EXPERIENCES, WORKING CONDITIONS AND HEALTH-DISEASE PROCESS: PORTRAITS OF TEACHERS’ REALITY¹

ABSTRACT:

The teachers’ working conditions and their experiences in the basic public education network were impacted by the educational reforms implemented in the 1990s, with a strong influence on neoliberal policy. As a result of this influence, there was a precariousness of public education in basic education. The repercussions of this educational scenario, characterized by terrible work achievement conditions and devaluation of the teaching career, have been affecting the teacher's life story and caused illnesses in this working class. In this context, the aim of this study was to understand the processes involved in the illness of public school teachers in the city of Montes Claros-MG, based on experiences and working conditions. This is qualitative research, based on Symbolic Interactionism, carried out through the Grounded Theory, from a social constructionist perspective. Twelve teachers of basic education in state schools were interviewed. The data, in the analysis process, produced encodings that resulted in seven axial categories, which were searched to elucidate the theoretical assumptions of this investigation. The results of this study showed that the illness of basic education teachers involves multifactorial processes and causes. The discussions of this study pointed at the illness of basic education teachers involves multifactorial processes and causes, such as: the precariousness of teaching work; subjective manifestations of teachers' malaise and impasses in overcoming this feeling; facing conflicts with students and family members at school; the mismatches in the teacher's pedagogical practice and the repercussions of work on the teacher's personal life. Thus, as a result, all these processes were related to the physical and/or mental illness of the teachers participating in this research.

Keywords
Teachers; working conditions; health-disease process; grounded theory

RESUMO:

As condições de trabalho docente e as vivências dos professores da rede básica de ensino público foram impactadas a partir das reformas educacionais implantadas na década de 1990, com forte influência da política neoliberal. Como resultado dessa influência, houve a precarização da educação pública na educação básica. Repercussões deste cenário educativo, caracterizado por péssimas condições para realização do trabalho e desvalorização da carreira docente têm afetado a história de vida do professor e provocado adoecimentos nesta classe trabalhadora. Nesse contexto, o objetivo deste estudo foi de compreender os processos envolvidos no adoecimento de professores de escolas públicas da cidade de Montes Claros-MG, a partir de vivências e condições de trabalho. Trata-se de uma pesquisa qualitativa, fundamentada no Interacionismo Simbólico, realizada por meio do método Grounded Theory, na perspectiva construcionista social. Foram entrevistados 12 professores da educação básica em escolas estaduais. Os dados, no processo de análise, produziram codificações que resultaram em sete categorias axiais, as quais buscam elucidar os pressupostos teóricos desta investigação. As discussões deste estudo apontaram que o adoecimento dos professores da educação básica envolve processos e causas multifatoriais, tais como: a precarização do trabalho docente; as manifestações subjetivas do mal-estar docente e os impasses na superação desse sentimento; o enfrentamento de conflitos com os alunos e familiares na escola; os descompassos na prática pedagógica do professor e as repercussões do trabalho na vida pessoal do professor. Assim, como resultados, todos esses processos apresentaram relação com o adoecimento físico e/ou mental dos professores participantes dessa pesquisa.

Palavras-chave:
Docentes; condições de trabalho; processo saúde-doença; grounded theory.

RESUMEN:

Las condiciones del trabajo docente y las experiencias de los profesores de la red pública de enseñanza básica fueron impactadas a partir de las reformas educacionales implementadas en la década de 1990, con fuerte influencia de las políticas neoliberales. Como resultado de esta influencia, se produjo la precarización de la enseñanza pública en la educación básica. Las repercusiones de este escenario educativo, caracterizado por las malas condiciones de trabajo y la desvalorización de la carrera docente, han afectado la historia de vida de los maestros y provocado enfermedades en esta clase trabajadora. En este contexto, el objetivo de este estudio fue comprender los procesos involucrados en la enfermedad de los profesores de escuelas públicas de la ciudad de Montes Claros-MG, a partir de experiencias y condiciones de trabajo. Se trata de una investigación cualitativa, basada en el Interaccionismo Simbólico, realizada a través del método de la Teoría Fundamentada, desde una perspectiva construccionista social. Fueron entrevistados 12 profesores de educación básica de escuelas públicas. Los datos, en el proceso de análisis, produjeron codificaciones que resultaron en siete categorías axiales, que buscan dilucidar los supuestos teóricos de esta investigación. Las discusiones de este estudio señalaron que la enfermedad de los profesores de educación básica involucra procesos y causas multifactoriales, tales como: la precarización del trabajo docente; las manifestaciones subjetivas del malestar del profesor y los impases en la superación de este sentimiento; el enfrentamiento de conflictos con alumnos y familiares en la escuela; los desajustes en la práctica pedagógica del profesor y las repercusiones del trabajo en la vida personal del profesor. Así, como resultados, todos estos procesos se relacionaron con la enfermedad física y/o mental de los profesores participantes en esta investigación.

Palabras clave:
Facultad; condiciones laborales; proceso salud-enfermedad; grounded theory

INTRODUCTION

The teaching work category encompasses the subjects/workers in their experiences, complex dimensions, experiences, identities, and the entire dynamics of the teacher's work processes that permeate the school environment, with repercussions in the context of the school community and the lives of teachers. Therefore, teaching work is made up of social relationships and identities, since, through the teaching-learning process and the relationships established at school, teachers interact in social dynamics, participating in society and contributing to human formation, citizen, and subject technique. In this way, teaching activities comprise the responsibilities and relationships that are experienced at school, in addition to on-site management, being demarcated by specific legislation and influenced by historical and political issues (ASSUNAÇÃO; ABREU, 2019).

Basic education teachers must be attentive to the student’s training, with commitment, skills, and competencies; and in their daily life, they must have the preparation of classes and a careful look at the execution of their pedagogical practice as their guiding principle, contextualized with the school reality, always considering the students' comprehensive training. For this endeavor to occur, these teachers must establish relationships with “knowledge” (teaching subject, the relationship between theory and practice, language, and knowledge production); with “doing” (planning, methods, objectives, student motivation, and evaluation), and with “being” and “feeling” (pleasure, enthusiasm, demands, principles and values) (CUNHA, 2008; NEVES; BRITO; MUNIZ, 2019).

