Educator stress is a major problem worldwide. This study focuses on the role of the principal in the secondary school in providing support and assisting educators manage work-related stress, with particular reference to schools in Kwa-Zulu Natal, South Africa. The problem was investigated by means of a literature study and empirical investigation. The literature identified perspectives on educators' stress, the stress process of the educator and the principal, causes of work-related stress in educators and coping strategies. Furthermore, principals' leadership styles, theories of motivation and causes of principals' stress were discussed. A qualitative inquiry using focus group interviews was undertaken with a small sample of secondary school educators selected by purposeful sampling. Findings suggested that educator stress was caused by a lack of learner discipline; deterioration in educational standards; workload; policy changes; promotion procedures and the principal's leadership style. Based on the findings, recommendations were made for improvement of practice. / Educational Studies / M. Ed. (Education Management)

Background: Work-related stress (WRS) is associated with musculoskeletal pain (MSP), changes in the autonomic nervous system (ANS) and anxiety. Objective: To determine the feasibility of a follow-up study and treatment efficacy of the Reaset Approach on MSP, ANS and State-Trait anxiety. Methods: 15 subjects with WRS and MSP were assigned into 3 groups (Body, Head-Neck, Head-Neck-Body). Each group received a single 25 minute ‘Reaset Approach’ intervention. Heart rate variability (HRV), electro-dermal activity (EDA), State Trait Anxiety (STAI) and MSP were measured. Results: HRV parameters: SDNN increased in 13 of 15 subjects while SD1 and SD2 increased in 12 of 15 subjects. EDA reduced in 10 of 14 subjects. State Anxiety reduced in all subjects and Trait Anxiety reduced in 14 of 15 subjects. MSP reduced in all subjects after the intervention and were still lower three days afterwards. Conclusions: This pilot study determined that a follow-up study can ensue provided minor modifications are implemented and that the ‘Reaset Approach’ has an influence on the ANS, anxiety and MSP. Results do differ between groups. The intervention groups including the head and neck modalities demonstrated better results. / Hintergrund: Arbeitsbedingter Stress (ABS) ist verbunden mit muskelschmerzen, Veränderungen im autonomen Nervensystem (ANS) und Angst. Ziel: Machbarkeit einer Follow-up-Studie und Wirksamkeit der Behandlung des Reaset Ansatzes auf ANS, Muskelschmerzen und State und Trait- Angst bestimmen. Methoden: 15 Patienten mit ABS und Muskelschmerzen wurden in 3 Gruppen eingeteilt (Körper, Kopf-Hals, Kopf-Hals-Körper). Jede Gruppe erhielt eine einzige 25 Minuten dauernde 'Reaset Approach’-Behandlung. Herzfrequenzvariabilität (HRV), elektro-dermale Aktivität (EDA), State-Trait-Angstsinventar (STAI) und Muskelschmerzen (SF-MPQ) wurden gemessen. Ergebnisse: Die HRV-wert: SDNN ist bei 13 von 15 Probanden erhöht, während SD1 und SD2 bei 12 von 15 Probanden zugenommen hat. EDA war bei 10 von 14 Probanden reduziert. Die State-Angst hat bei allen Probanden und die Trait-Angst bei 14 der 15 Probanden abgenommen. Muskelschmerzen waren bei alle Probanden anschließend an und drei Tage nach der Intervention reduziert. Schlussfolgerung: Diese Pilotstudie hat gezeigt, dass eine Follow-up-Studie fortgesetzt werden kann, sofern kleinere Änderungen durchgeführt werden. Die 'Reaset Approach’ hat einen günstigen Einfluss auf die ANS, State-Trait-Angst und Muskelschmerzen. Ergebnisse zwischen den Gruppen sind unterschiedlich. Die Interventionsgruppen mit einschließlich der Kopf-Hals-Modalitäten zeigten bessere Ergebnisse..

