Aprendizagem na interação ensino-serviço-comunidade: a formação na perspesctiva dialógica com a sociedade

Considerando o papel do ensino superior em saúde para a sociedade brasileira, em que os egressos dos cursos ofertados na área serão os profissionais prestadores de serviços à população, este estudo objetivou analisar o componente ensino do PET-Saúde da Família - Natal-RN na formação de estudantes dos cursos de graduação em saúde da UFRN. Foi realizada pesquisa qualitativa com análise de documentos das disciplinas SACI e POTI datados entre 2009 e 2011 (portfólios, avaliações de desempenho e oficina de avaliação), mediante o auxílio do software Alceste© e análise de conteúdo, segundo Bardin. Na análise foi encontrado como potencialidades: o alunato trabalhando em grupo tutorial multidisciplinar, cuja interação e contato com a Unidade de Saúde da Família, incluídos os profissionais, bem como a comunidade, instiga nos aprendizes o diálogo consigo mesmo e com o outro, numa construção dos ser/agir no mundo. Os textos trabalhados durante as aulas permitem refletir e teorizar a respeito da realidade observada, auxiliando-os na identificação dos problemas e no traçar estratégias de intervenção. Já a observação da realidade reveste o aluno de humanização. Este passa a captar as necessidades e dificuldades enfrentadas pela comunidade observada. Nas fragilidades ficaram evidenciados: problemas de relações interpessoais entre os estudantes da SACI; a maioria dos projetos de intervenção ocorrendo numa perspectiva paternalista, reproduzindo o modelo de prestação de serviços na saúde mais praticado nas sociedades brasileiras; dificuldades em aprofundar no aprendiz, a importância da teorização dos assuntos; problemas de financiamento de projetos de intervenção; descumprimento do plano de ensino em alguns grupos tutoriais; e, por fim, dificuldades dos alunos e monitores em acompanhar as atividade de pesquisa e extensão do PET-Saúde, pela falta de integração dos projetos pedagógicos dos cursos. Conclui-se que o componente ensino do PET-Saúde da Família adota metodologias ativas de ensino na inserção de alunos na Atenção Primária em Saúde, proporcionando uma formação dentro de princípios éticos e humanísticos a partir do trabalho em equipe e da inclusão reflexiva dos alunos na Estratégia Saúde da Família. Apesar da existência de fragilidades concernentes às relações interpessoais, descompasso entre as proposições multiprofissionais e interdisciplinares da SACI e POTI e as dificuldades de pô-las em prática em currículos fragmentados e organizados por disciplinas pouco flexíveis, potencialmente, ao fim dessas experiências conectadas a Atenção Primária, os discentes apresentam uma nova visão do cuidado com a saúde, próxima às necessidades da população, iniciando uma tomada de postura crítica e reflexiva, entendendo-se com sujeitos ativos no construir a saúde coletivamente

Avaliação da satisfação das usuárias sobre a atenção à saúde da mulher no Rio Grande do Norte

This work discusses the evaluation of the satisfaction of the users on the women health care focusing on the quality of the primary care in the State of Rio Grande do Norte-BR. The main objective of this research is evaluate the satisfaction of the users about the actions applied to women health in the primary health care in Rio Grande do Norte, observing the information available through the Programa de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB). The specific objectives are: the evaluation of aspects related to women health; the evaluation of the specific actions related to welcoming the pregnant and; the evaluation of the information related to the postpartum. This dissertation is characterized as an evaluative research made through a multicentric transversal study, using a quantitative approach, which is part of the External Evaluation of the PMAQ-AB in the State of Rio Grande do Norte, made by the Federal University of Rio Grande do Norte. Some secondary data of the interviews with the users who were in the Basic Health Units were used during the External Evaluation of the PMAQ-AB in Rio Grande do Norte. The sample was collected following these criteria: the users that were in the Basic Health Units to attend to any procedure; they must had used the services for at least one year; and they must had agreed to participate the research. The ones that were attending to the services for the first time and the ones that did not use the services for at least 12 months were excluded from the sample. To the data collection it was used a chart of variables/indicators with the following information to the analysis: Women Health Care, Specific Care of the Pregnant and Information about he postpartum. The descriptive analysis of the data were made through absolute and relative frequencies of the variables using the software Statistic Package for Social Sciences (SPSS) for Windows, version 22.0.0. The results show a positive picture of the satisfaction of the users about the actions of the primary healthcare in women health in the State of the Rio Grande do Norte. Another important analysis is the integration of the primary health care with other points of the Healthcare System aiming to reorient the Model of Healthcare as a starter of the access and quality of the services given to the users. Therefore, the evaluation of the satisfaction of the users in health care is essential among all the agents involved in the process of consolidation of the Unified Health System SUS. Also having the need of rethinking the professional practice, reorganizing the processes of work of the multiprofessional teams in health care, enabling financial resources, inputs and materials, planning and systematizing new actions of healthcare aiming to ensure a perfect health care to the people

