Consequences of intangibility in the management of new mental health services
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2009 |
| Outros Autores: | , |
| Tipo de documento: | Artigo |
| Idioma: | por eng |
| Título da fonte: | Revista de Saúde Pública |
| Texto Completo: | https://www.revistas.usp.br/rsp/article/view/32666 |
Resumo: | OBJECTIVE: To analyze work organization in psychosocial healthcare services from the logic of the service management field. METHODS: Organizational analysis was performed, using a case study in a psychosocial healthcare service located in the city of São Paulo, Southeastern Brazil, between 2006 and 2007. A total of five sources of information were analyzed: Ministério da Saúde (Brazilian Ministry of Health) documents, research reports made in the service studied, service records, interviews with healthcare workers and managers and simple observation. Interviews dealt with objectives, results and assessment of work process. Each source was treated differently, according to its purpose. A subsequent dialogue about the results obtained aimed to make a set of observations on which the case study was founded. RESULTS: The service proposes to deliver a very intangible result, which views the user in their social context. The intended change in the user's conditions was described as "the person living better". Such condition is difficult to be defined and understood in terms of the details and limits of this change, thus hindering measurement of results. In addition, the work process involves activities which are not routinary, not predictable and sometimes simultaneous, so that the team finds it difficult to recognize and legitimize efforts made to perform work, a fact described as "work invisibility" by workers. CONCLUSIONS: The assessment process was found to be a complex aspect of this intangibility, associated with inadequacy and insufficiency of the municipal health system's management structure to include a service of this nature. Results enabled better understanding of a field of work where workers' and users' subjectivity is inherent in the service management process. |
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Consequences of intangibility in the management of new mental health services Consecuencias de la intangibilidad en la gestión de los nuevos servicios de salud mental Conseqüências da intangibilidade na gestão dos novos serviços de saúde mental Serviços de Saúde MentalRecursos Humanos em SaúdeGestão em SaúdeEstudos de Casos OrganizacionaisOrganização do trabalhoServicios de Salud MentalRecursos Humanos en SaludGestión en SaludEstudios de Casos OrganizacionalesOrganización del trabajoMental Health ServicesHealth ManpowerHealth ManagementOrganizational Case StudiesWork Organization OBJECTIVE: To analyze work organization in psychosocial healthcare services from the logic of the service management field. METHODS: Organizational analysis was performed, using a case study in a psychosocial healthcare service located in the city of São Paulo, Southeastern Brazil, between 2006 and 2007. A total of five sources of information were analyzed: Ministério da Saúde (Brazilian Ministry of Health) documents, research reports made in the service studied, service records, interviews with healthcare workers and managers and simple observation. Interviews dealt with objectives, results and assessment of work process. Each source was treated differently, according to its purpose. A subsequent dialogue about the results obtained aimed to make a set of observations on which the case study was founded. RESULTS: The service proposes to deliver a very intangible result, which views the user in their social context. The intended change in the user's conditions was described as "the person living better". Such condition is difficult to be defined and understood in terms of the details and limits of this change, thus hindering measurement of results. In addition, the work process involves activities which are not routinary, not predictable and sometimes simultaneous, so that the team finds it difficult to recognize and legitimize efforts made to perform work, a fact described as "work invisibility" by workers. CONCLUSIONS: The assessment process was found to be a complex aspect of this intangibility, associated with inadequacy and insufficiency of the municipal health system's management structure to include a service of this nature. Results enabled better understanding of a field of work where workers' and users' subjectivity is inherent in the service management process. OBJETIVO: Analisar a organização do trabalho em centros de atenção psicossocial a partir da lógica da área de gestão de serviços. MÉTODOS: Foi realizada uma análise organizacional por meio de estudo de caso em um serviço de atenção psicossocial em São Paulo (SP), entre 2006 e 2007. Foram analisadas cinco fontes de informação: documentos do Ministério da Saúde, relatórios de pesquisa realizada no serviço estudado, registros do serviço, entrevistas com trabalhadores do CAPS e gestores de saúde e observação simples. As entrevistas versaram sobre objetivos, resultados e avaliação do processo de trabalho. Cada fonte recebeu tratamento diferenciado de acordo com sua finalidade. Posteriormente um