La procrastinación laboral se puede definir como el hecho de postergar actividades y tareas por horas o días, debido al esfuerzo intelectual que conllevan, la dificultad, o simplemente, por el desagrado o malestar que ocasionan a la persona, esto no es un tema ajeno al ámbito organizacional, por ello se planteó la siguiente interrogante: ¿Cuál es el nivel de procrastinación laboral en trabajadores de una empresa privada del rubro de telecomunicaciones en Chiclayo, 2022? Por otro lado, es un estudio no experimental, descriptivo, el cual tuvo como objetivo, determinar los niveles de procrastinación laboral en los trabajadores de una empresa privada del rubro de telecomunicaciones. La técnica fue la encuesta, y se aplicó la escala de procrastinación en el trabajo (PAWS) de Metin et al. (2016) a una muestra de 102 colaboradores. Como resultados se encontró que existe un nivel bajo de procrastinación con un 37,2%. Sin embargo, se sugiere un porcentaje significativo en el nivel alto con un 32,4% / Work procrastination can be defined as the fact of postponing activities and tasks for hours or days, due to the intellectual effort that they entail, the difficulty, or simply, because of the displeasure or discomfort that they cause to the person, this is not a topic alien to the organizational scope, for this reason the following question was raised: What is the level of work procrastination in workers of a private company in the telecommunications sector in Chiclayo, 2022? On the other hand, it is a non-experimental, descriptive study, which aimed to determine the levels of work procrastination in the workers of a private company in the telecommunications sector. The technique was the survey, and the procrastination scale at work (PAWS) by Metin et al. (2016) to a sample of 102 collaborators. As results, it was found that there is a low level of procrastination with 37.2%. However, a significant percentage is suggested at the high level with 32.4%.

本研究探討心理衛生社會工作者與精神病患照顧者工作之中相互期待的角色內涵、影響角色期待之因素或歷程，以及相互期待之認知、行動如何修正與調整。本研究採質性研究深度訪談法，採立意抽樣選取研究對象，對三十九位受訪者（二十六位心理衛生社會工作者、十三位精神病患照顧者）進行半結構式訪談，主要研究發現如下： 1. 精神病患照顧者的照顧內容和與角色立場： （1）照顧內容：症狀因應、社區生活 （2）照顧態度：積極主動、合理期待、自我照顧 （3）與其他家屬互動：聚會交流、自助助人、權益倡導 2. 照顧者樣態與社會工作者對照顧者之角色期待： （1）所見樣態：積極參與、消極參與、不當期待、家庭動力不穩 （2）對照顧者之角色期待：配合服務、適度支持、個別化期待、如個案需要協助 （3）影響因素：社經認知條件、家庭文化因素、疾病照顧經驗、社區環境、社工接觸經驗 3. 社會工作者與照顧者之工作方法，與照顧者對社會工作者的角色期待： （1）工作方法：傾聽陪伴支持、協作釐清期待、衛教家屬團體、家庭動力工作、社區資源連結、權益倡導協調 （2）指導原則：聚焦正向改變、以個案為中心、重視家庭經驗、尊重照顧知識、抱持覺察開放的態度 （3）照顧者對社會工作者之角色期待：教育引導、家庭陪伴、權益倡導 （4）影響社會工作者角色因素：個人因素、專業教育、組織因素、結構因素 4. 照顧者與社會工作者關係：夥伴關係、工作關係、彈性關係 5. 照顧者與社會工作者相互角色期待調整方式： （1）照顧者對社會工作者期待調整：接受現況、調整期待、自立自強 （2）社會工作者對照顧者期待調整：接納現況、調整期待、擇善固執 （3）社會工作者挫折因應方法：經驗回饋、自我照顧、團隊支持 最後，研究者結合上述研究結果，嘗試繪製出心理衛生社會工作者與照顧者相互角色期待內涵與影響因素之概念架構圖，並提出本研究限制與建議，提供照顧者、心理衛生社會工作者和政策制定者、未來研究者參考，期冀本研究有助於減少照顧者可能產生的失望，甚至進而奠定一個基於夥伴關係的服務方式。 / The purpose of the study was to explore the content of mutual role expectation for mental health social workers and caregivers, the factors influencing role expectation, and the adjustment process of role expectation. This study used purposive sampling to select thirty-nine participants (twenty-six mental health social workers and thirteen caregivers), conducting in-depth interviews by using a semi-structured interview outline. The major results of the study include: 1. Care content and role of caregivers: (1) Care content: symptom management, community life promotion. (2) Care attitude: proactive, reasonably expected, self-care. (3) Interaction with other caregivers: family support group and gathering, help others and self-help, advocacy. 2. Caregiver pattern and role expectation of caregivers: (1) Caregiver pattern: actively participated, passively participated, improperly expected, unstable family dynamics. (2) Role expectation of caregivers： service adherence, moderate support, individual expectation, potential client. (3) Factors influencing role expectation: socioeconomic and cognitive conditions, family and cultural factors, caring experience, community environment, the experience of contacting social worker. 3. Working methods and role expectation of social workers: (1) Working methods: listening and accompanying, cooperating to clarify expectation, group psychoeducation, family systems therapy, mobilizing community resources, advocacy and negotiation. (2) Guiding principles: focus on positive changes, case-centered, attention to family experience, respect for caring knowledge, open-mindedness and self-awareness. (3) Role expectation of social workers: educator and guide, family supporter, advocate. (4) Factors influencing role expectation: personal factors, professional education, organizational factors, structural factors. 4. Professional relationship: partnership, working relationship, elastic relationship. 5. Adjustment process of role expectation for caregivers and social workers： (1) Role expectation of caregivers adjusted by social workers: accepting the status quo, adjusting expectation, self-reliance. (2) Role expectation of social workers adjusted by caregivers: accepting the status quo, adjusting expectation, persisting. (3) Frustration coping methods: experience feedback, self-care, team support. Based on above findings, researcher drew out the depiction of mutual role expectation for mental health social workers and caregivers, as well as the factors influencing role expectation, proposing the study restrictions and suggestions on policy making, partnership-based approach for mental health social workers and caregivers, and further research.