Avaliação da qualidade da atenção primária à saúde da criança no Rio Grande do Norte: visão das usuárias

The study aims to evaluate the quality of the work processes of the teams from the Family Health Strategy regarding the comprehensive health care for children, in the view of users in the state of Rio Grande do Norte. This is a cross-sectional observational evaluative research with quantitative approach. The primary data are part of the External Review from the Program of Improving Access and Quality of Primary Care (PMAQ) in 2012. 190 women were interviewed. The inclusion criteria was the presence in the clinic at the time of the survey, have attended the service in the last 12 months and be a mother or companion of a child up to two years old. A research protocol was developed in the dimensions of Growth and Development, Breastfeeding and nutrition, and health problems and its variables. The results revealed that mothers / companions who responded to the questionnaire 71% were aged between 18 and 35 years, 92.1% were literate, 96.3% had a monthly income and 62.6% received financial assistance from the government. As for the children, 39.4% were aged between 13 to 24 months. In promotion and prevention actions for children, 64.2% had consultation up to the 7th day of life, 91.1% underwent the screening test, 95.3% had a health handbook, 98.9% had a vaccine, 17.9% breastfed or breastfeed from 6 to 24 months. As for link and continuity of care, 86.8% of the children were accompanied by the same professional staff and 59.5% left with next consultation scheduled. In acute situations 42.4% of the children went to the health unit and 64% of these were attended. It is concluded that the actions involving prevention and health promotion of children in RN, are evaluated positively by the service users and meet the requirements of MS, as well as link and continuity of care. The weakness in access and reception of users is evident, indicating the need to adapt the service to the demand of health and planning actions to welcome all who seeks basic health unit-UBS

Avaliação do pré-natal na atenção primária à saúde no Rio grande do Norte: visão das usuárias

ABSTRACT This study aimed to evaluate the quality of prenatal Primary Care in Rio G rande do Norte, Brazil in 2012 under the program Improving Access and Quality of Primary Care. The study was cross - sectional, quantitative. Included 156 mothers of children under 2 years who received prenatal care at the health evaluated. We applied a ques tionnaire on profile, minimum queries, regularity of attendance, laboratory tests, vaccination, participation in educational activities, guidance received, clinical and obstetric procedures and prescription Ferrous sulphate and folic acid. The descriptive analysis of the criteria used Humanization Program Prenatal and Birth. The results showed that 92% of mothers had six or more visits; 85% with the same care was professional; 94% subsequent appointments scheduled. As for tests and procedures the percentage s were: Urine 98%; HIV - 96%; VDRL and 88%; 91% glucose; tetanus vaccination 93%; educational groups 56% with 36% participation, knowledge of the delivery location and 59% achievement breast exam 65%, 33% and preventive gynecological 43%; 98% supplemented wi th 96% Ferrous Sulfate and Folic Acid. It was concluded that there were advances in Rio Grande do Norte concerning assistance and there are weaknesses in the educational practices and conducting some minimal clinical examinations.