Les impacts des changements climatiques sur la population sont nombreux et ont été relativement bien documentés, ce qui n’est pas le cas de ces impacts sur la santé et la sécurité des travailleurs. L’objectif de cette thèse est de documenter les effets négatifs des changements climatiques sur la santé et la sécurité des travailleurs dans une région d’un pays industrialisé à climat tempéré, comme le Québec. Pour y arriver, deux approches ont été utilisées : a) les dangers et les effets sanitaires ont été identifiés par une revue de la littérature validée par des experts nationaux et internationaux, et des priorités de recherche ont été établies à l’aide d’une méthode de consultation itérative, b) des modèles statistiques, utiles à l’estimation des impacts sanitaires des changements climatiques, ont été développés pour apprécier les associations entre la survenue de lésions professionnelles et l’exposition des travailleurs aux chaleurs estivales et à l’ozone troposphérique, deux problématiques préoccupantes pour le Québec. Le bilan des connaissances a mis en évidence cinq catégories de dangers pouvant affecter directement ou indirectement la santé et la sécurité des travailleurs au Québec (vagues de chaleur, polluants de l’air, rayonnements ultraviolets, événements météorologiques extrêmes, maladies vectorielles transmissibles et zoonoses) et cinq conditions pouvant entraîner des modifications dans l’environnement de travail et pouvant ultimement affecter négativement la santé et la sécurité des travailleurs (changements dans les méthodes agricoles et d’élevage, altérations dans l’industrie de la pêche, perturbations de l’écosystème forestier, dégradation de l’environnement bâti et émergence de nouvelles industries vertes). Quant aux modélisations, elles suggèrent que les indemnisations quotidiennes pour des maladies liées à la chaleur et pour des accidents de travail augmentent avec les températures estivales, et que ces associations varient selon l’âge des travailleurs, le secteur industriel et la catégorie professionnelle (manuelle vs autre). Des associations positives statistiquement non significatives entre les indemnisations pour des atteintes respiratoires aiguës et les concentrations d’ozone troposphérique ont aussi été observées. Dans l’ensemble, cette thèse a permis de dégager douze pistes de recherche prioritaires pour le Québec se rapportant à l’acquisition de connaissances, à la surveillance épidémiologique et au développement de méthodes d’adaptation. Selon les résultats de cette recherche, les intervenants en santé au travail et les décideurs devraient déployer des efforts pour protéger la santé et la sécurité des travailleurs et mettre en place des actions préventives en vue des changements climatiques. / The impacts of climate change on human health are multiple and have been extensively studied in the general population, whereas these impacts on the working population have received little attention. In this perspective, the objective of this research is to document the negative effects of climate change on Occupational health and safety (OHS) in northern industrialized countries with a temperate climate, such as in Quebec. To achieve this goal, two approaches were used: a) exposure/hazards and potential effects of climate change on OHS were identified using a narrative review of the scientific literature validated by a working group of international and national experts and Quebec’s stakeholders, and research priorities applicable to the Quebec context were established by a consensus approach, b) statistical models, useful for quantifying the health impacts of climate change, were developed to estimate the associations between occupational illnesses, injuries and exposure to summer outdoor temperatures or tropospheric ozone, as these climate conditions are among the most preoccupying issues related to climate change in Quebec. The literature highlighted five categories of hazards that are likely to impact OHS in Quebec (heat waves/increased temperatures, air pollutants, UV radiation, extreme weather events, vector-borne/zoonotic diseases) and five conditions that could potentially affect the working environment and negatively impact the OHS (changes in agriculture/breeding methods, alterations in the fishing industry, disruptions of the forest ecosystem, deterioration of the built environment and emerging green industries). The modeled associations suggest that daily compensations for heat-related illnesses and work-related injury increase with ambient temperature, and that these relations vary according to workers age, industries and physical demand of the occupation (i.e. manual vs other type). Positive non-statistically significant associations were observed between acute respiratory problems compensations and levels of ozone. Overall, this work produced a list of twelve research topics for the Quebec context, all related to the knowledge acquisition, the surveillance of diseases or the development of adaptation strategies. According to this thesis, stakeholders and decision-makers should make effort to increase the protection of workers health and safety in the context of climate change.

