1000 resultados para Atenção aos usuários de drogas
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A busca por um modelo democrático de saúde despertou a atenção do governo brasileiro para o estabelecimento de prioridades e estratégias, que impulsionaram a implantação do Programa de Saúde da Família (PSF), atualmente denominada Estratégia Saúde da Família (ESF), a fim de aproximar a equipe de saúde da comunidade e, assim, implementar ações de promoção da saúde e de prevenção do adoecimento. Nessa perspectiva a Terapia Comunitária (TC) emerge como uma tecnologia de cuidado voltada à saúde mental na Atenção Básica de Saúde. Desde 2007, a TC vem sendo desenvolvida no município de João Pessoa/PB por profissionais da ESF: enfermeiras, agentes comunitários de saúde, médicos, odontólogos, fisioterapeutas, nutricionistas, psicólogos, entre outros. O estudo teve como objetivos: avaliar a satisfação dos usuários em relação à TC na Atenção Básica no município de João Pessoa/PB; medir o nível de satisfação dos participantes da TC em relação a essa ferramenta do cuidado; identificar elementos importantes para a satisfação em relação à TC por parte dos usuários. Trata-se de um estudo avaliativo, transversal e observacional, realizado no período de maio a agosto de 2009. Utilizou-se como instrumento de coleta de dados a Escala de Avaliação da Satisfação dos Usuários com os Serviços de Saúde Mental Satis-BR, bem como um instrumento de perguntas complementares utilizado pelos terapeutas comunitários. Os resultados revelaram que dos 198 (100%) entrevistados, 105 (53%) verbalizaram satisfação e 93 (47%) muita satisfação nos encontros de TC, o que evidencia que a totalidade da amostra está satisfeita com a terapia. Os elementos importantes que concorreram para a satisfação dos usuários da TC foram: respeito, dignidade, escuta, compreensão, acolhimento, apoio nas necessidades e boas instalações dos locais onde ocorre a terapia. A TC vem fortalecendo o cuidado à saúde mental, por se constituir como uma tecnologia de prevenção e fortalecendo a porta de entrada para a rede de saúde mental e de apoio psicossocial. Conclui-se, portanto, que a TC vem se destacando como instrumento de inclusão da saúde mental na Atenção Básica no atendimento aos usuários do Sistema Único de Saúde
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Introdução: A criação de programas de equipe multiprofissional de saúde desponta como uma alternativa eficiente para controlar a evolução dos pacientes portadores de diabetes, e a inserção do farmacêutico em tais programas tem contribuído para melhorar o acompanhamento desses pacientes. Objetivo: Avaliar o impacto da intervenção do farmacêutico no acompanhamento dos pacientes diabéticos tipo 2, em farmácias comunitárias. Métodos: Ensaio clínico randomizado, uni-cego envolvendo 100 pacientes diabéticos tipo 2 de ambos os gêneros, usuários de farmácia comunitária, com idade igual ou superior a 30 anos, em uso de hipoglicemiantes orais com adição ou não de insulina e foram acompanhados por 6 meses. Os pacientes do grupo controle receberam o tratamento habitual existente em qualquer farmácia, e os de intervenção receberam o acompanhamento do farmacêutico incluindo intervenções aos problemas relacionados aos medicamentos. Os desfechos primários avaliados foram os valores da hemoglobina glicada (HbA1c), glicose basal e um questionário de qualidade de vida validado denominado de Diabetes Quality of Life Measure (DQOL) - Brasil; e como desfechos secundários as dosagens dos triglicérides, colesterol total, (HDL) colesterol, (LDL) colesterol, tensão arterial e a satisfação do usuário com o serviço prestado. Essa pesquisa contou com a colaboração de vários profissionais das diferentes áreas do conhecimento a seguir nominados: médico, farmacêutico bioquímico, enfermeiro, nutricionista e estatístico. Resultados: Finalizaram o estudo 89 pacientes. Durante o acompanhamento 95,7% (45/47) dos pacientes no grupo intervenção apresentaram problemas relacionados aos medicamentos (PRM), perfazendo um total de 141, com uma média de 3 eventos por paciente, ocorrendo uma resolutividade de 61,7% (87/141). A categoria que mais apresentou PRM foi a de efetividade com 34,1% (48/141) e a classe farmacológica mais utilizada foi a dos hipoglicemiantes orais com 35% (49/141). As variáveis de desfechos primários como hemoglobina glicada (HbA1c) e a glicose basal não apresentaram valores estatisticamente significantes quando comparadas o final com o inicial do acompanhamento nos grupos intervenção e controle considerando um p<0,05, mas o questionário de qualidade de vida DQOL Brasil apresentou resultados estatisticamente significante com um p=0,000. Os desfechos secundários, com exceção da satisfação do usuário, não apresentaram valores xi estatisticamente significantes quando comparados o final com o início do acompanhamento nos grupos de intervenção e controle. Conclusão: Os resultados indicam que as modificações das variáveis clínicas não apresentaram valores significativos no controle da enfermidade e comorbidades, enquanto que na avaliação da qualidade de vida os pacientes afirmaram que melhoraram; portanto, pode-se postular que a intervenção farmacêutica é uma atividade necessária, mas que a prática do Pharmaceutical Care trará benefícios com sustentabilidade para os pacientes se houver uma efetiva integração do farmacêutico numa equipe multiprofissional de saúde, o que está indisponível nas Farmácias Comunitárias