All these didactic-pedagogical relationships should exist in a professional dynamic, in which the educational objective goes hand in hand with the reduction of social inequalities, in a political scenario of valuing education workers, with an adequate school infrastructure and with investments in public education. However, what is perceived in public education, in basic education in Brazil, is a process of precarious teaching work, with strong repercussions on the experiences, working conditions, and the process of illness of basic education teachers. This new chaotic reality of Brazilian education was strongly influenced by neoliberal ideals, such as a policy of downsizing the state, with direct impacts on Brazilian public schools and the teaching profession (PAULA; LIMA, 2020).

Influenced by the new neoliberal economic order, the Brazilian educational system, in line with this thinking, reduced spending on social welfare, which can be understood as spending on health, education, and pension funds (ANDERSON, 1996; PAULA; LIMA, 2020). Within the scope of educational reforms (Lei de Diretrizes e Bases da Educação Nacional (LDB) nº 9394 of 1996), there was a weakening of the teaching profession, making the teacher, from an economic point of view, a professional with characteristics of flexible, variable, and multifunctional, with precarious hiring regime; and permanent teachers, with much fewer formal labor rights (BRASIL, 1996).

Thus, the school starts to be thought of as a private company, with managerial management, and teachers are seen as responsible for cumulative assignments, the performance profile (teachers with numerous functions), and continuous performance evaluation. The resources allocated to the teacher's work, such as school spaces/infrastructures, structures, and teaching materials, are reduced. Most of the time, salaries are incompatible with the demand for work. In teaching work with an intense, repetitive rhythm, full of multiple tasks, and exhausting working hours, primary school teachers are routinely exposed to situations that compromise their physical and/or mental health, resulting from the structure and organization of their work (PASINATO; FÁVERO, 2020; PREVITALI, 2020; MORAIS; ABREU; ASSUNAÇÃO, 2023).

The entire structure and organization of basic education work were influenced by neoliberal policy, which advocates serving the largest number of students possible (clientelism and training for the world of work), without, however, a compatible investment in public education. Therefore, the terrible working conditions in public schools are evident, always overloaded with an excessive number of students per class, of classes, and, in many cases, with teachers working double shifts (mainly women) due to low salaries. Many teachers, in addition to working double shifts, also perform family and home care duties. The excess of activities that teachers carry out outside class hours (such as lesson planning, test corrections, and other activities that need to be developed) are also emphasized, with repercussions and losses for teachers, such as the reduction of teaching time to take care of themselves, stay with their family, and enjoy leisure activities (SOUZA; LEITE, 2011; ALVES, 2020).

The precariousness of teaching work is also perceived in the school context, with an unfavorable work environment, very precarious facilities, the presence of allergens, temperature variations, lots of noise, lack of resources and assistants, infrequent breaks, and uncomfortable postures. The realities of schools are also quite different, with the presence of an audience of students who bring with them the consequences of social inequalities. In this way, the teacher ends up performing a social function that often goes beyond the teaching-learning process. The teacher is faced with situations that require attention and assistance from students, playing the role of family members and other professionals, such as psychologists and social workers, in their daily practice. In addition to all this destructuring and disorganization of teaching work, teachers perceive the devaluation of their work, materialized by the lack of time for updating and, mainly, by low pay and social devaluation (OLIVEIRA; PEREIRA JUNIOR; REVI, 2020).

It is important to highlight that the working conditions of these professionals greatly contribute to the exercise of teaching hopelessness, with strong impacts on teaching work and personal life. In this context, all these issues highlighted above converge to the illness of basic education teachers (ALVEZ, 2020).

Workers' health is part of an interdisciplinary field, linked to social movements, which originated through criticism of the limitations of the social and political models in force at the time. This area of study is part of collective health, and it is a locus of interdisciplinary and multi-institutional discussion, constituting work as one of the main social determinants of health (COSTA et al., 2013). In this direction, worker health must be associated with forms of empowerment of working subjects, with special attention to the well-being and quality of life of these professionals in the work environment. However, what is perceived, most of the time, is that the reality of the social practice of work, which education workers have experienced, is the loss of biopsychosocial health, with a significant reduction in quality of life (GARCIA et al., 2010; DIAS, NASCIMENTO, 2020).

Thus, the work activity of teaching in basic education is greatly influenced by the social and political context in Brazil and, due to this influence on the teacher's working conditions, illness has affected many of these workers. These illnesses are cumulative processes, generated by a perennial feeling of discomfort, disillusionment, and frustration with one's work. The lack of identification with teaching, the incentives for teaching work, and the exercise of hopelessness are confluences that result in various forms of illness among teachers. The physical and mental illness of teachers has become a public health problem and, therefore, it is necessary to understand this process, seeking an intertwining between health and illness, social and working conditions of teachers, as well as the relationship with the political sphere (BORGES, 2020; ASSUNAÇÃO; ABREU, 2019; RIBEIRO, et al., 2022).

The objective of this study was to understand the processes involved in the illness of teachers from public schools in the city of Montes Claros-MG, based on experiences and working conditions.

METHODOLOGY

This is a study with a qualitative approach, based on the Symbolic Interactionism method, with the main purpose of developing assumptions or a theory related to the illness of Basic Education teachers in the public education network, creating conceptual frameworks about this topic, by the method of Grounded Theory or Theory Based on Data, from the social constructionist perspective, proposed by Kathy Charmaz (CHARMAZ, 2009).

This research comes from the project entitled “Health and teaching work: meanings, experiences and interpersonal relationships” (“Saúde e trabalho docente: significados, experiências e relações interpessoais”), by the study group called ProfSMoc, composed of teachers and students from the State University of Montes Claros-MG (Unimontes). This study was developed in state schools in the city of Montes Claros-MG, starting in March 2017.

Teachers, of both genders, from the state public network in the city of Montes Claros-MG, working in complete primary and secondary education, from the various subjects that make up these teaching modules, were investigated. As inclusion criteria, teachers from the state public basic education network, who participated in previous research carried out by the ProfSMoc study group, were incorporated into this study. Thus, based on the quantitative results of the project: “Chronic health conditions and associated factors among public school teachers: a population-based study” (“Condições crônicas de saúde e fatores associados entre professores da rede pública: estudo de base populacional”), those teachers who presented a high degree of stress, depression, burnout, and polypathologies were included in this investigation, based on five self-referenced clinical conditions (SILVA et al., 2017).

In this study, theoretical or intentional sampling was established, as defined by Strauss and Corbin (2008). The group of teachers was divided into two sample groups: teachers who had worked in teaching for more than ten years and teachers who had worked in teaching for less than ten years. This was an important contrast to generate the process of building a theory based on data.