Introduction : L’asthme professionnel (AP) est diagnostiqué au Québec avec le test de provocation bronchique spécifique (TPS). Le TPS consiste à exposer le patient à un agent causal suspecté en vue de provoquer une réaction asthmatique. Un TPS négatif est possible quand un agent causal a été omis de l’histoire professionnelle du patient. L’évaluation des expositions professionnelles par une expertise en hygiène en santé du travail est considérée comme une méthode précise, lorsque des données de mesure ne sont pas disponibles. Cependant, l'apport de cette méthode dans le diagnostic de l’AP n'a jamais été examiné dans un contexte clinique. Objectifs : Déterminer l'apport de l'évaluation des expositions professionnelles par une expertise en hygiène du travail dans l'investigation de l'AP. Comparer les expositions professionnelles détectées par un clinicien et par un hygiéniste chez 1) des sujets avec de l’AP prouvé par des TPS positifs, 2) chez des sujets avec des TPS négatifs. Méthodes : Une analyse des expositions potentielles par le clinicien a précédé la réalisation du TPS. Une évaluation des expositions professionnelles a été réalisée par un hygiéniste. L’hygiéniste n’avait pas connaissance du diagnostic du patient. Résultats : 120 sujets (TPS positifs : 67 négatifs :53) ont été enrôlés dans l’étude. L’hygiéniste a identifié l’agent causal dans la très grande majorité des TPS positifs. Dans 33 TPS négatifs, l’hygiéniste a détecté des agents sensibilisants non identifiés par le médecin. Conclusion : L’évaluation des expositions professionnelles par une expertise en hygiène du travail est une méthode pouvant compléter l'évaluation clinique pour la détection d’agents sensibilisants associés à l’AP. L’inclusion de cette approche dans l’évaluation clinique de l’AP aurait comme effet de réduire la survenance d’un diagnostic erroné. / Introduction: Occupational asthma (OA) is diagnosed in the province of Quebec with the specific inhalation challenge (SIC) test. The SIC test consists of exposing the patient to a suspected causal agent in order to induce an asthmatic reaction. When a causal agent has been omitted from the occupational history, the SIC test can be negative. An expert assessment of occupational exposures by an occupational hygienist is considered an accurate method when quantitative measurements are not available. However, its contribution has never been evaluated in the diagnosis of OA. Objective: Evaluate the contribution of an occupational exposure assessment by an expert industrial hygienist to the diagnosis of OA. Compare the occupational exposures detected by an occupational hygienist and a clinician in: 1) OA subjects with a positive SIC, 2) Subjects with a negative SIC. Methods: The clinician assessed the workplace exposures during a routine clinical evaluation preceding the performance of the SIC. An expert assessment of work histories was performed by an occupational hygienist blind to the diagnostic status of the patient. Results: 120 subjects (Positive SIC: 67 Negative SIC: 53) were enrolled in this study. The occupational hygienist detected the causal agent in almost all cases of OA. In 33 negative SIC, the occupational hygienist identified sensitizing agents which were not detected by the clinician. Conclusions: An expert assessment of occupational exposures by an occupational hygienist is a method which could complement the clinical assessment for the detection of sensitizing agents associated with OA. This method could be included in the clinical evaluation of OA in order to decrease the probability of misdiagnosis.

Objetivo: analisar a organização do trabalho no desenvolvimento das Lesões por Esforços Repetitivos/ Distúrbios Osteomusculares Relacionados ao Trabalho - LER/DORT, em taquígrafos de ambos os sexos, de duas Casas Parlamentares na região metropolitana de São Paulo. Método: estudo qualitativo; os instrumentos de coleta utilizados foram: entrevista individual, observação do trabalho e questionário de saúde e trabalho, composto de questões de identificação, estilo de vida, dados ocupacionais e de morbidade e o Questionário Nórdico de Sintomas Osteomusculares. Resultados: Identificaram-se fatores biomecânicos como prováveis causas de LER/DORT, tais como: manutenção de postura estática e movimentos repetitivos de digitação / manuseio de gravador; e aspectos da organização do trabalho, como por exemplo: divisão de tarefas por ciclos de tempo, pessoal reduzido, horários e pausas irregulares. Os taquígrafos relataram: exigências física, cognitiva, sensorial e psicológica do treinamento/ trabalho, pressão temporal, receio de errar, sobrecarga de trabalho nos períodos de pico e desgaste motivado pela disponibilidade integral de horários. Os trabalhadores identificaram como causas de LER/DORT: as dimensões temporal, ambiental, e da ação do trabalho, bem como aspectos individuais e condições fora do trabalho. Conclusões: (a) A taquigrafia parlamentar caracteriza-se pela fragmentação das tarefas, ritmo imposto e prazos rígidos, semelhante a uma linha de montagem; (b) aspectos da organização do trabalho podem influenciar a sobrecarga biomecânica e o aumento no tempo de exposição ao risco para LER/DORT entre taquígrafos; (c) para serem eficazes, medidas preventivas devem considerar os aspectos biomecânicos, bem como as características da organização do trabalho e a participação dos trabalhadores. / Objective: to analyze some of the relevant aspects of work organization in the development of Work Related Musculoskeletal Disorders- WRMSD among male and female shorthand typists, in two parliamentary institutions in the metropolitan area of the city of São Paulo. Method: qualitative study; the instruments used to collect data have been: individual interview, observation of the work and questionnaire of health and work, composed of identification, occupational and morbidity questions and the Nordic Musculoskeletal Questionnaire. Results: Biomechanical factors such as the maintenance of static posture and the repetitive movements of typing / handling the voice recorder have been identified as probable WRMSD causes; as well as some aspects of work organization, such as: task division in time cycles, reduced staff, irregular schedules and breaks. The shorthand typists have spoken about: physical, cognitive, sensorial and psychological requirements of training/work, time pressure, fear of making mistakes, work overload in rush periods and strain caused by the full-time availability schedule. The workers have come up with WRMSK causes: time, environmental and action dimensions of their work, as well as individual aspects and extra-work conditions. Conclusions: (a) The parliamentary shorthand typing work is characterized by divided tasks, rigid work rhythm and deadlines, like a factory assembly-line; (b) several elements of work organization may influence the biomechanical overload and it may also increase the exposure to WRMSD risk among shorthand typists; (c) effective preventive measures must consider the biomechanical elements, as well as the aspects of organization of the work and workers’ participation.

