Análise de qualidade da atenção à criança na estratégia saúde da família: o óbito infantil evitável como referência

Alma-Ata declaration bring the Primary Attention to the Health (PAH) as first level of health attention for individuals, family and community, which considers infant group as priority. Several initiatives that gave bases to integral attention to the children health formalized in the principles of Unique Health System. Family Health Strategy (FHS) comes to strengthen this attention, instituting new ways of work organization and professional practices that gave impact in their quality indicators. One of them is children mortality, showing decline in their values. Though, studies indicates persistence of avoidable infant deaths. In Natal RN, this reality is also perceptible leading to inquietudes, mainly at the space of services production, it means, which motivated the accomplishment of the present study intending to analyse the way that the organizational and structural processes as long as the professional practices in FHS interfered in the quality of children s health attention who died by avoidable death in the year of 2007 in municipal district of Natal-RN. It treats, therefore, to an exploratory and descriptive survey of cases study type, thar had as primary sources the oficial documents of MH, the family prontuary, pregnant card, child card and testimony obt ined from instrument of research elaborated based in investigation form of infant death by MH, applied to 10 mothers of children who had avoidable death. In analysis it was appealed silmultaneous triangulation of methods and sources, allowing a bigger aproximation from obtained informations. To elucidate the cases, the aspects studied were analyzed to the light of explicative model of Social Determinants of Health. Among individual and family aspects were highlighted the related to age, schooling, family habits and customs and mother s economic condition, besides of pregnancy age, newborn weight and associated diseases, which don t differ from literature about the theme. Reffering to the factors organizational and structural processes and professionals practice, highlihgted, the treatment given by the professionals, the territorialization and adscription of areas, the difficulty of having access to the services or sleepers and the reference and counterreference. But also, the ausence or few greet, the lack of communication, few assiduity and ponctuality by professionals in service, among others. In a general way mothers considers the attendance received in the hospital good and very good , opnions that in the Basic Attention weren t so favorable, in spite of many of predictible actions in this level have been performed in the studied cases. It is observed, therefore, that the social determinants of health has a strong influence in ocurrence of infant deaths, what implicates in a large actuation by Infant Mortality Committee from municipal district. This way, it becomes fundamental the reflection and evaluation about the effectiveness and execution by the processes of vigilance to health in FHUs; the rethink about the social determinants of health in a wide and articulate way to the services quality, to permanent education, to management in service, to the given attention and to the way how it is installed the popular participation and social control. To the professionals it is presented the great challenge to review their daily practice, their values, behaviors and commitment, which ones must be guided by logical of sharing, work in team, humanescence and alterity, not only by the accomplishment of a professional duty

Conhecimento dos enfermeiros do Hospital Universitário Onofre Lopes sobre sistematização da assistência de Enfermagem

Nursing as a profession goes in search on quality of their care through new frameworks, trying to break postures of the health care system so fragmented in the care. To change professional practices, it is necessary to build their own knowledge grounded on Nursing Care System. The aim of this study was to analyze the influence of nurses' knowledge on care systematization in nursing in the University Hospital Natal-RN. It is an analytical descriptive study carried out at the Onofre Lopes University Hospital (HUOL), Natal-RN, 2010, the sample was composed of 40 active nurses working in hospitalization units of the hospital, the inclusion criteria were being in the monthly scale sector and agree to participate in the study. The non-participant observation and another interview were used for collecting data, statistical analysis was descriptive and inferential with reliability test, Pearson test, chi-square and Fischer, the variables that correlated were analyzed in a model Multiple logistic , calculating odds ratio. The results were: predominance of female professionals (90%), predominantly in the age range 39-46 years (37.5%), nurses who have the undergraduate degree at the Federal University of Rio Grande do Norte (80%), and who have expertise training as a minimal degree (62.5%). Among the surveyed, the knowledge showed significance with the graduation time (p = 0.018) and time working in HUOL (p = 0.036). The majority of the professionals surveyed do not know which organ is responsible for the SAE legislation (52.5%), aware of the steps needed to build the nursing diagnosis (92.5%), understand the characteristics of nursing planning (90% ). However the same professionals do not perform physical examination in patients (50.0%) did not classify the clinical findings (68.4%), and identify the problems encountered as a classification (13.2%). The planning of nursing care is carried out by verbal order of nurses (82.5%), 41% of the professionals assess only the intervention stage, in other words, the actions taken. Regarding the practical application of nursing records 53% of nurses do not realize records, 30.8% is incomplete, the other held notes (p = 0.003). The nurses know the nursing process (90% of appropriate responses), despite the actions defined by the theory are not applied in practice. Investigators believe the condition of the hospital teacher (22.5%) could positively affect the implementation of the SAE associated with the interest of professionals (20%). Of the respondents, 17.5% accept as truth the lack of facilities to assist the SAE implementation in the hospital. It was concluded that nurses know the theory that underlies the SAE and the nursing process, but do not develop the service know as well, there is need for action to boost the SAE implementation as practice of nurses in the hospital investigated

