A história dos transplantes vem rompendo barreiras e enfrentando desafios embora de forma incipiente, por diversas décadas, conquistando impressionantes resultados, demonstrando a evolução científica e tecnológica aplicada ao setor. Assim, observa-se que, ao longo dos tempos, o número de doações tem aumentado. Porém, não o suficiente para reduzir a lista de espera, cabendo então a reflexão acerca das causas que dificultam esse processo. Diversos são os motivos pelos quais afetam a doação de órgãos, ressaltando-se a recusa dos familiares e a não notificação de possíveis doadores. Assim, vale ressaltar a importância do preparo profissional no que diz respeito à abordagem familiar, momento decisivo para que se possa dar continuidade ao processo de captação de órgãos. Diante do exposto, o estudo tem por objetivo explorar, recolher, organizar, sintetizar e compartilhar visão dos familiares em relação a atuação dos profissionais no processo de doação de órgãos. A metodologia retrata uma revisão sistemática da literatura brasileira sobre o tema central baseando na busca de artigos que demonstrassem resultados de pesquisas realizados no País, entre 2001 e 2011, no portal PubMed e nas bases de dados SCOPUS, CINAHL, EMBASE, Web of Science, Science Direct, LILACS, BDENF. Tal busca guiou-se pela pergunta: Qual a visão dos familiares, que passaram pela abordagem para doação de órgãos, referente à atuação dos profissionais que atuam neste processo? Como resultados dos 265 trabalhos encontrados, foram considerados pertinentes, à temática em apreço, 06 artigos, os quais foram submetidos à leitura criteriosa da metodologia utilizada, dos sujeitos investigados, dos resultados obtidos e das conclusões. As sínteses foram construídas a partir da análise temática dos resultados. Surgiram 03 categorias. Sendo elas: 1) Falta de confiança na atuação profissional; 2) Atuação profissional sem compreensão e acolhimento no momento familiar; 3) Falta de informação pelo profissional. Desta última, emergiram duas subcategorias: 1) Falta de informação pelo profissional à família referente à possível Morte Encefálica; 2) Falta de informação pelo profissional à família referente aos trâmites pós-doação. Consideramos, portanto, que a complexidade de ações que são necessárias no processo de doação de órgãos, foi revelada como burocrático, demorado, desgastante e cansativo, resultando em sofrimento e submetendo tanto a família quanto os profissionais a situações estressantes. Disto depreendemos haver necessidade de maiores investimentos na formação dos profissionais que atuam neste processo, melhorando seu suporte emocional e sua atuação, a qual é considerada incipiente pelos familiares. / Transplants\' history are breaking barriers and facing challenges for several decades achieving impressive results. It demonstrates scientific and technological developments applied to this sector. Although an increasing on organs donations have been noted, it is not enough to reduce waiting list. Therefore there is a need for reflection on the causes, which makes this process. There are several reasons that affect organ donation, and shall be emphasized: relatives\' refusal and failure in notifying potential donors. It is also worth highlighting the importance of professional competence in respect of family approach, a decisive moment that gives continuity to the process of organ retrieval. In this light, the study aims to explore, collect, organize, synthesize and share the opinion of relatives about the role of professionals during process of organ donation (POD). As methodology a systematic review of Brazilian literature was conducted between 2001 and 2011. Data was collected from (i) PubMed, (ii) SCOPUS, (iii) CINAHL, (iv) EMBASE, (v) Web of Science, (vi) Science Direct, (vii) LILACS, and (viii) BDENF. Such data collection was performed based on one question: What is the opinion of relatives, who went through organ donation approach, referring to professionals\' actions working in this process? Six out of 265 papers were considered relevant, and then a careful reading executed to assess methodology, subjects investigated, results and conclusions. Analyses have enable to define three categories: (a) lack of confidence in the professional, (b) professional attitude without understanding of relatives emotional state, (c) professional apathy in provide information to family. The last category was subdivided in (i) lack of info about a possible brain death, and (ii) subsequent procedures about POD. These study revealed a complexity in POD particularly on bureaucracy, delay, family\'s fatigue and wear. Thus, we may conclude to be necessary investing efforts on professional training involved in the POD to protect family\'s psychological state.

