HIV prevention among gay and other men who have sex with men: public policy and social movements in Brazil, 1983-2019.

This article revisits the history of HIV prevention for gay and other men who have sex with men in relation to public health policy and the role of LGBT and AIDS-related social movements in Brazil. An interpretive study was undertaken informed by philosophical and phenomenological hermeneutics. It included interviews with policymakers, researchers and activists involved in HIV and AIDS, especially HIV prevention among gay and other men who have sex with men. Prevention initiatives were analysed with a focus on the social and programmatic aspects of vulnerability to HIV, and advances and setbacks in the Brazilian response to the epidemic. The recent crisis in HIV prevention triggered by a growing conservatism in Brazilian politics and the current government's LGBT-phobia pose barriers that compromise issues of profound importance with regards to policy on HIV and AIDS: namely, engagement with human rights and social participation.

[Historical aspects of the institutionalization of adolescent healthcare in the state of São Paulo, 1970-1990]. / Aspectos históricos da institucionalização da atenção à saúde do adolescente no estado de São Paulo, 1970-1990.

The article explores historical aspects of integral healthcare for adolescents in the state of São Paulo, particularly in regard to the implementation of pioneering services and programs. Against the backdrop of Brazil's social and political context during this period, it contextualizes the challenges, clashes, and difficulties that arose within the institutions involved in developing this field, from the perspectives of clinical medicine and of collective health. Grounded on documental material, the study re-examines the construction of groups of expertise and of the field of adolescent health care as part of the dialectical interplay between the construction of a new area of medical practice based on clinical work and a field of knowledge and practices in collective health based on integral health care of an interdisciplinary, inter-sectoral nature.

Health and human rights: Contributions of hermeneutics to a necessary dialogue.

The relationship between health and human rights has gained growing importance, whether in activist agendas or in governments strategies to face the challenging scenarios of global public health. However, there are important gaps to be filled so that the articulation between these two fields develops its full potential, and the question of knowledge plays a key role in this regard. This study aims at examining the possibilities and challenges of integrating a human rights perspective into the construction and validation of health knowledge, based on the contribution of authors from various theoretical traditions that have discussed the so-called 'hermeneutic turn' in contemporary philosophy and science. The thesis developed is that recognizing the place of hermeneutics in human rationality and its consequences for understanding various forms of knowledge and their respective practical meanings is a fundamental step towards an effective articulation between the fields of health and human rights. I argue that the hermeneutic rescue of the value of practical reason can enhance emancipatory reconstructions in the exercise of cognitive-instrumental rationality in the field of health.

Nurses and health care for gay adolescents.

OBJECTIVE: to analyze nurses' statements about health care for gay adolescents. METHOD: qualitative study, anchored on the Thematic Analysis of Clarke and Braun, with adoption of Symbolic Interactionism as a theoretical framework, since it favors the understanding of the relationship between behaviors, interactions, and social meanings. Twelve nurses recruited using the snowball sampling technique were remotely interviewed via the Google Meet® video-conferencing app. RESULTS: four themes were elaborated throughout the comprehensive-interpretative process: "Gay adolescents, agendas, and relation with health;" "The gay adolescent's family and care;" "Relationship with gay adolescents in care," and "Limits to nursing care for gay adolescents." CONCLUSION: the statements denounce stigmas and symbols derived from cisheteronormativity as intervening in the relationship and indicate the urgency of investing in the intersubjective encounter with gay adolescents and their families in a horizontal, affective, and empathic relationship, with chances of favoring public defense of the right to health. There are comments on the nurses' attitude and qualification of care for this population. KEYPOINTS: (1) Tendency towards "de-subjectifying" objectification in health practices. (2) Hegemony of cisheteronormative logic as a limitation to care. (3) Sex and sexually transmitted infections (STIs) as stigmas attached to gay adolescents. (4) Family and health care for homosexual adolescents: opportunities and obstacles. (5) The limits and powers of nursing to enable equity in care for gay adolescents.

Older adult health and primary care: autonomy, vulnerabilities and challenges of care.

