Anna Luiza Castro Gomes

As concepções de vínculo e a relação com o controle da tuberculose

El estudio analiza las concepciones de vinculo que orientan las practicas de los Equipos de Salud de la Familia (ESF) con relacion a las medidas de control de la Tuberculosis (TB) en el ambito de la APS, en el municipio de Bayeux-PB/Brasil. Mediante un abordaje cualitativo, en que participaron 37 profesionales de la salud, siendo los datos recolectados por la tecnica de grupo focal, en abril de 2007 y analizados conforme el analisis del discurso. Las concepciones de las ESF sobre el vinculo revelaron coherencia con los conceptos teoricos estudiados, siendo evidenciados, en la relacion equipo/enfermo: confianza, compromiso, intimidad, y responsabilidad. Aspectos de potenciacion del vinculo: el tiempo de actuacion de la ESF en la comunidad; numero de consultas y visitas domiciliares, participacion en el control de la TB. Fragilidades en el vinculo: insuficiencia de medidas intersectoriales, situacion socioeconomica del enfermo, abandono de la familia. Destacamos la necesidad de efectuar cambios que fortalezcan la relacion ESF/enfermo y de ese modo, concretice en lo cotidiano de los servicios de salud, un cuidado fundamentado en la integralidad.This study analyzed the concepts of bonding that guide the practice of Family Health Program (FHP) teams in terms of tuberculosis (TB) control measures in the public health setting, in the city of Bayeux, Paraiba, Brazil. Using a qualitative approach, the study involved 37 health care professionals. Data collection took place using the focal group technique, in April 2007. Data analysis was performed based on discourse analysis. It was observed that FHP team concepts about attachment were in agreement with the studied theoretical concepts, with evidences of trust, commitment, intimacy, and responsibility in the team/patient relationship. The following aspects strengthen the bond: the time that FHP teams work in the community; the number of home visits and consultations and the involvement with TB control. Bond weaknesses: insufficient intersectorial measures, the patients socioeconomic situation, and family abandonment. It is emphasized that there is a need for changes that would strengthen the relationship between the FHP team/patient. This way there would be a concrete care founded on the integrality of health care service routine.This study analyzed the concepts of bonding that guide the practice of Family Health Program (FHP) teams in terms of tuberculosis (TB) control measures in the public health setting, in the city of Bayeux, Paraiba, Brazil. Using a qualitative approach, the study involved 37 health care professionals. Data collection took place using the focal group technique, in April 2007. Data analysis was performed based on discourse analysis. It was observed that FHP team concepts about attachment were in agreement with the studied theoretical concepts, with evidences of trust, commitment, intimacy, and responsibility in the team/patient relationship. The following aspects strengthen the bond: the time that FHP teams work in the community; the number of home visits and consultations and the involvement with TB control. Bond weaknesses: insufficient intersectorial measures, the patients socioeconomic situation, and family abandonment. It is emphasized that there is a need for changes that would strengthen the relationship between the FHP team/patient. This way there would be a concrete care founded on the integrality of health care service routine

Intersetorialidade e vínculo no controle da tuberculose na Saúde da Família

This is a qualitative study which aims to analyze the performance of the Family Health teams in the control of tuberculosis according to the relationship between bonding and the development of intersectoral actions in the metropolitan region of João Pessoa, Paraíba, Brazil. To construct the empirical material focus group techniques were used. Seven focus groups were conducted, involving 37 professionals of the Family Health teams. For analysis, the discourse analysis technique was used. It was concluded that the lack of intersectoral action weakens the bond between tuberculosis patients, their families and the Family Health team. It is noteworthy that intersectoral measures are fundamental in the development of integral care for tuberculosis patients in the context of Primary Health Care.Se trata de un estudio de abordaje cualitativo, cuyo objetivo fue analizar el desempeno de los equipos de Salud de la Familia en el control de la tuberculosis segun la relacion entre vinculo y desarrollo de acciones intersectoriales en un municipio de la region metropolitana de Joao Pesoa, en el estado de Paraiba, en Brasil. Para la construccion del material empirico fue utilizada la tecnica de grupo focal. Siete grupos focales fueron realizados, envolviendo 37 profesionales de los equipos de Salud de la Familia. Para el analisis, se utilizo la tecnica de analisis del discurso. Se concluye que la escasez de acciones intersectoriales fragiliza el vinculo entre el enfermo de tuberculosis, su familia y el equipo de Salud de la Familia. Se destaca que las medidas intersectoriales son fundamentales para el desarrollo de un cuidado integral al enfermo de tuberculosis en el ambito de la Atencion Basica a la Salud.Trata-se de estudo de abordagem qualitativa, cujo objetivo foi analisar o desempenho das equipes de Saude da Familia no controle da tuberculose, segundo a relacao entre vinculo e o desenvolvimento de acoes intersetoriais, em municipio da regiao metropolitana de Joao Pessoa, Paraiba, Brasil. Para a construcao do material empirico, foi utilizada a tecnica de grupo focal. Sete grupos focais foram realizados, envolvendo 37 profissionais das equipes de Saude da Familia. Para analise, utilizou-se a tecnica de analise do discurso. Conclui-se que a escassez de acoes intersetoriais fragiliza o vinculo entre o doente de tuberculose, sua familia e a equipe de Saude da Familia. Destaca-se que medidas intersetoriais sao fundamentais para o desenvolvimento de cuidado integral ao doente de tuberculose, no âmbito da Atencao Primaria a Saude.

