The objectives of this study were to understand how the work of the Family Health Strategy team is organized in relation to the care of the rural workers exposed to pesticides; describe the particularities of the rural work and workers; characterize the social demographic data of the health professionals who work at the ESF and identify the health actions done by the ESF teams in relation to the rural workers, as well as to those exposed to pesticides. It is an explorative-descriptive study of qualitative approach developed with 15 health professionals of the Family Health Strategy in the city of Nova Palma/RS. The instruments of data collection were the passive observation and the semi structured interview. To analyze the data it was applied the thematic analyzes. The results are shown in two articles. The first article is organized in two categories: particularities of the rural work and workers and the attitude of the rural workers toward the pesticides. The second article is composed by the categories: social demographic categorization of the participants of the survey; experience of the health professionals in the rural area and the professional conduct of the health professional in case of intoxication. To serve ethical precepts it was fully accomplished the 196/96 resolution. This study may contribute to the care of the rural workers exposed to pesticides so that it could be organized by the health team in a way to contemplate such specificity by the full time attention to health. Moreover, the aim of this study is to contribute to managers, health workers and researchers to their practices in studies that disclose the specificity and the aggravation resulting from activities that expose the workers to the use of pesticides. The construction of this study allowed the comprehension of the rural work dynamics, by the view of the health professionals. Giving this, it is emphasized the necessity of investment in the organization of actions related to the rural workers health in general, as well as in relation to pesticide exposition. / Os objetivos desse estudo foram compreender como é organizado o cuidado prestado pela equipe de Estratégia de Saúde da Família a trabalhadores rurais expostos a agrotóxicos; descrever as peculiaridades do trabalho e do trabalhador rural; caracterizar os dados sócios demográficos dos profissionais da saúde que atuam na ESF e identificar as ações de saúde realizadas pelas equipes ESF com trabalhadores rurais, bem como com aqueles trabalhadores expostos a agrotóxicos. Trata-se de um estudo de abordagem qualitativa, do tipo exploratório-descritivo desenvolvido com 15 profissionais de saúde da Estratégia de Saúde da Família do município de Nova Palma/RS. Os instrumentos de coleta de dados foram a observação não-participante e a entrevista semi-estruturada. Para análise dos dados foi empregada a análise temática. Os resultados estão apresentados em dois artigos. O primeiro artigo está organizado em duas categorias: peculiaridades do trabalho e do trabalhador rural e a postura do trabalhador rural frente aos agrotóxicos. O segundo artigo é composto pelas categorias: caracterização sócio demográfica dos participantes da pesquisa; atuação dos profissionais de saúde no espaço rural; e conduta do profissional de saúde em casos de intoxicação. Para atender os preceitos éticos foi cumprida integralmente a resolução 196/96. Este estudo poderá contribuir para que o cuidado aos trabalhadores rurais expostos aos agrotóxicos seja organizado pela equipe de saúde, de forma a contemplar tal especificidade, por intermédio da atenção integral a saúde. Além disso, visa contribuir para que gestores, trabalhadores de saúde e pesquisadores possam assentar suas práticas em estudos que revelam a especificidades e os agravos decorrentes de atividades que expõem os trabalhadores ao uso de agrotóxicos. A construção desse estudo permitiu a compreensão da dinâmica do trabalho rural, pela ótica dos profissionais de saúde. Frente a isso, enfatiza-se a necessidade de investimento na organização de ações voltadas a saúde dos trabalhadores rurais de forma geral, bem como com relação à exposição a agrotóxicos.