Made available in DSpace on 2016-04-04T18:27:29Z (GMT). No. of bitstreams: 1 Maria Agnes.pdf: 656379 bytes, checksum: daf554214415430971a28992ea11ac46 (MD5) Previous issue date: 2007-02-07 / This research intended to comprehend psychologists experiences in relation to the workers mental health at organizational contexts. It constituted an exploratory qualitative study. Dialogic interviews were carried through by the researcher with four organizational psychologists, starting from an abstained question that stimulated them to share their living experiences regarding the theme. The depositions were recorded, transcripted and phenomenologically analysed, according to the steps proposed by Amedeo Giorgi. A general synthesis was elaborated based on the researcher s psychological understanding of the shared living elements. It was concluded that the workers mental health is a theme that challenges psychologists; despite their ageement about the presence of suffering within work contexts, they feel difficulty in developing an adequate psychological practice. It aroused as significant to psychologists inserted in organizational contexts the conflict between assuming a psychological practice which provides the worker with support, listening and empathic understanding and, by the other side, a professional role that aims to apply theoretical knowledge in order to adjust behaviors, by the means of enlisting, selecting and training, mainly to attend the organization s needs. Therefore a dichotomy arouses characterized by the psychologist dealing with organizational general determined tasks and at the same time trying to practice a psychological attendance toward the workers human needs. This study brought to light a fragmented Psychology occupied by the exercising of various roles determined to psychologists in several work contexts. This confusing social understanding of Psychology s knowledges and professional practices makes ageement to other researchers assumptions according to the urgent need for interlocution among psychological fields and also a reflection on limits and possibilities of a psychological social clinic frame of reference. The psychological clinic contextualized in the institutions allows psychologists to support the other person s subjective suffering (private) in a social dimension (public interprise). This social dimension brings man a certain fluidity that prevents him of been prisioner of his own existence, otherwise his being privated of seeing and listening to others also turns him unable to be seen and listened and therefore excluded of the common world. / Este estudo teve como objetivo compreender a experi?ncia de psic?logos em rela??o ? sa?de mental do trabalhador no contexto de organiza??es. Constituiu-se como uma pesquisa qualitativa, de car?ter explorat?rio. Foram realizadas entrevistas dial?gicas com quatro psic?logos organizacionais, a partir de uma quest?o que estimulou os participantes a compartilharem suas viv?ncias a respeito do tema. Os depoimentos, gravados e transcritos, foram analisados, fenomenologicamente, de acordo com os passos propostos por Amedeo Giorgi. Uma s?ntese geral foi elaborada a partir da compreens?o psicol?gica sobre os elementos do vivido, compartilhados com a pesquisadora. Concluiu-se que a quest?o da sa?de mental do trabalhador desafia os psic?logos, pois embora constatem a presen?a de sofrimento no ambiente de trabalho, sentem dificuldade em exercer uma pr?tica psicol?gica compat?vel. Destaca-se o conflito vivenciado pelo psic?logo inserido no contexto organizacional entre um fazer psicol?gico, pautado numa escuta diferenciada que visa acolher e compreender o trabalhador, e uma pr?tica profissional que objetiva aplicar conhecimentos te?ricos para ajustar comportamentos, mediante as atribui??es de recrutar, selecionar e treinar, atendendo, principalmente, as metas da organiza??o. H?, portanto, uma dicotomia caracterizada pelo exerc?cio de tarefas pr?-determinadas pela organiza??o em detrimento de uma pr?tica psicol?gica fundada na aten??o psicol?gica ao trabalhador. Este estudo desvelou a Psicologia fragmentada nos diversos pap?is ocupados pelo psic?logo em diferentes contextos de trabalho. Uma compreens?o social dicotomizada em rela??o aos saberes e fazeres da Psicologia corrobora o pensamento de outros pesquisadores que sugerem a necessidade de uma interlocu??o entre as diversas ?reas da Psicologia e de uma reflex?o competente sobre limites e possibilidades de uma aten??o psicol?gica cl?nica social. A cl?nica contextualizada nas institui??es permite ao psic?logo acolher o outro no seu sofrimento subjetivo (privado), mas em uma dimens?o social (espa?o p?blico). Esta dimens?o permite ao homem um certo deslocamento, uma fluidez que o impede de ser aprisionado em sua pr?pria exist?ncia, pois, ao sentir-se privado de ver e ouvir os outros, priva-se de ser visto e ouvido e acaba isolado, exclu?do do mundo comum.

