Solange L'Abbate

Educação em saúde: uma nova abordagem

This article describes a series of experiences in the area of Health Education. The experiences, carried out with groups of health professionals working in institutions, begin with the social relationships in which these professionals are involved in their day-to-day work, in contact with other social agents and groups. One of the basic assumptions is that social relationships are an important aspect of the public health services provided to the population. As a result, health workers need specific training in this area to develop and improve their professional performance. The experiences show the importance of making theoretical and methodological approaches (like Educational Psychodrama and the Arvoredo Method) available to these workers. Those who have participated in such training programs have considerably improved their professional/social skills. One of the basic tenets of these approaches is the constant search for autonomy, as an essential element for people to increase awareness of themselves as individuals and as citizens, be they health care professionals or users. The experiences and methods described in this article may serve as one way of reducing the serious gaps in todays public health services.

A análise institucional e a saúde coletiva

Na sua historia recente, a saude coletiva se institucionalizou na dupla dimensao: teorico-pratica e politico-ideologica. Sendo a analise institucional uma abordagem que busca a transformacao das instituicoes a partir das praticas e discursos dos seus sujeitos, pode-se dizer que ha grande potencialidade para o crescimento da utilizacao do seu instrumental na saude coletiva, considerando as dimensoes da pesquisa, da intervencao e da formacao dos profissionais. A tudo isso acrescenta-se a analise da propria saude coletiva como uma instituicao complexa, contraditoria, sendo ela mesma atravessada por inumeras instituicoes.

A atenção em Saúde Mental em municípios de pequeno e médio portes: ressonâncias da reforma psiquiátrica

From the analysis of the national Mental Health policy, formulated in the past years, and from the experiences developed after 1987, it is sought to: understand how Brazilian Health System has contributed to the development of the psychiatric reform in towns; verify how the assistance offered in those towns is making the psychiatric reform principles feasible as well as improving the users living conditions; and research the role of the workers and managers in the construction of new care practices in Mental Health. The analysis of the discursive practices point out that the various social segments involved in Mental Health have acquaintance with the principles and proposals of the psychiatric reform. However, the municipal administrations do not thoroughly take on the proposals of the Health Ministry to this field, under the allegation of lack of financial funds to meet the demands. The users and their relatives have gradually assumed the new intervention proposals, but the mechanisms of participation and popular organization are still incipient. Lastly, it is important to stress that for an effective consolidation of the current psychiatric reform proposals, there must be, among other actions, more commitment by the managers as far as Mental Health is concerned, more investments in multi-professional teams, encouragement to the organization and the users and relatives participation and integration of health devices, social assistance and the culture existing in towns.

A reforma psiquiátrica brasileira: aspectos históricos e técnico-assistenciais das experiências de São Paulo, Santos e Campinas

Este artigo tem como objetivo abordar as experiencias desenvolvidas, a partir da decada de 1980, nos municipios de Sao Paulo (capital), Santos e Campinas, no sentido de compreender as suas determinacoes materiais, sociais e politicas, o avanco do processo de rompimento com o modelo manicomial e a emergencia de forcas criativas e produtivas, necessarias para a construcao da atencao psicossocial em saude mental, bem como conhecer a contribuicao do Sistema Unico de Saude no avanco da reforma psiquiatrica nos municipios. A investigacao que fundamenta este trabalho e parte de uma tese sobre a atencao em saude mental, na qual os projetos inovadores desses municipios serviram de moldura e parâmetro para a analise da politica de saude mental em municipios de pequeno e medio portes do estado de Sao Paulo.

Utilização de vídeo como estratégia de educação nutricional para adolescentes: comer... o fruto ou o produto?

This paper describes the evaluation of the video Eating... the fruit or the product?, conceived as a nutrition education strategy for adolescents. The purposes of the research were to identify the elements of the video that stimulated the participants reflection about the argumentation topics and to identify the elements of the script that made it easier or more difficult for adolescents to understand the theme. The method was based on qualitative and quantitative analyses. The subjects were 14 office-boys from a public institution in the state of Sao Paulo, Brazil. The data were collected in two phases: the first one included a workshop with the group, and the second phase involved an individual interview, three months later. The elements that stimulated the adolescents reflection were the characters symbolizing the brand influence and the advertising power, and a scene of a man eating in the garbage. Difficulties came from scenes which were silent, abstract or based on values different from the ones of the office-boys social class.

