During the last several decades, many people, fleeing from disasters or political threats, have applied for asylum in the European countries. Council Directive 2003/9/EC, laying down minimum standards for the reception of asylum-seekers, as well as several other directives, have been developed in the EU in order to ensure fair treatment of the asylum-seekers in all the European countries. However, there are huge differences in the national asylum laws of countries and consequently, the way they treat the asylum-seekers. In this research, the national asylum laws of Germany and the Netherlands are studied and compared, showing that though following the Council Directive, fair or equal treatment of asylum-seekers cannot be guaranteed. In the Netherlands asylum-seekers are granted with a great extent of benefits while in Germany, they are greatly discriminated against. Based on the Social Determinants of Health Model, developed by Dahlgren and Whitehead in 1991, the hypothesis is that the asylum seekers in the Netherlands enjoy better health status than the ones in Germany, because based on the Dutch asylum laws, they have better living and working conditions. In order to confirm or negate this hypothesis, a meta-study of available literature on the health status of asylum-seekers has been done. However, the hypothesis could not be confirmed/ negated due to extreme lack of availability of data in this area. By discussing the relationship between life conditions and health of individuals, reviewing current legal instruments regulating asylum in the EU and analyzing the available data on the health status of asylum-seekers, this paper draws the attention to the importance of data and research on these topics and the need for development of practices for collection of such information. Availability of such information can affect future decision and policy makings regarding asylum-seekers and their health and might result in comprehensive reformations in the current national or international legal instruments.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

The healthcare strike action that rocked South Africa in 2007 and 2010 highlighted the trend of professional nurses towards exercising their rights as employees to embark on strike actions, often also in solidarity with other categories of employees. This study aimed to highlight the problem brought about by the lack of proactive strategies to maintain a balance between human and professional rights and responsibilities of nurses within the legal framework of South Africa. The theoretical grounding of the study included both organisational change models and transformational leadership models. A descriptive and analytic design was followed, using both qualitative and quantitative non-probability sampling approaches to meet the research objectives of determining factors for nurses‘ involvement in strikes and their impact. Eighty professional nurses were included as the total sample of the study with 53 that did not participate in strike action and 27 that participated in strike action. A sample of eleven nurse managers was also included in the study to determine their views on strikes by nurses and their understanding of the changing work environment. To determine the overall impact of the nurses‘ strike, 40 healthcare consumers were included. The sample was selected from four provinces: Eastern Cape, KwaZulu-Natal; Western Cape and Gauteng. The study was limited to professional nurses, nurse managers within the public-health sector and healthcare consumers using public-health facilities. The findings and the relevant literature referred to in this study indicate that though there are different reasons for strike action in the public-health sector by area or by country, remuneration is undoubtedly the most mentioned reason. Important to note is that salary per se is not the most critical actor but it is a tangible measure of the value that the employer places on people. In the absence of other incentives in the nursing environment, it becomes the focal point. However, addressing salary issues alone will not prevent strike action in the public-health sector / Health Studies / D. Litt. et Phil. (Health Studies)

INTRODUÇÃO: A depressão é uma doença crônica recorrente que pode levar à incapacidade. Burnout ou esgotamento profissional é uma síndrome psicológica caracterizada por exaustão emocional, cinismo e ineficácia. Estresse crônico no trabalho tem sido vinculado à depressão e ao esgotamento. OBJETIVOS: Este estudo tem o objetivo de investigar a associação entre exposição a estressores psicossociais do trabalho, quando avaliados pelos modelos Demanda-Controle-apoio social no trabalho e Desequilíbrio Esforço-Recompensa-comprometimento excessivo, com dois desfechos: depressão (depressão maior e outras depressões) e esgotamento (níveis moderado e alto), entre bancários. METODOLOGIA: Estudo de corte transversal com 1.046 bancários do estado do Pará e do Amapá. Foi utilizado um questionário autoaplicável contendo características sociodemográficas, de depressão (Questionário sobre a Saúde do Paciente-9 ou PHQ-9), de esgotamento (Maslash Burnout Inventory) e de estresse no trabalho (Demand-Control-Support Questionnaire e Effort-Reward Imbalance Questionnaire). Como desfechos foram considerados dois níveis de depressão [depressão maior (DM) e outras depressões (OD)] e dois de esgotamento [nível alto de esgotamento (NAE) e nível moderado de esgotamento (NME)]. Modelos de regressão logística foram utilizados para estimar associações entre níveis de depressão e os dois modelos de estresse, controlando para as covariáveis relevantes, e para estimar as associações entre os níveis de esgotamento e os dois modelos de estresse, também controlando para as covariáveis relevantes. RESULTADOS: Em relação à depressão, a prevalência geral foi de 32,0%, sendo 17,6% de DM e 14,4% de OD, não havendo diferença estatisticamente significante entre os sexos. Atividades de alta demanda e baixo controle, bem