A rede de saúde do trabalhador sob a perspectiva do usuário: Análise das trajetórias e das implicações do adoecimento para o trabalhador

Abstract

Introduction: The creation of the National Worker Health Network (RENAST) in 2002 represents an important landmark for Public Health, having the Reference Centers for Worker’s Health (CEREST) as a privileged locus to implement, articulate and pactuate actions improving worker's health (WH). Focusing on interdisciplinarity and intersectoriality, the WH aims at completeness in health care. General objective: Analyze the trajectory of the workers in the health network of the worker. Specific objectives: Characterize the profiles of CEREST users; Identify how the user understands the work and the relationship it has with its health or illness; To know the main difficulties to access the health network of the worker and Analyze the subjective implications of the processes of illness and remoteness for the worker. For that, the theoretical foundations of the Psychodynamics of Work were used to understand the subjective experiences of the workers, as well as studies that problematize the implications of the new modes of management in the subjectivity. Method: The nature of the study was quantitative-qualitative, with a descriptive and exploratory approach. In study I, a documentary survey was carried out through the tabulation of 273 medical records corresponding to the years 2015 and 2016, in order to know the profiles of the workers attended at CEREST. Variables were defined, analyzing them from the Statistical Package for Social Sciences (SPSS) software. In study II, eleven interviews were conducted with users hosted by two ST Reference Centers. The interviews were analyzed through analysis of thematic content and divided into three main categories: About work: Sense and work-health-disease processes; About worker health network: Trajectory and difficulties to access services; and finally, Implications of illness and withdrawal from work. Results: In the study I, the predominant age group was workers aged between 21 and 30 years (42.7%), who had a formal contract (90.1%). The sectors with the highest number of users were industrial (50.0%), services (35.0%), telemarketing (11.3%), commercial (2.9%) and rural (0.7%) . The first cause of withdrawal was Tendonitis, Tendinopathies and Bursitis (30.5%). It was verified that most of the referrals to the centers were done by private medical services (25.5%), followed by INSS (17.9%) and colleagues (9.1%). Only 1.8% of these referrals were performed by SUS. Regarding the results of study II, it was noticed that some subjects point to work as something positive that comes from financial sustenance, independence and health, but when illness occurs, there is a change of representation, passing the work to be experienced with suffering. About the understanding that workers have of RENAST, the majority revealed to know little about the network. The trajectories experienced were unique, presenting pathways with innumerable comings and goings to health and social welfare institutions, with emphasis on individual actions. The main difficulties to access the network were: the lack of medical care in the company, the lack of humanization of professionals, the financial question to pay for exams, the waiting time in the consultations and the lack of accessibility in cases of disability. The implications of illness are highlighted: change in routine, difficulties in daily tasks, income impaired, experiences of uselessness and impotence, lack of understanding of co-workers after illness and interruption of life projects. Conclusion: The aim of this study is to identify the potentialities and difficulties of workers' health policies. The continuous evaluation of the local network contributes to clarify a specific reality. It is hoped, therefore, to assist in the planning of joint and articulated actions among the various sectors and services of RENAST, considering the relationships between work and subjectivity.