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This study had as objective to identify to the perception of mothers and professionals of health on the attention to the health of HIV-Positive children/adolescents in the city of Natal-RN. It is a descriptive-exploratory study with quantitative and qualitative approach, carried through in the Giselda Trigueiro Hospital and in the State and Municipal Health Councils in Natal - RN, from march to december of 2005. The sample was composed by 56 participants, 33 mothers of children who use specialized assistance and 23 professionals. Data collection occurred with the application of a half-structuralized interview. Quantitative data were analyzed through descriptive statistics and qualitative data were submitted to content analysis. Prevailing categories in relation to the cartography of the attention to seropositive children and adolescents in Natal were: Organization and dynamics of the attention; Institutional management and human development; Control and prevention; other contexts of attention; relationship/communication team-patient and organization and functioning of the services. The profile epidemiologist of the children, adolescents and of the people/mothers, who take care of them with HIV/Aids, followed the evolution of the epidemic in the country and the world. It was verified that mothers need care and information; however they make a positive evaluation of the attendance they receive. It was also observed many gaps in the services of assistance, in which the researched group was attended, beyond imperfections in the communication between health professionals and users. The professionals recognize the advances that the politics represent for the assistance of people with Aids; however feel themselves limited by the precariousness of the system and the partner-economic conditions of the people. According to these data, it can be verified great challenges to go through in the context of integrality of the assistance to HIV positive children and adolescents in the city of Natal and in the improvement of the communication in the institution of reference
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Comprehending social representations of users relatives of Psychosocial Care Centers (CAPS) from Natal-RN, about their participation in the activities of these services, was the purpose of this study. The research instrument used was a semi-structured interview, led to 28 relatives of users of East and West CAPS II, East and North CAPS-ad, involved in the Relative Therapeutic Group, in Relative Meeting, in the Assembly of Users, Technicians and Relatives, according to the therapeutic schedule of each health services, between August to November 2007. Data obtained in family and users identification were characterized with the aid of charts and boards in absolute and/or percentage values. The discursive material from the guide from interviews was submitted to the informational resource ALCESTE (Analyse Lexicale par Contexte d'un Ensemble of Segments of Texte), and analyzed on the basis of the Theory of Social Representations and Central Nucleus Theory. Most of the relatives were women, married, aged over 50 years, who participated for more than two years in CAPS activities, and a coexistence of more than 11 years with the user. From the classification system of ALCESTE were selected categories, identified by: Category 1, Treatment Improvements and Expectations; Category 2, Living User Before and After; Category 3, Activities Relevance, Contradictions and Suggestions; Category 4, Guidelines -- Psychopharmacology and Medicalization; Category 5, Family Participation and Activities; and Category 6, Therapeutic Conditions Thanks, Tips and Vulnerability. The social representation of the family exists in the desire for change, identifying that we need to promote change by the continuity of therapeutic activities and overcome the detected inconsistencies, targeted by strengthening and by the stability of improvements in living and health conditions of users, experienced in CAPS treatment. The central nucleus had corresponded to positive changes in health and living conditions of users, and the peripheral elements were constituted by family conducts before and during treatment, and the expectations of changes in activities, especially in workshops. Despite this family participation be considered important, it still does not meet conditions to promote the inclusion of family, under an emancipating point of view, capable of causing in subject the hope for autonomy, initiative, individual and collective growths, a closer and active involvement in therapeutic activities, in workshops and discussions