Initially, interviews were carried out with teachers who constituted the first sample group, and, during the study, other interviews were carried out to constitute the second sample group.

The data saturation process (theoretical saturation) occurred as the analysis categories were refined, until reaching the point where no more evidence of new categorization groups was obtained. Thus, 12 interviews made up the final sample group: a group composed of 6 (six) teachers who had more than 10 years of work and another group proposed by 6 (six) teachers who had less than 10 years of work (GLASER; STRAUSS, 1967; GOMES et al., 2015).

To collect the data, contact was made with state public schools in the city of Montes Claros-MG, which were already being researched by the ProfSMoc study group (quantitative research described previously). The teachers selected for this research were invited in advance to be interviewed. The Informed Consent Terms (ICF) were signed. The interviews took place in state schools, always with a prior appointment with each teacher, individually, in rooms reserved for this purpose. The interviews were carried out in the first and second semesters of 2017 and lasted an average of 1 hour. They were recorded and later transcribed.

The research individuals were twelve teachers, ten female teachers and two male teachers. Therefore, most teachers in this research are women, a striking characteristic in teaching, especially in primary and secondary education. The ages of the teachers ranged from 34 years old to 57 years old. Six teachers are married, five teachers are single, and one is a widow. Only four teachers have specialization and all of them have degrees. Teachers have degrees in different areas of knowledge. All research participants work as teachers only in public education, only five teachers are public servants and seven are hired. Six teachers work in primary education (1st to 5th year - Elementary School); three teachers work in middle school (6th to 9th year) and three teachers work in high school.

For this investigation, narrative or in-depth interviews were used and focused on the illness processes of teachers in the public education network that present relationships with the working conditions of these professionals, with consequences in everyday life (health, work, family, friends, life routines, etc.) (CHARMAZ, 2009).

The first interview of the first sample group, after its transcription, was subjected to an exhaustive reading process, making the first highlights of excerpts and free codes, to produce open and axial categories, with the help of the Atlas.ti 9.0 software. Once the first categories were established, the interview was read by two other researchers, who validated them through the triangulation process. Furthermore, the first teacher interviewed also confirmed the coding data from the interview. Thus, we moved on to the other interviews, which constituted the first part of the theoretical sampling. After this process, an external researcher validated the organization of the data (focused coding). From these interviews, it was possible to establish comparisons that allowed the formulation of theoretical assumptions with the elaboration of a first diagram of the construction of the theory or assumptions, presented in Figure 1.

Figure 1
Diagram of working conditions and health-illness process.

After completing the first stage of constituting the first sample group, a new trip to the field was carried out to test the theoretical assumptions with the second sample group. Thus, with this stage completed, data collection was completed, as it answered the theoretical questions proposed for the analysis, pointing out conceptual elements that relate teachers' illnesses to working conditions in different state public schools.

In terms of methodological sequence, the 12 interviews followed these steps: initial coding (carefully reading each line of the interview and creating a free code for each line) - in this research, 1,877 (one thousand, eight hundred and seventy-seven open or free codes), corresponding to the analysis of the 12 interviews; focused coding (brought together the most significant and frequent previous codes with the creation of subcategories, which seek to establish relationships between codes produced and allow the formulation of hypotheses and their verification). In this research, 24 subcategories or 24 code families were created; selective or axial coding (which aimed to group focal subcategories into axial categories, specifying the connections between them). Axial categories expand the analytical capacity of emerging ideas, reaching emerging analyses in theory. Seven axial categories were created; and, finally, theoretical coding was carried out, recognized as the final phase of categorization, in which concepts were extracted and integrated into a central theoretical category, allowing a deeper understanding of the empirical world. It is important to highlight that, in this method, all codes were exhaustively compared, until this format was highlighted.

Throughout the entire analysis process, 35 memos were developed, which are written about the data and research directions, with a theoretical basis. In this research, the appropriate use of literature was adopted in all phases of the research, and the literature was compiled after data analysis (CHARMAZ, 2009). Furthermore, Atlas.ti 9.0 software tools were used, helping to organize the data for subsequent analysis by the researcher.

The study project was previously evaluated and approved by the Research Ethics Committee of the State University of Montes Claros-MG (Opinion no.: 1,969,497), following CNS resolution No. 466, of December 12, 2012 (Ethics in Research with human beings) and with CNS resolution No. 510, of April 7, 2016 (Ethics in Research in Human and Social Sciences).

RESULTS AND DISCUSSION

The findings gathered here were extracted from the narratives of the research individuals, which allowed the construction of a central substantive theory about teacher illness, marked by proceduralities and causalities that emerged from the refinement of concepts, as represented below:

Figure 2
Diagram of the central theory of the investigation.

Thus, the process of constructing concepts will be discussed, using as reference words, excerpts of speeches and related categories that permeate the emergence of the central theory of this investigation, bringing together subjective trajectories, spaces of interaction and temporality. Teachers are identified throughout the discussion with the letter “P” and numbers from 1 to 12, identifying the 12 teachers participating in this study.

Concept 1: Precariousness of teaching work: state restrictions and poor management in basic education

Throughout data coding, concepts emerged from the statements of the interviewed teachers and were discussed based on the literature. The first concept concerns the precariousness of teaching work. Changes in capitalist production processes are constant and, in this context, show stages that alternate between the decline and rise of the system (MOURA et al., 2019).

Marx (1973) pointed out the dynamics of capitalist development and the accumulation of capital based on the extraction of surplus value from work. In this sense, through the modifications of the capitalist world, neoliberal ideology emerges, which highlights the prerogative of the minimum state, associated with the reduction of public power's role in social demands (including education), increased control of public spending, deregulation labor rights, tax reforms, and investments to make the economy strong and promote monetary balance (ANDERSON, 1996; OLIVEIRA; SILVA; BENIGNO, 2021).

In this logic, the neoliberal period is marked by the search for profit recovery strategies, since the Fordist/Taylorist accumulation pattern was exhausted. Neoliberal proposals were contrary to the state's social policies and saw them as villains of the economy. Thus, neoliberal thinkers stated that State expenditure on public policies and union representation exhausted companies' profits (GOMES et al., 2012, BORGES, 2020).

