Ser-no-mundo com a criança portadora de câncer compreendendo a experiência de psicólogos nos serviços de oncologia pediátrica de Natal-RN

Cancer goes on to be a frightening disease by humanity, simetimes,it is considered as death, suffering and stigma synonym. Occurring at childhood, this meaning seems to acquire a more intense conotation, having in view of the perplexity and godliness feeling in the presence of the precocity of events, nearly always associated to the death. A psychologist co-existence with the cancer children is going acquiring, thus, a permeated sense by incognitas , fears and fantasy, which raised us the following question: how does the psychologist that answers children with cancer lives this experience? Therefore, the aim this research was to understand this co-existence experience. Our theoretical perspective comes from an existencial fenomenology and, more specifically, the Humanistic Approach and Martin Heidegger Existencial Ontology. The metodology is qualitative of phenomenological character. The access instrument to the experience was the narrative, such as purpose by Walter Benjamin. They were carried out nine semi-open interviews with psychologists who work on pediatric oncology services of Natal-RN city. Such interviews were recorded in cassette, transcripted and later, re-educated. These interviews were recorded, transcribed and later on edited with the help of the interviewee and turned into a text. The narrative comprehension was carried out on Heidegger Existencial Ontology, on dada exaustive reading and the clipping of indicative passages of experience sense of being psychologist on this area. The research suggests that the experience is oriented of clinic kowing-doing, being crossed by implications of key thematics which indicate the care as central ontologic element that orientates the way as these professionals come being in the world in association with the clientèle. Besides, the caring experience of these children acquire the sense of true living experience, since the cancer undoes the immortality illusion, launching the psychologist to his/her condition of being to the death and with that, calling him/her the authenticity. Is is only not dealt with to experience the anguish and the death imminence, but above all, re-meaning them in favour of a continual learning, of quality answering , besides other possibilities. Working with child cancer brings news perspectives and world views, making the psychologist a more human people and sensitive to the distracted needs. And we believe that, regardless of area which actuates, being psychologist is a particular way which choose to be citizen. Is is a project that will be delimited by society, history and culture and after all, by us like human being. Therefore, we understand that the results this research suggest the discussed thematic deepening on this intervention field in order to new sense possibilities can arise giving origin to other reflections about the clinical practice, the professional formation in Psychology and other possible developments

Praça: lugar de lazer: relações entre características ambientais e comportamentais na Praça Kalina Maia Natal RN

Nowadays, the urban chaos brings some problems to the citizens such as mental fatigue, irritability and lack of attention, emphasizing the need for open urban spaces, capable to contribute to the restoration of physical and mental balance of people. By the variety of alternative uses available, many of them related to the stimulus of entertainment activities, the squares have been identified as restorative environments, especially by its potential as a place of leisure. In this context, the objective of this dissertation is to understand the use of the square as leisure environment, by a square in Natal RN, establishing the relationship between environmental and behavioral characteristics. More specifically, I attempt to identify the major activities that happen there, the people that develop them and the spatial and temporal configurations of this occupation. Among the 290 squares available in the city, the Kalina Maia Square was selected, which is located in the district of Lagoa Nova. The case study chosen was based on criteria relating to scale, shape, location on the urban environment, variability of uses and conservation status. In the study were used behavioral mapping place-centered and people-centered, behavior trace analysis and 14 interviews. The results show that the square is used by people from different ages and social classes, subdivided into groups with specific days and times. These users are usually engaged in activities related to various types of leisure, with sports predominance. The relationship between spatial configuration and behavior shows that there is a sectorization of uses, being possible to identify the environmental characteristics that most favor observed activities, especially in relation to shading and presence of furniture and equipment. Moreover, throughout the day it appears that the affordances inherent to the various fixed objects on the square are decoded differently by various categories of users, by giving them insights that help the development of leisure activities that characterize each group

