Navegando por Palavras-chave "Qualitative Research"

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    O agir leigo e o cuidado em saúde: a produção de mapas de cuidado
    (Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, 2014-07-01) Cecilio, Luiz Carlos de Oliveira [UNIFESP]; Carapinheiro, Graça; Andreazza, Rosemarie [UNIFESP]; Souza, Ana Lúcia Medeiros de; Andrade, Maria da Graça Garcia; Santiago, Silvia Maria; Meneses, Consuelo Sampaio [UNIFESP]; Reis, Denizi Oliveira; Araújo, Eliane Cardoso de [UNIFESP]; Pinto, Nicanor Rodrigues da Silva [UNIFESP]; Spedo, Sandra Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Instituto Universitário de Lisboa Instituto Superior de Ciências do Trabalho e da Empresa; Universidade Estadual de Campinas (UNICAMP)
    This study aimed to characterize which regulatory logics (other than government regulation) result in healthcare output, using a two-stage qualitative study in two municipalities in the ABCD Paulista region in São Paulo State, Brazil. The first stage included interviews with strategic actors (managers and policymakers) and key health professionals. The second phase collected life histories from 18 individuals with high health-services utilization rates. An analysis of the researchers’ involvement in the field allowed a better understanding of the narratives. Four regulatory systems were characterized (governmental, professional, clientelistic, and lay), indicating that regulation is a field in constant dispute, a social production. Users’ action produces healthcare maps that reveal the existence of other possible health system arrangements, calling on us to test shared management of healthcare between health teams and users as a promising path to the urgent need to reinvent health.
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    Atuação dos coordenadores de grupos de saúde na rede docente assistencial
    (Faculdade de Saúde Pública da Universidade de São Paulo, 2010-02-01) Santos, Luciane de Medeiros dos [UNIFESP]; Oliveira, Eleonora Menicucci de [UNIFESP]; Crepaldi, Maria Aparecida; Aurélio da Ros, Marco; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Santa Catarina Centro de Ciências Humanas e Filosofia; UFSC Centro de Ciências da Saúde
    OBJECTIVE: To analyze the model for actions by health promotion group coordinators, in primary healthcare units with links to professional training. METHODOLOGICAL PROCEDURES: A qualitative study was carried out in the municipality of Florianópolis, Southern Brazil, in 2001. Four groups were evaluated, over a total of 24 sessions at primary healthcare units. Participant observation was performed to start the fieldwork. The reports were analyzed by means of the technique of enunciative-pragmatic discourse analysis. ANALYSIS OF RESULTS: The types of action among the coordinators that were congruent with the preventive model were: oppression, bench teaching, biologism and higienism, prescription of approaches, blame apportionment, infantilization, reduction of collective problems, denigration of group settings and use of monologue. The types of action consonant with the new promotion model were: facilitation of free expression and autonomy, empathetic communication, constructivism, receptiveness, active listening and promotion of overcoming of violence and alienation. CONCLUSIONS: The coordinators acted primarily by means of the preventive model, without using technical and theoretical resources that allude to group methodology in the field of healthcare. The actions within the preventive and new health promotion models that were identified reveal characteristics that are grounded in, respectively, the ethics of oppression/subordination of users and cooperation/acceptance of users as free and responsible for their choices and consequences.