como baixo apoio social estiveram associados a OD e DM, mesmo após ajuste para sexo, idade e outras condições de trabalho. Risco de DM e OD também foi associado ao alto esforço/baixa recompensa, comprometimento excessivo e desequilíbrio esforço-recompensa após modelo ajustado. A prevalência geral de esgotamento foi de 71,8% (31,1% nível alto e 40,7% moderado), não havendo diferença estatisticamente significante entre os sexos. Exposição a condições psicossociais adversas de trabalho como alto desgaste, baixo apoio social no trabalho, alto esforço e baixa recompensa, e comprometimento excessivo, mostrou forte associação com NME e NAE. Estas associações foram independentes de idade, sexo e outras características ocupacionais. CONCLUSÃO: Este estudo identificou que condições psicossociais da atividade bancária que envolvam alto desgaste, baixo apoio social no trabalho, alto esforço e baixa recompensa, e comprometimento excessivo, podem representar possíveis fatores de risco para DM e OD, bem como para NAE e NME, entre os trabalhadores da atividade bancária / BACKGROUND: Depression is a chronic, recurrent disease, which may lead to disability. Burnout is a psychological syndrome with emotional exhaustion, cynicism and inefficacy. Work-related chronic stress has been associated with depression and burnout. AIM: This study investigated the association between exposure to psychosocial stressors in the workplace, as assessed by the Job Demand-Control-Support and the Effort-Reward Imbalance-Overcommitment models, with two outcomes: depression (major depression and other forms of depression) and burnout (moderate and high levels). METHODS: This is a cross-sectional study with 1,063 bank employees in the states of Pará and Amapá, Brazil. A self-applied questionnaire was used containing characteristics on sociodemographic indicators, depression [(Patient Health Questionnaire-9 (PHQ-9)], burnout (Maslash Burnout Inventory), and work-related stress (Demand-Control-Support Questionnaire and Effort-Reward Imbalance Questionnaire). As outcomes, two levels of depression [(major depression (MD) and other forms of depression (OD)] and burnout [moderate level (MLB) and high level (HLB)] were considered. Logistic regression models were used to estimate associations between the two levels of depression and the two stress models, controlling for relevant covariates, and to estimate associations between the two levels of burnout and the two stress models, also controlling for relevant covariates. RESULTS: The overall prevalence of depression was 32.0%, with 17.6% for MD and 14.4% for OD, with no statistically significant difference between genders. Highly demanding activities, low levels of control, and low social support at work were associated with MD and OD, even after adjusting for gender, age, and other work-related conditions. The risk of MD and OD also was associated with high effort/low reward, overcommitment and effort-reward imbalance after model adjustment. In relation to burnout, the overall prevalence was 71.8%, with 31.1% for HLB and 40,7% for MLB, with no statistically significant difference between genders. Exposure to adverse psychosocial conditions in the workplace, such as high strain, low social support at work, high effort/low reward, and overcommitment showed strong association with HLB and MLB. These associations were independent of age, gender and other occupational characteristics. CONCLUSION: The results identified that psychosocial conditions in banking activity involving high strain, low social support at work, high effort/low reward, and overcommitment may represent possible risk factors for MD and OD, as well as for HLB and MLB among bank employees

Objetivos: o apoio social no trabalho (AST) de professores está associado à prevenção de agravos à saúde e à melhoria do ambiente psicossocial de trabalho, sendo a compreensão de sua estrutura, relevante. Procurou-se descrever a estrutura de AST de professores considerando o sentido suportivo atribuído aos seus conteúdos nas relações sociais de trabalho. Métodos: realizou-se um estudo com contribuição da pesquisa qualitativa em uma escola pública de educação básica da cidade de São Paulo. Foram aplicadas a observação participante e entrevista individual em profundidade como técnicas instrumentais. Fez-se análise de conteúdo e os resultados foram discutidos com base em aproximações teóricas com a representação social, os fatores psicossociais e a organização do trabalho docente (FPS/OT). Resultados e discussões: foram descritos e especificados os tipos (emocional, instrumental, informativo e de apreciação) e fontes (professores, diretoria, pais/responsáveis e alunos) de AST, que se relacionou com práticas cotidianas para a amenização das exigências de OT e da precarização de recursos educacionais. Sugeriu-se o desenvolvimento de grupos de discussão no trabalho. / Objectives: social support at teachers’ work (SSW) is associated with illness prevention and improvement of psychosocial working conditions. Hence, identyfing teachers’ SSW specific structure is important. The objective of this study was to describe teachers’ SSW specific structure in terms of its content. Methods: contributions from qualitative case study were used to assess teachers social relations within Sao Paulo’s public elementary school. It was applied participant observations and individual unstructured interviews as instrumental techniques. Data were formulated with content analysis and discussed form a theoretical approach with Social Representation Theory, Psychosocial Factors at Work and Work Organization (PSF/WO). Results and discussion: teachers’ SSW structure was based on sources (principal, coworkers, student’s fathers and student themselves) and types (emotional, instrumental, informational and appraisal). SSW was associated with workers’ formulation of daily educational practices and WO, improving precarious working conditions. It was suggested the development of discussion groups at work.