Thus, neoliberal reforms (implemented, especially, by the rulers of the 1990s and the first decades of the 21st century in Brazil) modified the Brazilian educational system, under the guidance of international mechanisms. These changes aimed at the direct or indirect privatization of public services, the reduction of spending on education and other social sectors, in addition to management and control over teaching activities (PAULANI, 2005; PAULANI, 2016). In this sense, these measures affected teachers' working conditions, marked by the precariousness of teaching work, budget restrictions for state education, and inefficient management of the education area (PASINATO; FÁVERO, 2020).

Many teachers interviewed in this research pointed out, in their speeches, the impacts of precarious teaching work on the daily lives of state public schools:

“The government would have to provide us with minimum working conditions at school, but it doesn’t. I returned here [school] in 2010. Since 2014, the director of this school has been asking for the school to be renovated. At this school, during the rainy season, if the student touches the wall, they get shocked” (P5).

“We have a student here who uses a wheelchair and there is no bathroom for her, we have to send her away early because there is no adapted bathroom for her” (P1).

“Sometimes, when we go to do an activity at school, we don’t have enough money to buy paper, and we have to help. Here, we have even crowdsourced student lunches, because students on afternoon shifts cannot go without a snack. So that’s it” (P6).

Given this, through P5's report, the slowness of government bodies in the state of Minas Gerais in carrying out physical renovations at this school, greatly increasing the chances of students at that institution receiving electric shocks, with an imminent risk of death. This fact highlights how abandoned public schools are, from a structural point of view, being a possible reflection of the state's budgetary restraint (PASINATO; FÁVERO, 2020).

Another very delicate issue was addressed by P1, which highlights the lack of physical structure, with a focus on accessibility for wheelchair-bound students. Article 27 of the Statute of Persons with Disabilities (BRASIL, 2015) establishes education as a right for people with disabilities, ensuring an inclusive education system at all levels. This article makes it clear that it is the duty of the State, the family, the school community, and society to ensure quality education for children and young people with disabilities, protecting them from all forms of violence, neglect, and discrimination. Consequently, the perversity of the precariousness of the physical structure of public schools can be noted, which deprives students with disabilities of the right to access full-time education and the physical spaces of the school.

In addition to the points identified so far, P6 points out that teachers, on some occasions, need to donate to the school community to make up for, for example, a lack of work materials and even food for students' meals. The complexity of state restrictions (minimum state logic) has prevailed within schools and, once again, the financial impact and responsibility for purchasing basic materials for work and food for students fall on the education worker (FRANCKLIN, 2018).

Another aspect reported in the teachers' speeches concerns the precariousness and flexibility of teachers' employment contracts and the loss of rights. These new labor relations and precarious contractual forms also affect teachers and are increasingly accentuated by neoliberal influences (SILVA; GOMES; MOTTA, 2020). Next, P11 demonstrates that she feels unstable all the time in the teaching contracting regime for the public education sector:

“I'm thinking about the future all the time, because as I'm not permanent at the school, every year I'm hired, and the contract ends at the end of the year. So I am looking for a job again, so it's instability, I have stability throughout the year. We don’t know if the rules for hiring will remain the same, so it does create instability” (P11).

In this sense, the increase in temporary contracts in public education networks in the state of Minas Gerais, the low salary, the lack of respect from governments for a decent national salary, the inadequacy or absence of career and salary plans and the loss of labor and social security guarantees arising from the State reform processes have made the situation of instability and precarious employment in public teaching increasingly acute (FRANCKLIN, 2018; PREVITALI, 2022).

The existence of different employment relationships within the public teaching profession is also another aspect that represents stratification and fragmentation of the class, because, although permanent and temporary teachers are teachers in the state network (as they have different employment relationships), they do not share the same interests. These teachers generally do not fight for the same ideals, which weakens the demanding power and organization of the category, destabilizing the teaching worker union. Therefore, the precariousness of teaching work, the logic of the minimum state, and the deficient public management of public education have generated teaching malaise (OLIVEIRA, 2004; FERREIRA; ABREU, 2014; FERREIRA, 2019).

Concept 2: Subjective manifestations of teaching malaise: experiences of devaluation and frustration in the teaching career

The second concept of the theory was based on data collected from teachers and concerns the subjective manifestations of teacher malaise, generated by the reality of the public education scenario in Brazil and the experiences of devaluation and frustration in the teaching career.

The way teachers deal with daily school life has been different, as the working conditions imposed on this class have resulted in significantly negative changes. Consequently, educational reforms, combined with this new scenario of changes in the world of work (neoliberal influences), have had an unfavorable impact on teachers, causing strong impacts on their professional valuation (ALVES et al., 2020).

The precariousness of teaching work (imposed by productive restructuring, state administrative reform, and education management) has links with flexibilization, terrible working conditions, competitiveness, weakening, the loss of autonomy, lack of support for training and teaching qualifications and the valorization of knowledge from experience to the detriment of pedagogical knowledge. Thus, because of this process, the presence of suffering, illness, withdrawal, excessive tiredness, conflicts, and loss of control over their work is observed by the teachers (PENTEADO; SOUZA NETO, 2019). These highlighted speeches are among the collected in the interviews:

“Yeah... (deep breath). I feel frustrated with teaching. Because education has taken a path nowadays that we cannot carry out our work” (P1).

“I'm dying to get out of the classroom soon. Today I feel tired, and dissatisfied because we work a lot and have no financial return. Our system doesn't value us, we don't have autonomy, so we don't have pleasure, we work because we need a salary. Of course, we do, and even though we are dissatisfied with the work financially, we do our work responsibly, [..] but I don't feel satisfied today” (P8).

Concerning what was said by teachers P1 and P8, the frustration and dissatisfaction present in the teaching career may be related to the changes in the education system, which took place from the 1990s onwards. In legal aspects, in Brazil, educational policies implemented in recent decades have resulted in substantial changes in education systems, as well as in the understanding of the characteristics of teaching work. In these new scenarios in the public education sector (in basic education), schools began to organize to meet greater demands. There was an increase in enrollment, an increase in classes, and the number of students, as well as an increase in teaching modalities. Within this form of organization, the tasks assumed by the school and, consequently, the functions of teaching work were expanded. Therefore, the more complex the demands that schools must respond to, the roles of teachers also increase in complexity (ASSUNAÇÃO; OLIVEIRA, 2009; MORAIS; ABREU; ASSUNAÇÃO, 2023).

