Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2016-10-04T21:15:12Z No. of bitstreams: 1 carolinactg.pdf: 1825671 bytes, checksum: 240fecd0c706da1635555c608ae4db08 (MD5) / Made available in DSpace on 2016-10-04T21:15:12Z (GMT). No. of bitstreams: 1 carolinactg.pdf: 1825671 bytes, checksum: 240fecd0c706da1635555c608ae4db08 (MD5) Previous issue date: 2013-03-27 / Funda??o de Amparo ? Pesquisa do Estado da Bahia - FAPEB / Research on the practices of SUS management in Primary Care in the city of Alagoinhas-BA, whose aims were understand the sense and/or the meaning on the care management in Primary Heath Care, considering the participation of managers, health workers and users in Primary Care in the city of Alagoinhas ?BA; analyze the practice of the SUS management in Primary Care and discuss the competence and attribution of the municipal government (managers, health workers and householders), policies and 'new' models of health in Primary Care. Qualitative research, with family health units as investigation field. The participant subjects in the study were divided into four groups: Group I, managers; Group II, health workers; Group III, users; Group IV, key informants, in total 26 participants. We used systematic observation, semi-structured interviews and document analysis as data collection techniques. The method of data analysis was an approximation with Hermeneutics-dialectical, from which were drawn three categories of analysis: categorical-Practice of management in Primary Health Care: sense and meaning; category 2-A orchestra-'ideal' of rationality, hegemonic order and productive and category 3-social Control: in search of democracy. According to the survey results, the SUS management practices in Primary Care of Alagoinhas-BA municipality occur disjointed among user subjects, health workers and managers, characterized by the centralization of decision-making power of managers to the detriment of the interests of users and workers, reflecting the fragility of the citizenship exercise. Thus, social control, permanent education and health planning as a tool for sharing of power among subjects has only been theorized, reproducing one centralized management, since the senses and meanings for the management sometimes approach, sometimes depart from the practices of the involved participants. In the subject understanding, the management practices should be established in the user-centered model of health to provide the best service to users. However, these manager practices are still rooted in the hegemonic model, focused in normative planning. Regarding to the workers, there is a double understanding: the planning owns features of normative focus and a small part in the situational-local strategic focus. However, the workers practices have been developed in care model of Programmatic Actions, welcome and user participation in the work process. The social participation occurs in the county through the Municipal Health Council and community neighborhood Association. Faced with such reality, the practices of health management in the county of Alagoinhas are stuck to the model of a Taylorist management, although of starting hearing the echo of co-management in family health Units. / Estudo sobre as pr?ticas de gest?o do SUS na Aten??o B?sica no munic?pio de Alagoinhas-BA, cujos os objetivos foram Compreender o(s) sentido(s) e/ou significado(s) sobre a gest?o do cuidado na Aten??o B?sica de Sa?de, considerando-se a participa??o dos gestores, trabalhadores de sa?de e usu?rios da Aten??o B?sica no munic?pio de Alagoinhas-BA; analisar a pr?tica de gest?o do SUS na Aten??o B?sica e discutir a(s) compet?ncia(s) e a(s) atribui??o(?es) do governo municipal (gestores, trabalhadores de sa?de e mun?cipes) as pol?ticas e ?novos? modelos de sa?de na Aten??o B?sica. Pesquisa qualitativa, tendo como campo de investiga??o as unidades sa?de da fam?lia. Os sujeitos participantes do estudo foram divididos em quatro grupos: Grupo I, gestores; Grupo II, trabalhadores de sa?de; Grupo III, usu?rios; Grupo IV, informantes-chave, no total 26 participantes. Como t?cnicas de coleta dos dados utilizamos observa??o sistem?tica, entrevista semi-estruturada e an?lise de documentos. O m?todo de an?lise de dados foi uma aproxima??o com a Hermen?utica-dial?tica, a partir do qual foram elaboradas tr?s categorias de an?lise: categoria1-Pr?tica da Gest?o na Aten??o B?sica de Sa?de: sentidos e significados; categoria 2-A orquestra ?ideal? da racionalidade, ordem hegem?nica e produtiva e categoria 3-Controle social: em busca da democracia. De acordo com os resultados da pesquisa, as pr?ticas de gest?o do SUS na Aten??o B?sica do munic?pio de Alagoinhas-BA ocorrem desarticuladas entre os sujeitos usu?rios, trabalhadores de sa?de e gestores, caracterizada pela centraliza??o do poder de decis?o dos gestores em detrimento dos interesses dos usu?rios e trabalhadores, traduzindo a fragilidade do exerc?cio da cidadania. Desse modo, o controle social, a educa??o permanente e o planejamento em sa?de como instrumentos de partilhamento do poder entre sujeitos tem sido apenas teorizado, reproduzindo uma gest?o centralizada, j? que os sentidos e significados para gest?o ora aproximam, ora se afastam das pr?ticas dos sujeitos envolvidos. Na compreens?o dos sujeitos, as pr?ticas de gest?o devem ser baseadas no modelo de sa?de usu?rio-centrado para proporcionar o melhor atendimento aos usu?rios. No entanto, as pr?ticas dos gestores ainda continuam arraigadas no modelo hegem?nico, focado no planejamento normativo. Quanto aos trabalhadores h? um entendimento duplo: o planejamento possui caracter?sticas do enfoque normativo e uma pequena parte no enfoque estrat?gico situacional local. Contudo, as pr?ticas dos trabalhadores tem sido desenvolvidas no modelo de aten??o das A??es Program?ticas, acolhimento e participa??o dos usu?rios no processo de trabalho. A participa??o social ocorre no munic?pio atrav?s do Conselho Municipal de Sa?de e Associa??o comunit?ria de bairro. Diante de tal realidade, as pr?ticas de gest?o em sa?de no munic?pio de Alagoinhas encontram-se presas ao modelo de uma gest?o Taylorista, apesar de come?ar a ouvir o eco da co-gest?o nas Unidades de sa?de da fam?lia.

