Ciranda de roses: vulnerabilidades, demandas e necessidades de saúde de trabalhadoras em assentamento rural
Data
2014-12-17
Autores
Cabral, Fernanda Beheregaray 
Orientadores
Bretas, Ana Cristina Passarella
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Compreender as vulnerabilidades, demandas e necessidades de saúde para trabalhadoras que vivem em assentamento rural e como elas desenvolvem o cuidado em saúde. Método: Estudo de caso social, com abordagem qualitativa, desenvolvido no Assentamento 16 de Março, em Pontão/RS. Os dados foram produzidos mediante entrevistas, observação participante e oficinas problematizadoras. Participaram do estudo em torno de 40 mulheres. Da análise temática dos dados emergiu a categoria Vulnerabilidades Programáticas para trabalhadoras em assentamento rural: elementos produtores e protetores, composta por cinco temas. Resultados: Do primeiro tema, apreendem-se dificuldades estruturais e contextos de vulnerabilidade incidentes nas trajetórias dessas mulheres desde o acampamento, com repercussões nos processos saúde/não saúde/Cuidado. No assentamento, a cooperação foi o princípio organizativo dessas famílias, tendo por limites programáticos ações pontuais de assentamento e a ausência de política efetiva de reforma agrária. O segundo tema problematiza o trabalho reprodutivo na agricultura, a dupla jornada feminina e outras vulnerabilidades de gênero. O trabalho cooperado mais flexível favorece a participação em atividades políticas, sociais e de lazer, e o morar em agrovila fortalece redes sociais. Ambos promovem saúde e reduzem vulnerabilidades. No terceiro tema, estressores laborais, risco de acidentes, exposição aos agrotóxicos, relações interpessoais conflituosas, rede social restrita, pouco lazer e baixa estima geram estresse, ansiedade e depressão, potencializando vulnerabilidades. No quarto tema, as concepções sobre saúde das trabalhadoras variaram de enfoques prevencionistas e medicalizantes a promocionais, associados aos aspectos objetivos e subjetivos do conceito ampliado de saúde como direito de cidadania. O uso de plantas medicinais emerge como a principal prática de cuidado ante limites programáticos, conferindo visibilidade à negação da integralidade do Cuidado em serviços de saúde. O quinto tema analisa vulnerabilidades, demandas e necessidades de saúde para trabalhadoras e sua interface com o plano programático da vulnerabilidade. Em todos os temas, além de demandas e necessidades em saúde, foram apontados elementos produtores ou redutores de vulnerabilidades individuais, sociais, programáticas e de gênero. Conclusões: Caminhos possíveis para a reconstrução das práticas de saúde no SUS demandam organização e fortalecimento dos serviços em redes, garantia e ampliação de acesso, acessibilidade e produção de perspectivas mais próximas da longitudinalidade do Cuidado, da integralidade, da humanização, da universalidade e da equidade. Também investimentos na formação profissional para ampliação de horizontes normativos (ofertas não biomédicas), com ênfase em posturas inclusivas, receptivas e acolhedoras, pautadas na escuta e troca de saberes. A fusão de horizontes em busca de solo comum (a compreensão de que só cuida quem se afeta) emerge como potente dispositivo produtor de encontros entre sujeitos, que assumem conjuntamente, a partir da dialogicidade, o desafio de se tornarem mais capazes no cuidado em saúde. O êxito técnico e sucesso prático dessas ações em prol da promoção da saúde e construção de projetos de felicidade para trabalhadoras em assentamento rural implica o reconhecimento da diversidade e transitoriedade de seus modos de andar a vida e dos interesses que as movem para o atendimento de suas demandas e necessidades de saúde.
