Uma experiência de plantão psicológico no CTI: semera e acolher

Este estudo avalia a implantação e desenvolvimento do Serviço de Plantão Psicológico em um Centro de Terapia Intensiva - CTI de um hospital universitário vinculado a rede pública de saúde, na capital paraense. O serviço foi disponibilizado aos familiares de pacientes internados e demais membros da equipe de saúde intensivista, funcionando na antessala do referido setor, duas vezes por semana, durante quatro meses. Alicerçado sob os pilares da Abordagem Centrada na Pessoa (ACP) buscou-se compreender os pressupostos teórico-metodológicos que fundamentam essa modalidade de cuidado, as especificidades do setting no que se referem aos objetivos, ações e funções do plantonista, assim como, as urgências reveladas neste contexto. Para tanto, elegeu-se como método do estudo a pesquisa qualitativa de base fenomenológica, sendo avaliadas as trajetórias do semear e germinar do Plantão Psicológico. São analisados seis casos clínicos, os quais lançam luz sobre essa modalidade de atenção psicológica no CTI. Quanto ao perfil da clientela atendida se observou que essa foi composta predominantemente por familiares, mulheres entre 20 a 75 anos, em média com o Ensino Fundamental e renda de um salário mínimo mensal. Os resultados indicam a necessidade e viabilidade da oferta do Plantão Psicológico no CTI, as demandas urgentes por auxílio psicológico, desveladas nos sentidos que os clientes atribuíram as suas experiências, tais como, medo de que o familiar faleça, sensação de abandono do familiar, culpa por não poder permanecer ao seu lado, tristeza intensa em razão do estado de saúde ou quando do óbito, entre outros. Dois tipos de atendimentos foram, naturalmente, criados: o individual e o grupal, sendo consideradas as especificidades das demandas. Ressalta-se também quanto a esta modalidade a disponibilização do pronto atendimento as urgências, acolhimento e estímulo a comunicação. Portanto, considera-se que a oferta do Plantão Psicológico no CTI revelou-se necessária como um espaço de cuidado psíquico aceito, utilizado e legitimado pelos clientes, além de se configurar em dois momentos distintos, antes e após ás visitas, sendo que no primeiro destes, destacam-se as intervenções voltadas ao acolhimento e fortalecimento da organização do self, enquanto no segundo, aquelas voltadas a ajudar os clientes na ressignificação de suas experiências ameaçadoras e a reorganização do self.

Between the processes of strengthening and weakening of the Family Health Strategy

This was a qualitative study with the purpose of designing a meta-model for the work process of the Family Health Strategy (FHS) team. It was based on the experience of six sample groups, composed of their members (physicians, professional nurses, dentists, dental assistants, licensed technical nurses and community health agents) in a city in São Paulo state, Brazil, totaling 54 subjects. Six theoretical models emerged from non-directive interviews. These were analyzed according to Grounded Theory and submitted to the meta-synthesis strategy, which produced the meta-model between the processes of strengthening and weakening of the FHS model: professional-team-community reciprocity as an intervening component. When analyzed in light of the Theory of Complexity (TC), it showed to be a work with a vertical and authoritarian tendency, which is largely hegemonic in the tradition of public health care policies.

Prevalence of health promotion programs in primary health care units in Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Characteristics of physical activity programs in the Brazilian primary health care system

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Importance of physical therapy in the family health strategy: integrative review

Objective: to analyze the importance of physical therapy in the Family Health Strategy (FHS). Methodology: integrative literature review, guided by the research question << What is the importance of physical therapy in the FHS? >>. The survey was conducted in the Virtual Health Library and in the website Google Scholar in November and December 2012. The inclusion criteria were: fully available scientific study, published between 2007 and 2012, with free access, and having at least one of the DeCS selected in the title. Results: we found out that the importance of physical therapist’s action at the FHS has been recognized both by professionals included in the teams and users of health care units, showing that, by means of the physical therapist’s preventive and clinical action, the costs and demands in the tertiary care can be reduced. Conclusion: the population and the professionals recognize the physical therapist’s positive impact on the FHS.

Knowledge and practice of women regarding cervical cancer in a primary health care unit

Objectives: evaluating the level of information about the examination of uterine cervical cancer and its association with sociodemographic variables in women of a health care unit in the city of Bauru, São Paulo, Brazil. Methods: we conducted a cross-sectional descriptive study with 370 women aged 25 to 59, through structured interviews in their own homes; we used descriptive statistics and the χ2 test. Results: 40.5% of the women had not undergone the Papanicolaou test at the recommended frequency; 58.2% incorrectly defined the test, and 69.5% did not know about the risk factors for the development of cervical cancer; the knowledge about the test showed statistically significant association with schooling and family income of the studied population. Conclusions: women present deficiencies on the proper practice of the Papanicolaou test, on knowledge about the test, risk factors and prevention methods. Therefore, it is necessary to develop primary health actions for the most vulnerable population.

