O atendimento ao idoso na unidade de saúde da família: um estudo de representações sociais

The attention to health issues in aging has increased and it becomes a challenge for public policies directed to the elderly. This study aimed at learning the social representations built by seniors about the service in the Family Health Unit. It is an exploratory study, funded by the Theory of Social Representations of Moscovici. It was held at the Health Unit of the Family Felipe Shrimp, located in the neighborhood Felipe Shrimp in the city of Natal / RN-Brazil. The participants were one hundred and two elderly / as, served by the Family Health Strategy. The data collection period was extended from July to September 2014. Data were collected through the Word Free Association Test and Interview semi-structured, and analyzed with the help of EVOC software. Interviews were conducted with 20 elderly and subjected to content analysis. The research was approved by the Ethics Committee of the University Hospital Research Onofre Lopes, in the opinion 704,323. It was possible to apprehend negative connotations regarding attendance, listing it as bad and disrespectful, and the limited hours of service, difficult to schedule appointments and tests and inadequate infrastructure, the most marked aspects. Seniors express satisfaction with the medical care, however, they understand that it is necessary that all services are properly integrated to a qualified service. The statements reveal that the service in the drive needs to implement new strategies host for users to participate more in educational and health promotion. It is noted, the need of integrated care, the host of qualified hearing in the health services that they address the elderly seeking care at the clinic of the family, so sticking to the principles of the Unified Health System.

Deliberação e participação: dinâmica e efetividade do conselho de saúde de Mossoró/RN – 2009/2012

The social participation in Brazil takes a new impetus with the (re)democratization process of the Brazilian society and is strengthened by the resurgence of the civil society and the 1988 Constitution. In this context, the study is conducted with the scope to verify the effectiveness of deliberative Municipal Health Council of Mossoro (CMSM), with theoretical and methodological support based on the following models: the participatory normativity, which measures the degree of institutionalization, democratization and council representation; and the effectiveness of deliberative that, from the calling capacity and agenda of the participants, from the kinds of manifestation, from the decisions and the council’s office, that measures the degree of effectiveness of the deliberative council. It appears, thus, that the council has an average degree of effectiveness deliberative, standing out as means an institution that practice, despite the existence of obstacles and challenges, the role of control over municipal health policies, due, among other factors, the conservative political context, the asymmetry of resources between the counselors, the little substantive participation of the actors who attend its meetings, either counselor or not, and in particular, the reduced influence of the members in its decision-making process. In public management of Mossoro, social participation, especially social control over public actions, face, today, great number of difficulties to be held. The study recognizes that, in such circumstances, the council partially fulfills the role for which it was created, what does not impede, however, be characterized as an important deliberative space, since it allows the participation of representatives of the various segments of the state, society, their demands and intentions. Overcoming such obstacles moves through the interest of civil society to wake up and fight for the spaces in these institutions.

Os rumos do fundo público no capitalismo contemporâneo: uma análise sobre o financiamento da Política de saúde no estado do Rio Grande do Norte

This work analizes the financing of Health Policies on the state of Rio Grande Do Norte, starting at the presumption that SUS is “Bombarded” by fiscal ajustments, as a neoliberal strategy to face capital crises.The trafectory of the financing of SUS demands the comprehension of two principles which are, in essence, contradictory: the “principle of universatility”, which is caracterized by the uncompromising defence of the fundaments of the Sanitary Reform, and the “principle of containment of social costs”, articulating the macroeconomic policy that has being developed in Brazil since the 1990s and which substantiantes itself on the 2000s.This last defends the reduction of the social costs, the maintanance of primary surplus and the privatization of public social services. Considering these determinations, the objective of this research constitues in bringing a critical reflection sorrounding the financing of the Health Policies on the state of Rio Grande do Norte, on the period from 2004 to 2012.Starting from a bibliografic and documentary research, it sought out to analyze the budget planning forseen on the Budget Guideline Law (LDO) and on the Multiannual Plans (PPA), investigating the reports of the Court of Auditors of the State of RN and gathering information about expenses with health, available on the System of Information About Public Budgeting in Health (SIOPS).The Analises of the data obtained, in light of the theoretic referece chosen, reveals trends in the public budget setting for health on the State of Rio Grande do Norte, which are: a tiny share of investment expenditure on health, when compared to other expenses, the amount used in daily fees and advertising; the high expense in personnel expenses, especially for hiring medical cooperatives;the strong dependence of the state on revenue transferences from the Union; the aplication of resources in actions of other nature considered as health, in exemple of the expenditures undertaken by the budgeting unit Supplying Center S/A (CEASA) on the function of health and subfunction of prophylactic and therapeutic and on the Popular Pharmacy program. Since 2006, expenses refering to Regime Security Servers (RPPA) on the area of health also have being considered as public actions and services in health for constitutional limit ends, beyond the inconsistencies on the PPAs with the actions performed efectively.