Submitted by Jadson Francisco de Jesus SILVA (jadson@uefs.br) on 2018-01-22T23:33:37Z No. of bitstreams: 1 DISSERTA??O PDF.pdf: 1421296 bytes, checksum: d0447d18981b9ca5dfeb2437db3a6a97 (MD5) / Made available in DSpace on 2018-01-22T23:33:37Z (GMT). No. of bitstreams: 1 DISSERTA??O PDF.pdf: 1421296 bytes, checksum: d0447d18981b9ca5dfeb2437db3a6a97 (MD5) Previous issue date: 2015-08-28 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / Introduction: accountability is understood as a powerful tool in health work process, being able to provide remarkable changes in the organization of care model, aimed at solving the demands of people who enter the health services. However, the accountability assumed by the worker or health care team when hinged to the host, qualified listening and create bonds, is configured in a key agency and can provide closer relations between workers and users, promoting the recognition of the actual conditions and health needs of people and the community. Objectives: To discuss the different approaches on accountability and present them in an articulated wayunderstanding relational device associated with the definition of essential tool in the development of health work proposed for the Primary Health Care (ABS); analyze how the accountability of staff working in the Family Health Strategy in a city of Bahiahas been built in search of solving the demands of users. Methodology: qualitative and reflective approach was used in this study the. Therefore, we sought to identify texts through theoretical review, which addressed the different dimensions of health accountability, the Virtual Health Library (BVS) and Higher Education Personnel Improvement Coordination database(CAPES) from searching the word "accountability", identifying initially 348 studies, 38 of them were selected, relevant to the development to the study. Semi-structured interviews with users (13), health workers (22) and leaders (09), totalling 44 interviewed, and systematic observation of 07 (seven) Family Health Units in a municipality of Bahia were conducted. Data analysis was guided by the theme and reflective content analysis, and analytic flowchart. Results: accountability can be built from the user's first contact with the service, with potential to expand more responsive practices between workers and users. However, the organization of services in the Family Health Strategy (ESF) is driven by scheduled or induced demand focusing on users residing in the territory of social health unit, in certain lines of care, with directions agenda, attention occurring in the specific dayin the week and delimitation of quantitative spaces. The attention to spontaneous demand is organized based on the recognition of acute demand, based on illness and in need of immediate care; and non-acute demand, represented by situations that can wait for the service. It was identified lack of teamwork, reflecting a context in which every employee carries accountability for their practice in isolation, disjointed and directed almost exclusively induced demands. Concluding Remarks: The organization demands for ESF happens through the actions programming, directed to induced demand, based on individualism of the subject. The care to spontaneous demand has been driven by the logic of care to acute demand when there are urgent attention. The accountability for the development of health practices is taken individually, for each worker performs his function without promoting joint practices with the other team members. Finally, it is necessary to understand that accountability is underpinned in the actions of all subjects involved, associated with interconnected health services, making this way an articulated network of assurance continued care to users and families. / Introdu??o: a responsabiliza??o ? compreendida como uma potente ferramenta no processo de trabalho em sa?de, sendo capaz de proporcionar mudan?as significativas na organiza??o do modelo de aten??o, visando ? resolubilidade das demandas das pessoas que adentram os servi?os de sa?de. No entanto, a responsabiliza??o assumida pelo trabalhador ou equipe de sa?de, quando articulada ao acolhimento, escuta qualificada e cria??o de v?nculo, configura-se em um essencial agenciamento, podendo proporcionar estreitamento das rela??es entre trabalhadores e usu?rios, favorecendo o reconhecimento das reais condi??es e necessidades de sa?de das pessoas e da coletividade. Objetivos: discutir as diferentes abordagens sobre a responsabiliza??o e apresent?-las de maneira articulada a compreens?o de dispositivo relacional, associada ? defini??o de ferramenta essencial no desenvolvimento do trabalho em sa?de proposta para a Aten??o B?sica ? Sa?de (ABS); analisar como tem sido constru?da a responsabiliza??o das equipes que atuam na Estrat?gia Sa?de da Fam?lia em um munic?pio da Bahia, em busca da resolubilidade das demandas dos usu?rios. Metodologia: utilizou-se nesse estudo a abordagem qualitativa e reflexiva. Para tanto, buscou-se identificar textos por meio de revis?o te?rica, que abordavam as distintas dimens?es da responsabiliza??o em sa?de, na Biblioteca Virtual em Sa?de (BVS) e na base de dados da Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES), a partir do argumento de busca "responsabiliza??o", identificando-se inicialmente 348 estudos, sendo selecionados 38, considerados relevantes para o desenvolvimento para o estudo. Adotou-se tamb?m, entrevistas semiestruturadas com usu?rios (13), trabalhadores de sa?de (22) e dirigentes (09), totalizando 44 entrevistados, e a observa??o sistem?tica de 07 (sete) Unidades de Sa?de da Fam?lia em um munic?pio da Bahia. A an?lise de dados foi orientada