Articulação ensino/serviço na visão de discentes de enfermagem

It is a descriptive study with a qualitative approach aimed at understanding the impact of the teaching / service between the Nursing College of University of Rio Grande do Norte (FAEN / UERN) and health services in the city of Mossoró / RN on student s learning process. Hence, it was inquired to rescue and over-elaborate the trajectories experienced by students who were graduating in the year of 2009 the Nursing graduation course. It was used, as guidance tool a questionary with both open and objective questions to support the data collection. The data analysis was accomplished based on the precepts proposed by Bardin. The research revealed a clear need of bond establishments with the involvement of the students on services as well as professionals inserted on Academy, in a way that knowledge can be built collectively and the difficulties can be eased.

O projeto politico pedagógico de enfermagem e o sistema único de saúde: a visão de discentes

This research aims to analyze, in the view of students, the pedagogic project of undergraduate nursing course, of UFRN, and its articulation with the SUS, in an attempt to understand the issues that permeate the teaching and learning of nursing. This is a qualitative study that used the focus group technique as a tool to collect empirical data. There were three meetings, where we had the collaboration of 23 graduating students from the eighth period of the semester 2009.1. For the analysis of information, we use a theoretical framework based on curriculum guidelines and basic principles of the SUS, making the analogy of the results with the metaphor of Greek mythology, Ariadne's thread, in dialogue with authors who discuss education as a transformative practice. Thus, the texture of the yarn was built of five thematic fields: joint the pedagogic project with the SUS; the teaching/service and theory/practice relation; interdisciplinarity or transdisciplinarity; didactic/methodological and relational approaches; and co-participation of students in the pedagogic project. According to the discussions, we find many difficulties in the teaching and learning process of undergraduate nursing in UFRN to strengthen the SUS, including: dislocation of educational institutions with services, professionals, managers and community; dichotomy between theory and practice; reality of services as a learning field and working process in health; posture adopted by professionals, teachers and other subjects included in the process of health education; decontextualization and fragmentation of teaching with the practice in health and nursing; excessive use of very illustrative methodologies, but little problem-solving; difficult and precarious situation in the relations between teachers and between teachers/students, regarding the acceptance of differences; absence of participation of students in the evaluation process and conduct of the educational project in progress. In this sense, we understand the need an auto-reflexive act of teaching and conducting collective pedagogical course with a view to achieving the SUS. Thus, it is necessary to support practices motivated by the polyphonic dialogue and the exercise of symbiosis and autopoiesis of subjects/actors jointly responsible for the ongoing process of learning for life.

Análise da contribuição de estagiários remunerados na força de trabalho em enfermagem

The present study analyses non obligatory and remunerated traineeships in nursing, as a contribution to work process in health and learning of students at nursing technician courses. It objectives to examine the contribution of medium level nursing students on scholarships at a teaching hospital s work force, at Natal/RN. It s a quantitative/qualitative, that uses descriptive statistics and analysis fulfilled with categories that emerged from research, through a dialog between the studied authors in the theoretical reference of nowadays work process, work force, non obligatory and remunerated traineeships, and night shifts. The collaborators of this research were 105 (73,43%) nursing technicians, medium level students on scholarships that fulfill remunerated traineeships at the hospital. The feminine gender was a major part of the collaborators, with 90 (85,70%), in which medium age was 29,71 years, 62 (59,00%) single, 57 (54,30%) don t have kids, 100 (95,23%) students on scholarships with complete medium level, 78,10% with professional experience before their insertion at the remunerated traineeships, 73 (69,50%) referred to enjoy the area, reason for the nursing technician course choice. About the technician course conclusion, 83 (79,00%) affirmed that happened between 2005 and 2008, and about traineeships time in the institution, 38 (36,20%) have between one and six months. About learning, 74 (70,50%) referred to learn with the nursing technicians and all fulfilled specialized courses, or grade up to bond with the school and be able to be trainees. These courses were considered low quality ones, what justifies the number of 54 (51,40%) students with scholarships that said their performance in studies is good and 75 (71,40%) are able to join it with the traineeships without problems. About remuneration as scholarship, 71 (67,60%) referred that helped to keep up with the studies, because this amount has specially this purpose, paying studies. About nonobligatory traineeships, the ABEn-RN affirmed that there s no following process to this traineeship mode, as long as there was never this concern, because obrigatory traineeships demand a lot of the efforts in the meetings. And COREN-RN doesn t supervise this way of contract. The present research observed that there is, in fact, a contribution of medium level nursing students on scholarships work force on the researched institution. Resigned to work circumstances established by the institution, representing the lack of human resources, materials, work conditions, and work insertion in night shifts, it s possible to affirm that the situation is irregular about the students on scholarships, besides the determinant risk factor to their lives and health. In addition to it, the students on scholarships, in order to maintain the quality of trainee in the institution, are obligated to fulfill courses to grade up, or specialized courses in nursing technician, at schools referred as bad quality ones

