Márcia Niituma Ogata

A comunicação no contexto do acolhimento em uma unidade de saúde da família de São Carlos, SP

Um dos pilares que sustenta a estrategia do acolhimento e a relacao entre os atores envolvidos. Este trabalho teve como objetivos compreender as percepcoes de trabalhadores e usuarios de uma unidade de saude da familia sobre o papel da comunicacao no contexto do acolhimento, e desenvolver acoes educativas que permitissem reflexao e discussao sobre o tema. Utilizamos uma abordagem qualitativa, na modalidade pesquisa-acao. Realizamos a coleta de dados mediante observacao participante e entrevista semi-estruturada. Da analise emergiram cinco categorias: concepcoes de comunicacao, criacao do vinculo, escuta qualificada, comprometimento e espacos coletivos. Nas acoes educativas realizadas, os usuarios explicitaram sua expectativa de contar com profissionais qualificados para uma escuta acolhedora e resolutiva, e os trabalhadores apontaram como fundamental o nivel de comprometimento profissional da equipe. Propomos como um caminho a otimizacao dos espacos existentes por meio da valorizacao de discussoes sobre aspectos relacionais, tal como a comunicacao.

O controle social no Sistema Único de Saúde: concepções e ações de enfermeiras da atenção básica

This study is based on the supposition that the primary health care nurse can perform an important role in the construction of effective social control in the Brazilian Public Heatlh Care System (Sistema Único de Saúde). The objectives of this research are to analyze nurses’ who work in primary public health care institutions in the city of São Paulo, Brazil conceptions and identify their activities of social control. The data was collected using semi-structured interviews and analyzed through qualitative and quantitative methods. The principle conceptions were placed into four thematic categories: the users evaluating and constructing better health care; management is important but needs efficiency; it is necessary for people to learn to take part; and ant work: orienting the population in the construction of social control. The nurses related that they achieve many activities which seek social participation, but other actions must be implemented within basic care for the strengheening of social control in health care. RESUMEN: Partimos del presupuesto de que la enfermera de la atención básica puede desempeñar un importante papel en la construcción del control social en el Sistema Único de Salud. Los objetivos de este estudio fueron los de analizar las concepciones e identificar las acciones de control social de enfermeras que trabajan en las unidades de atención básica de salud de un municipio del interior del estado de Sao Paulo. Los datos fueron recolectados mediante entrevistas parcialmente estructuradas, y analisados cuanti-cualitativamente. Las concepciones fueron analisadas a partir de cuatro categorias temáticas: usuarios evaluando y construyendo un servicio de salud mejor; el consejo gestor es importante, pero debe funcionar; para ello, es necesario aprender a participar; y, el trabajo de hormiguita: orientando la población en la construcción del control social. Las enfermeras relataron que realizan varias acciones teniendo en vista la participación social, sin embargo, otras acciones necesitan ser implementadas en la atención básica para el fortalecimiento del control social en la salud. P A L A V R A S C H A V E : C o n t r o l e s f o r m a i s d a sociedade. Conselhos de saúde. Participação comunitária. Política de saúde.Partimos do pressuposto de que a enfermeira da atencao basica pode desempenhar um papel importante na construcao do controle social no Sistema Unico de Saude. Tivemos como objetivos analisar as concepcoes e identificar as acoes de controle social de enfermeiras de unidades de atencao basica a saude de um municipio do interior paulista. Os dados foram coletados por meio de entrevistas semi-estruturadas e analisados qualitativa e quantitativamente. As concepcoes foram analisadas em quatro categorias tematicas: usuarios avaliando e construindo um servico de saude melhor; o conselho gestor e importante, mas precisa funcionar; e preciso aprender a participar; e trabalho de formiguinha: orientando a populacao na construcao do controle social. As enfermeiras relataram realizar varias acoes visando a participacao social, porem, outras acoes ainda precisam ser implementadas na atencao basica para o fortalecimento do controle social na saude.