Orientador: Eliete Maria Silva / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Enfermagem / Made available in DSpace on 2018-08-25T15:28:42Z (GMT). No. of bitstreams: 1 Santos_DanielaValentimdos_M.pdf: 7290095 bytes, checksum: b019946b07ea6d0efe9b37e5ac47bee4 (MD5) Previous issue date: 2014 / Resumo: A temática da violência contra a mulher está contemplada em diversas políticas públicas, conferindo visibilidade a este agravo. Entretanto, a efetivação dessas políticas passa por uma ampla rede de serviços, que para dar suporte à mulher deve ser integrada. Entre os pontos de atenção desta rede está a Atenção Primária à Saúde, que é a porta de entrada preferencial do Sistema Único de Saúde e principal estratégia para oferecer acesso, atenção integral e impactar na situação de saúde das pessoas, como é o caso da violência. O objetivo deste estudo foi caracterizar a força de trabalho da enfermagem na Atenção Primária à Saúde, em município de grande porte do interior paulista, e descrever as práticas dessa equipe no cuidado com mulheres em situação de violência. Constitui-se em pesquisa quantitativa, descritiva, transversal, com amostra aleatória, realizada com auxiliares e técnicos(as) de enfermagem e enfermeiros(as) de todas as unidades básicas de Sorocaba. Foi utilizado formulário com questões semiestruturadas, com informações sociodemográficas e sobre detecção de situações de violência. A coleta de dados ocorreu no mês de fevereiro de 2014. O software SAS, versão 9.2, foi utilizado para realizar os testes estatísticos Mann-Whitney, Kruskal-Wallis e Qui-quadrado. Foram considerados significantes os valores de p menor que 0,05. Para as respostas textuais, procedeu-se a análise de conteúdo. Os resultados referem-se a 236 profissionais de enfermagem, sendo 54(22,88%) auxiliares de enfermagem, 48(20,34%) enfermeiros(as) e 134(56,77%) técnicos(as) de enfermagem. A distribuição entre os sexos foi semelhante entre as categorias, e todas apresentaram predomínio do sexo feminino, 210 (88,98%). Quanto ao quesito raça/cor, predomínio de pessoas que se autodeclararam brancas 188 (88,98%). As diferenças entre as categorias da enfermagem foram significantes; os auxiliares de enfermagem apresentaram maior média de idade (49 anos), tempo de serviço público (21 anos) e tempo de unidade básica (12 anos) que enfermeiros(as) e técnicos(as) de enfermagem. A respeito do atendimento às mulheres, entre os profissionais de enfermagem da APS, 133(56,33%) já suspeitaram que alguma mulher tivesse sofrido violência. As principais dificuldades relatadas pelos profissionais para investigar suspeitas de violência foram: medo da mulher falar sobre o assunto, falta de treinamento e capacitação e receio de sofrer represálias do agressor. Dessa forma, concluímos que a força de trabalho na atenção primária é feminina, com predomínio de profissionais de nível médio. Nossa pesquisa corrobora com pesquisas, que evidenciam que as situações de violência contra a mulher permeiam as práticas de enfermagem na Atenção Primária à Saúde. Consideramos que o enfoque das políticas públicas de enfrentamento da violência contra a mulher deve abranger a capacitação e o suporte para os profissionais da Atenção Primária à Saúde para que estes serviços não se reduzam a pontos de triagem e encaminhamento / Abstract: The theme of violence against women is addressed in various public policies, giving visibility to this damage. However, the effectiveness of these policies goes through an extensive network of services, which should be integrated to support the woman. Among important aspects of this network is the Primary Health Care, which is the preferred gateway of the Unified Health System and principal strategy to provide access, comprehensive health, and impact on people's health situation, as in the case of violence. The objective of this study was to characterize the workforce of nursing in the Primary Health Care, in large inland municipality of São Paulo, and describe the practices of that team in the care of women in situations of violence. Consists of quantitative, descriptive, and transversal research, with random sample. Held with the nursing assistants, nurses and nursing technicians from all the basic health units of Sorocaba. It was used a form with semi-structured questions, demographic information and about detection of violence situations. Data collection