Investigando o cuidado em equipe de enfermagem em uma UBS da cidade do Natal-RN

On the health area, care is seen as an important concept for professionals. Recently there is a trend, the epistemological point of view, to think carefully as category allowing discuss and re (thinking) practices of humane health care. The objective of this study is to investigate the understanding of care in nursing staff in a Basic Health Unit (BHU) in the city of Natal. The participants were two nurses and two nursing technicians working on the BHU of Guarapes district, located on the west side of Natal - RN. As Theoretical support for data interpretation, was used the concept of care taking, using Heidegger’s theories as reference, through Ayre’s ideas. This is a qualitative research using autobiographical as a methodology. The methodological strategy approach used were focus group and individual interviews. The data were discussed by three angles: knowledge (concepts and theories behind the practical model), technical (the way to do), and ethics (values that bases practices) by hermeneutics Gadamer's dialectic. The results showed the necessity to expand the discussion on care, in practice the understanding of care seems to get narrower concerns with technical success by professionals. The care, as a meeting between beings, the desired humanized care, seems to be understood in parts in theory, but also distances itself from reality in professional practice.

Histórias de adoção tardia: considerações a partir da analítica existencial heideggeriana

Adoption establishes a filiation status, resulting from a legal act, which attributes to the child and parents the rights and obligations associated with such condition, being legally irrevocable. Nevertheless, in practice there are adoptions that do not concretize and the child returns to justice during or even after the legal process is closed. Late adoption is the denomination of the adoption of children over two years and it is still permeated by myths and stigmas, leading to a frequent return of the child to justice in these cases. The late adoption involves a process of building a unique relationship with a child whose backstory is commonly marked by the dissolution of the relationship with the family of origin, due to violation of rights and, in some cases, the experience of institutional care. Given such a scenario, this research, based on the Existential Analytic proposed by Martin Heidegger, seeks to understand the experience of mothers and children in the process of late adoption, in order to obtain subsidies to psychological attention in this context. This is a qualitative, phenomenological study with a comprehensive focus. The participants were two mothers and two children who have gone through late adoption for about two years. The procedures of data generation contemplated narrative interviews with mothers and individual meetings with children, in which ludic resources were used as mediators of expression (free drawings, unfinished children's story and "Story-Drawings" on late adoption). The procedures were audiotaped and transcribed. Data analysis was grounded in Heidegger's hermeneutics. The late adoption process, permeated by historical, social and cultural determinants and the web of meanings that create the historical singularity of each person involved have proved to be complex as seen in the narratives. The construction of the meanings of parenthood and filiation has been developing in the families in the study, from the experience of being-with-the-other, caring and dwelling in their peculiar modes of expression. The family of origin and the adoptive family mingle and differentiate by means of the experience of children, especially because of the existence of biological siblings. Data point to the importance of psychological care to family core in late adoption processes

Avaliação da qualidade da assistência à mulher e ao filho durante o parto normal

The practices developed in the everyday life of obstetric services are sometimes out of step with the recommendations of the public health policies. Accordingly, this research had the objective of assessing the quality of the care provided to women and children during cases of natural childbirth in municipal public maternity wards of the city of Natal/RN, Brazilian Northeast. We developed a cross-sectional and quantitative study in two maternity wards that provide care actions to pregnant women at regular risk (maternity wards A and B). The participants were 314 puerperal women who were treated during the period between April and July 2014, whose children were born alive, through transpelvic way, with spontaneous or induced beginning of labor and that showed physical and emotional conditions to respond to the proposed questions. The data collection instrument was constructed on the basis of the recommendations of the World Health Organization focused on the care of normal childbirth and validated by skilled judges, and the final version has obtained optimum agreement (k = 0,96; IVC = 0,99). Associated with these recommendations, we used three indicators: percentage of women with induced labor or subjected to elective cesarean section (Indicator A); percentage of women served by a qualified health professional during labor and childbirth (Indicator B); and Bologna Index (Indicator C). The research obtained a favorable opinion of the Research Ethics Committee from the Federal University of Rio Grande do Norte, under the nº 562.313 and Certificate of Presentation for Ethics Appreciation: 25958513.0.0000.5537. The analysis of categories related to the recommendations of the World Health Organization was conducted by means of absolute and relative frequency and the Chi-square Pearson’s and Fisher’s exact tests made the comparison of the differences observed between the two maternity wards. Furthermore, we calculated the percentage of the indicators A and B and with the results of the Indicator C, the quality was assessed as follows: the closer to 5, the better will be the quality, and the closer to 0, the worst will be the quality, and the Mann-Whitney U test was used to compare the differences of the obtained averages. The significance level of 5% was considered in all statistical tests. The differences between the maternity wards were identified with regard to the provision of liquids orally (p=0,018), stimulus for non-supine positions (p=0,002), existence of partograph (p=0,001), support or welcoming by health professionals (p= 0,047), intravenous infusion (p<0,001), supine position (p<0,001), use of oxytocin (p<0,001), food and liquid restriction (p= 0,002) and, lastly, the fact of the touch is performed by more than 1 examiner (p=0,011). The indicators A and B showed percentages of 13,09% and 100%, respectively. The overall average of the Indicator C was equal to 2,07 (± 0,74). There was a statistically significant difference between the averages of the maternity wards (p<0,001). The care actions provided during the process of labor and childbirth is inappropriate, especially in the maternity ward B. It is necessary to implement improvements and redesign the obstetric model in force

