Humanização do atendimento à criança na atenção básica: visão dos profissionais

Objetivou-se compreender a humanização do atendimento à criança na Atenção Básica na visão dos profissionais. Estudo qualitativo, realizado em uma Unidade de Saúde da Família de Natal-RN, Brasil. Dezesseis profissionais responderam a um formulário contendo questões referentes ao atendimento à criança, à humanização e às práticas realizadas para humanizar o atendimento. Os dados foram categorizados por temas e analisados a partir dos princípios da Política Nacional de Humanização. Para os profissionais, humanizar o atendimento envolve acolher, escutar, aconselhar sobre o que está sendo realizado com a criança, valorizar a família, e tornar o sujeito ativo no atendimento, mesmo que de forma incipiente. A maioria dos profissionais descreveu atendimento que valorizava parte dos princípios da política de humanização, mesmo com dificuldades para implementá-los na rotina. Requer, portanto, estímulos e atualização dos profissionais para uma postura autocrítica sobre o atendimento

Representações sociais dos trabalhadores de saúde da atenção básica sobre envelhecimento e o atendimento ao idoso

This study aims to identify the social representations built on senior care health workers of Primary Care. This is an exploratory research within the subsidized social representations held in 100 Basic Health Units in the city of João Pessoa-PB, with a sample of n= 204 workers of both sexes, who agreed to participate. To collect the data used to set an interview in two parts: the first looked at the Test of Free Association of Words using the inductive stimulus "senior care". The interviews were analyzed with the help of a software for quantitative analysis of textual data ALCESTE (version 2010). The results were interpreted from the theoretical framework of social representations. The study included 178 women (87.25%) and 26 men (12.75%), working in Family Health Units in the city of João Pessoa, the majority are aged between 40-49 years of age ( 28.92%), and have higher education with 81.86%. The results of Alceste link to the term inducer six (6) where the hierarchical classes representing senior care workers as synonymous with care and attention, showing situations neglect of the elderly, for that patience is required to promote the increase of disease prevention and living with the elderly to generate humanization in health services. It is considered that the social representations of health workers on assistance to the elderly may support modeling of strategic actions in health services with health promotion programs for large groups, able to modify practices and behavior in elder care and strengthening the policy was directed at the elderly

Qualidade de vida, funcionalidade e morbidade referida : avaliação em idosos na atenção básica de saúde

Demographic and epidemiological transformations have led to an increase in elderly populations in the world, and chronic diseases become the main health problem in this population, with consequences for the independence and autonomy, and interfering in the lifestyle and daily activities, and may decrease the welfare and quality of life. So, there is an urgent need for multidisciplinary research on the quality of life, understood as a multidimensional and subjective concept, as well as the associated factors, such as health habits, presence of chronic conditions and functional capacity. Thus, In qualitative terms, the Article 1 provides an assessment and perception of the elderly about their quality of life. Article 2, in turn, presents the results of more extensive quantitative research, which can be seen that age, presence of chronic diseases and depression were associated with the quality of life. Thus, we discuss the need for action was planning and health strategies, with interdisciplinary approach, considering the environmental context and reality of family elders, promoting quality in the process of aging

Prática do acolhimento à pessoa idosa na atenção básica: uma estratégia de humanização

The aging of the population already is a fact, before considered a phenomenon, today, is part of the reality of the majority of the societies in the world. The present study it has as objective to analyze the practical one of the shelter developed for the team to multidiscipline for the elderly in the Strategy of Health of the Family. One is about a descriptive and exploratória inquiry, developed by means of quantitative boarding. The population of this study consisted of nineteen teams that work in the inserted ESF in the urban zone of the city of Sousa-PB, understanding a complete of 133 professionals. The collection of date was carried through through a questionnaire contends closed questions, referring to the partner-demographic date e, specific open questions. The main results indicate that the professionals of Health of the city of Sousa, PB, that had participated of this study had consisted in a complete of 76. Amongst these, 20% are nurses, followed of the odontólogos in 6%; 35% are ACS and technician of nursing with 19%. The age of the interviewed ones meets in the age band enters, 21 and 30 years, in 43%. The majority is of the feminine sex with a 84% total. Already in accordance with civil state 34% is married. If treating to the wage, the doctor has of greater of 12 wages. The participants present the percentile greater of formed time of with referring 33% of 1 the 3 years of formation. E finally, the changeable time of performance, if had detached 39% of the participants with 08 the 11 years. With regard to as if it processes the reception and attendance to the person in the ESF, we can observe that, with priority attendance was prominence with 27% of the participants, followed of a considerate attendance with 26%. Already in relation to the actions that are developed daily in the ESF, these they are come back toward the HIPERDIA with 40%, followed of actions ruled in orientation with 27%. Some actions they are carried through in accordance with the aged necessity of each (13%) and through visits domiciliary (9%). It was asked to them as the shelter was facilitated in the UBS, these had told that it is through the attention that is excused the aged one (35%), and finally, as this made it difficult age, in its majority with 37% they had not wanted to answer, followed of the lack of understanding with 26%. With this study it was possible to conclude that the practical one developed for the professionals of the ESF of the city of Sousa, PB with the elderly, is characterized by an assistance ruled in the clinical aspect, little focused in the actions that to permeate the PNH

