O objeto desta tese é o movimento da Reforma Psiquiátrica no Município de Cuiabá/MT, analisado por meio dos processos de trabalho das equipes de saúde mental nos serviços extra-hospitalares de atenção à saúde mental, numa abordagem dialética-marxista. Compreende-se que o processo de trabalho, sendo o fundamento do modo de produção e, portanto, da sociabilidade humana, permite analisar toda a problemática envolvida nas práticas de saúde, que se efetivam em uma determinada realidade concreta, complexa e representam a síntese de múltiplas determinações histórico-sociais. O movimento de Reforma Psiquiátrica nos anos 1970/1980 teve, em Cuiabá/MT, uma correspondência com a expansão da rede hospitalar psiquiátrica privada, determinada pelo peculiar processo de desenvolvimento econômico-social local. Atualmente, constata-se uma hegemonia do setor hospitalar privado no contexto de assistência à saúde mental em Cuiabá e, simultaneamente, uma discreta reorganização administrativa da assistência orientada para práticas extra-hospitalares que, entretanto, não confronta, quantitativa e qualitativamente, com o modelo de atenção médico-psiquiátrico que embasa as práticas da psiquiatria hospitalar. Tal reorganização visa atender, prioritariamente, às regras atuais de financiamento do setor. Observou-se uma centralização do poder administrativo e vínculos, muitas vezes, precários de trabalho dos profissionais, além da ausência ou restrição de número e de categorias de profissionais que seriam necessários para imprimir uma modificação no modelo de atenção ao trabalho das equipes. A cidadania – instrumento e finalidade do processo terapêutico na Reforma Psiquiátrica - é dissociada da vivência e organização do trabalho de profissionais e usuários. A referência de cidadania predominante nos processos de trabalho foi a cidadania tutelada. Não se observou uma problematização da condição de cidadania de doentes mentais e, não sendo exploradas as contradições das práticas que os profissionais operam - simultaneamente restrição de liberdade e atenção psicossocial - observou-se uma alienação dos mesmos em relação ao seu trabalho, que ficou então reduzido à realização de atividades. A medicalização é o mecanismo estruturante de todas as práticas analisadas e os instrumentos mais evidentes na abordagem terapêutica são os medicamentos psicotrópicos. A conformação de um novo paradigma de assistência – Reforma Psiquiátrica – requer a confrontação com o antigo modelo médico psiquiátrico, o que não se observou na realidade estudada. / The study object of this thesis is the movement for a Psychiatric Reform carried out in the district of Cuiabá (MT), analyzed through the work processes of the teams in charge of mental health outpatient attention and based on a dialectic-Marxist approach. It is understood that the working process, being the foundation of the production manner and human interaction, allows us to analyze all the problems involved in health practices which become effective in a certain concrete and complex reality. These practices represent a synthesis of the multiple socio-historical orders. The movement of Psychiatric Reform in the 70’s and 80’s in Cuiabá coincided with the growth of the number of hospitals in the private area, determined by the peculiar local socio-economic development process. We can, nowadays, notice the preeminence of private hospitals in the context of mental health assistance in Cuiabá and, at the same time, observe a slight administrative re-organization of the assistance to outpatients although it cannot be compared, in quantity nor quality, to the medical-psychiatric attention model provided by hospital psychiatry. This re-organization seeks to attend to, on a first instance, the present financing rules of the sector. A centralization of the administrative power has been observed together with somehow failing work-bonds for professionals and the absence or restriction of number and professional categories that should be considered essential to achieve a modified pattern of attention to the teams’ work. Citizenship – instrument and purpose of the therapeutic process within the Psychiatric Reform – is disassociated from the experience and working organization of professionals and users. The predominant reference to citizenship in the working processes is that of a tutored citizenship. We were not able to observe the problematics of the citizenship condition of the mentally disabled and as the contradictions in the professionals’ practice – simultaneous occurrence of independence restrictions and psycho-social attention – were not explored, a certain alienation was detected as far as their work was concerned, which was reduced to task compliance. Medication is the structuring mechanism of all the analyzed practices and the most apparent instruments for the therapeutic approach are psychotropic drugs. The conformation of a new assistance paradigm – Psychiatric Reform – requires the confrontation with the old psychiatric medicine model, which was not observed in the reality context we studied.

