Alda Martins Gonçalves

A reforma psiquiátrica no Brasil: contextualização e reflexos sobre o cuidado com o doente mental na família

This work analyzes the consequences of the Brazilian psychiatric reform to the care provided to the mentally ill in their family environment. It is a descriptive and exploratory study based on a qualitative approach, using the historical-dialectic materialism as its theoretical and methodological framework. The subjects of the research were 11 women that provided care to mentally ill persons. The analysis of their discourses revealed unique aspects related to caring for the mentally ill in their family environment and the difficulties resulting from the process of institutionalization of the mentally ill. The conclusion is that women who provide care for the mentally ill have an important social role that is indispensable to the consolidation of the psychiatric reform in the country.El presente trabajo analiza las consecuencias de la reforma psiquatrica basilena sobre el cuidado del enfermo mental en la familia. Se trata de un estudio descriptivo-exploratorio de abordaje cualitativo, cuya fundamentacion teorico-metodologica fue orientada por el materialismo historico-dialectico. Los sujetos de la investigacion fueron once mujeres cuidadoras de enfermos mentales. El analisis de sus discursos revelo las singularidades del cuidar de un enfermo mental. Se concluye que la mujer cuidadora del enfermo mental cumple un papel social importante e indispensable en la consolidacion de la reforma psiquiatrica en el pais.

Internação domiciliar no Sistema Único de Saúde

OBJETIVO: Analisar o funcionamento dos Programas de Internacao Domiciliar implantados em tres municipios, identificando elementos que sinalizam a insercao desses programas na mudanca da atencao a saude. METODOS: Estudo descritivo-exploratorio com abordagem qualitativa realizado em Marilia e Santos, SP, e em Londrina, PR. Os dados empiricos foram obtidos por meio de entrevistas realizadas com cinco enfermeiras e um assistente social que atuam nos servicos de Internacao Domiciliar e da analise de documentos dos referidos programas. Para o tratamento dos dados das entrevistas foi utilizada a tecnica de analise de discurso. RESULTADOS: Os achados permitem afirmar a importância do servico de Internacao Domiciliar como estrategia para a desospitalizacao e humanizacao do cuidado. Identificaram-se elementos que caracterizam a pratica nos servicos de Internacao Domiciliar voltada para a construcao de modelo assistencial com enfase nas tecnologias leves e na atuacao multiprofissional e intersetorial. Pode-se constatar avancos na implantacao de servicos de Internacao Domiciliar, bem como obstaculos para que a mudanca do modelo de atencao se processe. Dentre esses, destaca-se a ineficiencia dos mecanismos de referencia e contra-referencia e dificuldades na relacao dos profissionais da equipe de saude com usuarios, familiares e cuidadores. CONCLUSOES: O cuidado com os Programas de Internacao Domiciliar representa uma estrategia na reversao da atencao centralizada nos hospitais para a construcao de nova logica com enfoque em promocao e prevencao a saude, diminuicao de riscos e humanizacao da atencao e, como tal, devem ser engendradas estrategias para permitir sua implantacao na rede publica.OBJECTIVES To assess home care programs implemented in three cities and to identify components indicating the integration of these programs into the reform of health care. METHODS An exploratory descriptive study with a qualitative approach was carried out in the cities of Marília and Santos, state of São Paulo, and Londrina, state of Paraná, Brazil. Empirical data was obtained from interviews with five nurses and one social worker who worked in home care services, and through analysis of reports on these programs. The data was analyzed using the discourse analysis technique. RESULTS The findings show the importance of home care services as a strategy for dehospitalization and humanization of care. Components were identified showing that home care focused on building up a health care model based on light technology, and multiprofessional and intersectorial work. It was found that, despite advances in the implementation of home care services, there are obstacles for an effective health care model change, such as ineffective referral and counter-referral mechanisms and complex relationship of health care providers with service users, their families and caregivers. CONCLUSIONS Care provided by home care programs is a strategy to decentralized care based on hospitals and to build up a new approach focused on health promotion and prevention, reducing risks and humanizing care. Strategies must be drawn up to allow its implementation in the public health network.

