Representações sociais e práticas discursivas de profissionais do programa saúde da família sobre o pré-natal

The present study had the objective to identify to the Social Representations of the professionals of medicine and nursing superior level of the Program Health of the Family concerning the assistance for the gestation. The research was qualitative under the optics of the Theory of the Social Representations of Serge Moscovici, of the Central Nucleus of Jean-Claude Abric and of the Analysis of Content of Laurence Bardin. We worked with the following instruments for the collection of data: Questionnaires, with social-demographic data; Free association of Words, with the inductive terms Pregnancy, Assistance for Gestation and Care; Production of mental image and half-structuralized Interview, with the following question: What does the assistance for the gestation represent for you? . We interviewed all the professionals of nursing and medicine of the Program Health of the Family in the city of Santa Cruz /RN (ten for each profession) in the period of February and March of 2007. From the analysis of the social-demographics data, we respectively identified the following percentages for nursing and medicine: the feminine sex for nursing predominated (90%); the age between 24 and 33 (70 and 60%); the religion catholic (80 and 50%) and 50% of the two groups has up to two years of formation and work in the score of the research. The analysis of the others instruments resulted in two categories: Institutionalized vision and Vision of the Common-sense. In the free association of words, the category institutionalized vision is configured as Central Nucleus and of the common sense one as nucleus Peripheral, demonstrating that the Social Representations of the assistance for the gestation attendance are in the universes consensual. In the mental images, we identified to this same construction. In the content of the interviews, the institutionalized vision is permeated by the responsibility of making and the availability of having - assistance for the gestation is recommended by the Health department and necessary genders - while the vision of the common-sense can be represented by the category sort, whose role of professionals of the assistance for the gestation is to strengthen the responsibility for the woman of a maternity socially constructed. In short, the analyzed speeches reflect that, to the knowledge acquired in the academy, are incorporated in the knowledge of the daily professional, and conducted by popular myths. Medicine and nursing recognize the importance of the attendance in such a way for the chance to educate the women for the maternity as for the possibility to prevent complications, but in its speeches they had excluded from this process the masculine figure. We conclude that the meaning of the inductive term take care, part of the common-sense and is incorporated the institutionalized speech to humanize the assistance. However, the pregnancy ceases from being seen in its natural biological direction and starts to be analyzed as a moment of fragility and predisposition the illnesses. Finally, the social nursing and the central nucleus representations for the assistance in gestation for medicine is anchored in the speeches institutionalized and of the common-sense, reflecting the concern in establishing a humanized assistance with quality

Avaliação da qualidade da assistência aos portadores de úlceras venosas atendidos no ambulatório de um hospital universitário em Natal/RN

Study descriptive that was designed to assess the quality of care for people with venous ulcers (VUs) tended at the ambulatory of a university hospital in Natal / RN. The target population of the study was composed by 40 users bearers of venous ulcers served in the ambulatory of angiology of a university hospital in the level of tertiary education. The study received assent of the Ethics Committee of the Federal University of Rio Grande do Norte (Protocol No. 169/06). The collect of data was performed using a form of interview and tour with collection of measures biophysiologic, for a team comprised by the researchers and an academic of nursing, in the period of three months. The data were analyzed in SPSS 14.0, using descriptive statistics and presented in the form of charts, tables and graphs. Identified a clientele of holders of VUs predominantly female, married, aged up to 59 years, low level of education and household income, from Natal, retirees or those exercising professions and occupations that require long periods standing or sitting. In relation to the characteristics of health, those surveyed had risk factors for venous disease and had UVs chronic, located in Zone 2, lost tissue in grade II and serous exudates on average quantity. The assistance to holders of UVs has been characterized by a lack of professional nurses and unavailability of products for the realization of the right curative in ambulatory and outside it; by the inadequacy of products used in VUs, for long periods of treatment without resolution, where the compressive therapy is not priority, by the lack of completeness in the levels of assistance; by monitoring the bearer of UVs only by doctors and the nurses, even with the other team of professionals in the health service; by the completion of guidelines by health professionals and the lack the standardization of conducting laboratory and specifics tests. The assistance was assessed as inadequate in aspects: reference and counter-reference (75.0%), number of consultations with angiologists last year (87.5%), documentation of the clinical findings (85.0%), use of compressive therapy in the past 30 days (77.5%), part of the team interdisciplinary (97.5%), completion of laboratory and specifics tests in the last year (100%), availability of products used in achieving the curative in ambulatory (80, 0%), and indication of products used in the conduct of dressing outside the clinic (70.0%) and appropriate in the guidelines made on the use of socks, lifting of the members and prescription of exercises regular (82.5%) and indication products used in achieving the curative in ambulatory (97.5%). We conclude that the assistance provided to holders of UV was inadequate in 80% of cases interviewed, becoming non-resolutive and assistematic