Diante do expressivo número de Hospitais Psiquiátricos no Estado de São Paulo, que continuam presentes no atendimento das pessoas com transtornos mentais mesmo frente à política de desinstitucionalização e a priorização do atendimento nos serviços substitutivos, surge a questão se os profissionais que trabalham neles conhecem e discutem o conceito de reabilitação psicossocial e como trabalham no contexto da Reforma Psiquiátrica. Este estudo objetivou analisar as possibilidades e impossibilidades de se implantar estratégias de reabilitação psicossocial em hospitais psiquiátricos, foi escolhido como objeto as representações que os trabalhadores têm sobre a reabilitação psicossocial e como categorias analíticas, as representações sociais e o processo de trabalho em saúde. Os dados foram coletados no período entre novembro e dezembro de 2011, por meio de entrevistas semiestruturadas com questões norteadoras, junto a dezoito trabalhadores dos lares abrigados em um hospital psiquiátrico no Município de São Paulo. Após a transcrição das falas, os dados foram analisados conforme a metodologia de análise temática. A análise dos discursos dos entrevistados revelou temas que por aproximação configuraram a categoria Processo de Trabalho: Os temas que formaram esta categoria foram: o agente, instrumentos, objeto, finalidade e as dificuldades e facilidades do processo de trabalho. Também foram encontrados temas que por aproximação configuraram a categoria Processo de Reabilitação Psicossocial: objeto, instrumentos e finalidade do processo de reabilitação psicossocial. A categoria representações sociais possibilitou compreender a concepção dos trabalhadores sobre a reabilitação psicossocial; sendo sua finalidade independência, aumento do poder contratual, resgate da cidadania e dos direitos: de morar, trabalhar e reestabelecer laços sociais. A categoria analítica processo de trabalho desvelou o próprio processo de trabalho da equipe e o processo de reabilitar; os discursos apresentaram contradições em que coexistem as concepções embasadas no modelo da psiquiatria tradicional e concepções coerentes com as da reabilitação psicossocial. O que limita as possibilidades de reabilitação é: a precariedade da rede de saúde mental em São Paulo, escassez de recursos humanos e materiais, resistência por parte das famílias. As possibilidades ocorrem pela superação das práticas centradas na doença para práticas centradas nas necessidades materiais e psicossociais da pessoa. Os trabalhadores compreendem o hospital psiquiátrico como local de zero troca, reiterando vasta literatura sobre o tema, por isso, a finalidade do processo de trabalho é a alta do morador. Pode-se dizer que o trabalho nos lares abrigados proporciona a desospitalização do paciente e uma permanência com possibilidade de vida mais digna do que em enfermarias, pois tem a possibilidade de habitar e não simplesmente estar. Entretanto, é importante salientar que os moradores continuam sob o poder do hospital psiquiátrico e da equipe, limitados às normas institucionais, menos rígidas em relação às das enfermarias, mas ainda presentes, o que a análise revelou ser entendido pelos trabalhadores, evidenciando uma superação em relação à concepção do hospital como protetor ou local para tratar a crise. / Facing the expressive number of psychiatric hospitals in the state of São Paulo, which are still present in the assistance of people with mental disorders even facing the politics of desinstitutionalization and the prioritization in the assistance of substitutive services, arises the question whether the professional who works in them know and discuss the concept of psychosocial rehabilitation and how they work in the context of Psychiatric Reform. This study aimed in analyzing the impossibilities of implanting strategies of psychosocial rehabilitation in psychiatric hospitals, it was chosen as object the social representations in which workers have about the psychosocial rehabilitation and as analytical categories the social representations and in health work process. The data were collected between the periods from November to December of 2011, by means of semi-structured interviews with leading questions, with eighteen workers from shelters in a psychiatric hospital in the city of São Paulo. After the voices transcriptions, the data were analyzed following the methodology of thematics analysis. The analysis of the interviewed people have revealed themes that per approaching set the category Process of Work: the themes which have formed this category were : the agent, the instruments, objects, purpose and the difficulties and facilities in the process of work. There were also found themes that per approaching set the category Process in Psychosocial Rehabilitation: object, instruments and purpose in the process of psychosocial rehabilitation. The category social representations have allowed to make it understood the conception of workers about the psychosocial rehabilitation, being its purpose the independency, increase of contractual power, rescue of citizenship and the rights: of living, working and reestablish social bonds. The analytical category process of work unveiled the own team process of work and the process of rehabilitate; the