Avaliação do risco de quedas em idosos que frequentam os Serviços de Fisioterapia do SESARAM, E.P.E

As quedas são um problema comum e devastador entre os idosos, causando um enorme número de situações de morbilidade, mortalidade e necessidade de recorrer a cuidados de saúde. As maiorias das quedas em idosos relacionam-se com um ou mais fatores de risco. A investigação tem demonstrado que ter em atenção a estes fatores poderá reduzir significativamente as quedas. Verifica-se anualmente um grande afluxo de idosos ao Serviço de Fisioterapia do SESARAM, E.P.E. devido a sequelas de quedas. O presente estudo, inserido no Método Quantitativo – Correlacional, Tranversal, teve como objetivo avaliar o risco de quedas em idosos que frequentaram o Serviço de Fisioterapia do SESARAM, E.P.E. entre o 2.º e o 3.º trimestre de 2011 e correlacionar os vários fatores de risco que contribuíram para as mesmas. Foi selecionada uma amostra não probabilística, de idosos com mais de 65 anos (n=75) à qual foi aplicado um questionário sobre fatores de risco para as quedas e a Escala de Equilíbrio de Berg (EEB), a Escala de Atividades de Vida Diária de Katz e a Escala de Atividades Instrumentais de Vida Diárias de Lawton & Brody (AIVD), a Escala de Tinetti (Risco de Quedas) e o Teste de Levantar e Sentar em 30 segundos. Resultados: Cerca de 93% dos idosos sofreram quedas nos últimos 6 meses das quais 48% resultaram numa fratura. As mulheres caíram mais do que os homens (M=21 DP=3,5) e os idosos mais jovens que apresentavam maior risco de quedas. Cerca de 52% dos idosos praticam atividade física. Os idosos da amostra possuíam força muscular dos membros inferiores baixa (M=6,97), com um risco de quedas moderado (M=20,8 DP=3,8) e eram moderadamente dependentes (M=18,5, DP=3,9) nas AIVD. Conclusões: Os idosos com mais força muscular apresentavam menor risco de queda pois o coeficiente de correlação foi positivo e significativo e do mesmo modo aqueles que apresentam mais força muscular estão associados a valores elevados de equilíbrio e menores nas AIVD. Face a estes resultados do estudo justiça-se, a presença de uma equipa multidisciplinar, com vista a diminuir os fatores de risco para as quedas e fomentando estratégias de equilíbrio/força. Com a intervenção desta equipa, os idosos poderão manter-se mais independentes e com melhor qualidade de vida.

A educação como fator de produção: estudo exploratório ao nível da educação física e desporto escolar na RAM: análise da necessidade / possibilidade de uma rotura

A educação é um processo que visa garantir o desenvolvimento das capacidades e potencialidades de cada indivíduo, preparando-o para agir de forma assertiva, perante situações de insegurança e de imprevisibilidade da vida. Para compreender e poder intervir neste processo, analisámos fatores como a criatividade, a autonomia e a capacidade de adaptação, de modo a procurar perceber como intervêm, o que contemplam e como podem ser avaliadas no contexto do processo educativo. Também as contradições com que permanentemente nos deparamos entre as intenções manifestadas, o que é afirmado relativamente ao que se faz e o que encontramos, nos motivaram para o estudo desta dissociação entre o discurso e a prática. Acreditamos que estudos neste âmbito podem contribuir de forma significativa para serem encontradas soluções adequadas. Julgamos que é preciso repensar a Educação Física enquanto disciplina assim como as metodologias e processos utilizados, dado que o modelo atual não está em consonância com o que se pretende – desenvolver um Homem criativo, autónomo, capaz de se adaptar a novas situações, na Escola e na Sociedade. Atendendo ao Homem que se pretende formar Fernando, Lopes, Vicente, Prudente, (2010) defendem que a educação deve ser “pensada como um despertar para o conhecimento e o domínio de metodologias de estudo e trabalho e não como a aquisição de informação” (p.225); ao aprofundar estas questões poderemos melhorar e rentabilizar o trabalho, obtendo resultados mais efetivos para o sucesso do processo ensino-aprendizagem. Foi esta expectativa que nos impulsionou e que tornou este estudo ainda mais desafiador. Esperamos com a apresentação deste trabalho conseguir contribuir para uma “rotura” com a forma como se veem as práticas e para um despertar para uma nova estruturação do pensamento que conduza a uma atuação coerente, efetiva e integrada no processo pedagógico, no âmbito da Educação Física.