pela an?lise de conte?do tem?tica e reflexiva, e fluxograma analisador. Resultados: a responsabiliza??o pode ser constru?da desde o primeiro contato do usu?rio com o servi?o, com potencial de ampliar as pr?ticas mais responsivas entre trabalhadores e usu?rios. No entanto, a organiza??o dos servi?os na Estrat?gia Sa?de da Fam?lia (ESF) ? orientada pela demanda programada ou induzida com foco em usu?rios que residem no territ?rio social da unidade de sa?de, em determinadas linhas de cuidado, com direcionamentos de agenda, aten??o em dia da semana espec?fico e delimita??o de quantitativo de vagas. A aten??o ? demanda espont?nea se organiza com base no reconhecimento da demanda aguda, baseada na enfermidade e na necessidade de atendimento imediato; e a demanda n?o?aguda, representadas por situa??es que podem aguardar o atendimento. Identificou-se aus?ncia de trabalho em equipe, reflexo de um contexto em que cada trabalhador exerce a responsabiliza??o em sua pr?tica de forma isolada, desarticulada e direcionada quase que exclusivamente, as demandas induzidas. Considera??es finais: A organiza??o das demandas na ESF acontece por meio da programa??o de a??es, direcionadas ? demanda induzida, embasada no individualismo do sujeito. A aten??o ? demanda espont?nea tem sido orientada pela l?gica do atendimento ? demanda aguda, quando h? urg?ncia de aten??o. A responsabiliza??o pelo desenvolvimento das pr?ticas em sa?de ? assumida individualmente, pois cada trabalhador desempenha sua fun??o sem promover articula??o das pr?ticas com os demais membros da equipe. Por fim, se faz necess?rio compreender que, a responsabiliza??o se concretiza nas a??es de todos os sujeitos envolvidos, associada a servi?os de sa?de interligados, compondo desta forma uma rede articulada com garantia do cuidado continuado aos usu?rios e fam?lias.

Submitted by SBI Biblioteca Digital (sbi.bibliotecadigital@puc-campinas.edu.br) on 2017-04-07T13:13:15Z No. of bitstreams: 1 MARCELA SPINARDI CINTRA.pdf: 1007958 bytes, checksum: b6f1a9aae314afb1183a3868e2ebadcc (MD5) / Made available in DSpace on 2017-04-07T13:13:15Z (GMT). No. of bitstreams: 1 MARCELA SPINARDI CINTRA.pdf: 1007958 bytes, checksum: b6f1a9aae314afb1183a3868e2ebadcc (MD5) Previous issue date: 2017-02-15 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The idea that what psychologists do is clinical, based on the biomedical model, is still very much rooted in their own discourse and the other professionals. They seem to understand that this action is the main, if not the only, way for psychology to contribute to the users of the health system and to the community. However, there are professionals who seek to act according to the principles of SUS, relying on critical approaches to psychology, such as that developed in Latin America. These professionals approach the communities and present a differentiated practice in relation to the traditional one. Therefore, the objective of this research is to know the practices of some psychologists inserted in Primary Health Care, seeking to identify the bases that underlie them and if they are in consonance with Critical Social Psychology. This research has a qualitative character, using participatory research as a method, together with the conduct of open-ended questions interviews. Three psychologists who work in Health Centres of the city of Campinas participated in the study. In the research results, it can be observed that the professional?s ethical and political views are fundamental to have a critical and contextualized performance, as well as being shaped to perform at SUS. There are also considerations about the practices of these professionals, such as the work performed beyond the walls of the Health Centres and it also brings the relations established with the concepts of Critical Social Psychology. Questions that emerged from participation in their daily actions, such as interdisciplinary, hierarchy in relationships and social influence in health care also arose. / A vis?o de que o fazer dos psic?logos ? cl?nico, pautado no modelo biom?dico, se apresenta ainda muito enraizado no discurso deles pr?prios e dos demais profissionais. Parecem, assim, compreender que essa atua??o ? a principal, sen?o ?nica, forma de a Psicologia contribuir com os usu?rios do sistema de sa?de e com a comunidade. Por?m, existem profissionais que procuram atuar de acordo com os princ?pios do SUS, se baseando em abordagens cr?ticas da Psicologia, como aquela que se desenvolveu na Am?rica Latina. Esses profissionais se aproximam das comunidades e apresentam uma pr?tica diferenciada com rela??o ? tradicional. Assim, o objetivo desta pesquisa ? conhecer pr?ticas de alguns psic?logos inseridos na Aten??o B?sica, buscando identificar as bases que as fundamentam e se est?o em conson?ncia com a Psicologia Social Cr?tica. Essa pesquisa tem car?ter qualitativo, usando a pesquisa participante como m?todo, juntamente com a realiza??o de entrevistas abertas. Participaram da pesquisa tr?s psic?logos que atuam em Unidades B?sicas de Sa?de da cidade de Campinas. Nos resultados da pesquisa, podese observar que o posicionamento ?tico pol?tico do profissional ? fundamental para se ter uma atua??o cr?tica e contextualizada, bem como uma forma??o voltada para a atua??o no SUS. Mostra-se tamb?m considera??es sobre as pr?ticas desses profissionais, como o trabalho realizado para al?m dos muros dos Centros de Sa?de e tamb?m traz as rela??es estabelecidas com os conceitos da Psicologia Social Cr?tica. Tamb?m aparecem quest?es que emergiram da participa??o nas suas a??es cotidianas, como a interdisciplinaridade, a hierarquia nas rela??es e a influ?ncia do social no cuidado em sa?de.

