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1.
Acad Med ; 95(6): 833-837, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32079955

RESUMO

With ever-growing emphasis on high-stakes testing in medical education, such as the Medical College Admission Test and the United States Medical Licensing Examination Step 1, there has been a recent surge of concerns on the rise of a "Step 1 climate" within U.S. medical schools. The authors propose an alternative source of the "climate problem" in current institutions of medical education. Drawing on the intertwined concepts of trust and professionalism as organizational constructs, the authors propose that the core problem is not hijacking-by-exam but rather a hijackable learning environment weakened by a pernicious and under-recognized tide of commodification within the U.S. medical education system. The authors discuss several factors contributing to this weakening of medicine's control over its learning environments, including erosion of trust in medical school curricula as adequate preparation for entry into the profession, increasing reliance on external profit-driven sources of medical education, and the emergence of an internal medical education marketplace. They call attention to breaches in the core tenets of a profession-namely a logic that differentiates its work from market and managerial forces, along with related slippages in discretionary decision making. The authors suggest reducing reliance on external performance metrics (high-stakes exams and corporate rankings), identifying and investing in alternative metrics that matter, abandoning the marketization of medical education "products," and attending to the language of educational praxis and its potential corruption by market and managerial lexicons. These steps might salvage some self-governing independence implied in the term "profession" and make possible (if not probable) a recovery of a public trust becoming of the term and its training institutions.


Assuntos
Mercantilização , Educação Médica/tendências , Profissionalismo/normas , Faculdades de Medicina/organização & administração , Confiança , Humanos , Aprendizagem
2.
Movimento (Porto Alegre) ; 25(1): e25018, jan.- dez. 2019.
Artigo em Português | LILACS | ID: biblio-1047907

RESUMO

O Brasil se destaca pelo número de praticantes e conquistas internacionais no futsal. Este esporte encontra-se em processo de consolidação da profissionalização de suas práticas no país. Consequentemente, a mídia torna-se fundamental para a atração de consumidores e investidores. O objetivo deste estudo foi investigar a perspectiva de jogadores brasileiros de elite de futsal relativa à cobertura midiática sobre este esporte no Brasil. Foram realizadas entrevistas com 21 jogadores da seleção brasileira masculina principal de futsal. Após análise temática, as categorias analíticas foram discutidas com base na Teoria dos Campos de Pierre Bourdieu. Concluiu-se que, segundo os jogadores, o futsal ocupa um espaço desprestigiado na mídia esportiva, o que dificulta a atração de investimentos e desenvolvimento de carreiras. Os jogadores propõem ações ortodoxas que tentam se adaptar às normas do campo, de modo a alcançarem capitais econômicos e simbólicos que melhorem suas condições de trabalho e posição na estrutura social


Brazil has many futsal practitioners and is the main winner of world championships; professionalism is increasing in the country. Thus, the media play a key role in attracting consumers and investors. This study investigates the perspective of Brazilian elite male players on the media coverage. Semi-structured interviews were conducted with 21 national team members. After players' discourses underwent thematic analysis, analytic categories were subjected to Pierre Bourdieu's Theory of Fields. According to players, futsal is discredited in sports media coverage, hampering the attraction of investors and career development. Players propose orthodox actions to adapt to the rules of the field in order to gain economic and symbolic capitals that may improve their work conditions and social status


Brasil se destaca por el número de practicantes y por las conquistas internacionales en futsal, y la profesionalización de sus prácticas se consolida en el país. Los medios son fundamentales para atraer a consumidores e inversores, y este estudio investigó la perspectiva de jugadores de élite sobre la cobertura mediática. Se realizaron entrevistas con 21 jugadores de la selección masculina principal. Las categorías analíticas fueron discutidas con base en la Teoría de los Campos de Pierre Bourdieu. Según los jugadores, el futsal tiene poco prestigio en la prensa deportiva, lo que dificulta inversiones y desarrollar carreras. Los jugadores proponen acciones ortodoxas para adaptarse a las normas del campo y alcanzar capitales económicos y simbólicos que mejoren sus condiciones de trabajo y su posición social


Assuntos
Humanos , Masculino , Futebol , Meios de Comunicação , Sociologia , Esportes , Mercantilização
3.
New Bioeth ; 25(4): 349-358, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31702479

RESUMO

The use of human biological materials (HBMs) involves a number of issues from both an ethical and a legal point of view. In recent decades, the purposes for which this material has been used have increased. The development of therapeutic products has led to the configuration of a market in which products have acquired an economic value. As soon as the private sector crosses the threshold of access to the use of human cells and tissues, a conflict may arise between the altruistic principles motivating the act of donation and the profit-making objectives . When donated material emerges from the public management setting and becomes a source of profit, the instrument of informed consent may not adequately protect the dignity of the donors. In the era of medical biotechnology revolution, any use of the donated material must be justified and consistent with the values motivating the act of donation.


