223 resultados para Integralidade


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O objetivo desta pesquisa foi analisar como conselheiros municipais e vereadores do Recife reconhecem o direito à participação na gestão pública e o direito à representação eleitoral e às funções daí decorrentes. Deste modo, podem-se observar os impactos ocasionados pela instância de participação em uma instituição tradicional de representação política, de modo a aperfeiçoar o modelo de Gestão Social. A análise foi realizada à luz da teoria do reconhecimento, especificamente as ideias de Axel Honneth. Para tanto, foram aplicados questionários e realizadas entrevistas com conselheiros e vereadores do Município, assim como foram analisados documentos da Câmara. Observou-se que ambos os grupos mostram-se favoráveis ao diálogo entre as instâncias, apesar dos conflitos que ainda precisam ser vencidos. Vereadores têm assento nos conselhos, apesar de que a participação não acontece na prática. Concluiu-se que o reconhecimento não ocorre em sua integralidade, sendo uma luta em construção.

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Este trabalho aborda as representações e práticas dos fisioterapeutas inseridos no Sistema Único de Saúde. Com o intuito de desvendar o modo de pensar e agir, além do nível de inserção que alcançou a fisioterapia dentro do Sistema Único de Saúde, busquei compreender a lógica orientadora de suas ações terapêuticas bem como sua adequação às diretrizes desse Sistema. Para tal, utilizei uma abordagem antropológica de cunho qualitativo com o privilégio da observação participante e entrevistas semi-estruturadas realizadas em dois serviços de saúde de Porto Alegre: um hospital e um ambulatório de nível secundário. A revisão histórica da profissão ajudou na contextualização e, deste modo, entender por que os fisioterapeutas estão centrados na abordagem física das pessoas. Esse modo de tratar as pessoas é ensinado aos profissionais no processo de formação e reforçado na prática profissional dirigida à reabilitação, tendo o manuseio do paciente um valor importante para o fisioterapeuta. Por sua vez, este tipo de trabalho manual associado a um papel feminino do cuidado são fatores de demérito frente as outras profissões da saúde. Isto reforça a posição hierárquica inferior que o profissional possui dentro do Sistema Único de Saúde, que em alguns momentos é confundido como um especialista da medicina física. Desse modo, este trabalho contribuiu para repensarmos as concepções de saúde que são ensinadas na academia, o que vem a ser o “fazer fisioterapêutico”, bem como, a integralidade das ações terapêuticas dentro do Sistema Único de Saúde.

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O objetivo da presente dissertação é analisar a telemedicina como ferramenta para ampliar o acesso à assistência em saúde no Brasil, dentro do contexto do Sistema Único de Saúde (SUS). Atualmente, a dificuldade de acesso à assistência constitui um grande problema para sistemas de saúde e países no mundo todo. Foi utilizada metodologia qualitativa analítica do tipo “Theory Building from Cases”, envolvendo o estudo de dois casos: a Rede de Teleassistência de Minas Gerais e a Rede de Telessaúde do Canadá, buscando fornecer argumentos positivos para a incorporação da telessaúde em estratégias e políticas de saúde pública no Brasil. Os resultados mostraram que a telemedicina ampliou o acesso à assistência em áreas remotas e rurais, proporcionou economia de recursos devido à redução de deslocamentos de pacientes, possibilitou a educação à distância de profissionais de saúde e, com isso, melhorou a qualidade da atenção prestada. Assim, a conclusão da pesquisa foi que a telemedicina é uma ferramenta eficiente para ampliar o acesso à assistência em saúde no Brasil, colaborando para o cumprimento dos princípios do SUS de universalidade, integralidade, equidade e resolutividade. A incorporação da telessaúde dentro das políticas de saúde com financiamento integrado no orçamento público é fundamental para o sucesso desta ferramenta.