Objetivo: analisar a organização do trabalho no desenvolvimento das Lesões por Esforços Repetitivos/ Distúrbios Osteomusculares Relacionados ao Trabalho - LER/DORT, em taquígrafos de ambos os sexos, de duas Casas Parlamentares na região metropolitana de São Paulo. Método: estudo qualitativo; os instrumentos de coleta utilizados foram: entrevista individual, observação do trabalho e questionário de saúde e trabalho, composto de questões de identificação, estilo de vida, dados ocupacionais e de morbidade e o Questionário Nórdico de Sintomas Osteomusculares. Resultados: Identificaram-se fatores biomecânicos como prováveis causas de LER/DORT, tais como: manutenção de postura estática e movimentos repetitivos de digitação / manuseio de gravador; e aspectos da organização do trabalho, como por exemplo: divisão de tarefas por ciclos de tempo, pessoal reduzido, horários e pausas irregulares. Os taquígrafos relataram: exigências física, cognitiva, sensorial e psicológica do treinamento/ trabalho, pressão temporal, receio de errar, sobrecarga de trabalho nos períodos de pico e desgaste motivado pela disponibilidade integral de horários. Os trabalhadores identificaram como causas de LER/DORT: as dimensões temporal, ambiental, e da ação do trabalho, bem como aspectos individuais e condições fora do trabalho. Conclusões: (a) A taquigrafia parlamentar caracteriza-se pela fragmentação das tarefas, ritmo imposto e prazos rígidos, semelhante a uma linha de montagem; (b) aspectos da organização do trabalho podem influenciar a sobrecarga biomecânica e o aumento no tempo de exposição ao risco para LER/DORT entre taquígrafos; (c) para serem eficazes, medidas preventivas devem considerar os aspectos biomecânicos, bem como as características da organização do trabalho e a participação dos trabalhadores. / Objective: to analyze some of the relevant aspects of work organization in the development of Work Related Musculoskeletal Disorders- WRMSD among male and female shorthand typists, in two parliamentary institutions in the metropolitan area of the city of São Paulo. Method: qualitative study; the instruments used to collect data have been: individual interview, observation of the work and questionnaire of health and work, composed of identification, occupational and morbidity questions and the Nordic Musculoskeletal Questionnaire. Results: Biomechanical factors such as the maintenance of static posture and the repetitive movements of typing / handling the voice recorder have been identified as probable WRMSD causes; as well as some aspects of work organization, such as: task division in time cycles, reduced staff, irregular schedules and breaks. The shorthand typists have spoken about: physical, cognitive, sensorial and psychological requirements of training/work, time pressure, fear of making mistakes, work overload in rush periods and strain caused by the full-time availability schedule. The workers have come up with WRMSK causes: time, environmental and action dimensions of their work, as well as individual aspects and extra-work conditions. Conclusions: (a) The parliamentary shorthand typing work is characterized by divided tasks, rigid work rhythm and deadlines, like a factory assembly-line; (b) several elements of work organization may influence the biomechanical overload and it may also increase the exposure to WRMSD risk among shorthand typists; (c) effective preventive measures must consider the biomechanical elements, as well as the aspects of organization of the work and workers’ participation.