Despite this increased demand, there were no improvements in schools, nor salary adjustments for this working class. In this view, in the context of a school without investment, the process of disqualification and devaluation suffered by teachers in the public sector is identified. These professionals then start to lose autonomy in their jobs and, therefore, are not seen as active and participatory subjects in the conception and organization of teaching work. This working class is burdened by new school management policies, which demand herculean work from teachers, that transcends the pedagogical context and goes beyond the walls of the classroom (OLIVEIRA, 2004; OLIVEIRA; PEREIRA JUNIOR; REVI, 2020).

Esteve (1999) uses the expression “teaching malaise” to refer to the permanent and negative effects that affect the teacher's personality, because of the psychological and social conditions in which he/she teaches, considering changes in the educational sector. Some of these changes reflect, greatly, on the daily practice of the teacher in the classroom and extrapolate to personal life. Therefore, this professional develops negative feelings, capable of modifying the performance of their work (COSTA; CECCIM, 2022). In this understanding, it is noted that teachers' feelings are varied and concern the subjectivities of each person; however, in this research, most of the time, we observed a mix of frustration and dissatisfaction among the teachers. These aspects reinforce that teacher malaise is a notable presence in the lives of the professionals studied, with possible repercussions on their health.

Concept 3: Impasses in the search for overcoming teaching malaise

Based on the reports of teacher malaise in this research, the concept of attempts to overcome this feeling was recurrent in the speeches of almost all teachers and a large part of the speeches converged on abandoning the teaching profession.

This profession has not been more attractive due to devaluation and work overload. In this context, teachers have felt increasingly powerless, devalued, and disinterested in public education. The reports of many teachers about this reality point to feelings of impotence, frustration, helplessness, devaluation, and lack of interest in continuing to work in the area of education (OLIVEIRA; PEREIRA JUNIOR, 2020).

Low salaries, precarious situations, job dissatisfaction and professional discredit are among the factors that most contribute to teachers abandoning the teaching profession. If dissatisfaction with work is not reversed, abandonment of the profession will likely occur (DIAS; NASCIMENTO, 2020). The following excerpts of speeches aimed at overcoming teaching malaise:

“Regarding teaching, I intend to leave the area. I'm waiting for a competition, I believe my time in the education field is short. I'm looking for other paths. I'm looking for other competitions and studying for other competitions, I intend to leave education” (P11).

“The tendency, if we don’t have a drastic change in education, what will happen is teachers giving up their career” (P2).

Therefore, for a long time, teachers have been suffering from malaise in the profession, which causes personal lack of motivation with teaching, abandonment, dissatisfaction, indisposition, among other symptoms that demonstrate self-depreciation of the career. Therefore, to overcome this reality, education professionals have migrated to different paths, including abandoning their careers (CABRAL FILHO, 2022).

Concept 4: Facing conflicts with students and families at school

The education professional, inserted in the pedagogical praxis, experiences relationships with students, students' families, school management and co-workers. These relationships are sometimes conflicting, and can change the dynamics of the classroom, with repercussions on the teaching-learning process, on the human development of students and on the teacher's life (wear and tear, changes in health, etc.). In this topic, teachers' relationships with students and students' families will be emphasized.

Through the immersion of data from this research, the teachers interviewed pointed out that relationships with many students, in the context of the classroom, have been difficult. The teachers highlighted the daily work at school, with students whose profiles are increasingly complex, with high emotional and affective demands. Teachers also described that there are many undisciplined, violent and, in many cases, abused students, with needs that exceed the teacher's knowledge and training. All these issues, which become part of teaching work, seem to be naturalized by higher authorities in the area of Education (state, superintendencies, etc.).

Faced with this new reality, what has become increasingly evident is the feeling of obligation by the teachers to respond to the new pedagogical and administrative demands imposed vertically, providing support to students, even without specific training and teacher training. After these confrontations and experiences of new tasks at school, teachers express a feeling of insecurity and helplessness. They lack decent working conditions appropriate to the reality of public schools and, in this context, the subjectivities of each education worker begin to emerge (DIAS; NASCIMENTO, 2020). The following statements describe some anxieties regarding frequent (often conflicting) contact with students:

“In the past, you would have a class with thirty-five students, or thirty students at most, three of them didn’t want to know anything, today it’s the opposite: a class of thirty-five, two want something, thirty-three don’t want anything, then things reversed. Today they fight to get a lower grade, they ask and joke: “how much did you get? Um, what about you? Zero, oh I won then.” So they are fighting to get a lower grade, they are not aware because of the continued progression in the state, and the teacher has been faced with this sad reality” (P3).

“It's a very violent school, it has an absurd level of violence and in my case it was complicated, because I work to pacify and try to improve the students' worldview. It was difficult for those students, as they are not used to hearing words of kindness and affection. Most of the students know the language of violence and this had an impact on me, as a teacher, because sometimes I left there in pieces” (P7).

“Because you see in your eyes that the student has a problem, you realize whether it is a serious problem or not, you get emotionally involved, there is no way around it. We really get involved, we can't keep our distance and all of this is several worlds above your head, so it's exhausting. You need to be a psychologist, social worker, father and mother at the same time” (P4)

In line with P3's report, the student's lack of interest in studies and their indiscipline leave the teacher unmotivated with teaching (MORAIS; ABREU; ASSUNAÇÃO, 2023).

The lack of teacher autonomy, present in the school context, and the softening of the student flow process in relation to the next stage (proposed by the continued progression of students) have had an impact on the students' attitude, demonstrated through an increase in indiscipline, with consequent overload for teaching staff. Demo (1998, p. 159) highlights that [...] “the promotion of the student to the next stage, becoming automatic, conceals the lack of learning, leading public schools even more quickly and fatally to be recognized as poor thing for the poor.” This ease in the student's progression process has revealed discouragement, the lack of commitment and seriousness of students in relation to their studies in the context of the teaching-learning process and the results in the classroom have affected teaching practice (MELO; ROGGERO, 2023).

Another fact that has drawn attention is that the impact of social inequalities has affected public schools and, therefore, several social problems are present in the school context; as examples, the lack of family support, intellectual abandonment, violence present in communities, problems related to drug use and sexual abuse. However, the teacher who oversees educational processes cannot meet all these demands and ends up feeling distressed, as stated by P7 and P4.

During pedagogical practice and, often, outside the classroom context, teachers have performed roles as public agents, social workers, nurses, psychologists, among others. These demands have contributed to a feeling of loss of professional identity, deprofessionalization and the realization that teaching is sometimes not the most important thing (LIMA et al., 2020). The socioeconomic and cultural conditions of the population are directly related to the production of schooling. Thus, the democratization of school education requires the achievement, for the entire population, of socioeconomic conditions that allow them to enjoy the right to education and the construction of a school capable of meeting the demand to educate everyone with socially defined quality standards (JACOMINI, 2009).

