A articulação entre a estratégia saúde da família e o Centro de Atenção Psicossocial: análise de experiência em município do Nordeste brasileiro

The antimanicomial psychiatric reform is a process that seeks to deconstruct the exclusionary logic caused by hospitalizations, providing strategies for social reintegration of individuals. In this sense, the primary care through the Family Health Strategy - FHS comes progressively becoming strategic space in mental health interventions, configured as a field of practice and production of new modes of care. In this perspective, there has been a process of implementing this proposal in the Areia Branca City/RN, through the articulation of Psychosocial Care Network and the Family Health Strategy / ESF. However, this process has not been able to bring changes in practices. From the view that the relationship between mental health and primary care is a challenge currently being faced, that improving the care provided and the expansion of the access to services with guaranteed continuity of care depend on the effectiveness of this joint, established themselves as research objective: To investigate how is the relationship between the FHS team and CAPS team in care mental health in the town of Areia Branca - RN from the speeches of professionals. And if you had specific purposes: 1) Know the demand in existing mental health in the town of White Sand - RN served by FHS; 2) Identify limits and difficulties in the relationship between the ESF teams and CAPS; 3) Identify potential for linkages between ESF teams and CAPS for the establishment of local RAPS. This was a descriptive, exploratory study with a qualitative methodological design, whose subjects were professionals from the Family Health Strategy, professionals Psychosocial Care Center and responsible for the conduct / management of mental health in the municipality. The research tools used informal observations, semistructured interviews and focus groups were used. The data obtained were analyzed for the content analysis of Bardin, allowing discuss the relevance of the theoretical framework with data obtained through observation and interpretation of the relationship between the Family Health Strategy and the network of Psychosocial Care in Areia Branca-RN. On the one hand, there was strong demand for mental health arising from users and their families and / or caregivers. On the other, it was verified that although there is some progress with regard to perceptions of mental health, there are still practical, historical and contextually rooted, which act as barriers to effective response to this demand in view of deinstitutionalization. In this sense, it is considered important to emphasize that the teams of the Family Health Strategy should be trained to ensure the health practice with integrity and incorporating the mental health network in the municipality. This training must occur through continuing health education.

Acolhimento na estratégia saúde da família: o que dizem os usuários?

The objective of the National Humanization Policy (NHP) is to humanize relations between professionals and users. It is guided by the proposal of expanded clinic and proposes the embracement as a strategy for its existence. The embracement requires qualified hearing, the provision of adequate technologies and the establishment of relations for better solving health problems of users. The objective of this study was to evaluate user satisfaction of the Family Health Strategy (FHS) regarding the embracement from the perspective of qualified hearing and improved relations in the city of Recife- PE. In this quantitative, qualitative, evaluative and cross-sectional study, 297 users of the services offered by the FHS were interviewed in six health districts of the city. For data collection, the Satisfaction Rating Scale of users with Mental Health Services - Satis-BR- abbreviated and adapted to the subject embracement was used. Quantitative data were analyzed by using the software Statistical Package for Social Science (SPSS) 17.0, calculating the absolute and relative frequencies. Qualitative data were analyzed by content analysis of Bardin with the elaboration of thematic categories. The results indicate that most users are satisfied with the embracement offered by the teams. About 66% reported being very or fairly heard by professionals; 80.2% reported to have obtained some or much help when searched for embracement; 64.6% indicated that the embracement is friendly or very friendly. Regarding ambience, 55.9% of users demonstrated indifference and dissatisfaction with comfort and appearance; regarding general facilities of the service, 69.4% reported as regular to awful. Three thematic categories were revealed by the speeches: satisfaction with embracement, dissatisfaction with the ambience, and suggestions for improvements in embracement and service. This study contributed to the understanding that both the hearing and relations are present in the embracement of the city and also to demonstrate that the ambience is a possible weakness in the opinion of the users.

Promoção da alimentação saudável na atenção primária à saúde: contribuição para construção coletiva do saber-fazer