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    Avaliação da rede de centros de atenção psicossocial: entre a saúde coletiva e a saúde mental
    (Faculdade de Saúde Pública da Universidade de São Paulo, 2009-08-01) Onocko Campos, Rosana Teresa; Furtado, Juarez Pereira [UNIFESP]; Passos, Eduardo; Ferrer, Ana Luiza; Miranda, Lilian; Gama, Carlos Alberto Pegolo da; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP); Universidade Federal Fluminense
    OBJECTIVE: To analyze the assistance, management and workers' education models of a network of psychosocial healthcare services (CAPS). METHODS: This is a qualitative evaluation research, supported by the Gadamerian hermeneutics, carried out in the city of Campinas, Southeastern Brazil, in 2006-2007. Data were collected through 20 focus groups in centers known as CAPS III, with different groups of stakeholders (workers, municipal managers, users, family members and local managers). After the transcription of each group's recorded material, narratives were constructed following Ricoeur's theoretical framework. At the second stage of the focus groups, these narratives were presented to the participants, who could contest, correct and validate them. The preliminary results were discussed in workshops, with the aim of developing a good practice guide in CAPS III. RESULTS: The study identified strong points and weaknesses concerning the care provided during the crisis, articulation with the primary care network, formulation of therapeutic projects, management and organization in reference teams, educational background and psychological distress. CONCLUSIONS: The network of psychosocial care centers in Campinas stands out due to its originality in the implementation of six CAPS III and to its efficacy in providing comprehensive assistance to users and family members in the moment of crisis and in rehabilitation. The organization in reference technician and/or team prevails, as well as the development of therapeutic projects. Night teams reduction is the most important problem and the main source of workers' stress. The professionals' education proved to be insufficient to deal with the challenges faced by these services.
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    Caracterização da cultura de crack na cidade de São Paulo: padrão de uso controlado
    (Faculdade de Saúde Pública da Universidade de São Paulo, 2008-08-01) Oliveira, Lúcio Garcia de [UNIFESP]; Nappo, Solange Aparecida [UNIFESP]; Centro de Informações sobre Saúde e Álcool; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To characterize the situation regarding crack cocaine use in the city of São Paulo, along with the sociodemographic profile of its users. METHODOLOGICAL PROCEDURES: Qualitative ethnographic study carried out with an intentional sample of crack cocaine users (n=45) and former users (n=17). The participants were recruited by means of the chain sampling method and they underwent a semi-structured interview guided by a questionnaire, in 2004 and 2005. The combination of each question and its respective responses gave rise to specific reports that were interpreted individually. ANALYSIS OF THE RESULTS: The predominating profile of the crack cocaine users was that they were single young men of low socioeconomic class and low schooling level, without formal employment ties. The pattern of use most frequently cited was compulsive, characterized by multiple drug use and carrying out illegal activities in exchange for crack cocaine or money. However, controlled use was also identified. This consisted of non-daily use of crack cocaine mediated by individual factors that were developed intuitively by the user. Controlled use was similar in nature to the strategies adopted by former users to achieve a state of abstinence. CONCLUSIONS: The culture of crack cocaine use has undergone changes regarding the pattern of use. Although most users do so compulsively, the existence of controlled use was observed. This deserves to be investigated in more detail, particularly with regard to the strategies adopted to attain this.
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    Cartografia do Processo de Cuidado num Serviço de Atenção Domiciliar
    (Universidade Federal de São Paulo (UNIFESP), 2017-08-03) Pozzoli, Sandra Maria Luciano [UNIFESP]; Cecilio, Luiz Carlos de Oliveira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: The practice of caring for sick people in their homes refers to immemorial times. Since the last century, due to the aging of the population, there has been a growing institutionalization of such practice in home care services, which had assumed very different models and work processes in different countries. The main objective of this research was to know the process of care in the Home Care Service (SAD) of a medium-sized municipality in the State of São Paulo as a component of the Emergency and Urgency Network (RUE). Method: It is a case in which I take on a cartographic ethos in every way of the research, participating in the routine of SAD and recording in a field diary the daily scenes. I also have recorded interviews with caregivers and a hospital nurse, and I have conducted a focus group with Primary Care nurses (AB). As a data analysis strategy, the first approximation of the empirical material was the definition of Cutting Plans, that is, intentional cuts made from elements or components of home care policy. In the second analytical approach, there are the Visibility Plans, that are scenes of the daily life that reveal the complex relationships between the prescribed work (that the official policy defines) and the actual work (that is how care is performed by the teams in their concrete conditions of work). Results and Discussion: Through the cutting plans and visibility plans, it was possible to identify problems related to management, in particular those that establish limits for the team work; limitations in the use of the information system; the positive aspects and also the tensions present in the multiprofessional work; the conflicts present in the daily work; deficiencies in the training of workers; the isolation of SAD in relation to other health equipment; the limitations of AB to effectively support SAD; the overload of the caregiver and the inescapable need of strategies to support their work and elements of the patient universe, marked by the loss of autonomy and often by the lack of perspective of future building, showing human vulnerability in different perspectives and the sense that each family gives to the suffering experienced by the dependent family member of long-term care. Conclusions: The study evidenced that home care is a model of innovative care, if assumed by the health system with sufficient human resources, materials, equipment, transportation and agile and flexible information system to include real information. Caregivers suggested that care must to be integrated among professionals and with other points of the Health Care Network (RAS). There are difficulties for AB to assume this model of care, and the experience indicated the need of social support services to contribute to the quality of life of the caregiver.
