Darbo tikslas - įvertinti Šiaulių miesto ir Joniškio rajono sveikatos priežiūros darbuotojų nuomonę apie stacionarinių sveikatos priežiūros paslaugų organizavimą ir darbo aplinką. Darbo uždaviniai: 1. Nustatyti gydytojų ir slaugytojų nuomonę apie stacionarinių sveikatos priežiūros įstaigų darbo aplinkos ypatumus. 2. Ištirti ir palyginti sveikatos priežiūros darbuotojų nuomonę apie sveikatos priežiūros įstaigų darbo aplinką miesto ir rajono ligoninėse. 3. Įvertinti stacionarinių sveikatos priežiūros paslaugų organizavimo ypatumus ir problemas sveikatos priežiūros įstaigose. Tyrimo metodika: Vienmomentinis kiekybinis tyrimas atliktas 2012 m. kovo-rugsėjo mėnesiais. Tyrime buvo apklausti 497 respondentai: 111 i6 Joniškio ir 386 iš Šiaulių (atsako dažnis – 95,6 proc.). Tyrimui atlikti buvo panaudotas originalus klausimynas. Statistinė analizė buvo atlikta taikant SPSS programinės įrangos paketą. Tyrimo rezultatai: Vertinant respondentų darbo sąlygas nustatyta, kad daugiau nei pusė (53,6 proc.) savo darbo sąlygas vertina vidutiniškai, 39,0 proc. labai gerai ir gerai ir 7,4 proc. respondentų labai blogai ir blogai. Dauguma (91,3 proc.) respondentų savo darbo sąlygas apibūdino kaip lydimas emocinės/psichologinės įtampos, 61,4 proc. darbas lydimas fizinės įtampos, pusė - darbo priemonių stygių bei darbą su dezinfekuojančiomis medžiagomis, trečdalis - pažymėjo darbą ankštose patalpose, ketvirtadalis – darbą blogai vėdinamose patalpose, o 18 proc. respondentų paminėjo asmens apsaugos... [toliau žr. visą tekstą] / The aim - to evaluate the Šiauliai city and Joniškis district hospitals health care workers opinion on inpatient health care organization and the work environment. The objectives: 1. To determine the opinion of doctors and nurses about the inpatient health care work environment. 2. To investigate and compare the health care staff views on the health care work environment for city and district hospitals. 3. To assess and evaluate of inpatient health care organization characteristics and problems of health care facilities. Methods: A cross-sectional quantitative study carried out in 2012 March-September. The study surveyed 497 respondents: 111 from Joniškis and 386 from Šiauliai (response rate - 95.6%). The original survey questionnaire was used. Statistical analysis was performed using SPSS software package. The results. Evaluation of the working conditions of the respondents found that more than half (53.6%) their working conditions the average, 39.0% very well and good, and 7.4% very bad and bad. The majority (91.3%) respondents described their working conditions as the accompaniment of emotional/psychological stress, 61.4% work is accompanied by physical exertion, half - work equipment shortages and work with the disinfectant, a third - said the work in tight spaces, a quarter - work in poorly ventilated areas, and 18.0% respondents mentioned the lack of personal protective equipment. 30.2% respondents rated poor facilities for recreation, every tenth respondent is... [to full text]

A atuação das Equipes de Saúde na Atenção Primária em Saúde, estruturam suas ações à população disponibilizando como ferramentas de trabalho o Matriciamento e o Projeto Terapêutico Singular (PTS), para melhorar a produção do cuidado através de uma relação horizontalizada, compartilhada e colaborativa. Este estudo tem como objetivo identificar os pontos facilitadores e limitantes do processo de trabalho entre as equipes da Estratégia Saúde da Família (ESF) e do Núcleo de Apoio a Saúde das Famílias (NASF) em duas Unidades Básicas de Saúde (UBS) pertencentes à Atenção Primaria à Saúde - APS Santa Marcelina, na região da zona Leste de São Paulo e comparar as diferenças na forma e organização de trabalho entre as equipes. Trata-se de um estudo qualitativo cujos dados foram coletados através de grupos focais e entrevistas individuais, e foram analisados e apresentados pela técnica de analise de conteúdo de Bardin que permitiu observar as características pessoais para o trabalho como: afinidade, conhecimento técnico, compartilhamento do trabalho, confiança e confiabilidade, convivência pessoal e profissional, disponibilidade, perfil individual/ envolvimento e participação / interesse, valorização e vínculo, quanto às características estruturais para o trabalho como atualização, estrutura de trabalho, interação, organização do trabalho, trabalho em equipe e absenteísmo, que representam as diferenças, as facilidades ou as limitações do trabalho dentro do contexto do trabalho em equipe. Assim sendo, foi possível concluir que a presença fixa do NASF na Unidade facilita a prática do trabalho compartilhado entre as equipes tanto nas características pessoais como estruturais de trabalho, na perspectiva da transdisciplinariedade de saberes e da integralidade do cuidado em saúde. / The work of the Health Teams in