The recognition of the food as determinant and health-disease process etching requires new explanations and interventions of the food and nutrition policy action and demand health care model based on the completeness of the actions and focused on health promotion. This study, characterized as research-action of interventionist character, sought to develop strategies to support the transverse insertion of healthy eating promotion in professionals practices a core of support for the health of the family and a family health strategy Unit in the city of Natal, capital of Rio Grande do Norte, from the analysis of perceptions and work processes of these teams. Several methodological strategies were adopted: Dialectical Hermeneutical Circle, direct observation, reflective and Thematic Meetings Workshop "Rethinking the educational practices for promoting healthy eating". For data logging, search diaries - SD were used and moments. The analysis of procedural form occurred in conjunction with research participants, in constant movement of reflection-action-reflection, based on hermeneutics-dialectic. About the results, in relation to the promotion of health, showed the following insights: health promotion and disease prevention-related harms; health promotion related to quality of life and well-being, in its various dimensions; health promotion as a responsibility of the State; health promotion related to the actions of health education; health promotion as an expression of efficaciousness and accessibility to health services. Regarding healthy nutrition, predominated the perceptions relating to nutritional aspects. With regard to food and nutritional education - FNE, it was observed a predominance of perception of FNE as information, guidance and knowledge transfer for changes of dietary practices. As regards the working process, it was observed that among the actions for health promotion, educational activities predominate, such as lectures, conversations, groups that mostly occur in fragmentary form, without joint planning teams, varying according to the professionals and the moment of work in which they are carried out. The results pointed to the need for reorganization of the work processes, in the context of intra-and intersectoral coordination and the construction of new technologies, such as: Health project of the territory – HPT, Unique Therapeutic Project- UPT, Expanded Clinic and educational practices, Shared with active teaching and learning methodologies. From the results we believe that it is necessary to "thought reform", from changes in vocational training and strengthening of the permanent education spaces, whereas the complexity that involves feeding, food and nutrition education and health promotion. The reformation of thought must be articulate and closely tied to the production of knowledge and practices that encourage intersectoral approach, the transversality, dialogue and democratic and supportive attitude, based on the collective construction of know-how. We hope that this study can contribute with reflections and initiatives that encourage building practices that promote healthy eating in primary health care, in terms of completeness of the care and the attainment of food security and nutrition.

Preceptoria em profissionais de saúde: viabilizando meios para uma formação pedagógica em hospitais públicos em Natal-RN

This study aimed to construct and carry out a distance course of pedagogical training for health professional performing preceptorship functions in public health institutions. The preceptorship in health is a pedagogical practice that occurs in workplace, led by assistance professionals with teaching position or not, where the vast majority of these acts intuitively, reproducing their own training, confusing transmitting information with education. These preceptors often do not dominate the pedagogical knowledge, necessary for the organization of training activities, such as the various teaching-learning processes and the different assessment types. Student supervision is essential in the training process of students in the health field, and on the occasion of supervised internships that the teaching-learning process is based on practical experience with participation in real life situations and professional work. It was realized an exploratory study, descriptive with qualitative approach, with the development of tutoring teaching course in health as final product. Applied semi structured research instrument from may to july 2014. It were evaluated 162 health professionals who perform the preceptorship, which made it possible define the preceptor's profile and identify the educational requirements related to the educational process, which justified the construction of the program content and the professionals’ perception analysis about preceptorship through identification of three categories: clinic knowledge valuation; valuation of professional orientation and valuation of professional future. The course was available on distance mode through Moodle platform with forty hours of work load from October to November 2014. With the aim of capacitate the health professionals to development of necessary abilities and skills to tutoring performance through thoughts about tutoring concepts, professional training within the curricular guidelines and SUS precepts, the role of health professionals as educators, application of active teaching methodologies, and evaluation methods. The applications were done online through the provided link; 300 vacancies offered, 243 professionals applied, chosen 134 that works on tutoring, where 49 represented professionals that works on the location of the study. The course lasted 45 days, and counted with tutors responsible to interact and evaluate the students. 28 professionals joined the course, 12 concluded. Opportunities were identified to stimulate the involvement, however the professionals’ satisfaction shows that, make an investment on tutors education, starting from the Permanent Education precepts, will provide a bigger appropriation of the knowledge to the education and therefore the awareness of their role as an educator on work ambit, proportioning essential tools to tutors act while enabler of integration between theory and practice and result better teaching-learning process.

Análise do perfil de encaminhamento da atenção primária para pré-natal de alto risco: desafios para o ensino de competências em saúde materno-infantil

OBJECTIVE: to identify a profile of the main causes of inappropriate referrals from primary care to specialized services, as strategy for the curriculum development of core competencies related to maternal health. METHODS: a cross-sectional study was performed using document analysis of all referrals of pregnant women from primary care to the high-risk pregnancy service, state of Rio Grande do Norte, Brazil. All pregnant women referred from June to December 2014 (n = 771) were included. According to their causes the referrals were categorized as adequate, inadequate or inconclusive. RESULTS: a total of 188 referrals were classified as inadequate (24.4%) and 93 inconclusive (12.1%) totalizing 36.5% of inappropriate referrals. The main causes identified in these inappropriate referrals were: low-risk pregnancy (12.8%), unconfirmed hypertension (12.1%), risk of abortion (8.9%), teenage pregnancy (7.1%) , toxoplasmosis (5.3%), Rh incompatibility (4.6%) and urinary tract infection (4.3%). These data contributed to the formulation of the following products: 1) a continuing education program for health professionals working in primary care, undergraduate students and residents; and 2) development of a virtual platform to support professionals who need to refer patients to high-risk pregnancy service. CONCLUSION: the results of this study are relevant in the current context of education of health professionals, with potential for positively impact not only in the development of skills related to maternal health in undergraduate and graduate education, as well as contributing for improvement of the health care of the population.