Neste estudo, foram analisadas relações existentes entre liderança, motivação, clima organizacional, trabalho em equipe e o comprometimento organizacional e ocupacional. O estudo exploratório foi realizado em três partes, na primeira procurou-se identificar os fatores de desempenho mais importantes numa relação maior resultantes da pesquisa bibliográfica e na segunda buscou-se quantificar os quatro fatores de desempenho junto aos comprometimentos organizacional e ocupacional. Na primeira parte foi realizada uma pesquisa exploratória e na segunda parte foram entrevistados 52 servidores do CCTM no Instituto de Pesquisas Energéticas e Nucleares IPEN e 252 servidores do IAE no Centro Técnico Aeroespacial CTA. A pesquisa utilizou 18 indicadores de comprometimento organizacional e 18 indicadores de comprometimento ocupacional, todos extraídos do instrumento de Meyer, Allen e Smith. Além destes, foram utilizadas 7 variáveis demográficas e 71 variáveis de desempenho construídas a partir da revisão teórica realizada. Os resultados obtidos com a pesquisa exploratória da primeira parte identificaram os quatro fatores de desempenho já citados e na segunda parte os resultados obtidos nos dois principais locais comprovaram a hipótese que os locais ou grupos de servidores que apresentam maior grau de comprometimento tendem a um maior grau de desempenho. Na terceira parte do estudo utilizou-se a técnica de modelagem de equações estruturais partindo de um modelo teórico definido com as 12 variáveis de desempenho mais importantes em ambos locais da pesquisa e com o apoio dos softwares estatísticos SPSS e LISREL obteve-se um modelo de relacionamento causal mais fortalecido para explicar as variáveis envolvidas. / In this work relation among leadership, motivation, organizational climate, teamwork, and the organizational and occupational commitment, were studied. The exploratory study was accomplished in three parts. In the first it was identified the more important performance factors in a larger relation resultant of the bibliographical research and in the second, it was undertaken a quantification the 4 performance factors together to the organizational and occupational commitments. In the first part, it was accomplished an exploratory research close to some experienced servants, with emphasis in the management area. In the second part it was interviewed 52 employees of the CCTM\'s at the Energy and Nuclear Research Institute IPEN and 252 employees of the IAE at the Aerospace Technical Center CTA. This research used 18 indicators of the organizational commitment and 18 indicators of the occupational commitment, all extracted from the instrument of Meyer, Allen and Smith. Beyond of these, it was used 7 demographic variables and 71 performance variables built from the theoretical revision. The results obtained with the exploratory research of the first part identified the 4 factors aforementioned performance factors. In the second part the obtained results in the two firsts places proved the hypothesis that the servants locations or groups that show a higher degree of commitment tend to a higher degree of performance. In the third part of this study it was used the Structural Equations Modelling SEM, from one theoretic model defined with the 12 more important variables from performance in both researched locals and with assistance of two statistical softwares SPSS and LISREL it was obtained a model of causal relations more strengthened to explain the relationship among the used variables.