OBJECTIVE: To understand the relations between autonomy and health-disease-care processes of older adults in the daily life of primary health care. METHODS: Qualitative research developed in 2019, in a primary health unit in the central region of the city of São Paulo, using participant observation and in-depth interviews with 16 health professionals and 8 older adults. The construction and interpretation of the narratives produced in the study were guided by the perspective of Gadamer's philosophical hermeneutics and Ricoeur's theory of interpretation. The theoretical framework of vulnerability/Careᵃ, as proposed by Ayres, guided the definition of the study and interpretative categories. RESULTS: Closely related to the difficulties, facilities and strategies to cope with the daily challenges in the health care of older adults, autonomy was an important marker of vulnerability (interpersonal, social and programmatic), indicating areas that require special attention, such as drug dispensing, urban mobility, social isolation, financial frailties and adequacy of service routines. CONCLUSION: Distinctly from an individual attribute, autonomy has proved to be the expression of relational characteristics, requiring plural and flexible practical-moral strategies, techniques and horizons, although always guided by the same ethical commitment to respect the singular needs of individuals.

Nursing and hospitalized high-risk pregnant women: challenges for comprehensive care.

OBJECTIVE: To analyze the interactions between nursing and hospitalized high-risk pregnant women regarding the possibilities and limits of providing care guided by the principle of comprehensiveness. METHOD: A qualitative study based on the conceptual framework of comprehensiveness and developed from the precepts of thematic content analysis. Data were collected through open interviews and observation of the care scenario of twelve nursing professionals with hospitalized high-risk pregnant women. RESULTS: Twelve (12) nursing professionals participated in the study. Nursing practices are portrayed from two thematic categories: "Embracement: emotional and informational support" and "Assessing and monitoring gestational risk". The findings revealed intentions to embrace women, providing informal and emotional support, but under weaknesses in intersubjective relationships. There is an emphasis on "technical success", not always sufficiently articulated with "practical success" in care actions, with harm to achieving comprehensiveness. CONCLUSION: The findings revealed that an emphasis on the biomedical management of obstetric risk and structural and organizational limitations of work end up hindering incorporating into daily care the concerns and knowledge necessary for constructing its comprehensiveness.

A Saúde Coletiva e suas áreas: territórios ou aldeamentos? / Public health and its areas: territories or villagization? / La Salud Colectiva y sus áreas: ¿Territorios o asentamientos?

A progressiva conformação de áreas específicas de conhecimento e prática no interior do campo da Saúde Coletiva brasileira tem desafiado sua unidade e sua identidade enquanto tal. Como compreender o movimento centrífugo de diferenciação dessas áreas desde sua origem comum? Como resgatar uma identidade de campo e criar sinergias entre as áreas? O presente ensaio busca refletir sobre essas questões tomando por base aportes teórico-filosóficos da hermenêutica contemporânea (Gadamer, Ricoeur, Habermas). Critica-se a noção de territorialidade epistemológica e, recorrendo a uma identidade normativo-proposicional oriunda da facticidade do social na saúde, propõe-se a noção de "aldeamento" para (re)construir a unidade do campo em sua pluralidade, indicando-se alguns movimentos com potencial de estimular esse processo.(AU)

The progressive configuration of specific areas of knowledge and practice within the field of public health in Brazil poses a challenge for the maintenance of the field's identity and unity. How can we understand the centrifugal movement of the differentiation of these areas away from their common origin? How can we restore the identity of the field and create synergies between areas? This essay reflects on these issues drawing on the theoretical and philosophical contributions of contemporary hermeneutics (Gadamer, Ricoeur, Habermas). We provide a critique of the notion of epistemological territoriality and, utilizing a normative and propositional identity derived from the facticity of the social in health, we propose the notion of "villagization" to (re)construct field unity in its plurality, indicating some movements that have the potential to stimulate this process.(AU)

La progresiva conformación de áreas específicas de conocimiento y práctica en el interior del campo de la Salud Colectiva brasileña ha desafiado su unidad y su identidad como tal. ¿Cómo comprender el movimiento centrífugo de diferenciación de estas áreas desde su origen común?. ¿Cómo rescatar una identidad de campo y crear sinergias entre las áreas?. Este ensayo busca reflexionar sobre esas cuestiones, utilizando como base contribuciones teórico-filosóficas de la hermenéutica contemporánea (Gadamer, Ricoeur, Habermas). Se critica la noción de territorialidad epistemológica y, recurriendo a una identidad normativo-propositiva proveniente de la facticidad de lo social en la salud, se propone la noción de "asentamiento" para (re)construir la unidad del campo en su pluralidad, indicándose algunos movimientos con potencial para incentivar ese proceso.(AU)

[Black and non-Black women and vulnerability to HIV/AIDS in São Paulo, Brazil]. / Mulheres negras e não-negras e vulnerabilidade ao HIV/Aids no estado de São Paulo, Brasil.

