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- ItemSomente MetadadadosApoio à atenção básica de saúde: percurso da pesquisa-intervenção(Universidade Federal de São Paulo (UNIFESP), 2014-07-11) Brandalise, Carmem Lucia [UNIFESP]; Mendes, Rosilda [UNIFESP]; http://lattes.cnpq.br/3746693286898810; http://lattes.cnpq.br/1977459287536762; Universidade Federal de São Paulo (UNIFESP)This study analyzes the work of the Multidisciplinary Team in the Health and Care Section of Community, Department of Primary Care in the Municipality of Santos which is composed of several professional areas and divided up in a way that meets the four health districts of the municipality, organized to follow all Primary Care services. The methodology used was the research intervention, assuming the construction of spaces for collective questioning in a dialectical movement of action-reflection-action. The data were produced by six problem workshops arranged by themes chosen collectively by the subjects involved in the study: "support matrix"; "work process in health"; "care"; and "interdisciplinary and multidisciplinary." For the record, in addition to recording, it was used the methodology of the scribe, which consists of a free record of the progress of the meeting by one of the workshop participants. The ordering of data included the transcription of tapes and reading the records of the scribes and field diaries. The ordination and classification of data allowed to grasp the relevant issues settling four analytical categories: "The practice of teamwork"; "The practice of care: tensions between what you want and what you do"; "The ways of organizing work to transform the management of care"; and 'Research intervention: capability to invent and reinvent ". The study suggests the need to establish systematic spaces for discussion of the work process with primary care amount of units of responsibility of each SEATESC professional, as well as their monitoring schedules of the teams in the Primary Care services, to strengthen interdisciplinary work and the organization based on the real need of the local teams; and the SEATESC need of utilization of the potentiality of the intervention research method due to the possibility of experimentation, which allows to make room for collective reflections, to find alternative co-management and co-responsibility of care. Finally, the study found that subjects envision possibilities for the development of a supportive practice having reference from their own experience in SEATESC, so that productive assemblages are operated in a way that bring innovations to the practice of care professionals in order to qualify the care with the monitoring in network; the need to review the.
- ItemAcesso aberto (Open Access)O cotidiano de trabalho do ACS: trilhando caminhos entre prescrições e invenções(Universidade Federal de São Paulo (UNIFESP), 2016-08-16) Barros, Luciana Soares de [UNIFESP]; Cecilio, Luiz Carlos de Oliveira [UNIFESP]; http://lattes.cnpq.br/0618708799649594; ttp://lattes.cnpq.br/4628010238233390; Universidade Federal de São Paulo (UNIFESP)Introduction: This study focus on the work process of the Community Health Agents (ACS), an strategic actor in Brazilian National Health System (SUS) due to its role as “mediator”; between the community and the Primary Care Unit Health (UBS). Objective: This study aims give visibility to elements in the daily work of ACS, trying to understand how he organizes his care practices; builds his relationship with the health team; reflects on their performance in the context of the Family Health Strategy; and the main difficulties encountered to carry out his work. Method: Cartographic method made by participant observation in six UBS of the metropolitan region of São Paulo city that provides the production of field diaries with records of scenes observed in team meetings, group activities, home visits, walking through the territories and other activities. For analysis the concept of “visibility plan”; was used, which means what is highlighting or becomes visible / speakable from the connections of the scenes of similar “nature”; as recorded in field diaries. Results and discussion: From the visibility plans was possible to discuss issues relating to acquaintanceship of ACS with the refusal of the population; to violence and drug trafficking in the territory; to the difficult management of the community’s secrets; and to the multiple dimensions of the complex relationship with the community due to his dual resident / worker status. It was possible to understand a process of transformation of this worker, which has been presented as a multipurpose worker at UBS, occupying the role on an interim manner. This is different from the profile idealized by the ACS policy, which has a certain “militancy”; as a constitutive characteristic of the function. In addition it highlights the connection of the ACS with the rationalization of health practices, that has as elements the bureaucratization and the setting of production targets, increasing his work overload, but also his strategies to handle the flows, exercising their autonomy in the territory. The relationship of ACS with the health team points to domination and subordination of ACS, but also to his resistance movements, inventiveness and cooperative work. Conclusion: This study has highlighted a health worker in mutation that reproduces biomedical and bureaucratic practices, which can disfigure his role as a community link, but can also be quite creative, permanently (re)inventing his practices, in a way much more complex than prescribed in the original formulation of health policy, due, among other things, the complexity of the territories in which he operates.