Assuntos
Altruísmo , Bancos de Espécimes Biológicos , Mercantilização , Consentimento Livre e Esclarecido , Setor Privado , Doadores de Tecidos , Obtenção de Tecidos e Órgãos , Bancos de Espécimes Biológicos/economia , Bancos de Espécimes Biológicos/ética , Biotecnologia , União Europeia , Objetivos , Humanos , Pessoalidade , Setor Privado/economia , Setor Privado/ética , Obtenção de Tecidos e Órgãos/economia , Obtenção de Tecidos e Órgãos/ética
4.
Hist Philos Life Sci ; 41(3): 34, 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31485872

RESUMO

The growing commercialization of scientific research has raised important concerns about industry bias. According to some evidence, so-called industry bias can affect the integrity of the science as well as the direction of the research agenda. I argue that conceptualizing industry's influence in scientific research in terms of bias is unhelpful. Insofar as industry sponsorship negatively affects the integrity of the research, it does so through biasing mechanisms that can affect any research independently of the source of funding. Talk about industry bias thus offers no insight into the particular epistemic shortcomings at stake. If the concern is with the negative effects that industry funding can have on the research agenda, conceptualizing this influence as bias obscures the ways in which such impact is problematic and limits our ability to offer solutions that can successfully address the concerns raised by the growing role of private funding in science.


Assuntos
Pesquisa Biomédica/economia , Mercantilização , Transferência de Tecnologia , Pesquisa Biomédica/instrumentação
5.
Sociol Health Illn ; 41(8): 1685-1705, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31529559

RESUMO

Moving away from paternalism to more equal forms of interaction in the patient-doctor relationship has been seen in positive light by policymakers, patients' rights advocates and scholars alike. Nonetheless, against the background of commercialisation and consumerism, empirical research showcases how reduced asymmetries bring in tensions and friction between patients and doctors (Greenfield et al. 2012). This paper contributes to the discussion through the examination of the patient-doctor relationship in the niche setting of private transnational healthcare markets which involve patients travelling overseas for care and where commodification, consumerism and care go hand-in-hand. It is geographically focused on two large cities in South-Eastern Europe as settings where health care is provided to foreign patients - Athens and Istanbul - and empirically draws on qualitative interviews with doctors who run small/medium practices. The findings highlight that, despite excessive consumerism, power asymmetries are not mitigated but patient vulnerability shapes the patient-doctor relationship. In the transnational context, the patient faces an additional source of vulnerability: a condition of foreignness. As such, the findings stress that one relationship model (the consumerist) does not, per se, replace an older one (e.g. the Parsonian). Instead, the consumer-provider dimension co-exists with the client-expert, patient-doctor and, finally, host-guest relation.


Assuntos
Mercantilização , Internacionalidade , Turismo Médico , Relações Médico-Paciente , Grécia , Humanos , Entrevistas como Assunto , Satisfação do Paciente , Turquia
6.
Hist Philos Life Sci ; 41(3): 30, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31363860

RESUMO

This paper looks at the commodification of interferon, marketed by Hoffmann La Roche (short: Roche) as Roferon A in 1986, as a case study that helps us understand the role of pharmaceutical industry in cancer research, the impact of molecular biology on cancer therapy, and the relationships between biotech start-ups and established pharmaceutical firms. Drawing extensively on materials from the Roche company archives, the paper traces interferon's trajectory from observed phenomenon (viral interference) to product (Roferon A). Roche embraced molecular biology in the late 1960s to prepare for the moment when the patents on some of its bestselling drugs were going to expire. The company funded two basic science institutes to gain direct access to talents and scientific leads. These investments, I argue, were crucial for Roche's success with recombinant interferon, along with more mundane, technical and regulatory know-how held at Roche's Nutley base. The paper analyses in some detail the development process following the initial success of cloning the interferon gene in collaboration with Genentech. It looks at the factors necessary to scale up the production sufficiently for clinical trials. Using Alfred Chandler's concept of 'organizational capabilities', I argue that the process is better described as 'mobilisation' than as 'translation'.