Inovação pedagógica: o uso de TIC na inclusão sócio-laborativa de pessoa com necessidade especial

A escola é um local de ensino e de aprendizagem. Ao mesmo tempo, em que representa um passo na vida democrática, na busca por uma convivência solidária, participativa, bem como tolerante. A escola por mais que tenha se modernizado, ainda encontra-se muito aquém de se assumir como algo moderno, evoluído. A educação da Pessoa com Necessidade Especial (PNE) vem sofrendo ao longo de todo o processo histórico uma série de modificações. É possível alavancar a construção do conhecimento dessa população. O modelo de inclusão apregoado pelos documentos oficiais encontra-se muito distante de uma base inclusiva. A escola deve se transformar para acolher essa população. O que temos acompanhado é a difícil construção de uma educação e de uma sociedade inclusiva. O uso da Tecnologia da Informação e Comunicação (TIC) representa hoje um grande passo para a PNE, pois ao usar essa tecnologia dentro do processo de aprendizagem é possível fazer com que a mesma seja um fator para alavancar o processo de construção do conhecimento dessa população. A Educação Inclusiva é um processo em que se amplia a participação de todos os alunos que estão inseridos dentro do ensino regular. O processo de inclusão não pode ser visto como algo pronto e acabado. Pelo contrário, tem de ser trabalhado em todas as áreas da sociedade. Onde cada ser humano possa contemplar o outro como uma pessoa com que é detentor de habilidades, potencialidades independentemente de suas limitações físicas, cognitivas entre outras. A metodologia de base qualitativa toma a pesquisa etnográfica como caminho. Entendemos que dentro de uma abordagem etnográfica, o pesquisador faz parte do universo abordado. A pesquisa foi realizada na Casa da Esperança, no período de Agosto a Outubro de 2014. Foram selecionados 10 (dez) participantes na qual foram contactados os responsáveis pelos mesmos, onde explicamos o teor do estudo. A pesquisa se deu no horário em que os alunos estavam no seu local de estudo. A pesquisa foi composta por dois Questionários A e B, contendo cada um 09 (nove) questões, onde tudo foi acompanhado através do Diário de Bordo.

Cuidados de enfermagem ao paciente em pós-operatório de prostatectomia: revisão integrativa

Este estudo trata-se de revisão integrativa da literatura com objetivo de sintetizar o conhecimento produzido em artigos sobre os cuidados de enfermagem aos pacientes em pós-operatório de prostatectomia. Para seleção dos artigos foram consultadas cinco bases de dados – SCOPUS, CINAHL, PUBMED, LILACS e Cochrane – sendo incluídos dezenove artigos. Os resultados mostram estudos que se enquadram nos níveis II, IV, V, VI e VII de evidência, a maioria realizada nos Estados Unidos durante os anos de 1999 a 2011. Os cuidados de enfermagem identificados foram agrupados em seis categorias: acompanhamento psicológico, orientações pós-operatórias, tratamento da disfunção erétil, tratamento da incontinência urinária, tratamento da dor e tratamento da hiponatremia. Conclui-se que os estudos com maior nível de evidência identificado recomendam cuidados de enfermagem centrados no acompanhamento psicológico, nas orientações do período pós-operatório e no tratamento da disfunção erétil. Destaca-se ainda que tais recomendações concentram-se, sobretudo, nas ações de apoio emocional e educativo

Significados e percepções do homem diante da gravidez de sua companheira com síndromes hipertensivas

