Teses e Dissertações

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Navegando Teses e Dissertações por Orientador(es) "Alencar, Maria do Carmo Baracho de [UNIFESP]"

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    O afastamento do trabalho de sujeitos acometidos por doenças da coluna lombar: necessidades e desafios
    (Universidade Federal de São Paulo (UNIFESP), 2015-03-11) Montrezor, Janaina Bussola [UNIFESP]; Alencar, Maria do Carmo Baracho de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To investigate the process of illness and departure from the affected subjects working for diseases of the lumbar spine, relations with the organization of work; needs and challenges. Materials and Methods: Exploratory, descriptive and retrospective study with quantitative and qualitative data. Step (1) : documentary analysis of medical records (2010-2011) of subjects treated CEREST, being selected the medical records of subjects with a clinical diagnosis for ?Other dorsopathies? (M50 to M54), according to CID-10, of both genders, of different professional categories and that were experiencing or who have experience the absence from work process by these diseases. Step (2): script elaboration with semi-structured questions and interviews lasting about 60 minutes, recorded and transcribed for content analysis categories. Results: Analyzed the medical records (n=431), 15.77% (n=68) had a diagnosis of ?other dorsopathies?, and 52.9% (n=36) were male and 47.1% (n=32) female, being the most affected age group 41-50 years. 57.4% (n=39) were in absence from work situation, and 13.2% (n=9) also showed clinical diagnosis for mental disorders. Participated ten subjects, six females and four males, aged between 35 and 58 years, with diverse professions and all affected in the lower back. It was identified in interviews that some aspects of the conditions and organization of work that influenced in back pain, such as repeatability, efforts and physical burdens, fast-paced, undersized team; even the presence of pain at work; self-medication; fear of unemployment; functional difficulties in activities of daily living, work and leisure, generating feelings of inadequacy and worthlessness. Needs and challenges were questioned based on public policy discussions. Considerations: There are deficiencies in public policies that consider the real needs of workers and have interconnected actions, with the need to take into account the subjectivity of the worker, and interventions that go beyond traditional physical rehabilitation; it will also be necessary psychosocial rehabilitation and interdisciplinary interventions.
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    Afastamento do trabalho por lombalgia crônica: impactos na funcionalidade e o retorno ao trabalho
    (Universidade Federal de São Paulo (UNIFESP), 2016-05-12) Ramos, Maria do Carmo Vitorio Alves [UNIFESP]; Alencar, Maria do Carmo Baracho de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Low back pain has an impact on the workers, often leading to work withdrawal, incapacities and difficulties returning to work. Objective: To investigate the withdrawal from work due to low back pain, aspects related to functionality in daily life, and influences on return to work. Methods: The study is exploratory, descriptive, with emphasis on qualitative results. The study has three steps. (1): Documentary survey of open patient records attended at the Reference Center on Occupational Health-CEREST, Santos / SP, from July 1, 2014 to July 1, 2015, with data collection: demographic, clinical diagnoses , Symptoms, profession, situation in the company, among others. Selection of records of subjects with complaints of low back pain and clinical diagnoses referring to "Other Dorsopathies" (M.51 to M.54), according to the International Classification of Diseases ICD-10. (2): Selection of subjects who experienced the process of moving away from work due to illness, and returning to work. Invitation for the participation of semistructured interviews, based on script, recorded and transcribed in full for analysis of thematic content. (3): In addition to the subjects who participated in the interviews, the application of the Rolland Morris Disability Questionnaire (QIRM), as a complement. Partial results: The study is ongoing. From step 1, 502 medical records were analyzed. Of these, 110 had complaints of low back pain in the initial consultation, of which 64 were female (58.2%) and 46 were male (41.8%). The most frequent ICD-10 clinical diagnoses were: M54.5 (low back pain) with 54.5%; M51.2 (Other specified intervertebral disc displacements) with 33.6%; And M54.4 (Lumbago with sciatica) with 18.2%. According to the National Classification of Economic Activity - CNAE 32.6% of the sample were part of the "Domestic services" group; 22.1% of the Group "Cleaning activities"; And 11.6% of the Group "Supply and management of human resources for third parties". From step 2, eight (8) interviews were carried out, with five subjects (5) female and three (3) male, with a mean age of 48.5 years, and several professions, two (2) Two (2) domestic, one (1) manicure, one (1) handler, one (1) stevedore, and one (1) access controller. The interviews were transcribed in full and the data are under analysis; Some preliminary data have already shown the return to work for the same functions, disrespect to physical constraints, and the same job requirements. From the step 3, together with the subjects from the previous stage, the QIRM was applied, all interviewees had a score greater than 14, that is, all of them presented functional disability, and one (n = 1) had total functional disability.
