cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.14327370
title: Prevalence of symptoms of depression among community health workers

description: Abstract Community health workers are indispensable, and they are considered important actors in the organization of the Unified Health System. The present study had the goal of evaluating the prevalence of symptoms of depression related to the occupational, sociodemographic and lifestyle factors of the workers. We performed a cross-sectional study with 400 community health workers through individual interviews in basic health units of a municipality of the state of Minas Gerais, Brazil, between 2015 and 2017. The dependent variable was the prevalence of symptoms of depression (Patient Health Questionnaire), and the independent variables were psychosocial stress at work (demand-control model); social support; socioeconomic and demographic profile; self-perception of health; physical activity; labor characteristics and conditions; ability to work; and quality of life. The prevalence of symptoms of depression among the workers was of 20.6%. In the multivariate analysis, the prevalence of depression was associated with low or moderate ability to work, low social support, the upper, middle and lower strata of the lower class, and to the physical and psychological domains of quality of life. We suggest the creation of spaces to discuss mental health related to work.
DOI: 10.6084/m9.figshare.14327370.v1
title: Prevalence of symptoms of depression among community health workers

description: Abstract Community health workers are indispensable, and they are considered important actors in the organization of the Unified Health System. The present study had the goal of evaluating the prevalence of symptoms of depression related to the occupational, sociodemographic and lifestyle factors of the workers. We performed a cross-sectional study with 400 community health workers through individual interviews in basic health units of a municipality of the state of Minas Gerais, Brazil, between 2015 and 2017. The dependent variable was the prevalence of symptoms of depression (Patient Health Questionnaire), and the independent variables were psychosocial stress at work (demand-control model); social support; socioeconomic and demographic profile; self-perception of health; physical activity; labor characteristics and conditions; ability to work; and quality of life. The prevalence of symptoms of depression among the workers was of 20.6%. In the multivariate analysis, the prevalence of depression was associated with low or moderate ability to work, low social support, the upper, middle and lower strata of the lower class, and to the physical and psychological domains of quality of life. We suggest the creation of spaces to discuss mental health related to work.
DOI: 10.6084/m9.figshare.14327374.v1
title: From the specific actions to government mark: medicine in the trajectory of the national policy of education and work regulation in health

description: Abstract This article analyzes the trajectory of the Brazilian policy of education and work regulation considering institutional issues and forms of incorporation of medicine on the policy, comprising the period from 2003 to 2015. This study was based on contributions of historical institutionalism, involving the analysis of legal and normative documents, interviews with state personnel and data from federal financing reports of the policy. Five key moments were defined, considering political-institutional contexts, governmental initiatives, and the insertion of medicine into the agenda of governments. The emphasis on the medical profession evolved from one-off actions to the status of a landmark, in a context of loss of space of the health workforce agenda and increasing prioritization of education actions, associated with institutional gains and changes in funding. The More Doctors Program resulted from the dynamics of the trajectory, incorporating advances in the training and incorporation of physicians into the Unified Health System of Brazil. Challenges remain, however, related to precarious employment relationships, the privatization of medical education, and professional regulation that considers the exercise of medicine in the private sector.
DOI: 10.6084/m9.figshare.14269584
title: Provision of physicians in primary health care in the state of Paraíba, Brazil, according to the More Doctors’ Program

description: Abstract The provision of physicians has been the object of international discussions for decades, and the same is true for Brazil, where there is a situation of shortage and bad distribution of physicians. The present research had the aim of describing the profile of the physicians included in the ‘More Doctors’ Program (Programa Mais Médicos, in Portuguese). It is a quantitative, cross-sectional, descriptive study, followed by a case study with information from 272 questionnaires. The data were analyzed using the SPSS statistical software, version 22.0. The average age of the interviewees was 38.2 years, and 50.7% of them were female, 11% were in their first jobs, 51.1% had graduated between 1 and 5 years prior to the study, and 85% reported having experience working in primary health care. We observed that, with the implementation of the ‘More Doctors’ Program in the state of Paraíba, Northeastern Brazil, there was a change not only in the amount of doctors, but also in the number of job posts, in the number of physicians who go work on the countryside, and in the redistribution of these professionals. However, the results indicate that there still are 22 municipalities in Paraíba without physicians, and that 85.3% of the physicians included in the Program still did not have a specialist title. The conditions of access and the quality of the services provided still constitute a great challenge yet to be overcome.
DOI: 10.6084/m9.figshare.14327374
title: From the specific actions to government mark: medicine in the trajectory of the national policy of education and work regulation in health

