted interviews and participant observation with 43 physicians: 25 men and 18 women, aged between 28 and 69 years. The analysis, which was guided by the signs, meanings and actions model, led to the realization that the care varies according to the context: at the ‘gateway’ and at the ‘intensive therapy center’, the struggle to maintain life is intense; at the “chronic patient” sector, care is provided to people who survive, but who have a high degree of dependence. For the physician, ‘life’ means regaining previous function, while survival with dependence would mean a ‘living death.’ The physician refrains from dealing with a highly-limited human being, for he/she feels somehow guilty of the clinical picture, even though he/she feels compassion towards the patient who requires chronic care. The insufficiency of a long-term care network and the lack of palliative training on the part of the physicians cause suffering in those who care and in those who are cared for.
DOI: 10.6084/m9.figshare.7101656
title: POOR SELF-ASSESSMENT OF THE HEALTH OF PRIMARY HEALTH CARE NURSING WORKERS

description: Abstract The goal of this study is to assess the elements associated with the negative self-assessment of health among nursing workers. We performed a cross-sectional exploratory study, with a probability sample composed of 451 Primary Health Care nursing workers. We applied a questionnaire with sociodemographic data, as well as data on life habits, occupations, psychosocial aspects and satisfaction at work and morbidity of the workers. The self-assessment of health was measured through the question “Overall, in comparison with other people your age, how would you consider your own health status?” The data was analyzed using the model of logistic regression in blocks. We identified a prevalence of 15.8% of negative health self-assessments. The factors associated to it were: incompatibility of the activities developed with the position, medium and high housework overload, active work situation (high control, high demand), poor assessment of the quality of life, and common mental disorders. The findings confirm the relationship between the health-disease process and the life and working conditions, and point to a need for public policies of prevention and promotion of the health of nursing workers. By constituting favorable work situations, these policies may be highly relevant for the quality of the care provided to the users of the Brazilian Unified Health System (Sistema Único de Saúde, SUS, in the Portuguese acronym).