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Objetivou analisar a atuação dos enfermeiros da Estratégia Saúde da Família frente à violência intrafamiliar contra a criança, visando identificar ações de prevenção do problema. Pesquisa descritiva e exploratória de cunho qualitativo, cujos dados foram analisados conforme análise de conteúdo. Participaram do estudo 14 enfermeiros da Estratégia de Saúde da Família do município de Mossoró-RN. Dados coletados utilizando-se questionário semiestruturado. As ações de promoção à saúde são atividades educativas desenvolvidas após detecção de casos. O medo de represálias do agente agressor, a sobrecarga de trabalho, a falta de apoio dos gestores e a dificuldade para a materialização da interdisciplinaridade, intersetorialidade e integralidade da atenção foram mencionadas como barreiras ao enfrentamento do problema

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O presente estudo objetivou analisar as características epidemiológicas das condições de saúde bucal de 98 idosos de uma Instituição de Longa Permanência para Idosos (ILPI) e de 125 participantes de Grupos de Convivência, de bairros periféricos, socialmente semelhantes, de Fortaleza, Ceará, Brasil, para orientação do tratamento odontológico. Investigou-se a autopercepção em saúde bucal desses idosos a fim de realizar uma avaliação comparativa entre eles e com os levantamentos epidemiológicos de base nacional (SB Brasil) e de base estadual (SB Ceará). Devido a alguns idosos da ILPI recusarem o tratamento dentário e a identificação do elevado percentual de demenciados, optou-se por realizar uma avaliação cognitiva, o Mini Exame do Estado Mental (MEEM) visando identificar os aptos à reabilitação oral. Métodos: abordagem epidemiológica do tipo transversal, sendo a coleta de dados realizada por cinco examinadores, utilizando os critérios recomendados pela OMS (1997). Resultados: O CPO-D médio encontrado na ILPI, foi de 29,88, com predomínio do componente perdido (93,27%) enquanto o CPO-D médio dos não institucionalizados fixou-se em 30,17, com predomínio do componente perdido (63,70%). Também se avaliou o uso e a necessidade de prótese dentária: dos residentes na ILPI, 10,20% usavam prótese superior e 3,06%, inferior; 94,90% necessitavam de prótese superior e 97,96% de inferior; sendo a prótese total foi o tipo mais prevalente, 88,78% para ambos os arcos. O percentual do uso de prótese dos não institucionalizados foi 71,20% no arco superior, sendo 66,40% prótese total; já para o arco inferior, 32,80%, das quais 31,20% era prótese total. No presente estudo, tanto para uso quanto para necessidade, considerando ambos os arcos, a diferença entre os idosos institucionalizados e não institucionalizados foi estatisticamente significativa pelo teste Qui - quadrado (p<0,001). Como resultado do MEEM, observou-se deterioração cognitiva (escore ≤ 12) em 37,25% dos entrevistados, bem como um declínio cognitivo com o avanço da idade. Conclusões: Os resultados apontam que há um maior percentual de uso de prótese total no arco superior e maior frequência quanto à ausência de próteses de qualquer tipo no arco inferior. Evidenciou-se que os idosos pesquisados foram submetidos a tratamento mutilador e, como consequência necessitam de reabilitação oral, o que pressupõe a necessidade de políticas públicas para que isso ocorra efetivamente. Os participantes deste estudo caracterizam-se por uma autopercepção positiva da sua saúde bucal, a despeito das condições clínicas insatisfatórias e de precária saúde bucal, com acentuada prevalência de cárie dentária e edentulismo. O MEEM revelou deficiência cognitiva na maioria dos idosos, confirmando que a sua aplicação, previamente à reabilitação oral pode evitar desperdícios financeiros.Tais achados refletem a necessidade de implantação de políticas reabilitadoras em saúde bucal voltadas para o idoso; baseadas na perspectiva da integralidade como princípio doutrinário do Sistema Único de Saúde, o que redundaria numa melhor qualidade de vida, tanto pela melhor mastigação, digestão e nutrição, pelo maior aproveitamento dos alimentos, quanto pelo favorecimento à comunicação, pela dicção e fala, contribuindo para a socialização e consequente elevação da autoestima dessa clientela.