ZnO UV photodetector with controllable quality factor and photosensitivity

ZnO nanowires have an enormous potential for applications as ultra-violet (UV) photodetectors. Their mechanism of photocurrent generation is intimately related with the presence of surface states where considerable efforts, such as surface chemical modifications, have been pursued to improve their photodetection capabilities. In this work, we report a step further in this direction demonstrating that the relative photosensitivity and quality factor (Q factor) of the photodetector are entirely tunable by an applied gate voltage. This mechanism enables UV photodetection selectivity ranging from wavelengths from tens of nanometers (full width at half maximum - FWHM) down to a narrow detection of 3 nm. Such control paves the way for novel applications, especially related to the detection of elements that have very sharp luminescence.

O cuidado no trabalho em saúde: implicações para a formação de enfermeiros

Com o objetivo de identificar necessidades de mudanca na formacao dos enfermeiros ao assumirem o cuidado como dominio do nucleo especifico de sua pratica, desenvolveu-se um estudo qualitativo utilizando-se dados de entrevistas em grupos focais com docentes e estudantes de escolas de enfermagem do estado de Minas Gerais, Brasil. Nessas escolas de enfermagem existe a concepcao de cuidado traduzido como agir que incorpora uma visao integral do ser humano e que se concretiza em relacoes de intersubjetividade. Entretanto, prevalece uma pratica pedagogica e assistencial que reitera o modelo biomedico e enfraquece a nocao de cuidado expressa pelos participantes. Aponta-se, como desafio para a formacao, a ocupacao com um ensino que resgata as praticas cuidadoras do nucleo profissional especifico e das interseccoes no campo da saude, num movimento que valoriza a aprendizagem pautada na realidade e no qual o estudante vivencia e reflete sobre o processo de cuidar.With the aim of identifying the needs for changes in nurse training when taking care to be the domain at the specific center of nursing practice, a qualitative study was developed using interview data from focal groups involving lecturers and students from nursing schools in the state of Minas Gerais, Brazil. In these nursing schools, the concept of care that translates how to act incorporates an integral view of human beings and takes shape through relationships of intersubjectivity. However, the prevailing pedagogical and assistance-providing practice reiterates the biomedical model and weakens the notion of care expressed by participants. This indicates that the challenge for training is to be occupied with teaching that conserves the care practices of the specific professional center and their intersections within the healthcare field, in a movement that gives value to learning guided by reality, within which students experience and reflect on the care process.

Psychiatric reform in Brazil: contextualization and consequences regarding the care for the mentally ill in their family environment

This work analyzes the consequences of the Brazilian psychiatric reform to the care provided to the mentally ill in their family environment. It is a descriptive and exploratory study based on a qualitative approach, using the historical-dialectic materialism as its theoretical and methodological framework. The subjects of the research were 11 women that provided care to mentally ill persons. The analysis of their discourses revealed unique aspects related to caring for the mentally ill in their family environment and the difficulties resulting from the process of institutionalization of the mentally ill. The conclusion is that women who provide care for the mentally ill have an important social role that is indispensable to the consolidation of the psychiatric reform in the country.El presente trabajo analiza las consecuencias de la reforma psiquatrica basilena sobre el cuidado del enfermo mental en la familia. Se trata de un estudio descriptivo-exploratorio de abordaje cualitativo, cuya fundamentacion teorico-metodologica fue orientada por el materialismo historico-dialectico. Los sujetos de la investigacion fueron once mujeres cuidadoras de enfermos mentales. El analisis de sus discursos revelo las singularidades del cuidar de un enfermo mental. Se concluye que la mujer cuidadora del enfermo mental cumple un papel social importante e indispensable en la consolidacion de la reforma psiquiatrica en el pais.

El cuidado en el trabajo en salud: implicaciones para la formación de enfermeros

Com o objetivo de identificar necessidades de mudanca na formacao dos enfermeiros ao assumirem o cuidado como dominio do nucleo especifico de sua pratica, desenvolveu-se um estudo qualitativo utilizando-se dados de entrevistas em grupos focais com docentes e estudantes de escolas de enfermagem do estado de Minas Gerais, Brasil. Nessas escolas de enfermagem existe a concepcao de cuidado traduzido como agir que incorpora uma visao integral do ser humano e que se concretiza em relacoes de intersubjetividade. Entretanto, prevalece uma pratica pedagogica e assistencial que reitera o modelo biomedico e enfraquece a nocao de cuidado expressa pelos participantes. Aponta-se, como desafio para a formacao, a ocupacao com um ensino que resgata as praticas cuidadoras do nucleo profissional especifico e das interseccoes no campo da saude, num movimento que valoriza a aprendizagem pautada na realidade e no qual o estudante vivencia e reflete sobre o processo de cuidar.With the aim of identifying the needs for changes in nurse training when taking care to be the domain at the specific center of nursing practice, a qualitative study was developed using interview data from focal groups involving lecturers and students from nursing schools in the state of Minas Gerais, Brazil. In these nursing schools, the concept of care that translates how to act incorporates an integral view of human beings and takes shape through relationships of intersubjectivity. However, the prevailing pedagogical and assistance-providing practice reiterates the biomedical model and weakens the notion of care expressed by participants. This indicates that the challenge for training is to be occupied with teaching that conserves the care practices of the specific professional center and their intersections within the healthcare field, in a movement that gives value to learning guided by reality, within which students experience and reflect on the care process.