Made available in DSpace on 2014-12-17T15:38:44Z (GMT). No. of bitstreams: 1 DaniloCTL.pdf: 443940 bytes, checksum: d43c74f20d1acda992d023f9ea017bd8 (MD5) Previous issue date: 2009-03-13 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / This study aims to map the working process in the health area starting from the meeting between the family and health teams and mental trouble carriers./MTC. The area of research was the Family Health Unit of Ozeas Sampaio, which is located in the county of Teresina-PI. As regard to the methodology procedure, we used a semi-structured interview timetable, aimed to detail the care practices, admittance and diagnostics that those teams realize with their users. Three teams of eleven workers each were interviewed. There was a doctor, a nurse and two health community agents in each team. The other tools we used were a camp logbook, in which we wrote down some informal dialogs, daily observations and feelings of the unit, and also the accompaniment of the staffs in house calls as well as the weekly meetings in the unit. Those meetings allowed us the construction of two analytic axes: 1) description of the establishment (Family Health Unit) of the organization, (municipal foundation of health and the service network), and the institutions and practice of health. 2) Analysis of the meetings between the worker and the user of Mental Trouble Carriers. In the first axis, we verified the repetition of the working logic focused on jobs in the hospital with the maintenance of the hierarchical relations between worker and the work processes which dissociate management and watchfulness in health care. We identified the lack of physical structure, the lack of self-confidence of the worker in the attention of the mental health care. At the second axis, we assess that the meetings, at the Family Health Unit (FHU) or at the dwelling of the users cause nuisance, discomfort and anxiety to the workers because they deal with issues that go beyond what is named as being the health order such as life stories, family conflicts, unemployment, hunger, sexual and psychological violence. As a matter of fact, they involve difficulties for having new relationships, reception and responsibility for this request / Esse estudo objetiva cartografar os processos de trabalho em sa?de produzidos a partir dos encontros entre trabalhadores de equipes de Sa?de da Fam?lia e usu?rios portadores de transtornos mentais/PTM s. O campo de pesquisa foi a Unidade de Sa?de da Fam?lia (USF) Ozeas Sampaio, localizada no munic?pio de Teresina-PI. No que concerne aos procedimentos metodol?gicos, utilizamos um roteiro de entrevista semi-estruturado visando cartografar as pr?ticas de cuidado, acolhimento e diagn?stico que essas equipes realizam com esses usu?rios. Foram entrevistados onze trabalhadores de tr?s equipes diferentes, dentre eles um m?dico, um enfermeiro e dois agentes comunit?rios de sa?de de cada equipe. Outras ferramentas utilizadas foram um di?rio de campo, em que registramos di?logos informais, observa??es e sensa??es ocorridas no cotidiano da unidade; e tamb?m o acompanhamento ?s equipes em visitas domiciliares e ?s reuni?es semanais na unidade. Esses encontros possibilitaram a constru??o de dois eixos anal?ticos: 1) Mapeamento do estabelecimento (USF), da organiza??o (Funda??o Municipal de Sa?de e a rede de servi?os) e das institui??es e pr?ticas em sa?de; 2) An?lise dos encontros entre trabalhador e usu?rio PTM s. No primeiro eixo, verificouse a repeti??o da l?gica de trabalho hospitaloc?ntrico, com a manuten??o de rela??es hier?rquicas entre trabalhadores e de processos de trabalhos que dissociam gest?o e aten??o em sa?de. Identificamos a falta de estrutura f?sica, de capacita??o e de empoderamento dos trabalhadores para o cuidado em sa?de mental. No segundo eixo, observamos que os encontros, sejam na USF, sejam nas resid?ncias dos usu?rios, provocam nos trabalhadores inc?modo, desconforto e ang?stia, por lidarem com quest?es que v?o para al?m do que se especifica como sendo da ordem da sa?de, como as hist?rias de vida, conflitos familiares, desemprego, fome, viol?ncia f?sica, psicol?gica e sexual. Fato esse, que implica em dificuldades para cria??o de v?nculos, acolhimento e responsabiliza??o por essa demanda

Made available in DSpace on 2014-12-17T15:39:06Z (GMT). No. of bitstreams: 1 MarianaC_DISSERT.pdf: 567306 bytes, checksum: 98e0c97a228543f71cd01d3b7c71e3cb (MD5) Previous issue date: 2014-01-27 / Universidade Federal do Rio Grande do Norte / The Brazilian Ministry of Health regulated in 2008 the Family Health Support Nucleus (FHSN) as a device for support and complementarity to the Family Health Strategy. The FHSN, through the matrix support, potentiates the Family Health teams on dealing with a great variety of demands and activities that are under their responsibilities. It is structured in teams of professionals from various health specialties, among which is the mental health. In preliminary studies we noticed that the psychologists have been the main representatives of mental health professionals at the FHSN from Rio Grande do Norte (RN-Brazil). On this scenario, this study intends to problematize the professional