COMPETENCIES DEVELOPMENT, MENTAL HEALTH AND
WORK IN PRIMARY HEALTHCARE: A STUDY IN VITÓRIA-ES

Name: LEONARDO ALEXANDRINO DE ALMEIDA

Publication date: 01/02/2023
Advisor:

Name	Role
MÔNICA DE FÁTIMA BIANCO	Advisor *

Examining board:

Name	Role
ALFREDO RODRIGUES LEITE DA SILVA	Internal Examiner *
MÔNICA DE FÁTIMA BIANCO	Advisor *
RUBENS DE ARAÚJO AMARO	Internal Examiner *
THIAGO DRUMOND MORAES	Co advisor *

Summary: The present doctoral thesis aimed to analyze the development of competencies of primary healthcare professionals to identify the relationships between mental health and work. To achieve this, it was investigated how the theme is addressed in official documents and among managers and health professionals in the municipality of Vitória, ES, articulating contributions from the interpretative approach to the notion of competency and the Theory of Social Representations. The theoretical support of the research is anchored mainly in a contextual approach to competencies and competencies development, as well as discussions about occupational health, WRMH and continuing education in health. This study adopted a qualitative research approach. Both triangulation of sources of evidence and triangulation of methods or techniques were used in the methodological path. Initially, research was carried out on official documents from the Municipal Health Secretariat (SEMUS) of Vitória-ES. Semi-structured interviews were conducted with professionals who held management positions in SEMUS and with professionals who worked in two Basic Health Units (BHU) of the municipality. The documentary research was analyzed using the lexical analysis technique with support from IRAMUTEQ software, and the interviews were analyzed using content analysis with a posteriori categorization. The results of the documentary research indicate that: work is neglected as a determinant of health but recognized as a space for the development of professional competencies; there is a need for greater emphasis on work as a social determinant of health to strengthen and promote worker health practices at the municipal level. In the interviews with management positions, it was found that: there were different representations of competencies and SMRT among the interviewees; active methodologies were used for the development of competencies; and there were limitations to the development and mobilization of competencies in WRMH due to the managers` social representations and lack of work process transformations. The absence of the WRMH theme in ongoing devices and work processes potentiates difficulties in this area. In the research with BHU professionals, it was found that: there is little insertion of the WRMH theme in primary care, lack of integration among sectors and professionals, some actions are developed in an interdisciplinary way and the competence development strategies promote interdisciplinarity, but do not address the mental health of workers. From these results, we conclude that there is a need for explicit insertion of work as a determinant of health in the official documents of the municipality in order to guide the action of health professionals to consider the work processes of health system users in their daily care; there is a need to develop actions that favor the understanding of health processes in a broad way, the perception of WRMH as a collective responsibility, the untying of the notion of competencies exclusively to individual attributes, and the elaboration of protocols and instruments to investigate the causal link between mental health and work. Interdisciplinary work contributes to the development of professionals` competencies. However, the conception of competence linked to the professional category, the influence of disciplinary training, and the scarcity of financial and personnel resources make it difficult to take advantage of this contribution, notably for the approach of WRMH, which is seen as the responsibility of specialized areas of occupational health or mental health.

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