As práticas educativas na saúde da família: uma cartografia simbólica

This qualitative research aimed to understand the educational activities carried out in Family Health Units, of the municipality of Mossoró-RN. It was used symbolic cartography to organize and present data from reality. It started on the approach of Health Education and knowledge transformation practice, aiming at the development of autonomy and responsibility of individuals and healthcare, publicized by the appreciation of the interpersonal relations area established in services, such as educational emancipator practices contexts. Individual and collective interviews were realized, conducted with health professionals and users of ESF, about themes, activities, membership, the difficulties, the potential and the design of health education that permeate everyday Family Health Strategy. From what was apprehended, thematic maps were done with the analysis of educational practices of professionals belonging to the Family‟s Health. Links are built with the wires of conceptions of education reflected on themes and activities of family health teams. The storylines are rebinded by voices about the difficulties and the potential of educational processes for emancipator postures. For users, health education means proper care and information on disease prevention. Professionals understand that it is all information that is given to users, about health, social well-being, economic and general condition of human being as a way of preventing and treating disease. Mark printed on voices denote that activities and themes worked don‟t motivate users enough for their participation, being that physicians and dentists also get excluded themselves from educational practices. Elderly groups are those who get most involved with the activities. The size of the contained area and its seclusion from community make harder the access of users, as well as diminishing the quality of educational actions and links users-professionals. Therefore, the searching for medicines, medical consultations and wish to be well served are trademarks of voices from the users that interconnect with enlightening information and guidelines offered by professionals to users. It brings out practices that need to incorporate the social, the subjective and act with practices of prevention and health promotion, on the basis of lifestyles. The dialogical model, which needs to be approached since planning phase of health education actions could arouse interest of involved groups; promoting a relationship of dialogue and listening; discussing the local reality; stimulating practical methodological dialetics; promoting processes of deconstruction of concepts, values and attitudes, as more necessary than construction, using multiple languages. The defended thesis denotes paths to other studies aimed at understanding a dialogical template committed to exchanges of knowledge, and discover strategies that encourage formation of critical consciousness and the discovery of how is the training of new generations of healthcare professionals to belong to the project of society, in its technical, scientific, pedagogical, ethical, political and humanistic dimensions

Alfabetização de crianças e jovens: superando desafios da inclusão escolar

This work has its genesis in the life of a teacher. It contemplates the report of a great story that expresses the political will of anonymous people who sought/seek to overcome challenges and prejudices, a joint effort to make real the right to literacy. The reported story was developed in the Pedagogic Clinic Teacher Heitor Carrilho, Natal-RN which, concerned about the sentence of 'unable to learn the written language' attributed to children and young public school students, decided to invest in overcoming prejudices and fight against school failure of these underprivileged. The problem that motivated the study was thus set up: What particularities characterize a pedagogical practice which aims to teach literacy to children and youth from public schools, considered not capable of learning the written language? What theoretical and methodological procedures are shown as a boost to literacy in the development of a pedagogical practice systematically targeted to reflect the perspective of educating those students in public schools? Aiming to answer these questions, we conducted a qualitative research having as methodology, Life Stories and Research/Formation. For the construction of the data, it was decided to use the participative observation, semi-structured interviews and document analysis. Guided by the principles of content analysis the data analysis was built, from which emerged two categories: theoretical and methodological procedures aligned to the major axes of literacy and Procedures of the specific theoretical and methodological fundamentals of literacy. As subsets of the transverse procedures others were seized: didactic-pedagogic procedures; social affective procedures. Regarding these ones, the research shows the importance of the teacher to build a relationship of listening to the students and their families in order to organize the pedagogical work, looking at multiple dimensions of the subject: the intellect, the creative, the affective, moral, noting that between the methodology and didactics or as part of it, the links built represent great opportunities to promote literacy. Regarding the specific procedures, others were built: procedures that emphasize oral communication, procedures that favor writing and procedures that privilege reading. Under these procedures, the results of research show that you can only promote literacy if the teacher provides the students effective conditions of understanding the principles of alphabetical notation from the use of various kinds of texts, leading them to comprehend and use them in different contexts. Therefore, instructors must meet the learners' prior knowledge, their language, and the learning real needs that will bring new challenges consistent with their possibilities. The research confirms the importance of the Educational Support extra school. However, it is essential to emphasize that it is a function of the school to promote literacy for all students in the early years of schooling. It is recorded, however, that for the implementation of this desire, we must break the school model characterized by a rigid tradition, in which there is only room for those who learn the content taught in a minimum time. Unfortunately, despite the discourse of inclusion and ensuring the right to education, the school remains exclusive and selective separating the school learning of interpersonal relations and social integration and performance. On the one hand, research showed the difficulties of conducting studies and/or strategies that address the particularities of children and young people believed not capable of learning. On the other hand, the political commitment and motivation have increased the perception that it is possible to mitigate the existing deficits in the educational context, beginning with the everyday teaching practice, in which new knowledge can be learned, methodologies can be improved and, despite everything, the educational success can be built

