Interrelationship Between Organizational and Relational Aspects and the Return-to-Work Process: A Case Study with Nursing Professionals at a Teaching Hospital in Brazil.

Introduction The process of returning to work, especially for individuals with labor restrictions, impacts work teams and interferes with the labor reinsertion process. In this study, we aimed to understand the impact of these situations on a nursing team from both organizational and relational perspectives. Methods We conducted a qualitative research study at a university hospital in the municipality of São Paulo using three strategies: documentary analysis; semi-structured interviews with pairs of workers returning to a labor situation; and a focus group with nursing managers. Results Medical leaves of absence overburden the employees who remain working. Regarding the return to work, the participants reported both positive and negative aspects. One positive aspect reported was that those who return to work contribute to the division of labor, generating solidarity and cooperation. The negative aspects reported were related to the return of workers with labor restrictions who do not fully resume their activities, consequently generating conflicts within the work teams that interfere with the reintegration processes. The supervisors reported difficulties reorganizing work on a broad scale and assessing the workers' diagnoses and symptoms and the workers themselves in terms of the necessity of their leaves and the validity of their labor restrictions. Conclusion The organization of labor and social relationships among peers and supervisors is a significant contributor to the success or failure of the work reintegration process and therefore should be considered. We aimed to address this issue by highlighting the complexity of the return-to-work process among health workers.

An ergonomic approach to reorganize parking inspection agents' work productivity, health and safety in São Paulo, Brazil.

OBJECTIVE: The Traffic Engineering Company of the City of São Paulo (Brazil) observed a decrease in productivity, and an increase in sick leave, accidents and psychological distress among their parking inspection agents. To document this situation, qualitative research was undertaken to obtain an in-depth comprehension of work activity. PARTICIPANTS: Workers, managers and health and safety professionals contributed to the documentation of the problem and to the proposal of possible solutions. METHODS: Ergonomic work analysis focusing on real work activity, as well as interviews with individual or groups of stakeholders, were conducted. RESULTS: This research revealed that political-economic factors gradually contributed to: 1) an increasing work load; 2) growing fatigue throughout the day, increasing the workers' vulnerability to incidents and accidents and their tendency to react inappropriately to violence experienced on the street; and 3) excessive individual responsibility to manage dangerous situations. CONCLUSIONS: Recommendations to ameliorate the situation are proposed. These suggestions are discussed in terms of feasibility given the impact of macro social factors upon micro work activity, and the associated potential expansion of the ergonomist's role.

[Psychiatric institutions and communities: a study of the demand for mental health care in the State of São Paulo, Brazil] / Instituições psiquiátricas e comunidades: um estudo de demanda em saúde mental no Estado de São Paulo, Brasil.

Psychiatric hospitals have been accused of being both ineffective institutions and the main parties responsible for the chronic status of the mentally ill. However, there is a lack of research on the influence of mental health care facilities on either the communities in which they are located or the nearby out-patient services. Their presence may be a cause for increased psychiatric demand. This study investigates a possible association between the existence of such hospitals in given communities and an increase in hospitalization and demand for primary care services. The author compares the demand and client profile of out-patient services in similar communities, both with and without psychiatric hospitals Some evidence was found that in communities with such hospitals there is an increase in both hospital admittance and consultations in mental health care.