Lívia Cozer Montenegro

Diálogos entre a arte e a educação: uma experiência no ensino da disciplina de administração em saúde

En este estudio se describe una experiencia vivida en la ensenanza de la asignatura Administracion en Salud, en el curso de enfermeria, la cual fue mediada por el libro - Las Intermitencias de la Muerte de Jose Saramago. Se discute sobre el desarrollo de la autonomia, el potencial creativo y la capacidad de abstraccion en la formacion de enfermeros, a traves de la interfaz entre arte y educacion. Su objetivo es reflexionar sobre las posibilidades de aprendizaje usando las expresiones del arte, asi como analizar la experiencia de la ensenanza de la gestion del Sistema Publico de Salud en dialogo con el arte y la educacion. La experiencia vivida indica que la interfaz entre la produccion academica, la teorizacion de las practicas, la creatividad, la abstraccion etica y estetica produce sentidos de aprendizaje que van mas alla de la racionalidad instrumental, lo que contribuye a la formacion de ciudadanos y profesionales de salud.

Representações sociais de discentes de graduação em enfermagem sobre "ser enfermeiro"

Este estudio tuve como objetivo analizar las estructuras de las representaciones sociales sobre ¨ser enfermero¨ de 430 alumnos de Enfermeria de cinco Instituciones de Ensenanza Superior privadas de la ciudad de Belo Horizonte-MG, creadas en el periodo de 2003 a 2004. La recogida de datos ocurrio en el periodo de 2003 a 2004, usandose la tecnica de evocacion libre; los datos fueron procesados por el software EVOC (version 2003) y analizados por la tecnica del cuadro de cuatro casas. Los elementos del nucleo central fueron los terminos cuidar y responsabilidad, y los elementos perifericos fueron gestionar, profesionalismo, trabajo, realizacion, atencion y respecto. Los resultados muestran que la carga historica de la Enfermeria aun persiste, influenciando el saber y el hacer especifico, ligado a los sentimientos y comportamientos valorados y norteados por aspectos humanos, eticos e religiosos.

A integralidade sob a ótica dos profissionais dos Serviços de Saúde de Belo Horizonte

The objective of this qualitative case study was to present the understanding that health care workers and administrators of Belo Horizonte have about comprehensive care. Thirty-two workers were interviewed using a semi-structured questionnaire. Data analysis showed that comprehensiveness permeates the various levels of health care, adding the concept of health promotion. Interdisciplinary work emerges as a key element for the health care practice, which is made effective by sharing feelings. On the other hand, data show that comprehensive health care is only made effective provided that basic conditions are present, and services often do not provide those conditions. In conclusion, it is necessary to eliminate the fragmentations that exist in the form of health care organization as well as in the everyday practice of health care workers at the referred services so that it is possible to offer comprehensive, problem-solving care and humanize health care practices always aiming at the quality of life of the population.Trata-se de estudo de caso qualitativo, com o objetivo de apresentar a compreensao sobre integralidade para os profissionais e gestores que atuam em servicos de saude de Belo Horizonte. Foram entrevistados 32 profissionais a partir de um roteiro semiestruturado. A analise dos dados mostrou que os diferentes niveis de atencao perpassam a integralidade, agregando a nocao de promocao a saude. O trabalho interdisciplinar emerge como elemento fundamental para esta pratica, que se concretiza por meio de compartilhamento de sentimentos. Em contrapartida, os dados mostram que as praticas de integralidade so se concretizam em condicoes basicas, que os servicos muitas vezes nao oferecem. Conclui-se que e preciso eliminar as fragmentacoes presentes tanto na forma de organizacao dos servicos de saude quanto nas praticas cotidianas dos profissionais que atuam nesses servicos, para oferecer uma assistencia integral, resolutiva, e humanizar as praticas de saude, visando sempre a qualidade de vida da populacao.

