ResumoEste artigo discute aspectos da relação médico-paciente no contexto do encontro simbólico entre portadores de LER/DORT e médicos peritos do Instituto Nacional de Seguro Social de São Paulo (INSS/SP). A pesquisa empírica que serviu de base à discussão foi de abordagem qualitativa e utilizou como instrumento para obtenção dos dados a entrevista em profundidade, com roteiros distintos para médicos peritos e pacientes. Foram realizadas 9 entrevistas, 6 com pacientes e 3 com médicos peritos. Análise de conteúdo foi aplicada ao material empírico segundo a referência conceitual das representações sociais. As narrativas dos portadores as LER/DORT, as narrativas dos médicos sobre o trabalho pericial e as narrativas de ambos acerca das consultas periciais possibilitaram explorar o encontro simbólico, não necessariamente factual, da consulta pericial. A relação médico-paciente que se estabelece nesse encontro simbólico é extremamente peculiar, pois está direcionada à avaliação do processo saúde--doença do paciente, com base em premissas do direito previdenciário, fator que descaracteriza a relação médico-paciente assentada no imaginário social como espaço de cuidado e confiança. Como consequência, portadores de LER/DORT e peritos, no momento do encontro, estão em diferentes escalas de poder: aqueles são avaliados e estes avaliam a validade da queixa segundo os padrões do INSS/SP. Por isso, apresentam narrativas sobre as consultas permeadas pela tensão relativa às expectativas e necessidades quanto aos resultados. Palavras-chave: Pesquisa Qualitativa; Relações Médico-Paciente; LER/DORT; Transtornos Traumá-ticos Cumulativos. Anna Carolina Arena Siqueira AbstractThis paper discusses aspects of the physician--patient relationship in the context of the symbolic meeting between patients with RSI/WMSD and medical experts at the Brazilian National Institute for Social Security of São Paulo (INSS/SP). The empirical research which grounded the discussion had a qualitative approach and it used as instrument for obtaining data the in-depth interview, with different scripts for medical experts and patients. We conducted 9 interviews, 6 with patients and 3 with medical experts. Content analysis was applied to the empirical material according to the conceptual framework of social representations. The narratives of patients about RSI/WMSD, the narratives of medical experts about medical evaluation, and the narratives of both about INSS/SP medical consultations allowed exploring the symbolic meeting that occurred between than. The physician-patient relationship established in this symbolic meeting is extremely peculiar, since it is aimed at assessing the health-disease process of the patient, based on the premises of social insurance law, factor that mischaracterize this kind of relationship, established on the social imaginary as a space for care and trust. As a consequence, patients with RSI/WMSD and medical experts, at the meeting time, are in different power scales: the former are assessed and the latter assess the validity of c...

No abstract

We aimed to study the meaning of impacts that a Brazilian law (Lei de Modernização dos Portos Brasileiros 8630/93) produced in port workers of Port of Santos/SP, in a way to acess their port worker identity, health-illness care process, gender and masculinities themes. The empirical research which ground the discussion, had a qualitative approach and was perform between 2009/2010. It used as instruments for obtaining data ethnography observations (at workers selection places and pier) and 39 in-depth port workers interviews. From this point, were produced field diaries and an interview database that were analysed by metodos triangulation tecnic, according to the conceptual framework of hermeneutical referencial and content analysis. We shared the discussion in 3 chapters that brought out the leading temathics of our investigation: subjects characterization, their symbolic universe, workers health, gender and masculinities representations. According to port workers, that law dramatically modified their work organization, with some winning points like EPIs requirement, accident control and periodic exams. Beside that, port workers related considerable losses in the way of their brotherhood identity, based on craft skills and masculinities concepts, like 'be a worker' and 'support a family'. Port workers showed a perception about health-illness care process based in the idea that Port of Santos was a hazardous work place. In the other side, they avoid to look for medical treatments or absence from work for health problems. Their health care interface was restricted to periodic exams required from OGMO.

