Comprometimento organizacional, representações dos contextos de trabalho e a aplicação das políticas públicas para o idoso em Unidades de Saúde da Família de uma cidade do Estado da Bahia, Brasil
Ficheiros
Data
2013
Autores
Título da revista
ISSN da revista
Título do Volume
Editora
Resumo
Comprometimento organizacional e percepção/representação do contexto de trabalho são importantes aspectos da gestão de serviços de saúde, por interferirem no desempenho institucional e seu incremento poder melhorar a qualidade das práticas profissionais. Caracterizar o comprometimento organizacional (CO) e as representações do contexto de trabalho (CT) bem como a aplicação das estratégias de ação, formuladas nas políticas públicas de saúde para o idoso no Núcleo de Apoio à Saúde da Família (NASF) e nas Unidades de Saúde da Família (USF), integrantes do Sistema Único de Saúde (SUS), implantadas numa cidade da Bahia, Brasil, apresentam-se como objetivos desta investigação. Estudo descritivo e transversal realizado com 42 equipes mutiprofissionais das instituições de saúde do setor público – 4 equipes no NASF e 38 nas USF –, compostas por aproximadamente 700 profissionais. A amostra se constituiu de 160 pessoas distribuídas entre 6 Unidades de Saúde. Os dados foram obtidos por registros documentais da Tabela Unificada de Procedimentos a serem realizados com idosos, do Ministério da Saúde, pelo Relatório Consolidado das Famílias Cadastradas nas regiões de circunscrição das Unidades de Saúde da Família e pelo Relatório de Produção Ambulatorial de Procedimentos da Tabela Unificada. Foram também obtidos dados com a aplicação da Escala de Bases do Comprometimento Organizacional (EBACO) e da Escala de Avaliação do Contexto de Trabalho (EACT). O Relatório Consolidado das Famílias Cadastradas traz registrado 7.935 pessoas idosas e a Tabela Unificada de Procedimentos apresenta 6.995 procedimentos realizados nas 6 Unidades de Saúde pesquisadas. Comparando o número de idosos cadastrados por USF com o quantitativo de procedimentos efetuados, observa-se que as estratégias de ações previstas para esta população são aplicadas nos Serviços de Saúde visitados. A aplicação da EBACO evidenciou alto comprometimento para a maioria dos profissionais, na base Obrigação pelo Desempenho, um comprometimento acima da média na base Afetiva e alto comprometimento na base Obrigação em Permanecer. A base Linha Consistente de Atividade, apontou para um comprometimento acima da média, a base Falta de Recompensas e Oportunidades obteve comprometimento abaixo da média, a base Escassez de Alternativas, obteve um baixo comprometimento e a base Afiliativa obteve alto comprometimento. Da aplicação da EACT resultou uma avaliação moderada ou crítica para quase todos os itens que compoem o fator Organização do Trabalho (OT), exceto o item cobrança por resultados, avaliado como grave.
O fator Condições de Trabalho (CT) apontou para uma avaliação crítica, enquanto que a maioria dos itens do fator Relações Socioprofissionais (RS) foi avaliada como satisfatória, com avaliação moderada a crítica para os itens realtivos a tomada de decisão, individualismo, conflitos no ambiente de trabalho e sistema de comunicação. Conclui-se que a estrutura das Unidades de Saúde da Família apresenta condições de carências diversas e que as equipes de profissionais enfrentam grandes desafios no seu contexto organizacional. Apesar das adversidades, as equipes cumprem as estratégias de saúde do idoso e os objetivos institucionais eficientemente, contribuindo para melhorar a qualidade de saúde dos idosos e diminuir desigualdades sociais, fundamentando o soberano direito à saúde para todos, tal como estabelecido pela Organização Mundial de Saúde.