Objective: Understanding the vulnerabilities, demands and needs for healthcare workers living in a rural settlement and how they develop healthcare. Method: Social case study with a qualitative approach, developed in the settlement on March 16 in Pontão/RS, Brazil. The data were generated through interviews, participant observation and problem-solving workshops. The participants in this study were approximately 40 women. From the thematic analysis of the Programmatic Vulnerabilities category emerged the data for the rural settlement workers: producers and protective elements, composed of five themes. Results: The first theme apprehends structural problems and contexts of vulnerability incidents in the trajectories of these women from the camp, with repercussions on health / non-health / care processes. In the settlement, cooperation was the organizational principle of these families, taking specific actions for settlement programmatic limits and the lack of an effective land reform policy. The second theme discusses reproductive labor in agriculture, female double work shift and other gender vulnerabilities. The more flexible cooperative work favors the participation in political activities, social and leisure activities, and living in the agricultural community strengthens social networks. Both promote health and reduce vulnerabilities. The third theme, work stressors, risk of accidents, exposure to pesticides, conflicting interpersonal relationships, restricted social network, little leisure and self-deception generate stress, anxiety and depression, increasing vulnerabilities. In the fourth theme, the conceptions about health of workers ranged from preventers and medicalized approaches to promotional, associated with subjective and objective aspects of the expanded concept of health as a right of citizenship. The use of medicinal plants emerges as the primary care practice given the programmatic boundaries, giving visibility to the negation of the completeness in the healthcare services. The fifth theme analyzes vulnerabilities, demands and needs for health workers and their interface with the programmatic plan of vulnerability. In all themes, as well as demands and needs in health, producing elements or reducers individual, social, programmatic and gender vulnerabilities were appointed. Conclusions: Possible paths for the reconstruction of health practices in the SUS (Unified Healthcare Network) demand organization and strengthening of concrete services in networks, security and expansion of access, accessibility and production of nearest perspectives of the longitude, care of humanization, completeness, universality and equity. Also investments in vocational training for the extension of regulatory horizons (non-biomedical offerings), with emphasis on inclusive postures, receptive and welcoming, based on listening and exchange of knowledge. The fusion of horizons in search of common ground (understanding that only affects who cares) emerges as a powerful producer device encounters among subjects who jointly assume, from the conversation, the challenge of becoming more capable in health care. The technical success and practical success of these actions for the promotion of health and happiness construction projects to laborers in rural community and recognizing the diversity and transience of their ways of living life and interests that move them to meet their demands and health needs.
Ciranda of Roses: vulnerabilities, demands and needs for healthcare workers in rural settlement
Objective: Understanding the vulnerabilities, demands and needs for healthcare workers living in a rural settlement and how they develop healthcare. Method: Social case study with a qualitative approach, developed in the settlement on March 16 in Pontão/RS, Brazil. The data were generated through interviews, participant observation and problem-solving workshops. The participants in this study were approximately 40 women. From the thematic analysis of the Programmatic Vulnerabilities category emerged the data for the rural settlement workers: producers and protective elements, composed of five themes. Results: The first theme apprehends structural problems and contexts of vulnerability incidents in the trajectories of these women from the camp, with repercussions on health / non-health / care processes. In the settlement, cooperation was the organizational principle of these families, taking specific actions for settlement programmatic limits and the lack of an effective land reform policy. The second theme discusses reproductive labor in agriculture, female double work shift and other gender vulnerabilities. The more flexible cooperative work favors the participation in political activities, social and leisure activities, and living in the agricultural community strengthens social networks. Both promote health and reduce vulnerabilities. The third theme, work stressors, risk of accidents, exposure to pesticides, conflicting interpersonal relationships, restricted social network, little leisure and self-deception generate stress, anxiety and depression, increasing vulnerabilities. In the fourth theme, the conceptions about health of workers ranged from preventers and medicalized approaches to promotional, associated with subjective and objective aspects of the expanded concept of health as a right of citizenship. The use of medicinal plants emerges as the primary care practice given the programmatic boundaries, giving visibility to the negation of the completeness in the healthcare services. The fifth theme analyzes vulnerabilities, demands and needs for health workers and their interface with the programmatic plan of vulnerability. In all themes, as well as demands and needs in health, producing elements or reducers individual, social, programmatic and gender vulnerabilities were appointed. Conclusions: Possible paths for the reconstruction of health practices in the SUS (Unified Healthcare Network) demand organization and strengthening of concrete services in networks, security and expansion of access, accessibility and production of nearest perspectives of the longitude, care of humanization, completeness, universality and equity. Also investments in vocational training for the extension of regulatory horizons (non-biomedical offerings), with emphasis on inclusive postures, receptive and welcoming, based on listening and exchange of knowledge. The fusion of horizons in search of common ground (understanding that only affects who cares) emerges as a powerful producer device encounters among subjects who jointly assume, from the conversation, the challenge of becoming more capable in health care. The technical success and practical success of these actions for the promotion of health and happiness construction projects to laborers in rural community and recognizing the diversity and transience of their ways of living life and interests that move them to meet their demands and health needs.
Ciranda of Roses: vulnerabilities, demands and needs for healthcare workers in rural settlement
Descrição
Citação
CABRAL, Fernanda Beheregaray. Ciranda de roses: vulnerabilidades, demandas e necessidades de saúde de trabalhadoras em assentamento rural. 2014. 327 f. Tese (Doutorado) - Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, 2014.