Os significados do tabagismo construídos na dinâmica social

The present study has the purpose of catching the significances of smoking in the social dinamics based on the Theory of Social Representations. It was developed among adults with ages from 20 to 59 years, low social and economic conditions, at Natal RN, Brazil. The Free-words Association Test was applied as the instrument of data collection and a semi-structured interview with the smokers and non-smokers, besides a structured interview with smokers, non-smokers and ex-smokers. All data was analyzed by the descriptive statistics using the Analysis of Content Technique of the thematic kind and by the softwares ALCESTE and EVOC 2000. Elaborations about smoking were marked by social, cultural and historical dimension, however they showed sensibility to changes and revealed positive and negative aspects of the habit. The analysis of the semi-structured interviews showed the following categories and under-categories respectively: Initiation of the habit (Friends and Family and Appreciation and Beauty); Psychosocial Implications of smoking (Personal relationship, Work and Financial); Behavior when facing smoking (Positive, Negative and Neutral); Smoking Effects (Smokers´ health and the other people health); Description about oral diseases ( Bad breath, Oral cancer and Dental problems); Smoking treatment (Physician and psychological, Supernatural and Difficulties). ALCESTE analysis presented 4 classes: Ambivalence between pleasure and get ill, Smoking as a trouble and danger to society, Social discrimination of smokers and Mouth as a place of reaffirmation of the discrimination. Those helped us to understand the psychosocial repercussion of the habit. On the social representation structure we identified as a probable central nucleus of the smoker group the categories Pleasure and Bad to the health and as peripheral elements Alcoholic Drink, Financial damage and Nervousness. For the non-smoker group the category Bad to the health comes first and Stop Smoking comes as a peripheral element. Finally, we hope that the knowledge of these representations can contribute to plan and/or to rethink over the professional practices and public policies related to smoking. Besides that, for an amplified comprehension of the study object the discussions over the identified representations should be deepen and amplified to other population and social groups

A formação graduada em psicologia no Brasil: reflexão sobre os principais dilemas em um contexto pos-DCN

Criticism done to the undergraduate training process of the psychologist in Brazil raised debates known as "dilemmas of training". In recent years the classic training model, based on the Minimum Curriculum has undergone a series of changes after the National Curriculum Guidelines (DCN), modifying the context of courses. Thus, this paper aimed to investigate, in a post- DCN context how undergraduate courses in Psychology in Brazil have been dealing with the dilemmas of training. So, we decided to analyze the Course Pedagogical Projects (CPPs) of Psychology in the country. Forty CPPs, selected by region, academic organization and legal status were collected. The data was grouped into three blocks of discussions: theoretical, philosophical and pedagogical foundations; curriculum emphases and disciplines; and professional practices. The results were grouped into four sets of dilemmas: a) ethical and political; b) theoreticalepistemological; c) professional practice of the psychologist and d) academic-scientific. Courses claim a socially committed, generalist, pluralistic training, focusing on research, non-dissociation of teaching-research-extension, interdisciplinary training and defending a vision of man and of critical and reflective and non-individualistic psychology. The curriculum keeps the almost exclusive teaching of the classical areas of traditional fields of applied Psychology. Training is content based. The clinic is hegemonic, both in theory and in application fields. The historical debate is scarce and themes linked to the Brazilian reality are missing, despite having social policies present in the curricula. Currently, DCNs have a much greater impact on courses due to the influence of the control agencies, fruit of current educational policy, and the result is felt in the homogenization of curriculum discourses