The general aim of the research was to comprehend the Social Representations constructed by the man in the face of his companion s risk pregnancy caused by hypertensive syndromes. The study is of exploratory and descriptive character in a qualitative approach developed at two public maternity hospitals, both located in Natal-RN, with 65 men whose wives had undergone high-risk pregnancy. The project was submitted to the Ethics on Research Committee of the Federal University of Rio Grande do Norte, Brazil (CEP-UFRN), with favorable report no. 81/07. For data collection, the following multimethods were employed: a word free association test; a projective test for registering mental images; and a semistructured interview schedule. The speech contents were analyzed in accordance with the Theory of Social Representations and complemented by the Central Nucleus Theory. The discussion of the results was grounded on literary findings of the companion s participation in pregnancy as well as in risk pregnancy associated with hypertensive syndromes. The data showed fear as representation s central nucleus, while recollections of that feeling referred to death of both companion and child in addition to fear of the unknown. The categories preoccupation and carefulness, other feelings, and clinical picture of the disease represented components of the peripheral nucleus. The results concerning mental images followed the same category criteria of the word free association test fear, other feelings, preoccupation, carefulness, and clinical picture of the disease. After being processed in accordance with the principles of content analysis, the statements originated three thematic unities: fear and insecurity in the presence of the companion s risk pregnancy; attitudes of carefulness to the risk pregnancy of the partner; and humanized assistance during the companion s risk pregnancy. Considering the results, the conclusion is that the partner s risk pregnancy caused by hypertensive syndromes represents, for the man, feelings of fear, preoccupation, insecurity, lack of acceptance and information, as well as attitudes of carefulness. The results reveal necessity of reorganizing the obstetric assistance with an eye to including the man as participant in the reproductive process. That demands extension of humanized carefulness to the companion with a view to make him an active coadjutor in the assistance of high-risk pregnant

Resiliência e velhice: um estudo de fatores de risco e de proteção na saúde do idoso

Resilience consists of a capacity to adapt and overcome situations of risk, from the aid of protective factors. This construct constitutes a process of preventive and multidimensional present in all stages of human development. During this development, it has been immersed in the elderly biopsychosocial changes resulting from the aging process. In this sense, there was a need for a multidisciplinary study, combining psychology, medicine, nursing, social work and gerontology in order to check the resilience, its risk factors, such as life events and health, and protection, such as self-esteem and social support. For this, we performed a descriptive exploratory study of cross-sectional nature, along with a convenience sample consisting of 65 elderly users of the public health of the district east of the city of Natal/RN, Brazil. This research allowed the collection of socio-demographic, economic, relational, physical, biological and psychological in understanding the aging process. It is observed that the studied sample socio-economic status and chronic health conditions in their own lives and their families, that demand for care and attention every day, are resilient, have faced significant losses, have positive self-esteem and social support perceived as external satisfactory. Given this multidimensional nature, the aging process deserves the attention of many professionals and health policies, seeking provide to the elderly a better living conditions and mechanisms that promote well-being and health

Envelhecimento populacional: um diagnóstico dos idosos institucionalizados, em Natal/RN

The aging process lived by the Brazilian population concurred to the transformation in the family models, causing difficulties related to the elderly care on the Family environment, a fact that is one of the main reasons for their institutionalization. Facing this scenario, the need of investigating how the elderly lives on the long-term facilities (ILPI) has aroused. In this study, it has been conducted an analysis of the populational aging process, contrasting the Rio Grande do Norte to Brazil and the Northeast Region, between 1980 to 2010. Faced with the realization of this process, and the rising number of long-term facilities for the elderly (ILPI), it was needed to make a rescue of the abiding laws regarding elderly institutionalization, on the scope of Natal, which surged after the 1988 Federal Constitution, checking what were the impacts on the assistance of the institutionalized elderly. Lastly, it were investigated the possible determinants associated with the institutionalization, in Natal-RN, considering the aspects of the family structure, family relationship, economic, health and well being of the elderly. The results showed that Rio Grande do Norte, particularly Natal, follows the national scene, since between 1980 and 2000 its population passed the intermediate level in the process of population aging for, in 2010, to be considered elderly. Throughout this process, it was observed that Natal has been adapting to the federal legislation, through the creation of the municipal policy, City Council and other relevant standards for the elderly, promoting significant changes in ILPI.However, philanthropic institutions needs better resources for their maintenance. In research with the elderly, it was found that although the majority of the elderly have declared themselves satisfied with life, they had indicators of impairment of functional capacity and cognitive, isolated social behavior and depression, affecting the life quality of these elderly. These results reflect the need for greater investment of public power in the drafting, implementation and monitoring of public policies aimed at promoting changes that raise the level of life quality of this segment of the population

Novas fronteiras petrolíferas no Brasil : uma análise da necessidade de nova regulamentação da área do pré-sal sob a ótica constitucional

