Dora Lúcia Leidens Corrêa de Oliveira

A 'nova' saúde pública e a promoção da saúde via educação: entre a tradição e a inovação

In spite of the goals of ‘new’ public health and its emphasis on health promotion as an investment in the autonomy of the ‘public’ to make decisions on health, by means of interventions in its structural conditioning factors, health education in general remains focused on individual responsibility and disease prevention. The article discusses these issues, presenting the main proposals of health promotion that emerged in the 70’s as the main strategy of the so-called ‘new public health’. Based on a literature review, categorized according to the themes of interest for the proposed discussion, the article also analyzes the use of these proposals in the field of health education. The literature search for a theoretical background to support this analysis is justified by the relevance of the discussed issues for nursing practice and the limited production of theoretical approaches about health promotion and health education by nurses. DESCRIPTORS: health promotion; public health; education

EDUCAÇÃO EM SAÚDE: POR QUEM E PARA QUEM? A VISÃO DE ESTUDANTES DE GRADUAÇÃO EM ENFERMAGEM

The objective of this descriptive, exploratory study with a qualitative approach was to analyze the conceptions of Brazilian nursing undergraduates about health education and its subjects and agents. It was developed in the Undergraduate Nursing Courses of the Federal University of Santa Maria and the Federal University of Rio Grande do Sul, Brazil. The research participants were enrolled in their last semester before graduation. Data was collected using a semi-structured interview and submitted to thematic content analysis. The results suggest that health education work is permeated by conceptions that blend traditional and enlarged health education assumptions, although the former are more prevalent. Through this study, one perceives the dominance of conceptions which focus on biomedical knowledge translated through curricular experiences guided by preventive actions that emphasize technical and scientific knowledge and individual behavior changes. DESCRIPTORS: Health education. Health promotion. Education, nursing.The objective of this descriptive, exploratory study with a qualitative approach was to analyze the conceptions of Brazilian nursing undergraduates about health education and its subjects and agents. It was developed in the Undergraduate Nursing Courses of the Federal University of Santa Maria and the Federal University of Rio Grande do Sul, Brazil. The research participants were enrolled in their last semester before graduation. Data was collected using a semi-structured interview and submitted to thematic content analysis. The results suggest that health education work is permeated by conceptions that blend traditional and enlarged health education assumptions, although the former are more prevalent. Through this study, one perceives the dominance of conceptions which focus on biomedical knowledge translated through curricular experiences guided by preventive actions that emphasize technical and scientific knowledge and individual behavior changes.

Vulnerabilidade de puérperas na visão de Equipes de Saúde da Família: ênfase em aspectos geracionais e adolescência

The paper analyzes the emphasis of the professionals of Family Health Teams (FHTs) on adolescent womens puerperium as a period in which women are particularly vulnerable. The adolescent womens special vulnerability in the puerperium period is justified by their way of living, showing a natural tendency to making the adolescence phenomenon something natural. The analysis was performed on some results from a qualitative study performed with FHTs of Santa Maria/RS, which used the focus groups strategy and content analysis. This study adds important contributions to the work of health professionals, indicating and giving visibility to the circumstances and elements implied in the production of adolescent womens vulnerability in the puerperium. Results suggest that a reorientation of education and health promotion practices that goes beyond the informative component are needed. In addition, there is a need to incorporate the vulnerability perspective in the planning of those actions.The paper analyzes the emphasis of the professionals of Family Health Teams (FHTs) on adolescent womens puerperium as a period in which women are particularly vulnerable. The adolescent womens special vulnerability in the puerperium period is justified by their way of living, showing a natural tendency to making the adolescence phenomenon something natural. The analysis was performed on some results from a qualitative study performed with FHTs of Santa Maria/RS, which used the focus groups strategy and content analysis. This study adds important contributions to the work of health professionals, indicating and giving visibility to the circumstances and elements implied in the production of adolescent womens vulnerability in the puerperium. Results suggest that a reorientation of education and health promotion practices that goes beyond the informative component are needed. In addition, there is a need to incorporate the vulnerability perspective in the planning of those actions.