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This study had a multidisciplinary focus, investigating the areas of health and education, and proposes to discuss the formation of health professionals, requiring their understanding of the factors involved in the production of knowledge, given that this formation has an impact on the quality of human and social life. The aim of this work was to investigate the relationship existing between the process of physical therapist formation and the practical activities developed during the undergraduate course in the Northeast of Brazil. This is an exploratory descriptive study with qualitative significance. The sample consisted of 73 subjects (33 professors and 40 students) from 6 physical therapy courses at different institutions in the Northeast of Brazil. Data collection was conducted through focus group interviews. In addition, we used a school assessment instrument from the health area. The data, analyzed using dialectical hermeneutics, showed that the Northeast of Brazil has the second largest number of physical therapy courses in the country, with 93 (11 public and 82 private) out of a total of 510. These numbers represent a growth of 1062.5% since 1991. The pedagogical projects are guided by National Curricular Directives as well as by the country s health system. The prevalent pedagogy is that of transmission, and the contents/disciplines are generally not integrated with practice, a situation that hinders the integrality and interdisciplinarity of health care. It can be concluded that there is a need for implementing integrated curricula and for better qualified professors to effectively put this process into practice

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This study had as objective to identify to the perception of mothers and professionals of health on the attention to the health of HIV-Positive children/adolescents in the city of Natal-RN. It is a descriptive-exploratory study with quantitative and qualitative approach, carried through in the Giselda Trigueiro Hospital and in the State and Municipal Health Councils in Natal - RN, from march to december of 2005. The sample was composed by 56 participants, 33 mothers of children who use specialized assistance and 23 professionals. Data collection occurred with the application of a half-structuralized interview. Quantitative data were analyzed through descriptive statistics and qualitative data were submitted to content analysis. Prevailing categories in relation to the cartography of the attention to seropositive children and adolescents in Natal were: Organization and dynamics of the attention; Institutional management and human development; Control and prevention; other contexts of attention; relationship/communication team-patient and organization and functioning of the services. The profile epidemiologist of the children, adolescents and of the people/mothers, who take care of them with HIV/Aids, followed the evolution of the epidemic in the country and the world. It was verified that mothers need care and information; however they make a positive evaluation of the attendance they receive. It was also observed many gaps in the services of assistance, in which the researched group was attended, beyond imperfections in the communication between health professionals and users. The professionals recognize the advances that the politics represent for the assistance of people with Aids; however feel themselves limited by the precariousness of the system and the partner-economic conditions of the people. According to these data, it can be verified great challenges to go through in the context of integrality of the assistance to HIV positive children and adolescents in the city of Natal and in the improvement of the communication in the institution of reference

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This study approaches the topic of humanization in health that involves the set of policies implemented by the Ministry of Health in Brazil. Its aims are directed towards a reflection on the guiding theoretical and organizing axes of the National Humanization Policy (NHP) and their repercussions on municipal health policy of Natal, Brazil; an analysis of the results of the policy at the local level; knowledge of the views and experiences of the humanization agents in the daily work process and identification of the main challenges of the policy. The empirical field of investigation was the Family Health Strategy (FHS) of the city of Natal. The assumption of the study is that the FHS has produced local experiences with potentialities that must not be wasted, in which there are difficulties and discrepancies between the real and proposed model. The contradictions and challenges in the social and political context of Brazil in the early XXI century and their consequences in the field of health reflect anti-utilitarian aspects anchored strongly in the theoretical concepts of Boaventura de Sousa Santos about the sociology of privations and emergencies as well as of the work of translating. The predominantly qualitative approach collects some complementary quantitative data. The study procedures used were the following: bibliographic research; documental research; interviews; and direct observation. Interpretation of the information obtained was based on documental analysis and on the symbolic cartography of the social representations. Cartographic evidence suggests that practices still take place under dehumanizing conditions that compromise the quality of care given. However, there is a movement aimed at changing the work process that has been strengthening the link and widening the measures developed, incorporating new directions in diversity, integrality and solidarity. The map drawn shows a reality manifested by explicit intentions in a political agenda, by concrete solutions marked by an assortment of difficulties and expressed in the words of the agents and by latent clues identified in successful local experiences, posing many challenges for the consolidation of the proposed changes