Vivências de docentes de enfermagem no ensino do cuidar

Care, in a global perspective, appears in the main quarrels as the necessary phenomenon that will have to permeate the thoughts, the perception and values for the change that will lead to the overcoming of a paradigmatic crisis. The professional care was attributed, in elapsing of history, to the Nursing. Its historical evolution and articulation with the social processes, political and scientific in prominence place, in what it says respect to human well-being, not objectifying to cure, but to comfort, to complement the weak capacities and to the establishment the present capacities, alleviating pain, in other words, caring. The Teaching of care in Nursing, suffered great influences of the biomedical model, being like this, the education in Nursing has been criticized for if being valid pedagogical models incapable to promote the growth of the subjects, keeping it passive before your life processes, showing fragilities, attitudes and questionable behaviors, dissonances, appearing the imminence of an act of to care and to educate that needs to be considered as dialectical and intersubjective act. The objective of this research is to understand the lived experience of the nursing teachers in the Teaching of Care, in order to reflect about the insert of Nursing in the current world context, watching the dialetics of the Teaching of care and the paradigm changes in the section health. It is a phenomenological research that used the analysis of the located phenomenon, to obtain the units of meaning of the speech Nursing teachers about your experience lived in the Teaching of care. This study allowed the Nursing teachers could share your existences, senses and information on the interior of your pedagogic action exalting the interpretation, which appears intentionally in the conscience, emphasizing the pure experience of the be-professor, including emotions and affectivities in the teaching of care. In the construction of the results, three moments were devoted for discussion: Multidimensional Care; Care as Professional Practice; and the Teaching of care. The speeches had revealed rich, complex and for paradoxical times. The understanding of a sensitive teaching, that sometimes, arrives if to worry in rescuing the tenderness and the humanity, it is running into the other permeated speeches of fragilities, inconstancies, technifying, that showed lacks of pedagogic preparation. The Teaching of care needs to adopt a conception of education/learning and to use methodologies that can lead to an action liberating, capable to breach with traditional mooring cables and preconceptions or little healthful habits of life, favoring the use of methods that promote educating for the way of the sensitive, detaching aspects that they contribute for this end, as the intuition, the emotion, the creation, the perception and the sensibility. In this direction, it is considered important to deepen subjects that make possible the creation of care strategies and educational with the human being vision in your totality, therefore if it perceives that the necessary therapeutical boarding to be ampler, passing for the social individual, family and its relations

Satisfação da equipe de enfermagem do serviço de atendimento móvel às urgências (SAMU) no ambiente de trabalho

Descriptive exploratory study, prospective with quantitative approach, performed on the Medical Regulation Central of SAMU/Natal, aiming to identify the level of professional satisfaction of the members of the nursing team working at SAMU/Natal; and verify the degree of importance attributed by the professionals to each of the components Professional Satisfaction: autonomy, interaction, professional status , work requirements, organizational rules and remuneration. The population was of 60 professionals, with data collected from january to february 2005. We used an instrument translated and validated by Lino (1999) to the portuguese language, the Professional Satisfaction Rate (PSR). The results demonstrate that there was a slight predominance of the female gender (54,9%); aged between 36 and 45 years old (60,8%); married (58,8%), 82,4% with children, 30,8% aged between 05 and 09. Regarding formation, we observed that 78,4% were nursing technicians and 21,6% nurses, formed for 11 to 15 years (17,5%). From the 11 nurses, 09 (81,8%) informed they have specialization, 29,4% of the team has been working for 11 to 15 years on the urgency area, 58.8% works for more than 02 years on SAMU, 72,6% of the team members have fixed work schedules. There was homogeneity on the work shifts: 41,2% on the day shift and 53% on the night shift. Regarding the reason to be working on SAMU, 64% chose to work in the service, and among these 76,3% predominantly perform direct care to the patients, 96,1% like and are satisfied to work in the service. Regarding the remuneration, 90,9% informed they receive 05 to 10 minimum wages; 70% of the technicians informed they receive -2 to 05 minumum wages, 50,1% informed they receive no additional benefit. The analysis of PSR through Cronbach s Alpha Coeficient resulted on the value of 0,94 and through Kendall s Tau Coeficient on 0,87, demonstrating to be a trustworthy instrument to measure the level of professional satisfaction of the SAMU nursing team, in our environment. As for the level of importance attributed to the components of professional satisfaction, we indentified that the nursing team considered the Autonomy component as the most important, followed by the component Remuneration, Interaction, Work Requirements, Work Requirements, Organizational Rules and Professional Status . Regarding the current level of professional satisfaction, we identified they were most satisfied with the Professional Status , Autonomy, Interaction, Remuneration, Work Requirements and Organizational Rules. The real professional satisfaction level, calculated through statistics, however, tells these professionals are more satisfied with Autonomy, Remuneration, Interaction, Work Requirements, professional Status and Organizational Rules. The PSR in our work was of 8,6, indicating the SAMU Natal nursing team has little satisfaction on their work environment