O Serviço Ambulatorial Móvel de Urgência (SAMU) no contexto da reforma psiquiátrica: em análise a experiência de Aracaju/SE

This research investigated professional practices from Mobile Urgency Care Service (Serviço Ambulatorial Móvel de Urgência - SAMU) at psychiatric cases of the city of Aracaju/SE, Brazil and its possible articulations to psychosocial services network. The regulation no. 2048 of 11/05/2002 from Ministry Health establishes National Urgency Policy and designates that psychiatric cases are SAMU's responsibility. Then, it is necessary to propose an analyze of psychiatric urgency service under anti-asylums social movements standpoint, mainly because this service is responsive in assisting a person in crises. Fieldwork was developed in two phases. First one was made with SAMU workers and the information were produced by recorded semi-structured interviews. Results of this first phase indicate that urgency psychiatric conception from SAMU workers is based on aggressiveness concept; delays at psychiatric cases support and low training in mental health care which means several difficulties to emergency service. Although, we noticed that SAMU use asylum procedures at psychiatric cases like ropes and odder instruments to contain people. The second step of our research was to attend meetings to build a new psychiatric urgencies protocol for SAMU to define practices to auxiliaries, vehicular conductors and medical support regulation. Therefore, open interviews were accomplished with some participators and follows-up to psychiatric case on board of SAMU's cars. Afterwards we discussed how the urgency paradigm, that influence the protocol draw and as consequence distort what we believe is the essentially function of this device, that is to give care support to persons in crises and produce articulation to psychosocial services network

Abordagem clínica da atividade de trabalho do cozinheiro: interação de saberes, gênero profissional e inovação criativa

The focus of this dissertation is the study of work activities developed in the context of professional occupations characterized by varied previous schooling levels amongst those that work in them, and, at the same time, a high degree of complexity related to the typical tasks performed in the context of such professional practices. This dissertation intends to investigate the cook s professional activity, based on data from a determined specific professional genre in Natal (RN), in order to establish aspects related not only to the activity performed (activity which manifests itself empirically in registered behaviors), but also related to the real aspects of the work activity, that also compromises the non-realized options of the guiding of professional activity, be it by a matter of choice, be it due to the activity s own impediment. In this context, we tried to evaluate how much the professional activity observed keeps in relation to the reference practices of the professional genre, be it in terms of conformity, be it in terms of innovation (stylization) in relation to this genre. In addition, we tried to verify the contribution of the school and extra-school knowledge to the professional activity observed. Such work plan took on a preliminary step of the description of the socialprofessional profile of a cook in the city of Natal (RN), followed by a step of clinical labor approach, specifically utilizing as a methodological tool the simple and crossed self-confrontation procedure guided by the francophone theoretical referential of the Activity Clinic. The preliminary step in the description of profile of cooks from Natal (RN), of which 138 cooks took part in, evidenced three professional groupings, all predominantly masculine in their composition and fundamentally differentiated amongst each other by the time of professional activity, schooling type and time, work place and salary. The clinical approach step, composed by a pair of cooks, allowed us to verify elements of the cooks subordination to the professional genre, but also evidences of individual innovation (stylization) by these cooks, as well as the predominance of usage of extra-school knowledge when compared to school knowledge. We tried, in this step, to demonstrate how much the inclusion and submission to the genre dynamic, coordinated with the stylization initiatives, was able to contribute to the maintenance and amplification of the cook s power of acting in his professional practice.