Imaginários da formação em saúde no Brasil e os horizontes da regulação em saúde suplementar

This paper is part of a research into the imaginaries present in the training of health professionals with respect to the regulation and exercise of their profession. The professions selected were medicine, odontology and psychology, for which emerging courses require evaluation by the National Health Council. The imaginaries were understood as operators of the virtual and the real with the potential of affirming or denying forms and contents in relation to being a professional or being in the profession. There was evidence for an imaginary of free exercise of the profession in the public sector on state level, where more experience with diseases and diversities of suffering would be gained. The ideal work place would be the private sector allowing for free choices for both professionals and users, but not without connection to the public sector for providing experience, study opportunities and the possibility of research scholarships and overseas training. Despite the expectations in relation to the private sector, currently there is no education in the field of supplementary care or about the meanings of the regulation proposed by the Brazilian Health System.

The use of focus groups to investigate sensitive topics: an example taken from research on adolescent girls' perceptions about sexual risks

The methodology of focus groups has been increasingly employed in the context of research in the social sciences, particularly in health-related inquiries. Considerations about the sensitive aspects of such research are not, however, very often seen in research reports or discussion on ways of conducting sensitive research. The scope of this paper is to share an experience of conducting focus group research on sensitive topics, such as AIDS, risk and sexual issues, highlighting some methodological issues. More specifically, it suggests ways of working with teenage girls in focus groups about sensitive topics. The advantages of the use of focus groups to explore views on HIV/AIDS and other sexual risks are also discussed. Socio-cultural approaches to risk and feminist thinking permeate the main arguments.

Factors that hinder of integrality in dialysis care

Este artigo teve como objetivo analisar, sob a otica da equipe de saude e dos usuarios, os fatores que podem dificultar a pratica da integralidade do cuidado em uma unidade de hemodialise. Trata-se de pesquisa qualitativa, cujos dados foram coletados por meio de entrevista semiestruturada, com dezesseis profissionais de saude e oito usuarios de um hospital de ensino do Rio Grande do Sul, tendo sido, posteriormente, feita a analise de conteudo tematica. Essa analise sugeriu que, dentre os fatores que dificultam a pratica da integralidade no cuidado em hemodialise, se destacaram deficiencias na rede de servicos, demora no acesso a exames diagnosticos e a consultas com medicos especialistas e reduzido numero de profissionais nas equipes de apoio. Concluiu-se, entao, que a ampliacao na rede de servicos de saude e o estabelecimento de interface efetiva entre os servicos de hemodialise e essa rede poderao representar a superacao das dificuldades apontadas, e, assim, contribuir para a integralidade no cuidado em hemodialise.This study analyzes the factors, which from the perspective of the health team and users, hinder the implementation of integrality in care provided by a dialysis facility. This qualitative study collected data through semi-structured interviews held with 16 health professionals and eight users from a university hospital in Rio Grande do Sul, Brazil. Data were analyzed through thematic content analysis. Among the factors that hinder the implementation of integrality in hemodialysis care, the following were highlighted: a deficient service network, delay in accessing diagnostic exams and consultations with specialists, and a reduced number of professionals in the support team. The conclusion is that the health services network needs to be expanded and an effective interface between such networks and dialysis services needs to be established in order to overcome the reported difficulties and contribute to the implementation of integrality in dialysis care.

Condutas de risco: dos jogos de morte ao jogo de viver.