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Study of qualitative approach using the oral history methodology, in modality oral history of life, which aimed to: tell the stories of lives of users of psychotropic drugs for prolonged period of time, in Family Health Unit Santarém (FHU Santarém), Natal-RN-Brazil; identify possible causes which influence and trigger, respectively, use of psychotropic for prolonged period of time; search for greater knowledge about this problem of public health; contribute with the planning and development of nursing cares, to users of psychotropic drugs for prolonged period of time, as well as in Mental Health Care, integrally, in perspective of Family Health Strategy (FHS). It was used as a baseline survey, the coverage area of family health team, from FHU Santarém, which belongs to Health District North II, from Municipal Health Secretariat, in Natal-RN-BR. Eight employees who use psychotropic drugs for prolonged period of time were interviewed. They volunteered to narrate their life stories, which were analyzed by using the thematic modality, since the study is focused on the question of the use of psychotropic drugs for prolonged period of time. The thematic axis crisis, prejudice and care, defined by the categorization of common elements, found through successive and careful readings of narratives, were used to analyze these stories of lives. The study found that users of psychotropic drugs for prolonged period of time are affected by mental health crisis, feeling need to be heard, as well as the existence of social prejudice towards people with mental disorders, and non-completion of development of managed care, by the family health team, and particularly, the nursing care to people suffering from mental disorders and users of psychotropic drugs for prolonged period of time. It is proposed that, in the search of development and planning of nursing care to users of psychotropic drugs for prolonged period of time, and in mental health care, integrally, in FHS, the nurse can think and make a drawing about manners of performing nursing care to this clientele through the use of consultation of nursing, conducting home visits, collective construction of spaces for listening and socialization, which can be used as possible paths for the construction of such care
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The psychiatric care and mental health are undergoing constant change over the History. The Brazilian Psychiatric Reform, which brings up the deinstitutionalization as a structuring in the restorative care process. The Reform has as one of the mainly substitutive services the Centers for Psychosocial Care (CAPS), which work from the Singular Therapeutic Project (PTS) in order to restore the autonomy and restore the dignity of users. The therapeutic workshop is some of the resources used and work several kinds of activities as: writing, handcraft, music, poetry, and so forth. This study set up to apprehend the social representations of helping of the music workshop carried out in the CAPS II east of Natal/RN, from the reports given by the participants of the workshop, using the focal group as technique. This is a descriptive exploratory study with a qualitative approach. A total of 16 users participated in four musical therapeutic workshops from April to May 2010. The study was approved by the Ethics and Research Committee of UFRN. The discursive material from the workshop was submitted to the informational resource of Analyse Lexicale par Contexte d um Ensemble de Segments de Texte, ALCESTE, and analyzed based on the Theory of Representations and the Central Core Theory. The majority of subjects were men (62.5%), single (62.5%), aged 40-49 years (37.6%) and elementary school level (56.2 %). The reports were transcribed and submitted to the classification system of ALCESTE, which elected the following categories: Category 1 - Experience in the Word Family Sung, Category 2 - Musical Experiences and Approaches, and Category 3 - Feelings and emotions evoked by music. The representation of these individuals is anchored in the experience they have with the CAPS, lived and socialized by common sense, through this particular social group workshop objectified in music therapy as a therapeutic modality enjoyable. The central core revealed the intrinsic relationship between users and the music, establishing a relationship of openness to use the same while its therapeutic use in workshops of substitute services for mental health. Peripherals elements issues are related to listen, share and experience music in the family. Intermediary Elements relate to the feelings and emotions evoked by music, given her close relationship with it. It was found in the study that music can be construed as an artifact of good therapeutic responsiveness to users, configuring it as an invigorating and enjoyable therapy, confirming the need for continuity of this activity, as well as its expansion into the service
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The Brazilian Psychiatric Reform based on the desinstitucionalization of the assistance, translated to the emphasis on community/territorial treatment and in the social inclusion of the mental suffering, promoted advances in the psychiatric restructuring. In the Rio Grande do Norte (RN), we can enumerate as advances of the Brazilian Psychiatric Reform the expansion of the mental health care chain and the implementation of some strategies that, together, aims to further the psychosocial attention of the individual with psych suffering and to reduce the indices of psychiatrics readmissions in the state. In the current Brazilian‟s mental health situation we were interesting in answered the following question: what the impact of the substitutes services‟ extension in the revolving