Perfil do gestor municipal da saúde e a percepção da Estratégia Saúde da Família-DRS IX-Marília-SP

Pós-graduação em Saúde Coletiva - FMB

Planejamento, implantação e gestão de um curso a distância a partir da percepção dos enfermeiros da atenção básica sobre a integralidade na saúde

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Implementation of physiotherapeutic shares in the prevention of diabetes complications in a Family Health Strategy

Introduction In the Family Health Strategy (FHS), the treatment of Diabetes Mellitus (DM) includes education and lifestyle change strategies. Physiotherapists have a key role in this health setting. Objectives To implement actions of evaluation and guidelines for patients with type 2 DM who attend a Family Health Strategy (FHS), regarding diabetic foot and the practice of regular physical exercise in the control and prevention of the complications of Diabetes Mellitus. Methods 17 individuals from an FHS were evaluated, with the following procedures: clinical and anthropometric parameters, inspection, a questionnaire on diabetic neuropathy, tests of vibratory and tactile sensitivity, muscle function, range of motion, functional analysis, questions about exercise practice and guidance regarding controlling blood glucose and foot care. Results Deformities, dry skin, calluses, dehydration, ulceration, cracking and brittle nails were found. Peripheral neuropathy was not observed; tactile sensitivity was altered in the heel region and the vibratory sense was absent in 5% of individuals. A decrease in functionality of ankle movements was verified. Of the participants, 76% were sedentary, 24% knew about the benefits of practicing regular exercise, 25% had undergone a medical evaluation prior to performing physical exercise and, of these, 25% were supervised by a qualified professional. Discussion The implementation of physiotherapy actions in diabetics from an FHS was important for highlighting the presence of risk factors for diabetic complications. Conclusions Individuals attending the FHS need more information and programs for the prevention of diabetic complications.

Home care: uma análise

Pós-graduação em Direito - FCHS

Acesso aos níveis de atenção à saúde em um município do Estado de São Paulo: perspectivas de gestores, profissionais e usuários

Pós-graduação em Saúde Coletiva - FMB

Percepção da doença mental por profissionais de saúde: possibilidades de ampliação do cuidado

This study approached perceptions of mental illness by nineteen professionals who work in a Family Health Unit, by means of graphic representations (drawings). We used qualitative methods. Data was collected by means of a Presentative-Expressive Procedure. Four themes were identified using Thematic Analysis. The professionals associate mental disorders with: health care, medical-centered view, exclusion/inclusion, social environment. These perceptions are related to a biological paradigm, favoring the reproduction of prejudices about mental illness. The analysis also emphasizes the importance of a wide range of cares, while considering how difficult it may be for the professionals. We conclude that it is necessary to invest on professional preparation, in an attempt to transform ideoaffective contents presented by the subjects’ imaginary.

RB31-258 The Contribution fo Nebraska Farm Women to Family Income Through Poultry and Dairy Products

This investigation was made in 1929-1930 for the purpose of studying the activities of Nebraska farm women in the raising of poultry and in the care of dairy products, to discover whether or not such activities resulted in a contribution to the family income. With this in view, a group of women were asked to keep records for one year (from April 1, 1929 to March 31, 1930) of the value and amount of dairy and poultry products sold or used, of all expense incurred in production, and of the time spent both by the homemaker herself and by all other members of the household, in the production and sale of dairy and poultry products. When this study was outlined it was intended to cover only actual cash addition to the family income. This, however, did not prove to be feasible, as a considerable portion of the contribution to the family income was in the form of dairy and poultry products used at home.

A Culture of Relationships: Early Care for Italian and American Children

A culture of childhood is a shared vision – an agreed upon vision – of the needs and rights of children, including ideas about how the people of the community can collectively nurture them and at the same time be renewed by them. In other words, it is a set of values, beliefs, and practices that people have created to guide their way of nurturing young children and their families. The vision is about investing in young children and investing in the supports and relationships that children need to learn and grow, both for the reason that children carry our future and because they carry our hopes and dreams for the future. These hopes and dreams begin with birth. Sensitive, emotionally available parents create the framework for interaction with their children by responding to the baby’s cues, engaging the baby in mutual gazes, and imitating the baby. The baby, born with a primary ability to share emotions with other human beings eagerly joins the relationship dance. The intimate family circle soon widens. Providers, teachers, and directors of early childhood programs become significant figures in children’s lives—implicit or explicit partners in a "relationship dance" (Edwards & Raikes, 2002). These close relationships are believed to be critical to healthy intellectual, emotional, social, and physical development in childhood and adolescence as well. These conclusions have been documented by diverse fields of science, ranging from cognitive science to communication studies and social and personality psychology. Close relationships contribute to security and trust, promote skill development and understanding, nurture healthy physical growth, infuse developing self-understanding and self-confidence, enable self-control and emotion regulation, and strengthen emotional connections with others that contribute to prosocial motivation (Dunn, 1993; Fogel, 1993; Thompson, 1996). Furthermore, many studies showing how relationship dysfunction is linked to child abuse and neglect, aggression, criminality, and other problems involving the lack of significant human connections (Shankoff & Meisels, 2000). In extending the dance of primary relationships to new relationships, a childcare teacher can play a primary role. The teacher makes the space ready--creating a beautiful place that causes everyone to feel like dancing. Gradually, as the dance between them becomes smooth and familiar, the teacher encourages the baby to try out more complex steps and learn how to dance to new compositions, beats, and tempos. As the baby alternates dancing sometimes with one or two partners, sometimes with many, the dance itself becomes a story about who the child has been and who the child is becoming, a reciprocal self created through close relationships.

CARING FOR TUBERCULOSIS PATIENTS IN THE FAMILY HEALTH STRATEGY: THE NURSES' PERCEPTIONS

The objective of this study was to analyze the nurses' perceptions regarding tuberculosis control, according to the theoretical axis of comprehensive healthcare and the concepts of attachment and teamwork. This qualitative study involved 13 nurses from the Family Health Strategy of a priority city in the metropolitan region of Joao Pessoa, Paraiba, Brazil. Data were collected in focal groups and subjected to thematic content analysis. Factors that strengthen tuberculosis control were: supervised treatment, free medication and the provision of supplies. Weakening factors were: worker's turnover, the lack of encouragement for patients and incipient educational actions. The factors that, according to the nurses, weaken tuberculosis patient care should be reviewed by administrators, workers, users and educators with a view to redefining healthcare activities that strengthen attachment, comprehensive healthcare and teamwork.