occurred in February, 2014. The SAS software, version 9.2, was used to make statistical tests Mann-Whitney, Kruskal-Wallis and Qui-quadrado. P values less than 0.05 were considered significant. For textual responses, content analysis was conducted. The results refer to 236 nursing professionals, being 54 (22.88%) nursing assistants, 48 (20.34%) nurses, and 134 (56.77) nursing technicians. The gender distribution was similar between the categories, and all showed female predominance, 210 (88.98%). As for the item race/color, there was the predominance of people who declare themselves white, 188 (88.98%). The differences between the categories of nursing were significant; the nursing assistants presented a higher median age (49 years old), public service time (21 years) and basic unit time (12 years) than nurses and nursing technicians. Regarding the attendance to women, among the nursing professionals of APS, 133 (56.33%) had already suspected that a woman had suffered violence. The main difficulties reported by professionals to investigate suspicions of violence were: fear of women speaking about the subject, lack of training, and qualification and fear of suffering reprisals of the assailant. Thus, we conclude that the workforce in primary care is female, with a predominance of middle-level professionals. Our research corroborates with researches showing that the situations of violence against women permeate nursing practices in the Primary Health Care. We consider that the focus of public policies for combating violence against women should include training and support for professionals in the Primary Health Care so that these services do not reduce the points of sorting and routing within the basic unit / Mestrado / Enfermagem e Trabalho / Mestra em Ciências da Saúde

Bakgrund Hälso- och sjukvården har ett stort ansvar för suicidnära personer. Majoriteten av de som i slutänden tar sitt liv har tidigare varit i kontakt med vården, där första mötet ofta sker tillsammans med sjuksköterskan. Det är inte ovanligt att protokoll och anvisningar för hur vårdpersonalen ska ge dessa personer en fullgod omvårdnad saknas. Detta tillsammans med en bristfällig grundutbildning i ämnet omvårdnad av suicidnära patienter, vilket således tillsammans utgör orsaker till att sjuksköterskan saknar kompetens och redskap när det kommer till hur denna specifika omvårdnad bör utföras. Det betyder att den omvårdnad som ges således enbart kan komma att vara grundad i sjuksköterskans egna egenskaper och åsikter vilket i sin tur leder till en ojämn vård. Syfte Syftet var att undersöka betydelsefulla aspekter för omvårdnaden av suicidnära patienter inom hälso- och sjukvård ur sjuksköterskans perspektiv. Metod En litteraturstudie användes för att undersöka betydelsefulla aspekter för omvårdnad av suicidnära patienter. Databaserna PubMed, Cinahl och PsycINFO användes för att söka fram 15 artiklar som kunde belysa de aktuella aspekterna. En kvalitativ integrerad innehållsanalys grundad av Kristensson (2014) gjordes på alla artiklar i resultatet. Resultat Studien resulterade i sex kategorier av faktorer med underkategorier av betydelse för omvårdnadskvalitén. Kommunikation mellan sjuksköterskan och patienten, utbildning, rutinernas betydelse, teamsamverkan, vårdrelationen och sjuksköterskans personliga egenskaper. Dessa kategorier utgjorde de aspekter som sjuksköterskan ansåg viktiga för omvårdnaden av suicidnära patienter och var avgörande i många fall för att sjuksköterskan skulle känna att de kunde ge god omvårdnad. Viktigast var framförallt en välfungerande kommunikation mellan sjuksköterskan och patienten och relationen mellan dem samt egenskaper som sjuksköterskans besitter och hens utbildningsnivå för att kunna hantera en situation med en suicidnära patient och ge god omvårdnad. Slutsats Det är viktigt att sjuksköterskan tar sig tid, kommunicerar och lyssnar på patienten för att kunna bygga upp en god relation tillsammans vilket möjliggör upprättandet av en individuell vårdplan och att en personcentrerad vård utförs. För att sjuksköterskan ska veta hur man går till väga för att skapa en välplanerad omvårdnad för patienten krävs relevant utbildning i bland annat rätt bemötande, omvårdnad, psykisk ohälsa och riskfaktorer för suicid. Ett genuint engagemang i patientens mående och relevant utbildning är grunden i god omvårdnad för suicidnära patienter.