Magister Curationis - MCur (Dept. of Nursing) / This phenomenological study explored the lived experiences of undergraduate community health nursing students at the University of the Western Cape who conducted a family health assessment learning task in communities during their clinical fieldwork placement.The population included the 2008 semester two, third year undergraduate baccalaureus nursing students. These students completed their community health nursing modules at the end of the first semester. A total of nine (9) out of the eighty- nine (89) semester two students participated in this qualitative research study. The purposive and convenient sample consisted of those students who agreed to voluntarily participate in the research study. In-depth interviews were conducted with seven (7) female and two (2) male students to collect data. Field notes were taken and utilized to capture non-verbal communication of the participants. The focus f the researcher was to explore the lived experiences of students and not that of the family whom they interviewed. All interviews were audio recorded nd validated by participants after transcription, before any of the data was used for the data analysis process. The data collected was categorized into themes as guided by the systematic data analyses process according to Tesch’s (1990) method, as cited in Creswell (2003). Saturation was tested after nine interviews and the researcher found that no new data emerged. The importance of the research study was to reflect on the exploration of the self-reported lived experiences of the third year community ealth nursing students while conducting the family health assessment learning task. / South Africa

Magister Public Health - MPH / Introduction: Health Sector Reform was initiated as a component of the Structural Adjustment Policies that were imposed on the developing countries by the international monetary organizations such as the International Monetary Fund and the World Bank during the 1980s and the 1990s. It included three main components, that is, financing reforms, decentralization and introducing competition to the health sector. Changes to the Egyptian health system were introduced in the 1980s through the cost recovery projects, while the Health Sector Reform Program was announced in 1997. This culminated in a change from a Primary Health Care model to a Family Health Model as regards the Primary Health Care sector of the Egyptian health system. Changes in the health systems have profound effects on people, so that it is essential to study the ongoing transformation of the Egyptian health system and its implications. Aim: The aim of the current study was to determine the acceptability of the Family Health Model, which replaces Primary Health Care, as currently implemented in Wardan Village, Giza, Egypt. Methodology: The study was a cross sectional survey utilizing a structured questionnaire that was used to determine the awareness and perception/satisfaction of the community members in an Egyptian rural area (Wardan village, Giza Governorate) towards the transformation from primary health care to family health model. 357 subjects participated in this study. Results: Awareness of the study participants towards the transformation process was 15.6%. The overall satisfaction with the family health unit by the participants was 80.5% compared with 35.7% for the old PHC one. Higher satisfaction was associated with older age (p=0.02), less education (p<0.001), being married in the past or present (p=0.02), working status (p=0.007), and more years of using the unit (p<0.001). Acceptability of the family health model among the participants of the current study was high at 88.3%. Higher score of acceptability were associated with less education (p<0.001), being or have been married (p=0.048), and with working status (p=0.005). 93.8% of the participants think that family health unit services are accessible and 79.9% of the participants think that the family health unit provides quality services. Conclusion: The Family Health Model has achieved successes when implemented but encountered some difficulties that have limited the gains and interfered with some of its aspects. The current study has shown that the Family Health Unit has gained a high score of satisfaction and acceptability by the study participants, although the awareness of the study participants about the transformation of the Primary Health Care Model to a Family Health Model was low.