Doadores de sangue: qualidade de vida e atendimento em hemocentro de Natal / RN

The context of blood donation in Brazil faces problems since the start of its operations in the 1940, in the beginning the biggest obstacle was obtain safe and qualified blood, and then, established criteria for donations, the barrier is the low number of suitable candidates for donation. This suitability is associated with the good health of those who goes to the services of blood banks and the return of the donor is often conditioned by the way care is given and perceived by the user. The quality of life, defined as a perception that a person has of her/his position in the world, can influence the health and emerges as a way to focus on the subjectivity in a context dominated by objective and practical exams; listen to the views about the received services increases the focus on the user and provides feedback to the institution, guiding and planning its future actions. The purpose of this study was to verify the quality of life in blood donors and their perceptions of care in a blood center in Natal/RN. This is a descriptive cross sectional study conducted with blood donors from Dalton Cunha Barbosa blood center. The used protocols were: a structures questionnaire with questions on sociodemographic and services perception data, and SF-36 quality of life instrument. The sociodemographic and SF-36 data ware analyzed using descriptive and inferential statistics, using the statistical package PASW 18.0; those related to treatment were submitted to thematic content analysis. The results revealed a sample mainly composed by men, married people, who attended high school and had already made previous donations, with the first two groups returning more often for donations. The scores of the SF-36 confirm the certificated of good health of the screens, beind high in all areas and featuring a healthy population; statistically significant differences were denoted between sexes, levels of education and marital status. The speeches about the service were mostly positive and had as main focus acess, agility, technical aspects and subjective feelings. The data regarding the Rio Grande do Norte blood donors profile confirmed some characteristics of the Brazilian ones, those data of the SF-36 were similar to those found in studies with healthy groups and the impressions about the care received show similarities with national and international studies about the attendance at blood banks

Dados normativos do teste de atenção por cancelamento em estudantes de Natal/RN

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Um lugar para chamar de "meu" :estudo sobre relação afetiva com o lugar de moradores da praia de Pipa-RN

The chores and the daily physical and social demands make us feel more and more the need to be in a familiar and restoring environment, with which we frequently establish emotional bonds. The interaction with places for resting and leisure, exemplified in the Environmental Psychology literature as recreational and home environments, allow us to exercise our potentials and to strengthen our (personal and collective) identity. Bearing this in mind, this dissertation has as aim to study the relation of affection between the place and the inhabitants of the community of Pipa-RN, which has turned from fishermen s village into tourist destination, bringing with it many changes to the local population. To accomplish that, we made use of behavioral observations, interviews, and graphic and photographic documentation with 30 subjects selected through a network of indications, attending to the criterion loving Pipa . After analysis and systematization of the answers, we identified three super-categories: 1) Love, characterized by the strong representation that an environment has upon an individual without, necessarily, there being an affective link, allowing it to be nurtured from a distance and dissociated from the desire to be present; 2) Attachment, demonstrated by the difficulty in leaving the place, a bond that can be mediated by personal financial investments or expectation of future benefits; 3) Affiliation, which refers to the feeling of belonging to the place and its community, sharing its history, culture, habits, etc., independent from the place of birth. These super-categories are not exclusive, on the contrary, they can form combinations which we denominate as situations, that could vary from 01 (individual involved with none of the three) to 07 (individual involved with the three); there wasn t the combination between Attachment and Affiliation. These results showed that within the framework of relations of affection with the place, there are countless possibilities of interaction individual-environment, determined by the physicalenvironmental characteristics and by the assessment that each individual makes of it. With this small contribution to the theme, we hope to enlighten the perspectives for future research, especially involving the relation of affection for places and the adoption of proenvironmental conducts, as a question of preservation of the ecosystems and of the quality of life of the inhabitants

Mulheres em situação de violência e atenção em saúde mental: um estudo no município de Natal (RN)

The present study aims to meet the attention given to women with mental health needs in specialized services for the fight against violence against women, as well as psychosocial care network in the municipality of NatalRN. It is a qualitative research characterized as research-intervention that took place in the year 2011. The study started in the Centre of Reference in which individual semi-structured interviews were carried out directed to the coaching staff and manager, in order to know the care offered in relation to the aforementioned clientele. From the Reference Centre were identified through analysis of registration records, the routes traversed by users through the network of psychosocial care and hospital network. After the identification of the same were visited two day-care Centers, two psychiatric hospitals, a basic health Unit and the local shelter. In these organizations was investigated the reception and procedures offered to users in situations of violence, the knowledge of policies for women and the coordination with the attention to women, through interviews with semi-structured individual scripts directed to professionals. The interviews were analyzed taking as starting point the theoretical framework of French Institutional Analysis, which includes the assumption of events analysers for the critical reading of dimensions introduced in the practices of care of the teams that took part in the study. The survey results revealed difficulties on the part of the same host of users with this profile, both in the face of violence as services in mental health services. This fact led to the lack of support under the guarantee of their rights, ceasing the possibilities of confronting the situations of violence, as well as in the context of mental health care