Intersectorality and bonding in tuberculosis control in Family Health

This is a qualitative study which aims to analyze the performance of the Family Health teams in the control of tuberculosis according to the relationship between bonding and the development of intersectoral actions in the metropolitan region of João Pessoa, Paraíba, Brazil. To construct the empirical material focus group techniques were used. Seven focus groups were conducted, involving 37 professionals of the Family Health teams. For analysis, the discourse analysis technique was used. It was concluded that the lack of intersectoral action weakens the bond between tuberculosis patients, their families and the Family Health team. It is noteworthy that intersectoral measures are fundamental in the development of integral care for tuberculosis patients in the context of Primary Health Care.Se trata de un estudio de abordaje cualitativo, cuyo objetivo fue analizar el desempeno de los equipos de Salud de la Familia en el control de la tuberculosis segun la relacion entre vinculo y desarrollo de acciones intersectoriales en un municipio de la region metropolitana de Joao Pesoa, en el estado de Paraiba, en Brasil. Para la construccion del material empirico fue utilizada la tecnica de grupo focal. Siete grupos focales fueron realizados, envolviendo 37 profesionales de los equipos de Salud de la Familia. Para el analisis, se utilizo la tecnica de analisis del discurso. Se concluye que la escasez de acciones intersectoriales fragiliza el vinculo entre el enfermo de tuberculosis, su familia y el equipo de Salud de la Familia. Se destaca que las medidas intersectoriales son fundamentales para el desarrollo de un cuidado integral al enfermo de tuberculosis en el ambito de la Atencion Basica a la Salud.Trata-se de estudo de abordagem qualitativa, cujo objetivo foi analisar o desempenho das equipes de Saude da Familia no controle da tuberculose, segundo a relacao entre vinculo e o desenvolvimento de acoes intersetoriais, em municipio da regiao metropolitana de Joao Pessoa, Paraiba, Brasil. Para a construcao do material empirico, foi utilizada a tecnica de grupo focal. Sete grupos focais foram realizados, envolvendo 37 profissionais das equipes de Saude da Familia. Para analise, utilizou-se a tecnica de analise do discurso. Conclui-se que a escassez de acoes intersetoriais fragiliza o vinculo entre o doente de tuberculose, sua familia e a equipe de Saude da Familia. Destaca-se que medidas intersetoriais sao fundamentais para o desenvolvimento de cuidado integral ao doente de tuberculose, no âmbito da Atencao Primaria a Saude.

The concepts of bonding and the relation with tuberculosis control

El estudio analiza las concepciones de vinculo que orientan las practicas de los Equipos de Salud de la Familia (ESF) con relacion a las medidas de control de la Tuberculosis (TB) en el ambito de la APS, en el municipio de Bayeux-PB/Brasil. Mediante un abordaje cualitativo, en que participaron 37 profesionales de la salud, siendo los datos recolectados por la tecnica de grupo focal, en abril de 2007 y analizados conforme el analisis del discurso. Las concepciones de las ESF sobre el vinculo revelaron coherencia con los conceptos teoricos estudiados, siendo evidenciados, en la relacion equipo/enfermo: confianza, compromiso, intimidad, y responsabilidad. Aspectos de potenciacion del vinculo: el tiempo de actuacion de la ESF en la comunidad; numero de consultas y visitas domiciliares, participacion en el control de la TB. Fragilidades en el vinculo: insuficiencia de medidas intersectoriales, situacion socioeconomica del enfermo, abandono de la familia. Destacamos la necesidad de efectuar cambios que fortalezcan la relacion ESF/enfermo y de ese modo, concretice en lo cotidiano de los servicios de salud, un cuidado fundamentado en la integralidad.This study analyzed the concepts of bonding that guide the practice of Family Health Program (FHP) teams in terms of tuberculosis (TB) control measures in the public health setting, in the city of Bayeux, Paraiba, Brazil. Using a qualitative approach, the study involved 37 health care professionals. Data collection took place using the focal group technique, in April 2007. Data analysis was performed based on discourse analysis. It was observed that FHP team concepts about attachment were in agreement with the studied theoretical concepts, with evidences of trust, commitment, intimacy, and responsibility in the team/patient relationship. The following aspects strengthen the bond: the time that FHP teams work in the community; the number of home visits and consultations and the involvement with TB control. Bond weaknesses: insufficient intersectorial measures, the patients socioeconomic situation, and family abandonment. It is emphasized that there is a need for changes that would strengthen the relationship between the FHP team/patient. This way there would be a concrete care founded on the integrality of health care service routine.This study analyzed the concepts of bonding that guide the practice of Family Health Program (FHP) teams in terms of tuberculosis (TB) control measures in the public health setting, in the city of Bayeux, Paraiba, Brazil. Using a qualitative approach, the study involved 37 health care professionals. Data collection took place using the focal group technique, in April 2007. Data analysis was performed based on discourse analysis. It was observed that FHP team concepts about attachment were in agreement with the studied theoretical concepts, with evidences of trust, commitment, intimacy, and responsibility in the team/patient relationship. The following aspects strengthen the bond: the time that FHP teams work in the community; the number of home visits and consultations and the involvement with TB control. Bond weaknesses: insufficient intersectorial measures, the patients socioeconomic situation, and family abandonment. It is emphasized that there is a need for changes that would strengthen the relationship between the FHP team/patient. This way there would be a concrete care founded on the integrality of health care service routine