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    A compreensão do residente médico em reumatologia no atendimento aos pacientes com fibromialgia
    (Associação Brasileira de Educação Médica, 2009-09-01) Canzonieri, Ana Maria [UNIFESP]; Pollak, Daniel Feldman [UNIFESP]; Martins, Maria Anita Viviani; Universidade Federal de São Paulo (UNIFESP); Pontifícia Universidade Católica de São Paulo
    This study focuses on the understanding of rheumatology residents in caring for fibromyalgia patients. The syndrome is difficult to diagnose, and pain is the most important symptom. OBJECTIVES: Understand how residents understand the care, and discover what this care leads to. METHODS: Qualitative study based on hermeneutic phenomenology, with taped individual interviews answering the key question: What does it mean to you to treat fibromyalgia patients? The study analyzed the meanings provided by the residents. The research was performed in three public university hospitals, with second-year medical residents. RESULTS: Care for fibromyalgia patients proved to be a source of frustration, bringing a feeling of powerlessness and indignation; patients suffer from prejudice due to idiosyncrasies, social components, and non-adherence to treatment; the physician needs to be emotionally prepared to provide care - requirements include knowing how to listen and understand the patient-illness relationship; the diagnosis is marked by lack of laboratory confirmation and subjectivity in the work-up; the physician needs support from psychology, and the treatment requires a multidisciplinary team. CONCLUSION: Care is frustrating and generates a feeling of powerlessness. It requires greater psychological preparation during medical training and a more integrated approach between medicine, psychology, and physical therapy.
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    Contribuição da psicoterapia de grupo para o estudo de pacientes com disfunção temporomandibular
    (Universidade Federal de São Paulo (UNIFESP), 2019-03-28) Eberlein, Marina Cardoso Smith [UNIFESP]; Blay, Sergio Luis [UNIFESP]; Fiore, Maria Luiza de Mattos [UNIFESP]; http://lattes.cnpq.br/8745307752384207; http://lattes.cnpq.br/6012272319615108; http://lattes.cnpq.br/1514592934381737; Universidade Federal de São Paulo (UNIFESP)
    Objectives: reflect about the experience of group brief psychotherapy impact applied on three sets of patients from Temporomandibular Disorder Clinic at the Hospital São Paulo (UNIFESP) and to examine how such approach can promote raise of their emotional experiences awareness advancing beyond their body expressions. Analyze how this approach can increase the symbolic expression of the affection and which are the most recurrent themes brought into the three groups. Methods: the investigation design is a clinical qualitative retrospective research with three separate brief psychotherapy groups, each one performed with 12 therapy sessions, in a psychodynamic theoretical approach, totaling 18 patients (Group I with 6 participants, Group II with 8 and Group III with 4). The participants were selected by a personal psychological interview after a dentist referral. The sessions were documented and subsequently examined by the most significant and frequent thematic axes. Each group and each individual therapeutic process were analyzed. Results: The author observed a female gender prevalence in 8:1 in relation to male. The age group found was 36 to 77 years, most were professionally inactive (15), predominance of traumatic life stories with losses, abandonments, violence, poverty, fragility of reliable links. It was observed some varied group dynamics, from more structured and organized groups, where a reliable link was built, to less structured and disorganized experiences, where no link was established. It was observed a plurality of individual trajectories, without a homogeneous profile. The majority showed interest to continue the self-knowledge process. The most frequently topics were subjects related to the narcissistic issues like non-differentiation between self and not-self, the trauma, the violence, aggression and the body expression of suffering. Conclusion: The therapeutic group as an embracing model and tie stimulator could develop an experience of psychic integration and differentiation to patients with pain.
