Componente curricular projeto de vida: perspectivas de professoras da rede estadual de São Paulo / Curricular component life purpose: perspectives of teachers of the São Paulo state network / Componente curricular proyecto de vida: perspectivas de profesores de la red estadual de São Paulo

O objetivo deste estudo foi conhecer a experiência de alguns professores ao lecionar projeto de vida durante a implementação do componente curricular Projeto de Vida no estado de São Paulo. Realizou-se uma pesquisa qualitativa, de caráter exploratório. Participaram do estudo sete professoras que lecionavam o componente curricular Projeto de Vida em duas escolas públicas, de uma cidade do interior do estado de São Paulo, escolhidas por conveniência. Foram utilizados o Questionário de Dados Sociodemográficos e o Protocolo de Entrevista Semiestruturada para Projeto de Vida de Professores, elaborados para este estudo. As professoras foram entrevistadas individualmente, on-line, e as entrevistas foram gravadas em áudio e vídeo. Os dados foram analisados por meio de análise temática. Os resultados indicaram possibilidades e desafios em relação à implementação do componente curricular Projeto de Vida. Constatou- se que a maioria das docentes afirmou que escolheu esse componente curricular devido à necessidade de atingir a carga horária exigida na rede estadual. As professoras criticaram a proposta, os conteúdos e os materiais desse componente curricular. As críticas apresentadas pelas professoras estão em consonância com aquelas presentes na literatura em relação à reforma do Ensino Médio e ao Inova Educação. Esses resultados sugerem a necessidade de formação tanto nos cursos de licenciatura quanto em ações de formação continuada, para que os professores se sintam mais seguros e preparados para lecionar o componente curricular Projeto de Vida na Educação Básica. Propõe-se uma perspectiva de formação pautada na reflexão e na troca entre os pares para a construção de um projeto coletivo da escola para o componente Projeto de Vida.(AU)

This study aimed to know the experience of some teachers when teaching life purpose during the implementation of the curricular component "Life Purpose" (Projeto de Vida) in the state of São Paulo. A qualitative, exploratory research was carried out. Seven teachers who taught the curricular component "Life Purpose" (Projeto de Vida) in two public schools in a city in the inland state of São Paulo, chosen for convenience, participated in the study. The Sociodemographic Data Questionnaire and the Semi-structured Interview Protocol for Teachers' Life Purposes, developed for this study, were used. The teachers were interviewed individually, online, and the interviews were recorded in audio and video. Data were analyzed using thematic analysis. The results indicated possibilities and challenges regarding the implementation of the Life Purpose curricular component. It was found that most teachers chose this curricular component due to the need to reach the required workload in the state network. The teachers criticized the proposal, the contents and the materials of this curricular component. Teacher's critics are in line with the criticisms present in the literature regarding the reform of High School and Inova Educação. Therefore, training is essential, both in undergraduate courses and in continuing education actions, so that teachers can teach the curricular component Life Purpose in Basic Education. A training perspective based on reflection and exchange between peers is proposed for the construction of a collective school project for the Life Purpose component.(AU)

El objetivo de este estudio fue conocer la experiencia de algunos profesores al enseñar proyecto de vida durante la implementación del componente curricular Proyecto de Vida en el estado de São Paulo. Se realizó una investigación cualitativa, exploratoria. Participaron en el estudio siete profesores que impartían el componente curricular Proyecto de Vida en dos escuelas públicas en un municipio del estado de São Paulo, elegidos por conveniencia. Los instrumentos utilizados fueron el cuestionario de datos sociodemográficos y el protocolo de entrevista semiestructurada para proyectos de vida de profesores, desarrollados para este estudio. Las entrevistas a los profesores fueron en línea, de manera individual, y fueron grabadas en audio y video. Los datos se sometieron a un análisis temático. Los resultados indicaron posibilidades y desafíos en relación a la implementación del componente curricular Proyecto de Vida. La mayoría de los profesores declararon elegir este componente curricular por la necesidad de alcanzar la carga horaria requerida en la red estatal. Los profesionales criticaron la propuesta, los contenidos y los materiales de este componente curricular. Las críticas presentadas están en línea con las críticas presentes en la literatura respecto a la reforma de la educación básica e Inova Educação. Por lo tanto, la formación es fundamental, tanto en los cursos de grado como en las acciones de educación permanente, para que los profesores puedan impartir el componente curricular Proyecto de Vida en la educación básica. Se propone una formación basada en la reflexión y el intercambio entre pares para la construcción de un proyecto escolar colectivo en el componente Proyecto de Vida.(AU)

On Voluntariness in Wellness: Considering Organizational Health Contingent Incentives.

