Suely Itsuko Ciosak

Os conceitos de vulnerabilidade e adesão na Saúde Coletiva

Los conceptos de Vulnerabilidad y Adhesion han sido foco de debate en la Salud Colectiva. El desafio puesto por este campo, de propiciar tecnologias, dispositivos e instrumentos que apoyen la construccion de practicas calificadas, para atender a las necesidades de los grupos sociales, ha constituido el terreno donde se elabora el conocimiento, buscando la innovacion en el desarrollo de instrumentos que apoyen la captacion de la realidad, apoyen la lectura de las necesidades y en el desencadenamiento y sustentacion de proyectos de intervencion que produzcan el impacto deseado: atender los grupos sociales que mas carecen de apoyo para conquistar autonomia para vivir la vida con calidad y la consecucion del auto-cuidado, en el escenario de la equidad y de la justicia social. El articulo presenta aspectos de las categorias analiticas Adhesion y Vulnerabilidad, en cuanto a la proposicion de indicadores para su monitoreo, lo que puede contribuir para el desarrollo del concepto y para las practicas en el proceso de produccion a la salud.The Vulnerability and the Compliance are concepts that have being focus of debate in the Collective Health field. The challenge of the Collective Health is to promote tech- nologies, and tools to support qualified actions, and to answer to the social groups´ needs, looking for the innovation of the in- struments to apprehend the reality and to develop interventions that could produce impacts: attending these social groups who needs support to conquer autonomy in the self-care. This article presents aspects of the analytic categories Compliance and Vulnerability, proposing indicators for monitoring it, in order to contribute to the development of the concepts as to the health production process.

O tornar-se cuidadora na senescência

Este estudo, desenvolvido no municipio de Cascavel PR, com senescentes cuidadoras domiciliares de idosos dependentes, teve como objetivo verificar os motivos que as levaram a executarem esse papel. A metodologia utilizada foi a qualitativa, e a Representacao Social foi eleita como caminho teorico. Foram criterios de inclusao: sexo feminino; idade superior ou igual a 60 anos; cuidadores domiciliares principais de idosos dependentes por um periodo igual ou superior a tres meses. A coleta de dados deu-se entre novembro de 2006 a janeiro de 2007. A populacao constituiu-se de 13 senescentes, sendo 46,1% esposas, o que atribuimos a propria representacao social construida. A representacao social tambem esta relacionada a figura da mulher, geralmente a mais velha da familia, viuva ou solteira. Sem recursos e tratados com desigualdade pelo sistema, o idoso cuidador e, nesse caso, a idosa cuidadora senescente tornam-se mais um ponto vulneravel em nossa sociedade.

Atenção integral na saúde do idoso no Programa Saúde da Família: visão dos profissionais de saúde

O Brasil, ate o ano de 2025, sera o sexto pais do mundo em numero de idosos. E funcao das politicas publicas contribuir para que as pessoas alcancem idades avancadas com melhor saude. O objetivo deste estudo foi conhecer o que pensam os profissionais sobre necessidades de saude e atencao integral. Os sujeitos foram dezessete, que compoem duas equipes do Programa Saude da Familia, no Municipio de Santos. A abordagem foi qualitativa, os discursos foram analisados a partir da Representacao Social, referencial teorico do Discurso do Sujeito Coletivo. A analise revelou que os profissionais se esforcam para atender as necessidades de saude dos idosos atraves de acoes de prevencao e promocao da saude. No entanto, suas necessidades sociais e psicologicas nao estao sendo atendidas. Concluimos que os idosos necessitam de maior integralidade e agilidade no sistema de saude, porque possuem dificuldades no acesso e deslocamento nos servicos de saude.

