Reabilitação profissional e práticas intersetoriais

Abstract

Vocational rehabilitation is a service provided by the National Institute of Social Security / INSS in Brazil. During the follow-up of the vocational rehabilitation process, the rehabilitated person may receive vocational training from social resources available in the community. This training can contribute to both reintegration into the labor market and the social context in which the worker lives. Aim-To characterize the social security vocational rehabilitation and inter-sectoral practices during the return to work process. Methods-Searches for references published in scientific journals of the SciELO database were performed on the following topics: work, social security, and vocational rehabilitation, return to work, inter-sectorial Official documents (decrees of the Brazilian federal government on workers' health, social security and vocational rehabilitation) were evaluated. A case study with a qualitative approach was conducted from the dialectical critical theoretical perspective. Using the focus group technique, two sessions were held with the participation of nine (09) workers in vocational rehabilitation. Those were receiving professional training in a collaborating institution of the National Institute of Social Security, located in the city of São Paulo, SP, Brazil. There were conducted four (04) semi-structured interviews with the representative of the institution that provided the training and with three (03) other workers who had already completed the vocational rehabilitation process. Field data collection took place during four (4) months, between February and May 2019. The workers volunteered and agreed to participate in this study, signing an informed consent form. The project was approved by the Research Ethics Committee of the University of São Paulo, School of Public Health. Results-The interviews identified nuclei of meaning when grouped, allowed the formation of three categories of analysis of the vocational rehabilitation program. They were: a) perception about the vocational rehabilitation program; b) inter-sectorial practices within the network care; c) expectation of return to work. The results revealed the planning, monitoring and evaluation of actions were fragile. Management and social control were perceived ineffective. They also showed that there is still a long way to go in the practice of inter-sectoral approach, both of management, as well as the daily practices of vocational rehabilitation teams. There are difficulties and limitations of current management models at work. On the other hand, the results also pointed to the creation of new ways of partnering and the collective construction of inventive strategies with the social assistance network. There is a need to improve intersectoral management mechanisms that ensure greater articulation and support the practices of vocational rehabilitation services. This is a huge challenge, which requires the involvement of managers, professionals and users in the construction of a democratic management and committed to the directive i...