practice of the psychologists who work at the FHSN teams in RN, regarding how their work is done, discussing it under the perspective of collective health and the directions for the basic health care on Brazilian s health system. Still as a goal, in more specific ways: identify the forms of professional insertion of the psychologists in this field; characterize the work done by the psychologist at the FHSN (developed activities); and produce an analysis of the characteristics and limits of those actions, from theoretical and methodological references based on Marxian ontology. Were performed semistructured interviews with psychologists working in the oldest FHSN teams form RN. We conducted the analysis of the material following the blocks of information: determinants of the psychologist entry at the services, training for current practice; operation of FHSN; activities performed by FHSN team and the psychologist; joint actions; and limits of psychology practice in the FHSN. An important result, we observed the little articulation of practicing between the psychology and other professionals and teams, further indicating the prevalence of the traditional medical model (individual and outpatient) as guidance of their performance instead of the matrix logic that is the foundation of the proposed action for the FHSN. We also emphasize the potential of psychologists actions at the FHSN on contributing to the achievement of comprehensive care / O Minist?rio da Sa?de regulamentou em 2008 o N?cleo de Apoio ? Sa?de da Fam?lia (NASF) como um dispositivo de suporte e complementaridade da Estrat?gia Sa?de da Fam?lia. O NASF, por meio do apoio matricial, potencializa as equipes Sa?de da Fam?lia frente ? grande variedade de demandas e atividades que se encontram sob seu encargo. Estruturam-se em equipes com profissionais de diversas especialidades da sa?de, dentre as quais se encontra a sa?de mental. Em estudos preliminares, observou-se que os psic?logos t?m sido os principais representantes da sa?de mental nos NASF instalados no Rio Grande do Norte. Diante deste quadro, este estudo se prop?e a problematizar a pr?tica profissional dos psic?logos que atuam em equipes NASF no RN, no que se refere aos modelos de atua??o empregados, discutindo-as sob a ?tica proposta pela sa?de coletiva e pelos direcionamentos do SUS para a aten??o b?sica. Objetiva-se ainda, de maneira mais espec?fica: identificar as formas de inser??o profissional do psic?logo neste campo; caracterizar o trabalho exercido pelo psic?logo no NASF (atividades desenvolvidas); e produzir uma an?lise das caracter?sticas e limites dessa a??o, a partir das refer?ncias te?rico-metodol?gicas fundadas na ontologia marxiana. Foram realizadas entrevistas semiestruturadas com psic?logos que atuam nas equipes NASF mais antigas do RN. Realizou-se a an?lise do material seguindo os blocos de informa??o: determinantes da entrada no psic?logo nos servi?os; forma??o para a pr?tica atual; funcionamento do NASF; atividades realizadas pela equipe NASF e pelo psic?logo; articula??o de a??es; e limites da atua??o do psic?logo no NASF. Destaca-se nos resultados obtidos a pouca articula??o do trabalho do psic?logo com outros profissionais e equipes, indicando ainda a preval?ncia do modelo cl?nico tradicional (individual e ambulatorial) como orienta??o da sua atua??o em detrimento da l?gica matricial que ? fundamento da proposta de a??o do NASF. Ressalta-se ainda o potencial da a??o dos psic?logos no NASF, em contribuir para a realiza??o do cuidado integral

Made available in DSpace on 2015-03-13T17:10:55Z (GMT). No. of bitstreams: 1 RaphaelC_DISSERT.pdf: 1901364 bytes, checksum: 85ebf467d310eac30b64a7f180d8d1bc (MD5) Previous issue date: 2014-01-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Through the analysis of the informational activity at the primary care of SUS at the scale of places, this dissertation has as central objective to observe the dispute for the concepts of health and sickness, in the ambit of Brazilian Health Movement, featuring, on one hand, the clinic, biomedical or flexnerian line hegemonic, scientifically restrict and the primary frame of references for the Brazilian health politics and on the other hand a multiplicity of new proposals and critic thoughts to the current model, which have , as common characteristic, the worry with a territorial way of thinking the health context, therefore beyond the biological processes. On the first chapter we jut out with details these scientific and ideological movements, on a wider way, but also on the specificities of the public health s information politics. On the second chapter we analyze the downward health information circle at the basic care, observing the operational processes of the information s technical systems SIAB and e-SUS. On the third and last chapter, we give references to think about an upward health information circle, centered on the places, ruled by the notions of autonomy, organic solidarity and communicational density. It would possess, as method s primary horizon, the local organization of production and managing of information through the work of the Health Community Agent, privileging therefore the