Some would argue that if taking an examination to receive an incentive is not mandatory, it's voluntary no matter the size of the monetary reward. Others have concerns with how often employers use the word "required" when communicating how employees can earn an incentive. This in spite of clear rules that indicate "health contingent" incentive designs (those based on health measures rather than on completing activities) are an either/or proposition. That is, you can either earn (this amount) by (achieving a clinical standard) or by (participating in or attaining an alternative standard). This editorial examines the merits and demerits of organizational health contingent use of incentives. It is posited that employers can best satisfy a voluntariness standard in their use of financial incentives in wellness programs when the use of incentives are well integrated into a measurably robust, organizational culture that visibly values health; and when all employees are well versed in the meaning of, and opportunities for, reasonable alternatives for earning an incentive. Concerns about the administrative burden behind this idea and other potential unintended consequences of including measures of a culture of health to meet a voluntariness standard are also presented.

Attention to nurses' rewarding - an interview study of registered nurses working in primary and private healthcare in Finland.

AIMS AND OBJECTIVES: To identify meaningful types of rewards and the consequences of rewards as expressed by Finnish registered nurses working in primary and private healthcare. BACKGROUND: Previous studies have found significant associations between nurses' rewards and both their commitment and job satisfaction. Furthermore, appropriate rewards can have beneficial effects on factors including workforce stability and occupational satisfaction that are highly important in times of nurse shortages. DESIGN: A cross-sectional, qualitative interview study. METHODS: Data were collected via individual semi-structured interviews (n = 20) with registered nurses working in Finland's primary and private healthcare, and subjected to qualitative content analysis. RESULTS: Six meaningful types of rewards were identified by the registered nurses: Financial compensation and benefits, Work-Life balance, Work content, Professional development, Recognition, and Supportive leadership. Rewards encouraged respondents to perform their work correctly and reinforced occupational satisfaction, but also caused feelings of envy and stress. CONCLUSIONS: It is essential to pay attention to nurses' preferences for particular rewards and to reward management. When designing effective reward systems for registered nurses, it is not sufficient to provide financial rewards alone, as various kinds of non-financial rewards are both meaningful and necessary. RELEVANCE TO CLINICAL PRACTICE: When trying to improve registered nurses' commitment and job satisfaction through reward management, it is important to listen to nurses' opinions to create a reward system that integrates financial and non-financial rewards and is fair from their perspective. Healthcare organisations that offer registered nurses a holistic reward system are more likely to retain satisfied and committed nurses at a time of increasing nursing shortages.

Propuesta de enfermería con terapias complementarias para el abordaje de riesgos psicosociales a nivel laboral / Proposal to nursing with complementary therapies for the approach psychosocial risk factors at work

ResumenIntroducción: Es reconocido que el trabajo genera efectos positivos en las personas como seguridad económica, bienestar y satisfacción, aspectos que ofrecen beneficios en todo ámbito, inclusive en la salud. A pesar de lo anterior, el mundo laboral en la actualidad exige tomar decisiones, pensar críticamente, liderar, además de poseer conocimientos para ejecutar las labores en forma eficiente y eficaz, lo cual puede producir sobrecarga y disconfort que afectan física, psicológica y socialmente a un individuo.Desarrollo: El propósito de este trabajo es aportar al enfrentamiento de los riesgos psicosociales en el ámbito laboral, por medio de la utilización de terapias complementarias y/o alternativas desde la disciplina de Enfermería. Se postula que la enfermería posee un campo de saberes, ligados al cuidado holístico y a la promoción en salud, por ello se toma el marco legal actual y las bases disciplinares de Enfermería, las cuales dan soporte a la implementación de terapias complementarias o alternativas en salud laboral.Conclusión: Como consideraciones finales, se destaca que las bases disciplinares de la enfermería abogan por el cuidado de los trabajadores a través del uso de terapias complementaria, de modo que otorgue fundamentos teóricos y científicos al área de salud laboral para enfrentar los riesgos psicosociales en el trabajo desde una mirada trasformadora.