Estratégia de capacitação pedagógica do residente: uma perspectiva para melhoria do ensino na Universidade Federal do Rio Grande do Norte

Studies have shown that resident informally plays the role of teacher. It is estimated that up to 25% of the residents of the time is devoted to teaching, mainly contributing as a facilitator, however, almost the entire medical residency programs in Brazil did not offer teacher training during residency education. This paper aims to introduce educational content initiation to teaching as part of the training of resident physician inserted in residency program of the University Hospital Onofre Lopes (HUOL). It is an exploratory, descriptive and prospective study in HUOL the Federal University of Rio Grande do Norte. Three steps were developed: preparation and planning of a pedagogic course, associated with a motivating technical content (basic and advanced life support); second stage, testing of pedagogical model for medical students; and finally, replication to residents. The interventions were made two practice stations life support with performance evaluation in practical activity through OSPE (Objective Structured Practical Examination). The techniques presented teachings were one-minute preceptor and feedback. Data collection was conducted through a structured evaluation form during the life support stations and at the end of the course, and analyzed using descriptive statistics. The results showed that the feedback and one minute preceptor were considered important for teaching and learning for more than 85% of participants. The feedback from evaluators practices stations added information about the performance and were held appreciatively way, according to 100% of the participants. Positive aspects highlighted by the participants were related to educational content, especially the participants of the first intervention. The time of the lectures of motivating technical content was the most repeated negative. Based on the good acceptance of pedagogical contents, this pioneer teacher training strategy was included in the formal residency program in Cardiology of our institution. It is considered therefore that the educational training model with motivating technical content was feasible and had a good evaluation and acceptance by most participants in both interventions. Thus, we believe that the educational content can be inserted in the formal curriculum of medical residency of other programs at HUOL through the training model developed in this study.

Estratégia de capacitação pedagógica do residente: uma perspectiva para melhoria do ensino na Universidade Federal do Rio Grande do Norte

Studies have shown that resident informally plays the role of teacher. It is estimated that up to 25% of the residents of the time is devoted to teaching, mainly contributing as a facilitator, however, almost the entire medical residency programs in Brazil did not offer teacher training during residency education. This paper aims to introduce educational content initiation to teaching as part of the training of resident physician inserted in residency program of the University Hospital Onofre Lopes (HUOL). It is an exploratory, descriptive and prospective study in HUOL the Federal University of Rio Grande do Norte. Three steps were developed: preparation and planning of a pedagogic course, associated with a motivating technical content (basic and advanced life support); second stage, testing of pedagogical model for medical students; and finally, replication to residents. The interventions were made two practice stations life support with performance evaluation in practical activity through OSPE (Objective Structured Practical Examination). The techniques presented teachings were one-minute preceptor and feedback. Data collection was conducted through a structured evaluation form during the life support stations and at the end of the course, and analyzed using descriptive statistics. The results showed that the feedback and one minute preceptor were considered important for teaching and learning for more than 85% of participants. The feedback from evaluators practices stations added information about the performance and were held appreciatively way, according to 100% of the participants. Positive aspects highlighted by the participants were related to educational content, especially the participants of the first intervention. The time of the lectures of motivating technical content was the most repeated negative. Based on the good acceptance of pedagogical contents, this pioneer teacher training strategy was included in the formal residency program in Cardiology of our institution. It is considered therefore that the educational training model with motivating technical content was feasible and had a good evaluation and acceptance by most participants in both interventions. Thus, we believe that the educational content can be inserted in the formal curriculum of medical residency of other programs at HUOL through the training model developed in this study.

Formação profissional do cuidador de idosos em instituições de longa permanência

The old caretaker's work seeks to minimize suffering and morbidity resulting from physical, cognitive and emotional limitations of these individuals, being a practice permeated by the uniqueness of the subjects involved, therefore, a process in constant construction. In this notion, the caregiver's role is crucial to assist the elderly in everyday life, aiming at improving their quality of life. This study has descriptive and analytical character with quantitative and qualitative approach aimed to investigate the professional training of active caregivers in long-term stay institutions for the Elderly (ILPIs) in Natal/RN in the year 2014. For this, semi-structured interviews were conducted with 63 caregivers employed in nine ILPIs, representing 75% of the professionals performing activities in these institutions. The interviews captured data on the socioeconomic profile, the perception about the profession and training of caregivers. Data were analyzed by observation of absolute and relative measures of central tendency of the numeric variables frequencies. It was found that most caregivers had poor socioeconomic status and had no specific training course to practice caregiver role. However, among those who carried out courses, most reported that the content covered during the training gave security to perform the practice, although they have shown a contradiction when referred to the need to build capacity. The perception of care is mainly related to love and care for the other while the choice of profession is associated with care practice itself. The results also indicate the presence of a low level of formal training for the exercise of the occupation, also revealing the weaknesses ranging from the absence of a core curriculum that can guide the formation, compounded by the low educational professionals in focus.