Evolução dos isolamentos em doenças transmissíveis: os saberes na prática contemporânea

The identification of new infectious agents and the ever increasing expansion of known infections and diseases have been stimulating the revision of biosafety measures in the activities of professional health care workers. In the present article, the evolution of knowledge and practices of isolation and precautions were reviewed, which allowed us to recover the concepts and the interventions that were formulated and implemented. Since the beginning of the modern nursing, in the XIX century, the elements of the isolation practice for contagious diseases have remained basically the same. In other words, the emphasis on the use of mechanical, chemical and environmental barriers are given, based on inherent specificities of each part of the infectious chain process.The identification of new infectious agents and the ever increasing expansion of known infections and diseases have been stimulating the revision of biosafety measures in the activities of professional health care workers. In the present article, the evolution of knowledge and practices of isolation and precautions were reviewed, which allowed us to recover the concepts and the interventions that were formulated and implemented. Since the beginning of the modern nursing, in the XIX century, the elements of the isolation practice for contagious diseases have remained basically the same. In other words, the emphasis on the use of mechanical, chemical and environmental barriers are given, based on inherent specificities of each part of the infectious chain process.

Senescência e senilidade: novo paradigma na atenção básica de saúde

Senescence and senility are themes of growing interest, considering the inxrease of the elderly population in the wrold, particularly in Brazil. Health care for the edlery should value to maintain quality of life, considering the loss process particular of aging and the possiblities to prevent, maintenain and rehabilitate their health condition. Knowing the everyday lives of the elderly has been a challenge for health care professsionals regardint the implementation of programs and actions that aim to maintain the balance of the health-disease process, and it is in this search that we have made efforts to constibute, effectively, with the strategies to strengthen the edlerly and their relatives so it becomes possible to trigger health promotion actions, especially considering that the challenge for the millenium is to build collective awareness to achieve a society for all ages, with justice and the guarantee of full rights.Senescence and senility are themes of growing interest, considering the inxrease of the elderly population in the wrold, particularly in Brazil. Health care for the edlery should value to maintain quality of life, considering the loss process particular of aging and the possiblities to prevent, maintenain and rehabilitate their health condition. Knowing the everyday lives of the elderly has been a challenge for health care professsionals regardint the implementation of programs and actions that aim to maintain the balance of the health-disease process, and it is in this search that we have made efforts to constibute, effectively, with the strategies to strengthen the edlerly and their relatives so it becomes possible to trigger health promotion actions, especially considering that the challenge for the millenium is to build collective awareness to achieve a society for all ages, with justice and the guarantee of full rights.

The vulnerability and the compliance in Collective Health

Los conceptos de Vulnerabilidad y Adhesion han sido foco de debate en la Salud Colectiva. El desafio puesto por este campo, de propiciar tecnologias, dispositivos e instrumentos que apoyen la construccion de practicas calificadas, para atender a las necesidades de los grupos sociales, ha constituido el terreno donde se elabora el conocimiento, buscando la innovacion en el desarrollo de instrumentos que apoyen la captacion de la realidad, apoyen la lectura de las necesidades y en el desencadenamiento y sustentacion de proyectos de intervencion que produzcan el impacto deseado: atender los grupos sociales que mas carecen de apoyo para conquistar autonomia para vivir la vida con calidad y la consecucion del auto-cuidado, en el escenario de la equidad y de la justicia social. El articulo presenta aspectos de las categorias analiticas Adhesion y Vulnerabilidad, en cuanto a la proposicion de indicadores para su monitoreo, lo que puede contribuir para el desarrollo del concepto y para las practicas en el proceso de produccion a la salud.The Vulnerability and the Compliance are concepts that have being focus of debate in the Collective Health field. The challenge of the Collective Health is to promote tech- nologies, and tools to support qualified actions, and to answer to the social groups´ needs, looking for the innovation of the in- struments to apprehend the reality and to develop interventions that could produce impacts: attending these social groups who needs support to conquer autonomy in the self-care. This article presents aspects of the analytic categories Compliance and Vulnerability, proposing indicators for monitoring it, in order to contribute to the development of the concepts as to the health production process.

