Prazer, sofrimento e estratégias defensivas dos agentes comunitários de saúde no trabalho

Abstract

This is a qualitative research based on a descriptive-exploratory perspective whose aim was to understand the work process of Health Community Agents, to identify pleasure and suffering situations related to such work and to describe defensive strategies used by them in their daily practice. The informants of this study were agents in the Health Community Agents Program and Family Health Strategy team, counting with an amount of 24 subjects. One selected two data collection instruments, such as: a socio-demographic survey questionnaire and the focus group technique. Based on them, data treatment consisted of two steps: descriptive statistics was applied to socio-demographic data and content analysis was applied to qualitative data from the focus group. This study responded to the National Health Council Resolution 196/96. Concerning the obtained results, the whole HCAs were female; most of them married; with children; 39 years-old in average; high school degree and one to five years of work in the field. Concerning pleasure, it is linked to community appraisal and consideration; to the feeling of being useful; to the kindness patients show them; to problem solving; to the harmonious acquaintance among HCAs and to the part they make in festivities at work. Concerning suffering, one evidenced that it emerges when there are flaws in the health structure which do not allow the agents doing their function; towards the lack of privacy when they live in the same place they work; when in touch with families suffering in cases of illness or death; in daily acquaintance with social problems like violance and poverty; the clash between HCAs beliefs and community reality and the frustration when they cannot help avoiding the illness progress of their patients. Besides, one highlights as a source of suffering the lack of consideration of their work by the health team and their immediate managers, as well as their absence concerning HCAs work complains. In relation to the defensive strategies HCAs use, one highlights the ones related to avoiding the contamination of their non-working time with their work practice, such as, for instance: forgetting the problems of their daily practice; performing other activities; putting a physical barrier in their houses in order to avoid patients access; taking anti depression medicines; organizing a home visiting agenda; searching for help in their group of colleagues and in religion. The denial of suffering appears as a escape device, dissimulating it and even when anger intensifies they seem to be waiting for the divine providence . Regarding suffering as a result of violence, as they cannot fight it, the strategies they reported were: ignoring, denying or finding ways of rationalizing and explaining such situations. In which the relationship among members of HCA group is concerned, they developed strategies related to the creation of a dialogue and discussion space, strengthening the bonds among other HCAs, developing personal consciousness of the importance of their work and taking part in group therapy.