O trabalho em saúde como espaço pedagógico: desafios e possibilidades

The ongoing transformations in brazilian society, arising from technical and organizational changes in the working world, are making, with much emphasis, heated debates resurge related to themes and issues that refer to the relationship between work, skills and education. Thus, this study is inserted in the link between education and work, pointing to the work as an educational principle according to Antonio Gramsci. This paper aims to discuss the interfaces between education and work in the everyday health care teams and learn about the activities developed by health teams related to the learning processes in and with the work to analyze the opportunities and challenges of transforming spaces of health work in an environment of lifelong learning. This is a descriptive, exploratory with a qualitative approach case study developed from semi-structured interviews with the health staff professionals of the Unidade de Terapia Intensiva da Casa de Saúde Dix-Sept Rosado in Mossoró / RN , who answered open questions about the relationship between education and work. The interviews were conducted during the month of January 2010, the same being recorded, transcribed and analyzed, culminating in the production of new knowledge on the subject. It is understood that work and education activities are eminently human, therefore only the human being works and educates. Given the statements of participants, it is noticed that all work processes in health are learning moments. This happens through new demands imposed by the everyday of the services, by interaction with a multidisciplinary team, participation in educational activities and individual study. It was noticed that the institution in this case does not promote study courses related to Intensive Care and that there are obstacles to the realization of educational activities on and with the work, such as: excessive workload, inability to release staff to participate in events, low pay, which leads the worker to have more than one employment, rejection of new knowledge by some workers and lack of physical infrastructure and incentives for the activities. The daily situations must be transformed in learning, selfanalyzing the problems of practice and valuing the work process itself in its intrinsic context. We conclude that dealing with the web of relationships between educational processes and production processes of health services, unraveling the intricacies of the world of work and education requirements in this sector are increasingly on the agenda of Sistema Único de Saúde workers and managers. The continuing consideration of this issue becomes an essential condition for the proper discharge of their responsibilities. We consider that bringing the education to everyday life is the result of recognition of the educational potential of the work situation

Atividades profissionais da enfermagem no contexto hospitalar: influências nas relações de trabalho

The present study is based on an analysis of professional work relationships in the nursing team from the task/skills of its members as a contribution to understanding the work process in nursing. It is aimed to identify the skills of the nursing team members through the vision of nurses, technicians and nursing assistants, thus it attempts to find strategies to improve the health assistance to patients. It is a descriptive and analytical study with a qualitative approach grounded in theoretical and methodological framework of Symbolic Interactionism. The research was carried out in the participant work place, a Public Hospital of Reference for the SUS, located in the eastern health district of Natal/RN. Nineteen nursing professionals participated in the study, which seven was nurse and twelve nursing technician. As procedure to collect data we used an unstructured interview accompanied by a standard topic guide which was recorded and later transcribed. The content analysis was chosen as the main methodology to analyze the discussion, which gave rise to thematic categories that were considered relevant based on the theoretical framework of this study, and the interactionist theory. This study was in accordance with the ethical principles of the Resolution nº. 196/96, it has obtained an appropriate consent of the UFRN Research Ethics Committee. The results indicate that the professionals seen the nursing as a profession strongly attached to the health care process and as a profession that acquired a scientific status very recently. Regarding to the nursing functions in the work process in nursing, the professionals they identified the manage/administer category as the main activities developed by these professionals, thus the education and complex care in nursing categories. Concerning to the technicians and nursing assistants functions, it was figured out in the professional s opinion that there is not distinction among the attribution of these categories. The interviewed were unanimous in report that these professionals are more involved in direct patient health care through performance of basic duties in nursing care. Finally, with regard to the work relationship among nursing team members, the majority of those interviewed see this relationship as disharmony and quarrelsome and in general, there is not bond between categories that comprise the process of work in nursing. On the basis of our results we consider the importance of knowing the meaning of nursing given by these professionals; also their skills could be useful as basis to identify problems, which source could be detected in the power relationship, deviations of functions, gap between design (knowledge) and performance (doing) work, besides the loss of the global activities view in the process of nursing work

