The role of social capital in forming organizational commitment is the focus of this research. Organizational social capital is the idea that social relationships have value in the organization. The theoretical framework is based on Kanter's (1993) structure of organizational commitment. This research views the structure within organizations based on global empowerment, job satisfaction, organizational commitment, and social capital. In addition, the role that race, income, and education affect the organizational structure is also taken into account. The organizational configuration was assembled using a structural equation model with latent variables employing a sample of 235 certified nurse aides. The sample was collected from 10 nursing homes in the Dallas-Ft.Worth metropolitan area. It was expected that Kanter's general format is reestablished within the sample. In fact, the study found that empowerment significantly influences job satisfaction. In turn, job satisfaction does foster organizational commitment. Although Kanter's original thesis was supported in this analysis, it was also determined that social capital plays a significant mediating role in creating organizational commitment. Furthermore, this research indicates that social capital alone can create organizational commitment. Thus, in conclusion, this research builds on Kanter's original idea and argues that organizational commitment is based on job satisfaction, global empowerment, and social capital.

Les métiers d’aide-soignante, en France, et de préposés aux bénéficiaires, au Québec (Canada) (AS/PB) sont placés au bas de la hiérarchie organisationnelle des organisations gériatriques (EHPAD, en France, et CHSLD, au Québec). Les AS/PB détiennent néanmoins une fonction centrale dans ces organisations puisqu’ils doivent réaliser des actes d’accompagnement et d’hygiène auprès des personnes âgées dépendantes. Nous avons cherché à comprendre comment se transmettent les compétences professionnelles pour les membres de ces métiers. Deux solutions sont fréquemment données : pour les AS/PB, les compétences détiennent un caractère naturel; celles-ci ne seraient pas transmises, mais possédées naturellement. Les directions d’établissement, quant à elles, tendent à démontrer l’importance de la formation dans la libre acquisition des compétences. Nous avons choisi de suivre un autre cheminement de recherche. Nous avons étudié le processus d’intégration des nouvelles recrues dans les organisations gériatriques. 47 entretiens biographiques ont été réalisés auprès d’AS/PB, ainsi que 30 heures d’observation. Nos résultats nous ont prouvé que le fait de devenir AS/PB est largement conditionné par le jugement des pairs lors de l’intégration des nouvelles recrues dans l’organisation. Il semble ainsi qu’une sélection se réalise concernant celles et ceux qui pourront obtenir une place dans l’organisation gériatrique et un emploi d’AS/PB. Cette sélection prend sens lorsque l’on considère les difficiles conditions de travail subies par ces acteurs professionnels. La formation ne permet pas aux recrues de connaître les difficultés engendrées principalement par le manque de personnel et les absences à répétitions. Ces difficultés conduisent la majorité des acteurs à un désenchantement consécutif à l’écart entre l’image idéalisée du métier (le relationnel) et la réalité organisationnelle. Le groupe de pairs, lors de la phase d’orientation, juge préalablement les nouvelles recrues considérées aptes à « pouvoir-faire » les tâches malgré les difficiles conditions de travail. Les compétences professionnelles requises ne se limitent plus aux compétences domestiques. D’autres compétences tacites sont transmises aux recrues jugées compétentes par le groupe de pairs. Elles ont pour but l’utilisation collective de stratégies de contournement de la souffrance au travail. L’intégration a également une place centrale car elle est à la base d’une construction identitaire de la nouvelle recrue. Par le jugement des pairs (l’identité pour autrui), la représentation de soi (l’identité pour soi) tend à se transformer. Les acteurs sont amenés à se présenter comme des individus ayant eu depuis toujours le goût à devenir AS/PB. Pourtant, l’étude de leur trajectoire professionnelle nous permet de considérer qu’ils sont majoritairement touchés par des ruptures biographiques. On assiste ici à un véritable phénomène d’habilitation, c'est-à-dire de construction du professionnel compétent. En effet, par l’habilitation, les acteurs tendent à oublier le processus social qui les a conduits à occuper ce métier, et à présenter leur trajectoire professionnelle comme une continuité homogène. Le processus d’intégration possède de grandes similarités entre la France et le Québec. Le groupe de pairs détient une fonction intégrative importante dans les deux contextes. Il possède également une fonction solidaire, bien plus importante en France qu’au Québec. Face