INTRODUÇÃO: Os trabalhadores dos Serviços de Nutrição Hospitalar são submetidos às exigências físicas, cognitivas e psíquicas que levam à distúrbios osteomusculares relacionados ao trabalho. O objetivo deste estudo foi implantar ações de melhorias nas situações de trabalho de um serviço de nutrição hospitalar e avaliar a percepção dos trabalhadores e as repercussões sobre os sintomas osteomusculares. MÉTODO: Esta pesquisa foi desenvolvida em um hospital público especializado em cardiologia, localizado em São Paulo, Brasil, após aprovação pelo comitê de ética da instituição. A coleta de dados foi realizada por meio da aplicação de questionários e análise ergonômica do trabalho. Os questionários continham dados sócio-demográficos, história ocupacional, situação de trabalho atual, sintomas osteomusculares e satisfação no trabalho. Do total de 130 trabalhadores, 115 participaram voluntariamente. A análise ergonômica do trabalho foi efetuada de acordo com Guérin et al (2001), sendo realizadas entrevistas, medições do ambiente da cozinha e análises biomecânicas. A partir dos resultados foram implantadas ações de intervenção baseadas na ergonomia participativa durante um ano. Após esta fase, 89 (77%) trabalhadores responderam novamente ao questionário, sendo incluídas perguntas sobre a percepção das modificações. A análise dos dados incluiu testes estatísticos para verificar se houve mudança da prevalência de sintomas antes e após as intervenções, com nível de significância de 5%, por meio dos Programas SPSS 13.0 e Excel 2003. Além disso, foram analisados os dados de percepção dos trabalhadores e dos especialistas em ergonomia sobre o impacto das melhorias na saúde e no processo de trabalho. RESULTADOS: A população constitui-se, em sua maioria, por mulheres, na faixa etária de 25 a 34 anos, com grau médio de escolaridade, casadas, com filhos, e ocupavam o cargo de atendente de nutrição. A maioria trabalhava de 5 a 10 anos no hospital e em jornada de trabalho de 40 horas semanais. Os principais problemas observados foram espaço físico reduzido, equipamentos e materiais de trabalho inadequados, absenteísmo e déficit de pessoal, volume excessivo de trabalho com elevado esforço mental, alta prevalência de sintomas osteomusculares, principalmente nos membros inferiores e ombros. Após as intervenções realizadas, houve melhoria na situação de trabalho com redução nos sintomas osteomusculares e os trabalhadores perceberam as seguintes mudanças nas situações de trabalho: melhoria na iluminação e no controle do ar condicionado, aquisição de batedeira de tamanho médio, conserto de equipamentos, substituição dos pratos de vidro por descartáveis, aquisição de cadeiras, introdução de pausas durante a jornada de trabalho, ginástica laboral e treinamento em liderança para as chefias. Neste período houve ampliação no número de leitos do hospital com conseqüente aumento no volume de trabalho e diminuição da satisfação no trabalho associados à crise financeira da instituição com suspensão de contratações e da compra de materiais e equipamentos. CONCLUSÕES: As intervenções repercutiram em melhorias, principalmente quanto ao ambiente e equipamentos, e na redução dos sintomas osteomusculares nos membros inferiores, ombros, pescoço/região cervical, antebraço e região lombar, apesar desta redução não ter sido estatisticamente significativa. / INTRODUCTION: Hospital food service workers have high level of physical, cognitive and mental demands that are associated with musculoskeletal disorders. The objective of this study was to introduce improvements in the working conditions in a hospital food service and to evaluate the workers perceptions and its effects on musculoskeletal symptoms. METHOD: this study was performed in a public cardiac hospital in São Paulo, Brazil, after its approval by the Ethics Committee. The data were collected by questionnaires and ergonomic analysis of the work. The questionnaire included: socio-demographic, workhistory, work conditions, musculoskeletal symptoms and job satisfaction. A hundred and fifteen questionnaries were applied from 130 workers. The work ergonomic analysis was carried out in accordance with Guérin et al (2001), by means of interviews, observations of kitchen working conditions and biomechanical analyses. Based on the results, interventions have been undertaken by means of a participatory ergonomic approach over one year. After this, another ergonomic analysis was carried out and 89 workers (77%) answered a new questionnaire that also included questions about their perception of the improvements. Data analysis was done by statistical tests to verify symptom prevalences before and after the interventions with a 5% level of significance. SPSS 13.0 and Excel 2003 software was used. RESULTS: The workers were women in the 25-34 age-group, had secondary education, were married, had children and occupied the position of nutrition attendants. They were in this hospital for from 5 to 10 years and on a 40 hour working week schedule. Most of problems observed were reduced space, inadequate equipment and work materials, absenteeism, insufficient number of workers, great volume of work with mental demands, high prevalence of musculoskeletal symptoms mainly in lower members and shoulders. After the improvements in working conditions, the symptoms of musculoskeletal disorders reduced and the workers perceived the following changes in the work process: better lighting and control of air conditioning, acquisition of low capacity mixer, repair of equipment, use of disposable utensils instead of glass plates, acquisition of more chairs, introduction of breaks during working hours, work related gymnastics, workshops for leadership training. In this period the number of hospital beds was increased with a corresponding intensification of the work load and a decline on job satisfaction. The hospital was in a financial crisis with consequences in terms of the hiring of personnel and the acquisition of equipment and materials. CONCLUSION: Interventions brought improvements mainly as regards the work environment and equipment and in the reduction of musculoskeletal symptoms in the lower members, shoulders, neck/cervical region, forearm and lumbar region, though this reduction has not been statistically significant.