La santé des travailleurs et la santé mentale spécifiquement liés au travail sont la base pour la discussion de cette thèse. Son objectif était de construire des propositions pour une clinique de santé mental et travail pour les services du Sistema Único de Saúde (SUS) et à cette fin a été utilisé, de manière complémentaire, le Self Reporting Questionnaire (SRQ-20) . Les entrevues ont été menées auprès de 24 travailleurs masculins et féminins, soignés aux Service de Maladies du travail de l'Hospital de Clínicas de Porto Alegre (ADT / HCPA). En outre, nous avons cherché à identifier la maladie en santé mentale liés au travail aujourd'hui; comprendre comment les formes de gestion influencent la maladie en milieu de travail et proposont d'autres possibilités pour le soin à la santé mentale des travailleurs et travailleuses du SUS. L'utilisation de la Psychodynamique du Travail a permis la compréhension de la situation de souffrance / maladie mentale liés au travail, en soulignant dans la plupart des cas, la violence psychologique subi dans l'environnement de travail comme un déclencheur pour la maladie actuelle. Seulement 10 de ces travailleurs interrogés sont accompagnés par des professionnels de la santé mentale, pas toujours avec la fréquence necessaire, seulement 01 dans le service du SUS, mais 20 font l'usage de médicaments psychiatriques. Avec les histoires racontées de leur travail et maladie, les travailleurs et les travailleuses ont demandé l'écoute de leur souffrance et le soin par des professionnels qui pouvaient comprendre ce qu'ils ont vécu à l'époque. En ce sens, penser la Clinique du Travail dans le SUS, non seulement mobilisé le développement de la souffrance / maladie des travailleurs, mais collabore à l'avancement de la mise en oeuvre de ce qui est recommandé dans la Politique Nationale de Santé de travailleurs et Travailleuses, ce qui signifie jeter un coup d'oeil le réseau de la santé et les services qui peuvent potentiellement rendre les soins de santé mentale et travail, la compréhension du processus de modulation, de métamorphoses et de transformations qui ont eu lieu dans l'organisation du travail, et par conséquent dans les relations de travail. La construction d'une Ligne de Soins (LC) en Santé Mentale du Travailleur peut alors être l'expression de la Clinique du travail dans le SUS et doit être insérée dans le système de santé existant, à condition d'avoir été construits possibilités pour cette insertion. Il est entendu que le LC devrait être dans la discussion de la mise en oeuvre de la politique publique nationale comme une possibilité de soins aux travailleurs et travailleues. / A saúde do trabalhador e especificamente a saúde mental relacionada ao trabalho são a base de discussão dessa tese. Seu objetivo foi o de construir propostas para uma clínica em saúde mental e trabalho para os serviços do Sistema Único de Saúde (SUS) e, para tanto foi organizado roteiro de entrevista e utilizado o Self Reporting Questionnaire (SRQ-20), de forma complementar. Foram realizadas entrevistas com 24 trabalhadores e trabalhadoras atendidos no Ambulatório de Doenças do Trabalho do Hospital de Clínicas de Porto Alegre (ADT/HCPA). Além disso, buscou-se identificar o adoecimento em saúde mental relacionado ao trabalho na atualidade; compreender como as formas de gestão influenciam o adoecimento nos ambientes de trabalho na atualidade e propor outras possibilidades para a atenção à saúde mental dos trabalhadores e das trabalhadoras atendidos no SUS. A utilização da Clínica Psicodinâmica do Trabalho permitiu a compreensão da situação de sofrimento/adoecimento psíquico relacionado ao trabalho, destacando-se na maioria dos casos, a violência psicológica sofrida no ambiente laboral como desencadeante para o atual adoecimento. Apenas 10 desses trabalhadores entrevistados são acompanhados por profissional de saúde mental, nem sempre com periodicidade, apenas 01 em serviço do SUS, mas 20 fazem uso de medicação psiquiátrica. Com o relato das histórias vividas no trabalho e de seu adoecimento, os trabalhadores e as trabalhadoras solicitavam escuta ao seu sofrimento e a possibilidade de atendimento por profissionais que pudessem compreender o que haviam sofrido ou estavam vivendo no momento. Nesse sentido, pensar a Clínica do Trabalho no SUS, mobiliza não apenas a elaboração do sofrimento/adoecimento dos trabalhadores, mas colabora no avanço da implantação do que está preconizado na Política Nacional de Saúde do Trabalhador e Trabalhadora, o que significa lançar um olhar para a rede de saúde e os serviços que potencialmente podem realizar atendimento em saúde mental e trabalho, entendendo os processos de modulações, metamorfoses e transformações que tem ocorrido na organização do trabalho, e consequentemente nas relações de trabalho desenvolvidas. A construção de uma Linha de Cuidado (LC) em Saúde Mental do Trabalhador pode ser então a expressão da Clínica do Trabalho no SUS e deve estar inserida na rede de saúde já existente desde que sejam construídas possibilidades para essa inserção. Entende-se que a LC deve estar na discussão da implantação da política pública nacional como uma possibilidade de atendimento para os trabalhadores e as trabalhadoras. / Workers health, and more specifically, mental health related to work, is the basis of the discussion of this thesis. The main goal was to set up proposals for a workers mental health clinic within the Sistema Unico de Saude (SUS), that is, the Brazilian Universal Health Care System. For that, an interview guide was organized and the Self Reporting Questionnaire (SRQ-20) was used as a complement. Interviews were performed with 24 workers, male and female, that were receiving care at the Hospital de Clinicas of Porto Alegre, Brazil, at the Workers Disease Unit. Moreover, it was intended to identify mental health illness as related to work in today’s world; to understand how management influence ailment in the work place today, and to propose different ways of attending to the workers mental health who receive treatment in the SUS. The use of the Psychodynamic Workers Clinic allowed for a better understanding of the psychological suffering/illness related to work, and, for the majority of the cases, it was highlighted the psychological violence experienced in the work premises as what was the beginning of the current illness. Only 10 of these interviewed workers receive mental health care, though not always periodically, only 01 within SUS services, but 20 use psychiatric medications. With the life portrayals of the work related stories and their ailment, workers requested their sorrows be heard and the possibility of getting treated by professionals that could understand what they had gone through or were going through at the moment. In this sense, to think of a Workers Clinic in the SUS system, mobilizes not only the formulation of the suffering/ailment of the workers, but also helps in the advancement of the implementation of recommendations in the National Policies of Workers Health, which means taking a look at the health services that can potentially provide mental health and care to workers, understanding the processes of modulation, metamorphosis and transformations that have been taking place in the work place, and consequently understanding the work relations developed thereafter. The elaboration of a Line of Care (LC) for the Workers Mental Health can be the expression of the Workers Clinic at SUS and needs to be inserted in the health system already existing as long as possibilities for this insertion are constructed. It is understood that the LC needs to be in the discussion in the implementation of the national public policies as a possibility of treatment for the workers.