Assuntos
Antineoplásicos/história , Mercantilização , Desenvolvimento de Medicamentos/história , Indústria Farmacêutica/história , Interferon alfa-2/história , Antineoplásicos/economia , Ensaios Clínicos como Assunto/história , Indústria Farmacêutica/economia , História do Século XX , Humanos , Interferon alfa-2/economia , Interferência Viral
7.
BMC Public Health ; 19(1): 594, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31101045

RESUMO

BACKGROUND: Intimate partner violence (IPV), HIV and sexually transmitted infections (STI) can contribute to disparities in population health, depending on the individual, social and environmental factors characterizing a setting. To better understand the place-based determinants and patterns of these key interrelated public health problems in Uganda, we compared risk factors for IPV, HIV and STI in fishing, trading and agrarian communities in Rakai, Uganda by gender. METHOD: This study used cross-sectional data collected from 14,464 sexually active men (n = 6531) and women (n = 7933) as part of the Rakai Community Cohort Study, a population-based open cohort study of men and women aged 15-49 years. We used multilevel modified poisson regression models, which incorporated random intercepts for community and households. Factors associated with IPV, HIV and STI were assessed separately for men and women in fishing, trading and agrarian communities. RESULTS: A larger proportion of participants in the fishing communities than those in trading and agrarian communities were HIV positive, engaged in HIV risk behaviors, had STI symptoms and reported perpetration of or victimization by IPV. Female gender was a shared correlate of IPV, HIV and STI in the fishing communities. Engagement in multiple sexual relationships or partner's engagement in multiple relationships were shared correlates of IPV, and HIV in agrarian communities and IPV and STI in trading communities. CONCLUSION: Programs should target factors at multiple levels to reduce risk for syndemic conditions of HIV, STI and IPV in Rakai, Uganda particularly among men and women in fishing communities.


Assuntos
Agricultura , Infecções por HIV/epidemiologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Fatores Sexuais , Doenças Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Estudos de Coortes , Mercantilização , Estudos Transversais , Feminino , HIV , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Análise de Regressão , Fatores de Risco , Parceiros Sexuais , Uganda/epidemiologia , Adulto Jovem
8.
BMJ ; 365: l1475, 2019 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-30944107
9.
Sociol Health Illn ; 41(6): 1005-1022, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30847964

RESUMO

With an increasing range of products in global and local markets, more options are available for individuals to enhance their image and their (cognitive, social and physical) performance. These 'performance consumptions' relate to ideals of well-being and improvement, and are based on constructed desires, expectations and needs that go beyond the (often blurred) dichotomy of health and illness. Drawing from mixed-methods research in Maputo, Mozambique, this paper discusses individuals' use of medicines and other substances - pharmaceuticals, food supplements, traditional herbs, cosmetics and energy drinks - for managing different aspects of their everyday lives. Through an overview of the main consumption practices, we explore the underlying purposes and strategies of users, and the perceived legitimacy and risks involved when using a variety of products accessible through formal and informal exchange channels. From tiredness to sexual and aesthetic management, we show how the body becomes the locus of experimentation and investment to perform in accordance with socially expected roles, individual aspirations and everyday tasks. With insights from individuals' accounts in Maputo, we aim to add to discussions on pharmaceuticalisation of body management by showing how the emergence of new performance consumptions is articulated with the reconfiguration of more 'traditional' consumption practices.


Assuntos
Mercantilização , Suplementos Nutricionais , Substâncias para Melhoria do Desempenho , Preparações Farmacêuticas , Adulto , Bebidas Energéticas , Feminino , Humanos , Masculino , Moçambique , Plantas Medicinais
10.
Psychopharmacology (Berl) ; 236(9): 2641-2652, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30927021