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    O itinerário terapêutico de trabalhadores afastados por Ler/Dort
    (Universidade Federal de São Paulo (UNIFESP), 2017-03-06) Zavarizzi, Camilla de Paula [UNIFESP]; Alencar, Maria do Carmo Baracho de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To investigate the therapeutic itinerary about workers removed for RSI/WMSD attended at the Reference Center Occupational Health – East (CRST -East), SP. Methods: The study is exploratory, descriptive, retrospective and emphasis on qualitative results. Consists of 2 steps: (1) Analysis of data in open clinical recordsat the WHRC-East from January 2014 to June 2015 of subjects with symptoms of musculoskeletal complaints in the upper limbs and related to RSI/WMSD, with a data collection: personal, clinical diagnostics, occupation and current situation (absence of work, active or other). (2) Selection of subjects aged between30 to 59 who experienced the absence of work along the INSS, and due to illness related to RSI/WMSD, to conduct semi structured interviews, based on a previously prepared script, which were recorded and and integral transcribed for thematic content analysis (Bardin, 2010). Results: 646 records were openede regarding the study period. Of these, 66.4% (n = 429) of subjects were zoonosis agents function in the East Zone of São Paulo, others workers, 33.3% (n = 215) were the community in general. The subjects who complained musculoskeletal symptoms related to RSI/WMSD in upper limbs, 10,21% (n = 66), which were made descriptive analysis and selection for stage 2. Ten (n = 10) workers participated in the interviews, of which six (n = 6) were female and four (n = 4) male, 35-58 years old, from elementary school to higher education. The professions were varied. Emerged in the interviews: the “banalization” of pain and self-medication for fear of unemployment, resulting in aggravation with the impossibility of working, among others, and performing the DLA (s), causing suffering. At that time, one of the first medical resources used by most of the interviewees was the emergency room. Health care did not differ between that of the medical agreement, private and public agreement, all with emphasis on the biomedical model with induction to the consumption of consultations with specialists, medicines, exams and physiotherapy sessions. The search for care in the CRST was due to the need for assistance by those who were in the waiting list for medical care, and for the opening of CAT denied by the company. From the INSS there was a sense of humiliation and injustice and the evaluation of incapacity for work was focused on the complementary exams and reports, and for the workers to obtain this documentation was often necessary the pilgrimage by several services. The therapeutic itinerary of the workers generated a process of social exclusion because the majority was unemployed and some of them inserted in informal Jobs. Final considerations: There is a need for improvements in the intersect oral actions between the INSS, health services and companies to guarantee integral health care for workers who contribute to the process of rehabilitation of workers in situations of withdrawal from work by RSI / WMSD, as well as during the processes of return to work.
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    O percurso terapêutico de motociclistas vítimas de acidente de trânsito e o retorno ao trabalho
    (Universidade Federal de São Paulo (UNIFESP), 2020-05-05) Lima, Jaqueline de [UNIFESP]; Alencar, Maria do Carmo Baracho de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Aim: To investigate the therapeutic route of motorcyclists who have been victims of traffic accidents and about the process of returning to work, assisted by a rehabilitation service in the city of Santos/SP. Methods: The present study had two stages: (1) selection of motorcyclists victims of traffic accidents, attended at the Specialized Rehabilitation Center (CER) of the Municipality of Santos/SP in the period between October 2018 to May 2019 and application of a questionnaire designed to obtain sociodemographic and job; (2) conducting semi-structured interviews with these working motorcyclists attended at the unit, recorded for thematic content analysis. Results: 30 motorcyclists participated in the first stage, aged between 20 and 51 years old, from various professions, most of them male (53.3%), and from high school (60.0%) participated in the study. Regarding the injuries, 60.0% suffered fractures, 30.0% polytrauma, with the upper limbs being the most prevalent body region (46.6%). It was noted that 53.3% elapsed time from the accident until the evaluation in the rehabilitation service was 30 to 120 days and for 46.6% the rehabilitation started only after 120 days. Of the motorcyclists, 66.6% had previously suffered a traffic accident and involving a motorcycle before, and 76.7% were away from work, among other data. In the second stage, 10 motorcyclists were interviewed and, with their perceptions, the main themes emerged: the traffic accident: fear and insecurity; the itinerary and health assistance; removal from work and the rehabilitation process, and; expectations of returning to work. Conclusion: The sequence of events in the therapeutic itinerary was reported in the perception of motorcyclists. The identification of the main facilitators and barriers in the process and for returning to work provoked reflections on the problem, regarding the qualification of practices in prevention, promotion and rehabilitation in health with this population.
