Rural context and professional rehabilitation in a region of the Ribeira Valley

ABSTRACT Aim: To investigate the sociodemographic profile, of work and health, of workers from a region of Registro (SP), locate in Ribeira Valley, and to identify the barriers and facilitators in the professional rehabilitation process of the National Institute of Social Security (INSS), of insured persons workers of this region. Methods: Two steps: (1) A list of workers was obtained from the Family Health Strategy of rural neighborhoods in the city of Registro (SP), and a questionnaire with sociodemographic data, of work and health, was applied, under the form of an interview. (2) Subsequently, two reference professionals of the INSS, who worked at the headquarters of this region were identified and, in addition, individual interviews were conducted to analyze thematic content. Results: Regarding the profile of the subjects, most workers worked on banana plantations, lived on farms, had low schooling; all reported musculoskeletal symptoms, among others. In interviews with reference professionals of the INSS, it was possible to observe, among the main barriers found to professional rehabilitation: the profile of insured rural people with low schooling, with difficulties in transportation, few courses offered, and the evaluation of the medical expert based on the biomedical model, with suffering and injustice. Among the facilitators: the welcome of the social workers reference professionals, the bond established and the empathy. Conclusion: There is a need for public policies that can guarantee the rights of workers and promote improvements in the current model of professional rehabilitation.

摘要
研究目的：调查位于里贝拉谷（Ribeira Valley）的圣保罗州雷吉斯特罗市（Registro，SP）某区域劳动者的社会人口学特征、工作与健康状况，并识别本区域参保劳动者在巴西国家社会保障局（Instituto Nacional do Seguro Social，INSS）职业康复流程中面临的障碍与促进因素。
研究方法：分为两个阶段：（1）从雷吉斯特罗市（SP）农村社区的家庭健康策略（Family Health Strategy）服务中获取劳动者名单，以访谈形式施测包含社会人口学数据、工作与健康相关信息的问卷。（2）随后识别出两名驻该区域总部的巴西国家社会保障局（INSS）对口专业人员，并通过个人访谈开展主题内容分析。
研究结果：就研究对象的特征而言，绝大多数劳动者就职于香蕉种植园、居住于农场，受教育程度偏低；所有受访者均报告存在肌肉骨骼症状等健康问题。在对INSS对口专业人员的访谈中，可观察到职业康复面临的主要障碍包括：受教育程度偏低的参保农村劳动者群体特征、交通出行困难、可提供的培训课程匮乏，以及基于生物医学模式的医学鉴定评估存在不公与弊端。而促进因素则包括：对口社工的接待服务、建立的联结关系与共情关怀。
研究结论：亟需出台公共政策以保障劳动者权益，并推动现行职业康复模式的优化完善。