OBJECTIVE: To analyze the characteristics related to individual vulnerability among HIV seropositive women, according to skin color. METHODS: A multicenter study carried out between 1999 and 2000 in health services specialized in STI/Aids in the state of São Paulo, involving 1,068 women living with HIV who are aged 18 or above. Sociodemographic data and characteristics relating to infection and healthcare were obtained by means of individual interviews based on standardized questionnaire. The variable race/color was self-reported and women who referred to themselves as black or mixed-race were grouped together as black. The definition of variables by race/color was done using central tendency and proportions, and an association analysis using the chi2 Pearson test. RESULTS: The differences between black and non-black women were statistically significant with regards to: schooling; monthly, individual and family income per capita; number of direct dependents; opportunities to see a nutritionist, gynecologist or other medical professional; understanding what the infectologist said; speaking with the infectologist or gynecologist about her sex life; having correct knowledge about CD4 exams and viral load; the sexual means of exposure. CONCLUSIONS: The use of race/color as an analytical category provides opportunities to understand better how social interactions, in the context of gender and socioeconomic conditions, create and recreate disadvantages for black women and their exposure to health risks, and also impose limits on the way they use of resources for their healthcare.

Interdisciplinaridade, interprofissionalidade e diversidade racial na formação antirracista do profissional de saúde: vozes e aprendizados / Interdisciplinarity, interprofessionality, and racial diversity in the anti-racist training of health professionals: voices and learnings

RESUMO Trata-se de relato crítico-reflexivo sobre a experiência de disciplina optativa voltada à formação de profissionais da saúde no combate ao racismo, oferecida aos estudantes de graduação da área de saúde na Universidade de São Paulo, durante a pandemia de Covid-19. A partir da descrição e da reflexão sobre as atividades de ensino e avaliação propostas, buscou-se reconhecer e apre(e)nder a contribuição da integração de saberes (interdisciplinaridade), de profissões (interprofissionalidade) e da diversidade racial no processo ensino-aprendizagem voltado ao combate ao racismo. São relatadas perspectivas de discentes, monitoras e docentes. A oferta da disciplina, com apoio de convidados, permitiu que o projeto abordasse o racismo e suas influências na saúde das pessoas negras e estimulou a produção cultural dos estudantes. A iniciativa mostrou-se uma possibilidade de introduzir mudanças na formação dos futuros profissionais de saúde em prol tanto da integralidade do cuidado quanto da colaboração interprofissional no combate ao racismo.

ABSTRACT This is a critical-reflective report on the experience of an elective course aimed at training health professionals in fighting racism. It was offered during the COVID-19 pandemic to undergraduate students from all the health subspecialties at the University of São Paulo. From the description and reflection on the proposed teaching and evaluation activities, we sought to recognize and learn/apprehend the contribution of the integration of knowledge (interdisciplinarity), professions (interprofessionality), and racial diversity in the teaching-learning process aimed at fighting racism. The perspectives of students, monitors, and teachers are reported. The support of guest teachers allowed this initiative to address racism and its influences on the health of black people, and the educational strategies encouraged students' cultural production. The initiative proved to be a possibility for introducing changes in health education in favor of both comprehensive care and interprofessional collaboration in dismantling racism.

Nurses and health care for gay adolescents / Enfermeiros diante do cuidado à saúde de adolescentes gays / Los enfermeros frente al cuidado de la salud de los adolescentes gays

Abstract Objective: to analyze nurses' statements about health care for gay adolescents. Method: qualitative study, anchored on the Thematic Analysis of Clarke and Braun, with adoption of Symbolic Interactionism as a theoretical framework, since it favors the understanding of the relationship between behaviors, interactions, and social meanings. Twelve nurses recruited using the snowball sampling technique were remotely interviewed via the Google Meet® video-conferencing app. Results: four themes were elaborated throughout the comprehensive-interpretative process: "Gay adolescents, agendas, and relation with health;" "The gay adolescent's family and care;" "Relationship with gay adolescents in care," and "Limits to nursing care for gay adolescents." Conclusion: the statements denounce stigmas and symbols derived from cisheteronormativity as intervening in the relationship and indicate the urgency of investing in the intersubjective encounter with gay adolescents and their families in a horizontal, affective, and empathic relationship, with chances of favoring public defense of the right to health. There are comments on the nurses' attitude and qualification of care for this population.