AbstractIntroduction: It is recognized that the work generates positive effects on people and economic security, wellbeing and satisfaction, both of which offer benefits in all areas, including health. Despite this, the world of work now requires decisions, think critically, lead, besides having expertise to perform tasks efficiently and effectively, which may result in overload and discomfort affecting physically, psychologically and socially an individual.Developing: This article is a theoretical reflection conducted with the purpose of contributing from the discipline of nursing, facing the psychosocial risk factors at work through the usage of complementary and/or alternative therapies. This is proposed since nursing possesses knowledge linked to holistic care and healthcare promotion. For that purpose, the current legal framework globally and nationally, and the disciplinary bases for nursing, are presented, which contribute to the implementation of complementary or alternative therapies on occupational health.Conclusion: As closing remarks, it is proposed that nursing possesses disciplinary bases which advocate for the workers healthcare through the usage of complementary therapies. Therefore, that profession might present theoretical and scientific fundamentals to the occupational healthcare in order to face psychosocial risk factors at work with a transforming perspective.

Worksite health and wellness programs: Canadian achievements & prospects.

Canada has experienced a substantial reduction in mortality related to cardiovascular disease (CVD). There is a general consensus that more effective and widespread health promotion interventions may lead to further reductions in CVD risk factors and actual disease states. In this paper, we briefly outline the prevalence of selected risk factors for CVD in Canada, describe characteristics of the Canadian labor market and workforce, and depict what is known about health and wellness program delivery systems in Canadian workplaces. Our review indicates that there have been numerous and diverse relevant legislative and policy initiatives to create a context conducive to improve the healthfulness of Canadian workplaces. However, there is still a dearth of evidence on the effectiveness of the delivery system and the actual impact of workplace health and wellness programs in reducing CVD risk in Canada. Thus, while a promising model, more research is needed in this area.

Cardiovascular disease prevention and implications for worksite health promotion programs in Brazil.

Economic growth, an aging population, and changes in lifestyle patterns have contributed to the rise in cardiovascular disease (CVD) in Brazil. Worksite health and wellness programs are viewed as a potentially viable means to address the increase in disease burden in Brazil. The purpose of the present review is to investigate actions proposed by the Brazilian Government for CVD prevention and the current state of worksite health promotion. Our review of literature found that the Brazilian Government has been showing a growing interest in developing and promoting CVD preventive strategies, primarily through better control of known risk factors (i.e. smoking, obesity, physical inactivity, high cholesterol, high blood pressure, and high blood glucose). Current initiatives are considered positive steps toward better CVD prevention in Brazil. With respect to worksite health and wellness, additional work is needed to determine optimal program delivery models, financial implications and individual/population compliance with healthier lifestyle choices.

Aligning incentives in health care: physician practice and health system partnership.

BACKGROUND: The key to successfully aligning hospitals and physicians is financial integration and joint incentives for academic, quality, and clinical productivity. Many physician practices and health systems are moving toward closer integration, but mainly through consolidation and employment strategies. QUESTIONS/PURPOSES: We describe a fully integrated physician and hospital relationship including an overview of an aligned funds flow process that affords the department support for clinical services and teaching, research, and administrative activity. We also describe a physician compensation model that provides incentive not only for increased clinical performance, but also quality and academic objectives. METHODS: The content of this article was acquired through our own experience in managing the Department of Orthopaedic Surgery at the University of Pennsylvania Health System including the health system's funds flow process. Based on input from both health system leaders and the faculty, the department's compensation plan was totally redesigned to create a line-of-sight plan that credits clinical performance and academic productivity. RESULTS: Our model is multifactorial and provides sustainable support for the department and a compensation plan that is competitive within the local market and nationally. The health system's funds flow process has enhanced alignment of the faculty and hospitals by providing compensation for nonclinical time and assists the department's growth strategies by providing funding for new faculty and gain-sharing of improved hospital margin. The implementation of the compensation plan increased productivity by 8% in its first year with no additional resources. Academic productivity in that same year was arguably at or above any other year in the department's history in terms of accepted publications, national presentations, and research grants awarded. CONCLUSIONS: A model of complete integration between an academic department and a health system is achievable through a systematic process of mission-based support.