Diese Dissertation besteht aus vier Aufsätzen, die zur empirischen Literatur der Allokation der Arbeitszeit beitragen. Der erste Artikel untersucht die Wechselbeziehung zwischen Arbeit und Sozialleben von Paaren und untersucht die Synchronisation der Arbeitszeiten. Ein neuer Analyseansatz wird vorgeschlagen, der es ermöglicht, den durchschnittlichen Einfluss der Arbeitsbedingungen der deutschen Bevölkerung auf die Allokation der Freizeit zu bestimmen. Der zweite Aufsatz untersucht, ob Arbeit zu unüblichen Bedingungen gemäß der Theorie kompensierender Lohndifferentiale durch höhere Löhne entlohnt wird. Die Ergebnisse zeigen, dass solche Arbeiter 9--10 Prozent höhere Stundenlöhne erhalten. Diese Zuschläge haben einen u-förmigen Verlauf über die Einkommensverteilung für Schichtarbeiter. Die Ausrichtung der Analyse auf monetäre Kompensation solcher Arbeitsbedingungen, vernachlässigt mögliche adverse Auswirkungen auf das Sozialleben und die Gesundheit. Der dritte Artikel untersucht daher nicht-pekuniäre Aspekte. Freizeit wird in solchen Jobs zu einem höheren Anteil allein verbracht, was sich negativ auf das Wohlbefinden auswirken kann, da der Grenznutzen der Freizeit sinkt. Die drastischen Auswirkungen dieser Arbeit zieht ein erhöhtes Risiko auf den mentalen und physischen Gesundheitszustand mit sich, der sich aus einer signifikant niedrigeren Schlafallokation ergibt. Besonders betroffen sind ältere Arbeitnehmer, die eine höhere Wahrscheinlichkeit haben, diesen Arbeitsbedingungen schon über einen längeren Zeitraum ausgesetzt zu sein. Abschließend untersucht der vierte Aufsatz den kausalen Zugewinn auf die elterliche Zeit mit Kindern, den Arbeitnehmer durch mehr zeitliche Arbeitsflexibilität erreichen. Gleitzeitregelungen erlauben es Müttern somit, etwa 30 Prozent mehr ihrer verfügbaren Zeit mit ihren Kindern zu verbringen. Zeitliche Flexibilität kann somit die adversen Effekte der Beschäftigung von Müttern auf die kognitive Entwicklung ihrer Kinder abmildert. / This thesis consists of four essays that contribute to the empirical literature of the allocation of market work. The first essay studies the interrelation between working schedules and social life of couples by investigating the synchronization of schedules. A novel approach is proposed that allows for a determination of the average impact of working conditions of the German population on the allocation of leisure. From these findings, couple-specific conclusions concerning the active synchronization of schedules can be drawn. The second essay is devoted to empirically testing the assumption of compensating wage differentials predicting that work at non-standard hours shall be compensated by higher wage rates. The results suggest 9--10 percent higher hourly wage rates. Wage premia are U-shaped across the earnings distribution for shift workers. Since the focus on monetary compensation of such working condition neglects potential adverse consequences on the worker''s social life and individual health, the third essay explores such non-pecuniary aspects. Such jobs entail significantly higher levels of solitary leisure which is likely to adversely affect the worker''s well-being by reducing the marginal utility of leisure. The more severe consequence of work at undesirable hours is the augmented risk to physical and mental health which arises from the significantly lower allocation of time to sleep. In particular older workers who are potentially exposed to such working conditions over a longer time horizon bear the highest risks. Finally, the fourth essay studies the causal gain from temporal work flexibility on parental time with children. Flexitime arrangements allow mothers to spend 30 percent more of their disposable time on childcare. The results are generalizable to Germany as a whole. The paper provides empirical support for the importance of temporal work flexibility on mitigating adverse effects of maternal employment on the child''s cognitive development.