It's search metasynthesis type, in order to know, describe and analyze the academic literature in the Mental health and work area in the context of Brazilian postgraduate. Developed in five phases: Exploration, Refining, Crossing, Description and Analysis. With the first takes place cataloging of all the documents present in the files of theses and dissertations of the Coordination of Improvement of Higher Education Personnel - CAPES and the Virtual Health Library - Psychology - BVS-PSI from 10 search descriptors considered representative area in the literature. In the second phase, it is found among the documents found in the previous phase, which are related to the area, by reading the title, abstract and keywords of these. In the third phase is carried out a comparative analysis in order to eliminate duplicate documents. The fourth phase describes all documents according to type: thesis or dissertation; the historical ranking; area of knowledge; geographical disposition and institutional origin. In the last phase analyzes the contents of the descriptor located 16 theses Mental health and work, the most representative among those used in the previous phases. This phase identifies the following categories: history, social demands, public policy, epistemology, method and theory. The results indicate that mental health and work has its largest production, 84% under the master; in 1989 was located first thesis; between the years 2000 to 2012 88% of the documents were produced; predominance of studies related to psychology, 56% occurs; the southeast region has 46% of production; São Paulo accounts for 30%; production is 46 IES, being USP, UFRJ, UFRGS, UNB and the UFMG that most produce. There is even those produced studies respond to historically situated social demands; the relationship with the public policies is a challenge in view of the finding that the state should protect the work also has become precarious; the field of Occupational Health underlies the area; distinct methodological strategies and theoretical frameworks are used in studies. It is concluded that the adoption of an ethnographic approach as a method and an integrative approach as theoretical framework, the results achieved can convert into practical action in favor of labor, the fundamental premise of the area, given its epistemological assumptions. In this context, the researcher is involved turning their efforts to politically coherent performance with the field of Occupational Health. / Trata-se de pesquisa do tipo metassíntese, com vistas a conhecer, descrever e analisar a produção acadêmica da área da Saúde mental e trabalho no contexto da Pós-graduação brasileira. Desenvolve-se em cinco fases: Exploração, Refinamento, Cruzamento, Descrição e Análise. Com a primeira realiza-se a catalogação de todos os documentos presentes no banco de teses e dissertações da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) e da Biblioteca Virtual em Saúde – Psicologia (BVS-PSI) a partir de 10 descritores de busca considerados representativos da área na literatura especializada. Na segunda fase, verifica-se, dentre os documentos localizados na fase anterior, quais guardam relação com a área, por meio da leitura do título, resumo e palavras-chave destes. Na terceira fase realiza-se uma análise comparativa a fim de eliminar duplicidade de documentos. A quarta fase descreve todos os documentos quanto ao tipo: tese ou dissertação; a seriação histórica; a área do conhecimento; a disposição geográfica e a procedência institucional. Na última fase analisa-se o conteúdo de 16 teses localizadas pelo descritor Saúde mental e trabalho, o mais representativo dentre os utilizados nas fases anteriores. Essa fase identifica as seguintes categorias: história, demandas sociais, políticas públicas, epistemologia, método e teoria. Os resultados indicam que a Saúde mental e trabalho tem sua maior produção, 84%, no âmbito do mestrado; no ano de 1989 foi localizada a primeira tese; entre os anos de 2000 a 2012 foram produzidos 88% dos documentos; ocorre predominância de estudos ligados à Psicologia, 56%; a região sudeste concentra 46% da produção; São Paulo, responde por 30%; encontra-se produção em 46 IES, sendo USP, UFRJ, UFRGS, UNB e UFMG as que mais produzem.Verifica-se ainda que os estudos produzidos respondem a demandas sociais historicamente situadas; a relação com as políticas públicas constitui um desafio tendo em vista a constatação de que o Estado, que deveria proteger o trabalho, também o tem tornado precário; o campo da Saúde do Trabalhador fundamenta a área; são utilizadas distintas estratégias metodológicas e referenciais teóricos nas pesquisas realizadas. Conclui-se que, a adoção de uma abordagem etnográfica enquanto método e de uma abordagem integradora enquanto referencial teórico, pode converter os resultados alcançados em ações práticas em favor do trabalho, premissa fundamental da área, tendo em vista seus pressupostos epistemológicos. Nesse contexto, o pesquisador é implicado politicamente voltando seus esforços para uma atuação coerente com o campo da Saúde do Trabalhador.