Using role substitution to address the health workforce shortage and to facilitate integration?

The health workforce is perceived to be in short supply in most developed and developing countries. There are concerns that this could result in reduced coverage of health services and the delivery of suboptimal care. Strategies to address the health workforce shortage have focussed predominantly on recruitment and training, with relatively little regard to the equally important issue of retention. One approach that may improve job satisfaction, opportunities for specialisation and the workload of health workers, and thus, improve retention and more importantly, patient outcomes, is role substitution. Many complementary and alternative medicine (CAM) practitioners appear to be well placed in terms of educational preparation to substitute (either horizontally or vertically) a number of roles traditionally performed by conventional health disciplines. As well as the potential benefits to the health workforce and the quality of patient care, role substitution could provide an important first step toward integrating CAM practitioners into mainstream health care settings.

Nurse manager leadership development: leveraging the evidence and system-level support.

The complexities of healthcare demand new leadership approaches to achieve organizational goals while developing and sustaining healthy work environments. The nurse manager is the defining role, crucial to achievement of workplace outcomes. Preparing nurses for this dynamic, complex role is often dependent on didactic education or on-the-job training that falls short of true leadership development. The authors describe an innovative approach to the development of successful nursing leaders across an integrated healthcare system.

Evaluation of the parallel rural community curriculum at flinders university of south Australia: lessons learnt for Africa

Objectives. To review data collected during an evaluation of the Flinders University Parallel Rural Community Curriculum (PRCC) in order to reflect on its relevance for medical education in Africa.Setting. The PRCC offers a community-based longitudinal curriculum as an alternative for students in their pre-final year of medical training. Design. Individual and focus group interviews were conducted with students; staff; health service managers; preceptors and community members. Results. Students are exposed to comprehensive; holistic; relationship-based care of patients; with a graded increase in responsibility. Students have varying experience at different sites; yet achieve the same outcomes. There is a strong partnership with the health service.Conclusions. The principle of balancing sound education and exposure to a variety of contexts; including longitudinal community-based attachments; deserves consideration by medical educators in Africa

Atención primaria de salud: factores de desmotivación y estabilidad laboral de médicos generales / Primary Health Care_ De-motivation factors and work stability of primary cara physicians

Objetivo. Conocer las motivaciones laborales de los médicos chilenos con mayor permanencia en Atención Primaria de Salud (APS). Metodología. Estudio cuanti-culitativo descriptivo. Se reunió información biodemográfica y laboral de médicos chilenos que trabajaban en 10 de 15 establecimientos de APS de un Servicio de Salud urbano (Región Metropolitana). Siete médicos con mayor estabilidad laboral, es decir, permanencia superior al promedio, y 2 directivos fueron entrevistados en profundidad. Los resultados fueron sometidos al juicio de expertos. Resultados. Se identificaron 21 médicos chilenos, que cubrían un tercio de las horas médicas totales. La mitad de estas horas eran cumplidas por los de mayor antigüedad. La permanencia promedio fue 8,5 años. Los profesionales con mayor estabilidad laboral fueron significativamente mayores (44 vs. 28 años) y habían ejercido cargos directivos. Destacaron las motivaciones trascendentes, como la vocación, relación entablada con pacientes y comunidad y el compromiso con la salud pública. Entre las propuestas sugeridas para el reclutamiento de médicos destaca el desarrollo profesional, mientras que las estrategias para combatir la monotonía favorecerían su estabilidad laboral. Conclusiones. Este estudio permite una aproximación a las motivaciones que llevan al médico chileno a trabajar en forma estable en APS. Parece fundamental tener una visión más holística que la sola atención curativa individual y la resolución de contingencias, promoviendo estrategias que permitan al profesional trascender e impactar en la salud de la población (AU)