Vivência do homem no puerpério

After the birth of a child, during the post-partum period, the exercise of fatherhood, the sexual relationships either marital or sexual as well as the definition of the male role are all aspects that can change. These changes are guarded and can contribute to strengthen the familiar bond or deprive it. Thus, this study aims to understand the male experience during the partner s puerperal period. In this period, the male interacts and participates according to his understanding of the post-partum period. The male experiences different situations with his partner, family and social environment. This research is descriptive-exploratory and has a qualitative approach. It was developed with 15 men that live with their live with their partners during the puerperal period. The data was collected through a semi-structured interview. These data was treated according to content analysis proposed by Bardin. These were analyzed through Symbolic Interacionism according to Blumer. Thus, three themes emergedshares of care in the home environment, meanings attributed to the puerperium, emotions emerged during the post-partum - the seven subcategories-taking care of the wife and child, supporting the family, moment to rest, fulfillment through fatherhood, sense of joy, feeling of concern and sense of exclusion. It was seen that the subjects experience post-partum mainly by taking care of their partner and child and providing support of the family. Besides the mentioned aspects, there was meaning attributed to the puerperal period, considering it a period of rest for the partner and above all, fatherhood. Thus, even understanding that it is excluded, the subjects expressed joy and worriness towards the child s future, related to the insecurity in which the country goes through in current conjuncture

Qualidade de vida na perspectiva de idosos institucionalizados no Município de Natal - RN

A descriptive and exploratory Study, quantitative in nature, with the aim to assess the Quality of Life (QL) of the elderly leaving in a Long Residence Institution (LRI) according to their own perception. It was conducted in six Public Institutions of Long Residence for Seniors, in the municipality of Natal - RN, in the period of July to August 2007. The data was collected using two structured interview forms: the first, containing questions about socio-demographic aspects and the second - the WHOQUOL-OLD, prepared by the World Health Organization to assess elderly s quality of life. The reference population was 266 old persons, and a random sample, of 43, being 28 women and 15 men, who account for 30%. The results indicated there is a predominance of older women (65.1%) and the average age is 76.6 years; the predominant religion is the Catholic - 44.2% and, 32.6% are unmarried without children. As for schooling and precedence, 41.9% are illiterate and 67.4% come from the rural area. The time of residency in the institution goes between 1 to 5 years for 69.8% of the elderly, 37.2% of them residing in the institution for not having another option. Most elderly informed using medicines. 51.3% said they are taking anti-hypertensive. As for the other aspects of QL: sensory aspects, autonomy, past, present and future activities, social participation, death and dying and intimacy, the WHOQOL-OLD, showed an average total score of 52.9% (scale of 0 to 100), with a tendency to neutrality, denoting that the elderly, in this study, evaluated their QL as neither satisfactory or unsatisfactory. Of all the facets of the instrument of QL, the sensory facet secured the highest average scores (68,1%), showing that the elderly are "happy" in the situation in which they find themselves, not showing significant disabilities. The facet of autonomy, which refers to the independence and the ability to make decisions on their own life, received the lowest average scores (40.7%), showing the dissatisfaction of the elderly on this aspect. The evaluation of the elderly on other facets were: social participation (48.2%); activities past, present and future (44.6%) and intimacy (50.6%), all perceived as neither unsatisfactory or satisfactory. On the item death and dying, the elderly people declared themselves satisfied, with average score of 65.5%. The analysis of the reliability of the WHOQOL-OLD by the Cronbach Alpha showed 0.57, considering the 24 items that cover the instrument, showing regular internal reliability of the instrument, in our reality. The result is probably due to differences between the regions south and east and the broader sociocultural diversity. We believe that the elderly in this study, tended to realize their QL as neutral, considering it as neither unsatisfactory or satisfactory, result likely related to the resignation with the destine, characterized, at the time, by the finitude of life, feeling very common among elderly, or perhaps, even for an accommodation, often accompanied by discouragement, present in the daily life of many of them