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The Family Health Program implemented in Brazilian municipalities from 1994 represents today the most promising proposal to promote important changes in municipality`s health systems, to allow universal access to health care, comprehensiveness, equity and to promote social control, achievements provided by the health reform process and incorporated to the Unified Health System principles. However, many are the challenges imposed to the Family Health Program so that it can cause these advances. In this study, we aimed to answer the following research question: what are the results of the Family Health Program in relation to beneficiaries at small, medium and large municipalities? The hypothesis that guided this work was that the variation in levels of achievement/results (strict, impacts and effects) of the Family Health Program is related to the size of the municipalities. Therefore, our general aim was to evaluate the results of the Family Health Program in municipalities at Rio Grande do Norte, Brazil. And as specific objectives, to measure strict results, effects and impacts of the Program, from the criteria of efficiency and effectiveness on the beneficiated population, and to measure the Program`s impact on the organization of municipality`s health system. This is an impact assessment research, developed from multiple case studies with quanti-qualitative approach. The study included small municipalities (Acari and Taipu), midsize (Canguaretama and Santa Cruz) and large (Natal and Mossoró). The individuals chosen to the research were users/beneficiaries of the Program and health professionals. Data analysis was performed using descriptive statistics and content analysis compared from the Program`s logical /theoretical model. The results obtained in relation to the principles evaluated (universality, comprehensiveness and community participation) presented that municipalities show different results, although not directly related to the size, but related with characteristics of the Program`s implementation form in each municipality and the arrangements made for its operationalization. The positive effect that generated significant change in people`s lives has been linked to the increase of access and to the decrease of geographic barriers. However, to the municipal health system, regarding the changes desired by the Program, it was not observed a positive impact, but a negative impact related to the increase of barriers for the user to access other levels of the health system

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Public politics of Service to the Child: The Challenge of the Action Articulated in the Project Belém Criança (2001-2004) if it constitutes in a study on the politics directed toward the children of 0 the 6 years. It has as objective to analyze the configuration of the politics of integral attention to the child, evidencing the form as the same ones they had been redimensioned by the neoliberal ideas and by the lines of direction of the international organisms. The work has like empiric reference the project Belém Criança, developed by county of Belém from a partnership with the Deep of United Nations for Infancy (UNICEF), in the period of 2001 and 2004. The project intends to develop an articulated action among the several county departments which offer assistance to the children looking for to rationalize the resources and to optimize the services. Amongst the methodological procedures that materialized the research distinguished: The bibliographical review and documental allowed to analyze the contextualization of the public politics and, between them, the social politics of attendance to the child; the historical revolution this attendance; the paper of the UNICEF how articulator of the politics in municipal scope; and the paper of county how executer these politics. Still it was utilized, the half-structuralized interview, Having like subjects: the representative of the UNICEF in Belém, the municipal co-managers and actors of community in which the project was implemented. The result of the analyzes review that, historically, the politics destined to the child they had been being dimensioned having like support the fight of social movements vindictive for publics politic which guarantee the fundamentals rights these citizen. Although legal dimension of current politics of attendance to the child, to assume a vision of completeness and the guarantee of the rights, it still has a great exaggeration between the speech and the practical one. Actually, the same one are elaborate inside the neoliberal optics, with ruled actions by the beginning in combat to the poverty, implanted with low costs and with practice which to lead to the excessive fragmentation, generating inadequate actions and punctual programs which don t guarantee the social quality of the attendance. This perspective was evidenced to the most of the actors which the Project Belém Criança don t constitute itself a real public politic toward the child of 0 the 6 years, although present innovating aspects, how the mobilization and participation. It was demonstrated yet, in the participant s depositions of the research, that the bureau had numberless of difficulty to develop the action preview in the project, it has seen the great complexity of articulation between the several organism responsible by politics of attendance