Bakgrund   Schizofreni bedöms vara en av de tio mest funktionsnedsättande tillstånden i världen och omkring 20 miljoner människor har diagnosen. Det är den vanligaste psykossjukdomen och innebär för många drabbade ett lidande med en negativ inverkan på personens psykosociala tillvaro och fysiska hälsa. Personer med schizofreni utsätts ofta för stigmatisering i samhället, vilket resulterar i social utsatthet och ensamhet. Även i vården förekommer stigmatisering av sjukdomen, och att befinna sig i vårdsammanhang är för vissa personer med schizofreni sammankopplat med diskriminering och känslor av utsatthet. Sjuksköterskors professionella ansvar är att bemöta alla personer med respekt och med ett etiskt förhållningssätt. Det är av stor vikt att sjuksköterskor har kompetens att bemöta personer med schizofreni med ett personcentrerat förhållningsätt för att främja patientgruppens psykiska och fysiska hälsa.   Syfte Syftet var att belysa sjuksköterskors attityder och erfarenheter av att bemöta personer med schizofreni i olika vårdkontext.    Metod  En litteraturöversikt där resultatet baserades på15 vetenskapliga artiklar. Författarna har använt databaserna PubMed och CINAHL för att finna de vetenskapliga artiklarna. Tydliga urvalskriterier beskrivs i litteraturöversikten och artiklarna är sökta mellan åren 2010 till 2020. En integrerad dataanalys har utförts på inkluderade resultatartiklar.   Resultat Resultatet indikerar att stigmatisering av personer med schizofreni förekommer i större grad hos bland sjuksköterskor med mindre arbetserfarenhet. En öppen och ärlig dialog framkom som viktiga aspekter i patientrelationen mellan sjuksköterskor och patienter med schizofreni.   Slutsats Enligt funna resultat visades att högre kompetens gav mer trygghet hos sjuksköterskorna vilket tydliggör vikten av rätt utbildning hos sjuksköterskor för att kunna arbeta personcentrerat. Att reflektera kring sina egna fördomar och sin egen attityd kan minska en negativ attityd mot personer med schizofreni. Reflektionen medför också en minskad stigmatisering av patientgruppen. En öppen och ärlig kommunikation kan även främja relationen mellan sjuksköterskan och patienten och främja välmående. / Background  Schizophrenia is estimated to be one of the ten most disabling conditions in the world with around 20 million people affected. It is the most common psychotic disease and has a negative impact on the person's psychosocial existence and physical health. People with schizophrenia are often exposed to stigma in society, which results in social vulnerability and loneliness. Even in healthcare, stigma is preceded about the disease and being in a care context is for some people with schizophrenia linked to discrimination and feelings of vulnerability. Nurses' professional responsibilities is to treat all people with respect and with an ethical approach. It is of importance that nurses have the competence to care for people with schizophrenia with person-centered care in order to improve their wellbeing mentally and physically.   Aim The aim was to describe nurses' attitudes and experiences of treating people with schizophrenia in different care contexts.   Method A literature review where the results were based on 15 scientific articles. To find the scientific articles the authors have used the databases PubMed and CINAHL. Clear selection criterias was described in the literature review and articles are sought between year 2010 to 2020. An integrated data analysis has been performed on included results articles.   Results  The result indicates that stigmatization of people with schizophrenia occurs to a greater extent in nurses with less work experience. An open and honest dialogue emerged as important aspects in the nurse-patient relationship.   Conclusions According to the results found, it was shown that higher competence gave more security to the nurses, which clarifies the importance of the right training for nurses to be able to work person-centered. Reflecting on one's own prejudices and one's own attitude can reduce a negative attitude towards people with schizophrenia. The reflection also leads to a reduced stigma of the patient group. Open and honest communication can also promote the relationship between the nurse and the patient and promote well-being.