diálogo dos resultados obtidos visou a construção de uma cadeia de observações sobre a qual se fundamentou o estudo do caso. RESULTADOS: O CAPS se propõe a entregar resultado altamente intangível, que contempla o usuário no seu contexto social. A mudança almejada nas condições do usuário foi descrita como "a pessoa vivendo melhor". Tal condição possui difícil definição e compreensão acerca dos detalhes e limites dessa mudança, sendo, portanto, difícil medir os resultados. Aliado a isso, o processo de trabalho envolve atividades não rotineiras, não previstas e algumas vezes simultâneas, de tal forma que a equipe encontra dificuldade de reconhecer e legitimar os esforços para fazer o trabalho acontecer, fato descrito pelos trabalhadores como invisibilidade do trabalho. CONCLUSÕES: O processo de avaliação mostrou-se um aspecto complexo dessa intangibilidade aliado à inadequação e a insuficiência da estrutura administrativa do sistema de saúde municipal para acolher um serviço dessa natureza. Os resultados permitiram compreender melhor um campo de trabalho em que a subjetividade de trabalhadores e de usuários é inerente ao processo de gestão de serviços. OBJETIVO: Analizar la organización del trabajo en centros de atención psicosocial a partir de la lógica del área de gestión de servicios. MÉTODOS: Fue realizado un análisis organizacional por medio del estudio de caso en un servicio de atención psicosocial en Sao Paulo (Sureste de Brasil), entre 2006 y 2007. Fueron analizadas cinco fuentes de información: documentos del Ministerio de la Salud, informes de investigación realizado en el servicio estudiado, registros de servicio, entrevistas con trabajadores de CAPS y gestores de salud y observación simple. Las entrevistas trataron sobre objetivos, resultados y evaluación del proceso de trabajo. Cada fuente recibió tratamiento diferenciado de acuerdo con su finalidad. Posteriormente un diálogo de los resultados obtenidos visó la construcción de una cadena de observaciones sobre la cual se fundamentó el estudio del caso. RESULTADOS: El CAPS se propone a entregar resultado altamente intangible, que contempla el usuario en su contexto social. El cambio basado en las condiciones del usuario fue descrito como "la persona viviendo mejor". Tal condición posee difícil definición y comprensión acerca de los detalles y límites de ese cambio, siendo, por tanto, difícil medir los resultados. Aunado a eso, el proceso de trabajo envuelve actividades no rutinarias, no previstas y algunas veces simultáneas, de tal forma que el equipo encuentra dificultades de reconocer y legitimar los esfuerzos para hacer el trabajo acontecer, hecho descrito por los trabajadores como invisibilidad del trabajo. CONCLUSIONES: El proceso de evaluación mostró un aspecto complejo de esa intangibilidad aunado a la inadecuación y la insuficiencia de la estructura administrativa del sistema de salud municipal para acoger un servicio de esa naturaleza. Los resultados permitieron comprender mejor un campo de trabajo en que la subjetividad de trabajadores y de usuarios es inherente al proceso de gestión de servicios. Universidade de São Paulo. Faculdade de Saúde Pública2009-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/3266610.1590/S0034-89102009000800007Revista de Saúde Pública; Vol. 43 No. suppl.1 (2009); 36-42 Revista de Saúde Pública; Vol. 43 Núm. suppl.1 (2009); 36-42 Revista de Saúde Pública; v. 43 n. suppl.1 (2009); 36-42 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporenghttps://www.revistas.usp.br/rsp/article/view/32666/35066https://www.revistas.usp.br/rsp/article/view/32666/35067Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessSilva, Marcia Terra daLancman, SelmaAlonso, Carolina Maria do Carmo2012-07-09T02:08:24Zoai:revistas.usp.br:article/32666Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-07-09T02:08:24Revista de Saúde Pública - Universidade de São Paulo (USP)false |
| dc.title.none.fl_str_mv |
Consequences of intangibility in the management of new mental health services Consecuencias de la intangibilidad en la gestión de los nuevos servicios de salud mental Conseqüências da intangibilidade na gestão dos novos serviços de saúde mental |
| title |
Consequences of intangibility in the management of new mental health services |
| spellingShingle |
Consequences of intangibility in the management of new mental health services Silva, Marcia Terra da Serviços de Saúde Mental Recursos Humanos em Saúde Gestão em Saúde Estudos de Casos Organizacionais Organização do trabalho Servicios de Salud Mental Recursos Humanos en Salud Gestión en Salud Estudios de Casos Organizacionales Organización del trabajo Mental Health Services Health Manpower Health Management Organizational Case Studies Work Organization |
| title_short |
Consequences of intangibility in the management of new mental health services |
| title_full |
Consequences of intangibility in the management of new mental health services |
| title_fullStr |
Consequences of intangibility in the management of new mental health services |
| title_full_unstemmed |
Consequences of intangibility in the management of new mental health services |
| title_sort |
Consequences of intangibility in the management of new mental health services |
| author |
Silva, Marcia Terra da |
