O processo de trabalho do técnico em saúde bucal e suas relações com a equipe de saúde bucal na Região Metropolitana da Grande Vitória, Espírito Santo, Brasil

Abstract

O objetivo deste estudo é analisar a compreensão dos cirurgiões-dentistas (CDs) sobre o processo de trabalho e as relações da equipe de saúde com os Técnicos em Saúde Bucal (TSBs). Em cinco municípios da Região Metropolitana da Grande Vitória (RMGV), Espírito Santo (ES), Brasil, foram selecionados 18 sujeitos, a partir de uma amostra probabilística de 217 CDs que atuavam no Sistema Único de Saúde (SUS). Os sujeitos foram entrevistados a partir de um roteiro-guia semiestruturado, do qual constavam temas relacionados à organização do trabalho na saúde bucal; às atribuições e responsabilidades do TSB; à relação entre o cirurgião-dentista e o TSB; à relação com a equipe de saúde e autonomia do TSB. Os dados foram analisados a partir da Análise de Conteúdo sugerida por Bardin. Constatou-se que os CDs valorizam a importância da participação dos TSBs na reorganização do trabalho odontológico e a construção de uma relação de parceria e cooperação. Contudo, os CDs reconhecem que a relação com os TSBs é prejudicada pela desinformação sobre o processo de trabalho. Além disso, os CDs demonstram receios quanto à possibilidade de os TSBs tornarem-se dentistas práticos e tomarem seu espaço no mercado de trabalho. Também há preocupações sobre a responsabilização legal dos CDs sobre atividades desenvolvidas pelos TSBs.

Work process of an oral health team according to the dentists

“…In the public sector, it is extremely important to organize the work and delegate in the correct manner, so that among other gains, a larger number of persons could be contemplated to receive oral health care actions 5,7,18 . However, in a recent analysis, Warmling et al 14 discussed Law 11.889/2008 indicating that it has not been shown to be a legal instrument capable of encouraging promotion of extending the skills and attributions of these workers.…”

“…the public 9,14 and private sectors 8,15 . However, the dentists' view about this question is till incipient and focused on the role of the dentist-professor in the education of the technicians 5 .…”

“…From the time this measure was introduced, a significant increase in the work market was noted for components of the oral health, and a perceptible intensification of the education and hiring of auxiliary personnel for the public sector 5 . But a deeper look into the distribution of these opportunities showed, that in April 2015, with 35673 Oral Heal Teams (ESBs) implemented in the country, the jobs for CDs, TSBs and ASBs were distributed as follows: 45.4%, 9.1% and 45.4%, respectively 6 .…”

“…A large portion of dentists have not yet learned how to work as a team, and maintain the monopoly of activities and functions that could and must be delegated 8,11 . Esposti et al 5 verified that although dentists understood that the relationship of partnership and cooperation with the TSBs was fundamental, negative ideas persisted and were related to the fear of losing the work market, and the legal responsibility related to their activities, foreseen in the regulation of exercising the profession. Along this line, in the law there is nothing attributed to CDs that allows them to reduce/curtail the professional skills of assistants [12][13] .…”

“…Organization of the work in oral health must contemplate the participation of the TSBs, so that they also perform clinical attendance in individual actions, therefore, there is need of adequate physical space for their work 5 . This is guaranteed to Modality 2 oral health teams, by means of incentives to acquire an additional dental office, in accordance with Administrative Ruling GM/MS No.…”