Kênia Lara Silva

Integralidade do cuidado na saúde: indicações a partir da formação do enfermeiro

This study has the objective of understanding the training of nurses for comprehensive health care. It used data from interviews with teachers, students and service nurses submitted to discourse analysis. There is an understanding of comprehensive care in the training of nurses from the perspective of establishing a healthcare model in which care is directed to the patient. There are reflections regarding the technologies and the form of organization of the work, expressed in a permanent tension: Clinical versus Collective Health as a challenge for comprehensive care. It was identified that building completeness in the formation implies assuming acting in health as an educative principle in a new form of learning-teaching in health, which breaks up with preformed, out-of-context knowledge. The conclusion is that comprehensive health care is taken as an object of reflection in the movement for change in the pedagogical practices, and that it is reflected in health attention.This study has the objective of understanding the training of nurses for comprehensive health care. It used data from interviews with teachers, students and service nurses submitted to discourse analysis. There is an understanding of comprehensive care in the training of nurses from the perspective of establishing a healthcare model in which care is directed to the patient. There are reflections regarding the technologies and the form of organization of the work, expressed in a permanent tension: Clinical versus Collective Health as a challenge for comprehensive care. It was identified that building completeness in the formation implies assuming acting in health as an educative principle in a new form of learning-teaching in health, which breaks up with pre-formed, out-of-context knowledge. The conclusion is that comprehensive health care is taken as an object of reflection in the movement for change in the pedagogical practices, and that it is reflected in health attention.

Nursing education: seeking critical-reflexive education and professional competencies

The study describes changes that are noted in students during training and which contribute to define a professional profile. We carried out a descriptive-exploratory study with a qualitative approach, based on dialectics as a theoretical-methodological framework. The data was obtained from documented analysis and through focal groups with teachers, students and service nurses. The results show the student’s position as an active subject in the teaching-learning process, through a movement of transformation of academic structures. A correlation was found between the movement that seeks students’ greater political, active and critical participation as a way of determining and guiding the profile of the generalist nurse and greater social insertion. We conclude that, despite efforts, training guidelines and the definition of the professional profile in the study settings is directed at the demands of the labor market, and that competency-based training is still incipient.

Formação do Enfermeiro: desafios para a promoção da saúde

Estudo qualitativo, descritivo-exploratorio, realizado em dois cursos de Enfermagem com o objetivo de analisar os referenciais de promocao da saude na formacao do enfermeiro. Foram entrevistados 19 coordenadores, docentes, estudantes e profissionais de servicos envolvidos na formacao do enfermeiro. Os resultados indicam imprecisao conceitual entre promocao da saude e prevencao de agravos na formacao do enfermeiro. As concepcoes de promocao da saude reveladas estao associadas a praticas que incidem sobre qualidade de vida sustentada em um conceito amplo e complexo de saude e que sao incipientes nos cenarios da atencao a saude. Conclui-se que a promocao da saude e tomada como decisao politica para mudanca na formacao do enfermeiro, explicitada nos projetos pedagogicos das instituicoes cenario do estudo. Entretanto, esta incorporacao e incipiente e heterogenea quanto a formulacao teorica, indicando a necessidade de ampliacao dos espacos de analise conceitual nas relacoes que proporcionam a producao de saude e do processo formativo.This was a descriptive/exploratory study of qualitative character carried out in two Nursing Schools in the State of Minas Gerais. The goal was to analyze the referential of nurses regarding health promotion. Nineteen course coordinators, faculty members, students and professionals of the health services involved in nurse training were interviewed. The results indicate a conceptual imprecision about health promotion and disease prevention. Revealed conceptions of health-promoting practices are associated to practices that affect the quality of life, which lies on a broad and complex concept of health, and are incipient in the current health care scenario. The conclusion is that health promotion is taken as political decision for a change in nurse training, as made explicit in the pedagogical projects of the institutions taking part in the study. However, such incorporation is incipient and heterogeneous in terms of its theoretical formulation, thus indicating the need for widening the space for a conceptual analysis in the relations that allow for the production of health and of a training process.