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    Saúde e trabalho na bananicultura em uma região do Vale do Ribeira
    (Universidade Federal de São Paulo (UNIFESP), 2020-01-30) Simas, José Martim Marques [UNIFESP]; Alencar, Maria do Carmo Baracho de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Banana cultivation has undergone several transformations to meet the demands of capitalist society, in a scenario of work overload, increased use of pesticides and risks to workers' health and safety. Objective: To investigate workers' health status and understand the relationship between health and work in banana cultivation in a region of Vale da Ribeira. Methods: Quantitative and qualitative study conducted in three steps. (1) Selection of workers in banana farming linked to a SP Registry Family Health Strategy (FHS) and application of the Sociodemographic Profile, Health and Work Conditions in Banana Farming Questionnaire (SPHWC), Nordic Musculoskeletal Questionnaire (NMQ) and Self-Report Questionnaire 20 (SRQ-20). (2) Pulmonary function test (spirometry) with subjects from the previous stage. Data from steps 1 and 2 were analyzed using the R Development Core Team® statistical system, with a significance level of p≤0,05. (3) Individual interviews recorded and transcribed in full for thematic content analysis, with subjects who reported some health problem detected in the previous steps. Results: Participed in stage 1, 36 workers from 10 rural properties, without general size and oriented by the employer and agribusiness system (80,0%). Most individuals were male (94,4%), with a mean age of 37,4 years, married (86,1%), with up to two children (51,6%) and elementary school incomplete (50,0%). Monthly income of one to two minimum wages (71,4%), in informal employment (33,3%) and with up to 10 years of work in banana cultivation (66,7%). Musculoskeletal disorders were reported in 66,7% of individuals, mainly in the lumbar (63,9%), shoulders (47,2%) and knees (44,4%) regions. Stressful or tiring work tasks were reported mainly in cutting (64,5%), load (61,3%) and fertilization (16,1%), associated with muscle fatigue (p= 0,001) and work load from 6 to 10 hectares/worker (p= 0,026). The presence of common mental disorders (CMD) was predominant in 25,0% of the associated individuals and informally at work (p= 0,005). In stage 2, there were 30 subjects and there was a prevalence of ventilatory dysfunction in 26,7% of cases, with mild (13,3%) and moderate (10,0%) obstructive ventilatory disorders, and mild mixed ventilatory disorder (3,3%). All workers were exposed to pesticides and the higher the exposure to pesticides, the greater the presence of lung disorders. In stage 3, 11 workers participated and from the interviews there were notes about hard work and tiring, with physical overload, forced and tiring; many demands and pressures to achieve goals and maintain productivity and product quality; high turnover; work in adverse weather conditions; naturalization of hard work, pain and suffering; humiliation; fear; disrespect; repetitive strain injuries/work-related musculoskeletal disorders (RSI/WRMD); pesticide exposure and related health problems; inadequate provision and no provision of individual protection equipment (IPE); late payments and non-payment of salaries, restriction of freedom and Inadequate housing. Final Considerations: Workers changed their health status, showing musculoskeletal disorders, respiratory disorders and common mental disorders, as well as suffering and wear caused by working in poor banana growing conditions.
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    A saúde mental de trabalhadores afastados por Ler/Dort e o retorno ao trabalho
    (Universidade Federal de São Paulo (UNIFESP), 2017-06-29) Fialho, Marciene Campos [UNIFESP]; Alencar, Maria do Carmo Baracho de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To investigate the experiences of leaving and return to work of the subjects affected by RSI /WMSD and to understand the repercussions on mental health. Methods: The study contains three steps. (1) Documentary analysis of medical records opened next to Worker´s Reference Center -CEREST, Santos / SP, from July 1st , 2014 to July 1st , 2015, obtaining the datas: demographic, professional category , situation in the company, clinical diagnoses, among others. Also, the selection of workers who had some established clinical diagnosis for RSI / WMSD, and the lived situation of leaving and return to work. (2) Individual semi-structured interviews were carried out with the selected subjects, based on a pre-elaborated script, where information related to the experiences and feelings regarding leaving and return to work process was obtained, among others. (3) As a complement, semi- structured interviews were carried out with some professionals of reference from the Professional Rehabilitation Program of INSS, from Baixada Santista. Results: In the first step of the study, 502 medical records were analyzed, 47 of which contained records of subjects with established clinical diagnoses for RSI / WMSD. From the interviews of the second stage, five (5) subjects participated aged between 35 and 56 years, completed elementary and middle school education, both genders and from a variety of professions. From the interviews emerged the meanings attributed to the work, reiterating it as a constituent of the identity of the subject, the suffering and illness before the organization of work, the revolt at the humiliations experienced in the INSS and the barriers encountered in the process of return to work, mainly before the companies which are mostly not prepared to receive their employees in this process. The third stage participated five (5) subjects, aged between 31 and 64 years, all of the female gender, varied professions and complete upper level of education. From the interviews have emerged a high demand for the Rehabilitation Program due to the lack of criteria in evaluating the work potential of the workers out of the labor market, the difficulties in relations with medical experts and a disarticulation among professionals and other institutions and / or sectors that interferes in the Program, a concern of the professionals of reference with the return to work when they are not vinculated anymore, about the disrespect to the restrictions, as well as, the helplessness and professional exclusion of the workers.. Final considerations: It can be inferred that the situation of leaving and return to work have direct repercussions on the mental health of workers. Thus, Psychology can act and contribute in several aspects.