Primary Health Care, structure their actions to the population making available as work tools the \"Specialist Orientation\" and the Singular Therapeutic Project (STP), to improve the production of care through a horizontal relationship, shared and collaborative. This study aims to identify the facilitating and limiting points of the work process between the Family Health Strategy (FHS) and the Family Health Support Center (FHSC) teams in two Basic Health Units (BHU) belonging to Attention Primary Health Care - (APHC) Santa Marcelina, in the eastern region of São Paulo and compare the differences in the form and work organization among the teams. This was a qualitative study whose data were collected through focus groups and individual interviews, and were analyzed and presented by the Bardin content analysis technique that allowed observing the personal characteristics for the work such as: affinity, technical knowledge, work, trust and reliability, personal and professional coexistence, availability, individual profile / involvement and participation / concern, valuation and bonding, as well as the structural characteristics for work such as updating, work structure, interaction, work organization, teamwork and absenteeism, which represent the differences, facilities or limitations of work within the context of teamwork. So it was possible to conclude that the fixed presence of the FHSC in the Unit facilitates the practice of the work shared among the teams in both the personal and structural characteristics of work, in the perspective of the transdisciplinarity of knowledge and the integrality of health care.

Bakgrund: I socialtjänstens utredning om barn är barnen en viktig informationskälla. I svensk lagstiftning beskrivs det att barnets bästa ska betraktas när åtgärder rör dem. Socialarbetare känner sig ibland osäkra inför samtal med barn. Syftet med denna studie är att undersöka vilken möjlighet socialarbetarna har gällande kompetensutveckling i att samtala med barn och behovet av verksamhets ut veck l ing för att förbättra samtal med barn. I studien ingår det två arbetsgrupper, socialarbetare som arbetar inom öppenvården och socialarbetare som arbetar med främst myndighetsutövning, mellan dessa grupper kommer det ske jämförelse för att se om det finns likheter och olikheter i upplevelsen av sin kompetens. Metod: Studien har genomförts med kvantitativ metod där datainsamlingen har bestått i online - enkäter. I studien är det totalt 10 av de totalt 13 tillfrågade kommunerna i Region Jönköpings län som har tackat ja till att vara med. Av tillfrågade 77 socialarbetare inom den sociala barnavården deltog 52 (65,7 procent) och av dessa arbetar 19 inom öppenvården och 33 arbetar med myndighetsutövning. Resultat: I studien framgår det att det finns förbättringsmöjligheter i samtal med barn för socialarbetare rörande utbildning och arbetsmaterial. I studien framgår det också att det inte finns några signifikanta skillnader mellan socialsekreterare och behandlare. Slutsats: Studien tyder på att socialarbetare är i behov av mer kunskap kring samtal med barn, samt att det finns områden som behöver förbättras för att känslan i samtalet med barnet ska bli mer positiv. / Background: Children are an important source of information in the investigations of the social services. Swedish law stipulates that the best interests of the child should be considered when measures concern them. Social workers sometimes feel insecure about speaking with children. The purpose of this study is to examine the opportunities of social workers for training in speaking with children, and the need for development of the organization in order to improve conversations with children. Two groups are included in the study, social workers that work with non-institutional care, and social workers that primarily work with the exercise of public authority. These groups will be compared to see whether there are similarities and differences in their perception of competence. Method: The study has been done by a quantitative method where data has been collected with online surveys. In total, 10 of the 13 municipalities in Jönköping County have participated in the study. Out of the 77 social workers in child welfare asked to participate, 52 (65.7 per cent) chose to do so, whereof 19 work with non-institutional care and 33 with the exercise of public authority. Results: The study shows that there is room for improvement of social workers’ conversations with children with regards to education and work material. The study also shows that there are no significant differences between different types of social workers. Conclusions: The study indicates that social workers need more knowledge of speaking with children, and that there are areas that need improvement for the conversation with the child to be perceived as more positive.