Serviços-escola de psicologia do Rio Grande do Norte: formação profissional e política pública de saúde em debate

The Psychology University Services is stablished normatively as an indispensable equipment to the recognition of the graduation courses of psychologists by the Brazilian Education Ministery. The Public Healthcare Policies (Universal Health System/SUS) constitutes itself as a input field of the professional category, but shows huge challenges in the formation of these professionals. The objective of this work is to analyse the functioning of the Psychology University Services (SEP) and the Superior Educational Institutions from Natal, understood as important formation devices to attend the actual demands of the psychologist's work on SUS. For this, it sought a) characterize the psychological practices developed in the SEP; b) relate the National Curricular Lines of Direction of the psychology courses to the skills and competences developed in the SEP to the performance on the public healthcare policies; c) mapping ways of including the SEP in the network designed by the healthcare policy. Interviews were performed with 13 academic supervisors, 8 field supervisors and technicians of superior level (TNC), along with 9 managers, being for of the Psychology University Services and 5 of the graduation programs. Questionnaires were also applied to 57 interns and 24 graduates. Besides that, two conversation circles were performed with the faculty and technician members from two of the Educational Institutions that were participating of the research, as well as a workshop with students and psychologists, promoted by the CRP 17. We observed that most part of the faculty members and managers know the DCN and comprehend that the formation is in process of change in what concerns to the extension of the formation to the performance of the psychologists in various contexts. However, most part of the TNC don't know about them. Moreover, the results point to the predominance of the assisting model based on the traditional clinic psychology, although the articulation with the public healthcare and social assistance networks can already be timidly visualized. Different modalities of practices in theses Psychology University Services were also detected, such as conversation groups, thematic workshops, organizational consultancies, team meetings with the interns and TNS in a daily basis, matriciament in mental health, therapeutic monitoring, among others. Yet, the SEP in Rio Grande do Norte are still isolated from the other courses that perform in the healthcare area and also from the services that compose the public healthcare and public policies.

Near miss materno e iniquidades em saúde: análise de determinantes contextuais no Rio Grande do Norte, Brasil

The scope of this study was to identify socioeconomic contextual and health care factors in primary care associated with maternal near misses and their marker conditions. This is an ecological study that used aggregated data of 63 clusters formed by the municipalities of State of Rio Grande do Norte, Brazil, using the Skater method of area regionalization, as the unit of analysis. The ratio of maternal near misses and their marker conditions were obtained from the Hospital Information System of the Brazilian Unified Health System. In multiple linear regression analysis, there was a significant association between maternal near misses and variables of poverty and poor primary health care. Hypertensive disorders were also associated with poverty and poor primary care and the occurrence of hemorrhaging was associated with infant mortality. It was observed that the occurrence of maternal near misses is linked to unfavorable socioeconomic conditions and poor quality health care that are a reflection of public policies that accentuate health inequalities.

Near miss materno e iniquidades em saúde: análise de determinantes contextuais no Rio Grande do Norte, Brasil

The scope of this study was to identify socioeconomic contextual and health care factors in primary care associated with maternal near misses and their marker conditions. This is an ecological study that used aggregated data of 63 clusters formed by the municipalities of State of Rio Grande do Norte, Brazil, using the Skater method of area regionalization, as the unit of analysis. The ratio of maternal near misses and their marker conditions were obtained from the Hospital Information System of the Brazilian Unified Health System. In multiple linear regression analysis, there was a significant association between maternal near misses and variables of poverty and poor primary health care. Hypertensive disorders were also associated with poverty and poor primary care and the occurrence of hemorrhaging was associated with infant mortality. It was observed that the occurrence of maternal near misses is linked to unfavorable socioeconomic conditions and poor quality health care that are a reflection of public policies that accentuate health inequalities.

Projeto SB Brasil 2010: elemento estratégico na construção de um modelo de vigilância em saúde bucal

O projeto começou a ser pensado no âmbito do Comitê Técnico Assessor (CTA) em Vigilância em Saúde Bucal do Ministério da Saúde desde abril de 2009. Foi submetido à consulta pública durante o mês de junho de 2009, resultando em uma participação significativa de diversos setores em seu processo de construção. Desde então, foi formado um Grupo Gestor que, por intermédio de oito Centros Colaboradores localizados nas diversas regiões do país, tem conduzido o projeto a partir de oficinas de trabalho nos estados e treinamento das equipes de campo.

Projeto SB Brasil 2010: elemento estratégico na construção de um modelo de vigilância em saúde bucal

O projeto começou a ser pensado no âmbito do Comitê Técnico Assessor (CTA) em Vigilância em Saúde Bucal do Ministério da Saúde desde abril de 2009. Foi submetido à consulta pública durante o mês de junho de 2009, resultando em uma participação significativa de diversos setores em seu processo de construção. Desde então, foi formado um Grupo Gestor que, por intermédio de oito Centros Colaboradores localizados nas diversas regiões do país, tem conduzido o projeto a partir de oficinas de trabalho nos estados e treinamento das equipes de campo.