De vilarejo a cidade: identidade de lugar de moradores nativos de Tibau do Sul-RN

This study aimed to analyze some indicators of the restructuring process of place identity of natives resident in Tibau do Sul, a coastal town in the state of Rio Grande do Norte state, in relation to changes occurring in this locale in the last few decades. The concept of place identity a complex psychological structure in constant process of restructuring stresses the focus of this analysis on the aspects referring to the relationships of people with their physical and social environment throughout the transition process from the former village of fishermen and peasant farmers to the current growing town. Interviews with insider informants on local history were carried out as a preliminary step to getting in touch with the native participants. In total, 29 native local residents were interviewed, according to a wide range of personal and professional roles, focusing on their cognitions in regard to their past and present relationships with this context, as well as those related to expectancy for the future. The analysis focused both on the elements of distinctiveness, continuity, self-esteem and self-efficacy, and on how each of them have been valued (positive or negative). The participants evaluations of themselves and of the locale, as well as their distinctions in relation to others (people and places) were, in general, very positive. Many elements of group and place continuity, and the possibility of the satisfaction of their needs were highlighted positively, especially comparing to similar situations in the past. The development of the town, related to tourism as well as to other former economic activities, seemed to contribute to the restructuring process of place identity in a way of achieving desirable states for its structure. The broadening of the analysis to consider a wider spatial and temporal context, however, shows that such positive evaluation can be said to hinder some coping strategies of local residents faced with unsustainable economic activities, oftentimes handled to favor a minority of the population

A relação juventude-trabalho no projovem integrado do município de Natal/RN

The National Program for Youth Inclusion (ProJovem) has been created in 2005 in order to break the reproductive cycle of social inequality, through the improvement of the basic education and the professional qualification. Therefore, our objective is to discuss how the categories youth-work are inserted and implemented on ProJovem Integrado , which could be translated as Integrated , in Natal/RN. In 2008, ProJovem is has started to be executed based in four modalities: (1) Teenagers Socio-Educational Service, (2) Urban, (3) Worker and (4) Countryside Land Knowledge, aiming to serve a population from 15 to 29 years old who were seldom helped by specifics policies so far. In order to implement this research, three semi-structured interviews have been made, as well as observations at the program units and analysis of the official documents. In Natal, the operating modalities are: ProJovem Urban, which three units, divided in two districts of the city; the ProJovem Teenagers , which has ten units on Natal s four administrative regions; and ProJovem Worker , which were still structuring its courses until the beginning of the data collection. The data has been qualitatively analyzed through the Marxian Theory, tied to the Constant Comparative Method. The referred approach, based on the Grounded Theory, enables the understanding of the phenomenon s meanings through the perspective of the participants. The neighborhoods in which ProJovem s units are inserted has been characterized as well the Program s target. The results have been presented in three blocks: a) the modality s structure, which includes the implementation, functioning and operationalization of the activities; b) management of the modality s management, concerned to the main difficulties, expectations and functions; and c) the relation youth-work at the modalities. About the objectives and qualification and insertion goals, there is incongruence at the offer of occupational arches. We have observed that offered occupations are historically subservient and precarious. Hence they do not promote significant changes on the students career paths by usually inserting them into informal jobs or underemployments. Besides that, the professional qualification is very incipient. For that reason, it does not go with the necessary requirements to enable the youngster to enter the work world. It is considered that other researches are necessary to for better understanding of the remaining aspects of the relation youth-work

Prospecção e formação no domínio das competências e habilidades em tecnologia da informação: o caso do projeto metrópole digital em Natal/RN