The Community Service Organization, a grassroots social service agency that originated in Los Angeles in the late 1940s, is generally identified by its male leadership. Research conducted for the present oral history, however, indicates that Mexican American women were essential to the founding of the organization, as well as to its success during the forty-six years it was in operation. This paper is a history of the founding of the CSO based on interviews with eleven Mexican American women and one Mexican American man, all of whom were founding members.

Este trabalho é uma produção cartográfica da experiência de análise produzida com a equipe de trabalhadores de uma unidade básica de saúde, na perspectiva da produção do acolhimento, buscando destacar as perdas de sentido que capturam a produção do cuidado e os movimentos que apontam para novas formas de acolher o usuário, e, apostando na tese de que é possível explorar linhas de fuga para produzir vida na saúde. Contextualizamos a experiência no processo sócio-histórico da saúde que conforma modelos assistenciais segundo um recorte interessado da realidade, utilizando o referencial teórico metodológico da análise institucional, linha esquizoanalítica (Deleuze & Guattari), e do processo de trabalho em saúde (Merhy), destacando três aspectos intrinsecamente relacionados: a configuração de uma nova ordem, a da sociedade mundial de controle (Deleuze), promovendo um controle contínuo, instantâneo, em espaço aberto, através de senhas de acesso, e o perigo desta lógica dar a tônica a práticas como as de Saúde da Família; o desafio da construção de uma grupalidade a partir da constituição de uma equipe de trabalhadores, frente aos intensos processos de produção de subjetividade, à lida com a diversidade e complexidade da demanda de problemas dos usuários, às dificuldades da reconstituição dos saberes e práticas que já não dão conta de responder aos problemas, aos obstáculos da inclusão das diferenças explicitadas nas relações entre trabalhadores, e desses com os usuários; enfim, a micropolítica da relação trabalhador-usuário comandada por investimentos de interesse e desejo, conscientes e inconscientes e o modo como reproduzimos ou não a subjetividade dominante no processo de trabalho em saúde com todo seu arsenal tecnológico próprio. Na ambigüidade do desejo de saber e do medo de se ver, em meio as dores e sofrimentos de usuários e trabalhadores, a equipe foi se percebendo produzindo a exclusão dos usuários camuflada por critérios técnicos, clínicos, burocráticos e administrativos. Vivenciou as dificuldades de superar os obstáculos a despeito das ressonâncias e implicações que as dores e problemas dos usuários causam nos próprios trabalhadores, os conflitos que emergem nas relações entre os trabalhadores para a resolução dos problemas, sem conseguir ser efetiva em afastar-se de suas próprias dificuldades para olhar para o usuário. A análise revelou o funcionamento da equipe como o de uma escola, que fecha no período de férias, mas mantendo atividades mínimas sem conseguir, entretanto, estruturar o trabalho de forma que contemple o descanso do trabalhador e as necessidades dos usuários. À medida que a grupalidade vai ganhando consistência, apesar das crises e conflitos, é possível arriscar na explicitação do não-saber, buscar cooperação mútua para produção de cuidado com o outro e para a lida com os afetos inerentes ao encontro com este outro. Alguns elementos mostraram-se provocadores da ordem instituída com potência para criação do novo, como a presença dos agentes comunitários na equipe, as discussões de casos de famílias para a construção de projetos terapêuticos mais implicados e a mudança do locus de trabalho da unidade de saúde para o domicílio como possibilidade de mudança nas relações de poder entre trabalhador e usuários. / This work is a cartographic production as to analysis experience produced with the professional team at a basic health care unit, in terms of the welcoming reception, focusing on sense losses that capture care production and motion focusing on new ways for attending users as well as advocating the idea that it is possible to explore escape lines for producing life in health. We contextualize experience