discourses have shown contradictions where there is the coexistence the conceptions based on the model of traditional psychiatry and conceptions consistent with the psychosocial rehabilitation one. What limits the possibilities of rehabilitation are: the precariousness in the mental health of public services in São Paulo, lack of human resources and materials, resistance from part of the families. The possibilities are given in the overcoming of practices centered in the disease for centered practices in the persons material and psychosocial necessities. The workers comprehend the psychiatric hospital as a place of zero Exchange, reiterating wide literature about the theme, thats why the purpose in the work process is the cure of the inhabitant. We could say that the work in the shelters allows the patient not to be in the hospital any longer with the chance of a healthier life than in the nursing, because there is the chance of living and not simply being. However, it is important to mention that the inhabitants keep under the control of the psychiatric hospital and its staff, being limited to the institutional, less strict when comparing to the nursing ones, but yet present, the analysis have shown it was understood by the workers making it evident an overcoming in relation to the concept of the hospital as a protector or a place to treat the crisis.

Objetivos - Compreender como as equipes de Saúde da Família consideram o território em seu processo de trabalho. Identificar e analisar as concepções de território dos profissionais das equipes de saúde da família. Analisar as potencialidades e limitações presentes nas concepções de território dos profissionais das equipes de saúde da família na perspectiva do cuidado integral à saúde na atenção básica. Procedimentos metodológicos - Pesquisa com abordagem qualitativa. Realizada analise documental e 22 entrevistas com profissionais de duas unidades de saúde da família do município de Jacareí - SP. Resultados - Os profissionais entrevistados apresentaram diferentes concepções sobre o território que atuam. Alguns profissionais associaram o território às características geopolíticas do mesmo, considerando apenas o território solo. Outros profissionais correlacionaram tais características com o modo de vida da população, considerando a ocupação e as dinâmicas existentes no mesmo, trabalhando com a lógica do território singularizado. Diversos profissionais trouxeram uma compreensão do território a partir dos determinantes e condicionantes do processo saúde-doença. Estas concepções trouxeram influencias do modelo de Programas de Saúde, do modelo das Vigilâncias em Saúde e do Modelo em Defesa da Vida. As diferentes concepções influenciaram de forma diversa nos processos de trabalho das equipes. As concepções relacionadas ao modelo dos Programas de Saúde favoreceram a inclusão de usuários com um conjunto de patologias pré-estabelecidas. As concepções baseadas no modelo das Vigilâncias em Saúde possibilitaram uma maior compreensão dos determinantes e condicionantes do processo saúde-doença. As concepções baseadas no modelo em Defesa da Vida se mostraram mais eficazes para a compreensão e consideração das necessidades de saúde dos usuários no processo de trabalho das equipes. Houve diferenças na organização dos processos de trabalho, na organização do cuidado e na forma de gestão das duas unidades estudadas. As equipes estudadas consideram parcialmente o território na organização do processo de trabalho, porém é necessária a ampliação do olhar sobre as vulnerabilidades existentes no processo saúde-doença, favorecendo uma clínica ampliada, mediante de arranjos institucionais pautados no vínculo, acolhimento e responsabilização da equipe com o cuidado integral em saúde, a partir das necessidades de saúde dos usuários / Objectives - Understand how teams of the Family Health consider the territory in their work process. Identify and analyze the concepts of territory of professional teams of family health. Analyze the strengths and limitations present in the territory conceptions of professional of teams of the Family Health in the perspective of comprehensive health care in primary care. Methodological Procedures - Research with a qualitative approach. Held documental analysis and conducted 22 interviews with two units of family health in the city of Jacareí-SP. Results - The professionals interviewed had different conceptions about territory they serve. Some professionals associated territory geopolitical features of it, considering only the ground territory. Other professionals such characteristics correlated with the mode of life, considering the occupation and the existing dynamic in it, working with the logic singled territory. Several professionals have brought an understanding of the territory from the determinants and constraints of the health-disease process. These conceptions brought influences the model of Health Programs, the model of Surveillance in Healthcare and Model in Defense of Life. Different attitudes influenced differently in the work processes of teams. The concepts related to the model of Health Programs favored the inclusion of users with a set of pre-established conditions. The concepts based on the model of