Sistematização da assistência de enfermagem (SAE) em um hospital pediátrico de ensino: uma pesquisa-ação

The incessant search if nurse for qualify nursing care makes the Nursing Assistance Systematization, a current topic of discussion throughout the country, not only in order to comply the legal requirements of their practice, but especially by the expected benefits of its application. In this meaning, this research had a qualitative approach, developed for a way of research-action. The general purpose was to analyze the change in the nursing practices in a pediatric teaching hospital, based on construction and implementation of Nursing Assistance Systematization by the nursing team. The results had the thematic analysis of Paulo Freire and were shown in the form of reports. To achieve these purposes, it began by steps pre-trial, to review the charts of the institution and an approach with the managers. In the situational diagnosis of nursing practices without the systematization followed by applying a questionnaire with a nursing team and a focal group with nurses. These ways supported the implementation stage of the Nursing Assistance Systematization which developed actions associate such as focal group with the nurses about the nursing history, capacity with the nursing team about the Nursing Assistance Systematization, development, application and reworking of printed, and discussions in the small groups. The evaluations of the changes after the actions of the research occurred through individual interview with the nurses, to check the results. The charts review confirmed the deficit in the records performed by the nurse on the chart, which reinforced the need for implementation of Nursing Assistance Systematization, an argument used on the meeting with the managers, who promptly agree with the search. The questionnaire and the focal group with the nurses reveal a process of nursing work without systematization, showing gaps in practices, but also obtained relate of expectations of improvements in quality of care as of Nursing Assistance Systematization, furnishing data to the development of ways following-up. The prints were gradually used and modified as the team understood the Nursing Assistance Systematization and its purposes through capacity course. The final evaluation pointed to the partial implementation of the stages of Nursing Assistance Systematization had been institutionalized at the history and the development of nursing, beyond difficulties with diagnosis and prescription of nursing, in later representing a paradigm shift. This search collaborated to change the view about the Nursing Assistance Systematization by nursing team at the institution had been revealed through introduction of new practices in the process of nursing work, as examination of physical exam of the patient, the interview in the admission of customers on service and the daily monitoring by nursing through development of nursing. Before addition, it was noted which the purposes of this search were achieved, since were analyzed the changes in the nursing practices with the systematization. The research-action achieved proposes of the involvement of nursing team in changing their practices. This search contributed to the implementation of the Nursing Assistance Systematization in a pediatric teaching hospital and showed which is possible to seek resolution of problems when the objective is of the group and gave access for further searches within this theme

Corações e mentes desvendam o Sistema Único de Saúde : visões e vivências de estudantes de enfermagem

One of the Ministry of Health s attempts at contributing to making collective health more appealing to health students is the Experience and In-Service Training within the Reality of the Unified Health Service Project (VER-SUS). Hence, the object of this investigation is to survey learners views on the teaching of nursing based in the experiences they have lived through in the VER-SUS. Its purpose is to analyze the views and lived-through experiences of nursing students on how the VER-SUS contributed to their professional education. This is a study of the descriptiveexploratory type with a qualitative approach. Eighteen undergraduate students from the nursing program at the Federal University of Rio Grande do Norte (UFRN), former VER-SUS participants, took part in this study, from 2006 to 2009. Information was collected using focus group techniques guided by a set of questions and semistructured interview with open and closed questions. The information collected was analyzed using content analysis technique, of the thematic analysis type. The UFRN Research Ethics Committee approved of the survey pursuant to Report Opinion number 223/2010 and CAAE number 0105.0.051.000-10. Lived-through experiences and in-service training gathered from the VER-SUS have contributed meaningfully to health education, as they helped understand the role of the university and of a health and nursing education within the hegemonic model of education. According to the views and lived-through experiences of nursing students who took part in the SUS project it was extremely relevant to use active methodologies in the teaching-learning process and have the facilitators act as liaisons for the SUS. It follows from this study that the VER-SUS does contribute to a health-nursing education and brings the students close to the reality of the community