within health social-historic process that presents assistance models according to a point-of-view based on reality, using the methodological theoretical reference of institutional analysis, schizoanalytical line (Deleuze & Guattari), and health work process (Merhy), focusing on three intrinsically related aspects: (1) configuration of a new order - the world control society (Deleuze), providing continuous, immediate, and open control though access passwords, and how dangerous it is for such logic to replace Family Health practice; (2) team building challenge through professional team constitution, facing subjectivity intense production process, diversity and complexity as to user problem demand, reconstruction of knowledge and practice that are no longer able to solve such problems, barriers to inclusion of differences regarding professional-professional relationship and professional-user relationship; (3) finally, professional-user relationship micropolicy regulated by conscious and unconscious, interest and wish investment and the way we reproduce or not dominant subjectivity at the working process in health care with its own technological devices. Upon ambiguity as to wish for knowledge and fear of seeing, among user and professional pain and suffering, the team started excluding users through technical, clinical, bureaucratic, and administrative criteria. It has experienced how difficult it is to overcome barriers as to resonance and implication user pain and problem bring to professionals, conflict deriving from professionals trying to solve problems, being unable to get away from their own problems in order to face users problems. The analysis has found that team works as a school closing for vacation and keeping minimum activities at the same time; however, it cannot structure work in a way that professionals can have some rest and meet users needs. As team gets consistency, in spite of crises and conflicts, it is possible to present not-knowing explication, and search for mutual cooperation for care production and inherent affection. Some elements are presented as regular order breakers for new creation, such as community agents within the team, family case discussion for therapeutical project construction and the working locus shift from health care unit to homes as a way to modify power relationship between professional and user.

Submitted by Vanessa Nunes (vnunes@unisinos.br) on 2015-03-16T17:56:17Z No. of bitstreams: 1 00000168.pdf: 2075539 bytes, checksum: eab9bbacd914e68a9484f20c7cd84cd6 (MD5) / Made available in DSpace on 2015-03-16T17:56:17Z (GMT). No. of bitstreams: 1 00000168.pdf: 2075539 bytes, checksum: eab9bbacd914e68a9484f20c7cd84cd6 (MD5) Previous issue date: 2012 / Nenhuma / A Tecnologia da Informação (TI) geralmente se caracteriza por prover sustentação tecnológica à operação dos processos de negócio. Por este motivo, a TI tem de ser escalável, acompanhando o crescimento da organização e a busca constante por resultados positivos, na tentativa de assegurar uma gestão de TI eficiente. Nesse contexto se insere a Governança de Tecnologia da Informação (GTI), propondo uma estrutura de relações e processos que dirige e controla uma organização a fim de atingir seu objetivo de adicionar valor ao negócio, através do gerenciamento balanceado do risco com o retorno do investimento em TI. Na governança de TI o processo de Compliance (conformidade) torna os executivos responsáveis por estabelecer, avaliar e monitorar a eficácia dos controles internos das organizações. Este trabalho realizou uma pesquisa que verifica qual é a percepção do quanto o Compliance influencia as práticas de Governança de TI. Realiza do em um contexto das instituições de Serviços Sociais Autônomos (SSA), este tipo de organização é auditada e controlada por órgãos fiscalizadores federais, tais como Tribunal de Contas da União e Controladoria Geral da União, também auditada e controlada internamente pelo Conselho Fiscal. Esta fiscalização e controle ocorrem devido aos valores da receita compulsória que são arrecadados pelo governo federal. A referida fiscalização exige um Compliance para toda instituição, inclusive para a TI. O estudo de caso foi realizado de forma quantitativa, com uma