Surveillance in Health allowed a greater understanding of the determinants and determinants of health-disease process. Conceptions based on the model in Defense of Life proved more effective for understanding and consideration of the health needs of the users in the team work process. There were differences in the organization of work processes in the organization of care and management in the form of the two units studied. The teams studied consider the territory part in the organization of the work process, but look at the expansion of existing vulnerabilities in the health- disease process is required, favoring an expanded, guided by the institutional arrangements in the bond, hosting and accountability of staff with clinical the comprehensive health care from the health needs of the users

House construction today is largely project-based, where the buildings are tailored tounique conditions and locations that are rarely the same as another build on anotherbuilding site. In addition to the building itself and the building site, involved actorsusually also change from project to project. As a result of today's project-basedconstruction, there is a lack of a standardized and systematic work process forconstruction work. A systematic work process could contribute to all the players' pursuitof profit. To explore the possibilities of creating an improved work process, this study focusedon balconies of wooden houses. The purpose and objectives of the work were therefore designed to evaluate today'sconstruction work for the design of balconies in wooden houses, where possible areasof improvement were evaluated to create a systematic work process for constructorsin designing and dimensioning balconies in wooden houses.In order to achieve the purpose and objectives of the work, four questions have beendeveloped that focus on the production of systematic work processes, the current workprocess of the construction work, design methods and balconies in wooden houses.Existing research and published material were found through a literature and contextstudy to further develop the study’s work. Theory regarding systematisation and process development, balconies,dimensioning of supporting structures, etc. was the basis for how the work would becarried out. The systematized work process for balcony design was, however, createdusing information from the qualitative interview study with a total of eight (8)respondents in different roles I house building. The work process was then partiallytested in a quantitative verification. The work resulted in a systematic work process in the form of a checklist that includesgeneral tips as well as a chronological workflow that describes how, when, with whomand what should and can be done at the balcony design to get the best possible results.A description of the existing balcony types has also been developed to simplify workand to clarify important points and tasks in the design of a particular type of balcony. The workflow is divided into the activities of the design and dimensioning, such asstart-up, design and dimensioning of the balcony's main components, detail designand dimensioning of fastening components, drawing up drawings and assemblydescriptions, and follow-up and development of the work process. Based on the results of the study, the questions were answered with a description ofthe four (4) types of balcony, which were based on theory and were strengthened bymeans of empirical data from the respondents. Two (2) of the balcony types are viiiconsidered more common, balconies with pillars to land and rods above the balconyplate, where the latter is considered the most common in wooden houses at present.Today's construction work for designing and dimensioning balconies in woodenhouses is similar in large part, but due to the use of prefabrication and standardizationdegree the work differs from each other. The verification of a part of the work process resulted in a balcony solution with crosslaminated timber as a balcony slab and in a comparison between results from aproposed software and hand calculations. The comparison showed that the softwarecan be used for dimensioning balconies with cross laminated timber, with the exceptionthat the dimensioning for fire must be done by hand because of deficiencies in thesoftware's settings. The study has shown that systematisation is often based on LEAN Production, whichwas created by the Japanese automotive industry, which focuses on creating efficientwork processes by circularly examining, testing, evaluating and developing workprocesses. The conclusion of the work is that it is possible to systematise construction work, butunlike the manufacturing industry, the work process must have adjustment possibilitiesduring the work to meet the commonly occurring changes in house construction.However, in order for the systematisation work to be carried out, increasedunderstanding and involvement from and by other actors than constructors arerequired. A systematic work process together with type solutions and standardized calculationmethods can shorten the design time, improve and secure the solutions, and allowmore time for creative thinking to further improve the balcony solutions and the workprocess.