La santé des travailleurs et la santé mentale spécifiquement liés au travail sont la base pour la discussion de cette thèse. Son objectif était de construire des propositions pour une clinique de santé mental et travail pour les services du Sistema Único de Saúde (SUS) et à cette fin a été utilisé, de manière complémentaire, le Self Reporting Questionnaire (SRQ-20) . Les entrevues ont été menées auprès de 24 travailleurs masculins et féminins, soignés aux Service de Maladies du travail de l'Hospital de Clínicas de Porto Alegre (ADT / HCPA). En outre, nous avons cherché à identifier la maladie en santé mentale liés au travail aujourd'hui; comprendre comment les formes de gestion influencent la maladie en milieu de travail et proposont d'autres possibilités pour le soin à la santé mentale des travailleurs et travailleuses du SUS. L'utilisation de la Psychodynamique du Travail a permis la compréhension de la situation de souffrance / maladie mentale liés au travail, en soulignant dans la plupart des cas, la violence psychologique subi dans l'environnement de travail comme un déclencheur pour la maladie actuelle. Seulement 10 de ces travailleurs interrogés sont accompagnés par des professionnels de la santé mentale, pas toujours avec la fréquence necessaire, seulement 01 dans le service du SUS, mais 20 font l'usage de médicaments psychiatriques. Avec les histoires racontées de leur travail et maladie, les travailleurs et les travailleuses ont demandé l'écoute de leur souffrance et le soin par des professionnels qui pouvaient comprendre ce qu'ils ont vécu à l'époque. En ce sens, penser la Clinique du Travail dans le SUS, non seulement mobilisé le développement de la souffrance / maladie des travailleurs, mais collabore à l'avancement de la mise en oeuvre de ce qui est recommandé dans la Politique Nationale de Santé de travailleurs et Travailleuses, ce qui signifie jeter un coup d'oeil le réseau de la santé et les services qui peuvent potentiellement rendre les soins de santé mentale et travail, la compréhension du processus de modulation, de métamorphoses et de transformations qui ont eu lieu dans l'organisation du travail, et par conséquent dans les relations de travail. La construction d'une Ligne de Soins (LC) en Santé Mentale du Travailleur peut alors être l'expression de la Clinique du travail dans le SUS et doit être insérée dans le système de santé existant, à condition d'avoir été construits possibilités pour cette insertion. Il est entendu que le LC devrait être dans la discussion de la mise en oeuvre de la politique publique nationale comme une possibilité de soins aux travailleurs et travailleues. / A saúde do trabalhador e especificamente a saúde mental relacionada ao trabalho são a base de discussão dessa tese. Seu objetivo foi o de construir propostas para uma clínica em saúde mental e trabalho para os serviços do Sistema Único de Saúde (SUS) e, para tanto foi organizado roteiro de entrevista e utilizado o Self Reporting Questionnaire (SRQ-20), de forma complementar. Foram realizadas entrevistas com 24 trabalhadores e trabalhadoras atendidos no Ambulatório de Doenças do Trabalho do Hospital de Clínicas de Porto Alegre (ADT/HCPA). Além disso, buscou-se identificar o adoecimento em saúde mental relacionado ao trabalho na atualidade; compreender como as formas de gestão influenciam o adoecimento nos ambientes de trabalho na atualidade e propor outras possibilidades para a atenção à saúde mental dos trabalhadores e das trabalhadoras atendidos no SUS. A utilização da Clínica Psicodinâmica do Trabalho permitiu a compreensão da situação de sofrimento/adoecimento psíquico relacionado ao trabalho, destacando-se na maioria dos casos, a violência psicológica sofrida no ambiente laboral como desencadeante para o atual adoecimento. Apenas 10 desses trabalhadores entrevistados são acompanhados por profissional de saúde mental, nem sempre com periodicidade, apenas 01 em serviço do SUS, mas 20 fazem uso de medicação psiquiátrica. Com o relato das histórias vividas no trabalho e de seu adoecimento, os trabalhadores e as trabalhadoras solicitavam escuta ao seu sofrimento e a possibilidade de atendimento por profissionais que pudessem compreender o que haviam sofrido ou estavam vivendo no momento. Nesse sentido, pensar a Clínica do Trabalho no SUS, mobiliza não apenas a elaboração do sofrimento/adoecimento dos trabalhadores, mas colabora no avanço da implantação do que está preconizado na Política Nacional de Saúde do Trabalhador e Trabalhadora, o que significa lançar um olhar para a rede de saúde e os serviços que potencialmente podem realizar atendimento em saúde mental e trabalho, entendendo os processos de modulações, metamorfoses e transformações que tem ocorrido na organização do trabalho, e consequentemente nas relações de trabalho desenvolvidas. A construção de uma Linha de Cuidado (LC) em Saúde Mental do Trabalhador pode ser então a expressão da Clínica do Trabalho no SUS e deve estar inserida na rede de saúde já existente desde que sejam construídas possibilidades para essa inserção. Entende-se que a LC deve estar na discussão da implantação da política pública nacional como uma possibilidade de atendimento para os trabalhadores e as trabalhadoras. / Workers health, and more specifically, mental health related to work, is the basis of the discussion of this thesis. The main goal was to set up proposals for a workers mental health clinic within the Sistema Unico de Saude (SUS), that is, the Brazilian Universal Health Care System. For that, an interview guide was organized and the Self Reporting Questionnaire (SRQ-20) was used as a complement. Interviews were performed with 24 workers, male and female, that were receiving care at the Hospital de Clinicas of Porto Alegre, Brazil, at the Workers Disease Unit. Moreover, it was intended to identify mental health illness as related to work in today’s world; to understand how management influence ailment in the work place today, and to propose different ways of attending to the workers mental health who receive treatment in the SUS. The use of the Psychodynamic Workers Clinic allowed for a better understanding of the psychological suffering/illness related to work, and, for the majority of the cases, it was highlighted the psychological violence experienced in the work premises as what was the beginning of the current illness. Only 10 of these interviewed workers receive mental health care, though not always periodically, only 01 within SUS services, but 20 use psychiatric medications. With the life portrayals of the work related stories and their ailment, workers requested their sorrows be heard and the possibility of getting treated by professionals that could understand what they had gone through or were going through at the moment. In this sense, to think of a Workers Clinic in the SUS system, mobilizes not only the formulation of the suffering/ailment of the workers, but also helps in the advancement of the implementation of recommendations in the National Policies of Workers Health, which means taking a look at the health services that can potentially provide mental health and care to workers, understanding the processes of modulation, metamorphosis and transformations that have been taking place in the work place, and consequently understanding the work relations developed thereafter. The elaboration of a Line of Care (LC) for the Workers Mental Health can be the expression of the Workers Clinic at SUS and needs to be inserted in the health system already existing as long as possibilities for this insertion are constructed. It is understood that the LC needs to be in the discussion in the implementation of the national public policies as a possibility of treatment for the workers.