- ItemEmbargoEnfrentamento da pandemia do COVID-19 na atenção primária sob a perspectiva da equipe de enfermagem e do agente comunitário de saúde(Universidade Federal de São Paulo, 2022-11-30) Sacramento, Avynner´s Silva e [UNIFESP]; Sala, Danila Cristina Paquier [UNIFESP]; http://lattes.cnpq.br/6367508233142381A pandemia de COVID-19 foi desafiadora para gestores, profissionais e toda a sociedade, exigindo respostas imediatas e complexas, em todos os componentes do sistema de saúde. Foi pensado mais em uma reorganização de serviços de APS para enfrentar a epidemia, e menos, nas necessidades dos profissionais de saúde. Por meio de uma pesquisa qualitativa, descritiva e exploratória, objetivou-se compreender as percepções da equipe de enfermagem e do Agente Comunitário de Saúde dos desafios do processo de trabalho na atenção primária durante a pandemia do COVID-19. A produção dos dados ocorreu por meio de entrevistas, desenvolvidas entre novembro de 2021 e maio de 2022. A análise por meio do conteúdo temático revelou a desconfiguração do trabalho na APS na pandemia e os sofrimentos das trabalhadoras na APS. É urgente, a necessidade de acolhimento, cuidado e valorização destes profissionais no pós-pandemia, provendo recursos, rede de apoio, qualificação para o desenvolvimento de trabalho baseado em dignidade.
- ItemAcesso aberto (Open Access)Experiência, produção de conhecimento e formação em saúde(UNESP, 2013-06-01) Capozzolo, Angela Aparecida [UNIFESP]; Imbrizi, Jaquelina Maria [UNIFESP]; Liberman, Flávia [UNIFESP]; Mendes, Rosilda [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)This paper presents partial research results relating to an experience of interprofessional training for healthcare work implemented at the Baixada Santista campus of UNIFESP, in Santos, SP, Brazil. The teaching strategies for this line of study had the goal of exposing students to continuing healthcare intervention experiences, from the first undergraduate year onwards, thus enabling critical thinking with regard to the dimensions involved in healthcare work. The aims of this study were to systematize, analyze and establish strategies for following up this training. Different data gathering tools were used, such as focus groups and semi-structured interviews, and the analyses were presented to and discussed with the subjects involved. This article addresses issues relating to the topic of experience and knowledge production. The results indicate that the training contributed towards constructing a modus operandi for future professionals that takes into consideration the complexity of the health-illness-care process.
- ItemAcesso aberto (Open Access)O hospital e a formação em saúde: desafios atuais(ABRASCO - Associação Brasileira de Saúde Coletiva, 2007-08-01) Feuerwerker, Laura Camargo Macruz; Cecilio, Luiz Carlos de Oliveira [UNIFESP]; Universidade Federal Fluminense Instituto de Saúde da Comunidade Departamento de Planejamento em Saúde; Universidade Federal de São Paulo (UNIFESP)Both the role of hospitals in health professionals education and hospital's needs in terms of professionals for health care and hospital management are changing as health systems move towards quality, comprehensiveness, efficiency and costs control. The article intends to analyze dilemmas and challenges in each of these fields, acknowledging hospitals' complexity, their critical role on healthcare delivery and their deep involvement in the hegemonic orientation for health education and practice.
- ItemAcesso aberto (Open Access)A morte de Ivan Ilitch, de Leon Tolstói: elementos para se pensar as múltiplas dimensões da gestão do cuidado(UNESP, 2009-01-01) Cecilio, Luiz Carlos de Oliveira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The author uses the short story The Death of Ivan Ilyich, by Leo Tolstoy, to explore the theme of the multiple dimensions of healthcare management (professional, organizational and systemic) by pointing out the omnipresence and complementariness of these dimensions. Although recognizing that there is no hierarchy between these three dimensions, the discussion focuses on the professional dimension, within which professionals meet users, and highlights how this has been the favored territory for management strategies governed by the search for increasing rationality, predictability and control over current health practices, either in the public or in the private healthcare sector. The author points out the risk that qualification and humanization healthcare programs might be contributing towards instrumentalization and excessive formalization of the meeting point between workers and users, which adds further difficulty to truly caring encounters like the one narrated by Tolstoy in his short story, or even makes them impossible.
- ItemAcesso aberto (Open Access)Narrativas na formação comum de profissionais de saúde(Fundação Oswaldo Cruz, Escola Politécnica de Saúde Joaquim Venâncio, 2014-08-01) Capozzolo, Angela Aparecida [UNIFESP]; Casetto, Sidnei José [UNIFESP]; Imbrizi, Jaquelina Maria [UNIFESP]; Henz, Alexandre de Oliveira [UNIFESP]; Kinoshita, Roberto Tykanori [UNIFESP]; Queiróz, Maria de Fátima Ferreira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)This account reports on the experience of the common training that has been taking place since 2007 at the Baixada Santista campus of the Federal University of São Paulo (Southeast Brazil), in the third semester of the undergraduate course, under the health work axis of the curriculum. The experience includes students and professors from different professional areas, ranging from physical education, physical therapy, nutrition, psychology to occupational therapy. The account presents the guidelines and strategies for organizing the 'Integrated clinical practice: analysis of health needs and demands' module, which adopts the production of life history narratives and health issues of people selected by professors together with the teams of the service network from the municipality of Santos, state of São Paulo. The narratives were produced in fortnightly meetings the students held with accompanied people in their homes and meetings held among supervisors and professors. The content of 120 reports on the completion of the module, produced by the students in 2007 and 2008, was analyzed aiming to identify the effects of the proposed training. Drafting the narratives helped the students expand their listening capacity and their perception of the complexity of the healthdiseasecare process, in addition to other aspects of what has been called the 'common practice' in the various health professions.