Regarding the relationship between school and family, it is necessary to highlight that these two centers of child/adolescent training represent contexts in which the educational process with complementary roles must occur. The human, sociocultural and existential formation of children and adolescents is in the dynamic and dialogued convergence of the values/directions of each of these social sectors. Thus, both the family and the school are co-responsible for the education of children and adolescents. However, the family context is the first space in which the individual's educational and training processes occur. There are different educational approaches in each social locus. What can be modified is what is taught in education and the methods for teaching (LOUREIRO, 2017). Based on this assumption, the family and school can be institutions that promote or inhibit individuals' educational processes.

“But the father, he is not present at school. He thinks it is the school's obligation to solve his son's problem. There are countless times when you call his father at school and the father turns around and says “oh: I already gave that one to God”. In other words, he gave it to God and put it in the school, right?” (P3).

“You don’t have family support, family support. Today, the family has delegated the role of educating their child to the school” (P12).

Through the speeches of these teachers, we can see that the fathers, mothers and those responsible for their children have given the school and, consequently, the teacher, responsibility for their children's education within the family structure. With all these changes in current society, which occur at a dizzying pace, the family, as a pillar of primary socialization, becomes unstable in its characteristics of constituting the integral formation of children (COSTA; SILVA; SOUZA, 2019).

Thus, family management has been failing in its educational mission, reporting to the school and other educational spaces “many of its traditional responsibilities, such as the socialization, education and citizenship practices of its children”. In this way, this “leads us to witness the scarcity of socializing capacity, as a crisis of the family and community as institutions with responsibilities” (ENGUITA, 2001).

When family and school maintain good relations, the conditions for better student learning and development can be maximized. Therefore, parents and teachers must be encouraged to discuss and seek joint and specific strategies for their roles, which result in new options and conditions for mutual help (LEITE; TASSONI, 2002; SANTOS et al., 2022).

In this researched sample, most teachers pointed out this distance between parents and school. Therefore, teachers have worked without the support of family members and, in addition, are charged with the family/comprehensive education of these students. Therefore, there is increased pressure on the teacher to ensure that students are fully educated, without, however, any compensation from parents to assist in their children's formative processes. If there was dialogue and cooperation between students' parents and the school, students would certainly enter classrooms with conditions for socialization, education and respect for teachers and the entire school community. This cooperation could greatly contribute to the implementation of a timely teaching-learning process for students.

Concept 5: Mismatches in teaching practice

The set of data that emerged from the teacher interviews led to this conceptual category, which brings epistemological reflections on education, teaching practice and the teaching-learning process.

Within the scope of the education professional's intervention, there is a fertile field for reflection, which is revealed when one looks directly at their concrete action in the classroom and the motivations that guide such actions. According to Cunha (2008), a simplistic view would say that the teacher's role is to teach and could reduce this act to a mechanical, decontextualized perspective. However, it is known that the teacher does not teach in a vacuum, in hypothetically similar situations. Teaching is always situated, with real students in defined situations. In this definition, the school's internal factors interfere, as well as broader social issues, which identify a culture and a historical-political moment (ARAÚJO, 2019).

Paying attention to this relationship of pointing out paths can be an attitude that reveals positive and negative pedagogical practices, a reflection of teaching behavior and of the structural and educational financing possibilities offered by the state. In concrete reality, teaching behaviors are reflected in the way in which the teachers organize their teaching program; choose their contents; develop their teaching procedures; evaluate their learning achieved; relate to their student. It is important to highlight that teaching practice is conditioned by the didactic resources and materials available at the school, the physical structure and facilities present at the school, the provision of didactic-pedagogical training/updating to teachers and, above all, the knowledge, creativity, and subjectivity of each teacher in the context of planning and practical application in the classroom (SANTANA, 2019). Below, we can observe descriptions of some discourses about teaching practice and its impasses:

“Sometimes, you could give a different class to the student, but you end up giving up, because the public school doesn't have the resources or because the room is too damaged. So I'm restricting, within the reality of school and education, in this country without investment. I’m losing hope in education” (P1).

“There is very little, if any, value placed on education. Who is at the end of the process, we don't see appreciation. We wanted so much to have minimal and basic things to teach a good class, for example, a video room and a board that didn't use chalk, a physical structure that could serve the students and even ourselves well. But we don't have a room computer to access the internet [...]. And there is nothing at school, and this ends up overloading you as a teacher, where you have to work hard to achieve your learning results, so it ends up wearing us down a lot as an educational tool” (P7)

At first, the speeches of these teachers draw attention to the exercise of hopelessness and disbelief about the Brazilian educational process in public schools. In line with the writings of Freire (2002), the exercise of autonomy for students is recommended in the teacher's pedagogical practice and approached as a “future with hope”, with possibilities of “dreaming about the transformation of society”, through the “problematization of the future”. However, what we see in this reality is an exercise in hopelessness, disbelief, and apathy in relation to the teaching staff's pedagogical practices.

How to experience a pedagogical practice with education for student autonomy, if the conditions and means for the training/education process are increasingly scarce? How to motivate a professional with a distorted identity, without stimuli and with counterparts in their work environment and in society? “To say that education will suppress all injustices, oppressions and, thus, completely change society, suppressing all heteronomies, is naive, in the same way as saying that education cannot bring about any change” (FREIRE, 2002).

Pedagogical practices appear increasingly limited and limiting, despite all the effort and subjectivity of the public education teacher. Therefore, we have been noticed nowadays that teachers have not received the slightest incentive to believe in Brazilian education and work with dignity in pedagogical practice, and governments have not given the deserved attention to educational structures. Aspects such as: investment in decent salaries for teachers, updated career plans, basic training and continuing training for teachers, infrastructure, and supply of materials/equipment for the proper functioning of schools, have made pedagogical practices inconsistent and ineffective (PREVITALI, 2022).

With this reality, teachers have been relying on despair and, unfortunately, abandoning their ethical and ideological commitments to the profession, in addition to abandoning their teaching career. These facts were evidenced by almost all teachers interviewed in this research.

Concept 6: Repercussions of work on personal life

The data analyzed in this research revealed some repercussions on teachers' personal lives, caused by teaching work, due to the accumulation of tasks and functions. The excess and overload allocated to basic education teachers, nowadays, have been a daily reality in the lives of teachers.

