Profissionais de saúde idosos : contextos, significados e processos de produção de saúde e adoecimento no trabalho na Região 28 de Saúde do estado do Rio Grande do Sul.

Abstract

Human aging can be understood as the natural course of life, and these oldest old need to remain active in work spaces for ever-increasing intervals of time and, therefore, work represents, when in harmony with needs, belonging/social identity, walking towards the promotion of health and a healthy life. In turn, the work of the elderly in health is observed under different eyes when in relation to the capital market, because it is a living work, that is, there is only one product as long as there is an agent responsible for the action, a fact that, with As age advances, it is common for this professional's performance to decline, sometimes resulting in ageism. Under these conditions, the elderly are no longer perceived as transforming agents of the environment and are now considered as resources to perform tasks. Article I: From aging to new ways of working: contexts, meanings and production processes of health and illness in the work of elderly health professionals – Objective: to analyze contexts, meanings and processes of production of health and illness in the work of health professionals elderly, in view of the new configurations and demands of the world of work and society. Methodology: qualitative, exploratory, descriptive dialectical study, articulated in the 13 municipalities of Region 28 of Health in the state of RS, with 26 elderly professionals in the health area; seven municipal health managers; 13 work team representatives, from primary, secondary and tertiary care, and three class representatives, councils, work area institutions or unions. For data collection, semi structured interviews were used and the Content Analysis technique was applied to analyze them. Results: work plays a key role in the lives of these elderly workers, so that the relationships developed allow positive conditions for quality of life, belonging and social identity. When not well adjusted to the conditions of old age, the work environment can generate conditions of discomfort, which can stimulate sickening aspects. In turn, impacts can be caused to the mental health of these elderly workers when their termination is involuntary, while they consider the continuity of activities even in unfavorable conditions. Final considerations: work in the field of health is capable of generating aspects that promote health for elderly workers when in conditions and well adjusted to needs. Staying in work activities after old age is a choice that needs to be observed under the singularities of the subjects, and the work scenario needs to be in line with the new conformation of the workforce. Article II: Old age under the lens of Normal and Pathological: aspects that encourage the health disease process in elderly health workers – Objective: to investigate the meanings produced in the speeches of these subjects about the possible relationships between the health-disease process and the health work scenario from the normal and pathological perspectives. Methodology: a qualitative, exploratory, dialectical descriptive study, developed in the 13 municipalities of Region 28 of Health in the state of RS, in primary, secondary and tertiary health care units. With 26 senior health professionals; seven municipal health managers; 13 work team representatives; and, three class representatives, councils, institutions in the area of work or unions. As a collection instrument, semi-structured interviews were used and for analysis, the idea association map technique was used. Results: two aspects could be observed, one of them mentions the working conditions capable of generating health for the elderly worker in the health area and the other still about the work influences that corroborate with the emergence of illness factors. As health factors, aspects of social belonging, environment adjusted to conditions and good relationships could be noted. Under former times, when poorly adjusted, they add to the factors that provide pathologizing ways of existing. Final considerations: being prepared for old age and the needs of work in the field of health, regardless of the factors present at the moment, intends on two positions: preparing the environment to welcome this elderly person and preparing to age under the new limitations and conditions of old age, so that the health-disease process can exist under the homeostasis that fosters quality of life at work. Article III: Context and meanings of work: a study on the 11 reality of elderly health professionals – Objective: to analyze the context and meanings of the work of elderly health professionals, given the new configurations of society and demands of the labor market. Methodology: descriptive exploratory qualitative study, developed in the health care network of the Municipality of Santa Cruz do Sul-RS. The study was composed of elderly health professionals, health managers and a representative of the Municipal Council for the Elderly (CMI). As a collection instrument: semi-structured interviews containing the sociodemographic and occupational profile and seven open questions. The study sample consisted of 20 subjects, 16 of whom were elderly health workers, three health managers and a representative of the CMI. Two subjects did not agree to participate in the study and 19 were on vacation or on leave. Results: three thematic categories emerge: “Elderly people: the context and meaning of health work”; “Labor market, inclusion and citizenship” and “Adaptations and changes in the work of the elderly in the health area”. As a result, the study pointed out that the inclusion of this elderly person in the work environment is the result of a range of factors that encourage and/or force the maintenance of an employment relationship, which many times