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    Contributions of Public Health to nursing practice
    (Assoc Brasileira Enfermagem, 2017) Jorge de Souza, Karen Mendes [UNIFESP]; Seixas, Clarissa Terenzi; Scherlowski Leal David, Helena Maria; da Costa, Aline Queiroz
    Objective: Analyze the perceptions of undergraduate nursing students about the contributions of public health to nursing practice in the Unified Health System. Method: Qualitative Descriptive Study. Data collection was carried out through semi-directed interviews with 15 students. The language material was analyzed according to content and thematic analysis. Results: Thematic categories were established, namely: "Perceptions about Public Health" and "Contribution of Public Health to nursing practice in the Unified Health System". Final considerations: Perceptions about Public Health are diversified, but converge to the recognition of this field as the basis for training nurses qualified to work in the SUS with technical competence, autonomy and focusing on the integrality in health care.
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    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.
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    Crenças atribuídas à opção de não usar MDMA (ecstasy): estudo qualitativo entre não usuários, usuários experimentais e ex-usuários
    (Universidade Federal de São Paulo (UNIFESP), 2011-01-26) Comis, Maria Angélica de Castro [UNIFESP]; Noto, Ana Regina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Although ecstasy (MDMA) is a drug mostly consumed in the eletronic scene context, not all individuals who faces an opportunity to use ecstasy do it. This study aimed at understanding the reasons ascribed to not using or stop using ecstasy in order to contribute to preventive actions or damage reduction activities. Methods: Snowball sampling was applied. By means of individual semi-structured interview, 53 participants were allocated in three groups: non-users (NU, n = 23), experimental users (EXP, n = 12) and ex-users (EX-US, n = 18). Literal transcriptions were submitted to content analyses using NVivo8. Results: Non-users (NU) and experimental users (EXP) attributed reasons mostly related to fear of effects and moral, family or religious principles. Ex-users (EX-U) claimed reasons related to health complications and being apart from the context of use, but they did not discard the possibility of future use. Aspects related to health, values and context were present at all groups. Final considerations: Negative effects and/or adverse consequences seem to lead the decisions among the different groups, and such information should be used by universal preventive actions. For those who have already used ecstasy, both social and environmental context seem to be the most important factors for decision making, evidencing the importance of context for selective prevention and damage reduction actions.
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    A dimensão da ética na pesquisa em saúde com ênfase na abordagem qualitativa
    (Faculdade de Saúde Pública, Universidade de São Paulo.Associação Paulista de Saúde Pública., 2012-03-01) Castro-Silva, Carlos Roberto de [UNIFESP]; Mendes, Rosilda [UNIFESP]; Nakamura, Eunice [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    This article addresses the ethical dimension in health research, relating it more specifically to the qualitative approach, based on contributions of the social sciences and ethnography in particular, as it presupposes building a relationship of trust and respect between researchers and researched subjects that is gradually configured. The ethical aspects permeate qualitative research from the choice of the subject matter, the methodological outlines, analysis of the results, to the commitment of providing a feedback for the researched subjects regarding the obtained information. The ethical aspects presuppose the value of an interpersonal relationship in which the different interests, values and worldviews stand as a possibility or not of a joint construction of knowledge. The choice of a subject or object of study is related to a particular life trajectory in which the researcher should ask himself, at all times, how to conciliate the constitution of an ethical attitude in relation to the researched subjects with his own desires, dreams, curiosities and expectations. The article aims to discuss such dilemmas experienced by the researcher, highlighting the importance of ethics for his personal, professional and socio-political growth, and emphasizing the desire for knowledge autonomy, solidarity with social groups and with people involved in the research. Based on the report of a research process, the article intends to contribute to the understanding of how ethical aspects are inextricably linked to research, and also to the researcher, bringing elements to the conduction of qualitative research especially in public health.