Interação entre a equipe de enfermagem e a gestante com diagnóstico de pré-eclâmpsia

The objective of this exploratory descriptive study with a qualitative approach was to analyze the perception of the nursing team and the pregnant women hospitalized with pre-eclampsia regarding the interactive process occurring in the care relationship. Data were collected by semi-structured interview with twenty nursing professionals that work in the high-risk ward and ten pregnant women with the diagnosis of pre-eclampsia. The discourses were analyzed using the content analysis method, in the modality of thematic identification. Three categories were identified that describe the perception of the interaction by the nursing professionals: recognizing the needs of the hospitalized pregnant woman, understanding the woman with pre-eclampsia, and presenting difficulties in the interactive process. With regards to the pregnant women, four categories emerged: recognizing the clinical care, feeling the lack of information, experiencing feelings during the hospitalization, and envisioning the interaction process. The meaning of the discourses was analyzed according to the principles of symbolic interactionism. The results indicate that both, the nursing professionals and the pregnant women, have a limited perception of their interaction, suggesting a need for further reflection about this reality in the health service units and in the nursing education environment

Sofrimento psíquico: representações sociais dos enfermeiros em ambiente hospitalar

We believe that the dissatisfaction arising from the lack of belief in the possibilities of change in the workplace, which cause difficulties to achieve professional results in the professional psychological distress that currently fits into the context of mental health. This is a qualitative, descriptive and representational research aiming to discover how the professional nurses represent the very psychological distress from work in the hospital environment. Aided and supported by specific objectives of identifying factors that generates this suffering and strategies for defense and confronting these professionals in the hospital. 22 nurses participated in this research, officials of the University Hospital Onofre Lopes, located in the city of Natal / RN, with length of service in the institution more than one year and less than five, and they accepted, by signing the Term of Free and Informed Consent, participate in the study. We use plurimethodological approach: a questionnaire, a semi-structured interview and the design-story with a theme adapted from Trinca with the support of the Theory of Social Representations and that nurses do in their psychological distress of the Central Core. We reviewed the data from the results generated by the ALCESTE software, based on hierarchical categorization downward, leading seven classes used as categories: Work process: completeness vs. incompleteness; labor contradiction of the nurse; qualitative aspects of interpersonal relationships; hospital surveillance: Challenges, muteness and neglect; Expectations, conflicts and feelings in the work process; Leisure: the other side of the work process, and Suffering generating aspects of in the work process. We consider the analysis of quarters generated by the program, which SLQ houses in the central core of the representations; the SRQ and the DLQ the intermediaries elements and the DRQ the peripheral elements that nurses do in their psychological distress. We analytically adequate results in the three belonging dimensions of social representations: the Subjectivity, the Intersubjectivity and Trans-subjectivity. We infer that the interpersonal relationship, the extra work, the deviation in the role of nurse show themself as the factors responsible for psychological distress of it. In that sense, the central core of SR of this profession is based on the level of trans-subjectivity and understood as a Social Representation controversy

Os profissionais de saúde diante da violência :mapeando o processo de implantaçãoda notificação na rede básica de saúde em Natal/RN

Violence is a complex and multifarious phenomenon that has convoked the government to think about strategies to face the question. This work is about one of these strategies proposed by brazilian Health Minister: the Individual notification/investigation Card - Domestic Violence, Sexual and/or others Interpersonal Violences . This instrument is a notification protocol which is been implanted in all of the country. This process is in course in Natal/RN. This work is a report of one research realized in five units of basic health care network of Natal/RN concerning this process about the implementation of the violence notification card. The study aims to cartography all the process of card implantation, discussing the used strategies, the drawn course, difficulties and possibilities as well as how the researcher intended to map subjective process involved at health professional acting at violence case and the propose to use the card. Meetings were held at each unit and a daily fieldwork report was used as research instrument. In this investigation it was observed that notifying violence involves a complexity that is not present in other kinds of notification as consequence of the phenomenon characteristic and health workers are invited to act in different perspective that knowledge and instruments of traditional health fieldwork available does not work. It was observed that the notification card, as a possible instrument of intervention, are considered important detectors from process of work at health basic care and health policies. Depending the way the instrument is used, it may incentive different discussions and manners to offer health care or in other way it can reproduce control and vigilance logics. Consequently it is necessary to consider some factors pointed out at this experience, implanting instruments like this, thinking about these limits and possibilities

Elaboração e avaliação de indicadores comportamentais de aderência ao tratamento hemodialítico

