Revista Brasileira de Medicina do Trabalho最新文献

{"title":"Working conditions of intensive care unit nurses and quality of care during the pandemic: a qualitative study.","authors":"John Camilo Garcia, Yuliana Cárdenas, Isabela García, Susana Vallejo, Anibal Arteaga","doi":"10.47626/1679-4435-2024-1277","DOIUrl":"10.47626/1679-4435-2024-1277","url":null,"abstract":"<p><strong>Introduction: </strong>During the COVID-19 pandemic, an increase in patient demand was observed in intensive care units, as well as a deterioration of working conditions and quality of care.</p><p><strong>Objectives: </strong>To analyze the working conditions of the nursing staff of an intensive care unit in the city of Medellín during the COVID-19 pandemic and their relationship with the quality of nursing care.</p><p><strong>Methods: </strong>A qualitative study was developed in the adult intensive care unit of a third-level health care institution in the city of Medellin, Colombia. In-depth interviews were conducted with nine nursing professionals. The analysis was carried out in parallel with the collection of information throughout the research with the support of the qualitative data research software Atlas.ti.</p><p><strong>Results: </strong>The two central categories of this research were working conditions and quality of care. A dialogic relationship was observed between the two central categories of this research (working conditions and quality of care), in which good working conditions configured good quality of care. Similarly, as phenomena such as tiredness, fatigue, and work overload were observed, professionals described a subjective decrease in quality of care with a higher incidence of adverse events, absenteeism, and cost overruns.</p><p><strong>Conclusions: </strong>The deterioration of working conditions, particularly the work overload experienced by nurses during the COVID-19 pandemic, had direct consequences on their health and well-being, as well as on patient safety, quality of care, and health care institution costs.</p>","PeriodicalId":38694,"journal":{"name":"Revista Brasileira de Medicina do Trabalho","volume":"22 4","pages":"e20241277"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrective measures to reduce the accident rate in a company cleaning services sector.","authors":"Wilder Alfonso Hernández-Duarte, Paula Andrea Nonzoque-Vertel, Genny Patricia Sánchez-Sierra, Silvana Hiscela Calderón-Aucu, Iván Darío Gaitán-Díaz","doi":"10.47626/1679-4435-2024-1266","DOIUrl":"10.47626/1679-4435-2024-1266","url":null,"abstract":"<p><strong>Introduction: </strong>The accident rates presented by organizations are a problem in different economic sectors which should be managed under the principles of continuous improvement typical of occupational safety and health management systems.</p><p><strong>Objectives: </strong>To define actions on the source, the environment, and the worker aimed at reducing accident rates in a company of the cleaning service sector.</p><p><strong>Methods: </strong>The accident rate was analyzed through the consolidation of a database provided by the company corresponding to the city of Bogota, Colombia during the 1^st semester of 2023. For the analysis of the basic causes of the occupational accidents reported, personal and work-related factors were identified, consolidating the data through Pareto diagrams. Subsequently, actions were taken on the source, the environment, and the worker.</p><p><strong>Experience report: </strong>In personal factors, 80% of the causes were due to insufficient practices and lack of attention. In the work-related factors, 45.2% of the accidents corresponded to unspecified work factors, i.e., there was not enough information to identify them. This involved analyzing the company's induction and training practices. By the end of 2023, only four accidents were reported.</p><p><strong>Conclusions: </strong>From the analysis of the basic causes of the accidents reported, the need to modify the methodology of induction and prevention training sessions was identified, taking into account workers' sociodemographic characteristics.</p>","PeriodicalId":38694,"journal":{"name":"Revista Brasileira de Medicina do Trabalho","volume":"22 4","pages":"e20241266"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors related to the prevalence of pregnancy complications among subsistence workers in Medellín - Colombia.","authors":"María Osley Garzón Duque, Paula Andrea Uribe Cardenas, Fabio León Rodríguez-Ospina, Manuela Jiménez Cifuentes, Valentina Zapata Paz","doi":"10.47626/1679-4435-2023-1143","DOIUrl":"10.47626/1679-4435-2023-1143","url":null,"abstract":"<p><strong>Introduction: </strong>For the informal female workers on the streets and sidewalks of big cities, called \"venteras,\" experiencing a pregnancy in a healthy environment is an ideal difficult to achieve.