Exposure to community violence of Health Strategy agents of Family and repercussions on their working practices: a qualitative study

Author(s)

Juliana Feliciano de Almeida

• Document type: Master's Dissertation
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD)
• Defense date: 2015-11-13

Examining board members

Maria Fernanda Tourinho Peres; Camila Caldeira Nunes Dias; Marcia Thereza Couto Falcão

• Advisor: Maria Fernanda Tourinho Peres

Abstract

In Brazil, the reflexes of community violence in the formation and development of the health care service actions, in the primary health care, present themselves as a reality to be better studied, as well as deserve more attention towards the repercussions suffered by the health care staffs. This paper aims at exploring qualitatively the representations of the community health workers and the manager of a Health Care Family Strategy facility concerning the community violence where they work, verifying the possibility of interference in this phenomenon in relation to the work they do. It was intended to investigate this interference in the bonds construction between the community health workers and the population attended by them. It was adopted the qualitative research methodology through social representation analysis, 12 open interviews with the community health workers and one interview with the health care facility manager had been made using a previously elaborated script with flexible questions, valuing the singularity of the interviewees\' answers. It is highlighted as a research result the confirmation of the hypothesis that the community violence spoils the care integrality, in other words, the elaboration of determined strategies of promotion, prevention and recovery, related mainly to the approach about the drug abuse. It was evidenced that the actions regulation in the health care area are conditioned by the open restrictions or put implicitly by the social dynamics existents in the territory. Furthermore, the formation of this phenomenon helps to explain a part of the episodes, which involve the workplace violence pointed in threats, fear and concern of the community health workers. Moreover, the community violence and its social representations interfere in the production of the bonds stablished with the users - built with greater or shorter closeness, depending on the user and the strategies assembled by each worker. However, besides interfering, the violence and the representations are co-producers categories of bonds, in the broadest sense, as they approximate/bond the workers to determined experiences, which may influence them in their decisions and in the actions taken, consciously or not. In the social science\'s point of view was highlighted the centrality, which the worker acquires in the rationale of porous borders mediation, well designated from legal to formal and from the \"world of crime\". The presence of community violence in the primary health care presents itself as a reality in which the workers have been living with for many years. This issue has been discussed in the area of the public health and it needs to be recognized and approached in the federal, state and municipal levels aiming the construction of policies and strategies that assist the achievement of these workers who are \"on the edge\" of the community services (AU)

• FAPESP's process: 13/09486-3 - Exposure to community violence of the agents of the Family Health Strategy and its impact on work practices: a qualitative study
• Grantee: Juliana Feliciano de Almeida
• Support Opportunities: Scholarships in Brazil - Master