RESUMO

RATIONALE: Non-medical prescription opioid use and opioid use disorder (OUD) present a significant public health concern. Identifying behavioral mechanisms underlying OUD will assist in developing improved prevention and intervention approaches. Behavioral economic demand has been extensively evaluated as a measure of reinforcer valuation for alcohol and cigarettes, whereas prescription opioids have received comparatively little attention. OBJECTIVES: Utilize a purchase task procedure to measure the incremental validity and test-retest reliability of opioid demand. METHODS: Individuals reporting past year non-medical prescription opioid use were recruited using the crowdsourcing platform Amazon Mechanical Turk (mTurk). Participants completed an opioid purchase task as well as measures of cannabis demand, delay discounting, and self-reported pain. A 1-month follow-up was used to evaluate test-retest reliability. RESULTS: More intense and inelastic opioid demand was associated with OUD and more intense cannabis demand was associated with cannabis use disorder. Multivariable models indicated that higher opioid intensity and steeper opioid delay discounting rates each significantly and uniquely predicted OUD. Increased opioid demand intensity, but not elasticity, was associated with higher self-reported pain, and no relationship was observed with perceived pain relief from opioids. Opioid demand showed acceptable-to-good test-retest reliability (e.g., intensity rxx = .75; elasticity rxx = .63). Temporal reliability was lower for cannabis demand (e.g., intensity rxx = .53; elasticity rxx = .58) and discounting rates (rxx = .42-.61). CONCLUSIONS: Opioid demand was incrementally valid and test-retest reliable as measured by purchase tasks. These findings support behavioral economic demand as a clinically useful measure of drug valuation that is sensitive to individual difference variables.


Assuntos
Analgésicos Opioides/administração & dosagem , Mercantilização , Desvalorização pelo Atraso/efeitos dos fármacos , Economia Comportamental , Medição da Dor/efeitos dos fármacos , Adulto , Analgésicos Opioides/economia , Desvalorização pelo Atraso/fisiologia , Prescrições de Medicamentos/economia , Feminino , Humanos , Masculino , Fumar Maconha/economia , Fumar Maconha/psicologia , Transtornos Relacionados ao Uso de Opioides/economia , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Transtornos Relacionados ao Uso de Opioides/psicologia , Medição da Dor/economia , Medição da Dor/psicologia , Reprodutibilidade dos Testes , Fatores de Risco , Autorrelato , Transtornos Relacionados ao Uso de Substâncias/economia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
11.
Med Anthropol ; 38(7): 620-633, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30730223

RESUMO

What is the relationship between race and value in human egg donation? Drawing on ethnographic and textual sources, I explore the construction of race and the commodification of eggs in human egg donation, in order to show the intersections of race and market value in the fertility industry. Focusing on egg donation among Asian Americans - which is the fastest-growing minority group in the United States and has high rates of assisted reproductive technology usage - I argue that actors involved in egg donation construct race along a spectrum, mobilizing race in diverse ways with respect to particular desires for family formation.


Assuntos
Mercantilização , Grupos de Populações Continentais/etnologia , Técnicas de Reprodução Assistida , Doadores de Tecidos , Antropologia Médica , Americanos Asiáticos , Feminino , Humanos , Estados Unidos/etnologia
12.
Kennedy Inst Ethics J ; 29(4): 305-331, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31983696

RESUMO

In phase I clinical trials, healthy volunteers are dosed with investigational drugs and subjected to blood draws and other bodily monitoring procedures while they are confined to clinic spaces. In exchange, they are paid. These participants are, in a direct sense, selling access to their bodies for pharmaceutical companies and their associates to run drugs through. However, commodification is rarely investigated as an ethical dimension of phase I trial participation. We address this gap in the literature by bringing the voices of phase I healthy volunteers into conversation with philosophical perspectives on body commodification. Querying the intersection of commodification and phase I clinical trials illuminates important features of healthy volunteers' experiences, disentangles commodification from a dominant narrative about exploitation, and brings focus to the question of what, if any, market norms will best protect the multiple ways in which healthy volunteers' welfare is impacted by clinical trial participation.


Assuntos
Ensaios Clínicos Fase I como Assunto/economia , Ensaios Clínicos Fase I como Assunto/ética , Mercantilização , Voluntários Saudáveis/psicologia , Renda , Princípios Morais , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Narração , Estados Unidos
14.
J Forensic Leg Med ; 61: 27-33, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30445223

RESUMO

This paper seeks to provide an ethical assessment of kidney sale based on the theories of a contemporary Shiite theologian, Muhammad Hussain Tabataba'i. It aims to offer a mechanism to decide the justifiability or unjustifiability of kidney sale in ethical terms. Tabataba'i considers ''Divine Consent'' as the criterion for the morality of an action. An action meets the "Divine Consent" requirement if it is done with a sincere intention, confirmed by reason and Divine revelations, brings about an internal peace for the agent, and preserves the agent's dignity and autonomy. Given this criterion and through an analytic and qualitative method, this paper aims to evaluate kidney sale in three cases: during one's lifetime, during brain death when the agent has left no will, and during brain death when the agent has left a will. It seems that, based on the theories of Tabataba'i, the above requirements are only met in the first two cases. Thus, kidney sale is morally justifiable in the first two cases but not in the third.