Our purpose is to examine the possibilities of Bakhtinian dialogical analysis for understanding students' experiences of medical training. Twenty-three interviews were conducted with eleven British medical students intercalating in psychology. Forty emotionally resonant key moments were identified for analysis. Our analysis illustrates students' use of the professional genre to present their training as emotionally neutral. However, we show how medical training can be framed in more unofficial and affective-laden ways in which threshold moments of crisis are presented as space-time breaches characteristic of the genres of adventure-wonder and adventure-ordeal. This affect was often depotentiated in the narratives through brief allusion to the professional genre. This cycling between genres suggests that the students were searching for an appropriate way in which to frame their experiences, a central dilemma being the extent to which medical training makes sense within an immediate and affect-laden, or future-orientated and affect-neutral, pedagogy. Finally, we identify how consultants are an important aspect of the affective experience of medical training who, at their best, offer inspiring exemplars of flexible movement between official and unofficial ways of being a doctor. In conclusion, we demonstrate the potential of genres to make sense, and to organize the experience, of medical training spatially in terms of moving between personal and impersonal contact, temporally in terms of moving between the extraordinary and routine, and affectively in terms of moving between potent and neutral affect. Learning to use the professional genre is part of enculturation as a doctor and can be helpful in providing a framework restoring coherence and composure through engaging with, and reformulating, difficult experiences. However, it is important to take seriously the resistance many of the students demonstrated to the professional genre as a possible barometer of its acceptability to the general public.

No / The United Kingdom is considered to be the world leader in nurse prescribing, no other country having the same extended non-medical prescribing rights. Arguably, this growth has outpaced research to evaluate the benefits, particularly in areas of clinical practice where patients have complex co-morbid conditions such as palliative care. This is the first study of non-medical prescribing in palliative care in almost a decade. AIM: To explore the current position of nurse prescribing in palliative care and establish the impact on practice of the 2012 legislative changes. DESIGN: An online survey circulated during May and June 2013. PARTICIPANTS: Nurse members (n = 37) of a regional cancer network palliative care group (61% response rate). RESULTS: While this survey found non-medical prescribers have embraced the 2012 legislative changes and prescribe a wide range of drugs for cancer pain, we also identified scope to improve the transition from qualified to active non-medical prescriber by reducing the time interval between the two. CONCLUSION: To maximise the economic and clinical benefit of non-medical prescribing, the delay between qualifying as a prescriber and becoming an active prescriber needs to be reduced. Nurses who may be considering training to be a non-medical prescriber may be encouraged by the provision of adequate study leave and support to cover clinical work. Further research should explore the patients' perspective of non-medical prescribing.

No / It is estimated that 820,000 people in the UK have dementia. Dementia costs the UK 17 billion a year and in the next 30 years this will treble to over pound50 billion a year. There is a need to raise competence of staff delivering care to people living with dementia across health, social and voluntary sector provision. Effective education and training will build capacity and improve staff knowledge. However, at present not enough is known about the experiences of staff involved in gaining the skills, knowledge and attitudes required to support provision of high quality care for people with dementia. This study was conducted within a large National Health Service Trust in the UK serving an urban, ethnically mixed population, in collaboration with a local university. The trust responded to government policy by seeking to identify staff training needs. The aim was to explore the experiences of staff working within a specialist mental health service in relation to development of skills for the provision of person-centred care for people with dementia. To achieve this, staff roles, experiences of dementia training and the ways in which staff feel they learn were explored through focus group interviews. Relatives' views of staff competencies necessary for effective care provision were also explored to supplement the data from staff. A total of 70 staff and 16 family carers participated and data were subjected to inductive thematic analysis. Five themes emerged: competency-based skills, beliefs, enablers and barriers and ways of learning. Findings suggested participants felt that skills for person-centred care were innate and could not be taught, while effective ways of learning were identified as learning by doing, learning from each other and learning from experience.