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-07-25T13:17:48Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) DISSERTAÇÃOOO.pdf: 2431467 bytes, checksum: 5fd4cac0b208f0602567479b027d240f (MD5) / Made available in DSpace on 2017-07-25T13:17:48Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) DISSERTAÇÃOOO.pdf: 2431467 bytes, checksum: 5fd4cac0b208f0602567479b027d240f (MD5) Previous issue date: 2016-09-30 / As modificações decorrentes do ciclo gravídico no corpo da mulher tornam-no mais sujeito a riscos como a lombalgia, sintomatologia que tem assumido relevante destaque pela sua alta incidência. Diante disto, objetivou-se avaliar a atuação do SUS por meio de sua rede preferencial, a Atenção Básica, quanto a efetivação da integralidade na atenção à lombalgia gestacional de mulheres residentes no Habitacional da Comunidade de Saramandaia – PE. Para tanto, foi aplicado um questionário a todas as gestantes residentes nesse habitacional, com ou sem referência de lombalgia. A partir da análise dos dados, verificou-se que, embora 95% das gestantes estivessem realizando pré-natal pela USF, houve uma prevalência de dor lombar de 75% atrelada às gestações atuais ou anteriores e a maioria das gestantes acompanhadas (78,94%) afirmou não receber orientações e 94,73% ainda não tinham sido encorajadas a praticar atividade física a fim de prevenir e tratar tal dor. Dentre as mulheres com lombalgia gestacional, 66,66% asseguraram piora do quadro no decorrer da gravidez e 100% das mulheres que referem dor lombar e que estão sendo acompanhadas pela USF declararam que os profissionais de saúde não estão atuando na sua dor e que ainda poderiam fazer mais pela mesma. Com base nesses dados, pode-se afirmar que a Atenção Básica tem se esvaído de sua responsabilidade em promover ações integrais no cuidado às mulheres gestantes da comunidade de Saramandaia – PE, pois estas não têm sido contempladas com a promoção de sua saúde, a prevenção e o tratamento da dor lombar, comprometendo suas possibilidades de viver o período gestacional de modo saudável. / The changes resulting from pregnancy cycle in a woman's body makes it more subject to risks such as low back pain, symptoms that has taken relevant highlighted by its high incidence. In view of this objective was to evaluate the SUS coverage through their preferred network, the Primary Care, as the realization of completeness in the care of gestational lumbago of women living in the Housing Saramandaia – PE community. To this end a questionnaire was administered to all pregnant women living in this housing, with or without reference lumbago. From the analysis of the data found that while 95% of pregnant women were performing prenatal by USF, there was a prevalence of low back pain 75% linked to current or previous pregnancies and the majority of women followed (78.94 %) said he did not receive guidance and 94.73% had not been encouraged to engage in physical activity to prevent and treat this pain. Among women with gestational lumbago, 66.66% assured picture worsens during pregnancy and 100% of women who reported back pain and being accompanied by USF declared that health professionals are not acting in their pain and still they could do more for the same. Based on these data it can be stated that Primary Care has been drained of their responsibility to promote comprehensive actions in caring for pregnant women Saramandaia – PE community because they have not been included with the promotion of their health, prevention and the treatment of low back pain, affecting their ability to live the pregnancy healthily.

Orientador: Mariana Dorsa Figueiredo / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T22:58:04Z (GMT). No. of bitstreams: 1 Machado_FabiolaMariaStolsesBergamo_M.pdf: 1027321 bytes, checksum: 379e0af8eb4b3cee1910230bebc78e28 (MD5) Previous issue date: 2014 / Resumo: O processo de envelhecimento populacional tem trazido desafios quanto ao cuidado de uma população idosa, na sua maioria com uma alta prevalência de doenças e sendo cuidada por um sistema de saúde que, apesar de amplamente respaldado em leis, apresenta uma escassez de equipes multiprofissionais e interdisciplinares com conhecimento sobre envelhecimento e saúde da pessoa idosa, além de uma baixa integração nestes diversos níveis de atenção. Nesta pesquisa, objetivamos implantar o Apoio Matricial especializado em saúde do idoso a uma Equipe de Saúde da Família da rede SUS de Piracicaba (SP) e gerar subsídios para estimular a implantação desse arranjo no município como um todo. O Apoio Matricial visa oferecer retaguarda assistencial e suporte técnico pedagógico, proporcionar a construção compartilhada de diretrizes clínicas entre os especialistas que oferecem este apoio e os componentes da equipe de Saúde da Família, além de ampliar a construção de vínculo entre profissionais e usuários. Pretende-se, com isso, desviar a lógica de encaminhamentos indiscriminados para uma lógica de co-responsabilização, produzindo uma maior resolutividade à assistência em saúde. Realizamos grupos de intervenção e grupo focal com os membros de uma equipe de Saúde da Família e do NASI (Núcleo de Atenção à Saúde do Idoso), ambulatório de referência à saúde do idoso às unidades de Atenção Básica do município de Piracicaba (SP). A análise destes dados se deu por meio da construção de narrativas, a partir das quais foi feito um estudo por categorias de análise, destacando as diferentes percepções e opiniões dos sujeitos. Pretendemos mostrar a importância do Apoio Matricial na aproximação dos profissionais das equipes de referência e especializada