urgency of the most contingent needs of the people in theirs every day s life / Atrav?s da an?lise da atividade informacional na aten??o B?sica do SUS, ou seja, na escala do lugar, esta disserta??o tem como objetivo central observar a disputa pelo conceito de sa?de e de doen?a no ?mbito da sa?de brasileira, destacando, de um lado, o pensamento cl?nico, biom?dico ou flexneriano hegem?nico, cientificamente restrito e principal quadro de refer?ncia da pol?tica de sa?de no Brasil e do outro lado uma multiplicidade de novas propostas e pensamentos cr?ticos ao modelo vigente que possuem como ponto comum a preocupa??o com a sa?de no contexto supra-biol?gico e, portanto, territorial. No primeiro cap?tulo destacamos com detalhes tais movimentos cient?ficos e ideol?gicos, tanto num sentido mais amplo quanto na dimens?o espec?fica das pol?ticas de informa??o em sa?de do SUS. No segundo cap?tulo, analisamos o c?rculo descendente de informa??o em sa?de na aten??o b?sica, observando o funcionamento dos sistemas t?cnicos de informa??o SIAB e e-SUS. Por fim, no terceiro e ?ltimo cap?tulo, lan?amos refer?ncias para se pensar um c?rculo ascendente de informa??o em sa?de, centrado a partir do lugar e pautado nas no??es de autonomia, solidariedade org?nica e densidade comunicacional, possuindo como principal horizonte metodol?gico a organiza??o local da produ??o e gest?o de informa??o a partir do Agente Comunit?rio de Sa?de, privilegiando dessa forma a urg?ncia das necessidades mais contingente das pessoas em sua vida cotidiana

Made available in DSpace on 2016-04-04T18:29:28Z (GMT). No. of bitstreams: 1 Valdemar Donizeti.pdf: 875191 bytes, checksum: 5e58d297ab7aabcbb231e27939dd96d6 (MD5) Previous issue date: 2006-08-14 / The history of the psychologist's profession, gets confused with this professional's own insert in the field of the attention to the public health and their eventualities. However, still an estrangement prevails between the psychologists' formation in the University and the reality of the public net of health. This situation is also reflected in the shortage of studies regarding the formation in psychology in public health. PUC-Campinas owns one of the pioneering experiences, dated of 1986, in the psychologists' formation in the basic attention, for performance in the Unique System of Health (SUS). This research has intended to apprehend the trainees' in Psychology in Health/Clinic s experiences in activities developed as participants of teams of health of the family in the municipal district of Campinas, validating them in the daily dialogue with the researcher. Six senior students of the degree level in Psychology of PUC-Campinas inserted in two groups of the apprenticeship with activities supervised in two Centers of Health-school located in Northwest area of the town. The attendance of the trainees experiencies by the researcher has began with the ingress on the field expressed in this study in ethnographic manner up to the composition of the data of the research that were produced in two moments: a) Diary of Versions of Sense - weekly registration of subjective synthesis individualy acomplished by six trainees; b) individual interviews, partly structured made by the researcher with each trainee. The depositions and diaries of sense versions were qualitatively analyzed starting from a phenomenological reading. The researcher s phenomenological interpretation enabled an interlocution with similar applications found in data basis. From the meaning analysis of the trainees experiences it was possible to infer: a) the formation of the trainee in a field as public health is first felt as something totally unknown, lived with surprise and a certain embarrassment concerned to the inexperience for the work in team of health of the family; b) on the other hand there is the rapid development of an empathy with the public health field, due to a rewarding living with the technicians team, enabling the birth of affective boundings and of a belonging feeling concerned to the health team; c) really feeling like a psychologist comes from the apprenticeship lived in the team meetings, on the exercise of a clinical practice centered in the collective knowledge and interdisciplinary - denominated enlarged clinic; d) as significant elements, facilitators of professional development are pointed out the home visit, the systematic meeting of the team, the professionals and users diversity, the situations lived in the territory; e) feelings of frustration and displeasure were expressed as resultant of troubles living due to the complexity of some cases, and of the lack of adhesion concerned to clinical attendance offered. This phenomenological view about the formation in service, having the experience of the own trainee as the investigation object translates the intention of the focus on social responsibility of the higher education institutions concerned to the commitment of qualifying professionals to act in the reality of the Brazilian society / A hist?ria da profiss?o do psic?logo, confunde-se com a pr?pria inser??o deste profissional no campo da aten??o ? sa?de p?blica e suas vicissitudes. No entanto, ainda prevalece um distanciamento entre a