The Oil industry in Brazil has gone through several stages during the economical, political and social historical process. However, the significative changes have happened in the last fifteen years, due to market opening arising from the relaxation of the state monopoly over the Oil deposits and its derivatives. The edition of the Constitutional Amendment #9, changing the first paragraph of the 177th item of the Federal Constitution, marked the end of a stiffness about the monopoly that the Brazilian state kept in relation to the exploration and research of Oil and Gas. The economical order was fundamental to actualize the idea contained in the #9 Amendment, since its contents has the power to set up measures to be adopted by public power in order to organize the economical relations from a social viewpoint. The new brazilian Oil scenery, called pre-salt, presents itself in a way to amaze the economical markets, in addition to creating a new perspective to the social sector. This work will identify, in this new scenario, the need for change in the legal system. Nevertheless, this subject must not be treated in a thoughtless way: being an exhaustible good, we shall not forget that the future generations also must benefit from the exploration of natural resources recently discovered. The settlement of a new regulatory mark, including the change in the concession contract model to production and sharing is one of the suggested solutions as a bill in the National Congress, in an attempt to ensure the sovereignty of the nation. The constitutionality of a new regulatory mark is questioned, starting from an analysis of the state monopoly, grounding the comprehnsions in the brazilian constitutions, the relevance of the creation of Petrobras for self-assertion of the state about the monopoly of Oil and derivatives, and its posture after the Constitutional Amendment nº 9 (1995), when a company stops having control of the state monopoly, beginning to compete in a fairly way with other companies. The market opening and private initiative are emphasized from the viewpoint of the Constitutional Principles of the Economical and Social Order. The relaxation of the monopoly regarding the exploratory activity in the Federal Constitution doesn't deprive from the Union the ownerships of underground goods, enabling to this federal entity to contract, directly or by concession of exploration of goods, to state-owned or private companies. The existing oil in the pre-salt layer transforms the scenario from very high risk to low risk, which gives the Union the possibility of defining another way of exploring this resources in the best interests of the Public Administration

O direito à saúde e a política nacional de atenção oncológica: uma análise a partir da crescente judicialização dos medicamentos antineoplásicos

The 1988 Federal Constitution of Brazil by presenting the catalog of fundamental rights and guarantees (Title II) provides expressly that such rights reach the social, economic and cultural rights (art. 6 of CF/88) as a means not only to ratify the civil and political rights, but also to make them effective and practical in the life of the Brazilian people, particularly in the prediction of immediate application of those rights and guarantees. In this sense, health goes through condition of universal right and duty of the State, which should be guaranteed by social and economic policies aimed at reducing the risk of disease and other hazards, in addition to ensuring universal and equal access to actions and services for its promotion, protection and recovery (Article 196 by CF/88). Achieving the purposes aimed by the constituent to the area of health is the great challenge that requires the Health System and its managers. To this end, several policies have been structured in an attempt to establish actions and services for the promotion, protection and rehabilitation of diseases and disorders to health. In the mid-90s, in order to meet the guidelines and principles established by the SUS, it was established the Política Nacional de Atenção Oncológica PNAO, in an attempt to sketch out a public policy that sought to achieve maximum efficiency and to be able to give answers integral to effective care for patients with cancer, with emphasis on prevention, early detection, diagnosis, treatment, rehabilitation and palliative care. However, many lawsuits have been proposed with applications for anticancer drugs. These actions have become very complex, both in the procedural aspects and in all material ones, especially due to the highcost drugs more requested these demands, as well as need to be buoyed by the scientific evidence of these drugs in relation to proposed treatments. The jurisprudence in this area, although the orientations as outlined by the Parliament of Supreme Court is still in the process of construction, this study is thus placed in the perspective of contributing to the effective and efficient adjudication in these actions, with focus on achieving the fundamental social rights. Given this scenario and using research explanatory literature and documents were examined 108 lawsuits pending in the Federal Court in Rio Grande do Norte, trying to identify the organs of the Judiciary behave in the face of lawsuits that seeking oncology drugs (or antineoplastic), seeking to reconcile the principles and constitutional laws and infra constitutional involving the theme in an attempt to contribute to a rationalization of this judicial practice. Finally, considering the Rational Use of health demands and the idea of belonging to the Brazilian people SUS, it is concluded that the judicial power requires ballast parameters of their decisions on evidence-based medicine, aligning these decisions housing constitutional principles that the right to health and the scientific conclusions of efficacy, effectiveness and efficiency in oncology drugs, when compared to the treatments offered by SUS

Vocabulário técnico e formação dos profissionais da área têxtil: necessidade, elaboração e avaliação de um dicionário de terminologia do vestuário