em saúde do idoso, aumentando a resolutividade na condução dos casos dos usuários idosos. Além disso, que haja a implantação permanente e a ampliação do apoio matricial entre o NASI e as Equipes de Saúde da Família; que o espaço criado pelo apoio matricial potencialize a confiança e atitudes adequadas dos profissionais perante os idosos, seus cuidadores e familiares / Abstract: The aging population process has brought challenges for the care of an elderly population, mostly with a high prevalence of diseases and being cared for a health care system in despite of widely supported in laws, has a shortage of multidisciplinary teams and interdisciplinary with insufficient knowledge about aging and health of the elderly, in addition to a low integration in these various levels of care attention. In this research, we aimed to deploy the Matrix Support specialized in health of the elderly to a Family Health Team of SUS in Piracicaba (SP) and generate subsidies to stimulate the deployment of this arrangement in the county as a whole. The Matrix Support aims to provide care backup and pedagogical technical support, provide the shared construction of clinical guidelines among experts that offer this support and the components of the Family Health Team, in addition of expanding the construction of link between professionals and users. It is intended, therefore to, deviate the logic of indiscriminate referrals to a logic of co-responsibility, yielding a better resolution to health care. We conducted groups of intervention and focal group with the members of a team of Health and Family NASI (Center for Health Care of the Elderly), ambulatory reference to health of elderly at primary care units of the municipality of Piracicaba (SP). Data analysis was done through the construction of narratives, from a study which was made by categories of analysis, highlighting the different perceptions and opinions of individuals. We intend to show the importance of the Matrix Support in integrating the professional of reference teams and specialized in the elderly population, increasing the resolution in the conduct of cases of elderly users. In addition, there is a permanent establishment and expansion of matrix support from the NASI and Family Health Teams, the space created by the matrix support to leverage the trust and appropriate of professionals attitudes towards the elderly, their caregiver and family / Mestrado / Política, Gestão e Planejamento / Mestra em Saúde Coletiva

Orientadores: Maria Filomena de Gouveia Vilela, Marcos Drumond Junior / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-29T00:50:18Z (GMT). No. of bitstreams: 1 Barbosa_Alexandra_M.pdf: 3758671 bytes, checksum: 5b18ea5bd270e94cbf170c9659825a57 (MD5) Previous issue date: 2015 / Resumo: Estudo de natureza qualitativa, o qual tem como objetivo geral analisar o processo avaliativo do PMAQ, a partir da experiência de sua implementação nas Equipes de Saúde da Família do Distrito de Saúde Leste, em Campinas. Como objetivos específicos, espera-se - contribuir na construção de uma metodologia pedagógica reflexiva e formativa para a abordagem dos resultados do processo avaliativo do PMAQ, junto às Equipes de Saúde da Família, colaborar para a incorporação de uma cultura avaliativa formativa no processo de trabalho das Equipes de Saúde da Família, e produzir uma análise comparativa entre o processo de Avaliação Externa e o de Autoavalição, propostos pelo PMAQ. A referente pesquisa se desenvolveu através de duas frentes metodológicas: 1) a análise documental dos relatórios de resultados dos processos avaliativos do PMAQ através da elaboração e oferta de uma Matriz Comparativa de Resultados facilitadora da visualização e análise desses resultados e a oferta de uma Oficina Pedagógica com os Gestores Locais, Apoiadores e com representantes das Equipes de Saúde da Família, que aderiram ao programa, ofertando a Matriz e incentivando devolutivas cuidadosas dos resultados para suas ESF, buscando propiciar reflexão sobre seu processo de trabalho; 2) Realização de dois Grupos Focais, um com representantes de cada uma das seis ESF do Distrito de Saúde Leste, que aderiram ao primeiro ciclo do PMAQ, e outro com os gestores locais e apoiadores destas Equipes de Saúde da Família, buscando levantar as potências e nós críticos do processo avaliativo disparado pelo PMAQ. Esse estudo pretende realizar uma reflexão sobre as estratégias de apoio às Equipes de Saúde da Família que aderiram ao Programa Nacional de Melhoria do Acesso e Qualidade-PMAQ, à medida que se dispõe a processar e analisar as vertentes do processo de implementação assim como os resultados obtidos, possibilitando, dessa forma, uma devolutiva de resultados qualificada a essas Equipes e Gestores. À vista disso, o presente trabalho tem a intenção de contribuir com a qualificação das práticas e o fornecimento de subsídio para possíveis necessidades de reorganização no processo de trabalho dessas equipes, além de incentivar a implementação e sistematização de uma cultura avaliativa