Serviço Social e violência: análise do trabalho profissional no Núcleo de Prevenção à Violência
Data
2024-09-27
Autores
Silva, Luana Euzébia da 
Orientadores
Diniz, Tânia Maria Ramos de Godoi
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
A violência é um tema que atravessa diversas disciplinas. Para o Serviço Social, entretanto, o tema permeia o cotidiano profissional e se relaciona diretamente com o seu Projeto Ético Político e o Código de Ética Profissional (CEP) quanto a luta pela construção de uma nova ordem societária, sem dominação ou exploração de classe, etnia e gênero (CFESS, 2012, p. 23). A partir desta visão e do trabalho desenvolvido na Atenção Básica de Saúde (ABS) evidenciaram-se limites na compreensão da violência entre os/as profissionais, especialmente no contexto da sociedade capitalista. A percepção de que as discussões sobre o tema são superficiais para lidar com estas demandas fez refletir sobre o arcabouço teórico e os métodos empregados neste fazer profissional. O ponto de partida desta análise se localiza na sociedade de classes, entendendo que a violência encontra suas bases no processo histórico de formação e consolidação do capitalismo. Dada a realidade brasileira, com o objetivo de enfrentar o problema da violência, foram criadas políticas e legislações, no âmbito da saúde pública. Entre elas a Política de Redução da Morbimortalidade por Acidentes e Violência (PRMAV), e a inserção da violência na Lista Nacional de Notificação Compulsória (LNNC) de doenças, agravos e eventos em saúde. Em consonância com essas legislações, a Prefeitura do Município de São Paulo (PMSP) em 2015 publicou a Linha de Cuidado (LC) para Atenção Integral à Saúde da Pessoa em Situação de Violência com objetivo de orientar e sistematizar o trabalho na área da saúde em todos os níveis de atenção, bem como definir a composição e os fluxos de atendimento no Núcleo de Prevenção à Violência (NPV). É patente que o/a assistente social se encontra inserido neste processo, e disto decorrem desafios próprios a efetivação da Política Pública de Saúde no contexto de avanço da ofensiva neoliberal que retira responsabilidades do Estado e amplia as disparidades sociais, o que contribui em larga escala para o aumento das situações de violência. Diante disto, o objetivo deste projeto é analisar o trabalho profissional dos/as assistentes sociais inseridos nos NPV, refletindo sobre a apreensão do aporte legal e teórico sobre o tema; sobre a construção das relações multidisciplinares e a compreensão das determinações que envolvem a questão da violência. Para tanto, a pergunta central que este projeto visa responder é: Como se dá e quais são os desafios postos ao trabalho profissional do/a assistente social, inserido no NPV, orientado pelo Código de Ética Profissional e as demais legislações sobre a questão da violência? Os objetivos específicos são: conhecer a apropriação teórica do fenômeno da violência na sociedade capitalista e seu conceito no campo da saúde pública; compreender a criação dos NPV no município de São Paulo e as legislações a ele pertinentes; e conhecer o trabalho dos/as assistentes sociais na Rede de Atenção à Saúde (RAS). Partimos das seguintes premissas: i) a condução das políticas públicas na atenção a violência não fornece condições reais para superação desta, o NPV enquanto estratégia de prevenção apresenta limitações que comprometem a apreensão do fenômeno da violência na sociedade capitalista, conduzindo as equipes de saúde a uma prática imediatista e superficial; ii) a inserção do/a assistente social nas equipes multidisciplinares dos NPV acontece de forma compulsória, muitas vezes sem orientação, formação e/ou supervisão ofertada pelas organizações que administram os serviços de saúde, contribuindo para que o trabalho profissional se dê de modo heterogêneo dentro da categoria; iii) o/a assistente social tem limites para o seu trabalho que se somam inclusive aos limites postos pelas políticas públicas, ainda assim acaba tendo papel central nas equipes de NPV, direcionando muitas vezes a condução dos casos. Trata-se de uma pesquisa de campo de cunho qualitativo, descritiva – exploratória que foi realizada com seis assistentes sociais que atuam na atenção básica. A entrevista semiestruturada foi realizada via meet, dada a facilidade de acesso da entrevistadora e entrevistado/a. Os resultados mostraram que há uma sobrecarga muito grande de trabalho devido ao sucateamento e precarização dos serviços de saúde no município de São Paulo, e que isso contribui para o imediatismo nas ações, a fragmentação e descontinuidade do atendimento às pessoas em situação de violência, com pouca capacidade de rompimento real da violência na sociedade. Os resultados apontam ainda para a presença grave e continuada de violência contra os trabalhadores da saúde e de realização do trabalho em condições aviltantes.