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The health transition experienced in Brazilian health care model requires a metamorphosis in human and society, placing new demands on health and education. The Faculty of Science, Culture and Extension of Rio Grande do Norte (Facex), aware of their responsibilities to the Health System, which brings the principle of comprehensiveness as its structural axis, dared to implement a course of nursing in complex thinking and Experiential Pedagogy Humanescente with curriculum inter / transdisciplinary. For deployment of proprosta was not enough to reform thinking of educators, there was a need corporalizar new teaching practices that are aimed at the integral formation of human beings. In this context, emerged the workshop on Human Education autopoietic, self-forming area of the educator, where he developed an Action Research Existential (PA-E) which enabled experience, describe and analyze how the human autopoietic educators could contribute to the practice educational humanescente transdisciplinary curriculum project. Were worked out in meetings, knowledge necessary to practice the transdisciplinary 1st Meeting - learn to create; 2nd Meeting - learn to recognize the laws of nature with emphasis on complexity theory, 3rd Meeting - learn to organize, 4th meeting - namely autoestruturar themselves; 5th Meeting - know how to choose, 6th Meeting - knowing innovate 7th Meeting - namely exchange. Next an autobiographical perspective, we chose the metaphorical possibility to narrate the ways and strategies covered by the author and apprentice in the company of the Little Prince de Saint-Exupery, in search of a sensible pedagogical practice complex, which promotes re-enchant transdisicplinar education. The route involved five methodological connections: a literature review which relate to training for care in undergraduate nursing: the study of learning processes that drive the formation humanopoiética, emphasizing the relationship that involves the complexity and embodiment in the educational process transdisciplinary, highlighting the analysis of what is to learn from the findings of biosciences and recent cognitive theories of Maturana and Varela, the description of the interdisciplinary curriculum of the nursing course of Facex and Training Workshop, Human autopoietic, with emphasis on Experiential Education Humanescente; the report of seven meetings of the Workshops (cocoon), recording the experiences and listening to educators (luminescent butterflies), the final reflections with learning opportunized. Experientiality lived through, the expressions and words, educators say the influence of workshops for their teaching practices, highlighting it as a space for selforganizing, creating, learning and enchantment, and can identify the workshop as a place of transformation necessary for deployment an interdisciplinary curriculum. The knowledge emerging from the study indicate the need for permanent spaces of self, in which the educator learns from its body, between cognitive processes and vital, and in the experiences of their formative process the opportunity to act on the dimensions of knowing and being

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Study descriptive that was designed to assess the quality of care for people with venous ulcers (VUs) tended at the ambulatory of a university hospital in Natal / RN. The target population of the study was composed by 40 users bearers of venous ulcers served in the ambulatory of angiology of a university hospital in the level of tertiary education. The study received assent of the Ethics Committee of the Federal University of Rio Grande do Norte (Protocol No. 169/06). The collect of data was performed using a form of interview and tour with collection of measures biophysiologic, for a team comprised by the researchers and an academic of nursing, in the period of three months. The data were analyzed in SPSS 14.0, using descriptive statistics and presented in the form of charts, tables and graphs. Identified a clientele of holders of VUs predominantly female, married, aged up to 59 years, low level of education and household income, from Natal, retirees or those exercising professions and occupations that require long periods standing or sitting. In relation to the characteristics of health, those surveyed had risk factors for venous disease and had UVs chronic, located in Zone 2, lost tissue in grade II and serous exudates on average quantity. The assistance to holders of UVs has been characterized by a lack of professional nurses and unavailability of products for the realization of the right curative in ambulatory and outside it; by the inadequacy of products used in VUs, for long periods of treatment without resolution, where the compressive therapy is not priority, by the lack of completeness in the levels of assistance; by monitoring the bearer of UVs only by doctors and the nurses, even with the other team of professionals in the health service; by the completion of guidelines by health professionals and the lack the standardization of conducting laboratory and specifics tests. The assistance was assessed as inadequate in aspects: reference and counter-reference (75.0%), number of consultations with angiologists last year (87.5%), documentation of the clinical findings (85.0%), use of compressive therapy in the past 30 days (77.5%), part of the team interdisciplinary (97.5%), completion of laboratory and specifics tests in the last year (100%), availability of products used in achieving the curative in ambulatory (80, 0%), and indication of products used in the conduct of dressing outside the clinic (70.0%) and appropriate in the guidelines made on the use of socks, lifting of the members and prescription of exercises regular (82.5%) and indication products used in achieving the curative in ambulatory (97.5%). We conclude that the assistance provided to holders of UV was inadequate in 80% of cases interviewed, becoming non-resolutive and assistematic