Ser cuidador de paciente com acidente vascular cerebral: histórias não contadas

The present study aimed to understand the experience of being a family caregiver of a patient with Cerebrovascular Accident (CVA). The relevance of the study is to prove existence of a large number of caregivers of incapacitated patients, due to the CVA and it is not an academic research object, according to the literature. It is a qualitative research, which the guiding principle is the oral history of life, according to the theoretical foundation and operating of Meihy. Therefore, the following steps were highlighted: the target community, composed of all family caregivers of CVA patients; the colony, composed by family caregivers of CVA patients assisted by Home Care Service (HCS) of the Hospital José Pedro Bezerra (HJPB), in the city of Natal/RN; the network was composed of six caregivers who met the criteria for inclusion, and as zero point the first volunteer group. The population was composed of all family caregivers of patients attended by the HCS, of the HJPB having been addressed through interviews. For the empirical research there was the consent of that institution and approval by the Ethics Committee in Research of the Federal University of Rio Grande do Norte as CAAE 24569413.0.0000.5537 and, above all, with the acquiescence of employees in participating in the investigation, signing an informed consent. Of the empirical material, five categories of analysis were identified: the sense of being a caregiver; what has changed in the life of the caregiver; the feelings emerge in the relationship of care; the distance from family and friends; difficulties faced by the caregiver. The results show that the caregiver's life goes through profound transformations within the family as well as in all spheres of life. For the caregivers, assuming the care of a relative with CVA means renunciation and donation, compromising sometimes the individual projects and the family as a whole. In addition, they point out the confrontation of difficulties within the the assistance and humanization in healthcare, information, physical and emotional overload, as well as financial problems. Despite all the adversities that compromise the caregiver's life, it was possible to identify attitudes of resilience among caregivers, making them their daily life less strenuous and with more lightness. It is expected, therefore, that this research can contribute to a better orientation of professionals with the caregivers

A influência do conforto luminoso na satisfação dos profissionais que atuam no ginásio do Centro de Reabilitação Infantil, Natal-RN

This study addresses the environmental quality in therapeutic spaces for children's rehabilitation. The assumption that space is active and interfere in interpersonal relationships, highlights the importance of natural light to the hospital architecture, to foster the creation of environments that encourage and assist in the recovery of patients in the rehabilitation process. Therefore, interferes with health humanization through positive actions in the physiological and emotional effects of natural light, as facilitators of the health recovery process. In Brazil hospital openings systems projects are built exclusively to follow requirements of the local construction code which do not consider the landscape, but only ventilation and heat stroke; and the luminance levels are treated just as recommendations for artificial lighting. The National Policy for Healthcare Humanization presents the environmental comfort as a priority. However, it does not guidelines for achieving it. In this context this research aims to evaluate the lighting comfort in infant therapeutic areas from the professional satisfaction, in order to identify human preferences on the variables: technical and constructive aspects, relationship with the exterior, internal visual interface and quality elements. With this purpose it was adopted as research strategy the Post-Occupancy Evaluation (Technical Functional) through a multi method approach, which included a case study in the rehabilitation gym of Children Rehabilitation Center, at Natal, Rio Grande do Norte, and a reference study at SARAH Rehabilitation Center, Fortaleza Unit at Ceará, both in Brazil northeast. The results indicate that the definition of openings systems should consider external and internal factors to the building, as the natural landscape, the immediate surroundings and activities to be performed. The POE found out the preference of the professional visual privacy in detriment to other analyzed aspects. Thus, it is expected that this study can contribute to the discussion of luminous quality and generate inputs for future projects or renovations in the Children's Rehabilitation Centers, which should not be projected as hospitals