ORGANIZAÇÃO DAS REDES DE ATENÇÃO À SAÚDE NA PERSPECTIVA DE PROFISSIONAIS DA ATENÇÃO DOMICILIAR

Trata-se de um estudo de caso qualitativo, cujo objetivo foi compreender a organizacao da rede de atencao a saude na perspectiva de profissionais que atuam na atencao domiciliar. Para a coleta de dados, foram realizadas entrevistas, com roteiro semiestruturado, com sete profissionais que trabalham na atencao domiciliar. Por meio da analise de conteudo, foi possivel identificar as seguintes categorias empiricas: Percepcao dos profissionais da atencao domiciliar sobre seu trabalho no contexto da rede de atencao a saude; Dificuldades para a articulacao do Programa de atencao Domiciliar com os outros servicos da rede; e Oportunidades para a articulacao entre os servicos de saude a partir do Programa de Atencao Domiciliar. Conclui-se que o trabalho desenvolvido no Programa de Atencao Domiciliar possui interface com outros pontos da rede de atencao a saude, sendo considerado significativo para se efetivar os principios doutrinarios do Sistema Unico de Saude.The aim of this qualitative case study is to analyze how the health system is organized from the perspective of homecare professionals. Data was collected by means of semi-structured interviews with seven professionals that provide home healthcare services. Content analysis revealed the following empirical categories: Perception of home care professionals in relation to their work and the health system; Difficulties in articulating the Home Care Program with other services of the health system; and, Opportunities to articulate the various health services with the Home Care Program. Results indicate that the work conducted in the Home Care Program significantly interfaces with other health service programs, and is considered important to implement principles of the National Health Service.

Comprehensive care from the perspective of health care workers from Belo Horizonte

The objective of this qualitative case study was to present the understanding that health care workers and administrators of Belo Horizonte have about comprehensive care. Thirty-two workers were interviewed using a semi-structured questionnaire. Data analysis showed that comprehensiveness permeates the various levels of health care, adding the concept of health promotion. Interdisciplinary work emerges as a key element for the health care practice, which is made effective by sharing feelings. On the other hand, data show that comprehensive health care is only made effective provided that basic conditions are present, and services often do not provide those conditions. In conclusion, it is necessary to eliminate the fragmentations that exist in the form of health care organization as well as in the everyday practice of health care workers at the referred services so that it is possible to offer comprehensive, problem-solving care and humanize health care practices always aiming at the quality of life of the population.Trata-se de estudo de caso qualitativo, com o objetivo de apresentar a compreensao sobre integralidade para os profissionais e gestores que atuam em servicos de saude de Belo Horizonte. Foram entrevistados 32 profissionais a partir de um roteiro semiestruturado. A analise dos dados mostrou que os diferentes niveis de atencao perpassam a integralidade, agregando a nocao de promocao a saude. O trabalho interdisciplinar emerge como elemento fundamental para esta pratica, que se concretiza por meio de compartilhamento de sentimentos. Em contrapartida, os dados mostram que as praticas de integralidade so se concretizam em condicoes basicas, que os servicos muitas vezes nao oferecem. Conclui-se que e preciso eliminar as fragmentacoes presentes tanto na forma de organizacao dos servicos de saude quanto nas praticas cotidianas dos profissionais que atuam nesses servicos, para oferecer uma assistencia integral, resolutiva, e humanizar as praticas de saude, visando sempre a qualidade de vida da populacao.

Potentialities of Atlas.ti for Data Analysis in Qualitative Research in Nursing

ATLAS.ti is a program used to organize and manage qualitative research data. The present study aims at describing the application of ATLAS.ti in two instances, highlighting its potentialities and limitations for data analysis. This is a user experience of ATLAS.ti (Archivfuer Technik Lebensweltund Alltagssprache) for the analysis of qualitative data of a dissertation and a thesis in nursing. The software proved to be an efficient tool to organize, capture and analyse data; it provided the researchers with an overview of the findings during the analytical process and helped in the optimization of time. Its limitations relate to difficulties concerning characteristics of the data analysis method, the need for training and purchasing of the program. The authors concluded that ATLAS.it an important tool for data analysis in qualitative research.

Experiences of Moral Distress in Nurses’ Daily Work

Background: Moral distress in the work of nurses has been an emerging ethical problem in the different levels of complexity in the Brazilian scenario. Objective: raise the situations perceived by nurses working in different health services across the country, as generators of moral distress. Methods: This is a descriptive study of quantitative approach, of survey type. The study was developed with 771 nurses that working in health services of different levels of complexity in the Brazilian scenario. The data were collected in open instrument, they were asked to identify work situations triggering potential mental distress/suffering. Data were statistically analyzed using SPSS statistical software and later organized in tables at the 2010 version of Excel®. Findings: In the survey, were cited 2304 situations of Moral Distress. The situations involve Working Conditions; Professional Relations; Professional Competence; Quality of Care; Access; Labor Organization and Conflict. Conclusions: it becomes important to reflect on the role of the nurse and the development of an ethical and autonomous practice in their daily tasks, given that moral distress deprived nurses from their roles.

Social representations of Nursing students about "being nurse"

Este estudio tuve como objetivo analizar las estructuras de las representaciones sociales sobre ¨ser enfermero¨ de 430 alumnos de Enfermeria de cinco Instituciones de Ensenanza Superior privadas de la ciudad de Belo Horizonte-MG, creadas en el periodo de 2003 a 2004. La recogida de datos ocurrio en el periodo de 2003 a 2004, usandose la tecnica de evocacion libre; los datos fueron procesados por el software EVOC (version 2003) y analizados por la tecnica del cuadro de cuatro casas. Los elementos del nucleo central fueron los terminos cuidar y responsabilidad, y los elementos perifericos fueron gestionar, profesionalismo, trabajo, realizacion, atencion y respecto. Los resultados muestran que la carga historica de la Enfermeria aun persiste, influenciando el saber y el hacer especifico, ligado a los sentimientos y comportamientos valorados y norteados por aspectos humanos, eticos e religiosos.