Vivendo o bem estar no desconhecido: experiência da mulher com a presença do acompanhante no processo de parto

The humanization of the birth process is a current health policy priority. Within that perspective, the presence of a partner during the birth is a benefit guaranteed by the Law 111008/05. The purpose of this study is to comprehend the woman s experience with the presence of a birth partner as a legal right. It is a qualitative descriptive study based on Symbolic Interactionism and conducted using the grounded theory methodology. Data were collected by semi-structured interviews conducted during August to December 2006, with women that had the presence of a partner during their birth experience and that were in the first 24 hours of puerperium. Data analysis resulted in the identification of the phenomena: FEELING GOOD, RECOGNIZING THE BOND WITH THE PARTNER, RECOGNIZING THE IMPORTANCE OF THE EXPERIENCE and NOT KNOWING THE RIGHT. These enabled the identification of the central phenomenon LIVING THE WELL-BEING IN THE UNKNOWN. The study demonstrated that the birth experience with the presence of partner is a positive one, resulting in benefits such as tranquility, support, and assurance, which, in that context, signify well-being. However, the women do not visualize the experience as a right, therefore remaining alienated from their civic practice. The understanding of the experience was enabled by the conceptual construction obtained from the categories of the interactions between the women and their birth partners during the event. The explanation of the phenomenon LIVING THE WELL-BEING IN THE UNKNOWN reflects the theoretical structure obtained from the integration of the identified concepts. The study points out the need for health professionals to improve the information given to women during the birth process and to work the civic duties of the women in reproductive health

A migração do cuidado em saúde: do hospital para o domicílio

This study is an analysis of opportunities and challenges of health assistance migration from hospitals to home care from the approach of the Domiciliary Internment Program (PID) in Natal / RN. The research aims to identify the ways that the multidisciplinary team act and know the stories of these professionals about the situation experienced in the transition between the instituting and instituted on home care modalities. PID has as a prior focus the elderly person in stable medical conditions, not to replace the hospital care, but to offer a therapeutic support turned to the exercise of their autonomy and coexistence with the situation of diseases. The home in their internal coexistence rules preserves own customs. As the hospital care migrates to the home care, it happens in the confrontation and rationality negotiation and becomes something new, that is going to be directed by an instituting dimension. In the view of New History, that suggests an interdisciplinary approach and interprets the problems on its time and from the technique of thematic oral history, it can be seen that working in interdisciplinary team is able to incorporate new values in the way of healthcare assistance, it longs for maintaining the maximum functional capacity of patients, it presents results as the prevention of diseases, costs reduction in connection with the Hospital Service, empowers and expands the possibilities for the patient recovery by aligning with the daily life and the opportunity of the patient being assisted by a multiprofessional team, interacting on the concrete reality. Therefore, PID is in line with the contemporary demands and as an instrument to be considered in the review of a wider concept of the health-disease process