aux jugements critiques des aidants familiaux, le groupe de pairs au Québec ne défend pas nécessairement ses membres. La responsabilité individuelle est plus souvent mise en avant. A contrario, en France, la solidarité des membres du groupe de pairs est essentielle. Mais celle-ci ne permet pas aux aides-soignantes de profiter des remarques valorisantes des aidants familiaux, qui auraient pu accroître leur reconnaissance collective / Nurse’s aides (called aides-soignantes) in France, and nurse’s aides (called préposés aux bénéficiaires), in Quebec (Canada) (AS/PB), are placed at the bottom of the organizational hierarchy of geriatric organizations (EHPAD in France and CHSLD in Quebec). The AS/PB still hold a central role in these organizations because they must perform acts of support and health among older dependant people. We tried to understand how professional skills are transmit for members of these occupations. Both solutions are frequently given: for AS/PB, skills have a natural character, they would not be passed, but naturally possessed. Managers of organizations, in turn, suggest the importance of learning the free skills. We chose to follow another path of research. We have studied the integration of new recruits in the geriatric organizations. 47 biographical interviews were conducted with AS/PB, and 30 hours of observation. Our results have shown that to become AS/PB is largely determined by peer judgment during the integration of new recruits into the organization. It thus appears that selection takes place for those who can secure a place in the organization and a geriatric use of AS/PB. This selection makes sense when we consider the difficult working conditions faced by these professional actors. The training does not allow recruits to experience the difficulties caused mainly by lack of staff absences and rehearsals. These difficulties lead most players to a disenchantment resulting from the gap between the idealized image of the trade (the relationship) and the organizational reality. The peer group during the orientation phase, the judge previously considered suitable for new recruits "can-do" tasks despite the difficult working conditions. The skills required are no longer limited to domestic skills. Other tacit skills are passed on to recruits deemed competent by the peer group. They aim to use collective strategies to circumvent the problems at work.  The integration also has a central role because it is the basis of identity construction of the new recruit. By peer judgment (the identity for others), the representation of self (identity for itself) tends to change. Actors are asked to present themselves as individuals who had always been the taste to become AS/PB. However, the study of their professional career allows us to consider that they are mostly affected by biographical breaks. We are witnessing here is a real phenomenon of « habilitation », that is to say construction professional. Indeed, by habilitation, the actors tend to forget the social process that led them to take this job and to submit their professional career as a homogeneous continuity. The integration process has strong similarities between France and Quebec. The peer group has an important integrative function in both contexts. It also features an integral, although higher in France than in Quebec. Faced with the critical judgments of caregivers, the peer group in Quebec do not necessarily defending its members. Individual responsibility is more often highlighted. In contrast, in France, the solidarity of the group of peer is essential. But it does not allow aides to enjoy the rewarding comments of caregivers, which could increase their collective recognition

Québec Université Laval, Bibliothèque 2016

Ce projet de mémoire s'inscrit dans un processus de compréhension des pratiques éducatives relatives aux élèves ayant une déficience intellectuelle. Par le biais d'entrevue semi-dirigée et d'une analyse de contenu, nous avons été à même de ressortir des conditions qui favorisent l'utilisation des aides techniques à la communication et les obstacles auxquels sont confrontés les intervenants scolaires. Les facteurs environnementaux exposés dans les résultats sont à la fois facilitateurs et obstacles. Nous constatons que la collaboration, la persévérance et la stimulation sont trois actions indissociables d'une implantation réussie. Cependant, certaines barrières (le faible niveau de formation, les réticences de l'environnement, les nouvelles technologies et le processus d'acquisition des aides techniques) rendent le processus d'utilisation des aides techniques à la communication plus difficile. Finalement, nous soulignons que l'utilisation des aides techniques en contexte scolaire permet de favoriser une estime de soi positive et est un excellent outil pour développer l'autonomie fonctionnelle et langagière chez les personnes ayant une déficience intellectuelle.