Percepção dos profissionais de saúde do Hospital Municipal do Huambo-Angola sobre a fisioterapia: projecto de implementação de um serviço de fisioterapia

Mestrado em Fisioterapia.

Influência da experiência profissional e das características visuais do operador no processamento da cintigrafia de perfusão do miocárdio

A cintigrafia de perfusão do miocárdio (CPM) é uma técnica usada no diagnóstico e estratificação de risco em pacientes com suspeita ou conhecida doença arterial coronária. O processamento da CPM é realizado maioritariamente de forma semi-automática. Neste permanecem passos manuais, que envolvem: delimitação da área de reconstrução; reorientação e ajustamento dos limites do miocárdio (longo eixo vertical - LEV; longo eixo horizontal - LEH; curto eixo. O desempenho dos técnicos de Medicina Nuclear (TMN) pode ser afetado por: fatores ambientais; fatores individuais (experiência profissional e características visuais). Acredita-se que a perceção visual ao nível do processamento da CPM se encontra relacionada com o estado de visão binocular. Assim, diferentes TMN que processem os mesmos dados poderão obter diferentes estimativas dos parâmetros quantitativos. Questão de investigação: Será que a experiência profissional e as características visuais do operador interferem na determinação dos PQ no processamento da CPM? Objetivos do estudo: Avaliar a influência da experiência profissional e das características visuais dos TMN na determinação dos PQ obtidos na CPM; e Analisar a variabilidade intra e inter-operador na determinação dos PQ obtidos na CPM.

Qualidade no ensino das competências comunicacionais nos estudantes da área da saúde

As últimas décadas caracterizaram-se por importantes contributos que recolocaram o ensino de competências comunicacionais como um dos aspetos centrais na formação dos profissionais de saúde. A própria OMS tem vindo a enfatizar este aspeto e, em 2002, a American Association of Medical Colleges e a American College of Graduate Medical Education consideraram a comunicação interpessoal como umas das seis aptidões centrais a desenvolver nos médicos. Perante estas recomendações e a demonstração, através de inúmeras investigações, de que as competências comunicacionais podem ser treinadas e aprendidas, e que estas aptidões permanecem ao longo do tempo; as instituições de ensino superior que formam profissionais de saúde, são chamadas a repensarem os seus curricula. Os consensos de Toronto e o de Kalamazoo surgiram como dois importantes marcos orientadores da uniformização do ensino e avaliação das competências comunicacionais nas escolas médicas. A presente comunicação, parte de um conjunto de investigações realizadas com estudantes de medicina, enfermagem, fisioterapia, farmácia e radioterapia, bem como da experiência de utentes adultos em serviços de medicina nuclear e radiologia e de crianças na consulta de pediatria e pretende apontar algumas linhas orientadoras sobre os conteúdos e as metodologias de ensino das competências comunicacionais, assim como da forma de avaliar estas competências ao nível do ensino pré-graduado dos futuros profissionais de saúde.

Objeção da consciência e aborto previsto em lei : vivências em um serviço público de saúde

Tese (doutorado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Departamento de Enfermagem, Programa de Pós-Graduação em Enfermagem, 2015.

Satisfação do utente, percepção da doença e atitudes face aos técnicos de saúde: estudo em utentes da consulta de seguimento de portadores de pacemaker e CDI.

Tese submetida como requisito parcial para a obtenção do grau de Mestre em Psicologia Aplicada Especialidade em Psicologia Clínica

Satisfação na educação à distância em uma disciplina semipresencial na área de saúde

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, 2016.

Saúde do idoso

O módulo Saúde do Idoso contém textos complementares cuidadosamente selecionados para permitir que o profissional de saúde aprofunde seus conhecimentos, na medida em que os problemas forem surgindo. Descreve as principais características da transição demográfica brasileira, seus determinantes e consequências, e discuti as características da transição epidemiológica, suas peculiaridades no Brasil e sua relação com o envelhecimento da população. Os fóruns deste módulo abordam temas inquietantes da Saúde do Idoso e têm como objetivo abrir o espaço para a discussão e troca de experiências entre alunos e tutores.