door phenomenon? This search aims to analyze the revolving door phenomenon occurrences based on the news strategies of mental health care in the Rio Grande do Norte. This is a descriptive-exploratory study with a qualitative approach, oriented by the theoretical framework of critical-dialectical approach about the Brazilian Psychiatric Reform and using the thematic oral history as method of information collects. The search was realized on the Hospital João Machado (HJM), estate reference in psychiatric treatment, and the participants was 20 professionals that work on it. The collection of information had started after the approval of the UFRN Research Ethics Committee with the opinion number 216/2011 and CAAE number 0021.0.051.000-11 and was realized using the direct observation and semi-structured interview. The study‟s results were categorized in two categories and five subcategories of analysis. CATEGORY 1) Current situation of the mental health care chain in the RN, with the subcategories: 1.1 Impact of the new services of mental health care in the revolving door phenomenon in the RN; 1.2 Implications of the new services of mental health care in assisting user to the HJM; 1.3 Issues the permeate the mental health care chain in the RN. CATEORY 2) Main causes of the revolving door phenomenon in HJM, with the categories: 2.1 Family problems; 2.2 Lack of assistance after discharge from psychiatric hospital. In summary, we conclude that the extension of the mental health care chain contributed for the reduction of the psychiatrics re-hospitalization‟s indices in RN. However, we realized that territorial services of mental health care are not the only responsible for the revolving door phenomenon. Factors as family problems and the disarticulation of the assistance after the discharge from hospital influence on the perpetuation of hospitalizations and re-hospitalizations in the local scenario. To study the revolving door phenomenon that occur in the psychiatrics‟ assistance considering the news strategies of mental health care allowed us to approach the advances and challenges brought by the RPb and by the desinstitucionatization in the state, indicating the need for further discussions and problem-solving strategies of psychosocial care.
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This dissertation has as aim the praxis of co-management of the health service of CAPS II OESTE of Natal-RN, where health workers, family members got to materialize guidelines and principles of psychiatric Brazilian reform in real possibilities of subjectivity construction, whereas they changed social relations in daily life. The path chosen to record was from testimonials and contributions of those who meant their done. Redeeming this story from social representations of the majority of their builders was an instigating, delicate and rewarding task, emphasizing the living memory, rebuilt in a line of time which could not be found in simple documentary collections. Mainly, by knowing that service routine was intense and had as characteristic the singular mobility itself from a creation process and therefore not always its dynamic allowed adequate records. At the same time, from this occurred the field and bibliographic research which allowed the detailed information from the prior milestones and motivated to the practice here reported. The rereading of concepts in an interface with the reports of the interviewees enabled the verification that the model of mental health advocated by psychiatric reform was understood. Once noticed the presence of the beliefs and values of people in motivating energy for the progress of reform, it has gone to fetch theoretical subsidies of administrative order to understand how they saw this building and that uniqueness has been printed. The theoretical way and praxis have tracked here has allowed to analyze how occurred such a process of production and subjectivity and collectives that when organize enabled themselves for analysis and intervention, including in crisis situations. Therefore, it was revealed that ethical and multi-disciplinarity, the humanitarian sense, the coresponsibility, co-production and horizontal management were the key factors for spread from a changing protagonist. One can thus conclude that co-management from that collective has been multi-disciplinary weaving a cross
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A partir da análise da Política Nacional de Saúde Mental formulada nos últimos anos e das experiências desenvolvidas após 1987 no país, procura-se compreender como o Sistema Único de Saúde tem contribuído ao avanço da reforma psiquiátrica nos municípios; verificar como a assistência oferecida nesses municípios está viabilizando os princípios da reforma psiquiátrica e a melhora das condições de vida dos usuários, bem como pesquisar o papel dos trabalhadores e gestores na construção de novas práticas de cuidado em Saúde Mental. A análise das práticas discursivas aponta que os vários segmentos sociais envolvidos na Saúde Mental conhecem os princípios e propostas da reforma psiquiátrica. No entanto, as gestões municipais não assumem integralmente as propostas do Ministério da Saúde para a área, sob a alegação de falta de recursos financeiros para a contrapartida exigida. Os usuários e familiares têm aos poucos assumido as novas propostas de intervenção, mas os mecanismos de participação e organização popular ainda são incipientes. Por fim, deve-se destacar que, para uma efetiva consolidação das propostas atuais da reforma psiquiátrica, é necessário um maior compromisso dos gestores com a atenção em Saúde Mental, maior investimento nas equipes multiprofissionais, o estímulo à organização e à participação dos usuários e familiares e a integralidade dos dispositivos de saúde, de assistência social e de cultura existentes nas cidades.