Thesis (MCur)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Controversy was observed regarding the opinions of nursing managers on the role of patient care workers (PCWs) in private hospitals. These opinions ranged from praise for their contribution towards patient care to serious concerns about the impact of their role on patient safety. The aim of this study was therefore to explore the role of PCWs in private hospitals in the Cape Metropole, South Africa. A qualitative approach with a descriptive design was applied to explore the role of PCWs as perceived by unit managers, nurses and patient care workers. Purposive sampling was used to select participants from medical and surgical wards from three different private hospitals, one each from the three major private hospital groups in South Africa (n=15). Permission to conduct the study was obtained from the Health Research Ethics Committee of the Stellenbosch University, as well as from the private hospital organisations. Fifteen semi-structured interviews were conducted, transcribed and analysed. Six themes emerged from the data. These included PCW activities, care organisation, position in the patient care team, training, reasons for employment and concerns about the PCW role. The findings indicated strong similarities with the health care asistant role as described in the literature study. The activities of PCWs are focused on direct patient care and they spend much time with patients. They are close observers of the patient’s condition and report to nurses. PCWs seem to be well integrated into the patient care team and are mostly seen as nurses. Yet, there are concerns about their evolving role despite their limited training programmes and the lack of direct supervision. The researcher recommends that the work of PCWs should be regulated, but that the nursing profession should critically evaluate the need for another nursing category in addition to that of the enrolled nurse auxiliary. / AFRIKAANSE OPSOMMING: Teenstrydigheid is waargeneem met betrekking tot die opinies van verpleegbestuurders oor die rol van pasiёntsorgwerkers (PSWs) in privaat hospitale. Hierdie opinies het variëer van waardering vir hul bydrae tot pasiёntsorg tot ernstige besorgdheid oor die impak van hulle rol op pasiënt veiligheid. Die doel van hierdie studie was dus om die rol van PSWs in privaat hospitale in die Kaapse Metropool in Suid Afrika te ondersoek. ‘n Kwalitatiewe benadering met ‘n beskrywende ontwerp is gevolg om die rol van PSWs, soos waargeneem deur eenheidsbestuurders, verpleegsters en PSWs self, te ondersoek. Doelgerigte steekproeftrekking is gebruik om deelnemers van mediese en chirurgiese sale uit drie verskillende privaat hospitale, een uit elk van die drie grootste privaat hospitaal organisasies in Suid Afrika, te kies (n=15). Toestemming om die studie te doen is verkry van die Etiek Komitee vir Gesondheidsorgnavorsing van die Universiteit van Stellenbosch sowel as van die privaat hospitaal organisasies. Vyftien semi-gestruktureerde onderhoude is gevoer, woordeliks getik en ge-analiseer. Ses temas het uit die data na vore gekom. Dit sluit die aktiwiteite van PSWs, die organisering van sorg, plek in die pasiёntsorg span, opleiding, redes vir indiensneming en besorgdheid oor die rol van PSWs. Die bevindinge toon ‘n sterk ooreenkoms met die rol van die gesondheidsorg assistent soos beskryf in die literatuur. PSWs fokus op direkte pasiёntsorg en spandeer baie tyd met pasiёnte. Weens hulle nabyheid aan die pasiёnt, kan hulle die pasiёnt se toestand waarneem en bevindings rapporteer aan verpleegsters. PSWs is oёnskynlik goed geїntegreer in die pasiёntsorgspan en word meesal as verpleegsters beskou. Tog is daar besorgdheid oor die uitbreiding van hulle rol ten spyte van beperkte opleidingsprogramme en ‘n gebrek aan toesighouding. Die navorser stel voor dat die werk van PSWs gereguleer behoort te word, maar ook dat die verpleegprofessie die nodigheid van ‘n addisionele kategorie tot die assistent verpleegster, krities moet evalueer.

The primary purpose of the study was to determine the effectiveness of an intensive, in-service training program for modifying selected personality traits among para-professional counselor aides restricted to working with emotionally disturbed youth in a residential treatment center. Additionally, an attempt was made to identify the areas in which personality traits were modified, both between experimental and control groups and between males and females.