</p><p><strong>Objectives: </strong>To determine the prevalence of pregnancy complications and their relationship with health, working, and non-working conditions among the \"venteras\" in downtown Medellín.</p><p><strong>Methods: </strong>This cross-sectional study utilized primary data collected through a survey administered to 291 workers. An assisted survey was conducted after obtaining informed consent from the participants. The variables included self-reported pregnancy complications, sociodemographic data, work-related conditions, home responsibilities, environmental factors, support and solidarity, and comorbidities. Descriptive and bivariate analyses were performed using chi-square tests and prevalence ratios (PR). A multivariate analysis was conducted using binomial regression. Statistical tests were carried out with 95% confidence intervals (95% CI) and a 5% margin of error.</p><p><strong>Results: </strong>The workers' mean age was 48 years, with a mean education of < 6 years; 39% had more than 2 dependents. Additionally, 53.6% reported feeling discriminated against by authorities, and 23.7% by their peers; 21.6% reported severe family dysfunction, and 15.5% showed moderate-to-severe depressive symptoms. The prevalence of complications during pregnancy was 36.9%. Factors contributing to the explanation (p < 0.05) of more complications included living in a room/boarding house (_AdjustedPR [_APR] = 3.78, 95% CI 1.20-11.91), working while pregnant (_APR 1.80, 95% CI 1.07-3.03), having moderate/severe depressive symptoms (_APR = 15.02, 95% CI 1.34-167.79), and exposure to pollutants for more than 10 hours a day (_APR = 8.11, 95% CI 8.04-214.09).</p><p><strong>Conclusions: </strong>Conditions associated with a higher prevalence of pregnancy complications in these workers are health determinants that require joint efforts from the state, workers, and society.</p>","PeriodicalId":38694,"journal":{"name":"Revista Brasileira de Medicina do Trabalho","volume":"22 4","pages":"e20231143"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hormonal responses to a stress load and state anxiety, mood, tiredness, and recovery in Portuguese police cadets.","authors":"Maria Rosário Abrantes, Raquel Barreto Madeira, Luís Fernandes Monteiro, Catarina N Matias, Luís Miguel Massuça","doi":"10.47626/1679-4435-2023-1161","DOIUrl":"10.47626/1679-4435-2023-1161","url":null,"abstract":"<p><strong>Introduction: </strong>Police officers are repeatedly exposed to conditions and incidents unique to their work.</p><p><strong>Objectives: </strong>To describe the hormonal response to a stress load (circuit fitness test) in police cadets, and to verify the association of hormone responses (cortisol and testosterone) with state anxiety, mood, tiredness, and recovery.</p><p><strong>Methods: </strong>This is an analytical, observational, cross-sectional study with a quantitative approach. A total of 31 police cadets (all male; age 21.0 ± 4.4 years) were evaluated on February 4, 2022, at Instituto Superior de Ciências Policiais e Segurança Interna, Lisbon, Portugal, in four dimensions: morphological, fitness for police work (simulated circuit), hormonal (cortisol and testosterone responses), and psychological (anxiety, mood, stress, and recovery).</p><p><strong>Results: </strong>We observed differences in cortisol concentration upon awakening and the reference value; a decrease in cortisol and testosterone concentrations until the time of fitness testing; and increases in cortisol and testosterone concentrations in response to completing the fitness test. Regarding the hormone response in anticipation of the fitness test, there is a direct correlation of cortisol with hostility and social stress and an inverse correlation of testosterone with conflicts/pressure, sleep quality, emotional exhaustion, and the sum of the recovery and stress scales. Regarding the hormone response to actually performing the task, a positive correlation was found between cortisol and personal acceptance and self-regulation.</p><p><strong>Conclusions: </strong>These findings suggest that the police cadets exhibited a healthy response to the proposed stress situation. However, whether they would respond likewise in real-world scenarios is unclear.