Terapia comunitária integrativa: construção de um espaço de escuta para os trabalhadores na atenção básica da saúde

This research, which appears in the form of a dissertation, entitled: Integrative Therapy Community: construction of a listening space to health care workers in primary care, addresses the Integrative Community Therapy (ICT) as a tool to create meeting spaces between health professionals where they can be receptive among one another. With the completion of this study aimed to analyze the ICT as a therapeutic approach and space of listening and speaking for health professionals cited here in order to identify their anxieties, doubts, worries and uncertainties arising from the context of labor relations and the impact of therapeutic experiences under the view of the participants. It was developed as an action-science research, involving several steps. The field of research was the ICT meetings of workers from the units under the Family Health Strategy of Northern Health Districts I and II of the city of Natal, using a qualitative approach. The interpretation of data collected was based on content analysis proposed by Bardin. Finally, this study showed the ICT as a space for dialogue and sharing, with repercussions on labor relations and expansions beyond the ICT meetings, reaching out to family and social relationships, contributing to creating bonds and solidarity networks. Under the view of the participants it was recognized as an experience that optimized the socialization, promoting the alleviation of suffering and increasing the well-being. Based on the study findings, it is inferred that ICT can be considered a viable tool for the receptiveness and humanized care of health care workers.

Controle da neoplasia maligna do colo de útero: a resolutividade na atenção básica

A quantitative, descriptive, cross-sectional and retrospective study, using technical procedures of document consultation from secondary sources and health household survey with application form for face to face inter views, with the assent nº.039/2011 from the Ethics Committee of the Federal University of Rio Grande do Norte. The aim of this study was to analyze the cervix cancer control in the area47 of the Health Family Centre Nova Natal II. The cancer cervix is the second most common cancer among women worldwide. In Brazil screening for early detection and treatment of disease has been poorly done and follow-up to reduce mortality has not been executed. From a total of1170women belonging to area 47, who under went screening by the Pap test in the period from 2005 to 2010,was elected a sample of 38 women with positive cervical changes, over 18 years old. The calculation of frequency analysis of socio demographic and clinical and epidemiological selected variables with the results of cervical changes, using the X2 test and taking as significance level of p<0.05 was not statistically significant. The predominant age range was 25 to 64 years (68.9%), most no white women (60.5%), predominantly with primary education (57.9%), most married (68.4%) and housewives (68.4%) with early age of sexual activity (86.8%), the minority smokers (13.2%), with a sexual partner (36.8%). At the time of interview, 42.1% of the women voiced complaint of discharge, while only 2.6% reported bleeding. In relation to the occurrence of STDs (including HPV), 10.5% of women reported being a carrier. The use of oral contraceptives was 32.3% of women, from 2 to 4 years (44.4%). The result of the last screening test performed, showed prevalence of immature squamous metaplasia (55.3%), followed by intraepithelial low- grade lesion (including the cytopathologic HPV effect and cervical intra epithelial neoplasia grade I) (31.6%); intraepithelial high-grade lesion (including cervical intraepithelial neoplasia grade II and III) (7.9%), atypical squamous non neoplastic cells (5.3%). There was no squamous cell carcinoma and adenocarcinoma. Most women received information about the action that should be done after the last screening test result (55.3%), but how to perform follow, most women did not report having done so (55.3%). The follow-up group of women studied, with varying degrees of cervical abnormalities, should only be completed with the discharge by cure, established inconsecutive negative cytology, a goal that is not being achieved in the area 47 of the Health Family Centre of Nova Natal II

Elaboração e validação de instrumento para consulta de enfermagem à puérpera no âmbito da atenção básica

