Cristina Maria Meira de Melo

A prática da enfermeira em auditoria em saúde.

El objetivo de la investigacion es conocer la practica de la enfermera en la auditoria de salud. La concepcion de analisis adoptada fue la de la hermeneutica-dialectica, y se desarrollo en tres locales: la auditoria interna de una organizacion hospitalaria, la auditoria externa de un comprador privado de servicios de salud y el sistema de auditoria del ambito estatal del Sistema Unico de Salud (SUS) en Bahia, Brasil. Fueron entrevistadas nueve enfermeras auditoras. En la auditoria del SUS, las enfermeras expresaron satisfaccion en el ejercicio de esta practica y en la valorizacion de su papel profesional. En la auditoria privada - interna y externa a las organizaciones de salud - las acciones de las enfermeras estan dirigidas a atender los intereses de sus contratantes, y poco se relacionan con la asistencia prestada por el equipo de enfermeria y con las necesidades de los usuarios de los servicios.

Avaliação da descentralização da vigilância epidemiológica para a Equipe de Saúde da Família

The aim of this study is to evaluate the decentralization of Epidemiologic Surveillance actions to the Family Health Program in a city in the state of Bahia, Brazil. The research was conducted as a case study, using adapted techniques of thematic and evaluative analysis. In face of the need to adopt a model for this analysis, it was decided to adopt the political model of implantation analysis. The primary data were collected in semi-structured interviews with managers of the local Health Department and the Family Health Team and the secondary data through document analysis. The study demonstrated that Epidemiologic Surveillance is understood in three ways: as a kind of medical police action; as an instrument of surveillance focused on the control of transmissible diseases and as surveillance addressing the risk of damages. As refers to the capacity of intervention, although mainly directed to disease detection and control, the performance of the Family Health Team was found positive. We conclude that it is possible to decentralize Epidemiologic Surveillance to the Family Health Program but the effective implantation of this process will depend on the support of health managers and professionals and on a political project assuming the decentralization of epidemiologic survey a strategy towards reorganization of the healthcare system in the city.

Saúde mental e trabalho: significados e limites de modelos teóricos

This text is a revision of the most important theoretical approaches that fundament the studies about Mental Health and Work, pointing to the basic concepts, categories of analyses and respective limits. The objective is to underline some conceptions about the theme, in the attempt to contribute with a way to face the problems, questions and difficulties imposed by the construction of this object of study. Thus, the text is based on the critical review of theoretical paradigms that predominate in studies about Mental Health and Work. Finally, it indicates some important theoretical questions about the relation between mental health and work.Este texto se constituye en una revision de las principales aproximaciones teoricas que fundamentan los estudios sobre la Salud Mental y Trabajo (SMT), apuntando sus conceptos basicos, categorias de analisis y respectivos limites. Propone ofrecer algunos balizamientos conceptuais acerca de la tematica SMT, en la tentativa de ecuacionar problemas, cuestiones y desafios colocados por la construccion del objeto de estudio. Para tal, el texto se apoya en la revision critica de algunos paradigmas teoricos predominantes en los estudios acerca de la SMT. Finaliza apuntando cuestiones teoricas importantes sobre las relaciones entre la salud mental de los individuos en su mundo de trabajo.

Produção do conhecimento sobre promoção da saúde e prática da enfermeira na Atenção Primária

Esta es revision integradora que analiza la produccion cientifica nacional acerca de la promocion de la salud y practica de la enfermera en la atencion primaria. Con el desarrollo del estudio, se encontro que la discusion de este tema es poco explorada en la enfermeria y que y la promocion de la salud sigue siendo entendida como sinonimo de educacion para la salud y / o de prevencion de enfermedades. Se concluye que la educacion para la salud es una estrategia esencial para el logro de promocion de la salud, con el entendimiento de que una no se limita a otra. Tambien es necesario que las enfermeras reconocen la promocion de la salud como un campo de praxis que puede transformar la realidad social y su propia practica.This is an integrative review that examines the national scientific production on health promotion and nurses practice in the field of primary health care. With the development of the study, it was found that the discussion of this theme is little explored in nursing and that health promotion is still understood as synonymous of health education and / or prevention of disease. It is concluded that health education is an essential strategy to achieve the health promotion, understanding that one is not restricted to the other. Moreover, it is necessary that nurses recognize health promotion as a field of practice can transform social reality and their own practice.

Avaliação da capacidade de gestão descentralizada da vigilância epidemiológica no estado da Bahia

Evaluative research into the capability of decentralized management of epidemiological vigilance (EV) was conducted in the operational, organizational and sustainable dimensions in the state of Bahia, Brazil. The quantitative approach was used in the construction of a baseline, with primary data obtained through an online questionnaire answered by thirty-eight municipal EV managers. In the qualitative approach to analyze the context and assess the management capability of municipalities in two case studies, techniques adapted to the analysis of discursive practices were used. This was done through semi-structured interviews with managers of regional and municipal government, health workers and representatives of the municipal health council. The case studies showed that the municipality with enhanced management capability is that in which the manager has the greatest potential of using the resources of his position, in addition to his ability to control, negotiate and coordinate with other actors. Due to decentralization of EV, considering the shared nature of management between the three spheres of government, there is a marked variation in the management capability of municipalities, determined by social, economic, political inequalities and management mechanisms adopted.

