Anamélia Lins e Silva Franco

A relação médico-paciente no Programa Saúde da Família: um estudo em três municípios do Estado da Bahia, Brasil

This study discusses the physician-patient relationship under the Family Health Program (FHP) in Bahia State, Brazil. Assuming that the physician-patient relationship is influenced by macro and micro-contextual factors, we linked health surveillance and the ecological model of human development, both influenced by contextualism. The methodological strategies included: a census of FHP physicians in Bahia and direct observation of consultations by 20 physicians in three municipalities (counties). There were significant differences in the implementation of the FHP in the three municipalities, with an impact on the physician-patient relationship. As for orientation of clinical practice, health surveillance has not been incorporated by the physicians observed in this study. According to the micro-contextual analysis, health problems were frequently not treated in a contextualized way. FHP guidelines, when incorporated by the municipalities, produce differences in care as observed in the physician-patient relationship. The health surveillance approach, reported as a tool for collective work, proves efficient for describing, evaluating, and improving the FHP, and this study concludes that it is a powerful conceptual tool for dealing with the physician-patient relationship.

Migração, estresse e fatores psicossociais na determinação da saúde da criança

Foi realizado um estudo de revisao com base nos referenciais teoricos de estresse e suporte social para avaliar a importância do estudo dos processos de adaptacao aos eventos vitais e mudancas de vida e suas relacoes com o estado de saude. Considerando-se que as criancas sao particularmente vulneraveis as mudancas nas condicoes ambientais, adotou-se como modelo de analise as relacoes entre os fatores psicossociais e saude da crianca, utilizando-se a migracao como evento capaz de alterar, entre outros elementos, os padroes de organizacao familiar e de interacao mae-crianca que podem determinar estados de saude e doenca.

Distribuição e atuação dos psicólogos na rede de unidades públicas de saúde no Brasil

An analysis of data obtained from the Brazilian Health Information System of the Ministry of Health was carried out allowing an overview of the distribution of psychologists in the Unified Health Brazilian System (SUS) and of the services they offer. Professionals of the psychological field comprised 1,0% of the total registered, and just as with other professions the northern region is in greater disadvantage. In addition, the distribution of psychologists per state is not related to the number of habitants or the health unit network. These data make it possible to discuss the adoption of different guiding policies for the action of psychologists in the public health services.

UM OLHAR SOBRE O PROGRAMA DE SAÚDE DA FAMÍLIA: A PERSPECTIVA ECOLÓGICA NA PSICOLOGIA DO DESENVOLVIMENTO SEGUNDO BRONFENBRENNER E O MODELO DA VIGILÂNCIA DA SAÚDE

The activities of the Family Health Program have posed many challenges. One of these challenges is exemplified in a need for developing theoretical propositions that guide the praxis of family health and foster analysis of its practices. The Bronfenbrenner ecological approach of human development and the health care model are presented as viable theoretical tools for the Family Health Program. Examples extracted from reports of users and professionals of health services are used to illustrate relevant constructs. Different levels of ecological comprehension can be identified in these examples in which the family occupies a fundamental role on the three approaches and complemented it as informant, object of care and of self-care.