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    A Estratégia Saúde da Família como cenário de aprendizagem: Análise de uma experiência de interação ensino-serviço na formação médica
    (Universidade Federal de São Paulo (UNIFESP), 2019-04-26) Fassina, Vanessa [UNIFESP]; Mendes, Rosilda [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The implementation of National Curricular Guidelines for medical graduation, from 2001, led to initial changes in training through the integration of teaching with the health system and also through the decentralization of the hospital learning scenario to Primary Care. The update, in 2014, has maintained the objective of providing a generalist, humanistic, critical and reflexive education, which favors the interaction of users and health professionals since the first years of graduation. From this perspective, it is proposed the use of new teaching methodologies and expansion of the learning scenarios that privilege the active participation of the student in the knowledge construction. As the activities take place in a practice context, the challenge is to permanently involve the professionals in the training process. This qualitative study, with the researcher's implication, aims to analyze the perception of students and teachers of a private university in the state of São Paulo, health professionals and municipal management in order to identify the contributions that the teaching-service interaction can offer for the production of a meaningful learning space in medical training. To obtain the data, it was conducted round table discussions with the students of the first, third and fifth periods of the Medicine course, semi-structured interviews with health professionals and municipal management and university teachers, as well as the elaboration of a research diary. The data were analyzed using the Content Analysis technique, with the disclosure of three categories of meaning. The first, Learning scenario: the practice in the health unit, which revealed that the insertion of students in a Family Health Unit favored the development of the physician patient relationship, experience the physician's work routine besides knowing the specificity and complementarity of the professions, however, there was little opportunity to practice what they learned in theory. The second, Learning scenario: opportunities and limitations of Home Visit, the home was a scenario in which students could learn more about the patients' life and not only have the punctual contact in the search of diseases; they could also develop skills such as communication and listening, but they complained about the repetitive frequency that they go to the houses and stay with the same families. The last one, (Un) meetings between students and health professionals, the fragile contact between them led to a lack of opportunity for creating a relationship and acquiring knowledge through the interprofessional practice. This study showed that the Family Health Strategy can contribute as a space for the production of meaningful learning, and it is necessary to recompose the relationships between subjects involved, as well as a permanent space for discussion about this new role of services training.
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    Extensão universitária e prática dos agentes comunitários de saúde: acolhimento e aprendizado cidadão
    (Faculdade de Saúde Pública, Universidade de São Paulo.Associação Paulista de Saúde Pública., 2014-06-01) Castro-Silva, Carlos Roberto de [UNIFESP]; Chiaperini, Pâmela Talamoni [UNIFESP]; Frutuoso, Maria Fernanda Petroli [UNIFESP]; Morell, Maria Graciela Gonzalez de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The interdisciplinary intervention by the university in areas of high vulnerability of Santos, besides contributing to the strengthening of the Brazilian National Health System (SUS), highlights the suffering faced by community health agents (CHA) in their routines, coming from requests from citizens. These result from social exclusion and the violence in which they live, as well as unhealthy working conditions and low pay. The purpose of this article is to present an experience of systematic intervention through a university extension project, bringing elements that enhance the actions of community health agents of the Family Health Strategy (FHS) in Santos. For this qualitative study we analyzed the field diaries of weekly meetings, from the perspective of teachers and students, for the period from August 2010 to June 2011. Data’s organization and analysis were based on the Grounded Theory. The results indicated the need of gathering the CHA experiences, broadening the understanding of the dilemmas faced by these professionals and consequently the impasses of implementing SUS and the FHS. Moreover, continued education should be encouraged, based upon a praxis able to promote CHA’s personal and professional projects.