Resumo Objetivo: analisar narrativas de enfermeiros sobre o cuidado à saúde de adolescentes gays. Método: estudo qualitativo, ancorado na Análise Temática de Clarke e Braun, adotando como referencial teórico o Interacionismo Simbólico, uma vez que ele favorece a apreensão da relação de comportamentos, interações e significados sociais. Foram entrevistados remotamente 12 enfermeiros, recrutados a partir da técnica de bola de neve, por meio da plataforma de vídeo Google Meet ® . Resultados: ao longo do processo compreensivo-interpretativo, foram elaborados quatro temas: "Adolescente gay, pautas e relação com a saúde"; "A família do adolescente gay e o cuidado"; "Relação com adolescente gay no cuidado" e "Limites para o cuidar de enfermagem ao adolescente gay". Conclusão: as narrativas denunciam estigmas e símbolos derivados da cisheteronormatividade como intervenientes da relação e indicam premência de apostas no encontro intersubjetivo com os adolescentes gays e seus familiares em relação horizontal, afetiva e empática, com chances de favorecer defesa pública do direito à saúde. Há apontamentos para a atitude dos enfermeiros e qualificação do cuidado a essa população.

Resumen Objetivo: analizar los relatos de los enfermeros sobre el cuidado de la salud de los adolescentes gays. Método: estudio cualitativo, anclado en el Análisis Temático de Clarke y Braun, adoptando el Interaccionismo Simbólico como marco teórico, ya que favorece la aprehensión de la relación de comportamientos, interacciones y significados sociales. Fueron entrevistados remotamente 12 enfermeros, reclutados a partir de la técnica de bola de nieve, por medio de la plataforma de video Google Meet ® . Resultados: a lo largo del proceso comprensivo-interpretativo, se elaboraron cuatro temas: "Adolescente gay, pautas y relación con la salud"; "La familia del adolescente gay y el cuidado"; "Relación con adolescente gay en el cuidado" y "Límites para el cuidado de enfermería al adolescente gay". Conclusión: las narrativas denuncian los estigmas y símbolos derivados de la cisheteronormatividad como intervinientes de la relación e indican la urgencia de apuestas en el encuentro intersubjetivo con los adolescentes gays y sus familiares en relación horizontal, afectiva y empática, con posibilidades de favorecer la defensa pública del derecho a la salud. Hay apuntes para la actitud de los enfermeros y calificación del cuidado a esa población.

["You learn, we teach"? Questioning relations between education and health from the perspective of vulnerability]. / "Você aprende. A gente ensina?" Interrogando relações entre educação e saúde desde a perspectiva da vulnerabilidade.

This article explores the meanings associated with the motto used in a World No-Tobacco Day campaign to stimulate a discussion of the principal underlying messages in the field of health education in Brazil. The study focuses on the concept of vulnerability to contextualize and explore its interfaces with education in order to highlight the theoretical, practical, and political productivity of the link between health education and studies on vulnerability. In conclusion, the necessary renewal of health practices in general and health education practices in particular can benefit tremendously from the vulnerability reference, to the extent that it demarcates a new horizon for situating and linking risks, "causalities", and "determinations", drawing health--as well as the possibility of illness--into the field of real life, into the world of inter-subjective relations, where these processes gain unique meanings.

[Comprehensiveness and healthcare technologies: a narrative on conceptual contributions to the construction of the comprehensiveness principle in the Brazilian Unified National Health System]. / Integralidade e tecnologias de atenção à saúde: uma narrativa sobre contribuições conceituais à construção do princípio da integralidade no SUS.

Comprehensiveness is the most challenging principle for building health reform in the Brazilian Unified National Health System (SUS). This study aims to identify critical moments in the conceptual debate on comprehensiveness and its contributions to reflection on healthcare technologies in the SUS. The essay addresses some conceptual constructs that approach comprehensiveness as an underlying principle in health programs and actions at various levels and in various dimensions of the healthcare organization - from intersubjective interactions to the organization of regional networks. The study was based on a non-systematic literature review on comprehensiveness and related themes in the Brazilian public health field in the last five decades. The study proposed a chronology/typology spanning the 1960s to the 2010s, divided into four significant periods or categories. The narrative is not intended to be exhaustive, but to build a comprehensive reference base capable of contributing to analyses, assessments, and debates on healthcare organization in the SUS according to the comprehensiveness principle.