Hospital de Pediatria da UFRN: resgatando memórias na construção da história

This study deals with a historical, descriptive and exploratory approach aiming to recall the origin and trajectory of the Pediatrics Hospital at Universidade Federal do Rio Grande do Norte. This research also deals with the insertion of the nursing department in the same Hospital. This was realized through existing records and discourse collected through interview of professionals-doctors, nurses, midwifes, nursing attendants and psychologists. Thus, a network was established and consisted of qualified informants, composed through reference analysis. Data treatment and analysis was performed based on the collection of oral data. The data was considered according to the font s context, all of which depending on process of comprehension and interpretation. The research was based on the main theme, through oral history used in order to build a historical background. These main themes were then subdivided and other discourses were made present such as: the historical scene, the dream came true and the insertion of nursing, present in the history construction; all of which enabled the research. Thus, in this process, it was possible to identify the most important characters of the origin of children s health services organization and assistance at Rio Grande do Norte. It was possible to perceive that this institution aimed to initiate health services that dealt with an education for future generations. This was observed through the creation of the Faculty of Medicine of Natal and as a consequence, the installation of a Pediatrics Hospital that dealt with medical education. The research made evident that the nursing contributed for a structuring of quality health assistance towards children, even though the resources and working conditions were scarce, extensive work shifts and low professional qualification. It was observed that the there was change in the category s profile, once nurses were introduced in the service. Once this happened, changes in mentality, and innovative processes as well as professional conducts were established. The distinctive relation between acting and doing of doctors and nurses were also dealt with. Thus, the first item is done towards the idealization, projection and prescription. The second issue deals with concretization in realization of something that was not projected and realized, causing suffering and unsatisfaction. At the end, it was possible to confirm that oral history is a very rich element and it is possible through subjects that build history, through their perceptation of the facts and the context in that their are inside

Dificuldades e/ou facilidades vivenciadas pelos profissionais que compõem a Estratégia de Saúde da Família

Descriptive and quantitative study, with the objective of review the positive and negative aspects experienced by professionals working in the Family Health Strategy (ESF) of Ceará-Mirim town, at Rio Grande do Norte state. The population included 190 healthcare professionals that integrate the family healthcare staff and the data-collection occurred in a meeting at their workplace, with the implementation of a questionnaire. Results were organized in Microsoft Excel spreadsheet software, with descriptive statistical analysis in tables, graphs and tables through frequencies, averages values and standard deviations. There is a predominance of females (n = 137) and higher rates in almost all professions, and higher average age (38.9%, SD = 7.8) and income wage (average = 10) in the medical category. Regarding the more developed activities, for physicians and nurses are the healthcare actions in the Unit, the oral hygiene for dentists, the immunization for auxiliary nurses (Aux-N), educational meeting for the dental office assistants (ACD), and home visitations to community-based health workers (ACS). About the easiness of work, 93.2% said to be presence of professionals with a personal profile in public healthcare; about the difficulties, 86.8% of professionals cited the unavailability of material, followed by salary range reported by nurses (80.9% ), dentists (80.0%), physicians (73.3%), ACS (83.1%), and Aux-N (90.5%). In relation to working conditions, the unavailability of materials was the most mentioned, with the exception of dentists who reported improvement in wages. We still identify among these difficulties: the drugs availability regarded as first grade obstacle by ACS and physicians, the type of contracts in second grade cited by the ACD and dentists and, in third grade, the salary range cited by dentists and auxiliary nurses. It is concluded that the difficulties and easiness faced by ESF professionals are divergent among themselves. For physicians and nurses, whose healthcare actions become directed to specific groups, the individual and the family, their difficulties relate to the unavailability of materials. For dentists, whose actions more quoted were topical application of fluoride and supervised toothbrush, their greatest difficulty is the salary range. As to the Aux-N, ACD and ACS, for all of them the unavailability of materials has hindered the implementation of their activities in ESF