No / To evaluate the effectiveness of a telehealth system, using digital pen-and-paper technology and a modified smartphone, to remotely monitor and support the effectiveness of wound management in nursing home residents. METHOD: A randomised controlled pilot study was conducted in selected nursing homes in Bradford, which were randomised to either the control or evaluation group. All patients with a wound of any aetiology or severity, resident in the selected nursing homes were considered eligible to participate in the study. Residents in the control homes who had, or developed, a wound during the study period, continued to receive unsupported care directed by the nursing home staff (defined as 'standard care'), while those in the evaluation homes received standard care supported by input from the remote experts. RESULTS: Thirty-nine patients with a wound were identified in the 16 participating Bradford nursing homes. Analysis of individual patient management pathways suggested that the system provided improved patient outcomes and that it may offer cost savings by improving dressing product selection, decreasing inappropriate onward referral and speeding healing. Despite initial anxiety related to the technology most nursing-home staff found the system of value and many were keen to see the trial continue to form part of routine patient management. CONCLUSION: The current study supports the potential value of telemedicine in wound care and indicates the value that such a system may have to nursing-home staff and patients. DECLARATION OF INTEREST: This study was funded by a Regional Innovation Fund grant from the Yorkshire and Humberside Strategic Health Authority. The authors have no conflict of interest to declare with respect to the article or its contents.

Esse estudo tem como objetivo conhecer as características da relação entre a medicina Homepática e a Biomédica enqua nto partícipes de um campo institucional comum, identificando o movimento de aproximação e afastamento entre homeopatas e médicos da biomedicina e identificando os elementos de caráter ideológico, cultural e técnico-cientifico que fazem parte desse processo, segundo o ponto de vista dos profissionais não homeopatas. Por meio de levantamento da atual situação da Homeopatia no campo da saúde no Brasil, identificam-se os municípios com serviços de homeopatia na rede SUS e as faculdades de medicina que desenvolvem atividades relacionadas à homeopatia. Foram selecionados para a pesquisa os municípios com maior produção ambulatorial de consultas homeopáticas de janeiro a novembro de 2003 (Datasus) e entre as faculdades aquelas de reconhecida relevância na formação médica. Foram entrevistados 48 profissionais de saúde (apenas dois não médicos), sendo 20 docentes/pesquisadores de 11 faculdades de medicina, 16 gestores e 12 médicos que trabalham na rede publica em 6 municípios de cinco estados e do Distrito Federal. As análises foram feitas tendo como categorias de referência as concepções de campo social e cientifico de Bourdieu, as concepções de racionalidades médicas de Madel Luz e os conceitos de modelos ou arranjos tecnológicos do trabalho em saúde de Mendes-Gonçalves, de formação de identidade profissional de médico e ideologia ocupacional de Donnangelo e Schraiber. Foram descritos e analisados através dos depoimentos dos entrevistados: os aspectos considerados facilitadores da aproximação entre as duas medicinas, os que dificultam a ampliação da presença da Homeopatia no campo da saúde, as diferentes formas de apresentação das resistências e as suas concepções sobre a Homeopatia. Entre outros, os resultados apontaram que a 6 legitimação profissional, a construção do SUS e a crise da biomedicina são condições favorecedoras da presença da Homeopatia nas instituições. Mas essas condições não garantem espaços de ensino ou assistência, e as iniciativas dos homeopatas ainda dependem de simpatias locais. Os entrevistados valorizam aspectos da pratica homeopática que recuperam a ideologia ocupacional associada ao ideal de boa prática médica: abordagem integral do paciente, a recuperação da dimensão humanística da medicina e os resultados que obtém ao resolver agravos para os quais os recursos da biomedicina são inadequados ou insuficientes. Facilitam a aproximação com a Academia o interesse no desafio cientifico que representa encontrar novos modelos de pesquisa para explicar, comprovar ou medir a ação da homeopatia e a inclusão de ambientes extrahospitalares como locais de ensino. Dificultam essa aproximação as resistências ao desconhecido e as dificuldades de compreender, com a visão da racionalidade cientifica moderna, a lógica em que a homeopatia opera. Uma outra forma de resistência é considerar a Homeopatia uma medicina apenas para agravos simples e banais, caracterizando-a como uma medicina insegura. O isolamento dos homeopatas e a falta de divulgação da sua cultura foram referidos como razões que mantém o desconhecimento sobre a Homeopatia. Os entrevistados defendem que aceitar os limites de cada medicina e buscar a complementaridade pode levar ao respeito à pluralidade das medicinas, necessária para dar conta de responder à complexidade presente no campo da saúde. / The objective of this study is to access the characteristics of the relationship between homeopathic