Ações de profissionais relativas ao banco de leite humano : uma perspectiva de mudança

This is an exploratory and descriptive study that aimed to investigate the actions of professionals in the context of breastfeeding, on the assumption that the actions taken by employees working together to postpartum and newborn are not competing to effect the distribution of pasteurized human milk so that it meets the needs of infants who depend on it. Thus, the study aimed to analyze the actions of medical and nursing staff of the distribution of pasteurized human milk to the newly born. The investigation was developed by action research in a federal hospital, located in the capital the state of Rio Grande do Norte, Brazil, reference assistance to women during pregnancy, childbirth and postpartum high risk in 2010. Study participants were fifty-five professionals chosen from the following inclusion criteria: to act in the NICU or rooming, being a pediatrician and / or neonatologists, nurses and technical nursing. According to the methodology of action research a questionnaire was applied, techniques in focus groups and courses were developed, and, finally, action evaluation. The project was submitted to the Ethics Committee at the Federal University of Rio Grande do Norte and approved with no protocol 448/2009. The problems identified in the responses issued by the social research were grouped into categories according to the similarity between them. The answer to the question of the survey - How is the need for pasteurized human milk for the newborns in neonatal intensive care unit and rooming identified? - Brought subsidies for action planning and implementation of strategies for change in the practice of professionals working in rooming and ICU. Thus, the study has relevance in social care and, when at the local level, will compete for the distribution pasteurized human milk to take effect as best as possible, as recommended by the Ministry of Health. It is also conceived that, in a macro view of society, it could contribute to minimizing the health problem that involves the child population

Registro de enfermagem no prontuário em um hospital universitário: uma busca pela humanização do cuidado

T he aim of this study is to analyze the view of nurses about nursing records in the patient chart, in perspective of the record of humanized care. This is a case study, with qualitative approach. For its achievement, was sought and granted authorization from the direction of the Hospital Universitário Onofre Lopes (HUOL) and the Ethics Committee in Research of HUOL as Statement No. 422/10. During data collection, interviews were conducted with 20 nurses of the institution. The data analysis was based on the theoretical framework of Minayo to thematic content analysis, grounded in authors who work with themes, nursing records and quality care. With the empirical material, we constructed a framework of analysis, which was identified four categories thus nominated, "Reading and learning from those who register," "nursing records and quality of care," "the essence of nursing records" and "intention and action on the record of the subjective aspects of the patient." The results show that the records are insufficient, even in the case of the procedures performed with the patients often do not inform about the aspects that deal with the subjectivity that surround it, and admit that the records do not represent a parameter for evaluating the quality of care at least at that institution. In summary, the respondents recognize the importance of valuing subjectivity of the patient in their treatment, yet admit to neglect this aspect as significant for comprehensive health care, humane and quality

Diagnósticos de enfermagem em pacientes no pós-operatório imediato de prostatectomia de um Hospital Universitário de Natal-RN

The characterization of the nursing diagnoses in prostatectomized patients is important to provide an unique nursing language, facilitating the communication between professionals and patients. The objective of this study was to analyze the nursing diagnoses of patients in the immediate prostatectomy postoperative period. This is a cross-sectional and descriptive study, developed at the surgical-clinic of Onofre Lopes University Hospital, in the Natal City RN - Brazil. The sample was composed of 50 patients included by the criteria: have presented a diagnosis of a benign prostatic hyperplasia or a prostate cancer, have been subjected to a prostate surgery at the mentioned hospital, and have been in the immediate postoperative period at the moment of the data collection. The exclusion criteria were: haven t been in an appropriate physical and mental condition, have presented a brain vascular disease, a lung disease, an advanced liver disease, a heart disease or a extensive coronary artery disease. The data collection instruments were: the script of an interview and physical examination. The data collection period was between November 2010 and April 2011. The data were organized in two phases: the diagnostic process and the construction of the database. The project was approved by the Ethics Committee of the Federal University of Rio Grande do Norte The results showed that most patients came from the countryside, was living with partners, had an average of 67.78 years, was pensionerthose with low schooling, Catholic and often did not perform preventive examinations of prostatic disease. The patients showed an average of 9.48 nursing diagnoses, defining characteristics 21.70 and 20.72 related or risk factors per patient. We identified 30 nursing diagnoses, of which 7 were above the 75 percentile: Risk of falls, Impaired ambulation, Risk of infection, Self-care deficit bath / hygiene and dress up and Risk for deficient fluid volume. The top six nursing diagnoses were in all patients, and therefore could not apply any statistical test. The others ND were associated with their defining characteristics and related or risk factors. We conclude that the nursing diagnoses identified in this study contribute to the progress of the nursing care to the prostatectomized patients in post-surgery period, allowing the deployment of nursing actions for the effective resolution of identified problems