forma??o de psic?logos na Universidade e a realidade da rede p?blica de sa?de. Esta situa??o tamb?m se reflete na escassez de estudos a respeito da forma??o em psicologia em sa?de p?blica. A PUC-Campinas possui uma das experi?ncias pioneiras, datada de 1986, na forma??o de psic?logos na aten??o b?sica, para atua??o no Sistema ?nico de Sa?de (SUS). Esta pesquisa objetivou apreender as viv?ncias de estagi?rios da ?rea de Psicologia na Sa?de/Cl?nica em atividades desenvolvidas como participantes de equipes de sa?de da fam?lia no munic?pio de Campinas, significando-as no di?logo cotidiano com o pesquisador. Participaram da pesquisa seis estagi?rios do ?ltimo ano do Curso de Gradua??o em Psicologia da PUCCampinas, inseridos em dois grupos de est?gio com atividades supervisionadas em dois Centros de Sa?de-Escola, localizados na regi?o Noroeste do munic?pio. O acompanhamento das viv?ncias dos estagi?rios pelo pesquisador iniciou-se com a entrada no campo, expressa neste estudo de maneira etnogr?fica, at? a composi??o dos dados da pesquisa que foram produzidos em dois momentos: a) Di?rio de Vers?es de Sentido registro semanal de s?nteses subjetivas efetivadas individualmente pelos seis estagi?rios; b) entrevistas individuais, semi estruturadas realizadas pelo pesquisador com cada estagi?rio. Os depoimentos e di?rios de vers?es de sentido foram analisados qualitativamente a partir de uma leitura fenomenol?gica. A interpreta??o fenomenol?gica do pesquisador acerca destes dados possibilitou uma interlocu??o com estudos semelhantes encontrados em bases de dados. A partir da an?lise dos significados das viv?ncias dos estagi?rios foi poss?vel concluir: a) a forma??o do estagi?rio num campo como o da sa?de p?blica ? sentido inicialmente como algo totalmente desconhecido, vivenciado com surpresa e um certo embara?o em rela??o ? inexperi?ncia percebida para este tipo de trabalho em equipe de sa?de da fam?lia; b) por outro lado, desenvolve-se rapidamente uma empatia com o campo da sa?de p?blica, em virtude de uma viv?ncia gratificante com a equipe de t?cnicos, possibilitando a forma??o de v?nculo afetivos e de um sentimento de pertin?ncia ? equipe de sa?de; c) sentir-se realmente como um psic?logo decorre da aprendizagem vivida no cotidiano das reuni?es de equipe, no exerc?cio de uma pr?tica cl?nica centrada no saber coletivo e interdisciplinar denominada cl?nica ampliada; d) como elementos significativos, facilitadores do desenvolvimento profissional, destacaram-se: a visita domiciliar, a reuni?o sistem?tica da equipe, a diversidade de profissionais e de usu?rios, as situa??es vividas no territ?rio; e) sentimentos de frustra??o e descontentamento foram expressos como decorrentes da viv?ncia de dificuldades face ? complexidade de alguns casos, e ? falta de ades?o dos pacientes em rela??o aos atendimentos cl?nicos disponibilizados. Esta leitura fenomenol?gica acerca da forma??o em servi?o, tendo como objeto de investiga??o a viv?ncia do pr?prio estagi?rio, traduz a inten??o de colocar em foco a responsabilidade social das institui??es de ensino superior em rela??o ao compromisso de capacitar profissionais para atuar na realidade da sociedade brasileira

Submitted by Fernanda Ciolfi (fernanda.ciolfi@puc-campinas.edu.br) on 2016-04-07T18:23:11Z No. of bitstreams: 1 Heidy Joahanna Garrido Pinzon.pdf: 1919376 bytes, checksum: aaaacf762cb9a911de4a979c7a12c936 (MD5) / Made available in DSpace on 2016-04-07T18:23:11Z (GMT). No. of bitstreams: 1 Heidy Joahanna Garrido Pinzon.pdf: 1919376 bytes, checksum: aaaacf762cb9a911de4a979c7a12c936 (MD5) Previous issue date: 2016-02-29 / The purpose of this research was to analyze the experiences of workers enrolled in the health systems of Colombia and Brazil, taking into account the interesting fact that these two health systems emerged from opposing guidelines. On one hand, among the countries which suffered the intense economic crisis of the 1980?s, Colombia was unified in the most rigorous and systematic model because of hegemonic sanitary controls required by the World Bank and the International Monetary Fund On the other hand, in Brazil, which also experienced the economic crisis, it was possible the creation of the Unified Health System (SUS ? Portuguese acronym), as a product of demands of popular movements, managing to establish health as a right of all citizens, which was written into the Federal Constitution of 1988. Thus, the SUS was born in the midst of the economic crisis of 1980, in a neoliberal scenario, in opposition to capitalist tendencies which were characterized by the search for new markets in the health sector, a tendency completely adopted by Colombia. Given this context, the present study aimed to understand the common experiences of basic care workers in Colombia and Brazil, against the capitalist logic. Based on the Social Psychology of Work?s approach, this research is qualitative in nature and has empirical style. It was developed by analyzing reflexive interviews of two groups of workers belonging to healthcare and administrative sectors of the Basic Attention: one in Bucaramanga, Colombia and the other in Campinas, Brazil. Content Analysis was used for the analysis process, which