A PROPÓSITO DA DIVERSIDADE, CULTURA E SAÚDE MENTAL: NOVAS DIMENSÕES PARA A COMPREENSÃO DA LOUCURA

The authors discuss psychiatric models, highlighting in Brazil the perspectives of the Psychiatric Reform and the defense of deinstitutionalization of illness and of the individual considered mentally ill. It is assumed that the meaning of insanity is broader and deeper than its cut just as mental illness. In this regard, it is noteworthy that the understanding of this trend requires taking into consideration the different dimensions of reality, among those are: epistemology, legal-policy, technical assistance and socio-cultural dimension. Therefore, institutional changes such as those expected with the emancipatory psychiatric reform, cannot be only marginal, cosmetic, or pointed to technical specificities, but must necessarily encompass the ideological aspects of power, resulting in the production of conditions for dialogue on topics still misunderstood in their complexity such as madness. DESCRIPTORS: Mental Health. Psychiatry. Health Care Reform.

TRATAMENTOS SUPERVISIONADO E AUTOADMINISTRADO: ANÁLISE COMPARATIVA ENTRE AS PROPORÇÕES DE CURA, ABANDONO E ÓBITO POR TUBERCULOSE EM JOÃO PESSOA/PB

Objective: To evaluate the proportions of healing, abandonment and death by tuberculosis in Joao Pessoa, PB, and to compare these rates according to the type of treatment instituted: supervised or self-administered. Methods: This was a retrospective cohort study with quantitative data retrieved from the Information System for Notifiable Diseases in the period 2007-2009. The sample consisted of 786 cases undergoing one of the two treatment modalities (supervised and self-administered). These data were compared regarding the rates of healing, abandonment and death by tuberculosis. The Hypothesis Test for Equality of Proportions was carried out on the R console version 2.10.1, with a significance level of 5%. This research followed ethical requirements and was approved by the Research Ethics Committee at the Lauro Wanderley University Hospital, Federal University of Paraiba, under protocol n. 033/10. Results: The proportions of healing decreased and those of abandonment and death by tuberculosis increased. Most patients underwent self-administrated treatment (64.7%). Although there were better proportions of healing, abandonment and death for the patients undergoing selfadministered treatment, these differences were not significant (p-value>0.05), resulting in rates statistically equivalents. Conclusions: It is necessary to intensify the actions targeting the consolidation of the supervised treatment as a strategy to increase healing rates and decrease abandonment and death cases by tuberculosis. DESCRIPTORS; Public Health. Tuberculosis. Comparative Study.

Acciones intersectoriales y vínculo en el control de la tuberculosis en la Salud de la Familia

