Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil.
Rev Saude Publica. 2010 Jun;44(3):520-7. doi: 10.1590/s0034-89102010005000011. Epub 2010 May 14.
To understand how Estratégia Saúde da Família (Family Health Strategy) nurses experience the overlapping of duties and building of technical autonomy.
This was a qualitative study performed with 22 nurses, in the city of Recife, Northeastern Brazil, between August 2005 and November 2006. Based on management evaluation (geographic access; conflicts in the team, between team and district and between team and community; and public violence in the area), four teams were selected in each of the six health districts. Semi-structured interviews were conducted. The main themes in the interview guide were about work expectations and relevance, its organization and process, and feelings towards these practices. The results were interpreted under the perspective of burnout.
The nurses' opinion on the excessive number of families, insufficient organizational support and pressures from user demands that had not been met was recurrent. Overlapping of health care and management caused work overload, creating anxiety, impotence, frustration and the feeling of being treated unfairly when tasks were divided among team members. The clinical dimension of practice led to a feeling of insecurity of a technical and ethical nature, in addition to the satisfaction for the power and prestige achieved by the professional category. Specialized medical training represented an obstacle to autonomy and responsibility becoming interdependent. Stress, dissatisfaction, becoming physically and mentally ill, recognition of the relevance of work and importance of one's performance, and low work involvement were reported.
In view of the lack of expectation of changes in the short term, the overlapping of low professional satisfaction and work overload causes negative attitudes, indicating the importance of health promotion to increase the possibility of influencing and changing work conditions.
了解 家庭健康策略（Family Health Strategy）护士如何体验职责重叠和技术自主的建立。
这是一项在巴西东北部累西腓市进行的定性研究，研究对象为 22 名护士，研究时间为 2005 年 8 月至 2006 年 11 月。基于管理评估（地理准入；团队内部、团队与区之间以及团队与社区之间的冲突；该地区的公共暴力），在每个六个卫生区中选择了四个团队。进行了半结构化访谈。访谈指南中的主要主题是关于工作期望和相关性、其组织和过程以及对这些实践的感受。结果从倦怠的角度进行解释。
护士们反复提到家庭数量过多、组织支持不足以及用户需求未得到满足的压力。医疗保健和管理的重叠导致工作负担过重，导致焦虑、无力、沮丧和不公平感，尤其是在团队成员之间分配任务时。实践的临床维度导致了技术和道德性质的不安全感，此外，专业类别所获得的权力和威望也带来了满足感。专门的医疗培训代表了自主权和责任的障碍，使两者相互依存。报告了压力、不满、身心疾病、对工作相关性和自身表现重要性的认识，以及工作投入度低等问题。
鉴于短期内对变革的期望不足，低专业满意度和工作负荷的重叠导致了消极的态度，这表明健康促进的重要性，以增加影响和改变工作条件的可能性。