Det primära syftet med detta examensarbete kan sägas vara att skapa en uppfattning hos Skanska Väg & Anläggning Sydost, som är initiativtagare till detta examensarbete, om vad BIM (Building Information Model) är och hur det lättast kan implementeras i deras arbetsprocesser. Det skulle vara omöjligt att täcka in alla aspekter av BIM under den korta tid som funnits till förfogande och inom ramen för detta examensarbete, därför har de aspekter som ansetts vara viktiga för företaget samt författaren lyfts upp för utredning. För att kunna nå dit har examensarbetet till uppgift att kartlägga och synliggöra de skillnader som finns mellan dagens byggprocess och BIM (Building Information Model) och utifrån det föreslå möjliga sätt att implementera denna arbetsmetod hos Skanska Väg & Anläggning Sydost. I examensarbetets första kapitel ges en kort introduktion och bakgrund till hur byggprocessen förändrats under tidens gång. Ett syfte och en frågeställning formuleras och en avgränsning för examensarbetets omfattning görs. I examensarbetets andra kapitel ges den teoretiska bakgrunden till dagens byggprocess. Viktiga aspekter av dagens byggprocess lyfts fram och förklaras. Därefter följer en presentation av begreppet BIM och vad det innebär. Därefter görs en kort genomgång för hur arbetet med BIM ser ut hos Skanska Sverige AB och generellt i byggbranschen. I examensarbetets tredje kapitel presenteras hur BIM används idag på vägprojekt utanför Katrineholm i ett projekt kallat för Förbifart Katrineholm där BIM tillämpats i viss utsträckning. Skillnaderna som finns mellan dagens byggprocess och BIM samt de för- och nackdelar som kan konstateras hos BIM i relation till dagens byggprocess presenteras. I examensarbetes fjärde kapitel besvaras frågeställningarna och resultatet analyseras samt diskuteras ur viktiga aspekter för byggande, för att i det femte kapitlet komma med konkreta förslag på hur en implementering av BIM i Skanska Väg & Anläggning Sydosts arbetsprocesser kan se ut. / The primary purpose of this thesis can be said to be to create a perception at Skanska Civil Southeast, which is the initiator of this thesis, on what BIM (Building Information Model) is and how it can most easily be implemented in their work processes. It would be impossible to cover all aspects of BIM in the short amount of time that has been available and in the context of this thesis, therefore, the aspects that were deemed important to the company and to the author has been picked up for investigation. To achieve this, the task of the thesis is to identify and highlight the differences between today's construction process, and BIM (Building Information Model) and from that suggest possible ways to implement this way of working to Skanska Civil Southeast. The thesis first chapter provides a brief introduction and background to the construction process and how it has changed over time. A purpose and questions on which the thesis is being based on are formulated and a boundary for the thesis is done. The thesis second chapter provides the theoretical background to today's construction process. Key aspects of today's construction process are highlighted and explained. This is followed by a presentation of the concept of BIM and what it means. After that, a brief review of how the work with BIM looks at Skanska Sweden AB and in the construction industry generally. The thesis third chapter presents how BIM is currently used on a road project just outside of Katrineholm in a project called Förbifart Katrineholm where BIM is being applied to some extent. The differences that exist between today’s construction process and the BIM and the pros and con that can be observed in BIM relative to today's construction process is presented. In the thesis fourth chapter answers the questions and the results are analyzed and discussed on important aspects of construction, to, in the fifth chapter make concrete proposals on how an implementation of BIM in Skanska Civil Southeast work processes may look like.