A pesquisa teve como objetivo elaborar e validar um instrumento para sistematizar a assistência de enfermagem à puérpera no âmbito da atenção básica. O documento foi construído com base na Teoria das Necessidades Humanas Básicas de Horta, na Padronização de um Conjunto Internacional de Dados Essenciais em Enfermagem e na Nomenclatura de diagnósticos e intervenções de enfermagem desenvolvida a partir dos resultados da Classificação Internacional para as Práticas de Enfermagem. Trata-se de um estudo do tipo metodológico desenvolvido em cinco etapas: identificação dos indicadores empíricos relativos à puérpera mediante revisão integrativa da literatura; avaliação dos indicadores empíricos e sua relação com as necessidades humanas básicas por grupo focal com cinco enfermeiras especialistas; estruturação do instrumento mediante a categorização dos indicadores; validação de forma e conteúdo do instrumento pelos especialistas, por meio da técnica Delphi; e aplicação e desenvolvimento das afirmativas de diagnóstico e intervenções de enfermagem. A coleta de dados da primeira etapa ocorreu nos meses de janeiro a março de 2013 nas bases de dados Scopus, Cinahl, Pubmed, Cochrane, e no periódico Journal of Midwifery and Women s Health. A segunda, terceira e quarta etapas se realizaram nos meses de maio a outubro de 2013. Participaram doze e sete especialistas na primeira e segunda rodada de avaliação respectivamente. A seleção dos especialistas ocorreu pela Plataforma Lattes mediante os seguintes critérios de inclusão: ser enfermeiro (a) docente e especialista em enfermagem obstétrica. A consulta a estes profissionais se deu via email e, ao aceitarem participar da pesquisa, assinaram um Termo de Consentimento Livre e Esclarecido. A pesquisa obteve aprovação da Comissão de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte, sob o protocolo nº 184.241 e Certificado de Apresentação para Apreciação Ética nº 11674112.3.0000.5537. Para análise dos dados da primeira etapa, utilizou-se a estatística descritiva e os resultados apresentados em forma de tabelas. Nesta etapa, identificou-se 97 indicadores empíricos e, quando relacionados com as necessidades humanas básicas, 46 desses encontravam-se nas necessidades psicobiológicas, 51 nas psicossociais e 01 nas necessidades psicoespirituais. Com relação à segunda e terceira etapas, os dados passaram por um processo de categorização e análise pelo Índice de Validade de Conteúdo. Os indicadores obtiveram um índice de validação de 100%. Na parte de avaliação da puérpera, os itens não validados foram excluídos do instrumento. Os demais itens obtiveram índice acima de 70%, sendo, portanto, o instrumento validado. O instrumento para a consulta de enfermagem é constituído de dados de identificação da puérpera, dados de avaliação das necessidades humanas da puérpera e itens do cuidado de enfermagem. Na versão final foram selecionados 73 Diagnósticos de Enfermagem e 155 Intervenções de Enfermagem a partir da categorização dos indicadores empíricos validados na segunda e terceira etapas do estudo. Com a conclusão do estudo, o enfermeiro disporá de um instrumento para sistematização da assistência à puérpera na atenção básica. Além disso, o documento servirá como ferramenta para o ensino e a pesquisa em enfermagem obstétrica

Os Centros de Especialidades Odontológicas como suporte da atenção básica: uma avaliação na perspectiva da integralidade

The public dental services in Brazil were limited, practically, to the basic care, so that the specialized services acted, up to 2002, no more than 3,5% of the total of clinical procedures. That lower offer reveals the difficulty of continuity of the attention, that is, the comprehensiveness in the assistance, particulary, the reference and counter-reference system. Brasil Sorridente search to supply those needs when proposing Speciality Dental's Centers(CEOs Centros de Especialidades Odontológicas, Brazil) to compose the services of average complexity. In 2005, Ministry of Health enabled the three CEOs of Natal, located in the North II, East and West Sanitary Districts. This investigation evaluated the implantation of these CEOs, as support of the family health care teams, in the perspective of organization of the services in assistencial nets in Natal/RN. It was a study of evaluation, with qualitative approach and some quantitative data as contribution. Dentists, users and managers were interviewed to identify and to understand their perceptions, relationships and experiences in the daily of the services. The conceptual base that orientated the investigation was the principle of comprehensiveness, in its operational sense of the hierarchization in health attention levels. The collection of data was done with documental research, direct observation and semi-structured interview. The analysis was accomplished by triangulation of the extracted content from the used techniques and sources of interviewed groups depositions, looking for theoretical-conceptual support in specific bibliography. The results pointed aspects that go away from the comprehensiveness like: low resolution of problems in the basic net; little valorization of the space in the health units; traditional models of access to health services, insufficient offer for some specialties, compromising the reference and counter-reference system; practices centered in procedures in the CEO; bureaucratic directions from basic care to the specialized service; disintegrated and disjointed system among levels of attention; disrespect to the municipal protocol. On the other hand, there is an approach of compreensiveness in situations like: increase of the access and covering in the Family Health Strategy (ESF Estratégia Saúde da Família, Brazil); larger approach between professional and user; tendency to the quantitative and qualitative growth of specialized actions; punctual initiatives of relationships among levels; existence of protocol to guide professionals