is understood as a set of research techniques, which aims to find sense or senses manifested in more diverse forms of communication. In the course of this investigation it was revealed that, in both countries, the main experiences of the health professionals, determined by neo-liberal logic, are related to the transformations introduced in the labor conditions and relations, and also in the organization of work. In the Colombian context, we find that the main problems presented by those interviewed have their origins in the transition process introduced by those reforms which gave rise to its current health care system. Such problems are reflected, mainly, in the deterioration of relations with patients, as well as, in the detriment of the configuration of the work teams, forced to live divided by the stark contrast between different contractual relations. This condition, which eventually causes an inherent difficulty to generate cohesion within the working groups, also appears in the Brazilian context, as a result of outsourcing, which has come to constitute an effective mechanism to weaken the SUS, to facilitate its waning and to place it on a path pointing in the direction of the current Colombian health system. Finally, in the two studied stages, this panorama of job insecurity, permeated by instability, intensification of responsibilities and overworked employees, reduction in wages, among others, has generated major consequences to the life and health of the workers, which are reflected in the deterioration of their mental and physical health, in the lack of social recognition, the deterioration of ethics and morality, also in some cases, even in constraints for the construction of a life project. / A presente pesquisa visa a analisar as viv?ncias de trabalhadores dos Sistemas P?blicos de Sa?de da Col?mbia e do Brasil, tendo-se em vista que esses dois casos ganham interesse de estudo por exemplificarem sistemas de sa?de cujo surgimento se d? a partir de diretrizes opostas. Por um lado, tem-se a Col?mbia que, dentre os pa?ses latino-americanos a sofrer a intensa crise econ?mica da d?cada de 1980, foi aquele que incorporou de maneira mais rigorosa e sistem?tica os crit?rios centrais do modelo hegem?nico das reformas sanit?rias estabelecidos pelo Banco Mundial e pelo Fundo Monet?rio Internacional. Por outro, observa-se a situa??o do Brasil, que tamb?m experimentou a crise econ?mica, onde foi poss?vel a cria??o do Sistema ?nico de Sa?de (SUS), produto das exig?ncias dos movimentos populares os quais conseguiram estabelecer a sa?de como um direito de todos os cidad?os, legitimando-se na Constitui??o Federal de 1988. Toma-se em considera??o, ent?o, como nasce o SUS, num cen?rio neoliberal em meio da crise econ?mica de 1980, em oposi??o a tend?ncias imperialistas que se caracterizavam pela busca de novos mercados no setor sa?de, enquanto a Col?mbia se subjugou totalmente a elas. Levando em conta esse contexto, o estudo aqui apresentado teve como objetivo compreender as viv?ncias de trabalhadores da Aten??o B?sica dos Sistemas P?blicos de Sa?de da Col?mbia e do Brasil, frente ? l?gica capitalista. Baseada no enfoque da Psicologia Social do Trabalho, esta pesquisa ? de natureza qualitativa e de tipo emp?rico. Desenvolveu-se mediante a realiza??o de entrevistas reflexivas em profundidade, com dois grupos de trabalhadores da Aten??o B?sica de n?vel assistencial e administrativo: um em Bucaramanga, Col?mbia e, outro, em Campinas, Brasil. Para o processo de an?lise, elegeu-se utilizar a An?lise de Conte?do, a qual ? compreendida como um conjunto de t?cnicas de pesquisa cujo objetivo ? a busca do sentido ou dos sentidos manifestos nas mais diversas formas de comunica??o. O percurso desta pesquisa revelou que, em ambos os pa?ses, as principais viv?ncias dos profissionais da sa?de, determinadas pela l?gica neoliberal, est?o relacionadas com as transforma??es introduzidas nas condi??es, rela??es e organiza??o do trabalho. No contexto colombiano estudado, identificamos a origem das problem?ticas centrais apresentadas pelos entrevistados no processo de transi??o induzido pela reforma que constituiu seu atual sistema de sa?de. Essas problem?ticas se traduzem, essencialmente, na deteriora??o das rela??es com os usu?rios, bem como na configura??o das equipes de trabalho, marcadas pelo contraste entre pessoas com diferentes v?nculos empregat?cios. Esta ?ltima condi??o, empecilho para a coes?o dos grupos de trabalho, tamb?m ? observada no contexto brasileiro pesquisado, como produto da terceiriza??o, que parece ter se tornado um efetivo mecanismo para enfraquecer o SUS, facilitar seu desmonte e coloc?-lo no mesmo caminho atualmente percorrido pelo sistema de sa?de colombiano. Por fim, exp?e-se como, nos dois cen?rios estudados, tal panorama de precariedade do trabalho, permeado pela instabilidade, intensifica??o e sobrecarga laboral, pela redu??o de sal?rios, dentre outros fatores, tem ocasionado graves consequ?ncias para a vida e a sa?de dos trabalhadores, que se refletem na degrada??o de sua sa?de f?sica e mental, na falta de reconhecimento social, na deteriora??o da ?tica e da moral e nas restri??es para a constru??o de um projeto de vida.