Avaliação das capacitações de Hanseníase: enfermeiros opinião de médicos e enfermeiros das equipes de saúde da família

MORENO,Cléa Maria da Costa,ENDERS,Bertha Cruz, SIMPSON, Clélia Albino. Avaliação das capacitações de Hanseníase: enfermeiros opinião de médicos e enfermeiros das equipes de saúde da família. Revista Brasileira de Enfermagem, Brasília, v.61,n.esp.p. 671-5.2008.

Nervos: rede de discursos e práticas de cuidado na atenção básica no município de Natal/RN

The Primary Health Care and one of its main strategies, the Family Health Strategy (ESF), are framed as the gateway to the Public Health System (SUS). Thus, most of the incident and prevalent health problems in the population attended should be solved at this level of care, including psychological suffering, and the so-called complaint of nerves. Nerves and nervous denote a complexity that is not always well comprehended by health workers, in such a way that the care to this kind of problem is usually inadequate. In this line of thought, the general objective of this study is to analyze the network of discourses and the care to the psychological suffering, expressed as nerves, in SUS daily Primary Health Care. Besides and more specifically, it aims at identifying the principles and guidelines of the Primary Health Care in mental health; to investigate health workers positioning before psychological suffering and complaints of nerves, and also analyze different actions and practices of care carried out in different Health Units towards complaints like nerves. Institutional Ethnography was the theoreticalmethodological perspective adopted for the work. This approach seeks to understand and analyze the institutional relationships in a particular context considering sociostructural influences and power relations, as well as daily discourses and practices. Based on interviews with health professionals, informal conversations and observations in six Health Units with ESF teams from different sanitary districts in Natal/RN, it was possible to check that the index of complaint of nerves is high. The referral to psychologists and psychiatrists, as well as the prescription of psychotropic drugs appear as the most common intervention at this level of care. In general, the participants complain that they have poor specialized knowledge about the theme of mental health. They face the problem of bad work conditions and the lack of institutional support, which make actions of illnesses prevention and health promotion even more difficult. Besides, there are different ongoing practices such as meetings for hypertensive and aged people, walk, visit, round-table discussions and community therapy. However, not all of these actions are aimed at the care of psychological suffering. It is observed that the Matrix Support, which is a methodological strategy of supervision and follow up forcases of mental health, hasn t been totally implemented in the municipal system, although it is a tool that has been used by psychologists in some Health Units in the city. It was also verified that the health care practices to the problem of nerves strongly depend on the professional s commitment with the PSF guidelines and on mental health policies, in addition to continued support, when available, from other professional who works as matrix supporter

Sofrimento solitário, mal-estar compartilhado :um estudo sobre a doença dos nervos

Nerves has been perceived as generalized suffering with multiple complaints, such as pain and other physical sensations, usually followed by symptoms of anxiety and/or depression. Even after medications have been prescribed, mainly psychotropic drugs to reduce these symptoms, exams aiming to discover the causes of the disorders, and a significant referral to health services, the problem tends to get progressively worse. The objective of this study is to characterize the diseases of clients who complain of nerves at the Unidade Mista de Felipe Camarão, Natal/RN, through in depth interviews, allowing for the clarification of ideas, beliefs and the meanings attributed to nerves by that person; to identify the symptoms and to know how they interfere in daily activities; to investigate the causes attributed to the problem and their relation to the biographical and psychosocial context of the patient. Thirteen women, health service clients, aged 30 to 59 years old, participated in the research. It was observed that they perceive, feel and act in unique ways with relation to symptoms, as well as to the attributed explanations and treatments given, showing the influence of life conditions, family context and their own subjectivity. Daily concerns and overwhelming responsibilities in the domestic environment, which usually stem from their precarious survival conditions, as well as marital conflicts motivated by the inequity of gender relations, contribute to trigger this type of suffering. The methodology of the research itself proved to be crucial to the comprehension and understanding of the meanings attributed to the complaints as well as to the argumenting process and the redefinition of the illness experience. Therefore, the importance of interdisciplinary intervention must be emphasize and specially the role of listening as relevant intervention resource

Avaliação das capacitações de Hanseníase: enfermeiros opinião de médicos e enfermeiros das equipes de saúde da família

MORENO,Cléa Maria da Costa,ENDERS,Bertha Cruz, SIMPSON, Clélia Albino. Avaliação das capacitações de Hanseníase: enfermeiros opinião de médicos e enfermeiros das equipes de saúde da família. Revista Brasileira de Enfermagem, Brasília, v.61,n.esp.p. 671-5.2008.