O agente comunitário de saúde como morador, trabalhador e usuário em São Carlos, São Paulo

This article aims to address a few aspects related to the lives of the community health workers in the city of Sao Carlos, Sao Paulo. Qualitative research was used to build this study, with the application of semi-structured interviews and thematic content analyses. Four categories resulted from the analysis: How I see my work; the difficulties and advantages of living in the neighborhood; the CHA in their different roles, and, ultimately, quality of life: life as it is. Being closer to the reality being studied enabled a view of the community health agents beyond the work dimension and highlighted aspects that particularize and set them apart from other professionals in the Unified Health System, namely: Being a worker, resident and user. We conclude that the community health agent needs to be understood based on the uniqueness of the profession, providing personal empowerment and a professional routine.Este articulo tiene por objetivo tratar de algunos aspectos de la vida de los agentes comunitarios de salud del municipio de Sao Carlos, San Pablo. Para la construccion de este estudio se utilizo la investigacion cualitativa, con la aplicacion de la entrevista semiestructurada y analisis tematica del contenido. Del analisis resultaron cuatro categorias: como veo mi trabajo; dificultades y facilidades de vivir en el barrio; el ACS en sus diferentes papeles; y, finalmente, calidad de vida: la vida tal como es. La aproximacion con la realidad estudiada permitio observar al agente comunitario de salud mas alla de la dimension trabajo y destacar los aspectos que lo caracterizan y diferencian de los demas profesionales del Sistema Unico de Salud, a saber: ser trabajador, residente y usuario. Llegamos a la conclusion de que el agente comunitario de salud necesita ser comprendido dentro de la singularidad que representa su profesion, proporcionando el fortalecimiento personal y profesional cotidiano.

Configurações dos Conselhos Municipais de Saúde de uma região no Estado de São Paulo

Este artigo discute o panorama das bases legais dos Conselhos de Saude em uma regiao com seis municipios do Estado de Sao Paulo. A abordagem metodologica, cujos resultados foram apresentados e discutidos em categorias, e descritiva e exploratoria, sustentada por pesquisa documental baseada nas normas nacionais, considerando aspectos de criacao, estruturacao, organizacao e funcionamento dos conselhos, criados em 1991. Quatro deles alteraram seus dispositivos legais sendo dois deles com inovacoes, tais como: eleicao do presidente, mandato nao coincidente com executivo, estrutura administrativa e comissoes. Algumas leis dos conselhos tem inconsistencias quanto as normas locais e nacionais em relacao ao carater deliberativo, paridade dos usuarios, regimento interno, gestor como presidente nato e nao garantia de estrutura administrativa e financeira para funcionamento. Conclui-se que, para garantir que os Conselhos de Saude exercam de forma adequada seu papel, e necessario buscar aprimoramento dos dispositivos legais e tambem enfatizar o aprimoramento do tema participacao social nos curriculos de Enfermagem.This article discusses the legal structure of the municipal Health Councils in a Health County in the state of Sao Paulo comprising six municipalities. This descriptive and exploratory study was based on documental research according to federal laws for the creation, organization, structure and routine work of the health councils. Results were presented and discussed in categories. The health councils were created in 1991, and four of them have changed their legal instruments, two of them have innovated in some procedures, such as election of the director, administration non-coincident with local majors, administrative structure and commissions. Some council regulations are in disagreement with local and federal laws, such as the deliberative character, parity representation of users, internal regiment, municipal staff in charge of council directory, and no guarantee of administrative and financial support for routine work. It can be concluded that it is necessary to improve and correct regulations to guarantee a suitable performance of health councils and also to improve the discussion about social participation in the nursing curriculum.

Atuação do auxiliar de enfermagem na Estratégia Saúde da Família

Objectives: To analyze the compression of nursing assistants on daily activities within Health Teams Family and to identify facilities and difficulties encountered by these professionals in the development of those activities. Methods: This is an exploratory, descriptive and qualitative study conducted with 17 nursing assistants in the Family Health Units. It was used the interview technique and the data were subjected to content analysis. Results: The activities of these professionals are guided by the procedural logic; for the workers, the link with the customer is a plus and the high demand a difficulty. Conclusion: The nurses’ way of working confirms the curative care model, pointing out the need to rearrange the practices to provide comprehensive care, pointing out the need to rearrange the practices to provide comprehensive care.

Perspectiva de los gestores de una región del estado de São Paulo acerca de la educación permanente em salud

OBJECTIVE Analysing the concepts of Continuous Health Education - CHE (EPS - in Portuguese), operated by municipal managers and translated into official documents. METHOD Qualitative research with the use of official documents and semi-structured interviews with the Municipal Health Secretaries or Coordinators of Primary Health Care in the Northeast Region of São Paulo State, and thematic analysis of empirical material. RESULTS Results indicate difficulties in the municipalities problematizing their management practices, services and health care; EPS tools presented are insufficient and unsatisfactory for amending the array of problems raised and are still far from the routine of Primary Care services. CONCLUSION Despite efforts to implement EPS actions for the strengthening of primary care, the process appears to be incipient.