description: Abstract This article analyzes the trajectory of the Brazilian policy of education and work regulation considering institutional issues and forms of incorporation of medicine on the policy, comprising the period from 2003 to 2015. This study was based on contributions of historical institutionalism, involving the analysis of legal and normative documents, interviews with state personnel and data from federal financing reports of the policy. Five key moments were defined, considering political-institutional contexts, governmental initiatives, and the insertion of medicine into the agenda of governments. The emphasis on the medical profession evolved from one-off actions to the status of a landmark, in a context of loss of space of the health workforce agenda and increasing prioritization of education actions, associated with institutional gains and changes in funding. The More Doctors Program resulted from the dynamics of the trajectory, incorporating advances in the training and incorporation of physicians into the Unified Health System of Brazil. Challenges remain, however, related to precarious employment relationships, the privatization of medical education, and professional regulation that considers the exercise of medicine in the private sector.
DOI: 10.6084/m9.figshare.14269584.v1
title: Provision of physicians in primary health care in the state of Paraíba, Brazil, according to the More Doctors’ Program

description: Abstract The provision of physicians has been the object of international discussions for decades, and the same is true for Brazil, where there is a situation of shortage and bad distribution of physicians. The present research had the aim of describing the profile of the physicians included in the ‘More Doctors’ Program (Programa Mais Médicos, in Portuguese). It is a quantitative, cross-sectional, descriptive study, followed by a case study with information from 272 questionnaires. The data were analyzed using the SPSS statistical software, version 22.0. The average age of the interviewees was 38.2 years, and 50.7% of them were female, 11% were in their first jobs, 51.1% had graduated between 1 and 5 years prior to the study, and 85% reported having experience working in primary health care. We observed that, with the implementation of the ‘More Doctors’ Program in the state of Paraíba, Northeastern Brazil, there was a change not only in the amount of doctors, but also in the number of job posts, in the number of physicians who go work on the countryside, and in the redistribution of these professionals. However, the results indicate that there still are 22 municipalities in Paraíba without physicians, and that 85.3% of the physicians included in the Program still did not have a specialist title. The conditions of access and the quality of the services provided still constitute a great challenge yet to be overcome.
DOI: 10.6084/m9.figshare.14327376.v1
title: Challenges in the training of mid-level workers for the Unified Health System in the state of Maranhão, Brazil

description: Abstract Historically, the training of mid-level health workers has been provided sporadically, with a focus on know-how. Within the context of the Brazilian Sanitary Reform, initiatives such as the ‘Large-Scale Training Project’ boosted the transition to an understanding of the critical-reflective technical work, and required a new model of training for basic- and mid-level workers. The Mid-Level Professional Training Program is the most recent large-scope initiative to qualify the work in the Unified Health System. We analyzed the profile, the work placement and the perception regarding the training process of this Training Program in the state of Maranhão, Brazil, of 404 graduates from the Technical School of the Unified Health System in Maranhão. We identified that: the socioeconomic profile of the graduates seems to mirror social inequalities; the teaching-learning process was in line with the guidelines of the Unified Health System, with pedagogical contradictions to be considered; and that there is a difficulty in retaining the trained professionals, which is expressed by the loss of ties, and the migration to private health services and to other fields not related to health. The qualification of professionals is complex, requiring actions in the field of political-pedagogical projects and work management projects, which go beyond the extension of the offer of enrollment spots in professionalization courses.
DOI: 10.6084/m9.figshare.14327376
title: Challenges in the training of mid-level workers for the Unified Health System in the state of Maranhão, Brazil