These professionals start to assume various functions and roles in their professional practice, which has led them to get lost in their professional identity formation processes. We noticed that “there is an authentic historical process of increasing the demands placed on teachers, asking them to assume an increasing number of responsibilities” (ESTEVE, 1999). This multifunctionality of teachers, a result of the Brazilian state's education policies, has directly impacted the accountability of these professionals for the success or failure of new government programs in basic education schools. Thus, the demand for results by government officials has often extended and impacted the health and routines of teachers' homes/families (MORAIS; ABREU; ASSUNAÇÃO, 2023). The following speeches describe some feelings and events in the repercussions of teaching on the personal lives of some teachers:

“I didn’t participate in my son’s childhood because of my work at school. So he grew up and is a good person, thank God. But I have this guilt with me, for not having participated in his life as a child. Because I worked in rural areas, I left home at dawn and arrived home at night. I practically didn't spend time with my son. The nanny took care of him. Today I feel that he is a needy boy” (P8).

“During this period, when I had a husband, I had this difficulty. I would arrive dead tired from school, I would prepare things for school again and he would not pay attention. Both he and my son were left without attention. And this caused stress and we ended up separating because of it” (P9).

“I didn't have much time to do sport, as working two jobs, taking care of the house and exercising is impossible for me. So this period that I was on leave I took advantage of to intensify a little more” (P4).

The speeches reported by these three teachers allow us to reflect on teaching duties and how their obligations exceeded their capabilities and working time at school, affecting family relationships and leisure time. The working conditions performed by teachers mobilize their physical, cognitive and affective abilities to achieve the objectives of school production. These conditions, increasingly degrading, can generate overexertion of their psychophysiological functions and impact social and family relationships in an overwhelming way (GASPARINI; BARRETO; ASSUNAÇÃO, 2005; ASSUNAÇÃO; ABREU, 2019).

Without equal adjustment of the number of tasks in schools, the most recent demands result in an intensification of teaching work, with a lot of extra-class work, as teachers increasingly have to respond to multiple tasks in the shortest possible time. In this context, P8 points out that, due to excessive work, she feels guilty for not having experienced her child's childhood; P9 states that she divorced her husband due to excessive schoolwork; P4 says she is unable to combine sports/leisure with teaching and domestic work.

Teachers are subjected to adverse situations daily and these experiences can be considered sources of pleasure and/or suffering. The data from this research emphasize that the suffering caused by excessive teaching work has been greater in this analyzed reality, with major repercussions on the personal lives of teachers. Teachers' extra-class work has entered these professionals' homes and, in many cases, taken away from them time for self-health care (adequate and balanced nutrition, time for exercise and leisure, sufficient sleep time to rest, etc.). Furthermore, time for care and affection with family and friends has also become increasingly reduced. The response to these factors has been stress and, very often, loss of interest in work, becoming ill and, in many cases, abandoning the profession (TIMM; MOSQUERA; STOBÄUS, 2015; FERREIRA, 2019).

Concept 7: Effects of the work process on life history: the teacher’s illness

The concepts listed and discussed so far reflect, in a certain way, on the change in the mental and physical health of the teachers in this study, with repercussions on the teachers' daily lives. In general, to respond to the multiple demands, workers develop operational strategies that result in overstraining the body, which ends up resulting in illnesses. These multiple activities, caused by overwork, contribute to teacher malaise, triggering health problems, such as body aches, musculoskeletal problems, stress, depression, panic syndrome, respiratory problems, loss of voice, metabolic syndrome, and various psychosomatic problems (EUGÊNIO; SOUZAS; DI LAURO, 2017). Below, some teachers report health repercussions resulting from their teaching work:

“So the students’ lack of discipline is exhausting and you can’t react the way you want and you have to suffocate feelings and get around that problem, and this generates a range of emotions that need to be released. As a result, you go home and don't have time to release it, and you arrive home stressed with this problem and, in addition, at home you find other problems that you have to deal with. And this only increases and becomes a snowball; there is a risk of you becoming a time bomb, there is a more advanced process of depression and panic syndrome among my colleagues” (P7).

“So when Tuesday afternoon arrived, the day before classes in the complicated classes on Wednesday, I started to feel tachycardia, my head hurt, I felt like vomiting. I began to realize that it was anxiety. So every Wednesday I was not well. Then I went to the doctor, who confirmed that it was anxiety and prescribed medication. I took the medication for two years” (P1).

“So I had to write so much on the board that I started to feel a lot of pain in my shoulder and there was no other resource. It's a distant place, I had to work and I ended up writing with my left hand to save my right side. Then, I started to develop bursitis, which was very painful, it was terrible. But because of work you don't think much, you can't protect yourself and you have to fulfill your role. Because after all, that’s what you’re there for, to complete a workload and do what is required, even though you feel pain” (P9).

“I spent 7 years practically living in a school. I went in at 7 am and left at 9 pm. Without going out for lunch. Because of this, some symptoms appeared. When I left this school, I had my first symptom of a disease called ulcerative colitis. I was away from school for a month. I didn't even know what the disease was. I started with bleeding and severe dysentery. And bleeding, bleeding, bleeding. Then I looked for the doctor. I took the exams and I had this problem. And since then I've been treating it. I had a very intense migraine. That migraine, having to stay in the dark room, vomiting, all emotional because of work” (P5).

The statements of P7 and P1 highlight teachers' illnesses about mental health. The term “time bomb”, used by P7, can denote the current situation of basic education teachers in public schools today. These workers are about to “explode” due to poor working conditions and severe health impacts. Because they are working in very crowded classes, with undisciplined students, with a lack of resources and didactic and pedagogical support, teachers have suffered mental health problems (MOURA, 2019). When it comes to mental health, in many cases, the use of medication seems to be the most appropriate option, as stated by P1.

In this context, chronic stress, typical of everyday teaching work, especially when there is excessive pressure, conflicts, few emotional rewards, and recognition, is called Burnout. This syndrome has been considered a social problem of great relevance, as it is associated with various types of personal dysfunctions, such as the emergence of serious psychological and physical problems, which can lead to the worker being completely incapable of working. The main components of Burnout syndrome are related to the three components described below: emotional exhaustion, depersonalization and reduced professional fulfillment (GASPARINI; BARRETO; ASSUNAÇÃO, 2005; DIEHL; CARLOTTO, 2015; RIBEIRO et al., 2022).