La littérature économique défend l'existence d'aides publiques à la R&D privée du fait des nombreuses externalités et distorsions qui conduiraient les firmes à sous-investir en R&D. La multiplication de ces aides à différents échelons territoriaux et l'apparition d'éléments plus contrastés concernant leur justification soulignent un besoin accru d'analyse de ces politiques et de leurs conséquences territoriales. L'objet de cette thèse est d'apporter de nouveaux éléments concernant la rationalité, les effets et l'efficacité des aides financières à la R&D privée.Le premier chapitre propose une discussion de la rationalité des aides financières à la R&D à partir de la littérature sur la croissance endogène et ses raffinements incluant une dimension géographique. Le décalage entre les approchesthéoriques et les approches empiriques concernant les origines et l'ampleur du sous-investissement des firmes en R&D fait plutôt ressortir l'hypothèse d'un sous-investissement limité et spécifique.Les chapitres 2 et 3 fournissent des analyses théoriques des effets dynamiques et spatiaux d'une politique centralisée de subvention à la R&D. Les résultats montrent que cette politique renforce la croissance économique, réduit les inégalitésterritoriales et améliore le bien-être global. Les bienfaits de ce type de politique sont non seulement dépendants de l'hypothèse retenue concernant les rendements de la R&D mais surtout des options retenues concernant le financement et l'allocation géographique des subventions. Le chapitre 4 fournit une analyse empirique de la capacité des aides financièresà la R&D à stimuler l'investissement privé en R&D, à partir d'un panel de pays de l'OCDE. Les résultats indiquent une sensibilité plus forte des investissements privés en R&D aux aides indirectes (incitations fiscales) qu'aux aides directes (subventions) et suggèrent l'existence d'effets de substitution entre ces deux types d'aides. / The economie literature largely defends the existence of financial supports to private R&D owing to the numerous externalities and distortions that lead firms to underinvest in R&D. The proliferation of these supports at different territorial levels and the recent emergence of more constrasting arguments concerning their rationale underline an increasing need for the analysis of these policies and the ir territorial impacts. The purpose of this PhD thesis is to provide new elements regarding the rationale, the effects and the effectiveness of financial supports to private R&D.The first chapter proposes a discussion on the ratio na le of financial supports to business R&D following the endogenous growth literature and its refinements including a geographical dimension. Divergences in the theoretical and empirical approaches concerning the origins and the magnitude of the private underinvestment in R&D eventually leads to the hypothesis of a limited and specifie private underinvestment in R&D.Chapters 2 and 3 provide theoretical analyses of the spatial and dynamics effects of a centralized subsidy policy for R&D. The results show that this policy strengthens economie growth, reduces territorial inequalities while improving the global welfare. The benefits of such policy are not only dependent on the chosen assumption about returns to R&D but more importantly on its design in terms of funding and geographical allocation of subsidies.Chapter 4 provides an empirical analysis of the capacity of financial supports to R&D to stimulate private investment in R&D from a panel of OECD countries.The results indicate a greater sensitivity of private investment in R&D to indirect supports (fiscal incentives) than to direct supports (grants and subsidies) and suggest the existence of substitution effects between these two forms of support.