população de 108 questionários eletrônicos enviados. Foram analisadas 78 respostas dos empregados dos Departamentos Regionais, distribuídos em todo o Brasil, que retornaram a pesquisa. A prática de governança de TI indicada por 92% dos respondentes como a que mais apoia o Compliance na Instituição, foi o Plano Diretor de Tecnologia da Informação (PDTI). Utilizou-se o teste estatístico não-paramétrico Kruskal-Wallis e o de Spearman para detectar diferenças significativas entre grupos da amostra com relação às questões das práticas de GTI. Os resultados obtidos levam a conclusão de que não há evidências estatisticamente significantes para aceitar que o Compliance influencie nas práticas de governança de TI na percepção dos empregados dentro da organização de Serviço Social Autônomo, objeto do estudo. / Information Technology (IT) is usually recognize by technological support, is fundamental to sustain what may be unglamorous and taken-for granted business operations. Due this reason, IT must be scalable with the growth organization and offers a means for increasing productivity. However, for ensure an effective IT management becomes complex. Information Technology Governance of (ITG), proposing a structure of relationships and processes that direct and control an organization to achieve its g oal of adding value to the business by managing risk balanced with the IT return on invest ment. In IT governance, Compliance process makes the executives responsible for establ ishing, evaluating and monitoring the effectiveness of internal organizations controls. T his paper makes a survey that checks the perception about the Compliance influence on IT Governance practices. Performed in a Brazilian organizations context, called Social Autonomous Service Organizations (SSA), this kind of organization is audited and controlled by federal oversight agencies, also internal audited and controlled by an Audit Committee. This control exists due the fact of compulsory contribution collected by the federal government. This requires a completed Compliance processes for organization, including IT. Case study was a quantitative way, with a statistic population of 108 sent electronic questionnaires. Responses analyzed from 78 employees of the Regional Departments in all Brazilian country survey answered. IT governance practice most indicated, with 92% answers, choose how as the most support Compliance process in organizations was the Plan for Information Technology (PDTI). Nonparametric statistical test Kruskal-Wallis and Spearmanρ has been used to detect significant statistical diferences between groups in the sample with respect to IT Governance practices. Results lead to conclusion that there no is significant statistical evidence to accept that Compliance influence on IT Governance practices, this is a perception fo r Social Autonomous Service Organizations employees.

Abstract The aim of this qualitative case study was to examine social service workers and managers approach towards the implementation of the Signs-of-Safety (SoS) model and their comprehension of working with the model. This study took place at a children and youth unit at a social service office in Stockholm. The empiric is based on three qualitative semistructured interviews and participant observations. The result was analyzed by definitions from Hasenfeld’s Human service organizations (HSO), Lipsky’s and Johansson’s definitions of "street-level bureaucrats", and room for manoeuvre. Lundquist’s definitions of "understand", "want" and "can" was also used, as well as the core-components that Fixsen, Naoom, Blase, Friedman och Wallace draw together of a successful implementation. The main result of the study indicates that the SoS-model contributes to the participation of children and parents and that it is complicated to implement the SoS-model in such a specialized organization. The study’s result also shows that the implementation is promoted by the support and the resources of every level in the organization and the fact that the initiative came from the street-level bureaucrats. The documentary system that comes with the BBIC is complicated to combinate with the SoS-model and therefore this might become a restricting effect.