comes from financial needs. Work can also be seen as something rewarding and that encourages them to continue living in harmony with life, family, society and the environment, bringing a feeling of happiness and well-being. However, it was evident that the worker suffers from different explicit and implicit prejudices, which are not identified as such, however, the impacts are perceived as factors arising from age and not from these costly labor relations. Final considerations: the wisdom of this context, from the point of view of the manager and the representative of the CMI, invites us to (re)think the ways in which this field of work is, or is not, prepared and proposed to receive and embrace this public and, although they have such explanations of the subjects were observed, no movements in that direction were evident. Article IV: The elderly and work in health: an integrative literature review – Introduction: the active aging of the population, as a consequence of the evolution of life expectancy, is associated with a greater permanence of the elderly in work activities. Objective: to identify reasons why the elderly remain in health work. Methodology: this is an integrative literature review, carried out in the Portal de Periódicos da Capes database. In this study, original and review articles were included, between the years 2011 to 2021, with the final sample consisting of nine articles. The Content Analysis proposed by Minayo and Bardin was used as a method, with two thematic categories being elaborated: Aspects that motivate and encourage the work of the elderly in health; and, Needs that influence the maintenance of work activities in elderly life. Of the studies found, the English language related to the work of the elderly in the field of health predominated. Results: the results pointed to the needs that make the elderly remain in work spaces, which are financial issues as a result of low social security values and the precariousness of public policies and actions aimed at the social inclusion of the elderly at work. Another factor explained in the face of data collection concerns the formation of bonds, social belonging and the aspects that culminate in health and disease processes and quality of life of this population. Final considerations: thus, it is evident that there are shortages of studies focusing on the work of the elderly in the health area, leaving gaps in the present study and at the same time allowing new research with this bias that corroborate with inclusive aspects and with the strengthening of this class. Article V: Cities and Communities Friendly to the Elderly: aspects that promote health and quality of life from the perspective of the objectives of sustainable development – Introduction: the aging process is considered heterogeneous from the individual and collective point of view. In this context, active aging stands out as an optimizer of health conditions, where cities and communities are responsible for providing a sustainable character in their services, scenarios and structures. Based on this, the concept of a Community-Friendly City for the Elderly emerges in order to benefit the potential of this population, seeking to highlight models that ensure healthy aging in all life conditions. Objective: to identify aspects and actions that promote health and quality 12 of life in Elderly-Friendly Cities and Communities, from the perspective of the Sustainable Development Goals. Methodology: an integrative literature review was carried out from 2005 to 2022, in the database of the Portal de Periódicos da Capes, with the terms “Sustainable Development”; "Health promotion"; “Aging” and “Quality of Life” and their peers in English. After selection criteria, 16 articles were used. Results: the findings had three aspects: accessibility, safety and inclusion; social participation; and, public policies. According to the findings of the present study, there is a divergent line between the speed of the aging process of the subjects and the social determinants of health and scenario in cities that aim to ensure the elderly population sustainable conditions for the aging process in a perspective with better quality of life conditions. Final considerations: therefore, the importance of preparing spaces and cities to embrace or maintain these elderly people in their entirety became evident. Article VI: Elderly health professionals: what factors foster and drive this public to remain in the job market after retirement? – Objectives: to analyze the discourses that promote the permanence of the elderly in health work after retirement. Methodology: qualitative exploratory descriptive study carried out in a city in the interior of the state of Rio Grande do Sul, with 16 health professionals aged 60 years or more, both working in Basic Health Units and in hospitals. Semi-structured interviews were used for data collection and Content Analysis was used for data analysis. Results: four positive aspects were highlighted regarding the maintenance of work activities in the health area, which concern issues of professional and personal satisfaction, cultivation of social relationships, maintenance of activities of daily living and the contribution to society. From another perspective, there were three negative points that, in a way, forced them to remain in the work activity, mainly related to economic needs, fear of loss of identity and desires for invisibility and social isolation. Final considerations: therefore, working gives them encouragement and quality of life, however, reasons arise that oblige them to remain in the work environment, to meet basic human needs and family economic conditions. E-book chapter: Aging and health work: context, challenges and possibilities – The growing number of elderly people encourages us to (re)think and observe the relationships developed by them in health work environments.