Violence is a topic that crosses several disciplines. For Social Work, however, the topic permeates the professional routine and is directly related to its Ethical Political Project and the Professional Code of Ethics (CEP) regarding the struggle to build a new societal order, without domination or exploitation of class, ethnicity and gender (CFESS, 2012, p. 23). Based on this perspective and the work developed in Primary Health Care (ABS), limitations in the understanding of violence among professionals became evident, especially in the context of capitalist society. The perception that discussions on the topic are superficial in dealing with these demands led to reflection on the theoretical framework and methods used in this professional practice. The starting point of this analysis is located in class society, understanding that violence finds its bases in the historical process of formation and consolidation of capitalism. Given the Brazilian reality, with the aim of addressing the problem of violence, policies and legislation were created in the scope of public health. These include the Policy for Reducing Morbidity and Mortality from Accidents and Violence (PRMAV) and the inclusion of violence in the National List of Compulsory Notification (LNNC) of diseases, injuries and health events. In line with these laws, in 2015 the City of São Paulo (PMSP) published the Care Line (LC) for Comprehensive Health Care for People in Situations of Violence with the aim of guiding and systematizing work in the health area at all levels of care, as well as defining the composition and flows of care in the Violence Prevention Center (NPV). It is clear that the social worker is included in this process, and this gives rise to specific challenges for the implementation of the Public Health Policy in the context of the advance of the neoliberal offensive that removes responsibilities from the State and increases social disparities, which contributes on a large scale to the increase in situations of violence. In view of this, the objective of this project is to analyze the professional work of social workers inserted in NPVs, reflecting on the understanding of the legal and theoretical contribution on the subject; on the construction of multidisciplinary relationships and the understanding of the determinations that involve the issue of violence. To this end, the central question that this project aims to answer is: How does it occur and what are the challenges posed to the professional work of social workers, inserted in NPVs, guided by the Code of Professional Ethics and other legislation on the issue of violence? The specific objectives are: to understand the theoretical appropriation of the phenomenon of violence in capitalist society and its concept in the field of public health; to understand the creation of NPVs in the city of São Paulo and the legislation pertinent to it; and to understand the work of social workers in the Health Care Network (RAS). We start from the following premises: i) the implementation of public policies in the care of violence does not provide real conditions for overcoming it; NPV as a prevention strategy has limitations that compromise the understanding of the phenomenon of violence in capitalist society, leading health teams to an immediate and superficial practice; ii) the inclusion of social workers in multidisciplinary NPV teams happens in a compulsory way, often without guidance, training and/or supervision offered by the organizations that administer health services, contributing to the professional work being carried out in a heterogeneous way within the category; iii) social workers have limits to their work that are added to the limits imposed by public policies, yet they end up having a central role in NPV teams, often directing the management of cases. This is a qualitative, descriptive-exploratory field research that was carried out with six social workers who work in primary care. The semi-structured interview was conducted via Meet, given the easy access of the interviewer and interviewee. The results showed that there is a huge workload due to the scrapping and precariousness of health services in the city of São Paulo, and that this contributes to the immediacy of actions, the fragmentation and discontinuity of care for people in situations of violence, with little capacity to truly break the violence in society. The results also point to the serious and continued presence of violence against health workers and the performance of work in degrading conditions.
Violence is a topic that crosses several disciplines. For Social Work, however, the topic permeates the professional routine and is directly related to its Ethical Political Project and the Professional Code of Ethics (CEP) regarding the struggle to build a new societal order, without domination or exploitation of class, ethnicity and gender (CFESS, 2012, p. 23). Based on this perspective and the work developed in Primary Health Care (ABS), limitations in the understanding of violence among professionals became evident, especially in the context of capitalist society. The perception that discussions on the topic are superficial in dealing with these demands led to reflection on the theoretical framework and methods used in this professional practice. The starting point of this analysis is located in class society, understanding that violence finds its bases in the historical process of formation and consolidation of capitalism. Given the Brazilian reality, with the aim of addressing the problem of violence, policies and legislation were created in the scope of public health. These include the Policy for Reducing Morbidity and Mortality from Accidents and Violence (PRMAV) and the inclusion of violence in the National List of Compulsory Notification (LNNC) of diseases, injuries and health events. In line with these laws, in 2015 the City of São Paulo (PMSP) published the Care Line (LC) for Comprehensive Health Care for People in Situations of Violence with the aim of guiding and systematizing work in the health area at all levels of care, as well as defining the composition and flows of care in the Violence Prevention Center (NPV). It is clear that the social worker is included in this process, and this gives rise to specific challenges for the implementation of the Public Health Policy in the context of the advance of the neoliberal offensive that removes responsibilities from the State and increases social disparities, which contributes on a large scale to the increase in situations of violence. In view of this, the objective of this project is to analyze the professional work of social workers inserted in NPVs, reflecting on the understanding of the legal and theoretical contribution on the subject; on the construction of multidisciplinary relationships and the understanding of the determinations that involve the issue of violence. To this end, the central question that this project aims to answer is: How does it occur and what are the challenges posed to the professional work of social workers, inserted in NPVs, guided by the Code of Professional Ethics and other legislation on the issue of violence? The specific objectives are: to understand the theoretical appropriation of the phenomenon of violence in capitalist society and its concept in the field of public health; to understand the creation of NPVs in the city of São Paulo and the legislation pertinent to it; and to understand the work of social workers in the Health Care Network (RAS). We start from the following premises: i) the implementation of public policies in the care of violence does not provide real conditions for overcoming it; NPV as a prevention strategy has limitations that compromise the understanding of the phenomenon of violence in capitalist society, leading health teams to an immediate and superficial practice; ii) the inclusion of social workers in multidisciplinary NPV teams happens in a compulsory way, often without guidance, training and/or supervision offered by the organizations that administer health services, contributing to the professional work being carried out in a heterogeneous way within the category; iii) social workers have limits to their work that are added to the limits imposed by public policies, yet they end up having a central role in NPV teams, often directing the management of cases. This is a qualitative, descriptive-exploratory field research that was carried out with six social workers who work in primary care. The semi-structured interview was conducted via Meet, given the easy access of the interviewer and interviewee. The results showed that there is a huge workload due to the scrapping and precariousness of health services in the city of São Paulo, and that this contributes to the immediacy of actions, the fragmentation and discontinuity of care for people in situations of violence, with little capacity to truly break the violence in society. The results also point to the serious and continued presence of violence against health workers and the performance of work in degrading conditions.
Descrição
Citação
SILVA, Luana Euzébia da. Serviço Social e violência: análise do trabalho profissional no Núcleo de Prevenção à Violência. 2024. 130 f. Dissertação (Mestrado em Serviço Social e Políticas Sociais) - Universidade Federal de São Paulo, Instituto de Saúde e Sociedade, Santos, 2024.