Travestis na atenção primária: o cuidado em saúde na cidade de Natal

Among the deviant a heteronormative ideal, transvestites are the ones that suffer abuse and discrimination. Have been found that health services often present themselves as places that maintains and reproduce such discrimination, which makes transvestites only sought medical care in the latter case. Based on the guidelines of the SUS and the National Humanization Policy as well as the inclusion and leadership of the users, we conducted a qualitative study seeking to understand the experience of transvestites in seeking health care within primary care in Natal-RN. We use as techno-methodological instruments in depth interview and workshop with use of "scenes". For interpretative analysis of the narratives we use to Hermeneutics-Dialectic. From the dialogue with the narrative we come to the following themes: 1) Understanding the meaning of being a transvestite; 2) The experience transvestite in search of health; 3) Transvestites and humanized health care. In the first point they reveal the daily struggle of transvestites between prejudice and the search for respect, as well as the meanings of being a transvestite, who appeared as: Being gay, being feminine, not transsexual and accept themselves as they are. In the second axis, expressed difficulties in access to and use of health services: the embarrassment by not using the social name; fear of going out during the day; the association of transvestites to HIV; and pain caused by discrimination from health professionals. It was also possible to identify simple demands such as illnesses from day to day, the demand for hormone therapy, which involves treatment needs as well as the vital need to have their rights XVII respected. The third axis, for the range of a humanized care identified that the respectful gaze guarantee their dignity and their right to health in a humane way, but it identified some necessary changes: Training of professionals, dialogue with the social movement, publicity campaigns and rapprochement with the transvestite. Finally, it is expected that the research will contribute to the field of knowledge know-how in health care transvestites, inside and outside of the university

Saberes sobre a literatura: um estudo com professores de 1º ao 5º ano do Ensino Fundamental

El estudio investiga los saberes literários del profesores del Enseño Fundamental de las series iniciales sobre la literatura. Cuando se piensa en la influencia del profesor como aquel que tiene papel decisivo en la enseñanza de la lectura y reconocimiento de la función y formación del mediador profesional, buscamos compreender que conocimiento tiene sobre la literatura. Optamos por los profesores que trabajan en los años iniciales del Enseño Fundamental basadas en el entendimiento de la educación básica, es de suma importância en la formación del lector literário. El estudio se caracteriza por ser un enfoque cualitativo. Adoptamos como procedimientos metodológicos, la entrevista semiestructurada, elaborada com preguntas abiertas que se centran en eventos de lectura de las practicas em família, en la escuela, en la educación superiory en el ejercicio de enseãnza grabadas en audio, además de elevar um diário de campo. La investigación lleva a cabo en cuatro escuelas de la ciudad de Natal – Rn, con dicinueve profesores que trabajan con alumnos de 1º a 5º año del Enseñanza Fundamental. El corpus de la entrevista constituye el análisis de los profesores y es analizado tomando como referencia los princípios de análisis de contenido, especificado por Laurence Bardin (1997). Se tomó como referencial sobre la lectura, la literatura y práctica pedagógica los estudios teóricos de Amarilha (1991, 1992, 1994, 1997, 2003, 2006, 2007, 2009, 2010, 2013); Cosson (2011); Lajolo (2006); Larrossa (1996, 2003); Morin (2010); Yunes (2003, 2010). Sobre la teoría literaria, Candido (2002, 2012); Zilberman (1993); Culler (1999). Acerca de la estética recepción, Eco (1994); Iser (1996); Jauss (2002). Sobre los saberes docentes, Nóvoa (1992, 1997, 2002); Perrenoud (1999, 2002), Tardif (1991, 2000, 2002, 2005). Sobre los saberes literários, Paulino (2004, 2007), dentre outros. El análisis señala que los profesores dominan vários conocimientos sobre la literatura que son transportados a la formación a través del diálogo con otras lecturas, con otros espacios interactivos, en convivência con otros lectores. Cabe destacar el saber que la literatura es humanizar el fator, por lo tanto, la necesidad de escolarizá que a través de las prácticas literárias que involucran estudiantes, professores y comunidad escola. El studio también revela que en la escuela recital literário es necesario para la enseñanza de valores, para enseñar a leer, para inculcar el amor por la lectura. En este contexto, destacamos la importancia de la mediación del profesor como formador de lectores que domina los conocimientos necesarios para satisfacer las necesidades de los estudiantes, desarrollando los letctores conocimientos para fomentar el gusto por el texto literário