Older adult health and primary care: autonomy, vulnerabilities and challenges of care / Saúde do idoso e atenção primária: autonomia, vulnerabilidades e os desafios do cuidado

ABSTRACT OBJECTIVE: To understand the relations between autonomy and health-disease-care processes of older adults in the daily life of primary health care. METHODS: Qualitative research developed in 2019, in a primary health unit in the central region of the city of São Paulo, using participant observation and in-depth interviews with 16 health professionals and 8 older adults. The construction and interpretation of the narratives produced in the study were guided by the perspective of Gadamer's philosophical hermeneutics and Ricoeur's theory of interpretation. The theoretical framework of vulnerability/Careᵃ, as proposed by Ayres, guided the definition of the study and interpretative categories. RESULTS: Closely related to the difficulties, facilities and strategies to cope with the daily challenges in the health care of older adults, autonomy was an important marker of vulnerability (interpersonal, social and programmatic), indicating areas that require special attention, such as drug dispensing, urban mobility, social isolation, financial frailties and adequacy of service routines. CONCLUSION: Distinctly from an individual attribute, autonomy has proved to be the expression of relational characteristics, requiring plural and flexible practical-moral strategies, techniques and horizons, although always guided by the same ethical commitment to respect the singular needs of individuals.

RESUMO OBJETIVO: Compreender as relações entre a autonomia e processos de saúde-doença-cuidado do idoso no cotidiano da atenção primária à saúde. MÉTODOS: Investigação qualitativa desenvolvida em 2019, em uma unidade básica de saúde da região central da cidade de São Paulo, utilizando observação participante e entrevistas em profundidade com 16 profissionais de saúde e 8 idosos. A construção e interpretação das narrativas produzidas no estudo foram orientadas pela perspectiva da hermenêutica filosófica de Gadamer e a teoria da interpretação de Ricoeur. O quadro teórico da vulnerabilidade/Cuidadoᵃ, tal como proposto por Ayres, orientou a definição do desenho do estudo e das categorias interpretativas. RESULTADOS: Estreitamente relacionada às dificuldades, facilidades e estratégias de enfrentamento dos desafios diários na atenção à saúde do idoso, a autonomia mostrou-se um importante marcador de vulnerabilidade (interpessoal, social e programática), indicando áreas que requerem atenção especial, como dispensação de medicamentos, mobilidade urbana, isolamento social, fragilidades financeiras e adequação das rotinas dos serviços. CONCLUSÃO: Distintamente de um atributo individual, a autonomia revelou-se expressão de características relacionais, exigindo estratégias, técnicas e horizontes prático-morais plurais e flexíveis, embora sempre orientados pelo mesmo compromisso ético de respeito às necessidades singulares dos indivíduos.

Ricardo Bruno: history, social processes and health practices.

This essay has the objective of revisiting the intellectual output of Ricardo Bruno Mendes-Gonçalves (1946-1996), Professor of the Department of Preventive Medicine of the Faculty of Medicine of the University of São Paulo and one of the theoreticians who participated in the construction of the field of Brazilian Collective Health during the years 1970-1990. On the basis of brief biographical and bibliographical information, as well as relevant aspects regarding the historical context in which his output is located, I examine the principal works of the author, their effects on the lines of investigation of investigation of his students and his legacy of contributions and challenges for Collective Health. I highlight the genesis and development of his Theory of the Health Work Process and its impact on the understanding and empirical investigation of the socio-historical dimensions of health practices and on the reconstruction of knowledge and technologies in the context of the Brazilian Health Sector Reform. In particular, I highlight his concern with the ethical perspective of academic praxis and in this sense, with hope as a human value which is historically objectified and intersubjectively constructed.

Mother recognition in the Neonatal Intensive Care Unit.

OBJECTIVE: analyze the maternal experience in a neonatal intensive care unit, focusing on relations of recognition. METHOD: a qualitative study, built on the perspective of Gadamer's hermeneutics, based on Honneth's concept of recognition. In-depth interviews were conducted with 10 mothers of children admitted to a neonatal intensive care unit. RESULTS: failures were reported in the process of mother recognition in the unit, with consequent feelings of insecurity and obligation to child care, resulting in fragility of self-esteem. CONCLUSION: interactions with health professionals in the NICU and its standards and protocols cause vulnerabilities and affect maternal recognition and autonomy.