La santé des travailleurs et la santé mentale spécifiquement liés au travail sont la base pour la discussion de cette thèse. Son objectif était de construire des propositions pour une clinique de santé mental et travail pour les services du Sistema Único de Saúde (SUS) et à cette fin a été utilisé, de manière complémentaire, le Self Reporting Questionnaire (SRQ-20) . Les entrevues ont été menées auprès de 24 travailleurs masculins et féminins, soignés aux Service de Maladies du travail de l'Hospital de Clínicas de Porto Alegre (ADT / HCPA). En outre, nous avons cherché à identifier la maladie en santé mentale liés au travail aujourd'hui; comprendre comment les formes de gestion influencent la maladie en milieu de travail et proposont d'autres possibilités pour le soin à la santé mentale des travailleurs et travailleuses du SUS. L'utilisation de la Psychodynamique du Travail a permis la compréhension de la situation de souffrance / maladie mentale liés au travail, en soulignant dans la plupart des cas, la violence psychologique subi dans l'environnement de travail comme un déclencheur pour la maladie actuelle. Seulement 10 de ces travailleurs interrogés sont accompagnés par des professionnels de la santé mentale, pas toujours avec la fréquence necessaire, seulement 01 dans le service du SUS, mais 20 font l'usage de médicaments psychiatriques. Avec les histoires racontées de leur travail et maladie, les travailleurs et les travailleuses ont demandé l'écoute de leur souffrance et le soin par des professionnels qui pouvaient comprendre ce qu'ils ont vécu à l'époque. En ce sens, penser la Clinique du Travail dans le SUS, non seulement mobilisé le développement de la souffrance / maladie des travailleurs, mais collabore à l'avancement de la mise en oeuvre de ce qui est recommandé dans la Politique Nationale de Santé de travailleurs et Travailleuses, ce qui signifie jeter un coup d'oeil le réseau de la santé et les services qui peuvent potentiellement rendre les soins de santé mentale et travail, la compréhension du processus de modulation, de métamorphoses et de transformations qui ont eu lieu dans l'organisation du travail, et par conséquent dans les relations de travail. La construction d'une Ligne de Soins (LC) en Santé Mentale du Travailleur peut alors être l'expression de la Clinique du travail dans le SUS et doit être insérée dans le système de santé existant, à condition d'avoir été construits possibilités pour cette insertion. Il est entendu que le LC devrait être dans la discussion de la mise en oeuvre de la politique publique nationale comme une possibilité de soins aux travailleurs et travailleues. / A saúde do trabalhador e especificamente a saúde mental relacionada ao trabalho são a base de discussão dessa tese. Seu objetivo foi o de construir propostas para uma clínica em saúde mental e trabalho para os serviços do Sistema Único de Saúde (SUS) e, para tanto foi organizado roteiro de entrevista e utilizado o Self Reporting Questionnaire (SRQ-20), de forma complementar. Foram realizadas entrevistas com 24 trabalhadores e trabalhadoras atendidos no Ambulatório de Doenças do Trabalho do Hospital de Clínicas de Porto Alegre (ADT/HCPA). Além disso, buscou-se identificar o adoecimento em saúde mental relacionado ao trabalho na atualidade; compreender como as formas de gestão influenciam o adoecimento nos ambientes de trabalho na atualidade e propor outras possibilidades para a atenção à saúde mental dos trabalhadores e das trabalhadoras atendidos no SUS. A utilização da Clínica Psicodinâmica do Trabalho permitiu a compreensão da situação de sofrimento/adoecimento psíquico relacionado ao trabalho, destacando-se na maioria dos casos, a violência psicológica sofrida no ambiente laboral como desencadeante para o atual adoecimento. Apenas 10 desses trabalhadores entrevistados são acompanhados por profissional de saúde mental, nem sempre com periodicidade, apenas 01 em serviço do SUS, mas 20 fazem uso de medicação psiquiátrica. Com o relato das histórias vividas no trabalho e de seu adoecimento, os trabalhadores e as trabalhadoras solicitavam escuta ao seu sofrimento e a possibilidade de atendimento por profissionais que pudessem compreender o que haviam sofrido ou estavam vivendo no momento. Nesse sentido, pensar a Clínica do Trabalho no SUS, mobiliza não apenas a elaboração do sofrimento/adoecimento dos trabalhadores, mas colabora no avanço da implantação do que está preconizado na Política Nacional de Saúde do Trabalhador e Trabalhadora, o que significa lançar um olhar para a rede de saúde e os serviços que potencialmente podem realizar atendimento em saúde mental e trabalho, entendendo os processos de modulações, metamorfoses e transformações que tem ocorrido na organização do trabalho, e consequentemente nas relações de trabalho desenvolvidas. A construção de uma Linha de Cuidado (LC) em Saúde Mental do Trabalhador pode ser então a expressão da Clínica do Trabalho no SUS e deve estar inserida na rede de saúde já existente desde que sejam construídas possibilidades para essa inserção. Entende-se que a LC deve estar na discussão da implantação da política pública nacional como uma possibilidade de atendimento para os trabalhadores e as trabalhadoras. / Workers health, and more specifically, mental health related to work, is the basis of the discussion of this thesis. The main goal was to set up proposals for a workers mental health clinic within the Sistema Unico de Saude (SUS), that is, the Brazilian Universal Health Care System. For that, an interview guide was organized and the Self Reporting Questionnaire (SRQ-20) was used as a complement. Interviews were performed with 24 workers, male and female, that were receiving care at the Hospital de Clinicas of Porto Alegre, Brazil, at the Workers Disease Unit. Moreover, it was intended to identify mental health illness as related to work in today’s world; to understand how management influence ailment in the work place today, and to propose different ways of attending to the workers mental health who receive treatment in the SUS. The use of the Psychodynamic Workers Clinic allowed for a better understanding of the psychological suffering/illness related to work, and, for the majority of the cases, it was highlighted the psychological violence experienced in the work premises as what was the beginning of the current illness. Only 10 of these interviewed workers receive mental health care, though not always periodically, only 01 within SUS services, but 20 use psychiatric medications. With the life portrayals of the work related stories and their ailment, workers requested their sorrows be heard and the possibility of getting treated by professionals that could understand what they had gone through or were going through at the moment. In this sense, to think of a Workers Clinic in the SUS system, mobilizes not only the formulation of the suffering/ailment of the workers, but also helps in the advancement of the implementation of recommendations in the National Policies of Workers Health, which means taking a look at the health services that can potentially provide mental health and care to workers, understanding the processes of modulation, metamorphosis and transformations that have been taking place in the work place, and consequently understanding the work relations developed thereafter. The elaboration of a Line of Care (LC) for the Workers Mental Health can be the expression of the Workers Clinic at SUS and needs to be inserted in the health system already existing as long as possibilities for this insertion are constructed. It is understood that the LC needs to be in the discussion in the implementation of the national public policies as a possibility of treatment for the workers.