Infecção de sítio cirúrgico no seguimento pós-alta: impacto na incidência e avaliação dos métodos utilizados

It is a prospective study in two teaching hospitals. They accompanied 501 admitted patients who were submitted to the surgery of the digestive system from August 2001 to March 2002. In the period of the study, 140 surgical site infections (SSIs) were diagnosed. Thirty-one SSIs were diagnosed in the hospital and 109 after the discharge. The incidence of SSIs was of 6,2%, rising for 28,0%, with postdischarge surveillance. The methods of postdischarge surveillance are also discussed and among the several options, as there is not one recommended as the best. However, it is suggested that some types of postdischarge surveillance must be accomplished. The choice of the method will depend on the sources of each institution.It is a prospective study in two teaching hospitals. They accompanied 501 admitted patients who were submitted to the surgery of the digestive system from August 2001 to March 2002. In the period of the study, 140 surgical site infections (SSIs) were diagnosed. Thirty-one SSIs were diagnosed in the hospital and 109 after the discharge. The incidence of SSIs was of 6.2%, rising for 28.0%, with postdischarge surveillance. The methods of postdischarge surveillance are also discussed and among the several options, as there is not one recommended as the best. However, it is suggested that some types of postdischarge surveillance must be accomplished. The choice of the method will depend on the sources of each institution.

Scabies epidemic: price and prejudice.

Scabies epidemics are not unusual, and the recommended way of stopping them is by simultaneous treatment of everybody in the facility; this has been known since the last century, when Norwegian scabies was a problem in Norway. When this is not done, scabies epidemics can smolder for months. Scabies should not spread with good infection control measures, but we learned that a good infection control service is not enough. Efforts have to be done to educate everybody in the hospital, including laundry workers, and to improve work conditions.

Internações por condições sensíveis à atenção primária no hospital geral de uma microrregião de saúde do município de São Paulo, Brasil

O indicador Internacoes por Condicoes Sensiveis a Atencao Primaria e adotado no Brasil para avaliacao da atencao basica. Considerando a sua recente adocao, este estudo tem como objetivo apresentar o panorama dessas internacoes em um hospital do municipio de Sao Paulo. Foi realizado um estudo ecologico exploratorio, tendo como fontes o Sistema de Informacao Hospitalar do Sistema Unico de Saude e uma amostra de prontuarios de pacientes internados neste hospital. Para analise, foi utilizada a estatistica descritiva. As Internacoes por Condicoes Sensiveis a Atencao Primaria seguem tendencia de reducao, sendo as pneumonias bacterianas as que mais internaram no periodo; maior frequencia para a faixa etaria de 65 anos de idade e mais, e para o sexo feminino. Internacoes por Condicoes Sensiveis, somente, nao sao suficientes para avaliacao da atencao basica, mas permite avaliar a organizacao da rede de saude, que deve assegurar continuidade do cuidado em busca do principio da integralidade.Ambulatory Care Sensitive Conditions List was adopted in Brazil, to evaluate access and care effectiveness. This study aimed to present panoramic view of these hospitalizations in a General Hospital of Sao Paulo Municipality, Brazil. The methodology used was type ecological and exploratory. The data source was the Hospital Information System of Brazilian Unified Health System collected and a sample of hospitalizations. The results showed that there is a reduction tendency of this kind of hospitalizations and the most important cause during three years was bacterial pneumonia. There was predominance of women and patients older than 65 years old. In conclusion, the List is an important tool to evaluate access and effectiveness of Primary Care Services, but also it is relevant to know and evaluate the health network organization due to assure continuity of care to reach the principle of integrality of health care. DESCRIPTORS: Hospitalization. Primary health care. Evaluation.

Potencialidade do conceito de vulnerabilidade para a compreensão das doenças transmissíveis

This article presents the evolution and the contribution of the scientific production related to the concept of vulnerability and its potential to help studying transmissible diseases. It presents the concept of vulnerability and the production of knowledge in nursing, developed particularly by the CNPq Research Group Vulnerability, Adherence, and Health Needs. The purpose is to improve the understanding of health issues, based on this concept, and permit the proposition of coping interventions that surpass the individual domain, thus contemplating the organization of health care work and the social determination of the health-disease process.This article presents the evolution and the contribution of the scientific production related to the concept of vulnerability and its potential to help studying transmissible diseases. It presents the concept of vulnerability and the production of knowledge in nursing, developed particularly by the CNPq Research Group Vulnerability, Adherence, and Health Needs. The purpose is to improve the understanding of health issues, based on this concept, and permit the proposition of coping interventions that surpass the individual domain, thus contemplating the organization of health care work and the social determination of the health-disease process.