Managers' perspective on continuous health education in a region of São Paulo State

OBJECTIVE Analysing the concepts of Continuous Health Education - CHE (EPS - in Portuguese), operated by municipal managers and translated into official documents. METHOD Qualitative research with the use of official documents and semi-structured interviews with the Municipal Health Secretaries or Coordinators of Primary Health Care in the Northeast Region of São Paulo State, and thematic analysis of empirical material. RESULTS Results indicate difficulties in the municipalities problematizing their management practices, services and health care; EPS tools presented are insufficient and unsatisfactory for amending the array of problems raised and are still far from the routine of Primary Care services. CONCLUSION Despite efforts to implement EPS actions for the strengthening of primary care, the process appears to be incipient.

Controle social do Sistema Único de Saúde: o que pensam os conselheiros municipais de saúde

This study uses a qualitative approach based on semi-structured interview for analyzing the social control perspective of health counselors, considering that there are still challenges for the consolidation of community participation. It was identified that some counselors do not recognize the social participation as a Single Health System directive. Despite the recognition of the councils as deliberative spaces, there are difficulties such as the centralization of decisions in the management, an over evaluation of technical knowledge and lack of health conferences. There are limitations on the exercise of effective advisory role because of the influence of the municipal administration, difficulties of communication with the bases of representation and access to information. It is concluded that it is necessary to search for the strengthening of social control to highlight theThis study uses a qualitative approach based on semi-structured interview for analyzing the social control perspective of health counselors, considering that there are still challenges for the consolidation of community participation. It was identified that some counselors do not recognize the social participation as a Single Health System directive. Despite the recognition of the councils as deliberative spaces, there are difficulties such as the centralization of decisions in the management, an over evaluation of technical knowledge and lack of health conferences. There are limitations on the exercise of effective advisory role because of the influence of the municipal administration, difficulties of communication with the bases of representation and access to information. It is concluded that it is necessary to search for the strengthening of social control to highlight the continuing health education for empowerment of counselors inside the councils established by the Health Pact.

Nursing assistant performance in the Family Health strategy

Objectives: To analyze the compression of nursing assistants on daily activities within Health Teams Family and to identify facilities and difficulties encountered by these professionals in the development of those activities. Methods: This is an exploratory, descriptive and qualitative study conducted with 17 nursing assistants in the Family Health Units. It was used the interview technique and the data were subjected to content analysis. Results: The activities of these professionals are guided by the procedural logic; for the workers, the link with the customer is a plus and the high demand a difficulty. Conclusion: The nurses’ way of working confirms the curative care model, pointing out the need to rearrange the practices to provide comprehensive care, pointing out the need to rearrange the practices to provide comprehensive care.

Municipal Health Council Compositions in the State of São Paulo

Este artigo discute o panorama das bases legais dos Conselhos de Saude em uma regiao com seis municipios do Estado de Sao Paulo. A abordagem metodologica, cujos resultados foram apresentados e discutidos em categorias, e descritiva e exploratoria, sustentada por pesquisa documental baseada nas normas nacionais, considerando aspectos de criacao, estruturacao, organizacao e funcionamento dos conselhos, criados em 1991. Quatro deles alteraram seus dispositivos legais sendo dois deles com inovacoes, tais como: eleicao do presidente, mandato nao coincidente com executivo, estrutura administrativa e comissoes. Algumas leis dos conselhos tem inconsistencias quanto as normas locais e nacionais em relacao ao carater deliberativo, paridade dos usuarios, regimento interno, gestor como presidente nato e nao garantia de estrutura administrativa e financeira para funcionamento. Conclui-se que, para garantir que os Conselhos de Saude exercam de forma adequada seu papel, e necessario buscar aprimoramento dos dispositivos legais e tambem enfatizar o aprimoramento do tema participacao social nos curriculos de Enfermagem.This article discusses the legal structure of the municipal Health Councils in a Health County in the state of Sao Paulo comprising six municipalities. This descriptive and exploratory study was based on documental research according to federal laws for the creation, organization, structure and routine work of the health councils. Results were presented and discussed in categories. The health councils were created in 1991, and four of them have changed their legal instruments, two of them have innovated in some procedures, such as election of the director, administration non-coincident with local majors, administrative structure and commissions. Some council regulations are in disagreement with local and federal laws, such as the deliberative character, parity representation of users, internal regiment, municipal staff in charge of council directory, and no guarantee of administrative and financial support for routine work. It can be concluded that it is necessary to improve and correct regulations to guarantee a suitable performance of health councils and also to improve the discussion about social participation in the nursing curriculum.