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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
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The Specialized Dental Care Centers (CEO) were developed to provide specialized dental care to the population, given the accumulated needs of health since the past. They must operate as units of reference for the Oral Health Team of the Primary Care, complementing the dental procedures performed at this level of attention. This study aims to assess the performance of CEOs of the Grande Natal Health Region as a strategy of Secondary Care consolidation in oral health through users, dentists and managers. For this to try to identify factors about access, hosting and satisfaction with the service, the actions developed in these centers, integration between the CEOs and the Basic Health Units (UBS), considering the reference and counter reference. Data were collected through semi-structured interview, conducted in four CEOs, among 253 users, 31 dentists and 4 managers. It was submitted to descriptive statistical analysis and to content analysis by software ALCESTE 4.5. The results revealed that the specialties of prosthesis, endodontics and surgery were the most sought by 38.2%, 23.7% and 21.7% of respondents, respectively. It was noticed that among users aged 18 to 30 years-old the greatest demand is for the specialty of endodontics (44.4%) and over 50 years for prosthesis (76.4%). There is a weakness in the reference and counter reference between UBS and CEO, because part of users goes directly to the centers without going before to the Primary Care and the majority does not want to return to the dentist of Health Unit. Satisfaction with care was reported by 90.9% of users, because they resolved the problems needed and were welcomed by the team. But the delay in care was the main factor for not satisfaction. For most dentists, some users could solve their problems completely in Primary Care, which shows the existence of unnecessary referrals to the CEOs, however they consider the existence of limiting factors in UBS that compromise the service. Most dentists revealed that some users do not get to CEOs with the basic dental treatment done, and some of them do not counter reference users. It can be concluded that the studied CEOs are being resolutive for those who access them, offering necessary care for the population, and if they don t account with this service, will encounter obstacles to resolution of problems, ranging seek care service in particular, in another public sector, or even giving up treatment. However, it is perceived the need of professionals training to understand the importance of the reference and counter reference, to that they can better serve and guide users. It is also important that cities offer better conditions to UBS and CEOs, so they can work together, with complementary actions of oral health, seeking full care, aiming for better resolution to the users' health problems
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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
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The research objective is explore practices to mutual help between CAPS users from the east and west regions of the city of Natal, RN, in Brazil. In the mental health field, we observe the care from substitutive services is based on technical knowledge where the person of the mental health professional is predominant. The Brazilian psychiatry reform invests in equipments and mental health care protocols, but it is necessary to invest more vigorously in new strategies and actors capable of obtaining resources to achieve this goal, such as the users. If one cornerstone of the psychiatric reform consists of changing the type of relationship established with the person with mental disorders, why this relationship, nowadays, is still dominated by technique and unevenness, where on one side we have a person who knows something and who needs take care of someone, and on other side we have another who knows nothing and thus needs to be cared for? Starting from this problematization of the traditional methods of health/mental health care, an attempt was made to investigate in what ways the mutual help practices between people with mental disorders can realize potential avenues not yet explored within the scope of psychiatric reform. The objective of this research was to map possible mutual help practices among the users, and the technical understanding of such practices. For that, we took part in the daily activities of the CAPS, mapping the experiences of mutual help among users. In addition, we accompanied the users in external activities (such as return home, trips, etc), and we had roundtables with the professionals. The research was guided by theoretical methodological references of the institutional analysis. The results pointed to a lack of behaviors of mutual help or support among users, something that can probably be explained by the service work dynamics, as well as the relationship between technicians and users, which has a tendency to create hurdles for meetings among users, as well as being non-conducive to theirempowerment