Educação em saúde na escola: uma abordagem do currículo e da percepção de alunos de graduação em pedagogia

Analisa-se, por meio de pesquisa descritiva, o modo como a Educacao em Saude tem sido abordada no curriculo de graduacao em Pedagogia de uma universidade estadual paulista. A investigacao foi dividida em duas etapas: a primeira analisa o curriculo do curso e a segunda, a compreensao dos estudantes de Pedagogia sobre o tema, por intermedio de respostas a um questionario. Em relacao ao curriculo, observou-se que duas, das 73 disciplinas analisadas trabalham, de modo explicito, a Educacao em Saude na escola. As respostas dos alunos revelaram que 65% dos respondentes nao percebem esta abordagem no curriculo, porem 85% consideram a atuacao do pedagogo indispensavel para o desenvolvimento do tema no ambiente escolar. Concluiu-se ser fundamental que o curriculo do pedagogo contemple, criticamente, a tematica da Educacao em Saude, dada sua relevância para a vida e a cidadania dos escolares de nivel medio.

O uso de diários como ferramenta de intervenção da Análise Institucional: potencializando reflexões no cotidiano da Saúde Bucal Coletiva

E significativo o numero de estudos de natureza qualitativa que utilizam a tecnica do diario em trabalho de campo. Tendo em vista as diferentes abordagens teorico-metodologicas as quais tais investigacoes se vinculam, este artigo tem como objetivo discutir as potencialidades de diferentes formas de producao de diarios, quando utilizados como uma ferramenta de intervencao da Analise Institucional na Saude Coletiva. Este estudo inscreve-se no contexto de uma pesquisa que analisou o trabalho de um grupo de profissionais da Saude Bucal dispostos a propor estrategias inovadoras no modo de producao do cuidado presente em seus cotidianos na atencao basica do SUS Campinas-SP. Realizar esses registros possibilitou aos diaristas uma reflexao acerca da propria pratica, desnaturalizando-a, o que permitiu explorar a complexidade do trabalho em saude bucal na atencao basica. Mostrou, tambem, ser um caminho possivel para dar sentido as suas praticas, sejam elas individuais ou coletivas.

Educação e serviços de saúde: avaliando a capacitação dos profissionais

This paper analyzes the results of a follow-up study and evaluation of the Specialization Course in Public Health administered from 1993 to 1995 by the Department of Preventive and Social Medicine at the School of Medical Sciences, Universidade de Campinas, Brazil. The study was conducted during the course and with a follow-up several months later. Students reported on their professional activities, difficulties and facilities in performing them, and their commitment to the public health services in which they worked. They also expounded on their needs and expectations regarding specialized training in public health. At the end of the required course load (first semester) and the optional courses (second semester), students evaluated the course contents relevance, their own understanding, and the strengths and weaknesses of the respective teaching strategies. Finally, six and eight months after the courses, the professionals evaluated how they were able to apply their new knowledge to their work. Various research instruments were used, including group dynamics, individual questionnaires, and focal groups, comprising a broad methodological approach. A single sample of individuals was thus studied at different moments with regard to this experience.

Análise institucional e educação: reforma curricular nas universidades pública e privada

This text discusses some professional practices carried out in the field of higher education in a context of curriculum changes in the medical and nursing courses of a public university (Universidade Federal Fluminense - UFF - in Niteroi, RJ, Brazil) and in the nutrition course of a private university (Universidade Metodista - UNIMEP - in Piracicaba, sp, Brazil). Based on concepts from institutional analysis, we investigate similarities and differences between the public and private processes of curriculum reform, as well as aspects of our own professional histories. This paper was produced in the context of disciplines and seminars in institutional analysis for the Graduate Program in Collective Health at the Department of Preventive and Social Medicine of the School of Medical Sciences at UNICAMP, conducted between 2002 and 2004 under the responsibility of the last-mentioned co-author of this article.

Health education in schools: an approach based on the curriculum and perception of undergraduate education students

Analisa-se, por meio de pesquisa descritiva, o modo como a Educacao em Saude tem sido abordada no curriculo de graduacao em Pedagogia de uma universidade estadual paulista. A investigacao foi dividida em duas etapas: a primeira analisa o curriculo do curso e a segunda, a compreensao dos estudantes de Pedagogia sobre o tema, por intermedio de respostas a um questionario. Em relacao ao curriculo, observou-se que duas, das 73 disciplinas analisadas trabalham, de modo explicito, a Educacao em Saude na escola. As respostas dos alunos revelaram que 65% dos respondentes nao percebem esta abordagem no curriculo, porem 85% consideram a atuacao do pedagogo indispensavel para o desenvolvimento do tema no ambiente escolar. Concluiu-se ser fundamental que o curriculo do pedagogo contemple, criticamente, a tematica da Educacao em Saude, dada sua relevância para a vida e a cidadania dos escolares de nivel medio.