Le contrat de travail est continu sur une longue période. Des conditions de travail du salarié peuvent être modifiées ou ajustées à tout moment pendant la durée d’une relation de travail en fonction de raisons diverses. La modification des conditions de travail, ou plus généralement encore, la modification de la relation de travail influence directement la vie privée et professionnelle du salarié et touche par conséquent en profondeur le salarié et l’employeur. La possibilité qu’un salarié puisse négocier son contrat de travail avec son employeur au moment de la conclusion du contrat, est en pratique faible. Il est donc nécessaire que le régime de la modification du contrat de travail garantisse que les conditions de travail convenues au moment de la conclusion du contrat de travail ne peuvent pas être modifiées unilatéralement par l’employeur indépendamment de l’avis du salarié. Les systèmes juridiques coréen et français reposent sur la force obligatoire du contrat de travail. Il est donc évident que le consentement du salarié est nécessaire pour modifier les conditions de travail du contrat de travail. Le régime de la modification de la relation de travail dépend de la limitation du pouvoir de l’employeur. En France, depuis 1996, a été introduit un système jurisprudentiel distinguant changement des conditions de travail et modification du contrat de travail. Avec l’évolution de la jurisprudence, le régime de la modification du contrat de travail se concentre sur le contrat de travail, il attache de la valeur à l’opinion du salarié en considérant le salarié comme une partie au contrat. En revanche, en Corée, la jurisprudence a mis l’accent sur l’interprétation de l’exercice du pouvoir de l’employeur en fonction de l’existence d’un motif raisonnable. Par ailleurs, à la différence de la France où le règlement intérieur a un domaine limité le règlement intérieur coréen joue un rôle similaire à celui d’un contrat de travail en pratique. À cet égard, si la modification du règlement intérieur est défavorable au salarié, le consentement du groupe de salariés doit être obtenu. Même si le consentement est exigé et même si le salarié a un droit de refus, le salarié qui refuse est toujours exposé au licenciement. Le concept de consentement du salarié est souvent trop fragile pour que l’on puisse se contenter de son existence et considérer qu’il s’agit d’une protection suffisante. Ainsi, il est nécessaire de rechercher la véritable volonté du salarié plutôt que de constater son consentement formel. La modification de la relation de travail ne doit pas être axée sur l’exercice de pouvoir de l’employeur, mais doit être interprété concrètement dans le contexte de l’évolution de l’environnement du travail et de la vie professionnelle du salarié. / The labour contract is continuous over a long period of time. The worker's working conditions could be modified or adjusted at any time during the duration of a labour relationship with various reasons. Changes in working conditions, or more generally, changes in the labour relationship directly affect the worker's private and professional life and therefore it has a profound impact on both the worker and the employer. The possibility that a worker could negotiate his labour contract with his employer at the time the contract is hard in practice. It is therefore necessary that the regime for amending the labour contract ensures that the working conditions agreed at the time of conclusion of the labour contract cannot be unilaterally modified by the employer regardless of the worker's opinion. The Korean and French legal systems are based on the binding power of a contract. It is therefore obvious that the worker's consent is required to modify the working conditions of the labour contract. The regime for modifying the labour relationship depends on limiting the employer's authority. In France, since 1996, a jurisprudential system has been introduced distinguishing between change of the working conditions and modify of the labour contract. With the evolution of precedent, the regime of modification of the labour contract focuses on the labour contract, it attaches value to the worker's opinion by considering the worker as a party to the contract. Whereas, in Korea, the precedent has focused on interpreting the exercise of employer authority on the basis of “reasonable cause”. Moreover, unlike France, where the regulation of employment has a limited scope, the Korean regulation of employment plays a similar role to that of a labour contract in practice. In this respect, if the amendment of the regulation of employment change unfavorable to the worker, the consent of the group of workers is required.Even if the consent of worker is demanded and even if the worker has a right of refusal about the suggestion of employer, the worker who refuses is still exposed to dismissal. The concept of the consent of worker is often too fragile to be satisfied with its existence. Also, it is difficult to assume that workers' consent is fully protected. Therefore, it is necessary to find method for reflect the worker's real intention. The change in the labour relationship must not be focused on the employer's exercise of authority, but must be interpreted concretely in the context of the changing work environment and the worker's professional life.