Perspectivados cirurgiões-dentistas sobre a inserção da fisioterapia na atenção básica de saúde

This work aims at investigating the surgeons-dentists acceptability in the field of public health in the city of Natal, State of Rio Grande do Norte, about the possibility of medicinal plants insertion in basic attencion of health. Moreover, it searchs to know if during their professinal formation it had some theoretician-pratical basement on this subject, as well as investigating their confidence on the medicinal plants. The basic motivation for developing this study is the possibility of contributing to the insertion of a tradicional health pratical at public assistance scope, endorsed by popular use, but now scientifically proven. For in a such way, the medicinal plants use is emphasized as a way to be followed to increase basic pharmaceutical assistance, improving the acess to the medicine and diminish expenses. Following this logic, family health program constitutes the way through which this pratical will be available to the users of health services. The research was done over thirty surgeonsdentists, all ofthem pertaining to public service ofNatal, state ofRio Grande do Norte. It was used, as research instrument, semi-estructured interview associated with methodological analysis user s speeches. On this form, this work is inserted in a trend observed nowadays not only in Brazil, where the use of the medicinal plants has been stimulated and defended to be inserted at programs ofprimary attenction of health

Avaliação da saúde bucal na atenção básica: a perspectiva do usuário

Nowadays, the basic attention in health works according to the Health Family Program (HFP), which is responsible for the organization of the health services with view to provide an appropriate attendance to the needs of the population. Its expansion is expressive in whole country and, the oral health, included in this process, has been seen as a possibility of change the health practices centered in the disease. In face of this perspective, the proposal of study is to discover possible changes in the health care model of oral health in a district, made possible through the perception, evaluation and degree of satisfaction of the user s health service. To reach such objectives, the district of Macaíba in the State of Rio Grande do Norte, was chosen for operational subjects, such as time of implantation of HFP and great covering of this program. The current research used interviews structured with objectives and subjectives questions and questionnaires of socioeconomic characterization addressed to two hundred and seventy (270) individuals (ninety users of an Urban PSF, ninety of a Rural PSF and ninety of an unit non PSF). The analysis of the data was accomplished through the software SPSS/99, that made possible a statistical and analytic appreciation. The HFP units and non HFP units has shown to sort the common odontology problems of the community, and this didn't establish a direct relationship with the general satisfaction. On the other hands, the programmed consultation is related with lager satisfaction of the users. The access form to the odontology treatment of the Units, the satisfaction with the attendance rendered by the dentist and the equip, enough dentists for the community and the social class of the user were decisive for the general satisfaction with the service of oral health. On the other hand, variables as age and education, resolution of the problem and physical conditions of the unit didn't influence the general satisfaction. In spite of the progresses in the implantation of the oral health in ESF, preventive activities, visits at home, access and social participation still reproduce the traditional model of attendance, showing a primary change process

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

Lugar, saúde e informação: os círculos de informação da atenção básica do SUS no contexto na disputa pelo conceito de saúde

Through the analysis of the informational activity at the primary care of SUS at the scale of places, this dissertation has as central objective to observe the dispute for the concepts of health and sickness, in the ambit of Brazilian Health Movement, featuring, on one hand, the clinic, biomedical or flexnerian line hegemonic, scientifically restrict and the primary frame of references for the Brazilian health politics and on the other hand a multiplicity of new proposals and critic thoughts to the current model, which have , as common characteristic, the worry with a territorial way of thinking the health context, therefore beyond the biological processes. On the first chapter we jut out with details these scientific and ideological movements, on a wider way, but also on the specificities of the public health s information politics. On the second chapter we analyze the downward health information circle at the basic care, observing the operational processes of the information s technical systems SIAB and e-SUS. On the third and last chapter, we give references to think about an upward health information circle, centered on the places, ruled by the notions of autonomy, organic solidarity and communicational density. It would possess, as method s primary horizon, the local organization of production and managing of information through the work of the Health Community Agent, privileging therefore the urgency of the most contingent needs of the people in theirs every day s life

