A viabilidade do tratamento comunitário em quatro regiões da cidade de São Paulo
Data
2023-09-01
Autores
Lima, Marcia Aparecida Ferreira 
Orientadores
Noto, Ana Regina
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
O Tratamento Comunitário (TC) é uma intervenção desenvolvida em países da América Latina e que, em sua essência, considera a complexidade e os fatores que envolvem o sofrimento social. Em sua metodologia, inclui a comunidade como um recurso para integração da pessoa em situação de exclusão social. Embora o TC seja amplamente utilizado por equipes multiprofissionais, é essencial obter evidências científicas sobre sua viabilidade. Assim, este estudo teve como objetivo investigar a viabilidade do TC em quatro territórios do Município de São Paulo, preenchendo a lacuna de conhecimento científico no que diz respeito à sua aplicação prática. Método: Estudo de métodos mistos, longitudinal, com a participação de 42 profissionais da saúde e assistência social, que receberam capacitação teórica e prática sobre a metodologia do TC. Os dados foram obtidos por meio dos estudos dos territórios, redes comunitárias, sistema estratégico de tratamento (SET) e de dados sociodemográficos usando a folha de primeiro contato(FPC). Foram realizados grupos focais e entrevistas com os participantes do processo de implantação do TC. Os dados quantitativos passaram por análise descritiva sociodemográfica e análise das redes comunitárias. Os dados qualitativos foram organizados, submetidos à triangulação e categorização com base nos indicadores de viabilidade: demanda, aceitabilidade, implementação, integração e expansão. Resultados: Foram acessadas 132 pessoas nos territórios por meio de ações de vinculação. Quanto à demanda, observou-se o desejo de mudanças de paradigmas e maior autonomia para a rede no atendimento daqueles com maior dificuldade de acesso aos serviços. A aceitabilidade foi evidenciada com a ampliação do olhar para trabalhar com a população em situação de vulnerabilidade, bem como a mudança qualificada no cotidiano de trabalho. Em relação à implementação, surgiu a necessidade de adaptações instrumentais. Considerações finais: Observou-se que a integração foi evidenciada com as comunidades, bem como com a ampliação da rede de recursos em cada território. A expansão revelou diferenças nos territórios de atuação, sobretudo em relação à rotatividade e ao índice de violência. Deste modo, este estudo evidencia aspectos favoráveis de viabilidade do TC nos territórios estudados, apontando para necessidade de adaptações a serem consideradas.
Community Treatment (CT) is an intervention developed in Latin American countries that, in essence, considers the factors and complexity of social suffering. Its methodology includes the community as a resource for the integration of people in situations of social exclusion. Although multidisciplinary teams widely use CT, obtaining scientific evidence about its viability is essential. Thus, this study aimed to investigate the feasibility of TC in four territories in the City of São Paulo, filling the gap in scientific knowledge regarding its practical application. Method: Mixed methods study longitudinal, with the participation of 42 health and social assistance professionals, who received theoretical and practical training on the TC methodology. The data was obtained through studies of territories, community networks, strategic treatment system (SET), and sociodemographic data using the first contact sheet (FPC). Focus groups and interviews were held with participants in the CT implementation process. Focus groups and interviews were held with participants in the TC implementation process. The quantitative data underwent sociodemographic descriptive analysis and analysis of community networks. The qualitative data were organized, and subjected to triangulation and categorization based on feasibility indicators: demand, acceptability, implementation, integration, and expansion. Results: 132 people were accessed in the territories through linking actions. Regarding demand, the desire for paradigm shifts and greater autonomy for the network in serving those with greater difficulty accessing services was observed. Acceptability was evidenced with the expansion of the perspective to work with the population in vulnerable situations, as well as the qualified change in the daily work routine. Regarding implementation, there was a need for instrumental adaptations. Final considerations: It was observed that integration was evidenced with the communities, as well as with the network of resources in each territory. The expansion revealed differences in the territories of operation, especially in relation to turnover and the rate of violence. This study highlights favorable aspects of CT viability in the territories studied, pointing to the need for adaptations to be considered.
Community Treatment (CT) is an intervention developed in Latin American countries that, in essence, considers the factors and complexity of social suffering. Its methodology includes the community as a resource for the integration of people in situations of social exclusion. Although multidisciplinary teams widely use CT, obtaining scientific evidence about its viability is essential. Thus, this study aimed to investigate the feasibility of TC in four territories in the City of São Paulo, filling the gap in scientific knowledge regarding its practical application. Method: Mixed methods study longitudinal, with the participation of 42 health and social assistance professionals, who received theoretical and practical training on the TC methodology. The data was obtained through studies of territories, community networks, strategic treatment system (SET), and sociodemographic data using the first contact sheet (FPC). Focus groups and interviews were held with participants in the CT implementation process. Focus groups and interviews were held with participants in the TC implementation process. The quantitative data underwent sociodemographic descriptive analysis and analysis of community networks. The qualitative data were organized, and subjected to triangulation and categorization based on feasibility indicators: demand, acceptability, implementation, integration, and expansion. Results: 132 people were accessed in the territories through linking actions. Regarding demand, the desire for paradigm shifts and greater autonomy for the network in serving those with greater difficulty accessing services was observed. Acceptability was evidenced with the expansion of the perspective to work with the population in vulnerable situations, as well as the qualified change in the daily work routine. Regarding implementation, there was a need for instrumental adaptations. Final considerations: It was observed that integration was evidenced with the communities, as well as with the network of resources in each territory. The expansion revealed differences in the territories of operation, especially in relation to turnover and the rate of violence. This study highlights favorable aspects of CT viability in the territories studied, pointing to the need for adaptations to be considered.
Descrição
Citação
LIMA, Marcia Aparecida Ferreira. A viabilidade do tratamento comunitário em quatro regiões da Cidade de São Paulo. 2023. 114 f. Dissertação (Mestrado em Psicobiologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2023.