Introduction: This work intents to characterize behavioral indicators of tack to the hemodialysis treatment in a sample of carrying patients of chronic kidney failure (CKF) in the great Natal/RN. The therapeutical adherence represents the agreement degree between the patient behavior and the health team lapsings. The CKF is the gradual and irreversible loss of the renal function, being the hemodialysis treatment an important alternative to assist or to substitute the kidneys. Method: The sample consisted in 80 chronic kidney patients in hemodialysis treatment in two located clinical centers in the region of the great Natal, RN. It was used as instruments (a) a protocol of clinical data collection, (b) the Millon Index of Personality Styles (MIPS) and (c) a script of halfstructuralized interview. Results: The results show a balance between the genders (51% of female and 48.8% of the male sex), average age and equal average time of dialysis respectively to the 43,4 years (±13,25 years) and 22,04 years (±4,24 years). The marital status of half of the sample is married, predominating basic education (43.6%) and a familiar income until a minimum wage (43.8%). It had been defined six physicianlaboratorial indicators to evaluate the therapeutical adherence, further the use of the evaluation of the health team and the patient themselves. Thus, there was an average adherence around 55.97% of the sample ±18.37%). However only between selfassessment of the patients about the adherence and the assessment made by blood pressure post-dialysis indicated a significant association (p=0,029, qui-square test). On the other hand, there was a significant association (p <0.05, chi-square test) among the criteria for treatment adherence and issues investigated in the interview - the perception on the quality of the health services provided to patients, the difficulties following the prescribed diet, the characterization of the days between dialysis sessions and the perception of patients about the dialysis sessions. It was also noted a significant association (p <0.05, Levene test) between adherence to therapy and scales that constitute the MIPS. The health team characterized the patients more adherent behavior as an attitude of acceptance of the treatment, looking actively for their implementation, for more information and knowledge, and establishing a positive communication with the team and with other patients. Similar results were confirmed by the MIPS evaluation. According to that assessment the more compliant patients adopt a more optimistic attitude, trying to act or adapt themselves to their environment, processing cognitively both concrete and objective information, such as more speculative and symbolic information. In addition they establish a gregarious, cooperative, submissive and flexibly pattern of interpersonal relationships to social demands. These characteristics managed to explain 55.7% of the adherence variation according the health team and 23.3% of the variation according the CaxP laboratory indicator. Conclusions: The MIPS shown to be able to identify the most and least adherent to therapy patients. The use of different adherence indicators is important for an evaluation covering the different facets of this process. The adhesion levels are observed within registered by the relevant literature. There is need for further studies with a larger sample to deepen the data findings in this work

"Quem sou eu?": uma (re)construção do sujeito por meio da narrativa autobiográfica - proposta didática com um olhar nas interações em sala de aula

As we are aware, the classroom is emerging as a continuous build learning experiences and environment, however, for students also it functions as a place also to be due to socializing with friends. However, not always these elements complement each other, so as harmoniously as we are aware that there are many difficulties, both in the act of learning as in interpersonal relations between them. From this, we understand that it is for the school to seek ways to contemplate such issues so that they feel inserted both with regard to this learning as well as being able to interact with themselves and with others, in a participatory manner, to live well socially. Thus, we find ourselves facing a similar situation with a 9th grade class where the students had certain limitations to have a good relationship with one another, causing thus problems in learning. On the other hand, this difficulty as affectively interact with each other, also, was increased by the difficulty that some students had to speak for themselves and to show their feelings and emotions, getting even more difficult this interaction at school. Thus, we found ourselves obliged to act immediately and need to bring about change in this picture. So it came out the idea of the application of an intervening action which started taking shapefrom a pedagogical project that we developed in other classes in previous years, this time adapted to the situation experienced by the group. The project, framed in the qualitative research and characterized from the action research approach took shape, and elected as its main objective to seek possible alternatives to develop the communicative competence of students, which is why we invest in exercise oral communication (speaking and listening) in order to promote the use of language, the interpersonal involvement facilitating thus their participation both in the classroom and in social life. To fulfill this goal, we set out to develop a didactic book whose support materialized through the autobiographical narrative (molded in writing production) and worked along a structured instructional sequence in three distinctstages that dialogued with each other. Therefore, we base our study from the socio-historical conception and dialogue proposed by Bakhtin in line with the sociodiscursivo interactionism of Bronckart and resort to other scholars as Dolz and Schneuwly, Marcuschi among others. The development of all stages of the project not only has had an immediate effect on what we proposed ourselves as also yielded us very gratifying moments reinforcing to us that the classroom environment goes far beyond the fact ministering content. And that work with orality, with views on affective interaction of these students resulted in a project, so to speak, exciting.