Submitted by SBI Biblioteca Digital (sbi.bibliotecadigital@puc-campinas.edu.br) on 2017-04-12T18:25:43Z No. of bitstreams: 1 HELOISA APARECIDA DE SOUZA.pdf: 1392683 bytes, checksum: 48e5ce3f21710277540177f37dd97013 (MD5) / Made available in DSpace on 2017-04-12T18:25:43Z (GMT). No. of bitstreams: 1 HELOISA APARECIDA DE SOUZA.pdf: 1392683 bytes, checksum: 48e5ce3f21710277540177f37dd97013 (MD5) Previous issue date: 2017-04-21 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Despite extensive evidence that the current working conditions can lead to mental exhaustion and illness among workers, public policies that specifically address this issue are still limited and ineffective in Brazil. Although there is no protocol to follow, there are many public health professionals who are concerned about the increase in work-related mental disorders. This thesis evaluated healthcare professionals working in the Sistema ?nico de Sa?de (SUS, Brazilian Unified Health System) seeking to investigate their conceptions and actions that are aimed at reducing and preventing mental health problems related to working conditions. This is a Work-related Mental Health qualitative research based on the ?theme-field? concept, in which the field is not a predetermined physical space, and dialogues and social interactions are used to address the topic investigated. The ?theme-field? approach was used by carrying out a document analysis, participating in different spaces and events, making contacts, and conducting interviews with several professionals in different health services provided by the SUS. Information gained by experience and observation was documented in a field diary; the interviews were recorded and transcribed. The material was analyzed based on the hermeneutic dialectic process. The results obtained reveal the importance of healthcare professionals? ethical and political commitment to carrying out actions that contribute to the protection of workers? subjectivity and to the development and implementation of public policies addressing this problem. Among the various possibilities of actions carried out in the public health system are those aimed at providing care, making referrals, preventing work-related mental exhaustion, promoting mental health in the workplace, encouraging workers to organize a resistance movement against mental illness, and investigating the association between mental illness and working conditions. The present study also discusses the challenges to the adoption of practices to promote mental health of workers who use the services provided by the SUS, the importance of solid and permanent education of healthcare professionals, and the role of psychology in actions aimed at protecting workers' mental health. / Apesar de las numerosas evidencias de que las condiciones de trabajo en la actualidad generan desgaste y enfermedad mental en los trabajadores, las pol?ticas p?blicas que abordan espec?ficamente dicha tem?tica todav?a son fr?giles en Brasil. Sin embargo, a?n sin un protocolo de acci?n que los oriente, existen muchos profesionales de la red p?blica de salud que son sensibles al aumento de los casos de enfermedad ps?quica relacionada con el trabajo. Esos profesionales son los protagonistas de esta tesis, que tiene como objetivo general analizar las concepciones y acciones de trabajadores del Sistema ?nico de Salud (SUS) que conllevan al enfrentamiento de los perjuicios a la salud mental relacionados a las condiciones de trabajo. Se trata de una investigaci?n cualitativa, situada en el campo de la Salud Mental Relacionada con el Trabajo (SMRT) y basada en la concepci?n de campo-tema, que no elige un lugar delimitado, buscando, a trav?s de di?logos e interacciones sociales, una leg?tima aproximaci?n con el tema estudiado. De esta forma, la inserci?n en el campo-tema se dio mediante el an?lisis de documentos, participaci?n en distintos espacios y eventos, contacto y entrevistas com diversos profesionales de diferentes servicios del SUS. Las observaciones y vivencias en el transcurso de la investigaci?n fueron registradas en diario de campo y las entrevistas fueron grabadas y transcritas. Todo ese material fue analizado apoy?ndose en la propuesta de la hermen?utica-dial?ctica. Los resultados de la investigaci?n revelan la importancia del compromiso ?tico y pol?tico de los profesionales de la salud con la realizaci?n de acciones que contribuyen a la protecci?n de la subjetividad de los trabajadores y a la necesidad de consolidar pol?ticas p?blicas que aborden el asunto. Entre las diferentes posibilidades de actuaciones realizadas en la red p?blica de salud, se destacan aquellas que propenden al atendimiento, remisi?n y prevenci?n de los casos de desgaste mental relacionados com el trabajo, as? como las acciones de promoci?n de la salud ps?quica en el ambiente de trabajo, el est?mulo a la resistencia de los trabajadores y el establecimiento de la relaci?n entre la enfermedad mental y las