description: Abstract Historically, the training of mid-level health workers has been provided sporadically, with a focus on know-how. Within the context of the Brazilian Sanitary Reform, initiatives such as the ‘Large-Scale Training Project’ boosted the transition to an understanding of the critical-reflective technical work, and required a new model of training for basic- and mid-level workers. The Mid-Level Professional Training Program is the most recent large-scope initiative to qualify the work in the Unified Health System. We analyzed the profile, the work placement and the perception regarding the training process of this Training Program in the state of Maranhão, Brazil, of 404 graduates from the Technical School of the Unified Health System in Maranhão. We identified that: the socioeconomic profile of the graduates seems to mirror social inequalities; the teaching-learning process was in line with the guidelines of the Unified Health System, with pedagogical contradictions to be considered; and that there is a difficulty in retaining the trained professionals, which is expressed by the loss of ties, and the migration to private health services and to other fields not related to health. The qualification of professionals is complex, requiring actions in the field of political-pedagogical projects and work management projects, which go beyond the extension of the offer of enrollment spots in professionalization courses.
DOI: 10.6084/m9.figshare.14327377
title: Disabled civil servants with ties to the indirect public administration in the northeast of Brazil

description: Abstract The 1988 Brazilian Federal Constitution established specific posts for disables people in the public sector. The present article had the goal of describing the demographic and socioeconomic profile of disabled persons in the nine states of the Northeastern region of Brazil and compare it to that of the civil servants without disabilities in 2017. It is a cross-sectional study with secondary data from the Annual List of Social Data about 312,194 civil servants. We calculated the frequencies of the civil servants with and without disabilities according to gender, type of disability, age group, level of schooling, occupation, type of employment bond, time on the job, wage, and weekly working hours. The percentage of people with disabilities was below 2%, and the sample had a mean age of 44.2 years (standard deviation: 10.4), a higher prevalence of the male gender, basic level of schooling, and their jobs were tied to the Brazilian Consolidated Labor Legislation. By stratifying by type of employment bond and other variables, the civil servant without disability has a longer time on the job, higher hourly wages, higher wages, and lower weekly working hours than the disabled civil servants. The lower presence of women among the persons with disabilities in the public sector, as well as the lower wages verified among the group of disabled civil servants may guide, within those spaces, the need for more policies of inclusion and isonomy, as well as for more studies following this line of investigation.
DOI: 10.6084/m9.figshare.14327380.v1
title: Ongoing education in health: practices developed in the unicipalities of the state of Goiás, Brazil

description: Abstract Ongoing education in health guides significant learning processes, and proposes the production of effective results in health actions. This study had the goal of outlining the profile of the practices of ongoing education in health in the municipalities of the state of Goiás, Brazil, under the perspective of the representatives of the field. The present cross-sectional research used a semi-structured questionnaire that was filled out online by the participants. Most of the respondents are local references regarding ongoing education in health (68.9%); they are nurses who also work as primary care coordinators (31.8%). There was a predominance of municipalities that identify the existence of ongoing education in their territories (66.2%). In general, the actions are promoted by the municipalities themselves (61.3%) or by the regional health department (37.9%), and ongoing education stands out, followed by the (re)organization of the work processes and education in health. Factors regarding attitude, interpersonal relationships and human resources were pointed out as the most frequent challenges. Based on this diagnosis, we understand that most of the problems identified could be subjected to intervention. This study provides inputs for the strategic planning of ongoing education in health, for the support to the agencies responsible for its promotion and management in the municipalities, and to strengthen the ongoing education actions in the health services.
DOI: 10.6084/m9.figshare.14327380
title: Ongoing education in health: practices developed in the unicipalities of the state of Goiás, Brazil

description: Abstract Ongoing education in health guides significant learning processes, and proposes the production of effective results in health actions. This study had the goal of outlining the profile of the practices of ongoing education in health in the municipalities of the state of Goiás, Brazil, under the perspective of the representatives of the field. The present cross-sectional research used a semi-structured questionnaire that was filled out online by the participants. Most of the respondents are local references regarding ongoing education in health (68.9%); they are nurses who also work as primary care coordinators (31.8%). There was a predominance of municipalities that identify the existence of ongoing education in their territories (66.2%). In general, the actions are promoted by the municipalities themselves (61.3%) or by the regional health department (37.9%), and ongoing education stands out, followed by the (re)organization of the work processes and education in health. Factors regarding attitude, interpersonal relationships and human resources were pointed out as the most frequent challenges. Based on this diagnosis, we understand that most of the problems identified could be subjected to intervention. This study provides inputs for the strategic planning of ongoing education in health, for the support to the agencies responsible for its promotion and management in the municipalities, and to strengthen the ongoing education actions in the health services.
DOI: 10.6084/m9.figshare.14327382.v1
title: Validation of the logical model of implementation of the ongoing education in Health Policy in Primary Health Care