Assuntos
Mercantilização , Análise Ética , Islamismo , Rim , Princípios Morais , Morte Encefálica , Humanos , Consentimento Livre e Esclarecido , Irã (Geográfico) , Transplante de Rim , Religião e Medicina , Obtenção de Tecidos e Órgãos/economia , Obtenção de Tecidos e Órgãos/ética
15.
Soc Sci Med ; 221: 19-26, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30553119

RESUMO

The potential medical risks to egg donors, in addition to the concern over the commodification of life, has led to debates surrounding the ethics of paying donors. In Canada, payment for eggs is prohibited by law; however, what is considered payment is contentious and has yet to be defined. The lack of legislative clarity coupled with increased ethical concerns over paying a donor has shifted egg donation from a medically-controlled procedure to a legal and social endeavor involving multiple professionals. Through semi-structured interviews with 52 medical and non-medical fertility practitioners, I show how medical practitioners use boundary-work to remove their practice from the ethical and legal debates surrounding egg donation, the "dirty work". I examine how the medical profession relies on discourses of "practicing science" to present their work as favorable and removed from current debates and potential legal ramifications. In showing how medical practitioners rely on boundary-work to distinguish their work from non-scientific and non-medical activities, I expand Gieryn's original conceptualization of boundary-work to demonstrate how medical practitioners can selectively draw on their practice of science to remove their work from ethically and legally contentious issues, the dirty work.


Assuntos
Atitude do Pessoal de Saúde , Pessoal de Saúde , Infertilidade/terapia , Doação de Oócitos/ética , Doadores de Tecidos/legislação & jurisprudência , Canadá , Mercantilização , Humanos , Entrevistas como Assunto , Serviços de Saúde Reprodutiva
16.
Rev. direito sanit ; 19(3): 7-15, 2019.
Artigo em Português | LILACS | ID: biblio-1015420

RESUMO

Exatamente porque saúde não é mercadoria, a regulação sanitária ganha relevo no mundo capitalista. O atual escândalo conhecido como Implant Files é suficiente para demonstrar que o apetite das empresas atuantes nessa área é insaciável e que, sem adequada regulação e atenta vigilância sobre elas, serão altamente prejudicados não só os pacientes (no caso, com sequelas provocadas por produtos de baixa qualidade e inadequados à necessidade), mas também os sistemas de saúde, que além de arcarem com os custos decorrentes da compra dos implantes, devem suportar os encargos de cuidar das sequelas e de eventual indenização.


Assuntos
Humanos , Masculino , Feminino , Saúde , Acesso Universal aos Serviços de Saúde , Mercantilização , Promoção da Saúde , Sistema Único de Saúde
17.
New Bioeth ; 24(3): 240-248, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30230422

RESUMO

Should egg donors be paid? A negative answer might be offered on the ground that payment for egg donation is coercive. But is this viewpoint tenable? Is the offer of payment for egg donation really coercive? Even if not coercive, might payment for egg donation nonetheless be seen as exploitative? And if so why? The central argument of this paper focuses on the question whether the offer of payment for egg donation is an exploitative inducement and therefore an undue inducement. Another question raised in this paper is whether, given that it is commodifying, payment for egg donation constitutes a failure to recognize the giftedness and true value of human life.


Assuntos
Temas Bioéticos , Mercantilização , Compensação e Reparação/ética , Motivação , Doação de Oócitos , Doadores de Tecidos , Coerção , Feminino , Humanos
19.
Aquichan ; 18(3): 263-274, July-Sept. 2018. tab, graf
Artigo em Português | LILACS, BDENF - Enfermagem, COLNAL | ID: biblio-973649