condiciones laborales. Asimismo, la investigaci?n tambi?n discute los desaf?os para la constituci?n de pr?cticas orientadas a la salud mental de los trabajadores del SUS, la importancia de la formaci?n inicial y permanente de los profesionales de la salud y el papel de la Psicolog?a en las acciones dirigidas a la protecci?n de la salud mental de los trabajadores. / Apesar das in?meras evid?ncias de que as situa??es de trabalho na atualidade geram desgaste e adoecimento mental nos trabalhadores, as pol?ticas p?blicas que abordam especificamente essa tem?tica ainda s?o fr?geis no Brasil. Entretanto, mesmo sem um protocolo de a??o que os oriente, existem muitos profissionais da rede p?blica de sa?de que s?o sens?veis ao aumento dos casos de adoecimento ps?quico relacionado ao trabalho. Esses profissionais s?o os protagonistas desta tese, que possui o objetivo geral de analisar as concep??es e as a??es de trabalhadores do Sistema ?nico de Sa?de (SUS) que visam ao enfrentamento do adoecimento mental relacionado ao trabalho. Trata-se de uma pesquisa qualitativa, situada no campo da Sa?de Mental Relacionada ao Trabalho (SMRT) e baseada na concep??o de campo-tema, que n?o elege um lugar delimitado, buscando, por meio de di?logos e intera??es sociais, uma genu?na aproxima??o com o tema estudado. Assim, a inser??o no campo-tema se deu por meio de an?lise de documentos, participa??o em diferentes espa?os e eventos, contatos e entrevistas com diversos profissionais inseridos em diferentes servi?os do SUS. As observa??es e vivencias no decorrer da pesquisa foram registradas em di?rio de campo e as entrevistas foram gravadas e transcritas. Todo esse material foi analisado apoiando-se na proposta da hermen?utica-dial?tica. Os resultados da pesquisa revelam a import?ncia do comprometimento ?tico e pol?tico dos profissionais da sa?de com a realiza??o de a??es que contribuam para a prote??o da subjetividade dos trabalhadores e para a necessidade de consolida??o de pol?ticas p?blicas que abordam o assunto. Entre as diferentes possibilidades de atua??es realizadas na rede p?blica de sa?de, destacam-se aquelas que visam ao atendimento, ao encaminhamento e ? preven??o dos casos de desgaste mental relacionados ao trabalho, bem como as a??es de promo??o da sa?de ps?quica no ambiente de trabalho, o est?mulo ? resist?ncia dos trabalhadores e o estabelecimento de rela??o entre o adoecimento mental e as situa??es laborais. A pesquisa discute ainda os desafios para o estabelecimento de pr?ticas que visam ? sa?de mental dos trabalhadores no SUS, a import?ncia da forma??o inicial e permanente dos profissionais da sa?de e o papel da Psicologia nas a??es que t?m o objetivo de proteger a sa?de mental dos trabalhadores.

Submitted by Fernanda Ciolfi (fernanda.ciolfi@puc-campinas.edu.br) on 2016-04-07T18:23:11Z No. of bitstreams: 1 Heidy Joahanna Garrido Pinzon.pdf: 1919376 bytes, checksum: aaaacf762cb9a911de4a979c7a12c936 (MD5) / Made available in DSpace on 2016-04-07T18:23:11Z (GMT). No. of bitstreams: 1 Heidy Joahanna Garrido Pinzon.pdf: 1919376 bytes, checksum: aaaacf762cb9a911de4a979c7a12c936 (MD5) Previous issue date: 2016-02-29 / The purpose of this research was to analyze the experiences of workers enrolled in the health systems of Colombia and Brazil, taking into account the interesting fact that these two health systems emerged from opposing guidelines. On one hand, among the countries which suffered the intense economic crisis of the 1980?s, Colombia was unified in the most rigorous and systematic model because of hegemonic sanitary controls required by the World Bank and the International Monetary Fund On the other hand, in Brazil, which also experienced the economic crisis, it was possible the creation of the Unified Health System (SUS ? Portuguese acronym), as a product of demands of popular movements, managing to establish health as a right of all citizens, which was written into the Federal Constitution of 1988. Thus, the SUS was born in the midst of the economic crisis of 1980, in a neoliberal scenario, in opposition to capitalist tendencies which were characterized by the search for new markets in the health sector, a tendency completely adopted by Colombia. Given this context, the present study aimed to understand the common experiences of basic care workers in Colombia and Brazil, against the capitalist logic. Based on the Social Psychology of Work?s approach, this research is qualitative in nature and has empirical style. It was developed by analyzing reflexive interviews of two groups of workers belonging to healthcare and administrative sectors of the Basic Attention: one in Bucaramanga, Colombia and the other in Campinas, Brazil. Content Analysis was used for the analysis process, which is understood as a set of research techniques, which aims to find sense or senses manifested in more diverse forms of communication. In the course of this investigation it was revealed that, in both countries, the main experiences