description: Abstract The goal of this study was to describe the process of validation of the logical model of implementation of the Ongoing Education in Health Policy in Primary Health Care in the municipality of Vitória, state of Espírito Santo, Brazil. It was an evaluability study in which quantitative and qualitative techniques were used. We used the Delphi method with 15 (municipal and state) specialists, between January and June 2019. The participants classified the structural components, and the activities and products needed for the implementation of the policy and its respective results and impacts. There was a consensus regarding the items that would reach more than 80% of agreement, which were confirmed by the analysis of the median and interquartile range. The results were organized according to the technical components. Financial and human resources were considered indispensable. Regarding the processes, the items considered relevant for the implementation of the policy were: collective development of the ongoing education in health actions and of a document to guide the actions of the municipality, as well as evaluation instruments. The items regarding the results and impact were considered relevant, except for those related to the organization and structuring of the policy at the state and regional levels. The validated logical model was established as a contribution to the management of the Ongoing Education in Health Policy in Vitória.
DOI: 10.6084/m9.figshare.14327382
title: Validation of the logical model of implementation of the ongoing education in Health Policy in Primary Health Care

description: Abstract The goal of this study was to describe the process of validation of the logical model of implementation of the Ongoing Education in Health Policy in Primary Health Care in the municipality of Vitória, state of Espírito Santo, Brazil. It was an evaluability study in which quantitative and qualitative techniques were used. We used the Delphi method with 15 (municipal and state) specialists, between January and June 2019. The participants classified the structural components, and the activities and products needed for the implementation of the policy and its respective results and impacts. There was a consensus regarding the items that would reach more than 80% of agreement, which were confirmed by the analysis of the median and interquartile range. The results were organized according to the technical components. Financial and human resources were considered indispensable. Regarding the processes, the items considered relevant for the implementation of the policy were: collective development of the ongoing education in health actions and of a document to guide the actions of the municipality, as well as evaluation instruments. The items regarding the results and impact were considered relevant, except for those related to the organization and structuring of the policy at the state and regional levels. The validated logical model was established as a contribution to the management of the Ongoing Education in Health Policy in Vitória.
DOI: 10.6084/m9.figshare.14327389
title: Social dimension in medical education: the context life in problem based learning

description: Abstract This study characterizes the social dimension in the contexts represented in problem situations in a São Paulo state medical course that uses Problem-Based Learning. A total of 69 problem situations were analyzed, triggering the learning process from the first to the fourth grade and their respective tutor guides. To read the material, the Social Dimension Analysis Guide was used, developed by the researchers based on related documents and literature. For analysis, the discursive textual analysis method was adopted. The comparison between the learning objectives presented in the problem situations and in the guides showed disagreements and dichotomies. The characterization of the explored contexts did not portray the real territory: social equipment was scarcely addressed, but the areas of competence of individual, collective and management care placed a satisfactory emphasis on public policies. The analyzes of areas of risk, diversity and vulnerable groups were superficial and the intersectoral approach was little used. It is hoped, with these results, to provoke reflections about the construction of problem situations in problem-based learning, because the deepening of the description, such as the expansion of its approach, may favor the theoretical-practical articulation, the extended learning and the training medical care focused on comprehensive care.
DOI: 10.6084/m9.figshare.14327389.v1
title: Social dimension in medical education: the context life in problem based learning

description: Abstract This study characterizes the social dimension in the contexts represented in problem situations in a São Paulo state medical course that uses Problem-Based Learning. A total of 69 problem situations were analyzed, triggering the learning process from the first to the fourth grade and their respective tutor guides. To read the material, the Social Dimension Analysis Guide was used, developed by the researchers based on related documents and literature. For analysis, the discursive textual analysis method was adopted. The comparison between the learning objectives presented in the problem situations and in the guides showed disagreements and dichotomies. The characterization of the explored contexts did not portray the real territory: social equipment was scarcely addressed, but the areas of competence of individual, collective and management care placed a satisfactory emphasis on public policies. The analyzes of areas of risk, diversity and vulnerable groups were superficial and the intersectoral approach was little used. It is hoped, with these results, to provoke reflections about the construction of problem situations in problem-based learning, because the deepening of the description, such as the expansion of its approach, may favor the theoretical-practical articulation, the extended learning and the training medical care focused on comprehensive care.