O acolhimento no ambulatório de um hospital universitário na visão de usuários

This present study of quantitative/qualitative approach, aims to analyze the outpatient care at the Hospital Universitário Onofre Lopes (HUOL), and, having as guide, the reception of the user. In this regard were invited and interviewed 20 users. Besides the interviews, conducted in a period of 45 days, in this same period of time was used a field diary for more significant notes of observations more significant. In the analysis, we drafted the socio-demographic profile of the group and identified their main complaints, problems and suggestions. For this, we have built graphics, tables and pictures, in addition to standing out their testimony, as a resource for better understanding of the subjective aspects. The theoretical reference consisted of documents from the Ministry of Health about the reception and humanization, and the studies of Merhy, Franco, Pinheiro, Matumoto, Mariotti, Teixeira, among others. The results show the ambulatory of HUOL as a privileged space and of credibility, where users commonly, find answers to their problems. However, these same users were unanimous in saying the difficulties they face in obtaining consultations, from the basic unit, until the hospital. Regarding the service, although they feel satisfied as for the assistance received, they list a series of problems, of structural relationship order: lack of visual signalling, information, wheelchairs, hygiene, in the waiting rooms that offer some comfort, besides the inattention of some professionals. In summary, in the study, undertaken now, we cannot say that there is in the reality studied, the reception, in its full meaning, but the HUOL as hospital-school, has all the potential to accomplish it

Prática do enfermeiro do Programa Saúde da Família PSF na promoção da saúde do adolescente

Attention to the health of adolescents, based on paradigm flexneriano, needs to be overcome. Since the International Conference of Ottawa (1986), the literature is developing a discussion of the promotion of health, based on the paradigm of social production in health, suggests a design to overcome the health care traditional practices. Program Health of the Family PSF has this purpose to transmute the model of existing assistance, where the nurse is an essential element to the work done in the program. Around this context, it is our purpose to analyze the practice of nurse of the PSF for the promotion of health of adolescents, produced by a search of descriptive quantitative approach with the inclusion of qualitative data. Interviews were conducted with 9 nurses 3 units of health of the family USF, Mossoró-RN and applied questionnaires with 74 teenagers aged between 15 and 19 years old, with some nearby public schools where USF operate these nurses. The quantitative descriptions were transformed on tables, pictures and graphics using the program Excel (Microsoft) and the qualitative were worked through the technique of analyzing the content of Bardin (2004). The review was realized using the reference to promote health brought by the study. The results show that the most common problems that happen with teenagers are the drugs (33,8%), pregnancy (27,0%) and political problems-socio-economic-cultural issues (24,3%). Adolescents are spontaneous demand and rarely seek the USF. The actions presented by the nurses as, lectures and groups, are nothing comparing to the macro-problems presented by adolescents, and verticalized irregular. The nurses know the promotion of health generally, not explaining how operate it from its daily practice. Concluded that the practice of nurse of the PSF has not yet reach the promotion of health of the adolescent, being necessary to scheduling modules on the subject to continuous training of teams, professionals from USF, as well as teachers and other staff of schools, giving space to the participation of academic. The discussions should be socialized with the community to discuss possibilities of confrontation of the problems, which also require socio-structural changes. This research can contribute as work-diagnosis, which experienced the reality of care in nursing PSF to a specific group

Envelhecer entre pássaros e anjos: um estudo etnográfico sobre o processo saúde doença do idoso no contexto familiar