Nursing and hospitalized high-risk pregnant women: challenges for comprehensive care / Enfermería y gestantes de alto riesgo hospitalizadas: desafíos para integralidad del cuidado / Enfermagem e gestantes de alto risco hospitalizadas: desafios para integralidade do cuidado

Abstract Objective: To analyze the interactions between nursing and hospitalized high-risk pregnant women regarding the possibilities and limits of providing care guided by the principle of comprehensiveness. Method: A qualitative study based on the conceptual framework of comprehensiveness and developed from the precepts of thematic content analysis. Data were collected through open interviews and observation of the care scenario of twelve nursing professionals with hospitalized high-risk pregnant women. Results: Twelve (12) nursing professionals participated in the study. Nursing practices are portrayed from two thematic categories: "Embracement: emotional and informational support" and "Assessing and monitoring gestational risk". The findings revealed intentions to embrace women, providing informal and emotional support, but under weaknesses in intersubjective relationships. There is an emphasis on "technical success", not always sufficiently articulated with "practical success" in care actions, with harm to achieving comprehensiveness. Conclusion: The findings revealed that an emphasis on the biomedical management of obstetric risk and structural and organizational limitations of work end up hindering incorporating into daily care the concerns and knowledge necessary for constructing its comprehensiveness.

Resumen Objetivo: Analizar las interacciones entre enfermería y gestantes de alto riesgo hospitalizadas en cuanto a las posibilidades y límites de realización de un cuidado orientado por el principio de la integralidad. Método: Estudio cualitativo, fundado en la base conceptual de la integralidad y desarrollado a partir de preceptos del análisis de contenido temático. La recolección de datos se dio mediante entrevistas abiertas y observación de la escena asistencial de doce profesionales de enfermería junto a gestantes de alto riesgo hospitalizadas. Resultados: Participaron en el estudio 12 profesionales de enfermería. La prácticas de enfermería están retratadas mediante dos categorías temáticas: "Acogida: apoyo emotivo e informativo" y "Evaluación y monitoreo del riesgo gestacional". Los hallazgos revelaron intenciones de acoger a la mujer, brindando soporte informal y emotivo, sin embargo bajo fragilidades en las relaciones intersubjetivas. Existe una énfasis en el "éxito técnico", no siempre articulado lo bastante con el "éxito práctico" en las acciones de cuidado, con perjuicios para el alcance de la integralidad. Conclusión: Los hallazgos desvelaron que el énfasis en el manejo biomédico del riesgo obstétrico y limitaciones estructurales y organizativas del trabajo terminan por dificultar la incorporación al cotidiano del cuidado de preocupaciones y saberes necesarios a la construcción de su integralidad.

Resumo Objetivo: Analisar as interações entre enfermagem e gestantes de alto risco hospitalizadas quanto às possibilidades e limites de realização de um cuidado orientado pelo princípio da integralidade. Método: Estudo qualitativo, fundamentado na base conceitual da integralidade e desenvolvido a partir dos preceitos da análise de conteúdo temática. A coleta dos dados se deu através de entrevistas abertas e observação da cena assistencial de doze profissionais de enfermagem junto a gestantes de alto risco hospitalizadas. Resultados: Participaram do estudo 12 profissionais de enfermagem. As práticas de enfermagem estão retratadas a partir de duas categorias temáticas: "Acolhimento: apoio emocional e informacional" e "Avaliação e monitoramento do risco gestacional". Os achados revelaram intenções de acolher a mulher, provendo suporte informal e emocional, contudo sob fragilidades nas relações intersubjetivas. Há uma ênfase no "êxito técnico", nem sempre suficientemente articulado ao "sucesso prático" nas ações de cuidado, com prejuízos para o alcance da integralidade. Conclusão: Os achados revelaram que a ênfase no manejo biomédico do risco obstétrico e limitações estruturais e organizacionais do trabalho acabam por dificultar a incorporação ao cotidiano do cuidado de preocupações e saberes necessários à construção de sua integralidade.

[Conceptions and typology of conflicts between workers and managers in the context of primary healthcare in the Brazilian Unified National Health System (SUS)]. / Concepções e tipologia de conflitos entre trabalhadores e gerentes no contexto da atenção básica no Sistema Único de Saúde (SUS).

This study aimed to analyze perceptions of conflict between workers and managers in primary healthcare units and to present a typology of conflicts on the job. This was a comprehensive interpretive case study with a critical hermeneutic approach. Data collection techniques included: focus group with managers, workplace observation, and worker interviews, conducted from April to November 2011. The results were triangulated and indicated the coexistence of distinct concepts of conflict, typified in six modalities: lack of collaboration at work; disrespect resulting from asymmetrical relations between workers; problematic employee behavior; personal problems; asymmetry with other management levels; and inadequate work infrastructure. The relevance of (non)mutual recognition, as proposed by Axel Honneth, stood out in the interpretation of the causes and practical implications of these conflicts.