Os profissionais das Unidades de Saúde da Família (USF) podem ser considerados altamente vulneráveis à violência no trabalho, uma vez que atuam diretamente na comunidade, por vezes em regiões com altas taxas de criminalidade e com falta de segurança, tendo muitas vezes condições e organização do trabalho desfavoráveis. Objetivou-se analisar a exposição dos trabalhadores de saúde à violência laboral nas USF e as suas interfaces com as condições e a organização do trabalho. Tratou-se de pesquisa com abordagem mista, que utilizou a estratégia aninhada concomitante, realizada em USF de uma capital da região sul do Brasil, com os profissionais que compunham a equipe mínima de saúde da família (n=190). Uma amostra probabilística de 106 profissionais respondeu ao Survey Questionnaire Workplace Violence in the Health Sector, dentre os quais 18 profissionais, vítimas de violência, responderam à entrevista semiestruturada. Os dados quantitativos foram submetidos à estatística descritiva e analítica, sendo considerado significativo p<0,05. Os dados qualitativos foram transcritos e submetidos à analise do tipo temática. O estudo foi aprovado pelo Comitê de Ética e Pesquisa da instituição proponente e coparticipante e todos os participantes assinaram o Termo de Consentimento Livre e Esclarecido. Na amostra (n=106), 80,2% tratou-se de mulheres, com mediana de idade de 42,5 anos, brancas (61,9%), casadas ou com companheiros (53,8%). Os ACS representaram 52,8% da amostra, seguidos de técnicos/auxiliares de enfermagem (23,6%), enfermeiros (15,1%) e médicos (8,5%). A maioria dos profissionais (69,8%) sofreu algum tipo de violência nos últimos 12 meses, sendo prevalentes as agressões verbais (65,1%), ocorridas por meio de xingamentos, ofensas, humilhações e ameaças Dos participantes, 33,8% referiram terem sofrido dois ou mais tipos de violência no trabalho, sendo os maiores perpetradores os pacientes para violência física (100%), agressão verbal (79,4%), discriminação racial (81,8%) e assédio sexual (60%). As chefias foram mencionadas como principais agressores nos casos de assédio moral (46,7%). Encontraram-se diferenças estatisticamente significantes entre vítimas e não vítimas no que se refere à categoria profissional e idade (p<0,05). Nas entrevistas foi destacada atuação na recepção como agravante para a exposição às situações de violência. As principais reações das vítimas foram: contar para o colega (entre 33,3% e 80% das situações) e relatar para o chefe (entre 20% e 56,5%). Permanecer superalerta, vigilante, de sobreaviso ou constantemente tenso foi o problema mais referido pelas vítimas, exceto nas situações de assédio moral, que desencadearam principalmente sentimentos de pesar para realizar as atividades. Abalos à saúde dos trabalhadores foram mencionados pelos participantes como consequências dos episódios de violência, bem como relatos de absenteísmo e a vontade de abandonar a profissão. Entretanto, os profissionais tendiam à naturalização e banalização desses episódios. As vítimas de violência apresentaram piores avaliações sobre as condições e a organização do trabalho, sendo significativamente piores as avaliações quanto aos relacionamentos com colegas e chefias (p<0,05) Melhorias no ambiente (61,3%) e investimento em desenvolvimento de recursos humanos (75,5%) foram destacadoscomo necessidades no que tange à problemática. Os participantes referiram inexistência de condutas que promovem a segurança no local de trabalho (entre 37,7% e 67%), uma vez que a vulnerabilidade dos profissionais à violência urbana do território foi mencionada como fator agravante dessas situações nas USF. Conclui-se que os profissionais das USF estão muito expostos à violência, especialmente do tipo verbal e vinda dos pacientes. A organização e as condições de trabalho estão implicadas na origem desta problemática e carecem de investimentos a fim de garantir a preservação da integridade física e psicológica dos trabalhadores e o cumprimento das atividades previstas de atenção à comunidade. / Professionals working at Unidades de Saúde da Família (USF – Family Health Units) may be considered highly vulnerable to violence in the workplace, since they work directly with the community, often in areas which present high rates of criminality and little security; and often in unfavorable work conditions and organization. The objective was an analysis of the exposition of such health workers to violence in the workplace in the USFs and their relationship with the conditions and the organization of where they work. This research present a mixed approach which used concomitant strategy, performed at a USF located in a capital city in the south region of Brazil; having as main object the professionals forming the basic staff for family health (n=190). A probabilistic sample of 106 practitioners answered the Survey Questionnaire Workplace Violence in the Health Sector; among them 18 workers, who have been victims of violence, answered a semi-structured interview. Quantitative data were subjected to descriptive and analytical statistics, being deemed significant the value p<0.05. Qualitative data were transcribed and subjected to an analysis of the thematic kind. This study was approved by the Ethics and Research Commitee of the proposing and coparticipant institution, and all subjects signed the Informed Consent form. In the sample (n=106), 82.2% were women, with and average age of 42.5, White (61.9%), married or living with a partner (53.8%). The Community Health Agents (Agentes Comunitários de Saúde – ACS) constituted 52.8% of the sample, followed by nursing auxiliaries and technicians (23.6%), nurses (15.1%) and doctors (8.5%). The majority of the professionals (69.8%) have suffered some form of violence in the last 12 months, such violence being verbal in most of the cases (65.1%), such as swearing, offences, humiliations and threats Among the participants, 33.8% reported having suffered two types or more of violence in the workplace, being the patients the perpetrators of physical violence (100%), verbal aggression (79.4%), racial prejudice (81.8%) and sexual harassment (60%). Those in leadership positions were reported as the main aggressors in case of psychological harassment (46.7%). Significant statistical differences were found in relation to the victims and non-victims when it comes to professional category and age (p<0.05). In the interviews there was great emphasis to the reception as an aggravating element