| author_facet |
Silva, Marcia Terra da Lancman, Selma Alonso, Carolina Maria do Carmo |
| author_role |
author |
| author2 |
Lancman, Selma Alonso, Carolina Maria do Carmo |
| author2_role |
author author |
| dc.contributor.author.fl_str_mv |
Silva, Marcia Terra da Lancman, Selma Alonso, Carolina Maria do Carmo |
| dc.subject.por.fl_str_mv |
Serviços de Saúde Mental Recursos Humanos em Saúde Gestão em Saúde Estudos de Casos Organizacionais Organização do trabalho Servicios de Salud Mental Recursos Humanos en Salud Gestión en Salud Estudios de Casos Organizacionales Organización del trabajo Mental Health Services Health Manpower Health Management Organizational Case Studies Work Organization |
| topic |
Serviços de Saúde Mental Recursos Humanos em Saúde Gestão em Saúde Estudos de Casos Organizacionais Organização do trabalho Servicios de Salud Mental Recursos Humanos en Salud Gestión en Salud Estudios de Casos Organizacionales Organización del trabajo Mental Health Services Health Manpower Health Management Organizational Case Studies Work Organization |
| description |
OBJECTIVE: To analyze work organization in psychosocial healthcare services from the logic of the service management field. METHODS: Organizational analysis was performed, using a case study in a psychosocial healthcare service located in the city of São Paulo, Southeastern Brazil, between 2006 and 2007. A total of five sources of information were analyzed: Ministério da Saúde (Brazilian Ministry of Health) documents, research reports made in the service studied, service records, interviews with healthcare workers and managers and simple observation. Interviews dealt with objectives, results and assessment of work process. Each source was treated differently, according to its purpose. A subsequent dialogue about the results obtained aimed to make a set of observations on which the case study was founded. RESULTS: The service proposes to deliver a very intangible result, which views the user in their social context. The intended change in the user's conditions was described as "the person living better". Such condition is difficult to be defined and understood in terms of the details and limits of this change, thus hindering measurement of results. In addition, the work process involves activities which are not routinary, not predictable and sometimes simultaneous, so that the team finds it difficult to recognize and legitimize efforts made to perform work, a fact described as "work invisibility" by workers. CONCLUSIONS: The assessment process was found to be a complex aspect of this intangibility, associated with inadequacy and insufficiency of the municipal health system's management structure to include a service of this nature. Results enabled better understanding of a field of work where workers' and users' subjectivity is inherent in the service management process. |
| publishDate |
2009 |
| dc.date.none.fl_str_mv |
2009-08-01 |
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info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
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article |
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publishedVersion |
| dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/32666 10.1590/S0034-89102009000800007 |
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https://www.revistas.usp.br/rsp/article/view/32666 |
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10.1590/S0034-89102009000800007 |
| dc.language.iso.fl_str_mv |
por eng |
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por eng |
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https://www.revistas.usp.br/rsp/article/view/32666/35066 https://www.revistas.usp.br/rsp/article/view/32666/35067 |
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Copyright (c) 2017 Revista de Saúde Pública info:eu-repo/semantics/openAccess |
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Copyright (c) 2017 Revista de Saúde Pública |
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openAccess |
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application/pdf application/pdf |
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Universidade de São Paulo. Faculdade de Saúde Pública |
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Universidade de São Paulo. Faculdade de Saúde Pública |
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Revista de Saúde Pública; Vol. 43 No. suppl.1 (2009); 36-42 Revista de Saúde Pública; Vol. 43 Núm. suppl.1 (2009); 36-42 Revista de Saúde Pública; v. 43 n. suppl.1 (2009); 36-42 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
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Universidade de São Paulo (USP) |
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USP |
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USP |
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Revista de Saúde Pública |
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Revista de Saúde Pública |
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Revista de Saúde Pública - Universidade de São Paulo (USP) |
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revsp@org.usp.br||revsp1@usp.br |
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1800221789553426432 |