A EDUCAÇÃO DE ENFERMAGEM: BUSCANDO A FORMAÇÃO CRÍTICO-REFLEXIVA E AS COMPETÊNCIAS PROFISSIONAIS

The study describes changes that are noted in students during training and which contribute to define a professional profile. We carried out a descriptive-exploratory study with a qualitative approach, based on dialectics as a theoretical-methodological framework. The data was obtained from documented analysis and through focal groups with teachers, students and service nurses. The results show the student’s position as an active subject in the teaching-learning process, through a movement of transformation of academic structures. A correlation was found between the movement that seeks students’ greater political, active and critical participation as a way of determining and guiding the profile of the generalist nurse and greater social insertion. We conclude that, despite efforts, training guidelines and the definition of the professional profile in the study settings is directed at the demands of the labor market, and that competency-based training is still incipient.

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.

Practices in community health toward equity: contributions of Brazilian nursing.

Although Brazil stands out as the eighth largest economy in the world, this country is burdened by huge social and economic inequalities. One of its greatest contemporary challenges is the construction of social policies, including healthcare, that seek to adjust social, economic, and cultural distortions. In the light of this scenario, Brazilian nursing has an important role in the defense of health with equity and quality of life, taking on a caring-based practice. However, to respond to these challenges in a propositional way, the nursing profession needs to reconsider its role and its purpose.

O processo de mudança na educação de enfermagem nos cenários uni: potencialidades e desafios

This study analyzes changes occurred in the nursing teaching and learning process from Brazilian Schools which pursue the UNI Project, by describing a movement toward change, besides resistance, conflicts, and current challenges involved. It is a qualitative study whose data were gathered by using Focal Groups and documents available in these institutions. Its results show there is a gradual, dynamic and continuous movement toward change, through the search for teaching models that might replace technical rationality with a critical-reflexive proposal. In spite of challenges related to evaluation and individual competencies to overcome resistance and conflicts, we have found that the change process was supported by the creation of participative spaces and horizontal relationships, allowing for a renewed valorization of nursing education.This study analyzes changes occurred in the nursing teaching and learning process from Brazilian Schools which pursue the UNI Project, by describing a movement toward change, besides resistance, conflicts, and current challenges involved. It is a qualitative study whose data were gathered by using Focal Groups and documents available in these institutions. Its results show there is a gradual, dynamic and continuous movement toward change, through the search for teaching models that might replace technical rationality with a critical-reflexive proposal. In spite of challenges related to evaluation and individual competencies to overcome resistance and conflicts, we have found that the change process was supported by the creation of participative spaces and horizontal relationships, allowing for a renewed valorization of nursing education. Descriptors: change process; nursing education; organizational innovation. Title: The changing process in nursing education inside uni-settings: capabilities and challenges

Políticas e práticas de saúde rumo à eqüidade

O texto abordou as desigualdades e a exclusao social em saude e estabeleceu as suas interrelacoes e determinacoes sociais, historicas, culturais e economicas. Apontou as iniquidades, como consequencia das desigualdades na producao e na distribuicao das riquezas expressas em servicos e bens materiais. Discutiu as praticas de gestao no campo da saude, como favorecedoras de equidade, indicando a gestao compartilhada, como uma ferramenta que potencializa os valores de cidadania e respeito a diversidade. Abordou a participacao e o controle social como praticas que promovem equidade nos servicos de saude. Comentou a experiencia da Secretaria Municipal de Politicas Sociais e de Saude de Belo Horizonte com o trabalho em territorios geopoliticos-sociais com praticas de gestao, assistencia e controle social que contribuem para a equidade. Concluiu que, alem das analises e macrointervencoes, e fundamental tomar os espacos micro do trabalho para reflexao e atuacao na construcao da equidade.The text approaches the inequalities and the social exclusion in health establishing its social, historical, cultural and economic inter-relations and determinations. It points to the iniquities as consequence of the inequalities in the production and distribution of the wealth expressed by access to services and material goods. It discusses the practices of management, in the field of the health, as supporters of the equity, indicating the shared management as a tool that promotes the values of citizenship and respect to the diversity. It approaches the participation and the social control as practices that promote equity in the health services. It comments the experience of the Department of Social Politics and Health of Belo Horizonte with the work in geopolitical and social territories with practices of management, assistance and social control that contribute for equity. It concludes that, beyond the analyses and macro interventions, it is basic to take the spaces micro of the work for reflection and performance in the construction of equity.