O Ministério da Saúde atribui cinco competências aos Agentes Comunitários de Saúde (ACS), uma delas é a Promoção da Saúde. As particularidades da inserção do ACS na comunidade e sua identidade cultural podem facilitar ou não o desenvolvimento de ações de Promoção da Saúde. As questões colocadas para esta pesquisa foram: O ACS tem potencial para promover a saúde? Que tipo de ações de Promoção da Saúde esses ACS realizam? Existe investimento diferenciado nas ações de Promoção da Saúde, por parte dos municípios? Com base nesse contexto, o objetivo geral desta pesquisa foi descrever e analisar as potencialidades do ACS para a Promoção da Saúde. E, como objetivos específicos: caracterizar o perfil sócio-demográfico dos ACS; caracterizar as competências dos ACS; caracterizar as ações vinculadas à competência Promoção da Saúde e analisar o potencial destas para o fortalecimento das comunidades. Os referenciais teóricos utilizados para análise e discussão dos resultados foram o modelo de Promoção da Saúde proposto por Labonté (1993) e o modelo teórico de organização e construção da comunidade para Promoção da Saúde, proposto por Nutbeam e Haris (2005). Trata-se de uma pesquisa de abordagem quanti-qualitativa, que teve como cenário de estudo o Colegiado Gestor Regional (CGR) Alto Capivari, na região de Presidente Prudente, composto pelos municípios de Iepê, João Ramalho, Nantes, Quatá e Rancharia. Os sujeitos desta pesquisa foram os 97 ACS que trabalhavam nas dezessete equipes de Saúde da Família do CGR, destes 81 participaram da pesquisa. Os dados foram coletados por meio de um questionário fechado composto por duas partes: 1) caracterização do perfil sócio-demográfico e 2) um formulário tipo Likert com as ações que compõem as competências do ACS. Foram organizados em um banco de dados com auxílio do software SPSS 16. Os dados foram analisados estatisticamente com base na frequência simples das ocorrências e no agrupamento das frequências positivas e negativas. Os resultados apontaram que os ACS que atuam no CGR são na maioria do sexo feminino, cor branca, ensino médio completo, apresentam média de quinze anos de residência no bairro onde trabalham e tempo médio de trabalho como ACS de dois anos. Identificou-se que a competência Integração da equipe com a população local apresentou 90,6% de realização, a competência Planejamento e Avaliação apresentou 71,5% de realização, a competência Promoção da Saúde apresentou 66,7% de realização, a competência Prevenção e Monitoramento de risco ambiental e sanitário apresentou 82,9% e a competência Prevenção e Monitoramento a grupos específicos e morbidades apresentou 86, 6%. O município de Rancharia é o que mais realiza ações de Promoção da Saúde, enquanto que o município de Quatá é o que menos as realiza. Conclui-se que as competências mais realizadas pelos ACS são aquelas que estão voltadas à articulação dos indivíduos/famílias com a equipe de saúde e ao controle de doenças e à vigilância sanitária. A competência Promoção da Saúde, entre todas, é a menos realizada, contudo o investimento na capacitação dos ACS para a execução das ações que compõem essa competência tem potencial para fortalecer e organizar as comunidades. / The Ministry of Health assigns five competences to the Community Health Workers (CHW), one of them is Health Promotion. The particularities of the CHW insertion and his cultural identity can either facilitate or not the development of actions for Health Promotion. The issues presented in this study were: Does the CHW have potential to promote health? What kind of Health Promotion actions do these CHWs carry out? Is there differentiate investment in Health Promotion actions, by the municipalities? Based in this context, the general aim of this study was describing and analyzing the potentialities of the CHWs on Health Promotion. And, as specific goals: characterizing the CHW´s socio-demographic profile; characterizing CHW´s competences; characterizing the actions linked to the Health Promotion competence and analyzing their potential to the strengthening of communities. The theoretical references used to analyze and discuss the result were the model of Health Promotion suggested by Labonté (1993) and the theoretical model of community organization and building for Health Promotion, proposed by Nutbeam and Haris (2005). It is a research on qualitative/quantitative approach which had as study scenario the Regional Management Collegiate (RMC) Alto Capivari, in the region of Presidente Prudente, formed by the municipalities of Iepê, João Ramalho, Nantes, Quatá and Rancharia. The subjects of this study were 97 CHW who worked in the seventeen teams of RMC Family Health, which 81 participated in the study. Data were collected through a closed questionnaire composed by two parts: 1) characterization of the socio-demographic profile and 2) a Likert form containing the actions which composes the CHW´s competences. They were organized in a database aided by the SPSS 16 software. Data were analyzed statistically based on the simple frequency of happening and on the grouping of positive and negative frequencies. The results have shown that the CHWs who work in the RMC Alto Capivari are the most female, white-skinned, complete high schooling, fifteen-year-old on average, living in the neighborhood where they work in and two-year average working time as a CHW. It has been identified that Team Integration with the local population competence presented 90.6% of accomplishment, Planning and Evaluation competence presented 71.5% of accomplishment, Health Promotion competence presented 66.7% of accomplishment, Prevention and Monitoring of sanitary and environmental risk competence presented 82.9% and Prevention and Monitoring to specific groups and morbidities competence presented 86.6%. The municipality of Rancharia is the one that accomplishes Health Promotion actions the most, while the municipality of Quatá is the one that accomplishes the least. It has been concluded that the most used competences by the CHWs are the ones related to the articulation of individuals/families with the health team and to the control of diseases and health surveillance. Health Promotion competence, among all of them, is the one used the least; nevertheless the investments in CHW´s training for the execution of actions which compose this competence has potential to strengthen and organize the communities.