Purpose - The aim of the paper is to understand how management is affected by having the customer as a member of the global virtual team within agile work methods. Research Method - This research is based on a qualitative methodological choice, and an embedded single case study conducted through a cross-sectional time horizon. The research is based on primary and secondary data. The primary data has been collected from management, employees, and customer, through semi- and in depth interviews, and observations in Sri Lanka. Secondary data is conceptualized from literature in the Global Virtual Team research field. Results - A customer is seen as a colleague and a critical team member, where the developers and management work closely with the customer. However, the customer is not fully seen as a traditional colleague. The customer’s influence outweighs the influence of the supplier, resulting in a dynamic shift of influence towards the customer. Not allowing the dynamic shift, i.e. not increasing attention towards the customer significantly, could result in a loss of business. Furthermore, the background of the customer affects the manager’s role as a Bridge Maker. How efficient the collaboration turns out within the team is dependent on the customer background, and how well the management allocates time and efforts accordingly. Research limitations - Due to time and resource limits, and the depth scope of the study, only one case firm and one customer laid the basis of this paper. Further investigation of how management is affected by having the customer as a member of the global virtual team could be the direction of future studies. Practical implications - The findings allow management to allocate their time and resources more effectively cross projects and increase the understanding of how the firm is affected by having the customer as a member of the team in the global virtual team setting. As a result, it will potentially increase the overall success of the company. Originality/value - This study supplies the contribution to existing management literature as it includes an external stakeholder, the customer, in the global virtual team, which is a growing phenomenon that has not been captured by current literature. Keywords - Global teams, Virtual teams, Multicultural teams, Customer as a team member, Bridge Maker, Team leadership, Biculturalism, Agile work process Paper type – Master thesis

Föreliggande studie har syftat till att, genom semistrukturerade djupintervjuer med professionella retuschörer aktiva i branschen, undersöka om gemensamma steg kunde urskiljas genom respondenternas beskrivningar av arbetsprocessen.Genom studien framkom det att respondenterna beskrev likartade processer samt att samarbete med medarbetare var en viktig faktor för ett utvecklande arbete. Beskrivningarna av arbetsprocessen tydde på att samtliga respondenter hade ett personligt intresse för arbetet och branschen.Respondenterna ansåg även att retuschörens tidigare erfarenhet var betydande och till stor del påverkar tidsåtgången för arbeten. De menade också att tidsåtgången även påverkas av hur utförlig arbetsordern är vid uppstart av projektet. Det framkom även att respondenterna själva inte genomför någon utförlig uppföljning och granskning av hur det slutliga materialet används. / The present study aimed to, through semi-structured in-depth interviews with professional retouchers active in the industry, examine if common steps could be identified by the respondents’ descriptions of the work process.The study revealed that respondents described similar processes, and collaboration with colleagues was an important factor for a developing work. The descriptions of the work indicated that all respondents had a personal interest in the work and in the industry.Respondents also felt that the retouchers previous experience was significant and largely affects the duration of the work. They also pointed out that the duration also is affected by the amount of details specified in the work order at the startup of the project. It also emerged that the respondents themselves did not make any detailed follow-up and review of how the final material was used.