This research work deals with the compilation of a dictionary on clothing terminology intended to be used as a pedagogic tool as part of the teaching and learning process in the Textile Engineering Course at the Federal University of Rio Grande do Norte. The main terms were selected and assessed by a team of textile teachers and students with the objective to be structured as a conceptual body of information on the following sub-areas of clothing terminology: materials (fabrics and trimmings) and products (garments). This research comprises three main steps: (a) characterization and understanding of the technical vocabulary in the clothing area as well as the identification of a pedagogic demand for a dictionary on clothing terminology, clearly expressed by the textile lecturers and students involved in the assessment of the need and validation of this project development; (b) a proposal for a specific methodology for the compilation of the dictionary which could help the communication process in the lecturing of clothing terminology and (c) based on the terminological principles and the technique of focal groups the dictionary was assessed. The technique of focal groups was used in the first step. In the second step the technique used was that of the terminological methodology adapted to the teaching approach in the Textile Course. In the third step the technique of focal groups was again utilized. It was observed that the main concern of lecturers and students is the lack of a standardized vocabulary, which renders difficult the communication process in both the teaching and learning activities as well as the professional ones in the textile industries. Various aspects, which can overlap, cause this lack of standardization. The main ones pointed out by the study team in the focal groups are: usage of regional words or expressions, usage of foreign words or expressions, analogies, and the low level of formal education, mainly among the industry workers. Another aspect to be considered is the lack of textile literature written in the Portuguese language of Brazil. This evidence shows the importance of a clothing terminology dictionary which will benefit both the education and professional activties in this field of knowledge. This dictionary will also give a substantial contribution to terminological standardization in our research field. With view to fulfill this demand, a dictionary of clothing terminology was compiled with 760 main entries, according to the modern practice in terminology with the necessary modifications concerning our needs. The result of the dictionary assessment was very assertive regarding its structure, contents and possible use in various contexts. The team work emphasized their contribution to the standardization process of the terms that proved to be one of the most important and difficult aspects of this researh work. The significance of this structured terminological dictionary was confirmed by the focal group participants relating to its use for teaching and learning activities, as a reference book, as a source of technical information and also as a tool for pedagogic studies and planning, as well as a significant collaboration to the pedagogic practices in the textile engineering course at University or any other educational institution. Besides, this dictionary can also be used to supply information within the textile field. We are aware that the present work will not exhaust the objectives of this research due to its limitations in opposition to the vast complexity demanded by the compilation of a complete work including all the areas and sub-areas of textile engineering. However, it is an important source for dissemination of concepts on the field of clothing terminology and a tool to effective standardization of the terms used in this subject field

A rotina de crianças de zero a dois anos na educação infantil e as especificidades infantis

In current upbringing production, children are often conceived as rightful subjects, and concrete and singular people, marked by specificities that schools must respect, mainly their personal wholeness, their care and attention needs, as well as their abilities to learn and produce culture. In the educational practices frame, routine is considered to have a definitive roll in time, space and activities structuring, as with actions and relations of subjects involved. In that perspective, this research aims to analyze routines of zero to two years old children in the upbringing context, relating to their childish specificities. Anchored in the qualitative approach, a Case Study was developed, according the procedures of daily routine observation and semi-structured interviews with six nursery teachers of CMEI Centro Municipal de Educação Infantil, Natal-RN, the research field. The data analysis was based in Speech Analysis principles. The teachers utterances regarding routine and it s roll in the frame revealed significances related to control/regulation of actions theirs and students aiming to streamline tasks; learning relative to routine itself, time and school practices. Thus, prospects of discipline and exercise of power of teachers over students surges, reducing their possibilities to participate. These conceptions reflect the daily routine of the kids and their teachers. By analyzing the methods of routine operation in the time/space/activities frame of CMEI, it was possible to perceive its homogenization of actions and rhythms, not only of the group s children, but the whole institution, which creates, many times, a controlling character that contains/prevents children s initiative. However, it was also possible to observe that in routine recesses, when it s relaxed, and other spaces, times and actions are provided, kids have the opportunity to experience and create different ways of action and relation with time, materials, other kids and teachers, being, as such, respected their specificities. We highlight the importance of reflections regarding routine in upbringing context, as to comprehend it s functions and the need for it s construction to take a multiple character that respects the plurality of situations and singularities of children as persons

A coordenação pedagógica e o processo de inclusão do aluno com necessidade educacionais especiais:Um estudo de caso

