O Genograma para compreensão do processo migratório de famílias em vulnerabilidade social / The Genogram for understanding the migratory process of families in social vulnerability / El Genograma para comprender el proceso migratorio de familias en vulnerabilidad social

O Trabalho Social com Famílias realizado no Sistema Único de Assistência Social (SUAS) abarca vários desafios. Um deles é a utilização de instrumentos adequados que possibilitem uma compreensão mais abrangente sobre a construção do sujeito, das desigualdades incidentes sobre ele, das estratégias de enfrentamento de vulnerabilidade e a contextualização desse processo em relação ao território em que vive. O objetivo deste artigo é apresentar, a partir de um relato de experiência, diferentes possibilidades de uso do genograma no trabalho social com famílias em situação de vulnerabilidade em contexto de migração. O genograma mostrou-se um instrumento importante para a compreensão da construção dos vínculos sociais no processo migratório. Este recurso possibilitou tanto para as profissionais quanto às famílias o entendimento da história de vida, da dinâmica de migração, da estrutura de desigualdades que motivam o fluxo migratório e das estratégias de sobrevivência vivenciadas pelas famílias diante das situações de exclusão social.

The Social Work with Families performed under the Unique System of Social Assistance (SUAS) covers various challenges. One of them is the use of appropriate instruments that allow a more comprehensive understanding of the subjects' construction, the inequalities that affect them, the strategies to face vulnerability and the contextualization of this process in relation to the territory in which they live. This article's aim is to present, based on an experience report, different possibilities of using the genogram in social work with families in situations of vulnerability in the context of migration. The genogram proved to be an important tool for understanding building social bonds in the migratory process. This resource made it possible for both professionals and families to understand life stories, migration dynamics, the structure of inequalities that motivate the migratory flow and the survival strategies experienced by families in the face of social exclusion.

El Trabajo Social con Familias del Sistema Único de Asistencia Social (SUAS) engloba varios desafíos. Uno de ellos es el uso de instrumentos adecuados para una comprensión más integral de la construcción del sujeto, las desigualdades que lo afectan, las estrategias para enfrentar la vulnerabilidad y la contextualización de este proceso en relación al territorio en el que vive. El objetivo de este artículo es presentar, a partir de un relato de experiencia, diferentes posibilidades de uso del genograma en trabajo social con familias en vulnerabilidad en el contexto de migración. El genograma resultó ser una herramienta importante para comprender la construcción de vínculos sociales en el proceso migratorio. Este recurso permitió, tanto a los profesionales como a las familias, conocer su historia de vida, la dinámica migratoria, la estructura de las desigualdades que motivan el flujo migratorio y las estrategias de supervivencia que enfrentan las familias ante la exclusión social.

From early detection to rehabilitation in the community: reading beyond the blog testimonies of survivors' quality of life and prostate cancer representation.

BACKGROUND: Survivors' testimonies can reveal much about men's experiences of prostate cancer and impacts on their quality of life (QOL) during the clinical trajectory of the disease. These survivors' shared thoughts and views were hypothesized to reflect salient features of their lived social representation of prostate cancer. CONTEXT: We explored the content of testimonies posted by men to a public blog hosted by a French national prostate cancer patients' association. The study question, "What do French bloggers' testimonies reveal about their lived experiences with prostate cancer, especially regarding their quality of life in community settings, that underpin their social representation of prostate cancer?" guided the exploration and analysis of the textual data. The aims were to better understand men's experiences and predominant thoughts and views, to elucidate patients' behaviours, and to enlighten medical policy and practice. PURPOSE: Explore issues of QOL as reported by French prostate cancer survivors in a public blog by: (a) identifying the salient aspects and issues of the experience of living with prostate cancer from the perspective of survivors; and (b) analyzing the content in the posted testimonies regarding perceived and lived impacts of prostate cancer on QOL. METHODS: A critical ethnographic study guided the selection of textual data from 196 male bloggers' testimonies about prostate cancer posted in the period from 2008 to 2013. Media content analysis method was undertaken on blog testimonies, framed by a multidimensional conceptual framework of QOL. RESULTS: Testimonies focused mainly on medical care and rehabilitation, recovery, health education and self-care, as well as on a global vision of prostate cancer and its impacts on personal views of manhood and masculinity. The language used indicated that political, educative and compassionate discourses were intertwined to create a complex representation of the experience and effects of prostate cancer; this multi-faceted representation can inform the public and professional debate about men's capacity to provide emotional support and problem-solve within a community of interest. CONCLUSION: Findings, while based on data limited to mostly one-time entries to a French blog, contribute to understanding a unique, collective expression of men's lived experiences of prostate cancer. These anonymous survivors shared their varied reactions, ways of coping, and thoughts on needed change.