Made available in DSpace on 2016-06-02T20:45:42Z (GMT). No. of bitstreams: 1 6486.pdf: 910985 bytes, checksum: 73870e5625c0b23486390d0c0474f40e (MD5) Previous issue date: 2014-10-29 / Universidade Federal de Sao Carlos / This study started from an analysis and reflection on Teamwork, from the perspective of professionals from a Family Health Unit (FHU) in a town in the state of São Paulo. The purpose was show the work process, based on the perspective of integrated care, considering the conception of the role of each professional as an integral member of a team, for the production of care. It also shows the vision of these professionals about teamwork, as well as those factors that favors and influence in the relationships established in the work process. The present used a qualitative descriptive-analytical approach to character, whose participants were health professionals, entered a team in the "Strategy of Family Health". Although professionals have noted the importance of interdisciplinary character, its representations indicate that they develop work isolated and fragmented actions. Value the participation of different professions / professionals as team members; however, their representations are not revealing the interaction between their knowledge. It is understood that discussions about teamwork in the context of the family health strategy are crucial to bring about changes in the profile of the various professionals involved, because this implies a collective activity where each member puts their knowledge, feelings ne expectations due to a common objective, that is, in the production of a complete care. / Este trabalho partiu de uma análise e reflexão sobre o Trabalho em Equipe, na perspectiva de profissionais de uma Unidade de Saúde da Família (USF), em um município do interior do estado de São Paulo. A finalidade foi evidenciar o processo de trabalho, baseado na perspectiva da integralidade das ações, considerando a concepção do papel de cada profissional como membro integrante de uma equipe, para a produção do cuidado. Revela ainda a visão destes profissionais sobre o trabalho em equipe, bem como os fatores, que o favorece e o influencia, nas relações estabelecidas no processo de trabalho. O presente estudo possui uma abordagem qualitativa de caráter descritivo-analítico, cujos participantes foram os profissionais de saúde, inseridos em uma equipe da Estratégia da Saúde da Família . Muito embora os profissionais tenham ressaltado a importância do caráter interdisciplinar, suas representações indicam que os mesmos desenvolvem basicamente trabalhos isolados e ações fragmentadas. Valorizam a participação de diferentes profissões/profissionais como componentes da equipe, no entanto, suas representações não são reveladoras da interação entre seus saberes. Compreende-se que as discussões acerca do Trabalho em Equipe no contexto da Estratégia Saúde da Família são de fundamental importância, para provocar mudanças no perfil dos diversos profissionais envolvidos, uma vez que este implica numa atividade coletiva, onde cada membro coloca seus conhecimentos, sentimentos e expectativas em função de um objetivo comum, ou seja, na produção do cuidado integral.

Made available in DSpace on 2015-05-14T12:47:17Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1529510 bytes, checksum: 3700d5780d9fbd29616d3122fd8554c3 (MD5) Previous issue date: 2014-07-15 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This research aimed to investigate the work process realized by the primary care professionals, focusing on women s health. Was conducted an exploratory and descriptive study, with quantitative approach in the Family Health Units of the five Health Districts in João Pessoa. Data were collected in the period September-December 2013 through the application of questionnaires to 204 professionals (nurses, doctors and dentists). The analysis was performed using the R software, which allowed obtaining descriptive statistics and the realization of the Cluster Analysis. Through the analysis, it was verified that nurses, doctors and dentists are associating elements of Assistance Model of Collective Health and hospital-centered model in the realization of health assistance and that only doctors perform a work process related to Assistance Model of Collective Health and this just for 13.33% of them. The work performed by more than 90% of professionals is fragmented, which makes hard to perform actions that reach a certain goal, specifically, to provide the expansion of women s rights, which requires identification of social needs of health and the use of knowledge of Collective Health as a way to transform the work object. / O estudo teve o objetivo de investigar o processo de trabalho realizado pelos profissionais da Atenção Básica, com foco na atenção à saúde da mulher. Para tanto realizou-se um estudo descritivo e exploratório, com abordagem quantitativa nas Unidades de Saúde da Família dos cinco Distritos Sanitários de João Pessoa. Os dados foram coletados no período de setembro a dezembro de 2013 por meio da aplicação de 204 questionários aos profissionais (enfermeiros, médicos e odontólogos). A análise foi realizada com o software R que possibilitou a obtenção de estatísticas descritivas e a realização da Análise de Agrupamento. Com a análise, foi possível verificar que os enfermeiros, médicos e odontólogos estão associando elementos do Modelo Assistencial de Saúde Coletiva e Hospitalocêntrico na realização da assistência em saúde, enquanto que 13,33% dos médicos realizam um processo de trabalho relacionado ao Modelo Assistencial de Saúde Coletiva e isso. O processo de trabalho na atenção à saúde da mulher ainda se configura fragmentado e curativo, dificultando o alcance da integralidade do cuidado à mulher enquanto direito constitucional.