This study deals with cognitive competences and abilities that are relevant to selection and education regarding Information Technology (IT). These competences relate to problem solving, decision making, and practical intelligence that regard scholar and extracurricular knowledge mobilization. The research aimed to contribute for the improvement of a selection instrument, consisting of five arrays of skills (dealing with objectives and prospection), as well as the development and comprehension of those skills that are involved in IT education. This is done by means of an analysis on the selection instrument used in the first selective process that occurred at Metropole Digital an Institute at the Federal University of Rio Grande do Norte in Brazil. This was evaluated aiming to acknowledge IT education (with basic training and emphasis on Web programming and electronics). The methodology used was of quantitative method involving performance scores relating education delivery. An Anova analysis of variance was done along with descriptive analysis involving socioeconomic data that was not observed in the meaningful relations between parental instruction and student performance in the graduate course. These analyses were able to point out the importance and need of the policies for vacancy reservation on behalf of public school students. A Spearman correlation analysis was done considering the instrument selection performance in the training course. The instrument is presented as a predictor that is significantly moderate and presents a good performance in the course as a whole. A Cluster and Regression analysis was also realized in the process. The first analysis allowed finding performance groups (Clusters) that ranged from medium and inferior. The regression analysis was able to point out association amongst criterion variables and the (average performance in basic and advanced modules) and explanatory (five matrixes). Regression analysis indicated that matrix 1 and matrix 3 were pointed out as being the strongest ones. In all the above analysis, the correlation between the instrument and the course was considered moderate. Thus this can be related in some of the aspects present in the course such as emphasis on evaluation itself as well as in technical contents and practical skills (educational ones) and competences and selection skills. It is known that the mediation of technological artifact in cultural context can foster the development of skills and abilities relevant to IT training. This study provides subsidies to reflect on the adoption of selection instrument and IT training in the Institute. Thus the research offers means to achieve a interdisciplinary discussion and enriching of areas such as Psychology and Information Technology; all of which regarding competencies and skills relevant in IT training

Suporte ao uso de álcool e drogas na atenção primária: um estudo com equipes de Natal/RN

National surveys indicate that 6.8 % of the brazilian population is dependent on alcohol and 1 % dependent on illicit drugs, representing a significant portion of the population affected by this issue . Primary Care becomes instrumental in expanding the coverage of this demand and in reducing unnecessary referrals for specialized care. This study aimed to investigate the responsiveness and institutional support of Primary Care Teams in relation to the demands of alcohol and drugs users. The research was conducted in a Family Health Unit in West Sanitary District of Natal City. With quantitative and qualitative nature, our study consisted of two stages. At first, we performed a mapping of alcohol and other drugs abusive use in a sample of the population assisted by Family Heath Teams, using sociodemographic questionnaire and ASSIST (Alcohol, Smoking and Substance Involvement Screening Test). 406 questionnaires were completed. Of these questionnaires, 27.8% are men and 72.2% women, of which 56% are between 20 and 39 years-old, they are housewives, have a stable relationship and are consumers of tobacco (37.6%), marijuana (13%) and especially alcohol (57%). In second stage, two Conversation Circles with Family Health Teams and the referential Family Health Support Center were formed to discuss the data of the mapping realized in the previous phase. The circles, which had participation of 20 of the 37 professional teams from Family Health and 2 from Family Health Support Center, showed a lack of professional training in the subject; inability of the healthcare network in the user embracement; belief of professionals that nothing can be done when matter is alcohol and drugs; and referencing as the only care action performed by teams. Thus we point out the need to support an approach on issues of alcohol and drugs which consider gender issues, investing in Harm Reduction Policy as a possibility of working in this context for recognizing each user in their uniqueness and strategizing with them to promote health in a broad and contextualized way

Desenvolvimento de uma metodologia para caracterização de amostras de sedimento: Rio Jundiaí RN

The study of sediment in water bodies presents great environmental importance, because of its ability to adsorb the pollutants, they may facilitate the understanding of the history of the current quality of the water system. Depending on how it is done the collection, analysis can show both a recent contamination as old. The detailed characterization of the sediment may reveal details that can understand how each type of pollutant interacts with the material given its composition. In this work it has developed a systematic methodology to characterize samples of sediment, with the aim to understand how a series of metal is distributed in different size fractions of the sediment. This study was conducted in five samples of sediment (P1, P2, P3a, P3B and P3c) collected in Jundiaí river, one of the most important tributaries of the river Potengi in the region of Macaíba, RN. The characterization was made with the samples previously sieved into meshes with different granulometries (+8#, -8+16#, -16+65# - 65+100#,-100+200#,-200+250# and -250#), using the following techniques: Analysis of specific surface area by BET method, determining the levels of organic matter (OM%) and humidity through the gravimetry and Analysis Thermogravimetric (TG), Infrared Spectroscopy in a Fourier transform (FTIR ), Analysis of X ray diffraction (XRD), analysis of heavy metals by optical emission spectrometry with the Argon Plasma (ICP-OES). The analyzed elements were Al, Cd, Cr, Cu, Fe, Mn, Ni, Zn and P. In addition to the techniques of characterization above, was also made the rebuilding of the samples P1, P2 and P3B in relation to the levels of organic matter and concentration of heavy metals. Then, the results of the recomposed samples were compared with those obtained in crude samples, showing great consistency. The gravimetry, used in determining the levels of organic matter, was not considered an appropriate method because the clay minerals present in the sediment samples analyzed fall apart in the same range of temperature (550-600 0C) used in roasting (600 0C). The results also showed the trend of organic matter and heavy metals to focus on the thin fractions, although the largest concentrations of metals are in intermediate fractions