abstract: This research is particularly concerned with organizations’ advocacy of value-based change aimed at improving consumers’ well-being. This work contributes to the Transformative Services Research area and presents a conceptualization of the value-laden service organization (VLSO), which I define as organizations that advocate for specific value-based behaviors from consumers both within and beyond the particular service setting. In a VLSO, consumers are expected to act in accordance with the values of the organization. If the consumer’s pre-existing value system is not aligned with the values of the service organization, the consumer may experience a sense of psychological disequilibrium, which can lead to unintended decrease in well-being. This research explores how value conflicts are managed by both the organization and by the consumers. This work emerges out of an interpretive study of a Catholic-based homeless shelter for pregnant women. From it, I identify the practices of consumers and the service organization and explored their interactions. This has resulted in a theoretical conceptualization of a Rescue Institution, which combines aspects of both a Total Institution and a Reinventive Institution in a unique way. Further, I conceptualize a cycle of agency and authenticity that maps the dynamics of the consumer in a VLSO as they negotiate the structure/agency duality. In gathering data, I used an interpretive approach over the course of three years’ of direct involvement with a service organization, St. Mary’s House. My methods included participant observation, collection of artifacts, and one-on-one in-depth interviews. I interviewed a total of 30 participants, whose transcribed interviews resulted in over 1500 pages of text. Analysis of themes and concepts occurred as a result of repeated examinations of both existing theory and data. My findings reveal key organizational and consumer practices that negotiate the tension between structure and agency. Organizational practices include rules and social norms, as well as two forms of hierarchy. Consumer practices, often in response to organizational practices, include a cycle of agency and authenticity and participation in a shadow structure. These practices collectively influence consumer’s interpretive drift, which is their adoption of the organization’s values that creates internalized change. I conclude with implications for theory and service organization management. First, value priorities mean that tradeoffs must be made, which can cause unexpected and painful conflict. The experience of change, from both the consumer and service provider perspective, can be very messy. This process includes a dynamic and individual negotiation of authenticity and agency, which will be of interest in future studies. The service providers must be open to this process, carefully navigating their responses to the consumer’s dynamic authenticity, agency and values. Service providers should expect and acknowledge the conflict in consumers’ experience in order to foster their long-term perspective and perseverance. / Dissertation/Thesis / Doctoral Dissertation Business Administration 2015

Este trabalho é uma produção cartográfica da experiência de análise produzida com a equipe de trabalhadores de uma unidade básica de saúde, na perspectiva da produção do acolhimento, buscando destacar as perdas de sentido que capturam a produção do cuidado e os movimentos que apontam para novas formas de acolher o usuário, e, apostando na tese de que é possível explorar linhas de fuga para produzir vida na saúde. Contextualizamos a experiência no processo sócio-histórico da saúde que conforma modelos assistenciais segundo um recorte interessado da realidade, utilizando o referencial teórico metodológico da análise institucional, linha esquizoanalítica (Deleuze & Guattari), e do processo de trabalho em saúde (Merhy), destacando três aspectos intrinsecamente relacionados: a configuração de uma nova ordem, a da sociedade mundial de controle (Deleuze), promovendo um controle contínuo, instantâneo, em espaço aberto, através de senhas de acesso, e o perigo desta lógica dar a tônica a práticas como as de Saúde da Família; o desafio da construção de uma grupalidade a partir da constituição de uma equipe de trabalhadores, frente aos intensos processos de produção de subjetividade, à lida com a diversidade e complexidade da demanda de problemas dos usuários, às dificuldades da reconstituição dos saberes e práticas que já não dão conta de responder aos problemas, aos obstáculos da inclusão das diferenças explicitadas nas relações entre trabalhadores, e desses com os usuários; enfim, a micropolítica da relação trabalhador-usuário comandada por investimentos de interesse e desejo, conscientes e inconscientes e o modo como reproduzimos ou não a subjetividade dominante no processo de trabalho em saúde com todo seu arsenal tecnológico próprio. Na ambigüidade do desejo de saber e do medo de se ver, em meio as dores e sofrimentos de usuários e trabalhadores, a equipe foi se percebendo produzindo a exclusão dos usuários camuflada por critérios técnicos, clínicos, burocráticos e