Primary Healthcare: De-motivation factors and Work stability of Primary care physicians. Objective. To determine Chilean physicians’ motivation for longer service in Primary Health Care (PHC). Methodology. Semiquantitative study of the demographic data of Chilean physicians working at 10 of 15 PHC centers in a Metropolitan area. High job stability was defined as an above average length of service. Seven physicians that were judged as “highly stable” according to this definition and two administrators took part in a detailed interview for the qualitative study. Results were submitted for subjective evaluation by a panel of experts. Results. The sample was made up of 21 physicians, the average length of service was 8.5 years. Physicians who had worked in PHC for a longer period of time were older (44 vs 28 years) and had performed administrative duties. They listed motivations such as vocation, physician-patient and physician-community relationship and commitment to public health. Amongst the proposals suggested in order to recruit PHC physicians and ensure job stability were opportunities for professional development, and strategies to avoid monotony. Conclusions. This study helps to determine what motivates Chilean physicians to remain in PHC for longer periods of time. A more holistic view of patient care, including direct patient contact appears to be needed, as well as providing an opportunity to participate in solving community problems (AU)

Employee motivation: a powerful new model.

Motivating employees begins with recognizing that to do their best work, people must be in an environment that meets their basic emotional drives to acquire, bond, comprehend, and defend. So say Nohria and Groysberg, of Harvard Business School, and Lee, of the Center for Research on Corporate Performance. Using the results of surveys they conducted with employees at a wide range of Fortune 500 and other companies, they developed a model for how to increase workplace motivation dramatically. The authors identify the organizational levers that companies and frontline managers have at their disposal as they try to meet workers' deep needs. Reward systems that truly value good performance fulfill the drive to acquire. The drive to bond is best met by a culture that promotes collaboration and openness. Jobs that are designed to be meaningful and challenging meet the need to comprehend. Processes for performance management and resource allocation that are fair, trustworthy, and transparent address the drive to defend. Equipped with real-world company examples, the authors articulate how to apply these levers in productive ways. That application should not be selective, they argue, because a holistic approach gets you more than a piecemeal one. By using all four levers simultaneously, and thereby tackling all four drives, organizations can improve motivation levels by leaps and bounds. For example, a company that falls in the 50th percentile on employee motivation improves only to the 56th by boosting performance on one drive, but way up to the 88th percentile by doing better on all four drives. That's a powerful gain in competitive advantage that any business would relish.

Engaging Quad/Graphics employees in the improvement of their health and healthcare.

In an era when rising healthcare costs threaten the competitiveness of American businesses in an increasingly global marketplace, we describe Quad/Graphics on-site primary care (QuadMed) clinics tightly integrated with wellness, fitness, rehabilitation, and occupational medicine. We further describe the Lean You wellness program recently put in place to stem the rising burden of obesity. The Lean You program illustrates how an integrated employer and health provider system can become even more engaged in collaborative care with its employees. Financial and clinical data suggests that at Quad/Graphics-QuadMed, these full-service health service approaches are effective.

Patient safety: mindful, meaningful, and fulfilling.

Five years after the landmark report of the Institute of Medicine To Err Is Human (Kohn, Corrigan, and Donaldson 2000), many are asking, "Is U.S. healthcare safer?" A number of articles addressing this question have been written, interviews with nationally recognized patient safety leaders have been published, and governing boards of many healthcare organizations are examining reports of care provided by their institutions. Robert M. Wachter, writing in the November 2004 issue of Health Affairs, concludes that, "At this point, I would give our efforts an overall grade of C+, with striking areas of progress tempered by clear opportunities for improvement." We describe in this article the pursuit of a culture of safety at William Beaumont Hospital in Royal Oak, Michigan. Our experience has offered us the opportunity to ponder a number of key questions: How does leadership guide an organization toward a culture of safety? Does culture truly drive behavior, or is it really the reverse? How can a culture of safety be measured or observed? What levels of resources and commitment are required for success? Is safety all about systems and processes, or are core values also involved? What role does the patient play in ensuring safe care? We attempt to offer guidance, and share lessons learned, for each of these important questions.

Delicate balance: 2003 salary survey.

Hospital boards are exercising more scrutiny than ever on executive pay, at a time when the disparity between salaries in health care and general industry has finally disappeared.

Big raises all around. Is everybody happy?

The latest numbers on salaries and bonuses are in from the Hay Group, and it's good news from a compensation standpoint: pay for everyone, from executives to nurses, is going up. But satisfaction on the job remains low and the workforce shortage is severe, leading to the question: does more pay make everybody happy? If not, why not?