</p>","PeriodicalId":38694,"journal":{"name":"Revista Brasileira de Medicina do Trabalho","volume":"22 4","pages":"e20231161"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal pain associated with common mental disorders among bus terminal workers in Brazil.","authors":"Sabrina Gabriele Maia Oliveira Rocha, Hermano Alexandre Lima Rocha, Sâmia Graciele Maia Oliveira Giacomini, Anamerinda de Oliveira Diaz, Luciano Lima Correia","doi":"10.47626/1679-4435-2024-1301","DOIUrl":"10.47626/1679-4435-2024-1301","url":null,"abstract":"<p><strong>Introduction: </strong>Common mental disorders affect almost one billion people worldwide and are among the main causes of work absenteeism, representing a high cost for society.</p><p><strong>Objectives: </strong>We aimed to identify factors associated with symptoms of common mental disorders among workers in urban bus terminals in Fortaleza, Brazil.</p><p><strong>Methods: </strong>This analytical cross-sectional study was based on data from periodical and pre-admission medical examinations performed in 2022. We investigated mental disorder symptoms with the Depression Anxiety & Stress Scales 21, correlating associated factors through multivariate analysis.</p><p><strong>Results: </strong>The prevalence of stress and anxiety was about 11%, while that of depression was 8.3%. Self-reported leg pain was associated with depression, anxiety, and stress. Smoking was associated with depression (adjusted odds ratio 4.96; p = 0.002) and stress (adjusted odds ratio 4.08; p = 0.003). Back pain was associated with stress (adjusted odds ratio 2.26; p = 0.018).</p><p><strong>Conclusions: </strong>To develop initiatives to reduce symptoms of common mental disorders and absenteeism, common mental disorders in workers should be assessed jointly with associated factors, such as chronic pain, smoking, and social factors.</p>","PeriodicalId":38694,"journal":{"name":"Revista Brasileira de Medicina do Trabalho","volume":"22 4","pages":"e20241301"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of underreporting occupational accidents among workers who handle laboratory animals.","authors":"Flávia Soares Lessa, Isabella Brasil Succi, Gilberto Marcelo Sperandio da Silva","doi":"10.47626/1679-4435-2024-1275","DOIUrl":"10.47626/1679-4435-2024-1275","url":null,"abstract":"<p><strong>Introduction: </strong>Occupational accidents pose a substantial health risk and represent a critical public health concern. While reporting occupational accidents is legally mandated, occupational accidents are significantly underreported, leading to institutional challenges and obstacles in planning and implementing preventive policies.</p><p><strong>Objectives: </strong>To evaluate how often workers who handle laboratory animals report their occupational accidents at the Instituto de Ciência e Tecnologia em Biomodelos/Fundação Oswaldo Cruz and to correlate this rate with their possible causes.</p><p><strong>Methods: </strong>This is an observational cohort study including workers who handle laboratory animals at the Instituto de Ciência e Tecnologia em Biomodelos/Fundação Oswaldo Cruz. Data were collected from questionnaires that these workers filled in and then compared to the accident records reported to the Núcleo de Saúde do Trabalhador (Brazil Workers' Health Center) between 2014 and 2019. We used the Research Electronic Data Capture for data entry and Stata 14 for statistical analysis.</p><p><strong>Results: </strong>Occupational accidents were underreported by 44.8% of the workers who handle laboratory animals at the Instituto de Ciência e Tecnologia em Biomodelos/Fundação Oswaldo Cruz. The characteristics of those who mostly underreported were women (63.6%), of mixed-race (55.6%), 35-44 years old (53.3%), with a doctorate degree (80%), and permanently employed (50%). The most common types of occupational accident reported in the questionnaires were scratches (17.2%) and bites (13.8%), while the most common injuries recorded were cuts (26.7%) and trips/falls (17.8%). Reasons for non-notification were apparent minor severity (57.2%), unwillingness to report (14.3%), no specific protocol to treat (14.3%), excessive bureaucracy (7.1%), and high occurrence (7.1%).</p><p><strong>Conclusions: </strong>The underreporting rate of occupational accidents is 44.8% at the Instituto de Ciência e Tecnologia em Biomodelos/Fundação Oswaldo Cruz. Workers' awareness of the importance and compulsory nature of reporting should be raised to reduce this rate.