Processo de cuidar de um centro de tratamento oncológico

The objective was to understand the process of caring for a center for cancer treatment from the perspective of nurses and patients. This is a qualitative research, xploratory and descriptive, performed in a cancer treatment center in Natal / RN / Brazil. Data collection occurred between August 2013 and February 2014, being effected by means of two techniques: photographic record and projective interviews with nurses and patients. Social actors included in the study were ten professional nursing and ten patients admitted to the surgical department of the institution. The criteria used for inclusion of professionals were: be professional in the field of nursing, being an employee of the hospital, to be inserted in the scale of nurses of the institution at the time of data collection. For the patients were included who had preserved their cognitive abilities and who were hospitalized and at any stage of treatment. We used content analysis proposed by Bardin, for the analysis of material collected during projective interview. The research followed the ethical and legal principles that govern scientific research on human beings, being conducted by the project approval by the Research Ethics Committee of the Northern League Against Cancer Riograndense with 295 673 and look CAAE 16104313.0.0000.5293. Referring to nurses, they demonstrated different views about care, which sprouted from a holistic, multidisciplinary approach and welcoming, as well as linked to the performance of procedures and compliance with the requirements technicality. Furthermore, these subjects also showed that care unfolds through the actions of management in carrying out the records in the humanization of care by meeting the needs of the patient and ambience. Front of patients, it is noteworthy that, for them, care happens through attitudes of caring and professional approach, and by performing procedures, being mentioned as a careless lack of structure of the institution and the discomfort caused by this condition factors. It was evident also that the actors involved in the care, the perception of professionals and patients, are represented by nurses, doctors, psychologists, nutritionists, as well as kitchen assistants and cleaners; beyond family companion, the individual himself as responsible for their care and volunteer caregiver. In this opportunity, it is concluded 9 that an understanding of care from the perspective of nurses and patients involves broad issues ranging from perceptions of care that embraces a dynamic complex elements and attitudes imbued with meanings, in which those involved can assume both the role of carers as care beings, even a carefully tied to prescribed routines and performing procedures. Thus, the findings described refer to reflections on the care provided to cancer patients and whether this, in fact, translates principles of a humane practice