This is a qualitative study which aims to analyze the performance of the Family Health teams in the control of tuberculosis according to the relationship between bonding and the development of intersectoral actions in the metropolitan region of João Pessoa, Paraíba, Brazil. To construct the empirical material focus group techniques were used. Seven focus groups were conducted, involving 37 professionals of the Family Health teams. For analysis, the discourse analysis technique was used. It was concluded that the lack of intersectoral action weakens the bond between tuberculosis patients, their families and the Family Health team. It is noteworthy that intersectoral measures are fundamental in the development of integral care for tuberculosis patients in the context of Primary Health Care.Se trata de un estudio de abordaje cualitativo, cuyo objetivo fue analizar el desempeno de los equipos de Salud de la Familia en el control de la tuberculosis segun la relacion entre vinculo y desarrollo de acciones intersectoriales en un municipio de la region metropolitana de Joao Pesoa, en el estado de Paraiba, en Brasil. Para la construccion del material empirico fue utilizada la tecnica de grupo focal. Siete grupos focales fueron realizados, envolviendo 37 profesionales de los equipos de Salud de la Familia. Para el analisis, se utilizo la tecnica de analisis del discurso. Se concluye que la escasez de acciones intersectoriales fragiliza el vinculo entre el enfermo de tuberculosis, su familia y el equipo de Salud de la Familia. Se destaca que las medidas intersectoriales son fundamentales para el desarrollo de un cuidado integral al enfermo de tuberculosis en el ambito de la Atencion Basica a la Salud.Trata-se de estudo de abordagem qualitativa, cujo objetivo foi analisar o desempenho das equipes de Saude da Familia no controle da tuberculose, segundo a relacao entre vinculo e o desenvolvimento de acoes intersetoriais, em municipio da regiao metropolitana de Joao Pessoa, Paraiba, Brasil. Para a construcao do material empirico, foi utilizada a tecnica de grupo focal. Sete grupos focais foram realizados, envolvendo 37 profissionais das equipes de Saude da Familia. Para analise, utilizou-se a tecnica de analise do discurso. Conclui-se que a escassez de acoes intersetoriais fragiliza o vinculo entre o doente de tuberculose, sua familia e a equipe de Saude da Familia. Destaca-se que medidas intersetoriais sao fundamentais para o desenvolvimento de cuidado integral ao doente de tuberculose, no âmbito da Atencao Primaria a Saude.

Los conceptos de enlace y la relación con el control de la tuberculosis

El estudio analiza las concepciones de vinculo que orientan las practicas de los Equipos de Salud de la Familia (ESF) con relacion a las medidas de control de la Tuberculosis (TB) en el ambito de la APS, en el municipio de Bayeux-PB/Brasil. Mediante un abordaje cualitativo, en que participaron 37 profesionales de la salud, siendo los datos recolectados por la tecnica de grupo focal, en abril de 2007 y analizados conforme el analisis del discurso. Las concepciones de las ESF sobre el vinculo revelaron coherencia con los conceptos teoricos estudiados, siendo evidenciados, en la relacion equipo/enfermo: confianza, compromiso, intimidad, y responsabilidad. Aspectos de potenciacion del vinculo: el tiempo de actuacion de la ESF en la comunidad; numero de consultas y visitas domiciliares, participacion en el control de la TB. Fragilidades en el vinculo: insuficiencia de medidas intersectoriales, situacion socioeconomica del enfermo, abandono de la familia. Destacamos la necesidad de efectuar cambios que fortalezcan la relacion ESF/enfermo y de ese modo, concretice en lo cotidiano de los servicios de salud, un cuidado fundamentado en la integralidad.This study analyzed the concepts of bonding that guide the practice of Family Health Program (FHP) teams in terms of tuberculosis (TB) control measures in the public health setting, in the city of Bayeux, Paraiba, Brazil. Using a qualitative approach, the study involved 37 health care professionals. Data collection took place using the focal group technique, in April 2007. Data analysis was performed based on discourse analysis. It was observed that FHP team concepts about attachment were in agreement with the studied theoretical concepts, with evidences of trust, commitment, intimacy, and responsibility in the team/patient relationship. The following aspects strengthen the bond: the time that FHP teams work in the community; the number of home visits and consultations and the involvement with TB control. Bond weaknesses: insufficient intersectorial measures, the patients socioeconomic situation, and family abandonment. It is emphasized that there is a need for changes that would strengthen the relationship between the FHP team/patient. This way there would be a concrete care founded on the integrality of health care service routine.This study analyzed the concepts of bonding that guide the practice of Family Health Program (FHP) teams in terms of tuberculosis (TB) control measures in the public health setting, in the city of Bayeux, Paraiba, Brazil. Using a qualitative approach, the study involved 37 health care professionals. Data collection took place using the focal group technique, in April 2007. Data analysis was performed based on discourse analysis. It was observed that FHP team concepts about attachment were in agreement with the studied theoretical concepts, with evidences of trust, commitment, intimacy, and responsibility in the team/patient relationship. The following aspects strengthen the bond: the time that FHP teams work in the community; the number of home visits and consultations and the involvement with TB control. Bond weaknesses: insufficient intersectorial measures, the patients socioeconomic situation, and family abandonment. It is emphasized that there is a need for changes that would strengthen the relationship between the FHP team/patient. This way there would be a concrete care founded on the integrality of health care service routine