Entre o sol e a liberdade impera a violência: formação de redes para a ação a partir da estratégia saúde da família

The research aimed to analyze the feasibility of forming a network of municipal services to prevent and treat child victims of violence from the Basic Health Units in the Family Mossoró / RN. The research is a qualitative approach and was developed in the form of action research. The population was composed of representatives of institutions of the child and primary care professionals. Data were collected through questionnaires, workshops and semi-structured interview. The results were analyzed from data collected through the questionnaire designed to assess the material, lectures, dialogues and assessments with the team and presented in accordance with the findings of the research. The study was approved by the Ethics in Research UFRN with protocol No. 158/2010, CAAE: 0176.0.051.000-10. Situational diagnosis in the participants answered a questionnaire to characterize and then launched the guiding question of the focus group FHS While professional what your perception towards violence against children? It was felt the fear and ignorance on the part of the unit staff on how to prevent and to refer cases of violence against children and adolescents in the area of coverage of the unit and also realized that the professionals felt victims of occupational violence before the violence has reached proportions that the area of the unit. Mind the need to change strategies to work to combat violence, we plan to conduct focus group workshop to complete the questionnaire, training for protection against occupational violence, and meeting with other bodies responsible visor protecting children and adolescents to draw the flowchart of the victims in safety net. The next moment training to fill the notification form professionals were interested in learning and use this tool to combat violence. At the third meeting in Unity, meeting with representatives of the Child Protection Council, the professional unit showed interest in interacting with the agency to expose and combat violence against children and adolescents. Due to difficulties in the physical structure of the unit was not possible to continue the research and planned every moment, and then completed the data collection with interviews with the participating professionals, to assess the meetings. Therefore, it is considered that action research has also achieved its goals because the team was involved in the collective construction of a proposed change in the practices of referral and prevention of violence against children and adolescents. This involvement was favored using the principles Freirian during the course of the study. However, it is assumed that the network was not fully implemented because it is known that it is in a continual process of improvement and must continue evolving with the unit team.

Reinternações psiquiátricas no Rio Grande do Norte: implicações e impacto das novas estratégias de atenção à saúde mental

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.

Inclusão da criança com deficiência na estratégia de saúde da família

The objective of analyze the shift of the working process of the ESF team in care of children with disabilities, from awareness-raising actions. It is a qualitative study, with the action-research method. Thirteen health professionals were involved from two teams of ESF unit area of the Unidade de Saúde da Família Dr. Chico Porto (UBSFCP) in Mossoró, from March to August 2011. Data were analyzed following the direction of freirean s thematic analysis. In the situational diagnosis of the current reality of CwD assistance in that UBSFCP, through participant observation and application of semi-structured interviews with professionals, we realize that despite these actions carry some assistance to the CwD, in practice few are used for inclusion and accessibility. The monitoring of the CwD is done through individual consultations by each team professional, home visits when possible, both ruled on the complaints and problems, with little solving in the used actions. Since the need for a change in the treatment model and training requirements as pointed out by professionals in the interview, then we decided to build the proposed of training suggested by the multidisciplinary team and put together collectively the achievement of this moment in all its phases. In the step of implementation (action), aspects related to the current situation in Brazil and Mossoró (Laws, policies and health care) for the CwD and CwD Assistance and their family in the ESF in the first two moments of the first training (action) were contemplate. On the second day we discussed the specialized care to CwD, contribution of the Handicapped Parents and Friends Association of Mossoró and in a second moment a workshop was held in which awareness for inclusion of CwD and actions of ESF were discussed. All these moments were discussed and collectively constructed. In the evaluation, we found that implementation (action) allowed to the professional the comprehension of new understandings about people with disabilities, on ways to include, guiding, caring, watching, and mainly to have a new vision on health assistance of the CwD, expanding assistance beyond clinical aspects and recognizing the educational aspects of the rights and duties of citizens and the inclusion of these children in the social spaces area. As difficulties, we face the need for some professionals to be absent to attend another job, solve personal problems, and little or no participation. Thus, during this action-research, the subjects were able to realize the importance of carrying out their practice to the quality of life for him and to the one they care