[Nursing in prison: inmates as patients]. / La pratique infirmière en milieu carcéral: des détenus pour patients.

There are very few studies investigating the work nurses do in prisons. Based on data stemming from a research in Psychodynamics of Work and a literature review, this paper describes nursing practices in a Canadian penitentiary institution. Three male nurses and two female nurses participated in three two-hour long focus group sessions. Central sources of pleasure that emerged from the focus groups were the scope of nursing care practice ; the autonomy and collaboration with physicians; nursing care practices devoid of moral value judgments, the humanitarian approach, caring and the wish to make a difference in the lives of the inmates ; the pride connected to this unusual professional context, and the recognition by peers and inmates. The main sources of suffering on the other hand were the feeling that rehabilitation was more an ideal than reality ; the paradox of providing both care and safety ; the scary characteristics of working alone ; the fear of lawsuits, and the feeling of being observed continuously. The resulting data we discuss show the issues of a certain dissociation that exists between the patient and the inmate, the fear of contamination of a healthcare nursing identity by the place of practice, but also the feeling of plenitude and sublimation. The conclusion stresses the tension that exists between security and caring, distance and proximity.

[Of Brazil and Quebec, food for thought: Brazilian community health workers bridge the gap between families and health professionals]. / Du Brésil au Québec, quelques éléments de réflexion: les agents communautaires de santé brésiliens font le pont entre les families et les professionnels de la santé.

The Brazilian unified health system consists of 27,000 family health teams with a network of approximately 300,000 community health agents whose mandate is to link the families they visit every month with health professionals at the family health unit. Since 2003, Quebec has been implementing its health and social services reforms by emphasizing the integration of care and services (public, associative and private) in local networks which have a formal population health responsibility. This commentary aims to underline some similarities and differences between the program of the Brazilian 'units of family health' and that of integrated network clinics (CRI) or Groups of family medicine (GMF) in Quebec. In both cases, a major concern is to organize primary care services in as close proximity as possible to the population of a given territory, and to improve accessibility and adequacy of services. In addition, through these community health agents, Brazil enables the creation of a social security network that assures an effective follow-up of all members of the population with regard to health services.

[Paradoxical situation in the organization of work: a threat for workers' mental health]. / Situation paradoxale dans l'organisation du travail: une menace pour la santé mentale des travailleurs.

For the past decades, in a world of high competition, firms struggle to regain an advantage over foreign competition. Thus, new management trends, usually based on price reduction, high quality products and speed production are now part of strategic reorganization plans of high impact on work organization particularly in terms of large demands put on workers, and take a heavy toll on workers. Thus the incidence of mental health problems in the work place has risen sharply in recent years and currently counts as one of the leading causes of work absenteeism. A study based on the psychodynamic of work was conducted among machine operators working in a high-technology company in the aviation sector. Important management and technological transformations were recently introduced in the factory. The content analysis of the study shows that the work organization places the operator in a double bind situation. They are caught between an injunction where the capacity of making a high quality product is directly opposed to that demanding speed production. Moreover, severe and arbitrary sanctions are applied when the operators do not comply with either injunction. The operators are put in a deadlock situation that creates fear and anxiety. They are obliged to turn to defensive psychological strategies such as individualism and cheating. Those defensive strategies have negative impacts on social relationships.

[From deintegration to professional reintegration following a sick leave from work for a mental health problem]. / De la désinsertion à la réinsertion professionnelle à la suite d'un arrêt de travail pour un problème de santé mentale.

The aim of this study is to better understand the factors involved in the process of professional reintegration following an absence because of a mental health problems. The methodology is based on data collected from individual interviews with workers who were on a sick leave for reasons of mental health problems as certified by a medical diagnosis. The analysis of the path of people allows to better seize the articulation between events preceding the work interruption, the process of restoration of capacities and conditions favoring or hindering the return to work. This study allows to conceive the interruption of work and the process of restoration of capacities as a turning point between the process of deintegration and professional reintegration and build a model that encompasses the dynamic of the whole factors involved.