Study, a descriptive-like one, is guided by ethnographic principles which have analyzed the elderly within the familiar context in his/her process of health and aging, in the neighborhood called Felipe Camarão, located in the western administrative region of Natal, RN, a Northeastern city of Brazil. The participants are elders aging 61 to 84 years old, living in this referring neighborhood, whose majority is constituted of migrants from the rural region of the state of the RN, retired, including widows, widowers and married couples, with low school-educational degree. For the information gathering it was utilized a semi-structured interview, the participant observation and the field diary, being put into effect, in majority, in the houses and in the Family Health Unit, in a period between March and October of 2006. For the results discussion it was utilized an analysis of thematic content and the program ALCESTE (In Portuguese, Análise Léxica por Contexto de um Conjunto de Segmentos de Texto or Lexical Analysis by Context of a Set of Text Segments), which through have emerged two corpus: the corpus I, Family and the elderly, and corpus II, The elderly and the aging within society. The analysis of the results has permitted to conclude that the family, also used by the public policies as a strategy of their practices in health, it is a necessary base support for the elderly citizen in his/her process of aging and of health. The elders familiar contexts have allowed this study to identify the existence of minimal social conditions of life, of new rearrangements of the current families by means of the plurigenerational acquaintanceship and the active presence of the elderly woman as a maintainer of this family; also by means of conflicted relationships among one another but in a bearable level of acquaintanceship. Different conceptions about the aging and the elderly generate disagreement and divergency however the family support and help for the solving of these problems and the attention to health are proceeding from the family components. However, it is noticed that loneliness is something present in these elder s everyday lives. About the attention to health, in a basic level of it, it was noticed that there are still a lot of gaps, mainly concerning promotional and preventing actions, deserving a higher sensitization and effort by the local health institutions

Vivendo e aprendendo no ambiente hospitalar: Percepções de crianças sobre a doença

This study focuses on the child within the hospital environment. Its purpose is to describe children s perceptions of their illness and time in hospital and to identify their main hardships during treatment. This study has a qualitative nature and is theoretically and methodologically supported by the creative and sensitive method developed by Cabral (1998), studies by Piaget, Vygotsky and Wallon on child development, and studies conducted by Pinto (2005), Collet (2004), Chiattone (2003), Silva (2002), Lima et.al (1999) on in-patient children. For this study, 13 children between the ages of 7 and 12 at a public hospital institution specialized in child care in the city of Natal, Rio Grande do Norte, were interviewed. As a criterion for taking part in this study the children would have to have been in hospital for over three days and be fully capable of physically and emotionally interacting with the researcher at the time the interview took place. Analysis drew on the study of the empirical material made up of interviews and a field diary where notes had been entered for the children s reactions, expressions and gestures. Results show that there is some understanding, on the part of these children, of their illness, with their parents as the main informants. They accept being in hospital because they need treatment, but they realize that life becomes different especially on account of the constraints resulting from the illness and the hospital itself. The main hardships during treatment are: lack of recreational activities in the evenings and on the weekends within the hospital environment; absence of family members, especially brothers and sisters; and lack of explanation on the part of health professionals regarding some procedures as these are being carried out. Our conclusion is that children perceive illness and the hospital environment as something that changes the rhythm of their lives bringing on them perturbations, fears and anxieties. Hence, we suggest that professionals working with in-patient children should be especially prepared to deal with these children and their parents, aiming at bringing down fears and anguishes, clear their doubts and, in addition, advise the parents in respect of their children s treatment while in hospital and after hospital discharge. The hospital environment should also be cheerful and colorful and have a toy room under the coordination of persons especially prepared for that purpose

O processo de cuidar do enfermeiro em unidade de terapia intensiva: uma análise dos conhecimentos utilizados

Care has always been present in the history of humanity and in contemporary nursing it is considered to be a fundamental characteristic. In the Intensive Care Unit (ICU), care occurs within an environment that is known for its stressful factors, technological equipment, social isolation and discomfort. Whilst the reality of nursing practice in ICU demonstrates the lack of planned and systematized care, there is an indication that the professionals working in this setting utilize some type of knowledge. Based on that premise, in this study we aim to identify the knowledge that the nurses use in providing care in the ICU. We believe that the identification and characterization of this knowledge, and how it presents itself in practice, requires a reflective analysis process. Therefore, we utilized a qualitative perspective and Kim´s (1999) investigative methodology of reflective inquiry that is based on the precepts of Action Science proposed by Argyris et al. (1985). The study was conducted with 8 intensive care nurses of a public hospital. Data were collected by means of non-participative observation of the nursing care actions and a semi-structured interview conducted within the reflective mode that focused on the nurses practice in the ICU. The results enabled us no only to detect that the nurses utilized knowledge and patterns of knowledge acquired or constructed, but to identify them as: scientific, philosophic, religious, empirical, personal, ethical, and esthetic knowledge. The predominance of the scientific knowledge in the care process suggests that these nurses hold an acquired scientific substance that they utilize to provide specialized care directed toward critical treatment. The conception of this reality surpasses the theoretical limits, the techniques, and the known facts, and denotes the need for a reflective process in action to aide in the comprehension of the knowledge involved in the construction of excellent care