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    Fissura por crack: comportamentos e estratégias de controle de usuários e ex-usuários
    (Faculdade de Saúde Pública da Universidade de São Paulo, 2011-12-01) Chaves, Tharcila Viana [UNIFESP]; Sanchez, Zila van der Meer [UNIFESP]; Ribeiro, Luciana Abeid [UNIFESP]; Nappo, Solange Aparecida [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To understand crack cocaine craving among users and describe craving behaviors and coping strategies. METHODOLOGICAL PROCEDURES: Qualitative study with a non-random criterion sample consisting of 40 current and former crack cocaine users conducted in São Paulo, southeast Brazil, in 2007 and 2008. Respondents were selected using snowball sampling technique. In-depth semi-structured interviews were conducted until theoretical saturation was attained. All interviews were transcribed and content analysis was performed to construct inferences and hypotheses based on the narratives. ANALYSIS OF RESULTS: The respondents showed a similar gender distribution, were 18 to 50 years of age, and had different levels of education. Most were from low-income background. In addition to craving resulting from crack cocaine withdrawal and environmental and emotional cue effects, it was found that crack cocaine itself triggers craving. The latter appeared to be a strong trigger of binge episodes. Binge episodes made them lose their moral values, and act dangerously to get more drug. The most common ways reported to get crack cocaine or money to buy it were: prostitution, manipulation of other people, go into debt, sell personal belongings to buy drug and theft. The respondents reported strategies to overcome their cravings as well as pharmacological and behavioral approaches to prevent cravings such as eating, having sex, playing soccer, working, avoiding social situations of crack use and taking depressants. CONCLUSIONS: Crack cocaine binges are caused by a craving induced by the effects of crack cocaine itself. Users develop self-control strategies to cope with their cravings that may help improve their drug use and treatment effectiveness.
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    Intervenção religiosa na recuperação de dependentes de drogas
    (Faculdade de Saúde Pública da Universidade de São Paulo, 2008-04-01) Sanchez, Zila van der Meer [UNIFESP]; Nappo, Solange Aparecida [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To analyze the role of emerging religious interventions in the recovery from drug addiction. METHODOLOGICAL PROCEDURES: An exploratory qualitative study carried out in the city of São Paulo, Southeastern Brazil, in 2004 and 2005. In-depth interviews were held with 85 former drug users who had turned to non-medical religious resources for the treatment of their drug addiction and who were free from drugs for at least six months. The religious groups included in the analysis were Catholics, Evangelicals and Spiritualists. The interviews contained questions relating to sociodemographic data, the religiosity of the interviewee, his or her history of drug consumption, medical treatment for drug addiction, religious treatment and prevention of drug consumption through religion. ANALYSIS OF RESULTS: There were differences between the religious groups in the way that the drug addict was supported. The group that most used religion as an exclusive form of treatment was the Evangelicals, who rejected the intervention of a doctor andr any kind of pharmacological treatment. The Spiritualists most turned to therapeutic support for alcohol dependence, as well as conventional treatment, on account of their greater purchasing power. Catholics generally relied exclusively on religious therapy, but were less likely to reject the possibility of medical treatment. The importance given to prayer as an anxiolytic method was common in the three treatments. Confessions and pardons - in the forms of (faith) conversions and penitence for Evangelicals and Catholics respectively - served to help to rebuild people's lives and restore their self-esteem. CONCLUSIONS: According to the interviewees, what helped them to maintain their abstinence from drugs was more than just religious faith. Other factors included the support, positive pressure and welcoming offered by the group, and the offer to rebuild their lives with the unconditional support of religious leaders.