O agente comunitário de saúde (ACS) é um ator social fundamental nas ações de controle da tuberculose (TB). Nesse estudo considerou-se à micro política voltada para prática do ACS. Objetivo do estudo: analisar segundo a visão do ACS a Busca de Sintomático Respiratório (BSR). Estudo descritivo do tipo inquérito, de forma transversal realizado em Natal, junho a setembro de 2009. População: 646 ACS do Programa de Agentes Comunitário de Saúde (PACS) / Estratégia Saúde da Família (ESF). Critérios de seleção: ACS trabalhando no período de coleta. Foram excluídos aqueles que estavam de férias, licença ou com atestados médicos. Utilizou-se amostragem de múltiplas etapas: cálculo da amostra baseado na população, partilha proporcional de acordo com a quantidade de ACS por distrito sanitário (DS) e amostragem casual simples. Prevendo-se uma taxa de não resposta de 10%, calculouse um n=108. Para coleta de dados utilizou-se um formulário aplicado aos ACS. Este compreendeu um total de 28 questões, divididas em três seções: caracterização dos ACS (08 questões), dados sobre a Estrutura das unidades de saúde (07 questões), dados sobre o Processo de atenção (13 questões). Os ACS responderam cada pergunta segundo diferentes escalas variadas de respostas: dicotômicas, de múltipla escolha com resposta única e uma escala de possibilidades preestabelecida (escala Likert) à qual foi atribuído um valor entre \"um\" e \"cinco\". A resposta mais favorável recebeu o valor mais alto da escala e a mais desfavorável recebeu o valor mais baixo. Os dados sobre Resultado (01 questão) foram coletados através de dados secundários. Para analisar os componentes Estrutura e Processo os valores próximos de 1 e 2 foram estipulados a classificação insatisfatória ,próximo de 3, regular e próximo de 4 e 5, satisfatória.Para analisar o componente Resultado da BSR, considerou-se à proporção de sintomático respiratório examinados. A maioria do ACS era do sexo feminino, nível médio e trabalhavam em unidades saúde da família com tempo médio de atuação de 122 (±47,4) meses. Consideraram como bom o trabalho na comunidade, julgaram regular a remuneração, sempre/quase sempre recebem capacitação em TB. Com relação à Estrutura das unidades de saúde apresentaram condições satisfatórias para formulários ( x = 4,90) e potes ( x = 4,25), e, no entanto apresentaram deficiências (regular) em geladeira ou caixa térmica ( x = 3,73), para armazenar o material coletado (escarro). Em relação ao ACS sentir-se preparado para identificar o suspeito de TB ( x = 4,4), orientar sobre TB ( x = 4,7) e baciloscopia ( x = 4,2), contudo muitas vezes não suspeita que a tosse possa ser TB ( x = 3,4). Foram insatisfatórias no componente Processo as ações de BSR ( x = 2,7) e levar pedido de baciloscopia para o usuário ( x = 2,2). Apenas 11% das baciloscopias esperadas foram solicitadas. A ação de BSR pelo ACS no território torna-se complexa por envolver a sua formação, a Estrutura e a organização do serviço de saúde sendo importante a supervisão do enfermeiro com foco nos mais diversos ângulos do seu trabalho ,desde as visitas domiciliares até as atividades comunitárias. / The community health agent (CHA) is a fundamental social actor in strategies for tuberculosis control (TB). This study considered the micro policy towards CHA practice. Aim of the study: to analyze, according to the CHA\'s view, the Respiratory Symptomatic Search (RSS). It is a cross-sectional descriptive study, a survey conducted in Natal, from June to September 2009. Population: 646 CHAs employed at the Community Health Agents Program (CHAP) / Family Health Strategy (FHS). Selection criteria: CHA employed at the data collection period. Those on vacation, absence or medical leave were excluded. Sample was calculated using multiple steps: sample calculation based on population, proportional division according to the number of CHAs by sanitary district (SD) and simple casual sampling. As a 10% loss rate of was expected, n = 108. Data was collected using a questionnaire completed by the CHAs. There were 28 questions, sorted into three sections: CHAs\' profile (08 questions), data about health