Promoção da saúde como decisão política para a formação do enfermeiro

It is a descriptive-exploratory study with a qualitative approach that has the objective of analyzing the health promotion in training nurses. The setting of the research was two nursing undergraduate courses in the State of Minas Gerais, Brazil. The results show that both schools used settings favorable to a health promotion approach in this training. They anchor this approach in the need to provide students experiences of learning from an immersion in the reality of professional life. It is prevalent on formation a tension between good educational pratices for health promotion were revealed those become into the daily of the service and practices that arrest the subjects on their ways of thinking. It is concluded that health promotion is recognized as a political decision in nursing education, although this is yet incipient and has a mixed theoretical formulation, indicating the need to increase opportunities for conceptual and operational discussion.It is a descriptive-exploratory study with a qualitative approach that has the objective of analyzing the health promotion in training nurses. The setting of the research was two nursing undergraduate courses in the State of Minas Gerais, Brazil. The results show that both schools used settings favorable to a health promotion approach in this training. They anchor this approach in the need to provide students experiences of learning from an immersion in the reality of professional life. It is prevalent on formation a tension between good educational pratices for health promotion were revealed those become into the daily of the service and practices that arrest the subjects on their ways of thinking. It is concluded that health promotion is recognized as a political decision in nursing education, although this is yet incipient and has a mixed theoretical formulation, indicating the need to increase opportunities for conceptual and operational discussion.

Serviços de atenção domiciliar na saúde suplementar e a inserção da enfermagem em Belo Horizonte/MG

Objective: To evaluate modalities of home care services, discussing the inclusion of nursing. Methods: A qualitative case study conducted with four health plan providers in the city of Belo Horizonte / Minas Gerais (Brazil). Data were obtained from interviews and case management. Results: The home care services are grouped into three modalities: long-term care at home; temporary care at home; and, use of intensive technologies and care. In these modalities, nurses assume care actions, management of the care, and qualifying the care through the appropriate use of soft technologies. There is a trend towards outsourcing of nursing services to home care. Conclusion: The inclusion of the work of nurses in home care modalities represents both a component of cost reduction and contributes to the technological transition by establishing new forms of care at home.ReSuMo Objetivo: Analisar modalidades de servico de atencao domiciliar discutindo a insercao da enfermagem. Metodos: Estudo de caso qualitativo realizado em quatro operadoras de planos de saude no municipio de Belo Horizonte/Minas Gerais. Os dados foram obtidos de entrevistas e acompanhamento de casos. Resultados: Os servicos de atencao domiciliar sao agrupados em tres Modalidades: Cuidados prolongados no domicilio; Atencao provisoria no domicilio e Uso intenso de tecnologias e de cuidados. Nas modalidades, a enfermagem assume acoes assistenciais e de gestao do cuidado e qualifica a atencao por meio do uso apropriado das tecnologias leves. Ha uma tendencia a terceirizacao do servico de enfermagem na atencao domiciliar. Conclusao: A inclusao do trabalho do enfermeiro nas modalidades de atencao domiciliar representa ao mesmo tempo um componente de reducao de custos e contribui para a transicao tecnologica pelo estabelecimento de novas formas de cuidado no domicilio. Descritores: Servicos de assistencia domiciliar; Cuidados de enfermagem; Reducao de custos