administrativos. Vivenciou as dificuldades de superar os obstáculos a despeito das ressonâncias e implicações que as dores e problemas dos usuários causam nos próprios trabalhadores, os conflitos que emergem nas relações entre os trabalhadores para a resolução dos problemas, sem conseguir ser efetiva em afastar-se de suas próprias dificuldades para olhar para o usuário. A análise revelou o funcionamento da equipe como o de uma escola, que fecha no período de férias, mas mantendo atividades mínimas sem conseguir, entretanto, estruturar o trabalho de forma que contemple o descanso do trabalhador e as necessidades dos usuários. À medida que a grupalidade vai ganhando consistência, apesar das crises e conflitos, é possível arriscar na explicitação do não-saber, buscar cooperação mútua para produção de cuidado com o outro e para a lida com os afetos inerentes ao encontro com este outro. Alguns elementos mostraram-se provocadores da ordem instituída com potência para criação do novo, como a presença dos agentes comunitários na equipe, as discussões de casos de famílias para a construção de projetos terapêuticos mais implicados e a mudança do locus de trabalho da unidade de saúde para o domicílio como possibilidade de mudança nas relações de poder entre trabalhador e usuários. / This work is a cartographic production as to analysis experience produced with the professional team at a basic health care unit, in terms of the welcoming reception, focusing on sense losses that capture care production and motion focusing on new ways for attending users as well as advocating the idea that it is possible to explore escape lines for producing life in health. We contextualize experience within health social-historic process that presents assistance models according to a point-of-view based on reality, using the methodological theoretical reference of institutional analysis, schizoanalytical line (Deleuze & Guattari), and health work process (Merhy), focusing on three intrinsically related aspects: (1) configuration of a new order - the world control society (Deleuze), providing continuous, immediate, and open control though access passwords, and how dangerous it is for such logic to replace Family Health practice; (2) team building challenge through professional team constitution, facing subjectivity intense production process, diversity and complexity as to user problem demand, reconstruction of knowledge and practice that are no longer able to solve such problems, barriers to inclusion of differences regarding professional-professional relationship and professional-user relationship; (3) finally, professional-user relationship micropolicy regulated by conscious and unconscious, interest and wish investment and the way we reproduce or not dominant subjectivity at the working process in health care with its own technological devices. Upon ambiguity as to wish for knowledge and fear of seeing, among user and professional pain and suffering, the team started excluding users through technical, clinical, bureaucratic, and administrative criteria. It has experienced how difficult it is to overcome barriers as to resonance and implication user pain and problem bring to professionals, conflict deriving from professionals trying to solve problems, being unable to get away from their own problems in order to face users problems. The analysis has found that team works as a school closing for vacation and keeping minimum activities at the same time; however, it cannot structure work in a way that professionals can have some rest and meet users needs. As team gets consistency, in spite of crises and conflicts, it is possible to present not-knowing explication, and search for mutual cooperation for care production and inherent affection. Some elements are presented as regular order breakers for new creation, such as community agents within the team, family case discussion for therapeutical project construction and the working locus shift from health care unit to homes as a way to modify power relationship between professional and user.

The purpose of this study is to describe and analyze how social workers experience their cooperation in childcare investigations, how they experience their discretion and what happens emotionally with social workers in relationship with child care investigations. The study is based on a qualitative method with semi-structured interviews. The interviews have been analyzed via a thematic analysis and have been interpreted with the theoretical frameworks, human service organizations, street level bureaucracy and power. The results show that work linked to childcare investigations arouses feelings of the social secretary. Feelings like hopefulness, fear, stress and powerlessness. Further results show that the social secretary prefers parents to accept voluntary efforts compared with imperativ efforts and cooperation is of the greatest importance to bring child care investigations forward. The study shows that the social secretaries consider themselves to have discretion in their work but their work is also controlled by the organization. Especially when it comes to imperative care, something that the law also prescribes.