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    Lay agency and healthcare: producing healthcare maps
    (Cadernos Saude Publica, 2014-07-01) Cecilio, Luiz Carlos de Oliveira [UNIFESP]; Carapinheiro, Graca; Andreazza, Rosemarie [UNIFESP]; Medeiros de Souza, Ana Lucia [UNIFESP]; Garcia Andrade, Maria da Graca; Santiago, Silvia Maria; Meneses, Consuelo Sampaio [UNIFESP]; Reis, Denizi Oliveira [UNIFESP]; Araujo, Eliane Cardoso [UNIFESP]; Pinto, Nicanor Rodrigues da Silva [UNIFESP]; Spedo, Sandra Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Inst Univ Lisboa; Universidade Estadual de Campinas (UNICAMP)
    This study aimed to characterize which regulatory logics (other than government regulation) result in healthcare output, using a two-stage qualitative study in two municipalities in the ABCD Paulista region in São Paulo State, Brazil. the first stage included interviews with strategic actors (managers and policymakers) and key health professionals. the second phase collected life histories from 18 individuals with high health-services utilization rates. An analysis of the researchers' involvement in the field allowed a better understanding of the narratives. Four regulatory systems were characterized (governmental, professional, clientelistic, and lay), indicating that regulation is a field in constant dispute, a social production. Users' action produces healthcare maps that reveal the existence of other possible health system arrangements, calling on us to test shared management of healthcare between health teams and users as a promising path to the urgent need to reinvent health.
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    O método etnográfico em pesquisas na área da saúde: uma reflexão antropológica
    (Faculdade de Saúde Pública, Universidade de São Paulo.Associação Paulista de Saúde Pública., 2011-03-01) Nakamura, Eunice [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The article aims to reflect on the possible theoretical and methodological contributions of social science research in health, given the increasing incorporation of qualitative methodologies, particularly ethnography, this research. The starting point for this discussion are three theoretical and conceptual keys to the consolidation of the ethnographic method in its origin, in conjunction with the very assertion of anthropological science, assuming that by understanding what is the ethnographic practice, we also understand the importance of the anthropological explanation of the different socio-cultural phenomena, among them health, illness and strategies for treatment or cure. These assumptions - ethnocentrism, relativism and culture - marked so the research and production of anthropological knowledge, theory and method that have become inseparable. Thinking of repetition and constant replenishment of inseparability in a dialectical movement of concrete experience with learned theories can be a major strength of the social sciences, particularly anthropology, for research in health. The absence of this reflection seems to risk the compromise that can interface with the theoretical and methodological rigor in the production and dissemination of scientific knowledge, the reduction and simplification of the technique. On the other hand, this same inseparability leads us to inquire about possible contributions of the incorporation of ethnographic method in research in the health of anthropological knowledge.
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    Narrativas: utilização na pesquisa qualitativa em saúde
    (Faculdade de Saúde Pública da Universidade de São Paulo, 2008-12-01) Onocko Campos, Rosana Teresa; Furtado, Juarez Pereira [UNIFESP]; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP)
    The present bibliographic review followed a path through several chains of thought concerned with studying narratives. Some classical studies on narrative structure with origins within literature, history, communications theory and psychoanalysis were analyzed with the aim of exploring whether their categories and concepts would be methodologically applicable to qualitative health-related research. In the conclusions, the potential for using narratives to study situations in which there is interest in mediations between experience and language, between structure and events, between subjects and collective groups or between memory and political action are highlighted. These are questions that traditionally are of interest within Brazilian public health with regard to the field of Policy, Planning and Management.