centers Structure (07 questions), data about the caring Process (13 questions). Each question was answered according to different answering scales: dichotomous, multiple answers with single option and a Likert scale ranging from \"one\" to \"five\". The most favorable answer was given the highest score and the most unfavorable was given the lowest score. Data about Result (01 question) was collected using secondary data. To analyze the Structure and Process components, scores similar to 1 and 2 were set as a dissatisfying, similar to 3 as regular and similar to 4 and 5 as satisfying. To analyze the RSS\'s Result component the proportion of respiratory symptomatic was considered. Most CHAs were female, with middle education level and employed at a health center for an average of 122 (±47.4) months. They rated community work as good, wages as regular, and reported education formation in TB always or almost always present. In the Structure component health centers met satisfying conditions regarding forms ( x = 4.90) and containers ( x = 4.25), despite some shortages (rated as regular) in refrigerators or thermal boxes ( x = 3.73) used to store collected material (sputum). The CHA\'s sense of preparedness to identify a TB suspect ( x = 4.4), to give orientations about TB ( x = 4.7) and about bacilloscopy ( x = 4.2), alghough in many occasions they don\'t suspect cough is a TB symptom ( x = 3.4). RSS\'s Process component was rated as unsatisfying ( x = 2.7) along with taking the bacilloscopy exam form to the patient ( x = 2.2). Only 11% of expected bacilloscopies were requested. The act of RSS by CHAs in the territory becomes complex because it involves education, health centers Structure and health care service organization. Nurse\'s supervision is important to focus on different views of the work process, from home visits to community activities.

O Ministério da Saúde atribui cinco competências aos Agentes Comunitários de Saúde (ACS), uma delas é a Promoção da Saúde. As particularidades da inserção do ACS na comunidade e sua identidade cultural podem facilitar ou não o desenvolvimento de ações de Promoção da Saúde. As questões colocadas para esta pesquisa foram: O ACS tem potencial para promover a saúde? Que tipo de ações de Promoção da Saúde esses ACS realizam? Existe investimento diferenciado nas ações de Promoção da Saúde, por parte dos municípios? Com base nesse contexto, o objetivo geral desta pesquisa foi descrever e analisar as potencialidades do ACS para a Promoção da Saúde. E, como objetivos específicos: caracterizar o perfil sócio-demográfico dos ACS; caracterizar as competências dos ACS; caracterizar as ações vinculadas à competência Promoção da Saúde e analisar o potencial destas para o fortalecimento das comunidades. Os referenciais teóricos utilizados para análise e discussão dos resultados foram o modelo de Promoção da Saúde proposto por Labonté (1993) e o modelo teórico de organização e construção da comunidade para Promoção da Saúde, proposto por Nutbeam e Haris (2005). Trata-se de uma pesquisa de abordagem quanti-qualitativa, que teve como cenário de estudo o Colegiado Gestor Regional (CGR) Alto Capivari, na região de Presidente Prudente, composto pelos municípios de Iepê, João Ramalho, Nantes, Quatá e Rancharia. Os sujeitos desta pesquisa foram os 97 ACS que trabalhavam nas dezessete equipes de Saúde da Família do CGR, destes 81 participaram da pesquisa. Os dados foram coletados por meio de um questionário fechado composto por duas partes: 1) caracterização do perfil sócio-demográfico e 2) um formulário tipo Likert com as ações que compõem as competências do ACS. Foram organizados em um banco de dados com auxílio do software SPSS 16. Os dados foram analisados estatisticamente com base na frequência simples das ocorrências e no agrupamento das frequências positivas e negativas. Os resultados apontaram que os ACS que atuam no CGR são na maioria do sexo feminino, cor branca, ensino médio completo, apresentam média de quinze anos de residência no bairro onde trabalham e tempo médio de trabalho como ACS de dois anos. Identificou-se que a competência Integração da equipe