of the health professionals, determined by neo-liberal logic, are related to the transformations introduced in the labor conditions and relations, and also in the organization of work. In the Colombian context, we find that the main problems presented by those interviewed have their origins in the transition process introduced by those reforms which gave rise to its current health care system. Such problems are reflected, mainly, in the deterioration of relations with patients, as well as, in the detriment of the configuration of the work teams, forced to live divided by the stark contrast between different contractual relations. This condition, which eventually causes an inherent difficulty to generate cohesion within the working groups, also appears in the Brazilian context, as a result of outsourcing, which has come to constitute an effective mechanism to weaken the SUS, to facilitate its waning and to place it on a path pointing in the direction of the current Colombian health system. Finally, in the two studied stages, this panorama of job insecurity, permeated by instability, intensification of responsibilities and overworked employees, reduction in wages, among others, has generated major consequences to the life and health of the workers, which are reflected in the deterioration of their mental and physical health, in the lack of social recognition, the deterioration of ethics and morality, also in some cases, even in constraints for the construction of a life project. / A presente pesquisa visa a analisar as viv?ncias de trabalhadores dos Sistemas P?blicos de Sa?de da Col?mbia e do Brasil, tendo-se em vista que esses dois casos ganham interesse de estudo por exemplificarem sistemas de sa?de cujo surgimento se d? a partir de diretrizes opostas. Por um lado, tem-se a Col?mbia que, dentre os pa?ses latino-americanos a sofrer a intensa crise econ?mica da d?cada de 1980, foi aquele que incorporou de maneira mais rigorosa e sistem?tica os crit?rios centrais do modelo hegem?nico das reformas sanit?rias estabelecidos pelo Banco Mundial e pelo Fundo Monet?rio Internacional. Por outro, observa-se a situa??o do Brasil, que tamb?m experimentou a crise econ?mica, onde foi poss?vel a cria??o do Sistema ?nico de Sa?de (SUS), produto das exig?ncias dos movimentos populares os quais conseguiram estabelecer a sa?de como um direito de todos os cidad?os, legitimando-se na Constitui??o Federal de 1988. Toma-se em considera??o, ent?o, como nasce o SUS, num cen?rio neoliberal em meio da crise econ?mica de 1980, em oposi??o a tend?ncias imperialistas que se caracterizavam pela busca de novos mercados no setor sa?de, enquanto a Col?mbia se subjugou totalmente a elas. Levando em conta esse contexto, o estudo aqui apresentado teve como objetivo compreender as viv?ncias de trabalhadores da Aten??o B?sica dos Sistemas P?blicos de Sa?de da Col?mbia e do Brasil, frente ? l?gica capitalista. Baseada no enfoque da Psicologia Social do Trabalho, esta pesquisa ? de natureza qualitativa e de tipo emp?rico. Desenvolveu-se mediante a realiza??o de entrevistas reflexivas em profundidade, com dois grupos de trabalhadores da Aten??o B?sica de n?vel assistencial e administrativo: um em Bucaramanga, Col?mbia e, outro, em Campinas, Brasil. Para o processo de an?lise, elegeu-se utilizar a An?lise de Conte?do, a qual ? compreendida como um conjunto de t?cnicas de pesquisa cujo objetivo ? a busca do sentido ou dos sentidos manifestos nas mais diversas formas de comunica??o. O percurso desta pesquisa revelou que, em ambos os pa?ses, as principais viv?ncias dos profissionais da sa?de, determinadas pela l?gica neoliberal, est?o relacionadas com as transforma??es introduzidas nas condi??es, rela??es e organiza??o do trabalho. No contexto colombiano estudado, identificamos a origem das problem?ticas centrais apresentadas pelos entrevistados no processo de transi??o induzido pela reforma que constituiu seu atual sistema de sa?de. Essas problem?ticas se traduzem, essencialmente, na deteriora??o das rela??es com os usu?rios, bem como na configura??o das equipes de trabalho, marcadas pelo contraste entre pessoas com diferentes v?nculos empregat?cios. Esta ?ltima condi??o, empecilho para a coes?o dos grupos de trabalho, tamb?m ? observada no contexto brasileiro pesquisado, como produto da terceiriza??o, que parece ter se tornado um efetivo mecanismo para enfraquecer o SUS, facilitar seu desmonte e coloc?-lo no mesmo caminho atualmente percorrido pelo sistema de sa?de colombiano. Por fim, exp?e-se como, nos dois cen?rios estudados, tal panorama de precariedade do trabalho, permeado pela instabilidade, intensifica??o e sobrecarga laboral, pela redu??o de sal?rios, dentre outros fatores, tem ocasionado graves consequ?ncias para a vida e a sa?de dos trabalhadores, que se refletem na degrada??o de sua sa?de f?sica e mental, na falta de reconhecimento social, na deteriora??o da ?tica e da moral e nas restri??es para a constru??o de um projeto de vida.