The school inclusion presents a number of challenges that has been mobilizing initiatives and studies about its effectiveness. If on one hand in such studies and initiatives it becomes important to emphasize on the role and training of teachers, on the other, there is few studies about the role (and performance) of the pedagogical coordination in face of this process. In this sense, this research focuses on the role of educational coordination in face of the school inclusion of students with Special Educational Needs (SEN) and it undertakes the following study s questions: has the action by the coordinator contributed to the process of including students with Special Educational Needs? How is it presented in the process of inclusion of students with SEN in regular education? And it aims to: investigate the role of the pedagogical coordinator in the process of inclusion of students with Special Educational Needs of Primary Education at regular schools; and to analyze the limits and possibilities of the coordinator actions in the process of inclusion of students with SEN. For the effectiveness of the research, a state school of Elementary School located at the city of Natal/RN was taken as an empiric field. It was selected as research subjects 4 coordinators, 2 teachers of the Multifunctional Resources Room and 2 teachers of 6th to 9th grades. The methodological approach that was used in this research is consistent with the qualitative approach, and it is configured as a case study, as it is understood that this type of research responds to the objective of the study, assuming the observation of everyday school life, the educational document analysis and interviews with the subjects as procedures and tools to build data. The construction and analysis of the data were followed by a dialogue with the literature dedicated to coordinating education and school enrollment. Considering the responsibilities of the contemporary pedagogical coordination due to the challenges and possibilities of schooling for all students, specially regarding to what is referred as collaborative work and ongoing training of teachers, this study points out to the lack of an articulated action related to the school inclusion process, considering the monitoring of the teaching activity and its dialogue with the Multifunctional Resources Room. Moreover, the emphasis on meeting the daily school routines and the compliance with bureaucratic procedures, put it into second, restructuring of the Political-Pedagogical and the possibility of mobilization of school around the problematization and systematization of an inclusive school project. The effectiveness of school s inclusion, therefore, implies the scaling of the functions of the pedagogical coordination, as well as the reorganization of the school it self, to ensure the mediation of collaborative actions, contemplating the teachers continuing education, having as a landmark difficulties, problems and experiences constructed in the school context

Histórias de vidas de Usuários de psicofármacos: o desafio do cuidar para a enfermagem

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

Acompanhando o crescimento e o desenvolvimento da criança : uma intervenção integrada entre enfermagem e família

The accompanying the growth and development of the child is the guiding line of basic health measures directed at this public, acting within the scope of health monitoring and inferring positively in the rate of infant morbidity and mortality, which are still a preoccupation worldwide and in Brazil. However, mostly, this practice is based on the biomedical model of care, individualized, with emphasis on the medicalization and complaints, favoring the passivity of users. Given this issue, aim to develop accompanying the growth and development of the child in a Basic Unit Family Health, through a collective approach of medical care next to a health team, especially nurses and caregivers. This is a qualitative study, with the research-action method. Involved the four nurses and twenty-six of children's caregivers of the area of Basic Unit Family Health of Cidade Nova, in Natal, in the period from February to July 2010. The results were analyzed following the direction of the thematic analysis of Freire. In the situation analysis of the current reality of the accompanying the growth and development the children in the Basic Unit Family Health, through participant observation and applying a questionnaire to the nurses, we realize that despite these professionals have a knowledge tied to the paradigm of health promotion, in practice the monitoring of child is done through individual consultations in outpatient room, based on complaints brought by caregivers, with little solvability in actions employed. Given the need for change in medical care model, we decided jointly, in the focal group, for the collective monitoring of children's the growth and development, featuring then this proposal to the multidisciplinary team, discussing the participation of professional categories and planned collectively the actions. In the implementation stage of collective action, we contemplate the execution by the caregivers of anamnesis and physical examination, recording data in the Child Health Handbook and discussion of clinical findings, under the supervision of nurses and facilitators. In the evaluation, we found that this collective accompanying strategy allowed to caregivers learn new knowledge, exchange experiences, assistance in home care, beyond reduce the waiting time for medical care and creating opportunity of more time for debate about the children‟s health situation, differing of ambulatory care. As difficulties, we face with a high rate of defaulters (53.8%), lack of motivation and passivity of the users, little participation of other health professionals and nurses' involvement in other activities, technical and bureaucratic in the moment of care. Thus, we note also a strong rooting of individual clinical model on the way of thinking and acting of nurses and caregivers