Influência espaço-temporal e fisiológica na absorção de nutrientes e elementos tóxicos por Eichhornia crassipes visando o uso adequado da sua biomassa: o caso do Rio Apodi/Mossoró - RN

This study aims to determine the amount of nutrients and toxic elements in aquatic macrophytes of species Eichhornia crassipes present in River Apodi/Mossoró - RN and check some of the possibilities of using the biomass produced, based on the influence of space - temporal and physiological absorption of nutrients by plants. For this, was determined: Leaf area, Leaf wet mass, Leaf dry mass, Real humidity, Apparent humidity, Ash, Total nitrogen, Crude protein, Calcium, Magnesium, Potassium, Total phosphorus, Sodium, Iron, Copper, Manganese, Zinc, Nickel, Cobalt, Aluminum, Cadmium, Lead and Total chromium at different times, 2 sampling points and 2 parts of plants (leaves and roots). The results show that the levels of nutrients, protein and toxic elements present in plant tissue of Eichhornia crassipes are influenced by spatial, temporal and physiological variability. In general, because the maximum values in the dry matter for total nitrogen (4.4088 g/100g), crude protein (27.5549 g/100g), total phosphorus (0.642 g/100 g), calcium (1.444 g/100g), magnesium (0.732 g/100 g), potassium (7.51 g/100 g), copper (4.4279 mg/100g), manganese (322.668 mg/100g), sodium (1.39 g/100g), iron (194.169 mg/100g) and zinc (3.5836 mg/100g), there was the possibility of using biomass of Eichhornia crassipes for various purposes such as in food animal, products production for human consumption, organic fertilizers, fabrication of brick low cost, and crafts. For all these applications requires a control of the levels of substances in plant tissue. Based on the levels of nutrients and crude protein, the younger plants (0 Month) would be best to have their biomass used. Moreover, one factor that contributes to the use of larger plants (6 Months), the levels of toxic elements which have significantly small or below the detection limit. Therefore, further studies quantifying the biomass produced/m2 at 0 and 6 months are needed for a more correct choice for the best time of harvest

Assinaturas antropogênicas de elementos maiores e traços em poeira urbana na cidade do Natal-RN

Although there are many studies on urban dust contamination by heavy metals in developed countries, little attention has been paid to this type of study in developing countries, including Brazil. Therefore, a series of investigations were performed to provide signatures of heavy metals in urban dust and assess the potential sources in the city of Natal - RN-Brazil. The fraction of these sediments was studied to pass through a sieve of 63 micrometers. For the study analyzed two groups of samples, one collected in September 2009 at the end of the rainy season (9 samples) and one collected in January 2010 in the dry season (21 samples). So in all, thirty sediment samples were collected from the street. Then, in Fluorescence Spectrometry X-rays were determined major elements SiO2, Na2O, K2O, Al2O3, MgO, P2O5, Fe2O3, MnO, TiO2 and CaO, and trace Rb, Cr, Ni, Cu, Zn, Sr and Pb by an ICPOES was determined Zn, V, Na, K, Ni, Mn, Mg, P, Fe, Cr, Cu, Pb, Ba, Ca and Al from leaching HCl 0.5 mol L-1 . The results of the concentrations of elements show that the greater presence of these occurs in the dry season, except for Si which is higher in the rainy season. Analyses by geoaccumulation Index (IGEO) Enrichment Factor (EF), Contamination Factor (CF), analysis correlation and Hierarchical Cluster, confirm that Zn, Cu and Pb is anthropogenic character. Zinc may be derived from various sources related to motor vehicles or the road signs and street grids. The elements Na, K, Mg and Ca may be related to droplets suspended in air containing cations and anions present in seawater (salty), common in Christmas throughout the year, brought by winds SE-NW. The elements Na, Mg, Ca and K are the most abundant in seawater and were analyzed in this study. This indicates that the source of these additional elements detected by analyzing the contamination factor may be the very sea. Moreover, Ni, Fe, Cr and Ba can be either as a source of anthropogenic geogênica. The source of Ca is different, because it comes in lime and paint (painting guides of buildings and streets) in construction materials, but may also be present in sediments in the fragments of shells or carbonate bioclasts common in the coastal area