A Psicologia do trabalho e das organizações na formação do psicólogo no Brasil

This research has aimed to analyze the presence of the Work and Organizational Psychology (WOP) at the psychologist s undergraduate education after 2004 s National Curricular Guidelines in Brazil. It has investigated in 43 Brazilian undergraduate courses of Psychology how their Course Pedagogical Projects (CPPs) approach the WOP issues. For that investigation, the CPPs, the subjects programmes related to the WOP and the curriculum grid have been accurately read and analyzed. Categories created by similar studies have also been used. The studied knowledge field has been cited by 41 courses, mainly on the definition of the egress s professional profile, on the expected competences and on the psychologist s formation process lines. Moreover, 28 courses have disposed curricular emphasis on the WOP and 12 have provided professional practices on that Psychology s field. All the courses have displayed, at least, one subject related to the WOP and in 29 cases there have been found between two and six subjects concerned to that field of Psychology, occupying nearby 10% of the whole courses credit hours. It has been verified that the Work and Organizational Psychology is allied to discussions about Quality of Life and Health of the Worker, bonded to work prescriptions at the Personnel Management departments and in other places such as syndicates. Additionally, 37% (147) of the WOP s subjects concerns to the contents of the Work Psychology, 21% (81) relates to the Organizational Psychology, 18% (71) are about Industrial Psychology s topics and 14% (55) debates the field generically. The most often issues are: Recruitment and Selection (25 courses); Training, Development, Learning and Education (24); and Work and Mental Health (24). Those topics have assumed three functions: providing principles for the acting at the WOP field; tutoring psychologists to analyze their own workplaces; and offering a comprehension of the human being mediated by the Work. It has been concluded that the WOP is incorporated on the psychologist s undergraduate education by considering the increasing of its presence and the occurrence of its traditional and emergent topics

A presença da produção científica em psicologia na formação de psicólogos do Rio Grande do Norte

The present research aimed to analyze the presence of national scientific production in undergraduate studies in Psychology of Rio Grande do Norte. Therefore, the bibliographical references contained in education plan of subjects linked to the common center of the courses, which were taught in 2011 in three Psychology courses of the state, were focused. The analysis of the material was based on bibliographical and contextual aspects of the production, such as year, nationality, type of material, authorship (including the link of authors to PPGs), structuring axis of the subject in which it was mentioned, among others. The results showed that the national production is predominant in all courses, and they are, mostly, originated from PPGs of Psychology. Among these, the publications resulted from programs in Southwest, with emphasis to PUC-SP, are recent (mostly from 2000s) and they are predominantly composed by books (organizations and full texts). Regarding the distribution of Psychology PPGs production by the structuring axes, it is observed that it surpasses the foreign production only in axis C (procedures of scientific investigation and professional practice) and axis F (professional practices). Accordingly, it is concluded that Psychology production is found in graduation, sharing space with foreign publications and from other areas of knowledge. On the one hand, this is positive, by taking into account the importance of several foreign works and from other fields to build the knowledge in Psychology; on the other hand, it shows that the production from this area is inserted in graduation in a less significant way than its growth, which points out the existence of gaps in the development of some investigative domains from national Psychology

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

Mestrado profissional em saúde da família: o curso sob a perspectiva dos mestrandos

Professional masters were created in Brazil in the 1990s in response to social changes in the world of work and aim to train high-level professionals with own profile for various activities of society and the productive sector. They are up in more innovative mode of graduate studies in Brazil, and therefore lack of legitimacy of their identity, which raises the need for discussions to get further information and outline the characteristics of this postgraduate modality. You want to build new understandings about their peculiarities starting from the perspective of students from the Professional Masters in Health Net Northeast Family Training in Family Health, and not only according to the similarities and differences with the academic master. This study aims to understand the meanings attributed by masters training in that course. This is a qualitative, exploratory study. The subjects are 100 students in training in 2013, distributed among the six institutions nucleation Network Northeast Training in Family Health. To collect information desk research was conducted in institutional records of all students, as well as interviews. We interviewed 15 students, distributed in the six nucleation institutions. Information obtained through recorded interviews were transcribed and resulted in two analytical corpus subsequently submitted to Alceste © 4.9 software for identification of semantic classes. It can be concluded that the course provided a redefinition of professional practices in the Family Health Strategy, considering the organizational context of primary care in the Northeast and the specifics of the health work. Even before the student body difficulties related to ownership of research methods, and the very active methodology of problem-based learning, the course effectively contributed to the improvement of work processes in primary care, valuing teamwork and allowing the acquisition of new scientific knowledge.