Reabilitação Profissional do INSS: uma análise à luz do Laboratório de Mudanças
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Data
2019-05-20
Autores
Tessarro, Melina Trento Vendrameto
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: No Brasil, o serviço de Reabilitação Profissional – RP é oferecido pelo Instituto Nacional do Seguro Social (INSS) e destinado aos trabalhadores contribuintes da Previdência Social com incapacidades para o trabalho, seus dependentes e pessoas com deficiência. Entende-se a prática da RP como resposta pública à questão da incapacidade, a saber, um processo para eliminar barreiras existentes ao retorno e permanência no trabalho após o estabelecimento de limitações. Porém, nas últimas décadas, transformações ocorridas na prestação do serviço de RP, pela previdência social, fizeram emergir problemas que refletem descompasso entre seus reais resultados e o que se espera como política pública de inclusão social. Objetivo: Este estudo objetiva compreender as causas sistêmicas e históricas dos distúrbios que ocorrem no serviço de reabilitação profissional desenvolvido pelo INSS na Agência de Previdência Social de Jaú/SP. Com isso, busca-se identificar as principais contradições e fontes de dificuldades percebidas pelos atores envolvidos no processo de RP e, assim, produzir informações que ajudem superar as contradições do modelo vigente. Método: Trata-se de pesquisa qualitativa apoiada em intervenção segundo Laboratório de Mudança (LM). A casuística do estudo foi composta por profissionais atuantes no serviço em estudo, representantes de empresas e segurado em processo de RP. O trabalho envolveu coleta de dados etnográficos, com análise documental, entrevistas individuais, que serviram como dados espelho para as sessões do LM. Baseando-se no ciclo de aprendizagem expansiva, as etapas desenvolvidas foram questionamento de problemas e análise histórica e empírica atual do sistema de atividade (SA) da RP. Resultados: A análise histórica identificou três períodos distintos, considerando eventos críticos que representaram mudanças na atividade em estudo. Podemos afirmar que o sistema da RP se transformou historicamente e levou a contradições entre componentes objeto, sujeitos e instrumentos. A redução do objeto da RP, para oferta de qualificação profissional, mostrou-se incompatível com sistema apoiado na oferta de serviços por atores externos à previdência social, sem articulação e coordenação desses serviços. Foram identificadas, também, dificuldades do sistema de atividade em lidar com objeto pré-definido como não elegível à RP, segundo seus critérios, embora imposto por determinação judicial. Além disso, a diminuição da capacidade instalada e acúmulo de tarefas pelos profissionais (mudanças na divisão do trabalho) impactam no atendimento à demanda do serviço. Tal realidade demonstra que há um descompasso entre a evolução histórica do SA da RP e as necessidades do objeto. Conclusão: O estudo possibilitou análise dos distúrbios do sistema de atividade da RP percebidos pelos atores envolvidos no processo e trouxe contribuições para desenvolvimento da atividade, apresentando potencial para enriquecer e testar as hipóteses de contradições e avançar na modelagem e implementação de nova proposta para a reabilitação profissional, a qual idealmente deveria ser testada em nível local.
Introduction: In Brazil, the Professional Rehabilitation (PR) service is offered by the National Social Security Institute (INSS) and is intended for contributing workers of Social Security with work disabilities, their dependents and people with disabilities. The practice of PR is understood as a public response to the issue of disability, a process to eliminate existing barriers to return and to stay in work after the establishment of disability. However, in recent decades, changes in the provision of PR services by social security have created problems that reflect a mismatch between their actual results and what is expected as a public policy of social inclusion. Objective: This study aims to understand the systemic and historical causes of the disturbances that occur in the professional rehabilitation service developed by the INSS at the Social Security Agency of Jaú / SP. With this, it is expected to identify the main contradictions and sources of difficulties perceived by the actors involved in the PR process and, thus, produce information that helps to overcome the contradictions of the current model. Method: This is qualitative research supported by intervention according to the Change Laboratory (CM). The casuistry of the study was composed of professionals working in the PR service, representatives of companies and insured in the process of PR. The work involved the collection of ethnographic data, with documentary analysis, individual interviews, which served as mirror data for LM sessions. Based on the expansive learning cycle, the stages developed were questioning of problems and historical and empirical analysis of the activity system (SA) of PR. Results: The historical analysis identified three distinct periods, considering critical events that represented changes in the activity in study. We can say that the PR system has historically transformed and create contradictions between components: object, subjects and instruments. The reduction of the object of the PR to the offer of professional qualification showed to be incompatible with a system supported by the provision of services by actors external to social security, without articulation and coordination of these services. Also identified are difficulties of the system of activity in dealing with pre-defined object as ineligible to the PR, according to its criteria, however that is imposed by judicial determination. In addition, the reduction of installed capacity and the accumulation of tasks by the professionals (changes in the division of labor) impact on the service demand. This reality shows that there is a mismatch between the historical evolution of SA of PR and the needs of the object. Conclusion: The study allowed the analysis of the disturbances of the RP activity system perceived by the actors involved in the process and brought contributions to the development of the activity, presenting the potential to enrich and test the hypothesis of contradictions and to advance in the modeling and implementation of a new proposal for rehabilitation which should ideally be tested at the local.
Introduction: In Brazil, the Professional Rehabilitation (PR) service is offered by the National Social Security Institute (INSS) and is intended for contributing workers of Social Security with work disabilities, their dependents and people with disabilities. The practice of PR is understood as a public response to the issue of disability, a process to eliminate existing barriers to return and to stay in work after the establishment of disability. However, in recent decades, changes in the provision of PR services by social security have created problems that reflect a mismatch between their actual results and what is expected as a public policy of social inclusion. Objective: This study aims to understand the systemic and historical causes of the disturbances that occur in the professional rehabilitation service developed by the INSS at the Social Security Agency of Jaú / SP. With this, it is expected to identify the main contradictions and sources of difficulties perceived by the actors involved in the PR process and, thus, produce information that helps to overcome the contradictions of the current model. Method: This is qualitative research supported by intervention according to the Change Laboratory (CM). The casuistry of the study was composed of professionals working in the PR service, representatives of companies and insured in the process of PR. The work involved the collection of ethnographic data, with documentary analysis, individual interviews, which served as mirror data for LM sessions. Based on the expansive learning cycle, the stages developed were questioning of problems and historical and empirical analysis of the activity system (SA) of PR. Results: The historical analysis identified three distinct periods, considering critical events that represented changes in the activity in study. We can say that the PR system has historically transformed and create contradictions between components: object, subjects and instruments. The reduction of the object of the PR to the offer of professional qualification showed to be incompatible with a system supported by the provision of services by actors external to social security, without articulation and coordination of these services. Also identified are difficulties of the system of activity in dealing with pre-defined object as ineligible to the PR, according to its criteria, however that is imposed by judicial determination. In addition, the reduction of installed capacity and the accumulation of tasks by the professionals (changes in the division of labor) impact on the service demand. This reality shows that there is a mismatch between the historical evolution of SA of PR and the needs of the object. Conclusion: The study allowed the analysis of the disturbances of the RP activity system perceived by the actors involved in the process and brought contributions to the development of the activity, presenting the potential to enrich and test the hypothesis of contradictions and to advance in the modeling and implementation of a new proposal for rehabilitation which should ideally be tested at the local.
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Palavras-chave
Reabilitação Profissional, INSS, Laboratório de Mudança, Vocational Rehabilitation, Change Laboratory