O significado da educação popular na formação dos trabalhadores de saúde: estudo com base em experiências de extensão universitária

A Saúde do Trabalhador (ST) refere-se a um campo do saber que compreende as relações entre o trabalho e o processo saúde/doença de modo articulado a um corpo de práticas teóricas interdisciplinares. No contexto das possibilidades para se efetivar a ST na amplitude que exige este conceito, diferentes iniciativas de Educação Popular em Saúde se articulam com demandas do Controle Social em Saúde, permitindo novas abordagens para configurar a formação crítica e ativa de trabalhadores de saúde e movimentos sociais no mosaico das políticas de ST. Nessa direção, os projetos de extensão universitária orientados pela Educação Popular têm desvelado caminhos metodológicos e novas possibilidades teóricas de pensar a Atenção à Saúde do Trabalhador, de forma articulada com a necessidade de re-significar o processo de formação dos profissionais da saúde, com ênfase no cuidado integral na atenção à saúde. O estudo promovido por ocasião do Doutoramento em Ciências da Saúde propiciou a avaliação do impacto e da potência das ações destes projetos na reorientação do cuidado guiado pela educação popular no campo da saúde do trabalhador. A sistematização foi utilizada como principal estratégia metodológica para a produção dos dados analisados, além de estratégias de pesquisa qualitativa como constituintes da fase exploratória do estudo, tendo como técnica central, nesse sentido, o grupo focal. Os resultados mostraram mudanças significativas no processo do cuidar em saúde guiado pela educação popular, A reorientação de práticas e saberes, coadunadas aos princípios fundamentais do Sistema Único de Saúde, foi observada nos sujeitos que participaram da experiência. A sistematização da experiência permitiu ainda concluir que estratégias de diálogo, organização político-social e troca de experiências de vida se apresentam como cenário significativo no compartilhamento de cultura e saúde do trabalhador, oportunizando crescimento coletivo e melhor qualidade de vida.

Reorientação da formação em saúde: a contribuição do programa PET-Saúde

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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

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

Articulação entre saúde mental infanto-juvenil e atenção básica em Natal-RN: limites e possibilidades

In the case of Brazilian Psychiatric Reformation, mental health juvenile reveals itself as a great challenge, with major gaps in terms of needs, services and actions on mental illness in children and adolescents. This research is a qualitative study of descriptive and exploratory, having to analyze the actions and practices of mental health juvenile articulated between the Psychosocial Care Center juvenile (Caps i) and the basic care in Natal-RN, and specific, identify the limits and possibilities for an important precedent of the care network. After submission to the Research Ethics Committee (CEP) of the University Hospital Onofre Lopes (HUOL) of the Federal University of Rio Grande do Norte (UFRN) obtained approval contained in opinion number 777.067 / 2014. For the data collection, it was initially carried out a documentary research in the Municipal Health Department of Christmas about the phenomenon under study, and subsequently, applied semi-structured interviews with the subjects of the research, which were workers Caps i of Natal-RN. The analysis was woven as the thematic analysis technique, understood within the method of content analysis. The results and discussions were organized by categories and subcategories, namely: CATEGORY 1: Limits and weaknesses in the linkage between the Caps i and basic care, with the subcategories: 1.1 Lack of specialized services and devices articulators in network, 1.2 The diversity of situations in the demand juvenile assisted; CATEGORY 2: possibilities for an effective network, with the subcategory: 2.1 Intersectoral collaboration as a strategy for solving attention. The analysis revealed that the integration and coordination of mental health services juvenile and primary care in the city of Natal-RN, has incipient initiatives and/or inadequate for the resolvability intersectoral, where the devices of attention to health involved cannot establish bonds effective and long-lasting in the perspective of co-responsibility and sharing of care. On the other hand, it appears that the existing shares and practiced, configure an exercise in approximation to the dialog between mental health juvenile and basic care. It is highlighted that the shared care and the establishment of intersectoral collaboration within and outside of the health sector is possibility of facilitating the necessary dialog between the services and professionals involved, thus, enabling a better prospect of resolvability of the Network of Psychosocial Care for the youth in reality being investigated.

Trabalho em equipe de saúde: uma análise contextual

COSTA, Roberta Kaliny de Souza ; ENDERS, Bertha Cruz ; MENEZES, Rejane Maria Paiva de . Trabalho em equipe em saúde: uma análise contextual. Ciência, Cuidado e Saúde, v. 7, p. 530-536, 2008.

Análise da organização da rede de saúde da Paraíba a partir do modelo de regionalização

Este artigo analisa a organização da rede de saúde da Paraíba a partir do modelo de regionalização proposto pelo estado da Paraíba. Material e Métodos: Trata-se de um estudo documental que tomou por base, prioritariamente, o Plano Diretor de Regionalização da Paraíba e os documentos oficiais do Ministério da Saúde que orientam a construção dos mesmos pelos Estados. Resultados: A análise dos dados revelou alguns limites no processo de implantação do PDR/ PB, tais como a ausência de análise das características sociais, econômicas e culturais durante a escolha das sedes das regiões de saúde e a inexistente descrição da organização da assistência à saúde do território estadual. Conclusão: O processo de regionalização e a formulação do PDR da Paraíba não seguiram a Instrução Normativa do Ministério da Saúde em alguns aspectos, desconsiderando as especificidades de cada região de saúde, o que pode resultar em problemas no acesso e na articulação da rede de serviços com vistas à legitimação das regiões de saúde desse Estado