medicine and biomedicine as both participants of an interinstitucional common field, identifying the approximation and distance movements between homeopathic physicians and biomedicine physicians and identifying the elements of an ideological, cultural and technical-scientific features that are part of this process, according to the non homeopathic professionals’ point of view. The municipalities with homeopathic assistance in the public network of services (SUS) and the medical schools that develop activities related to homeopathy are identified through a survey focusing the current situation of homeopathy in the health field in Brazil. The municipalities with greater clinic production of homeopathic consultations from January to November 2003 (Datasus) and the most recognized schools, as being of major relevance to the medical education, were selected. Forty eight health professionals were interviewed (only two were not physicians), of whom 20 professors of 11 medical schools, 16 managers and 12 physicians that work in the public assistance network in 6 municipalities of five states and the Federal District. The analysis was carried out using as reference categories Bourdieu’s conceptions of social and scientific field, Madel Luz’s conception of medical rationality, Mendes-Gonçalves’ concepts of models or technological arrangements of the health work, Donnangelo and Schraiber’s conceptions of professionals’ identity formation and occupational ideology. The discourses of the interviewed professionals were described and analyzed taking 8 into consideration: the aspects considered facilitators of the approximation between the two medicines; the ones that make difficult the expansion of the homeopathy presence in the health field; presentation forms of resistance; and the professionals’ conceptions of homeopathy. Among others, the results of the study pointed out, as facilitating conditions for the presence of Homeopathy in institutions, he professional legitimation, the construction of the Universal Health System (SUS) and the biomedicine crises. However, these conditions do not guarantee teaching or assistance spaces, and the homeopathy related initiatives still depend on local sympathies. The interviewed professionals valorize aspects of the homeopathic practice that recover the occupational ideology associated to the ideal of good medical practice: integral approach of the patient, the recovering of the humanistic dimension of medicine and the results that are obtained when solving a health problem in occasions when biomedicine’s resources are inadequate or insufficient. The approximation with the academic field is facilitated by the interest in the scientific challenge that represents the encounter of new research models to explain, proof or measure homeopathy’s actions and the inclusion of extra hospital ambiences as teaching places. This approximation is made difficult by the resistance to the unknown and the difficulties of comprehension of the logic in witch homeopathy operates, difficulties related to modern science’s view on rationality. Another form of resistance is to considerate homeopathy as a medicine directed only to simple and minor health problems, characterizing it as an insecure medicine. The isolation of homeopathic professionals and the little divulgation of their culture were mentioned as reasons that sustain the lack of knowledge on Homeopathy. The interviewed professionals defend the acceptation of each medicine’s limits and the searching for complementarities that can lead to respecting the plurality of medicines, conditions that are necessary to formulate an answer to the present state of complexity in the health field.

Um fosso separa o desenvolvimento teórico-metodológico na Educação e Comunicação de sua prática aplicada à Saúde, usualmente, centrada na transmissão de informações para a mudança de comportamento. Nesta pesquisa qualitativa, exploramos o uso do conceito de competência para deslocar o binômio informação - comportamento para uma articulação de outra ordem: problema – saber - ação. Levantamos as competências requeridas para o autocuidado no diabetes, na opinião de diabetólogos, e identificamos as já disponíveis entre portadores, por meio de grupo focal e entrevista. Os resultados mostram a riqueza de saberes e competências que possuem os portadores, o que pode abrir possibilidades novas de diálogo com os profissionais de saúde, bem como promissoras perspectivas de aplicação no campo da inteligência coletiva. / A huge gap separates the theoretical and methodological development in the field of Education and Communication from its practice in health centers, usually focused in the transmission of information aiming at behavioral changes. In our qualitative research we explored the use of competence concept to change the binomial information-behavior into problem- knowledge- action. The requested competences towards diabetic care according to diabetes specialists and those available among diabetics obtained through focus groups and interviews were identified. The vast knowledge and competence of the diabetics shown by the results lead to several new possibilities of dialog with healthcare professional as well as promising prospects of actual application in the field of collective intelligence