Les facteurs de risque de troubles musculo-squelettiques(TMS) tels que les facteurs physiques, organisationnels et psychosociaux sont un défi commun pour les industries de l'assemblage automobile qui entrainent des effets indésirables sur le système et les humains. L’ergonomie a déjà été intégrée dans les systèmes de production de ces industries pour la prise en charge de la prévention des TMS. La question est de savoir si l'approche ergonomique actuelle des industries automobiles, sur la base de normes à l'entreprise et des méthodes d'observation, peut fournir une connaissance partagée des facteurs ergonomiques pour les divers intervenants et pour faciliter l'amélioration des conditions de travail. Cette étude aborde la problématique du positionnement des différents méthodes d'évaluation (utilisées par les différents intervenants) et compare les résultats et apports de chaque méthode d'évaluation. Cette thèse propose que la procédure actuelle d'évaluation des risques de TMS ne favorise pas une connaissance partagée entre les intervenants dans les industries automobiles. On constate que les évaluations par auto-questionnaire (opérateurs) sont significativement différentes de celles issues des méthodes d'observation (ergonome) et des mesures directes (analyse biomécanique). Cependant, les opinions et jugements des opérateurs concernant les facteurs ergonomiques sont importants pour faciliter la réussite d'une approche ergonomique. Un entretien structuré et systématisé, basé sur des données objectives (Video-observations ou de mesure directe) liées aux activités et stratégies des opérateurs, pourrait être une procédure appropriée pour faire progresser l'ergonomie des situations de travail. Enfin, la connaissance tirée de cette thèse souligne que la variabilité des tâches dans l’industrie automobile nécessite une approche ergonomique qui partage les connaissances des risques entre les intervenants. Dans cette approche, les attitudes et les comportements des opérateurs sont pris en compte dans les projets d’amélioration continue. De plus, la participation des intervenants devrait être intégrée afin d'améliorer la prise en compte de l'ergonomie dans la production. Une synthèse de cette thèse en Français a été fournie dans l’annexe première. / Musculoskeletal risk factors such as physical, organizational and psychosocial factors are a common challenge for the automotive assembly industries and result in adverse human and system effects. Ergonomics has already been integrated inthe production systems of such factories to eliminate work related musculoskeletal disorders (WR-MSDs). The issue is whether the current ergonomic approach of car industries, based on corporate standards and observational methods, can provide a shared knowledge of ergonomic factors for various stakeholders and facilitate ergonomic improvement. This study focuses on the positioning of the different assessment methods (used by various stakeholders), agreement between their results in evaluation of physical risk factors and the influence of intervention and improvement following ergonomic assessment. This thesis proposes that the current procedure of risk factor assessment can not provide ashared knowledge and representation of risks between stakeholders in manufacturing industries. It was found that the operators’ assessments of risk factors (self-reported questionnaire) were significantly different from those assessed by observational methods (ergonomist) and direct measurement. However, the operators’ opinions and judgments of ergonomic factors of a job are of particular importance to the success of an ergonomic approach. A structured interview based on objective data (video-observation or direct measurement) linked the activities and strategies of atrisk operators might be an appropriate procedure to advance ergonomics.The knowledge gained from this study emphasizes that the variable nature of tasks in manufacturing industries needs an ergonomic approach which shares knowledge and representation of risks between stakeholders. In such an approach, attitudes and behaviors of operators are taken into consideration in developing new intervention processes, organizational and technical remedies. Moreover, involvement of stakeholders should be integrated and this should result in improving production ergonomics.

Thesis (Ph.D. (Industrial Psychology))--North-West University, Vaal Triangle Campus, 2006.