A saúde do trabalhador na atenção básica: concepções e práticas dos enfermeiros

This study aims to analyze concepts and practices developed by nurses in occupational health in primary care, and it is justified by the need to expand knowledge of this thematic area. This is an analytical qualitative study carried out in primary care units of health districts of the city of Natal-RN, in one health unit in each neighborhood. Data collection was held from August to October 2014, through semistructured interviews, in the following order: Selection of respondents and scheduling of interview; interviews and application of data collection instrument in order to trace socio-demographic profile of the target population; transcription of interviews; categorization of information and analysis in light of hermeneutic-dialectic. The concept of Occupational Health reported by subjects investigated, although simplified with respect to specificities of workers, was revealed with a wide dimension, with perspective of workers’ approach in their physical, mental and social context, suggesting a good seizure according to the expanded concept of health. Furthermore, it was possible to affirm the recognition of an incipient performance of primary care nurses on Occupational Health, whose performance was appointed as defective. In general, some specific actions of Occupational Health, carried out in health facilities, were cited. Other activities showed up to be routine, being held by a minority of professionals aware of the importance and need to reach these users, in order to engage them in the routine of the health unit. Most professionals reported not having approached Occupational Health during undergraduate nursing, highlighting a lack in theoretical and practical aspects of the area

Construção e validação de instrumento de coleta de dados do casal grávido no âmbito da atenção básica

The research aimed to construct and validate a data collection instrument of pregnant couple as part of primary care. It was considered hypothesis that level of agreement from 70% among participants to validate the expert panel. The document has been based on the Theory of Human Needs by Horta and adjusted by Garcia and Cubas. It is a study of methodological type developed in four stages: identification of empirical indicators to pregnant women through an integrative literature review; evaluation of empirical indicators and their relation to human needs by focus group; structuring of the second version of instrument by categorization of indicators and appearance and content validation of the third version of instrument by judges, by use of Delphi technique. The collection of data was the first stage in months from August to October 2014 in the Journal of Midwifery and Women's Health and Scopus, PubMed, Lilacs, CINAHL, Cochrane databases. The remaining steps were carried out from November 2014 to February 2015. For the focus group was counted with participation of six experts through two meetings. As for the judges, it was obtained a population of 63 and final sample of 51 judges divided into 46 basic health units of Municipal City Health Natal/RN, Brazil. The study was approved by the Research Ethics Committee of Universidade Federal do Rio Grande do Norte, under Protocol number 876.200. For data analysis of the first stage it was used descriptive statistics and results are presented in tables and charts. At that stage were identified 162 empirical indicators and, when they were related to human needs, 64 by them were on psycobiological, 97 on psychosocial and one (1) on psychospiritual needs. Regarding the second and third stages, data were treated by process of categorizing and analyzing the Content Validity Index. The indicators obtained a 100% validation index. In appearance and content validation phase of instrument non-validated items were excluded and other items obtained index above 70%. Furthermore, it obtained 99% content validity index in the second version and 95.7% in the third version of the instrument as a whole and, therefore, validated tool. This instrument contains Health Institution, pregnant woman and her partner identification data, information on the human needs of the pregnant and items pertaining to systematize the collection of pregnant couple data during prenatal care. By the conclusion of the study, nurse shall have an instrument to collect the data of pregnant couple in primary care innovative by considering psychobiological, psychosocial and psychospiritual pregnant needs and insert health and sociodemographic data of pregnant partner in the context of pregnancy. Also, the document will serve as a tool for teaching and research in obstetrical nursing.

Integração ensino e serviço: dizer e fazer saúde na atenção básica

The current discussion on Education and Health has shown the need for greater integration between health services and academia, and this issue has been addressed by researchers in the area as being of great importance. How do we say what we need to do? The National Policy on Education Permanent Health proposes the dissemination of pedagogical skills at SUS, so that the public health clearance to constitute an area of teaching and learning in work performance. This study aimed to know how is the process of integration between education and health services in primary health care, from the knowledge on the role of mentors in the training of undergraduate students in the healthcare field in UFRN. Qualitative Methodology possible, from the use of the techniques of Semi-Structured Interview and Direct Observation of achieving this goal. The analysis of data taken from the Hermeneutic-Dialectic Approach, taking as mediators knowledge of the areas of Education, Health Education and Public Health, showed that the performance of preceptors constitutes an important strategy to enable the integration of teaching and service, and the professionals involved in the preceptorship educate themselves while they educate. The educational process is permeated by knowledge and experiences heterogeneous, highly favorable to the training of students and professionals factor. Innovative educational practices proven capable of starting the mediation of preceptors and other professionals involved in the Work Programme Education for Health, extend learning. The curriculum components Integrated Activity of Health, Education and Citizenship, and Tutorial Program for Integrated Health Work chosen as the basis for this experiment set, for preceptors, the need to seek new knowledge, allowing each actor transcend its specific area of academic training and interact with other areas, which makes learning interesting, enjoyable and meaningful.