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    O trabalho na campanha de vacinação contra a COVID-19 e os impactos na saúde dos profissionais
    (Universidade Federal de São Paulo, 2023-01-30) Caires, Mariana Ursini [UNIFESP]; Alencar, Maria do Carmo Baracho de [UNIFESP]; http://lattes.cnpq.br/5727324642175380; Universidade Federal de São Paulo (UNIFESP)
    A pandemia de COVID-19 no Brasil, trouxe mudanças na vida de todas as pessoas, afetando a rotina de trabalho e repercutindo na saúde de muitos profissionais de saúde. Após cerca de um ano e com o ainda crescente número de casos, foi iniciada a campanha de vacinação contra a COVID-19 no município de São Paulo. Objetivo: Investigar e compreender as mudanças nos modos de organização do trabalho e os impactos à saúde durante o período de vacinação contra a COVID-19 em uma Unidade Básica de Saúde. Método: A pesquisa foi descritiva, exploratória e qualitativa e teve duas etapas: na primeira foram realizadas análises documentais de procedimentos e orientações para a vacinação contra a COVID-19, e observações semi-dirigidas com registros em diário de campo; na segunda, houve a aplicação de um questionário elaborado para obtenção de dados sociodemográficos, ocupacionais e de saúde, e a realização de entrevistas individuais que foram gravadas e transcritas para análise de conteúdo temática. Resultados: No total, doze trabalhadores foram entrevistados, de ambos os sexos, dos setores de enfermagem, equipe multiprofissional, administrativo, odontológico e médico. Foram elencadas as categorias: O medo relacionado à COVID-19; As novas exigências no trabalho durante a campanha de vacinação contra COVID-19 e os impactos na saúde; Relacionamento com a chefia e entre os membros da equipe; Relacionamentos com a população; e O trabalho e a vida privada. Surgiram nas entrevistas: o medo pela exposição ao vírus, sobrecargas de trabalho, excesso de informações novas, falta de treinamento, repetitividade, ritmo acelerado de trabalho, rigidez nas normas e regras, equipe subdimensionada, entre outros, vivências de violência e sofrimento. Por outro lado, para alguns, participar do processo de combate a pandemia de COVID-19, ajudar os usuários e a união entre a equipe foram fatores que trouxeram prazer aos trabalhadores. Conclusão: A campanha de vacinação contra a COVID-19 trouxe impactos negativos à saúde dos profissionais envolvidos, sendo necessário promover reflexões e melhorias nas condições e modos de organização do trabalho.
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    Vivências no trabalho de faxineiras acometidas por Ler/Dort nos serviços terceirizados
    (Universidade Federal de São Paulo (UNIFESP), 2018-02-20) Pestana, Barbara Militelo [UNIFESP]; Alencar, Maria do Carmo Baracho de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The Constant Changes In The World Of Work Have Brought Several Changes And Flexibilizations That Tend To Lead To Precarious Working Conditions, And In This Context Are The Categories Of Outsourced Cleaning Services. Objective: To Understand The Experiences At Work And Relationships With The Work Organization, And Relationships With The Process Of Illness By Rsi / Dort Of Outsourced Cleaning Service Workers. Methods: The Study Had Two Steps: (1) Investigation And Analysis Of Sinan Notification Registries, Opened In Cerestsantos, And Selection Of Professional Category 5143-20 Workers According To Cbo, And Who Worked In Outsourced Cleaning Service. (2) Preparation Of Script And Individual Semi-Structured Interviews To Analyze Thematic Content. Results: Of The Initial Listing, Thirty-Three (N=33) Were Cleaners And Female Workers. Seven (N=7) Workers, Aged Between 44 And 55 Years, With Low Schooling (N=4) Were Interviewed. Most Of The Interviewees Worked More Than 10 Years In Outsourced Cleaning Companies. Were Fo