Fundamentals and practice of care in Gerontological Nursing

Intense social, economic, political, cultural, environmental, epidemiological, and demographical transformations, coupled with accelerated technological innovation, have significantly affected life in society, requiring people to reflect about the conceptions of human nature itself. This context of transformation has incentivized individuals to value technological advances and the construction of more autonomous, global, and unstable human relationships, outlining a significant existential and sociopolitical dialectic in which individuals wish to live as long as possible, but do not accept the possible unfavorable consequences. In this context, pioneers have attempted to overcome the natural and inherent limitations imposed by the aging process. This sentiment, coupled the new demographic reality with an increasing number of older adults, has demanded health systems to take immediate measures to address the complex demands of “being old” in general and specifically, the promotion of healthy aging. It is necessary to expand specific health services with wide-reaching health promotion and control programs that span the entire life cycle, coupled with social integration programs that aim to provide better quality of life. However, investment in support infrastructure is also necessary, to provide families with support and above all work to transform the exclusion and discrimination suffered by the most fragile. In this direction, the United Nations Population Fund published a report about aging in the 21st century, in which it emphasizes that although many countries have made significant progress in adapting policies and legislation, more efforts are needed to ensure that older adults develop their potentials(1). Considering the experiences of other countries, Brazil is capable of developing effective measures to promote active aging and advance in the consolidation of comprehensive healthcare programs for older adults that recognize the full value of human beings. Nurses represent the highest contingent of professionals in the field of health in Brazil, and as such, they are responsible for providing concrete answers to health care for older adults and their families. The work process in primary health care to older adults is aimed at the specificities of this population, establishing relationships, and creating bonds with older adults, their families and the community. Given the complex nature of the aging process, nursing practice adopts an interdisciplinary approach and shares interactive, proactive, and dialogical attitudes when addressing health problems to conduct whatever improvement possible to the quality of life and wellbeing of older adults. As an emerging specialty in Brazil, gerontological nursing has strived to consolidate its practice based on a theoretical-conceptual framework that considers different lifestyles, understanding that each implies different aging processes. In this perspective, Gonçalves, Alvarez and Santos(2) pointed to the need of developing care-educational actions with older adults, such as: caring for the life and health of older adults, especially the health-illness process; preventing health complications; recovery and rehabilitation; and ongoing care in chronic situations and end-of-life care. Thus, gerontological nursing actions can be conducted in any health service, whether public or private, and at all complexity levels, ranging from home care to long-stay institutions for older adults. Due to its extension and complexity, gerontological nursing faces challenges to its work processes, but also presents innovative Fundamentals and practice of care in Gerontological Nursing

Collegiate management in inpatient pediatric unit from health professionals perspective

Resumo Os hospitais compõem o nível terciário da Rede de Atenção à Saúde, os quais englobam conjuntos de procedimentos que, no contexto do Sistema Único de saúde, envolve alta tecnologia e alto custo e integra os demais níveis de atenção à saúde. Dessa forma, a constituição de uma rede de serviços implica um novo modelo de gestão cujos pressupostos estejam voltados para a qualidade da assistência nos diferentes níveis de atenção à saúde. Um dos modelos de gestão que favorece a descentralização e a participação dos profissionais é o modelo de gestão colegiada. Assim, o objetivo do estudo foi conhecer a gestão colegiada na perspectiva de profissionais de uma unidade de internação pediátrica de um hospital universitário. Para tal, foi realizada uma pesquisa qualitativa, analítico-descritiva com 16 profissionais de diferentes categorias de um Hospital Universitário em Minas Gerais. A coleta de dados deu-se por meio de entrevistas com roteiro semiestruturado, as quais foram submetidos à Análise de Conteúdo. Percebeu-se que os profissionais consideram que a gestão colegiada possui entraves, são eles: falha na comunicação entre os profissionais e entre eles e a diretoria; reuniões pouco frequentes; falta de repasse e compartilhamento das informações e de participação da diretoria e; dificuldade de realizar o trabalho em equipe. Em contrapartida, o trabalho em equipe é efetivo nos projetos multiprofissionais. Conclui-se que a gestão colegiada acontece em um meio corporativista e pouco democrático, demonstrando a necessidade de transformação da cultura organizacional para que ela seja participativa.