formativa, em busca da melhoria da qualidade das ações de saúde ofertadas por estas equipes aos seus usuários / Abstract: Qualitative research aiming to produce a analysis of PMAQ evaluative process from the perspective of its implementation in the Family Health Teams in Campinas¿ East Health District. Expected results include yet: collaborate in the development of a pedagogic, reflexive and formative methodology within selected Family Health Teams for the analysis of results arising from the PMAQ evaluation process implemented throughout the wider Family Health Team community in the Campinas municipality; to work towards promoting evaluative and formative practices in the Family Health Teams¿ work process; and to elaborate comparative analysis between the processes of External Evaluation and Self-Evaluation, both proposed by the PMAQ. This research has been carried out using two main methodologies: 1) The documental analysis of the PMAQ evaluation process results reports by means of production and presentation of a Results Comparison Matrix which facilitates visualization and analysis of data from the results, followed by analysis of these results jointly with the preparation of a Pedagogical Work Group for local managers, facilitators and Family Health Team representatives participating in the program, where the Comparison Matrix was presented and tactful feedback to their Teams was incentivized seeking to encourage reflection on the work process; 2) The organization of two Focus Groups, one comprising representatives of each one of the six Family Health Teams from the East Health District who participated in the first PMAQ cycle, and another consisting of the local managers and facilitators of the same Family Health Teams, seeking to identify strengths and critical points in the evaluative process brought about by PMAQ. This study seeks reflection on support strategies for the Family Health Teams which have joined the PMAQ (Programa Nacional de Melhoria do Acesso e Qualidade) through analysis of aspects of the implementation process and of the results obtained thus enabling feedback of those qualified results to the teams and managers while contributing towards improving practices and helping with eventual work process reorganization in the teams, as well as implement and systematize an evaluative formative culture aiming at improving the quality of health actions available to the populations assisted by the teams / Mestrado / Política, Gestão e Planejamento / Mestra em Saúde Coletiva

Made available in DSpace on 2015-09-14T09:17:42Z (GMT). No. of bitstreams: 1 dissertacao_aparecida_de_fatima_grego.pdf: 2033299 bytes, checksum: 0dcc2d4e328c4f2f5d21c67cdc9c9c10 (MD5) Previous issue date: 2005-02-16 / The Cardiovascular Diseases are the main factor for morbimortality in the world population. Brazilian studies show that arterial hypertension is responsible for 40% of deaths caused by encephalic vascular accidents, and 25% of deaths caused by coronary disease. As a result, arterial hypertension is one of the most important risk factors to the development of cardiovascular diseases. The high cost of Arterial hypertension for social and medical care calls not only the country s but also all the Brazilian states and district s attention. Cultivating some new models of health attention and promotion in order to decrease some of the problems, what it is called the Family Health Program was settled in some districts, aiming to increase the adhesion to the treatment and create responsibilities to the social and individual healthcare. Thus, the knowledge of arterial hypertension distribution is an instrument of extreme importance to the implementation of actions which are going to act not only in the prevention level but also to avoid the aggravating points as well as the squeals, what meets the purpose of this study - to describe the population whose hypertension has been diagnosed and registered in the city of Luiziânia during the year of 2002. For that, it was used some data which were provided by the Basic Attendance Information System and the HIPERDIA (personal data records of diabetes and hypertension patients) of the district, which has two teams that could register and record personal information of approximately 557 people of 20 years old and over who have arterial hypertension, with a prevalence of 12.77%. Luiziânia has a population, with a predominance of white people, either in the population in general or in the arterial hypertension, and among women of all ages with the sum of 66%. According to the schooling distribution, and after organizing a somatory data between literate and illiterate people, without any specification, a rate of over 84% was found and 89.28% of those people have a good familiar situation that can facilitate the Family Health Program work. 60% of the male who have arterial hypertension are retired. For women, the sum of retired and housewives is 91%. According to the variable to obesity, a total series between overweight and obese people in I, II, and III