Resenha da obra: Le Breton D. Condutas de risco: dos jogos de morte ao jogo de viver. Campinas: Autores Associados; 2009

Women's vulnerability in the puerperium from the view of Family Health Teams: emphasis on generational aspects and adolescence

The paper analyzes the emphasis of the professionals of Family Health Teams (FHTs) on adolescent womens puerperium as a period in which women are particularly vulnerable. The adolescent womens special vulnerability in the puerperium period is justified by their way of living, showing a natural tendency to making the adolescence phenomenon something natural. The analysis was performed on some results from a qualitative study performed with FHTs of Santa Maria/RS, which used the focus groups strategy and content analysis. This study adds important contributions to the work of health professionals, indicating and giving visibility to the circumstances and elements implied in the production of adolescent womens vulnerability in the puerperium. Results suggest that a reorientation of education and health promotion practices that goes beyond the informative component are needed. In addition, there is a need to incorporate the vulnerability perspective in the planning of those actions.The paper analyzes the emphasis of the professionals of Family Health Teams (FHTs) on adolescent womens puerperium as a period in which women are particularly vulnerable. The adolescent womens special vulnerability in the puerperium period is justified by their way of living, showing a natural tendency to making the adolescence phenomenon something natural. The analysis was performed on some results from a qualitative study performed with FHTs of Santa Maria/RS, which used the focus groups strategy and content analysis. This study adds important contributions to the work of health professionals, indicating and giving visibility to the circumstances and elements implied in the production of adolescent womens vulnerability in the puerperium. Results suggest that a reorientation of education and health promotion practices that goes beyond the informative component are needed. In addition, there is a need to incorporate the vulnerability perspective in the planning of those actions.

Percepções de enfermeiras obstétricas sobre sua competência na atenção ao parto normal hospitalar

Investiga-se a percepcao de enfermeiras obstetricas sobre sua competencia na atencao ao parto normal (PN) hospitalar. Os dados foram coletados em pesquisa qualitativa, atraves de entrevistas individuais semi-estruturadas, realizadas em um hospital universitario de Porto Alegre, e submetidos a analise de conteudo. A analise foi embasada nos referenciais que definem competencia profissional como a capacidade de mobilizar diferentes conhecimentos, dependendo dos problemas da pratica a resolver. Para as entrevistadas, a competencia para atender o PN hospitalar e multidimensional, embora tenham enfatizado sua dimensao tecnica. Essa enfase e justificada pela inseguranca resultante da falta de espaco para realizarem este atendimento, em funcao de disputas com medicos e deficiencias na formacao. O desejo de serem competentes no atendimento ao PN nao se traduz, porem, na consciencia das suas responsabilidades na transformacao deste cenario. Isso sugere que, para agir nesta direcao, seria necessario, nao so desenvolver competencia tecnica, mas tambem etico-politica.

Repercussões da Lei Maria da Penha no enfrentamento da violência doméstica em Porto Alegre

The current paper sought to analyze the repercussions of Maria da Penha Law on addressing the issue of domestic violence against women in the city of Porto Alegre based on the view of professionals who constitute the care network for those women. Seven professionals, who work with the care for women who are victims of violence, were interviewed. Data suggests that the law has promoted changes in the field of violence prevention, assistance to women and punishment for the perpetrators, and it also increased the attention given to this phenomenon and enhanced female empowerment. It is concluded that the strengthening of the measures recommended by Maria da Penha Law still depends on investments in professional qualification, articulated actions between the places which provide assistance and the growing use of primary care services in order to improve the health of women and families exposed to violence.O presente estudo procurou analisar as repercussoes da Lei Maria da Penha no enfrentamento da violencia domestica contra mulheres, na cidade de Porto Alegre, a partir da visao dos profissionais que constituem a rede de atendimento a elas. Foram entrevistados sete profissionais que atuam na rede de atendimento a mulheres vitimas de violencia. Os dados sugerem que a Lei promoveu mudancas nos campos da prevencao da violencia, da assistencia a mulheres e da punicao aos agressores, com aumento da visibilidade conferida a esse fenomeno e empoderamento feminino. Conclui-se que o fortalecimento das medidas preconizadas pela Lei Maria da Penha ainda depende de investimentos na qualificacao dos profissionais, de acoes articuladas entre os locais de atendimento e de crescente utilizacao da atencao basica para a promocao da saude de mulheres e familias expostas a violencia.