Resumo: Introdução: A promulgação da Lei de Modernização dos Portos Brasileiros (8630/93) modificou drasticamente a organização do trabalho portuário no país, com repercussões para os aspectos da saúde do trabalhador. Objetivo: Elucidar concepções de Trabalhadores Portuários Avulsos (TPAs) do Porto de Santos/SP acerca dos impactos da promulgação da Lei 8630/93, nas esferas do trabalho e cuidado em saúde. Método: Foi utilizada metodologia qualitativa pelos instrumentos de observação etnográfica e 39 entrevistas em profundidade com TPAs. Ao material coletado foi aplicada técnica de análise por triangulação de métodos, sob referencial hermenêutico-filosófico de interpretação. Resultados: Para esses TPAs, a promulgação da Lei 8630/93 promoveu mudanças profundas na estrutura de organização do trabalho que conheciam e havia sido por eles forjada historicamente. Apontaram perdas em relação a diversos aspectos do universo do trabalho como: menores remunerações por serviço, incerteza em relação a 'ter serviço', perda de controle dos turnos de trabalho. Compartilhavam postura de descuido em relação à própria saúde, apesar do entendimento de que seu trabalho era arriscado, perigoso e permeado por acidentes. Conclusão: A Lei 8630/93 modificou a organização do trabalho que era praticada pelos TPAs do Porto de Santos/SP. Segundo os trabalhadores, isso acarretou muitas perdas reais (da autonomia, controle sobre os meios, ritmo do trabalho e remunerações) e simbólicas (unificação das categorias em TPAs e neutralização dos sindicatos). Subvalorizavam suas queixas de saúde e evitavam buscar atendimento médico, postura condizente com os modelos de cuidado atribuídos aos homens pelos referencias de gênero. Palavras-chave: Pesquisa Qualitativa, Saúde do Trabalhador, Identidade de Gênero, Saúde do Homem, ProcessoSaúde-doença, Categorias de Trabalhadores. Work and care: dockworkers conceptions about Brazilian port modernization law 8630/93Abstract: Introduction: Brazilian's ports had their work organization dramatic modified by Port Modernization Law (8630/93), with great impact to occupational health. Objective: This study investigated dockworkers conceptions about the impacts of Law 8630/93 to work and health care. Method: The empirical research that grounded the discussion had a qualitative approach and it used as instruments for obtaining data ethnographic observation and 39 in-depth dockworkers interviews. Methods triangulation was applied to the empirical material according to the conceptual framework of hermeneutical referential. Results: Since law 8630/93 was established, dockworkers have been named as Trabalhadores Portuários Avulsos (TPAs) and they reported that their work organization, that was historically build by them, has been suffering a lot of changes, as: lower payments, uncertainty about getting 'the job of the day' and lost of control about their shifts. They share a neglect way of care about their health issues although having the understanding that they perform risk jobs in a dangerous profession, surrounded by a...

Background: In North America and Europe return to work (RTW) rates vary among breast cancer(BC) survivors from 24-66% and 53-82% after 06 and 36 months of diagnosis, respectively. In 2017an observational study evaluated return to work among Brazilian patients treated in one publichospital in São Paulo, and described RTW rates of 30.3 and 60.4%, after 12 and 24 months of BCdiagnosis, respectively. The aim of the present study was to evaluate RTW rates among a broaderpopulation of Brazilian patients with BC, including patients treated in private hospitals, and todescribe factors associated with this outcome.Patients and Methods: Patients with BC registered on the portal of the NGO Instituto Oncoguia, oneof the largest Brazilian cancer patient support organization, and patients treated in one of the cancercenters from the Oncoclínicas group in Bahia, Rio de Janeiro or São Paulo. Patients received anemail invitation to participate in this study by answering an online survey. Inclusion criteria:Women with BC, diagnosed with stage I-IV within 12 to 36 months from survey date, age 18-65,with paid work before BC, who answered question related to returning to work after the diagnosis.The Institutional Review Board (IRB) of the Hospital Santo Antônio/Obras Sociais Irmã Dulce, inSalvador- Bahia, approved the study.Results: 124 women fulfilled all inclusion criteria and agreed to participate on this online survey.Most patients were white (71.8%), had college degree or higher education (74.2%) and were fromthe southeast region in Brazil (67.7%). Overall, 70.2% of patients returned to work after BCdiagnosis; 21.8% stayed away from work for < 6 months, 26.6% for 6-12 months, 22.6% for 12-24months, 19.3% for more than 24 months and 9.7% did not answer this question. Most participantswere treated in private hospitals/clinics (82%), reported they liked their job (64.5%) and receivedsupport from employer (56.4%), but only 33.1% indicated had been offered work adjustments aftercancer diagnosis. From the 29.8% that did not RTW, 78.4% declared they wished to return. Only19.3% said that they had no difficulties in returning to work. Most common difficulties to RTWwere difficulty concentrating (34.7%) and adjusting to working hours (19.3%). In the multivariateanalysis, factors associated with positive RTW outcomes included being treated in a private versuspublic hospital (OR: 13.74, CI95% 1.76-106.96; p = 0.012) and job satisfaction (OR: 4,69,CI95% 1.10-19.98; p = 0.036). Factors associated with negative RTW outcomes included > 24. months away from work (OR: 0.02, IC95% 0.01-0.32; p = 0.004) and depression diagnosed afterBC (OR: 0.13, IC95% 0.01-0.91; p = 0.04). A limitation of this study is the use of a conveniencesample, thus, the associations found are limited to the participating women .Conclusion: Differences in RTW rates in private versus public hospitals may explain the betterRTW rate found in this cohort, in contrast with previous study conducted with Brazilian patientstreated in a public hospital in São Paulo. Ultimately, identifying patients who will likely experiencedifficulties to RTW (patients who developed depression after BC and those not satisfied with theirjobs) can hopefully trigger patient support strategies. Organizations and government should betterassist patients in the rehabilitation work process and with possible career transitions. Citation Format: Luciana Landeiro, Luciana Holtzde Camargo Barros, Lycia TramujasVasconcellos Neumann, André Marques Santos, Anna Carolina Arena Siqueira, Rafael Kaliks. Return to work after breast cancer: Disparities among patients treated in public and private hospitals in Brazil [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-11-17.