Healthcare at work: implications for nurse training

Com o objetivo de identificar necessidades de mudanca na formacao dos enfermeiros ao assumirem o cuidado como dominio do nucleo especifico de sua pratica, desenvolveu-se um estudo qualitativo utilizando-se dados de entrevistas em grupos focais com docentes e estudantes de escolas de enfermagem do estado de Minas Gerais, Brasil. Nessas escolas de enfermagem existe a concepcao de cuidado traduzido como agir que incorpora uma visao integral do ser humano e que se concretiza em relacoes de intersubjetividade. Entretanto, prevalece uma pratica pedagogica e assistencial que reitera o modelo biomedico e enfraquece a nocao de cuidado expressa pelos participantes. Aponta-se, como desafio para a formacao, a ocupacao com um ensino que resgata as praticas cuidadoras do nucleo profissional especifico e das interseccoes no campo da saude, num movimento que valoriza a aprendizagem pautada na realidade e no qual o estudante vivencia e reflete sobre o processo de cuidar.With the aim of identifying the needs for changes in nurse training when taking care to be the domain at the specific center of nursing practice, a qualitative study was developed using interview data from focal groups involving lecturers and students from nursing schools in the state of Minas Gerais, Brazil. In these nursing schools, the concept of care that translates how to act incorporates an integral view of human beings and takes shape through relationships of intersubjectivity. However, the prevailing pedagogical and assistance-providing practice reiterates the biomedical model and weakens the notion of care expressed by participants. This indicates that the challenge for training is to be occupied with teaching that conserves the care practices of the specific professional center and their intersections within the healthcare field, in a movement that gives value to learning guided by reality, within which students experience and reflect on the care process.

What is the emphasis of Brazilian drug policy: resocialization or internment?

Objective: To analyze the discourses of public managers, at the municipal and state levels of the city of São Paulo Brazil and of community services that serve users dependent on drugs with mental disorders, in order to confront them with the current public policies of the Brazilian Ministry of Health and Check whether they have advanced or receded. Methods: Cross-sectional, interpretive qualitative study was carried out with four public managers and community service providers who attend drug users. Data were collected through semi-structured interviews. Results: The speeches indicated that despite the fact that despite participant health managers indicate which direction should be given the care to drug users, under some aspects, public policies in the last six years have receded. Conclusion: The Policy advanced with the structuring of the psychosocial care network and articulation with a single network of social assistance, among others, but fell back when it introduced the therapeutic communities in the health network and promoted hospitalizations with public funding.

La reforma psiquiátrica en Brasil: contexto y reflejos sobre el cuidado con el enfermo mental en la familia

This work analyzes the consequences of the Brazilian psychiatric reform to the care provided to the mentally ill in their family environment. It is a descriptive and exploratory study based on a qualitative approach, using the historical-dialectic materialism as its theoretical and methodological framework. The subjects of the research were 11 women that provided care to mentally ill persons. The analysis of their discourses revealed unique aspects related to caring for the mentally ill in their family environment and the difficulties resulting from the process of institutionalization of the mentally ill. The conclusion is that women who provide care for the mentally ill have an important social role that is indispensable to the consolidation of the psychiatric reform in the country.El presente trabajo analiza las consecuencias de la reforma psiquatrica basilena sobre el cuidado del enfermo mental en la familia. Se trata de un estudio descriptivo-exploratorio de abordaje cualitativo, cuya fundamentacion teorico-metodologica fue orientada por el materialismo historico-dialectico. Los sujetos de la investigacion fueron once mujeres cuidadoras de enfermos mentales. El analisis de sus discursos revelo las singularidades del cuidar de un enfermo mental. Se concluye que la mujer cuidadora del enfermo mental cumple un papel social importante e indispensable en la consolidacion de la reforma psiquiatrica en el pais.