Estudo representacional da participação familiar nas atividades dos centros de atenção psicossocial no município de Natal-RN

Comprehending social representations of users relatives of Psychosocial Care Centers (CAPS) from Natal-RN, about their participation in the activities of these services, was the purpose of this study. The research instrument used was a semi-structured interview, led to 28 relatives of users of East and West CAPS II, East and North CAPS-ad, involved in the Relative Therapeutic Group, in Relative Meeting, in the Assembly of Users, Technicians and Relatives, according to the therapeutic schedule of each health services, between August to November 2007. Data obtained in family and users identification were characterized with the aid of charts and boards in absolute and/or percentage values. The discursive material from the guide from interviews was submitted to the informational resource ALCESTE (Analyse Lexicale par Contexte d'un Ensemble of Segments of Texte), and analyzed on the basis of the Theory of Social Representations and Central Nucleus Theory. Most of the relatives were women, married, aged over 50 years, who participated for more than two years in CAPS activities, and a coexistence of more than 11 years with the user. From the classification system of ALCESTE were selected categories, identified by: Category 1, Treatment Improvements and Expectations; Category 2, Living User Before and After; Category 3, Activities Relevance, Contradictions and Suggestions; Category 4, Guidelines -- Psychopharmacology and Medicalization; Category 5, Family Participation and Activities; and Category 6, Therapeutic Conditions Thanks, Tips and Vulnerability. The social representation of the family exists in the desire for change, identifying that we need to promote change by the continuity of therapeutic activities and overcome the detected inconsistencies, targeted by strengthening and by the stability of improvements in living and health conditions of users, experienced in CAPS treatment. The central nucleus had corresponded to positive changes in health and living conditions of users, and the peripheral elements were constituted by family conducts before and during treatment, and the expectations of changes in activities, especially in workshops. Despite this family participation be considered important, it still does not meet conditions to promote the inclusion of family, under an emancipating point of view, capable of causing in subject the hope for autonomy, initiative, individual and collective growths, a closer and active involvement in therapeutic activities, in workshops and discussions

Beirando a vida, driblando os problemas: estratégias de bem viver

The purpose of this study is to analyze the strategies used by families living in at-risk-and-vulnerable situations registered with the Estratégia Saúde da Família (ESF) ( Family Health Strategy ) as they face their daily problems. This is an investigation of a qualitative nature, using interview as the main tool for an empirical approach. Ten women from the Panatis location in northern Natal, Rio Grande do Norte, whose families live in precarious social-economical situations were interviewed. The interviews occurred between the months of April and June, 2007. The reports revealed that a mixture of improvisations and creativity was used as strategies for overcoming the privations and necessities of daily life. We also reached the conclusion that these families sought solutions for their problems through religiosity and a gift reciprocity system as resources for obtaining personal recognition and support in adversity. The results, in addition, point to ESF as one of the strategies used by these families in the search for attention and care. From this perspective, ESF has proven to be a place for listening and the construction of ties that are consolidated through home visits, organized groups, in parties and outings that are promoted in the community, reestablishing contact and support among people and signaling a way out of abandonment and isolation. Holders of knowledge constructed through life experiences, the participants of the study led us to induce and infer the need to amplify space that will allow them to express meanings, values and experiences, and consider that becoming ill is a process that incorporates dimensions of life that go beyond the physical. As health professionals, we need to be aware of the multiple and creative abilities used in the daily lives of these families, so that we can, along with them, reinvent a new way of dealing with health