Avaliação das ações do Núcleo de Apoio à Saúde da Família (NASF) em Macaíba/RN

This research evaluated the contribution of the Support Center for Family Health (SCFH) in relation to its effect on the Family Health Units through perception of the Family Health Strategy (FHS) and SCFH professionals, in addition to the satisfaction of users in relation to that role. Data were collected in the public health services of the city of Macaíba-RN in 2012, through semi-structured questionnaire and non participant systematic observation and it counted as investigated subjects 272 individuals (60 FHS professionals, 12 SCFH professionals and 200 users representatives of 20 units). For analysis of the responses of the opened questions was used categorization process and, in relation to the observational method, that was based on checking the space organization, the characteristics of the participating subjects and the specific set of activities performed by SCFH teams through an observation guide. The results point to a good acceptance of the SCFH teams role by most FHS professionals who reported active participation in the health units routine, its integration activities to the FHS teams with resolving based health promotion actions. Regarding the SCFH professionals, they also reported positive contribution by participating actively in the units routine with integrated activities to the ESF teams and developing resolute actions. For users, the SCFH brought assurance services with better access to specialized, resolving and welcoming care. Systematic observation ratified data obtained by questionnaire. It was perceived the need to implement actions related to man`s health, to invest in expanding the number of the SCFH teams, the greater supply of medications, improving the regulatory process and planning together as a key strategy to promote a more effective integration between teams SCFH / FHS

Limites e possibilidades da educação em saúde na estratégia de saúde da família de Pau dos Ferros/RN

A Estratégia Saúde da Família (ESF) apresenta-se como um espaço privilegiado para a efetivação de práticas de educação em saúde orientadas pelo diálogo entre o saber científico e o saber popular, uma vez que é nesse espaço de saúde que profissionais e indivíduos/família se interrelacionam, criam vínculos, dialogam e constroem soluções para o enfrentamento dos problemas de saúde da população. O objetivo geral deste estudo foi analisar os limites e as possibilidades de efetivação da educação em saúde voltada para a coletividade na ESF de Pau dos Ferros/RN. Nesse sentido, buscou-se conhecer as concepções de educação em saúde dos profissionais de nível universitário da ESF; observar onde as práticas de educação eram desenvolvidas; conhecer os conteúdos e metodologias utilizadas para a efetivação das práticas de educação em saúde e caracterizar os espaços onde tais práticas eram desenvolvidas. Trata-se de uma pesquisa qualitativa, de caráter descritivo-exploratório realizada junto a nove equipes localizadas na zona urbana do município. Foram investigados 28 profissionais que atuam nessas equipes, dentre os quais elencamos: quatro médicos, oito enfermeiros e dezesseis cirurgiões dentistas. Fez-se uso da entrevista semiestruturada e da observação baseada em princípios etnográficos. Os dados foram analisados com base na técnica de análise de conteúdo de Bardin. O estudo obedeceu aos aspectos éticos contidos na Resolução 196/96 que regulamenta as Pesquisas Envolvendo Seres Humanos. Os resultados apontam que as concepções e práticas de educação em saúde dos profissionais da ESF são orientadas por uma educação bancária , pautadas pela transmissão e reprodução de conhecimentos. As temáticas são desenvolvidas de forma verticalizada, dissonantes da realidade de vida e saúde dos usuários. As práticas educativas são ofertadas majoritariamente por enfermeiros e estudantes de graduação em estágio na USF. Em sua maioria não são planejadas em equipe, e estão direcionadas à prevenção de doenças, distanciando-se da promoção da saúde. As principais dificuldades apontadas para a efetivação da educação em saúde dizem respeito à dificuldade de trabalhar em equipe, à falta de apoio da gestão, à estrutura física inadequada e a pouca adesão dos profissionais as práticas educativas. Portanto, a educação em saúde praticada na ESF não consegue instrumentalizar os sujeitos para que estes tenham autonomia e possam tornar-se sujeitos de suas vidas, de sua história. A prática educativa centrada na transmissão de conhecimentos ainda é uma realidade presente na ESF, constituindo-se em um desafio a ser superado