A preceptoria na estratégia saúde da família: o olhar dos profissionais de saúde

The proposal of teaching-service integration from work experience brings a challenge to the professionals involved in health services: to combine their healthcare practice to the preparation of new professionals in accordance with the national health model. In Recife, the assistance network is known as school network, since it provides all its health equipment for Higher Education Institutions, in special for professionals who work as preceptors, making this activity an important component of the services network. The objective of the present study was to analyze preceptorship experience herein Multidisciplinary Residences in Health in the look of health professionals. This is a qualitative descriptive study, involving physicians, dentists, and nurses that have worked as preceptors for at least two years in multidisciplinary residency linked to two Higher Education Institutions. A semistructured interview was used as research instrument and data were processed by using the software Alceste 4.9. Results indicated four semantic classes which were divided into two axis. Axis 1, composed of class 4, and Axis 2, composed of classes 3, 2 and 1. Categorization considered the relation between classes. It was observed that in class 4 work overload is a dilemma for professional participation in preceptorship. This is noted by the words manage, time, patient, give, and complicated. However, it is also observed that the preceptorship involves positive learning and teaching actions, reinforced by the words say, explain, and discuss. Class 2 shows the preceptorship as an experience exchange, a positive moment that provides theoretical upgrade to the preceptor, associated to the professional practices performed by the binominal preceptor-student in health services and communities. In this perspective, everyone is benefited since preceptorship is structured according to dynamic aspects of knowledge, experienced in settings permeated by people´s health necessities. In class 3, potentialities of this practice are shown, and personal compromise is the main reason of acting as a preceptor in this network of education/attention, demonstrated in the words reason, formation, to like and professionals. Last, but not the least, class 1 suggests the importance of preceptorship and one of the strategies to create the National Politics of Humanization, from the teachingservice-community integration, observed in the words: arrives, university, fundamental, manner, partnership, service, and student. Besides, it rates perspectives and challenges for the improvement of the preceptorship in health services. Integrating teaching and service can enhance the proposals of changes concerning the healthcare model practiced in services, but this relation is still superficial. The preceptor is an actor in action, playing real life roles, and that is when he becomes essential to seek training with the profile defended in the proposed training of a professional who is capable of learning to learn

“Currículo encarnado”: cartografia simbólica e afinidades pós-coloniais

This thesis has as main objective to reflect about the defining conceptual elements of the embodied curriculum concept, ident ified curriculum conception from the analysis about the rationality employed in the doctoral work of teacher Antonio Fernando Gouvê a da Silva, entitled The construction of the curriculum in popular critical perspective: the significant words to the context ualized practices , written and defended in the Postgraduate Program in Education: Curriculum, in the Pontifícia Catholic University of São Paulo, in 2004. We looked, also, on the problematization of the affinities between postcolonial theories – analytical perspectives towards the discussion about coloniality and their effect on contemporary social weaving – and the embodied curriculum concept. We argue that the reflections present in the aforementioned work bring an articulated curriculum concept based on three conceptual symbiotic elements, namely: negativity, dialogue and praxis, which, by endorsing the possibility of a curricular ingrained practice in the life context of the individuals, have some post - colonial inclinations that lead to the problematizat ion about the neo - colonial manifestations in curricular sphere, outlining a critique of the modus operandi of the colonialism, particularly, in its cultural and epistemic dimension from which the education is inseparable. For that, we used as methodologica l procedure the symbolic cartography, knowledge building strategy systematized by Boaventura de Sousa Santos, which allowed us to construct interpretive maps that enabled the symbolization of the universe which we longed to understand, that is, the concept ual categories mentioned above, which, in our view, underlie the concept of embodied curriculum. In this direction, we anchored ourselves in a meaningful dialogue with the theoretical approach of Paulo Freire and some of his interpreters regarding the disc ussion on curriculum, especially the reflections dev eloped by Antonio Fernando Gouvê a da Silva, and authors whose theoretical developments resonate in prospects for humanization, social justice and empowerment, among which we highlight: Theodor Adorno, Hug o Zemelman, Wilfred Carr, Adolfo Sánchez Vázquez, among others. We seek, in the same manner, on the contributions of authors considered post - colonial, as Hugo Achugar, Gayatri Spivak, Boaventura de Sousa Santos and Enrique Dussel, to name a few, the reason s why we consider the embodied curriculum as a place of political - pedagogical enunciation, conducive to an educational praxis that engages in a curricular work of reality translation in order to see what overwhelms it to, then, elicit the construction of a school curriculum as an awareness project for releasing in relation to what is unjust and inhumane. We consider, finally, that the success of this curriculum embodied translation implies a larger number of speakers mobilized in the production of knowledge that yearns for social emancipation and contribute to the enrichment of human capabilities as the maintenance of the life and the dignity of people.