com a população local apresentou 90,6% de realização, a competência Planejamento e Avaliação apresentou 71,5% de realização, a competência Promoção da Saúde apresentou 66,7% de realização, a competência Prevenção e Monitoramento de risco ambiental e sanitário apresentou 82,9% e a competência Prevenção e Monitoramento a grupos específicos e morbidades apresentou 86, 6%. O município de Rancharia é o que mais realiza ações de Promoção da Saúde, enquanto que o município de Quatá é o que menos as realiza. Conclui-se que as competências mais realizadas pelos ACS são aquelas que estão voltadas à articulação dos indivíduos/famílias com a equipe de saúde e ao controle de doenças e à vigilância sanitária. A competência Promoção da Saúde, entre todas, é a menos realizada, contudo o investimento na capacitação dos ACS para a execução das ações que compõem essa competência tem potencial para fortalecer e organizar as comunidades. / The Ministry of Health assigns five competences to the Community Health Workers (CHW), one of them is Health Promotion. The particularities of the CHW insertion and his cultural identity can either facilitate or not the development of actions for Health Promotion. The issues presented in this study were: Does the CHW have potential to promote health? What kind of Health Promotion actions do these CHWs carry out? Is there differentiate investment in Health Promotion actions, by the municipalities? Based in this context, the general aim of this study was describing and analyzing the potentialities of the CHWs on Health Promotion. And, as specific goals: characterizing the CHW´s socio-demographic profile; characterizing CHW´s competences; characterizing the actions linked to the Health Promotion competence and analyzing their potential to the strengthening of communities. The theoretical references used to analyze and discuss the result were the model of Health Promotion suggested by Labonté (1993) and the theoretical model of community organization and building for Health Promotion, proposed by Nutbeam and Haris (2005). It is a research on qualitative/quantitative approach which had as study scenario the Regional Management Collegiate (RMC) Alto Capivari, in the region of Presidente Prudente, formed by the municipalities of Iepê, João Ramalho, Nantes, Quatá and Rancharia. The subjects of this study were 97 CHW who worked in the seventeen teams of RMC Family Health, which 81 participated in the study. Data were collected through a closed questionnaire composed by two parts: 1) characterization of the socio-demographic profile and 2) a Likert form containing the actions which composes the CHW´s competences. They were organized in a database aided by the SPSS 16 software. Data were analyzed statistically based on the simple frequency of happening and on the grouping of positive and negative frequencies. The results have shown that the CHWs who work in the RMC Alto Capivari are the most female, white-skinned, complete high schooling, fifteen-year-old on average, living in the neighborhood where they work in and two-year average working time as a CHW. It has been identified that Team Integration with the local population competence presented 90.6% of accomplishment, Planning and Evaluation competence presented 71.5% of accomplishment, Health Promotion competence presented 66.7% of accomplishment, Prevention and Monitoring of sanitary and environmental risk competence presented 82.9% and Prevention and Monitoring to specific groups and morbidities competence presented 86.6%. The municipality of Rancharia is the one that accomplishes Health Promotion actions the most, while the municipality of Quatá is the one that accomplishes the least. It has been concluded that the most used competences by the CHWs are the ones related to the articulation of individuals/families with the health team and to the control of diseases and health surveillance. Health Promotion competence, among all of them, is the one used the least; nevertheless the investments in CHW´s training for the execution of actions which compose this competence has potential to strengthen and organize the communities.