Made available in DSpace on 2015-05-14T12:47:20Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1613460 bytes, checksum: cebcf9972d7471b5e4d13b136f8e76cd (MD5) Previous issue date: 2011-02-11 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Taking as object of study the Alternative Strategies and Tactics, conducted by nurses and doctors, in units of the units of the Family Health Strategy (ESF), a discussion was held on the work process in under the models of health care. The importance of the study lies in possibility of questioning the work process within several teams working in the Sanitary Districts III, IV and V of João Pessoa, in order to elucidate alternative acts and exchange of health information about successful experiences. The investigation was justified because of the need to develop proposals and to experience more integrals of the acts and actions of health derived from models hegemonic, explaining the existence of new practices gestated in day-to-day work of professionals (doctors and nurses). This is a exploratory - descriptive and inferential study, which included the quantitative and qualitative approaches. Data were analyzed from the Hypothesis Test, used as a method of decision making, and the material was obtained through semi-structured interview and analyzed through the technique of discourse analysis. The data analysis provided statistical evidence of maintenance in significant proportions, deeds and actions characteristic of the models of health care sanitarian and privativist and sharing space with doings characteristic of the ESF, was also significant proportion of nurses and doctors who claimed to develop strategies and tactical alternatives to these models. The professional discourse expressed the disconnection between the elements of the work process by same time that indicated the possibility of transforming reality imposed by hegemonic models, by means of overcoming invisibility of the individuals in the health services and, above all, through assimilation, articulation and legitimation of knowledge historically denied, but also effective for the quality of actions. It follows that the Alternative Strategies and Tactics viewed behave potential for transformation of work processes and overcoming models of health care that remain against the tide of reform that aims for the sector, in order to have comprehensive, humane and quality. / Tomando como objeto de estudo as Estratégias e Táticas Alternativas, desenvolvidas por enfermeiros e médicos, nas unidades da estratégia de Saúde da Família (ESF), discutiu-se acerca do Processo de Trabalho no âmbito dos Modelos de Atenção à Saúde. A importância do estudo reside na possibilidade de problematização do processo de trabalho no interior das várias equipes que atuam nos distritos sanitários III, IV e V de João Pessoa, visando a elucidação de atos alternativos de saúde e a troca de informações sobre experiências exitosas. Justificou-se a investigação em face da necessidade de se conceber e experimentar propostas mais integrais do que os atos e ações de saúde derivados dos modelos hegemônicos, elucidando a existência de novas práticas gestadas no dia-a-dia de trabalho de profissionais (médicos e enfermeiros). Trata-se de um estudo exploratório - descritivo e inferencial que comportou, simultaneamente, as abordagens quantitativa e qualitativa. Os dados foram analisados a partir do teste de hipótese, utilizado como método de tomada de decisão, e o material empírico foi obtido através de entrevistas semi-estruturadas e analisado por meio da técnica de análise de discurso. A análise dos dados forneceu evidências estatísticas da manutenção, em proporções significativas, de atos e ações característicos dos modelos de atenção privatista e sanitarista dividindo espaço com fazeres característicos da ESF, sendo também significativa a proporção de profissionais enfermeiros e médicos que afirmaram desenvolver estratégias e táticas alternativas a estes modelos. O discurso dos profissionais expressou a desarticulação entre os elementos do processo de trabalho ao mesmo tempo em que indicou a possibilidade de transformar a realidade imposta pelos modelos hegemônicos, pela via da superação da invisibilidade dos sujeitos nos serviços de saúde e, sobretudo, por meio da assimilação, articulação e legitimação de saberes historicamente negados, mas igualmente efetivos para a qualidade das ações. Conclui-se que as estratégias e táticas alternativas visualizadas comportam potencial para transformação dos processos de trabalhos e superação dos modelos de atenção à saúde que se mantêm na contramão da reforma que se pretende para o setor, no sentido de uma atenção integral, humanizada e de qualidade.