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No. of bitstreams: 2 license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) elaine_lourdes_carneiro.pdf: 2018444 bytes, checksum: a3b37838bef0c6cf66fcdce513304608 (MD5) Previous issue date: 2013 / Funda??o de Amparo ? Pesquisa do estado de Minas Gerais (FAPEMIG) / Estudo que objetivou desvelar o processo de atividade de trabalho que subjaz a realiza??o ou n?o das atividades referentes ? Vigil?ncia em Sa?de, prescritas no Relat?rio Final de Auditoria de Sistema Municipal de Sa?de/2009, a partir das significa??es produzidas por um T?cnico de um munic?pio auditado pela equipe do N?cleo Macrorregional de Auditoria Assistencial Jequitinhonha/MG. Assim como, definir juntamente a esse sujeito, estrat?gias de enfrentamento dos fatores que dificultam a realiza??o das atividades prescritas. Os cen?rios de estudo foram tr?s munic?pios auditados por essa equipe entre junho/2009 e dezembro/2010. Participaram sete sujeitos: quatro T?cnicos que realizam atividades de Vigil?ncia em Sa?de e tr?s Gestores Municipais de Sa?de. Contudo, apenas um teve todas as suas informa??es interpretadas nessa disserta??o. Os pressupostos epistemol?gicos orientadores do estudo foram algumas categorias da Psicologia S?cio-Hist?rica e da Cl?nica da Atividade. As t?cnicas utilizadas para apreens?o de informa??es foram: An?lise Documental, Entrevista Semi-estruturada e Centralizada/Tem?tica (ambas recorrentes), Narrativa de Hist?ria de Vida e o C?rculo de Cultura. Para an?lise das informa??es foram utilizados os N?cleos de Significa??o e uma adapta??o da estrat?gia anal?tica adotada por Murta (2008). Foram sistematizados seis N?cleos de Significa??o: I) As rela??es familiares, o trabalho e o gosto pelo estudo: elementos constitutivos da identidade atual; II) O conflito da profiss?o: atividade de trabalho idealizada versus atividade de trabalho real; III) Os desafios da atividade de trabalho no contexto do SUS real; IV) A atividade dirigida no contexto do SUS municipal; V) A atividade de trabalho e o Projeto de Fortalecimento da Vigil?ncia em Sa?de em Minas Gerais; VI) Ressignificando a Auditoria e experimentando os sentidos por ela produzidos. Elementos como felicidade pelo reconhecimento social alcan?ado pela profiss?o, cren?a em sua boa forma??o profissional e resolutividade no servi?o, dedica??o e envolvimento afetivo com a comunidade constituem os sentidos subjetivos atribu?dos pelo T?cnico a sua atividade de trabalho. Estes, o ajudam a superar elementos decorrentes de um conflito entre profiss?es (sentimentos de frustra??o, impot?ncia, falta de autonomia), al?m das condi??es prec?rias de trabalho no SUS (remunera??o, tipo de v?nculo, sobrecarga de atividades, defici?ncia na forma??o de profissionais e aspectos normativo-organizativos do servi?o), tamb?m constitutivos de sentidos subjetivos. O T?cnico acredita na proposta da Vigil?ncia em Sa?de para efetiva??o de a??es em n?vel local, bem como no Projeto do Estado/MG que tem este objetivo. A experi?ncia com a auditoria permitiu ressignific?-la; elementos como inquieta??o, inc?modo e ansiedade cederam lugar ao contentamento, interesse e tranquilidade. A auditoria representou oportunidade de autoan?lise de sua atividade, bem como trouxe frustra??o por identificar falhas na mesma. Observou-se ser pouco consistente o grau de orienta??o social do T?cnico em sua rela??o de trabalho com a equipe de sa?de. Em poucos momentos, o profissional trouxe em suas narrativas estrat?gias de enfrentamento dos entraves presentes na sua atividade de trabalho. Reflex?es finais dessa pesquisa apontam para a necessidade de maior cuidado com a forma??o dos trabalhadores da Sa?de para que ampliem seu poder de agir, desenvolvendo possibilidades de utiliza??o de estrat?gias criativas e vi?veis para lidar com o real da sua atividade no SUS. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2013. / ABSTRACT This was a study that aimed to unveil the work activity process underlying the implementation, or not, of the activities related to Health Surveillance, prescribed in the Final Audit Report of the Municipal Health System/2009, based on the meanings produced by a Technician of a municipality audited by the team of the Jequitinhonha/Minas Gerais Healthcare Audit Macroregional Center. Likewise, it was the objective of this work to define, together with this subject, strategies to face the factors that hinder the implementation of the prescribed activities. The study scenarios were three municipalities audited by this team between June/2009 and December/2010. Seven subjects participated, namely: four Technicians who carried our Health Surveillance activities and three Municipal Health Managers. However, just one of these subjects had all of his information interpreted in this dissertation. The epistemological assumptions guiding the study were some categories of Socio-Historical Psychology and of the Activity Clinic. The techniques used for collecting information were: Documentary Analysis, Semi-structured and Centralized / Thematic Interviews (both recurrent), Interviews based on Life Story Narratives, and the Culture Circle. The information was analyzed using the Meaning Cores and an adaptation of the analytical strategy adopted by Murta (2008). Six Meaning Cores were systematized, as follows: I) Family relationships, work and the love of study: constituent elements of the current identity; II) Career-related conflict: idealized career aspirations versus actual work activity. III) The challenges of the work activities in the context of the actual SUS (Brazilian Unified Healthcare System); IV) The activity conducted in the context of the municipal SUS; V) The Work Activity and the Health Surveillance Strengthening Project in Minas Gerais; VI) Resignifying Audit and experiencing the meanings produced by it. Elements such as happiness for the social recognition achieved through his professional career, belief in his good professional background and problem-solving capacity at work, his dedication, and affective involvement with the community constitute the subjective meanings attributed by the Technician to his work activity. These help him overcome the elements deriving from a conflict in his career (a sense of frustration, a feeling of powerlessness, and absence of autonomy), as well as the poor working conditions at SUS (remuneration, type of employment relationship, heavy load of activities, deficiency in the training of professionals, and normative and organizational aspects of the service), which also constitute subjective meanings. The Technician believes in the proposal of the Health Surveillance for the implementation of actions at a local level, as well as in the Minas Gerais State Project, which has this aim. This experience with healthcare audit made it possible to resignify it. Elements such as the restlessness, nuisance and anxiety gave way to contentment, interest, and peace of mind. The audit represented an opportunity for self-analysis in his activity. However, it also gave rise to frustration, inasmuch as shortcomings were identified in it. It was observed that the degree of social orientation of the Technician was rather inconsistent in his working relationship with the healthcare team. Just on a few occasions, the professional presented, in his narratives, strategies to tackle the barriers in his work activities. The concluding remarks from this research indicate that greater care should be taken in training Health workers, so that they can increase their power to act through the development of possibilities to use creative and feasible strategies to deal with the real situation of their activity at SUS.