Organizational commitment and perception /representation of work context are important aspects of management of health services, because affect institutional performance and its increase can improve quality of professional practices. To characterize organizational commitment and representation of work context are important aspects of the health services management, by interfering in institutional performance and its increase can improve the quality of professional practices. To mark organizational commitment (OC) and the representations of the work context (WC) and the implementation of strategies of action, made in public health policies for the elderly in the Support Center for Family Health (SCFH) and the Family Health Units (FHU), members of the Unified Health System (UHS), deployed in the city of Bahia, Brazil, present themselves as targets of this investigation. It is a descriptive and transversal study performed with 42 mutiprofissional teams in health institutions of public sector – 4 teams in SCFH and 38 in the FHU – composed of approximately 700 professionals. The validated sample consisted of 160 people distributed among 6 Health Units. Data were obtained by documentary records of Table Unified Procedures to be performed with the elderly, from the Ministry of Health, Consolidated Report of Family Members in regions constituency Units Family Health and Production Report for Outpatient Procedures Table Unified. Data were also obtained by application of Scale Bases of Organizational Commitment and the Rating Scale of Work Context. The Consolidated Report of Families Registered Members brings 7,935 elderly and Table Unified Procedures presents 6,995 procedures performed in 6 health units. Comparing the number of elderly registered for USF with quantitative procedures performed, it is observed that strategies of actions planned for this population are applied in Health Services visited. The application of Scale Organizational Commitment resulted in high commitment for most people, on Performance Bond base, a commitment above average, on Affective base and high Commitment on Obligation Staying base. The base Consistent Line of Activity held commitment above average, the base Lack of Rewards and Opportunities obtained below average, the base Shortage Alternatives exhibited a low commitment and the Affiliative base obtained high commitment. The application of Rating Scale of Work Context showed a moderate or critical situation for almost all the items that compose the factor Labour Organization (LO), except for item pressure for results, assessed as serious situation. The Working Conditions (WC) factor showed a critical situation. Most items of Relations Socio-occupational factor (RS) were evaluated as satisfactory situation, in a moderate to critical situation items related to decision making, individualism, conflicts in the workplace and communication system. Conclude that structure of the Family Health Units presents several needs conditions and that professional teams face challenges in their organizational context. However, these teams are involved in the fulfillment of the elderly health strategies and institutional objectives efficiently. The psychosocial phenomena related to Organizational Commitment and the representations of the Work Context can influence the institutional performance and its development can improve the health quality of the elderly population, contributing to the reduction of social inequalities, which underlies the sovereign right to health for all, as established by the World Health Organization.
Organizational commitment and perception /representation of work context are important aspects of management of health services, because affect institutional performance and its increase can improve quality of professional practices. To characterize organizational commitment and representation of work context are important aspects of the health services management, by interfering in institutional performance and its increase can improve the quality of professional practices. To mark organizational commitment (OC) and the representations of the work context (WC) and the implementation of strategies of action, made in public health policies for the elderly in the Support Center for Family Health (SCFH) and the Family Health Units (FHU), members of the Unified Health System (UHS), deployed in the city of Bahia, Brazil, present themselves as targets of this investigation. It is a descriptive and transversal study performed with 42 mutiprofissional teams in health institutions of public sector – 4 teams in SCFH and 38 in the FHU – composed of approximately 700 professionals. The validated sample consisted of 160 people distributed among 6 Health Units. Data were obtained by documentary records of Table Unified Procedures to be performed with the elderly, from the Ministry of Health, Consolidated Report of Family Members in regions constituency Units Family Health and Production Report for Outpatient Procedures Table Unified. Data were also obtained by application of Scale Bases of Organizational Commitment and the Rating Scale of Work Context. The Consolidated Report of Families Registered Members brings 7,935 elderly and Table Unified Procedures presents 6,995 procedures performed in 6 health units. Comparing the number of elderly registered for USF with quantitative procedures performed, it is observed that strategies of actions planned for this population are applied in Health Services visited. The application of Scale Organizational Commitment resulted in high commitment for most people, on Performance Bond base, a commitment above average, on Affective base and high Commitment on Obligation Staying base. The base Consistent Line of Activity held commitment above average, the base Lack of Rewards and Opportunities obtained below average, the base Shortage Alternatives exhibited a low commitment and the Affiliative base obtained high commitment. The application of Rating Scale of Work Context showed a moderate or critical situation for almost all the items that compose the factor Labour Organization (LO), except for item pressure for results, assessed as serious situation. The Working Conditions (WC) factor showed a critical situation. Most items of Relations Socio-occupational factor (RS) were evaluated as satisfactory situation, in a moderate to critical situation items related to decision making, individualism, conflicts in the workplace and communication system. Conclude that structure of the Family Health Units presents several needs conditions and that professional teams face challenges in their organizational context. However, these teams are involved in the fulfillment of the elderly health strategies and institutional objectives efficiently. The psychosocial phenomena related to Organizational Commitment and the representations of the Work Context can influence the institutional performance and its development can improve the health quality of the elderly population, contributing to the reduction of social inequalities, which underlies the sovereign right to health for all, as established by the World Health Organization.
Descrição
Dissertação de Mestrado em Gestão de Serviços de Saúde
Palavras-chave
Gestão dos serviços de saúde , Estado da Bahía (Região Nordeste, Brasil) , Políticas públicas , Serviços de saúde para idosos , Comprometimento organizacional