O trabalho em equipe na atenção primária à saúde: situação de Portugal e do Brasil

Introdução: Na Atenção Primária à Saúde, nos contextos internacional e nacional, o trabalho em equipe tem sido reconhecido como estratégia decisiva para a organização de processos que visam à integralidade do cuidado, além de possibilitar melhorias na satisfação dos usuários com os serviços de saúde. Neste sentido, o objetivo, deste estudo, é analisar o trabalho em equipe na Atenção Primária à Saúde. Método: Trata-se de uma pesquisa em banco de dados secundários. Realizou-se três estudos: a) O trabalho em equipe na Atenção Primária à Saúde, em Portugal, pesquisa avaliativa, de natureza qualitativa, tipo estudo de caso descritivo, que representou um recorte dos resultados derivados da pesquisa integrada ao projeto “Implantação das Unidades de Saúde Familiar em Portugal”, que teve como procedimentos entrevistas semiestruturadas, roteiro de coleta de informações (check list) e análise documental. Foi realizada a estratégia de triangulação dos dados com análise de conteúdo; b) trabalho em equipe, acesso e qualidade na Atenção Primária à Saúde, no Brasil, estudo transversal, de abordagem quantitativa, realizado a partir dos dados obtidos da “Pesquisa de Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica”, no Brasil, em 2013. Amostra composta de 17202 profissionais e 65391 usuários. Utilizou-se entrevista estruturada, com análise estatística realizada pelas frequências absolutas e relativas das variáveis através do programa Statistical Package for Social Sciences. c) satisfação dos usuários com o trabalho em equipe na Atenção Primária à Saúde, no Brasil, estudo transversal, de abordagem quantitativa, realizado a partir dos dados obtidos da “Pesquisa de Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica”, no Brasil, em 2013. Amostra composta de 65391 usuários. Realizou-se análise estatística das frequências absolutas e relativas das variáveis através do programa Statistical Package for Social Sciences. Utilizou-se, ainda, o Teste X2 , com nível de significância de 5%; análise de regressão logística múltipla. O modelo final foi ajustado pelo teste de Hosmer/Lemeshow, o qual indicou um ajuste de 66%. Resultados: Sobre o trabalho em equipe na Atenção Primária à Saúde, em Portugal, destacou-se a formação das equipes de forma voluntária, por meio de afinidades pessoais, a existência de “carteira básica de serviços”, juntamente com x intervenções de vigilância, promoção da saúde e prevenção de doença, cuidados em situação de doença aguda, acompanhamento clínico de doença crônica e de patologia múltipla, cuidados domiciliares, interligação e colaboração em rede com outros serviços (cuidados hospitalares), sistemas informatizados nas unidades de saúde. Os dados revelaram dificuldades quanto ao atendimento domiciliar. No Brasil, foi destaque o processo de trabalho, com avanços relacionados a realização de planejamento e programação das ações e o apoio da gestão. Existência de território definido e de prontuários familiares. É destaque a agenda compartilhada e pactuada entre os profissionais. As equipes realizam acolhimento e reuniões, cujos temas, discutidos, giram em torno do processo de trabalho e planejamento. Os desafios, enfrentados, estão relacionados ao agendamento dos usuários; ao número de pessoas sob a responsabilidade das equipes; à existência de população descoberta nas áreas adscritas à Unidade de Saúde; à incipiência na ação intersetorial e ao pouco envolvimento da comunidade pelas equipes. Quanto aos fatores associados à satisfação do usuário foi marcante: a faixa etária; a escolaridade; a raça; se a falta de material prejudica o atendimento e se a equipe consegue marcar consulta para outros profissionais. Conclusões: Constatou-se o trabalho em equipe como elemento central no processo de mudança na Atenção Primária à Saúde, tanto no contexto de Portugal quanto no do Brasil, o qual ampliou o acesso e a qualidade na oferta de serviços de saúde e obteve, ainda, o reconhecimento social, mesmo que, em ambas as realidades, não tenha avançado na coordenação do cuidado e no estímulo à participação social. Os fatores, associados com a satisfação do usuário, estão relacionados diretamente ao cuidado prestado e refletem a expectativa, por parte do usuário, de resolução concreta de suas necessidades.