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    Ouvidorias públicas de saúde: estudo de caso em ouvidoria municipal de saúde
    (Faculdade de Saúde Pública da Universidade de São Paulo, 2014-02-01) Silva, Rita De Cássia Costa Da; Pedroso, Marcelo Caldeira; Zucchi, Paola; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    OBJECTIVE: To analyze the role of a Municipal Health Ombudsman and its contribution to the public health management from the perspective of the public health system users and the municipal health counselors. METHODS: Qualitative research approach using the case study, descriptive and transversal methods. The unit of analysis was a Municipal Health Ombudsman, in the state of Minas Gerais, Southeastern Brazil, between May and August 2010. The study was observational in nature and data were collected through interviews with two groups of stakeholders: users and municipal health counselors. We interviewed 44 Brazilian Unified Health System users who had made direct use of the Municipal Health Ombudsman and all 20 municipal health counselors. The data obtained were analyzed based on three issues: (1) nature of the data obtained; (2) discussion of subsidies to qualify the ombudsman’s functioning as a management tool; (3) proposals for actions to improve democratic management in the area of public health. RESULTS: The complaints to the ombudsman denoted difficulties in access to health care services running the risk of their being perceived as shortcuts to gaining accessibility, disregarding the principle of social justice. The role of the ombudsman has the citizens’ approval. Users reported the following main functions of the ombudsman: to support the resolution of health problems, to listen and to clarify issues regarding Brazilian Unified Health System operations and procedures. Information was emphasized by health counselors as an instrument of power and access to the rights of Brazilian Unified Health System users. They highlighted that the ombudsman has the role of ensuring justice to foster an effective health policy, besides playing an important mediating role between the board of the municipal health system, its managers and citizens. Furthermore, the ombudsman was shown to have an execution role that transcends its regular functions. CONCLUSIONS: The study found that the ombudsman is a key management tool in monitoring the health care system. Therefore, the establishment of the ombudsman is an advance in the field of democratic management. Nevertheless, there are challenges to be overcome in order to improve ombudsman contribution to the execution of health policies and representing citizens in ensuring their rights to health care.
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    Pelos caminhos da integralidade: o que uma usuária-guia pode ensinar sobre a produção de redes de cuidado?
    (Universidade Federal de São Paulo (UNIFESP), 2017-12-01) Nardez, Danielle Abujamra Siufy [UNIFESP]; Mendes, Rosilda [UNIFESP]; http://lattes.cnpq.br/3746693286898810; http://lattes.cnpq.br/0844959075471900; Universidade Federal de São Paulo (UNIFESP)
    The Brazilian Unified Health System (SUS) has brought about significant changes in the way of caring for the health of the population and is a result of the ideals and struggles of social movements and the Sanitary Reform of the 1970s and 1980s. comprehensiveness of care and the study of their dimensions, giving evidence for the interface of the concept with the development of synergistic actions that optimize resources and prioritize established bonds between professionals and these with the community, surpassing the uniquely biologicist view of care. This research was aimed at analyzing the conformation of the networks constituted in primary care from the perspective of a guiding user and a family health team in the construction of integrality of care, understanding how the links are produced in order to extend the knowledge about the connections existing in the different configurations of a local health-producing network. It is a qualitative research in the research-intervention modality that made use of the mapping device to follow the processes of network formation for expanded care in health. The production of data was performed through workshops with the team and with the guide user and the production of the research diaries by the researcher and the team. The material was organized and categorized according to the research objectives. The results show that the way in which the guiding user produces care reveals the relationship between the formal and informal network. They also show that affectivity and bonding were perceived as unique experiences in this research process. The emphasis on the light / relational component of the linkages established between users and health workers also refers to the acceptance of this relationship. The path taken by the guiding user has left important marks in the way to understand the limits of the professional performance of health workers, as well as the reckless view of wholeness as totality. The reflection that now arises refers to the place where users are daily located in the health services of the network and what status their suffering acquires for the different levels of attention. It is also concluded that the method chosen for the production of data showed to be revealing clues to the research process bringing important analyzers to the center of the discussion of the results, providing an opening for new possibilities of investigation of the integrality and formation of the networks, key points for the analysis of health care production. Finally, the study suggests that affections occupy a central place in the processes of health production and that networks constructed from the singularities present in the cases should avoid being guided by the comprehension of integrality as an objective image, in order not to negate the subject and its history in the composition of extended care.