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The purpose of this study is to analyze, from the point of view of nurses, changes that took place in the process of providing health services after the introduction of the Family Health Program (FHP). It is na investigation of qualitative nature that uses semi-structured interviews as a main empirical approach tool. Six nurses from the city of Caicó, Rio Grande do Norte, who were working with basic care before the introduction of the FHP, within basic care, were: adscription and ties with the community; hospitality and the humanizacion of care-giving; decrease in cases of inpatient treatment; strengthening of the prevention of injuries and health promotion; improvemente of health indicatiors, finally, actions that point towads meeting the principles of wholeness, equity and universality as a declaration of the Brazilian National Health Care System (SUS). Nevertheless, in spite of all recognizable positive aspects, the FHP has some weaknesses, such as: the difficulty posed by colletive work; the mismatch between professional education and the demands of the current health standard; a poor physical infrastructure of the Basic Health Units; a high heath staff turnover and precarious work conditions. In addition to this, some strategies that can be used to help improve the process of providing health services have been pointed out, such as, coordination between sectors, continuous education, making work conditions less precarious and improving the means whereby heathy service management is conveyed,Tthus, finally, we understand that the FHP does bring forward meaningful changes to the process of provinding health services to strengthen the Brasilian National Health Care System (SUS), in spite of the fact that it lies within a scenario of adversities that can be overcome through the collective endeavor of the several social actors

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The family violence against children became visible, in the context of public health, due to the damage and injuries generated in the lives of children and to the growing need of investment in physical and human resources to fill this demand. In this context, it is believed that intervention could prevent such events and are configured as primary strategies to prevent the corollaries generated by the violence. In this perspective, this study aims to analyze the performance of nurses dealing with the Strategy of Family Health viewing to identify actions based on the paradigm of health distribution. This is a descriptive, exploratory and qualitative research. The data were analyzed based on the content analysis about the method proposed by Bardin. The study was conducted in Mossoró-RN and the participants were 14 nurses working for the Family Health Strategy in Health Units of this town. The instrument for data collection was a semi-structured questionnaire, with questions answered by the participants themselves. It was evident to the study that the nurses believe that health education are the main tool for dealing with domestic violence against children, being developed, however, in its positivist and vertical way. The actions used to develop health performed by the team on their daily lives are limited to educational activities and are carried exactly when cases of family violence against children are notified. Barriers to the practice emerged from fear of reprisals from the agressor, overwork, lack of management support and difficulty for the realization of interdisciplinary, intersectorality and comprehensive care.

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It is about a study of an exploratory/descriptive type with a qualitative approach whose aim was to analyze the actuation of nursing technicians in Family Health Strategy (FHS), taking into consideration the defined attributions by the Ministry of Health (MH). Thus, it was sought to identify what activities they carry out, the difficulties encountered, what contributed to their professional performance, and what vision they have about FHS and about themselves in the context. Based on the assumption that the practice of Nursing Technician is not still geared to completeness and that the developed actions by this professional are predominantly individual and curative. We know that FHS proposes the work organization as a team, with territory definition, prioritization of promotion actions, protection and recovery of the individual/family/community health, choosing as a central point the establishment of entails between the professionals and the same ones. However, the team work pass through interdisciplinary, tying and competence, starting making the difference in the way of thinking and doing health. To the accomplishment of this study were interviewed twenty one Nursing Technicians of Family Health Units from Sanitário Oeste district in Natal-RN, using semistructured instrument. From the analysis, three empiric categories emerged: starting from the first, The reality of a dream: what FHS is for the Nursing Technician, we obtained two classifications: one inherent to the own conception they have about FHS, nominated The realization of a dream in the possible and another that corresponds to what they think about FHS, while project that doesn't take place fully, denominated of The beauty of a dream that doesn't take place. The second category was The FHS: a dream built in the daily of Nursing Technician treats of the day by day information of that professional; the activities they perform and how those are established. This created three other items, to know: The role of a Nursing Technician: a project that became routine; The pre-determined role of a Nursing Technician: the scale as factor of (non-)autonomy; and, Knowledge about the practice in FHS: challenges that are presented to the role of Nursing Technician. The third category, denominated of Charms and disenchantment in the beginning of a new practice, it is related to the facilities or difficulties in professional's actuation and how he sees himself in the context. From it emerged the "flowers" and the "thorns" found on the construction of a dream, which gave this study the title. The results indicate that, being considered the characteristics of researched professional category, it becomes fundamental the resizing of labor relations in FHS, being imperative that new glances is conducted, so that the way as those Nursing Technicians interacts with the families can become compatible, together with the team, as well as to return the attention for their possibilities and limits in face of the work process in FHS. Besides, it is necessary changes in the professional formation, so that it can guarantee the conceptual bases in the construction of new practices, seeking to answer to the model of current attention.