Ce mémoire vise à vérifier l’effet modérateur du soutien social hors-travail sur la relation entre l’engagement organisationnel de type calculé et la détresse psychologique. Le soutien social hors-travail représente le réseau social externe au milieu professionnel du travailleur. L’engagement organisationnel de type calculé représente une forme d’engagement qui se manifeste lorsqu’un travailleur se sent obligé de demeurer à son travail pour des raisons extrinsèques plutôt que par choix personnel. La détresse psychologique représente un ensemble de symptômes inquiétants pouvant mener à des troubles de santé mentale. Un modèle conceptuel impliquant ces trois variables est développé, illustrant l’engagement calculé comme variable indépendante, la détresse psychologique comme variable dépendante et le soutien social hors-travail comme variable modératrice. De plus, plusieurs variables contrôles sont ajoutées à ce modèle. Pour parvenir à vérifier l’effet modérateur recherché, les données au premier cycle partiel de l’Étude Longitudinale de l’Observatoire sur la Santé et le Mieux-être au Travail (ELOSMET), basées sur un échantillon de 2400 travailleurs d’entreprises clientes de Morneau Shepell et Medavie/Croix Bleue, ont été utilisées. Dans un premier temps, des analyses descriptives ont été réalisées afin de relever les caractéristiques fondamentales de l’ensemble de l’échantillon de l’ELOSMET. Dans un deuxième temps, des analyses bivariées ont déterminé l’absence ou la présence de relation linéaire significative entre les variables. Enfin, des analyses multiniveaux ont permis d’établir les effets des différentes variables sur la détresse psychologique. Les résultats des analyses multiniveaux suggèrent que le niveau d’engagement de ce type est significativement associé à un niveau de détresse psychologique plus élevé. Ils ont également présenté une association significative entre un soutien social élevé et un niveau de détresse psychologique plus faible. Ceci dit, les analyses multiniveaux n’ont pas permis de confirmer le lien modérateur du soutien social hors-travail sur la relation entre l’engagement organisationnel de type calculé et la détresse psychologique. / The aim of this thesis is to verify the moderating effect of social support received outside of the workplace and its relationship between continuance organizational commitment and psychological distress. Social support outside of the workplace represents the support received from personal networks. Continuance organizational commitment represents the extrinsic motives to stay at a particular job alternately to its intrinsic motivation. Psychological distress represents a disturbing set of symptoms that can lead to mental health problems. A conceptual model involving these three variables is developed, presenting the continuance commitment as an independent variable, psychological distress as a dependant variable and social network support as a moderating variable. In addition, more variables are included in this model. The data used to verify the moderating effect is based on the first partial cycle of the “Étude Longitudinale de l’Observatoire sur la Santé et le Mieux-Être au Travail” (ELOSMET) sampling 2400 workers from Morneau Shepell and Medavie/Blue Cross. Firstly, the descriptive analysis was carried out to identify the fundamental characteristics of the sample. Secondly, a bivariate analysis determined the absence or the presence of significant linear relationship between variables. Lastly, a multilevel analysis enabled the study to find the different effects of the variables on psychological distress. These results suggest that the level of engagement of this type is highly correlated to a high level of psychological distress. They also showed a significant correlation between high social support and low psychological distress. That being said, multilevel analysis did not confirm a relationship of the moderated link of social support received outside of the workplace on the continuance organizational commitment and psychological distress.