Production of knowledge on health promotion and nurse's practice in Primary Health Care

Esta es revision integradora que analiza la produccion cientifica nacional acerca de la promocion de la salud y practica de la enfermera en la atencion primaria. Con el desarrollo del estudio, se encontro que la discusion de este tema es poco explorada en la enfermeria y que y la promocion de la salud sigue siendo entendida como sinonimo de educacion para la salud y / o de prevencion de enfermedades. Se concluye que la educacion para la salud es una estrategia esencial para el logro de promocion de la salud, con el entendimiento de que una no se limita a otra. Tambien es necesario que las enfermeras reconocen la promocion de la salud como un campo de praxis que puede transformar la realidad social y su propia practica.This is an integrative review that examines the national scientific production on health promotion and nurses practice in the field of primary health care. With the development of the study, it was found that the discussion of this theme is little explored in nursing and that health promotion is still understood as synonymous of health education and / or prevention of disease. It is concluded that health education is an essential strategy to achieve the health promotion, understanding that one is not restricted to the other. Moreover, it is necessary that nurses recognize health promotion as a field of practice can transform social reality and their own practice.

Mental health and work: meanings and limits of theoretical models

This text is a revision of the most important theoretical approaches that fundament the studies about Mental Health and Work, pointing to the basic concepts, categories of analyses and respective limits. The objective is to underline some conceptions about the theme, in the attempt to contribute with a way to face the problems, questions and difficulties imposed by the construction of this object of study. Thus, the text is based on the critical review of theoretical paradigms that predominate in studies about Mental Health and Work. Finally, it indicates some important theoretical questions about the relation between mental health and work.Este texto se constituye en una revision de las principales aproximaciones teoricas que fundamentan los estudios sobre la Salud Mental y Trabajo (SMT), apuntando sus conceptos basicos, categorias de analisis y respectivos limites. Propone ofrecer algunos balizamientos conceptuais acerca de la tematica SMT, en la tentativa de ecuacionar problemas, cuestiones y desafios colocados por la construccion del objeto de estudio. Para tal, el texto se apoya en la revision critica de algunos paradigmas teoricos predominantes en los estudios acerca de la SMT. Finaliza apuntando cuestiones teoricas importantes sobre las relaciones entre la salud mental de los individuos en su mundo de trabajo.

Subsídios para avaliação da gestão pública: processo de construção de indicadores para avaliação da capacidade de gestão de organizações sociais

The project for the reform of the administration of the Brazilian state highlighted the question of evaluation within public organizations. This study systematized the process of elaboration of a methodological proposal to evaluate the management capacity of non-state owned, public social organizations created within the framework of the reform. The objective was to define a conceptual guide for management and to define its dimensions. A selected set of variables, indicators and parameters was constructed, as well as a means of verification and the data necessary to feed the information processing system. The proposal presents a plan for analyzing the results. In the final comments, the authors argue that the conceptual choices and procedural decisions aim to produce a design of evaluation that should guarantee the reliability and sensitivity of results in their proximity to the phenomenon being evaluated, the applicability of the instrument and its reproducibility in different contexts.

Discutindo a avaliação de um programa de capacitação para enfermeiros

o artigo discute a pertinencia de atividades de treinamento desenvolvidas no setor saude, com base em uma experiencia concreta avaliada pelas autoras. Aponta e discute os elementos considerados relevantes para a introducao de treinamentos para trabalhadores da saude que pretendam contribuir no desenvolvimento de competencias e que ultrapassem a mera dimensao de adestramento para tarefas especificas. Distingue as dificuldades existentes tanto na utilizacao do treinamento como parte do processo de desenvolvimento de pessoas, bem como as dificuldades no processo de transferencia dos conhecimentos adquiridos no processo de trabalho.This article discusses the property of training activities developed in health sector, based on the authors experiences. It tries to evidence the most important aspects to introduce health workers training getting ahead mere especifical work dimention. It also intends to discuss the importance of this training as a part of the process for people improvement as well as for the knowledge transference process.

Nurses' practice in health audit

El objetivo de la investigacion es conocer la practica de la enfermera en la auditoria de salud. La concepcion de analisis adoptada fue la de la hermeneutica-dialectica, y se desarrollo en tres locales: la auditoria interna de una organizacion hospitalaria, la auditoria externa de un comprador privado de servicios de salud y el sistema de auditoria del ambito estatal del Sistema Unico de Salud (SUS) en Bahia, Brasil. Fueron entrevistadas nueve enfermeras auditoras. En la auditoria del SUS, las enfermeras expresaron satisfaccion en el ejercicio de esta practica y en la valorizacion de su papel profesional. En la auditoria privada - interna y externa a las organizaciones de salud - las acciones de las enfermeras estan dirigidas a atender los intereses de sus contratantes, y poco se relacionan con la asistencia prestada por el equipo de enfermeria y con las necesidades de los usuarios de los servicios.