to the exposition to situations involving violence. The victims‟ main reactions were: talking to a colleague (between 33.3%-80% of the cases) and reporting to the head (between 20%-56.5%). The most common problems referred by the victims were having to be extra alert, watchful, wary, or constantly tense, except in situations of psychological harassment, which unleashed feelings of grief and sadness to perform their duties. Damage to the workers‟ health were also described by the participants as a consequence of the episodes of violence, as well as accounts of absenteeism and wishes to abandon career. However, the professionals to see these episodes naturally and in a trivial way These victims of violence presented the worst evaluation in relation to workplace conditions and organization, being significantly worse the evaluation of the relationship with colleagues and heads (p<0.05). Improvement in the work environment (61.3%) and investments in the development of human resources (75.5%) were emphasized as the main needs in relation to this problem. The participants made reference to the non existence of conduct which might promote security at work (between 37.7%-67%), since the vulnerability of these professionals to urban violence in the area was mentioned as an aggravating factor in these situations in USF. It can be concluded that the professionals working at USF are extremely subjected to violence, in particular of the verbal type and performed by patients. The conditions and organization of the workplace are also implied in the origins of this problem and are poorly investigated in order to guarantee the preservation of the physical and psychological integrity of the workers, as well as the activities intended to the community. / Los profesionales de las Unidades de Salud de la Familia (USF) pueden ser considerados altamente vulnerables a la violencia en el trabajo, una vez que actúan directamente en la comunidad, por veces en regiones con altas tasas de criminalidad y con falta de seguridad, teniendo muchas veces condiciones y organización de trabajo desfavorables. Se objetivó analizar la exposición de los trabajadores de salud a la violencia laboral en las USF y sus interfaces con las condiciones y la organización de trabajo. Se trató de pesquisa con abordaje mixta que utilizó la estrategia aniñada concomitante, realizada en USF de una capital de la región Sur de Brasil, con los profesionales que componen la equipe mínima de salud de la familia (n=190). Una muestra probabilística de 106 profesionales contestó al Survey Questionnaire Workplace Violence in the Health Sector, entre los cuales, 18 profesionales, víctimas de violencia, contestaron a la encuesta semiestructurada. Los datos cuantitativos fueron sometidos a la estadística descriptiva y analítica, siendo considerado significativo p<0,05. Los datos cualitativos fueron transcritos y sometidos a la revisión de tipo temática. El estudio fue aprobado por el Comité de Ética y Pesquisa de la instituición proponente y coparticipante, y todos los participantes firmaron el Termo de Consentimiento Libre y Esclarecido. En la muestra (n=106), 80,2% se trató de mujeres, con mediana de edad de 42,5 años, blancas (61,9%), casadas o con compañeros (53,8%) Los ACS representaron 52,8% de la muestra, seguidos de técnicos/auxiliares de enfermería (23,6%), enfermeros (15,1%) y médicos (8,5%). La mayoría de los profesionales (69,8%) sufrió algún tipo de violencia en los últimos 12 meses, siendo predominante las agresiones verbales (65,1%). Ocurridos por medio de insultos, ofensas, humillaciones y amenazas. De los participantes, 33,8% refirieron haber sufrido dos o más tipos de violencia en el trabajo, siendo los mayores perpetradores los pacientes a la violencia física (100%), agresión verbal (79,4%), discriminación racial (81,8%) y asedio sexual (60%). Las cabezas fueron mencionadas como principales agresores en los casos de asedio moral (46,7%). Se encontraron diferencias estadísticamente significantes entre víctimas y no víctimas en lo que se refiere a la categoría profesional y edad (p<0,05). En las encuestas fue destacada actuación en la recepción como agravante para la exposición a las situaciones de violencia. Las principales reacciones de las víctimas fueron: contar para el colega (entre 33,3% e 80% de las situaciones) y relatar para el jefe (entre 20% y 56,5%). Permanecer muy atento, vigilante, estar sobre aviso o constantemente tenso fue el problema más referido por las víctimas, excepto en las situaciones de asedio moral, que desencadenó principalmente sentimientos de pesar para realizar las actividade Conmociones a la salud de los trabajadores fueron mencionados por los participantes como consecuencias a los episodios de violencia, bien como relatos de absentismo y la voluntad de abandonar la profesión, entretanto, los profesiones tendían a la naturalización y banalización de esos episodios. Las víctimas de violencia presentaron peores evaluativas cuanto a los relacionamientos con colegas y cabezas (p<0,05). Mejorías en el ambiente (61,3%) e inversiones en desarrollo de recursos humanos (75,5%) fueron destacados como necesidades en lo que dice respeto a la problemática. Los participantes refirieron a la inexistencia de conductas que promueven la seguridad en el local de trabajo (entre 37,7% y ¨&%), una vez que la vulnerabilidad de los profesionales a la violencia urbana de territorio fue mencionada como factor agravante de esas situaciones en las USF. Se concluye que los profesionales de las USF están muy expuestos a la violencia, especialmente del tipo verbal y venida de los pacientes. La organización y condiciones de trabajo están implicadas en la origen de esta problemática y carecen de inversiones a fin de garantizar la preservación de la integridad física y psicológica de los trabajadores y el cumplimento de las actividades previstas de atención a la comunidad.