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The present paper proposes an analysis about the Brazilian Psychiatric Reform as a public policy and deriving from a research developed with the workers of a Psychosocial Attention Centre III (CAPS III) and the managers of the Psychosocial Attention Web (REAP) in Aracaju. This analysis is developed as an investigation of the discharge at those services, understood not as a procedure, but as a dispositive from which different elements can be articulated: users, knowledge, technical procedures, police measures, juridical decisions, laws, services edifying. This, form the background of the articulation between mental alienation and the subject of right alienation, in the ways through which this articulation develops to the relations between madness,citizenship, internment and substitutive practices. Our investigation about the discharge as a dispositive was built with some narrative constructions, as a discourse analysis inspired by Michel Foucault s method, from the perspective of some of the main dispositive operators: workers and managers. The main aspect observed were: the articulations built by the discharge as a dispositive based on two discursive grate, the Reform as a new treatment substituting internship, and the Reform as juridical insertion and users rights practice; the exercise of these discursive grades based on the workers and managers perspective; the transference of limitations and contradictions of these grades to the competence of the dispositive operators, emerged in an outstanding way, as sometimes those operators are liable for the emergent limitations and difficulties, and some other times they are restrained by their institutional role, which is to maintain the domination relations articulated by the dispositive; finally, some aspects extracted which the dispositive operators - when they were expected to act in a way to maintain certain power relations - were capable to resist, managing other power relations from the dispositive, that we call, as Agamben, dispositive profanity
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This work discusses the evaluation of the satisfaction of the users on the women health care focusing on the quality of the primary care in the State of Rio Grande do Norte-BR. The main objective of this research is evaluate the satisfaction of the users about the actions applied to women health in the primary health care in Rio Grande do Norte, observing the information available through the Programa de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB). The specific objectives are: the evaluation of aspects related to women health; the evaluation of the specific actions related to welcoming the pregnant and; the evaluation of the information related to the postpartum. This dissertation is characterized as an evaluative research made through a multicentric transversal study, using a quantitative approach, which is part of the External Evaluation of the PMAQ-AB in the State of Rio Grande do Norte, made by the Federal University of Rio Grande do Norte. Some secondary data of the interviews with the users who were in the Basic Health Units were used during the External Evaluation of the PMAQ-AB in Rio Grande do Norte. The sample was collected following these criteria: the users that were in the Basic Health Units to attend to any procedure; they must had used the services for at least one year; and they must had agreed to participate the research. The ones that were attending to the services for the first time and the ones that did not use the services for at least 12 months were excluded from the sample. To the data collection it was used a chart of variables/indicators with the following information to the analysis: Women Health Care, Specific Care of the Pregnant and Information about he postpartum. The descriptive analysis of the data were made through absolute and relative frequencies of the variables using the software Statistic Package for Social Sciences (SPSS) for Windows, version 22.0.0. The results show a positive picture of the satisfaction of the users about the actions of the primary healthcare in women health in the State of the Rio Grande do Norte. Another important analysis is the integration of the primary health care with other points of the Healthcare System aiming to reorient the Model of Healthcare as a starter of the access and quality of the services given to the users. Therefore, the evaluation of the satisfaction of the users in health care is essential among all the agents involved in the process of consolidation of the Unified Health System SUS. Also having the need of rethinking the professional practice, reorganizing the processes of work of the multiprofessional teams in health care, enabling financial resources, inputs and materials, planning and systematizing new actions of healthcare aiming to ensure a perfect health care to the people