The statements of P9 and P5 concern physical illnesses, influenced by working conditions. P9 describes a clinical picture of bursitis in the shoulder due to excessive writing on the board during classes and reports working feeling pain to carry out daily classroom tasks. P5, on the other hand, describes a clinical picture of an ulcer, due to changes in mealtimes (lunch) for seven years, which took her away from work and caused some problems.

About the bursitis highlighted by P9, we can observe that such illness can be related to the biomechanical, organizational, and psychosocial factors of teaching work in public schools. The biomechanical factors of the teaching profession are related to repetitive and excessive activity, excessive muscular strength when carrying out some tasks, remaining in the same posture for a prolonged period, incorrect postures throughout the working day, poor physical conditioning, among others. Organizational factors are related to the teacher's work organization and are related to the repetitiveness of activities, the absence of rotations and breaks during the daily workday, inadequate workstations, fast pace, long working hours and doubles, among others. Psychosocial factors are related to anxiety, depression and, mainly, occupational stress in teachers. In addition to these factors, there is also the possibility of genetic predisposition for the development of some musculoskeletal injury, which can advance and accelerate the degenerative process of these injuries (FERNANDES; ALMEIDA, 2021).

P5's speech shows the absence from work due to illness. Therefore, the complaints/medical leaves of this class of teachers have demonstrated that education is taking different and tortuous paths. Teachers experience increased work demands, with exhausting working hours and the results affect the health and daily lives of teachers. Thus, many teachers experience changes in their life dynamics and, in more serious cases, temporary and/or permanent absences from work due to illness. Now, work, which should provide hope and prosperity in the life of the education worker, has played the opposite role, focusing on hopelessness and maladjustments in the teacher's life. P10's speech demonstrates the impacts of teaching work on her routine life:

“Because I'm getting home and I no longer have the patience to pay attention and talk to my daughter and my husband, because I've already had an excessive day of information, especially in the afternoon. I work in a suburban school, I face very serious discipline problems and apart from pedagogy, that's all there is to it! And then I come home tired and very impatient and still having to sort out household chores. It’s been difficult for me to balance everything” (P10).

P10 describes the feeling of lack of patience towards her family circle when she arrives home tired from work. It is very serious to realize that the work relationships experienced by this teacher have a negative impact on her relationship with her family. The accumulation of work, teaching, and domestic work, can contribute to illness.

In this scenario, teaching work seems to be exacerbating the risk of several clinical outcomes among education professionals, indicating the need for policies related to teaching activity and healthy lifestyle habits. With each passing day, teachers have suffered more impacts on their daily life activities, as teaching activities have become increasingly overloaded, stressful, with strong tendencies for teachers to become ill and with physical and psychological implications (MOTA JUNIOR et al., 2020). Thus, there is a pressing need for public policies that seek to reduce Brazilian social inequalities, so that educational processes can be satisfactory and inclusive, especially in the public sector.

FINAL CONSIDERATIONS

The perspective of the teachers' trajectory, crossed by contingencies extracted from the speeches, elucidates moments and events that are part of processes that contribute to the illness of this class. Thus, there is a temporality, proposed in the concepts that were generated by the data, which guided the conduct of this research.

All these concepts converged on overloads, tensions, impasses and repercussions on the life and work dynamics of basic education teachers. Consequently, from the circle proposed by these concepts, the illness process emerged. The fact is that the speeches of the teachers participating in this researched reality reflected anguish and frustration, as they are those who presented some illness resulting from work activities.

Teachers reported that the process of precarious education, with severe financial and organizational restrictions from the state, has negatively impacted teaching working conditions. The teachers' speeches highlighted a feeling of demotivation and frustration with their work, in addition to the perception of social devaluation of the teaching career. These feelings represent the feeling of teacher discomfort.

In the reality researched, the data that emerged from the teaching narratives pointed to the confrontation of daily conflicts within the school community, highlighting the management of various problems related to the student body and their families. Many of these tensions go beyond the indiscipline of students and reach social problems (violence, drugs, etc.) that recur in many communities in Brazil. Therefore, many tensions are generated and, once again, the absorption of these problems affects the teacher.

Mismatches in teaching practice also emerged through the data analyzed. Many teachers, who were concerned with lesson planning, the teaching-learning process and class methods, are faced with an archaic and resourceless school structure. It is a fact that the teacher's subjectivities can define positive or negative pedagogical practices, but it is sensible to analyze that, even though the intention of lesson planning is coherent and precise, there is no way to apply it in a poor school.

In this environment of frustrations, disappointments, anguish and disenchantment, teachers still experience excessive teaching activities, which negatively impact their personal/family life. This impact makes it impossible for teachers to self-care and spend time with family members during their leisure time. All these cyclical concepts, which materialize in the teachers' routine lives, accumulate, and bring to light the teacher's illness.

Thus, the work that gives meaning to life and that contributes to the empowerment of subject-workers then becomes a burden for education workers. The speeches of the interviewed teachers point to serious repercussions on the health, well-being, and quality of life of these education professionals.

Based on this, this research concludes that, in the reality researched, the entire process of precariousness in the state, guided by neoliberal policies, has changed working conditions, and increased the extent of teacher malaise. Teachers have been faced with conflicts and tensions in the school context daily, with negative impacts on their lives. These facts have resulted, most of the time, in processes of physical and/or mental illness among this working class. Through this social and political reality, we can observe the lack of public policies to promote teachers' health and investment in education.

It is important to highlight that, like any research method, there are methodological limitations in this investigation. This study aimed to obtain a more in-depth understanding of the illness process of basic education teachers, as well as the multifactorial processes/causes, implicit in the subjectivity of each teacher and the way in which this process impacts the life of each interviewee in a specific reality. However, it is possible to come across processes of physical and mental illness, through the experiences and working conditions, of teachers in public schools in other contexts and realities. These processes, in other realities, may present similarities or points of divergence in what was found in this research.

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• 1
  Article published with funding from theConselho Nacional de Desenvolvimento Científico e Tecnológico- CNPq/Brazil for editing, layout and XML conversion services.

DECLARATION OF CONFLICT OF INTEREST

• 5
  The authors declare that there is no conflict of interest with this article.

Publication Dates

• Publication in this collection
  07 June 2024
• Date of issue
  2024

History

• Received
  18 Oct 2021
• Accepted
  03 May 2023

• This document has a preprint version
  10.1590/SciELOPreprints.3065