</p>","PeriodicalId":38694,"journal":{"name":"Revista Brasileira de Medicina do Trabalho","volume":"22 4","pages":"e20241275"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental workload according to sociodemographic and occupational characteristics of professionals in charge of health programs.","authors":"Carolina Elena Luengo-Martínez, Jaime Sebastián Castro-Zapata, Nicole Constanza Guíñez-Pérez","doi":"10.47626/1679-4435-2024-1245","DOIUrl":"10.47626/1679-4435-2024-1245","url":null,"abstract":"<p><strong>Introduction: </strong>Primary health care services are focused on promotion, prevention, and rehabilitation, in addition to implementing various health programs. Mental workload is defined as mental, cognitive, or intellectual demands experienced by workers during their workday.</p><p><strong>Objectives: </strong>To describe mental workload according to sociodemographic and occupational characteristics of professionals responsible for health programs in primary care facilities in the Ñuble region, Chile.</p><p><strong>Methods: </strong>A descriptive, cross-sectional quantitative study was conducted with a sample of 69 professionals. Data were collected through surveys assessing sociodemographic and occupational characteristics, workplace environmental conditions, and the <i>Escala Subjetiva de Carga Mental de Trabajo</i> (Subjective Mental Workload Scale), validated for use in Chile.</p><p><strong>Results: </strong>The mental workload was moderate-to-high, with a mean score of 3.68. The dimensions \"cognitive demands and task complexity\" and \"task characteristics\" presented the highest mean scores, while \"time organization\" and \"work pace\" showed the lowest mean scores among the variables studied.</p><p><strong>Conclusions: </strong>Younger workers with fixed-term contracts, who perceived their work environment conditions as highly inadequate and were in charge of more than 16 people presented the highest levels of mental workload.</p>","PeriodicalId":38694,"journal":{"name":"Revista Brasileira de Medicina do Trabalho","volume":"22 4","pages":"e20241245"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigating burnout and suicidal ideation in the Brazilian health care workforce: the role of workplace support during COVID-19.","authors":"Carolina Meira Moser, Bárbara Tietbohl-Santos, Ana Margareth Siqueira Bassols, Pricilla Braga Laskoski, Simone Hauck","doi":"10.47626/1679-4435-2024-1290","DOIUrl":"10.47626/1679-4435-2024-1290","url":null,"abstract":"<p><strong>Introduction: </strong>The mental health of health care workers has become a major concern, especially in the context of the COVID-19 pandemic. Identifying associated factors that could be targeted for prevention and specific interventions is crucial.</p><p><strong>Objectives: </strong>To investigate burnout, suicidal ideation, and associated factors among Brazilian health care workers during the pandemic.</p><p><strong>Methods: </strong>A cross-sectional web-based survey was conducted from May 22 to June 22, 2020. The Copenhagen Burnout Inventory was used to assess three dimensions of burnout (personal, work-related, and client-related). Individual and occupational data were also evaluated.</p><p><strong>Results: </strong>Among 844 participants (81% female, age 41.9 ± 10.9 years), clinically relevant burnout rates were 54.6% according to the Copenhagen Burnout Inventory personal dimension, with an 8.3% incidence of suicidal ideation in the last month. Workplace support exhibited the strongest association with all three burnout dimensions (β = -0.29-0.37; p < 0.001) and suicidal ideation (Exp[b] = 0.95; p = 0.002), emerging as a crucial protective factor, even when adjusting for other variables. Older age, higher household income, and regular physical exercise also emerged as protective factors against burnout, but not against suicidal ideation. Female gender, direct involvement in care of COVID-19 patients, longer working hours, and self-perceived high-risk status for COVID were risk factors solely for burnout. Childhood trauma and a history of psychiatric diagnosis were associated with both burnout and suicidal ideation.</p><p><strong>Conclusions: </strong>Fostering a supportive work environment could prove to be an efective strategy to mitigate mental health risks among health care workers in response to chronic stress, even in vulnerable contexts such as major health crises.