RESUMO

RESUMO Objetivo: conhecer as identidades profissionais de enfermeiros portugueses e os sentidos das transições em curso, para fornecer os suportes necessários aos desafios identitários profissionais. Materiais e método: investigação de abordagem mista realizada entre 2016 e 2017. Utilizou-se como instrumento de recolha de dados um Inventário de Identidade Psicossocial de Zavalloni e Louis-Guérin, junto duma amostra de 102 enfermeiros, dos quais 19 foram posteriormente entrevistados. Resultados: analisaram-se alguns dados que correspondiam aos possíveis selves e à identificação do núcleo central e dos elementos periféricos da identidade profissional, tais como as condicionantes profissionais. Verificou-se a existência de um grupo dominante de enfermeiros numa dualidade identitária entre o enfoque nos cuidados e na autonomia profissional e o enfoque nas exigências institucionais, com o receio de despersonalização dos cuidados. Também se identificou um outro grupo profissional, mais relacionado com o cuidar, que não apresenta marcas dessa institucionalização, mas que deseja um maior desenvolvimento das relações humanas e do conhecimento científico. Conclusões: as possíveis transições identitárias identificadas podem ocorrer conforme os reforços e os reconhecimentos oferecidos, ora com correspondência a fatores de mercado e consequente despersonalização do cuidar, ora com a conquista da autonomia e resgate do cuidar, assentem na cientificidade profissional.


RESUMEN Objetivo: conocer las identidades profesionales de enfermeros portugueses y los sentidos de las transiciones en curso, para proporcionar el apoyo necesario a los desafíos de identidad profesional. Materiales y método: investigación de enfoque mixto realizada entre 2016 y 2017. Se utilizó el Inventario de Identidad Psicosocial de Zavalloni y Louis-Guérin como herramienta de recolección de datos, junto a una muestra de 102 enfermeros, de los cuales 19 fueron entrevistados posteriormente. Se analizaron datos que correspondían a los posibles selves, a la identificación del núcleo central, a los elementos periféricos de identidad profesional y las condiciones profesionales. Resultados: se verificó la existencia de un grupo dominante de enfermeros en una dualidad de identidad entre el enfoque en los cuidados y la autonomía profesional y el enfoque en las exigencias institucionales, con temor a la externalización del cuidado. Se identificó otro grupo profesional, más relacionado con el cuidado, que no presenta evidencias de institucionalización, sino que persigue un mayor desarrollo de las relaciones humanas y del conocimiento científico. Conclusiones: las posibles transiciones de identidad reconocidas pueden ocurrir según refuerzos y reconocimientos ofrecidos, que correspondan a factores de mercado y consecuente despersonalización del cuidado, o con la conquista de la autonomía y el rescate del cuidado, basado en la cientificidad profesional.


ABSTRACT Objective: To know the professional identities of registered nurses in Portugal and the meaning of ongoing transitions in order to provide the necessary support for professional identity challenges. Materials and method: Mixed approach research conducted between 2016 and 2017. A Psychosocial Identity Inventory was utilized as an instrument of data collection, along with a sample of 102 nurses, 19 of which were subsequently interviewed. We analyzed some data that corresponded to the possible selves and the identification on the core and peripheral elements of the professional identity, and also of the professional factors. Results: A dominant group of nurses was discovered divided between the focus on care with professional autonomy, and the focus on institutional needs, fearing the depersonalization in care. We also identified another professional group, more related to caring, which shows no signs of this institutionalization, but wishes to achieve a greater development regarding human relations and scientific knowledge. Conclusions: The possible identity transitions identified, can occur according to the acknowledgment of their work and reinforcements offered, sometimes corresponding with business model of healthcare management and subsequent depersonalization of care, or with a sense of autonomy achievement and the rescue of care, based on scientific profession.


Assuntos
Humanos , Identificação Social , Enfermagem , Relações Enfermeiro-Paciente , Portugal , Mercantilização
20.
Cien Saude Colet ; 23(7): 2159-2170, 2018 Jul.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30020372

RESUMO

Since the 1980s, European health systems have undergone several reforms, with emphasis on the tendency of their commodification. The objective of this article is to demonstrate how market mechanisms were implemented in the functioning of these systems, german, british and french - from the 1980s. The "mercantile" reforms were justified on the premise that the insertion of market logic could both reduce the need for public spending and increase the efficiency of existing expenditure. The work presents different forms of commodification implemented in the reforms, with the distinction between processes of explicit commodification, in which there is an effective increase in private, and implicit presence, in which there is incorporation of principles from the private sector in the public system, both in financing and in the provision of health services. In addition to detailing the different ways in which this phenomenon is expressed, the article briefly presents the potential negative effects of this process for health systems, especially in terms of access and equity, stating that the initial assumptions surrounding commodification (cost reduction and efficiency improvement) appear to be false.


Assuntos
Mercantilização , Assistência à Saúde/organização & administração , Reforma dos Serviços de Saúde , Assistência à Saúde/economia , França , Alemanha , Gastos em Saúde , Humanos , Setor Privado/economia , Setor Público/economia , Reino Unido
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