Le Plan d’action en santé mentale institué en 2005 marque le début d’une période de changements profonds qui auront un impact significatif sur les équipes de première ligne qui assurent la plupart des services au Québec. Le changement se manifestera sur deux fronts distincts. En premier lieu, le passage de services historiquement ancrés dans un modèle biomédical vers des services centrés sur le rétablissement. En second lieu, l’adoption de processus administratifs s’inscrivant dans une philosophie de gestion axée sur les résultats qui ont pour objectif de mesurer et d’assurer l’efficacité des services. L'objectif de cette étude est d’explorer le statu du développement des pratiques axées sur le rétablissement au niveau des travailleurs sociaux de première ligne dans le contexte administratif mentionné ci-haut. Le travail de recherche qualitatif et exploratoire est construit sur l’analyse de 11 interviews semi structurés avec des travailleurs sociaux et des gestionnaires dans des équipes de première ligne en santé mentale. Les entretiens m’ont non seulement permis d’identifier et d’examiner des actions concrètes s’inscrivant dans l’effort d’implantation du Plan d’action mais aussi de sonder et d’explorer la signification qui est donnée au rétablissement par les travailleurs sociaux de première ligne. Les résultats indiquent que certains facteurs relatifs à l'organisation du travail tels que la flexibilité, l'autonomie, la réflexivité et l’interdisciplinarité peuvent favoriser une pratique orientée vers le rétablissement. Aussi, les résultats démontrent que le modèle du rétablissement et la profession du travail social partagent des valeurs fondamentales mais que la signification et l'expression du rétablissement ont été profondément influencés par les modèles organisationnels et obligations administratives en vigueur. Il appert que les travailleurs sociaux sont confrontés, dans leur pratique, à des contraintes qui dépassent leur mandat professionnel et, à certains égards, leur savoir-faire. En somme, les résultats obtenus indiquent que le passage avec succès vers la pratique de services basés sur le rétablissement est compromis par les exigences d’un modèle de gestion axé sur les résultats. / Following the 2005 Mental Health Action Plan most mental health services are offered in primary care teams. This policy called for a paradigm shift away from a biomedical model of care toward a process-focused ‘recovery’ orientation in mental health. Concurrently, it called for the use of a results-orientation that is outcome-focused in order to ensure efficiency. The objective of this research project was to explore the development of recovery-oriented practices among social workers in first line mental health teams in Québec. To do this, I investigated the microprocesses of implementing recovery-oriented services and practices alongside results-oriented management techniques. In addition, this project explored the saliency of a recovery orientation specifically for first line mental health social workers. This qualitative, exploratory study consisted of 11 semi-structured interviews with social workers and managers in first line mental health teams. The results indicate that certain aspects of work organization, such as flexibility, autonomy, reflexivity, training, and interdisciplinarity can foster a practice that is recovery-oriented. In addition, the results show that the foundations of both the recovery orientation and the social work profession share common values. However, social workers face constraints to practice that go beyond their know-how and professional base. Our exploratory study leads us to contemplate the influence of work organization on changing practice. The results suggest that practicing from a recovery orientation was a shared ideal among the participants but that the meaning and expression of this ideal was profoundly shaped by practice contexts. The implications of these results are that recovery-oriented systems will be difficult to develop in a result-oriented paradigm.

Le Plan d’action en santé mentale institué en 2005 marque le début d’une période de changements profonds qui auront un impact significatif sur les équipes de première ligne qui assurent la plupart des services au Québec. Le changement se manifestera sur deux fronts distincts. En premier lieu, le passage de services historiquement ancrés dans un modèle biomédical vers des services centrés sur le rétablissement. En second lieu, l’adoption de processus administratifs s’inscrivant dans une philosophie de gestion axée sur les résultats qui ont pour objectif de mesurer et d’assurer l’efficacité des services. L'objectif de cette étude est d’explorer le statu du développement des pratiques axées sur le rétablissement au niveau des travailleurs sociaux de première ligne dans le contexte administratif mentionné ci-haut. Le travail de recherche qualitatif et exploratoire est construit sur l’analyse de 11 interviews semi structurés avec des travailleurs sociaux et des gestionnaires dans des équipes de première ligne en santé mentale. Les entretiens m’ont non seulement permis d’identifier et d’examiner des actions concrètes s’inscrivant dans l’effort d’implantation du Plan d’action mais aussi de sonder et d’explorer la signification qui est donnée au rétablissement par les travailleurs sociaux de première ligne. Les résultats indiquent que certains facteurs relatifs à l'organisation du travail tels que la flexibilité, l'autonomie, la réflexivité et l’interdisciplinarité peuvent favoriser une pratique orientée vers le rétablissement. Aussi, les résultats démontrent que le modèle du rétablissement et la profession du travail social partagent des valeurs fondamentales mais que la signification et l'expression du rétablissement ont été profondément influencés par les modèles organisationnels et obligations administratives en vigueur. Il appert que les travailleurs sociaux sont confrontés, dans leur pratique, à des contraintes qui dépassent leur mandat professionnel et, à certains égards, leur savoir-faire. En somme, les résultats obtenus indiquent que le passage avec succès vers la pratique de services basés sur le rétablissement est compromis par les exigences d’un modèle de gestion axé sur les résultats. / Following the 2005 Mental Health Action Plan most mental health services are offered in primary care teams. This policy called for a paradigm shift away from a biomedical model of care toward a process-focused ‘recovery’ orientation in mental health. Concurrently, it called for the use of a results-orientation that is outcome-focused in order to ensure efficiency. The objective of this research project was to explore the development of recovery-oriented practices among social workers in first line mental health teams in Québec. To do this, I investigated the microprocesses of implementing recovery-oriented services and practices alongside results-oriented management techniques. In addition, this project explored the saliency of a recovery orientation specifically for first line mental health social workers. This qualitative, exploratory study consisted of 11 semi-structured interviews with social workers and managers in first line mental health teams. The results indicate that certain aspects of work organization, such as flexibility, autonomy, reflexivity, training, and interdisciplinarity can foster a practice that is recovery-oriented. In addition, the results show that the foundations of both the recovery orientation and the social work profession share common values. However, social workers face constraints to practice that go beyond their know-how and professional base. Our exploratory study leads us to contemplate the influence of work organization on changing practice. The results suggest that practicing from a recovery orientation was a shared ideal among the participants but that the meaning and expression of this ideal was profoundly shaped by practice contexts. The implications of these results are that recovery-oriented systems will be difficult to develop in a result-oriented paradigm.