</p>","PeriodicalId":38694,"journal":{"name":"Revista Brasileira de Medicina do Trabalho","volume":"22 4","pages":"e20241290"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive multidisciplinary approach for identifying asbestos exposure among underground workers.","authors":"Alejandro Salvado, Lilian Capone, Paula Zamorano, Mayra Samudio, María Teresa Garcia-de-Dávila, Glenda Ernst","doi":"10.47626/1679-4435-2024-1271","DOIUrl":"10.47626/1679-4435-2024-1271","url":null,"abstract":"<p><strong>Introduction: </strong>Inhalation of asbestos fibers can lead to a range of diseases, including asbestosis, pleural plaques, lung cancer, and malignant mesothelioma. Despite regulatory efforts, asbestos-related diseases remain a significant public health issue.</p><p><strong>Objectives: </strong>This study aimed to assess the characteristics and prevalence of asbestos-related diseases among exposed workers.</p><p><strong>Methods: </strong>We conducted a descriptive cohort study with underground workers in Buenos Aires, Argentina, from March 2018 to March 2023. A comprehensive screening and surveillance program, including medical examinations, was implemented to identify exposure-related signs and symptoms. Histological sections from paraffin-embedded tissue blocks were analyzed using light and polarization microscopy for lung cancer cases.</p><p><strong>Results: </strong>A total of 2,690 participants were included, of whom 2.8% (n = 77) had asbestos-related diseases and 0.22% (n = 6) had lung cancer. Occupational exposure exceeding 20 years was significantly associated with an elevated risk of asbestos-related diseases (odd ratio: 3.02; 95%CI 1.7-5.3).</p><p><strong>Conclusions: </strong>The prevalence of occupational diseases among underground workers was consistent with findings from other surveillance programs for asbestos-exposed workers. Occupational exposure exceeding 20 years emerged as a significant risk factor, markedly increasing the likelihood of asbestos-related diseases.</p>","PeriodicalId":38694,"journal":{"name":"Revista Brasileira de Medicina do Trabalho","volume":"22 4","pages":"e20241271"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flexible work hours at the SUS: labor legislation at a specialized outpatient facility in Brazil.","authors":"Rodrigo França Gomes, Marco Antonio Pereira Querol","doi":"10.47626/1679-4435-2024-1288","DOIUrl":"10.47626/1679-4435-2024-1288","url":null,"abstract":"<p><strong>Introduction: </strong>The geographical shortage and poor distribution of physicians, their traditional autonomy with multiple jobs, and low salaries they are paid in the public sector have created a reality of widespread failure to comply with the work hours defined in the Brazil Unified Health System legislation, causing legal uncertainty for managers and physicians.</p><p><strong>Objectives: </strong>This report aims to analyze the perception of managers, health personnel, and users of the Unified Health System about the corporate experience of a new labor legislation that preserves statutory labor rights and sets flexible work hours for medical specialists in Praia Grande, São Paulo, Brazil.</p><p><strong>Methods: </strong>This is a qualitative study with a phenomenological basis, using ethnographic research. A total of 42 social actors were interviewed in person or remotely with a digital recorder, including managers, physicians, and clients of the Unified Health System at a specialized outpatient facility (mean interview length 24.1 minutes [95%CI 17.7-30.6]), and official documentation.</p><p><strong>Corporate experience: </strong>Emic and ethical perspectives from 489 units of meaning were compiled into 10 categories for analysis and presented in an ethnographic report for regrouping through nomothetic analysis, and records from an ideographic perspective for validity through integrative synthesis.</p><p><strong>Conclusions: </strong>The new legislation provided professional satisfaction, atracting and retaining specialist practitioners, providing legal certainty with external audit bodies and improving access to diagnostic and therapeutic procedures, microregulation between specialists and Primary Health Care, standing out as a successful experience for external audit bodies and atracting managerial interest from all over Brazil.</p>","PeriodicalId":38694,"journal":{"name":"Revista Brasileira de Medicina do Trabalho","volume":"22 4","pages":"e20241288"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}