stages respectively was done. It s important that the Family Health Program team can work, starting from these results, with young people and with a schedule of those preventive actions to arterial hypertension which are connected to habit changes and to the practice of physical exercises in order to decrease the risk factors. / As doenças cardiovasculares (DCV) constituem a principal causa de morbimortalidade na população mundial. Estudos brasileiros mostram que a hipertensão arterial é responsável por 40% das mortes por acidente vascular encefálico e 25% por doença coronariana; isso a transforma em um dos mais importantes fatores de risco para o desenvolvimento das doenças cardiovasculares. O elevado custo médico-social que a hipertensão arterial apresenta chama a atenção não só do País, mas também dos Estados e municípios brasileiros Cultivando novos modelos de atenção e promoção à saúde para a redução de problemas como este, foi instituído o Programa de Saúde da Família (PSF) em alguns municípios como uma forma de aumentar a adesão ao tratamento e criar responsabilidades de saúde grupal e individual. Desta maneira, o conhecimento da distribuição da hipertensão arterial é um instrumento de máxima importância para a implementação das ações no nível de prevenção como também para evitar agravos e seqüelas, o que vem ao encontro com o objetivo deste trabalho, que é de descrever a população hipertensa, diagnosticada e cadastrada na cidade de Luiziânia no ano de 2002. Para isso, utilizaram-se dados fornecidos pelo Sistema de Informação do Atendimento Básico (SIAB) e a ficha do HIPERDIA (Cadastro do Hipertenso e/ou Diabético) do município, que possui duas equipes que registraram e cadastraram 557 pessoas, com idade de 20 anos ou mais, portadoras de hipertensão arterial e com uma prevalência na população de 12,77%. A população em geral é de cor branca mesmo entre os que apresentam hipertensão com predomínio de 66% para o sexo feminino.Segundo a distribuição de escolaridade, entre os analfabetos e os alfabetizados sem especificação a taxa encontrada foi de 84%, na classificação por ocupação encontra-se uma taxa 60% de aposentados hipertensos no sexo masculino e de 91% de dona de casa e aposentadas no sexo feminino. Dos hipertensos, 89,28% tem uma situação familiar constante o que facilita o trabalho o trabalho para o Programa de Saúde da Família (PSF), por este motivo, é importante que a equipe do PSF possa trabalhar diante dos resultados, com a população de jovens e adultos, no planejamento de ações preventivas para a hipertensão arterial, ligados a mudanças de hábitos e à pratica de exercícios físicos no intuito de minimizar os fatores de risco.

Objetivo: As proposições do presente estudo do tipo transversal foram: avaliar o índice de respostas positivas sobre saúde bucal dadas em um inquérito validado contendo 18 questões fechadas, realizado com agentes comunitários de saúde (ACS) que atuam na zona urbana de Porto Velho, Ro e Verificar se os ACS exercem influência sobre os usuários de unidades de sua área de atuação. Métodos: No total, 656 sujeitos participaram do estudo. Para atender à primeira proposição, foram entrevistados 326 ACS. Para responder à segunda proposição, foram incluídos 167 usuários de unidades localizadas em áreas cobertas por ACS e 163 em áreas não cobertas. Foi aplicado o teste Mann-Whitney para verificar diferenças entre as amostras de ACS e usuários cobertos. O mesmo teste foi utilizado na comparação entre as duas amostras de usuários. Para identificar interferência do nível de escolaridade sobre o conhecimento dos usuários cobertos por ACS foi utilizado o teste Kruskal Wallis. O nível de significância adotado nos dois testes foi de 5%. Resultados: Em relação à primeira proposição, os conhecimentos sobre saúde bucal dos ACS apresentaram-se condizentes com os de outros estudos, quando a comparação foi feita previamente aos treinamentos específicos. Quanto à segunda proposição, os ACS não demonstraram exercer influência sobre os conhecimentos de usuários das unidades de saúde em que atuam. Conclusões: De forma geral, ficou patente a necessidade de cursos de capacitação específicos sobre o assunto ou a inserção desse tema nos programas de capacitação já existentes. Além disso, devem ser encontrados mecanismos para orientar os ACS a abordar a saúde bucal durante as visitas domiciliares. / Objectives: The purposes of the present cross seccional study were: 1) to evaluate the index of correct answers about oral health given in a validated inquiry with 18 closed ended questions, applied to community health agents (CHA) that work in the urban area of Porto Velho, Brazil and 2) to verify the influence of CHA on the users of public health care services of its area of work. Methods: The final number was 656 individuals that participated in the study. To answer to the first purpose, 326 CHA were interviewed. To answer to the second purpose, 167 users of health care services located in areas with CHA actuation and 163 in areas where they do not act are included. The Mann-Whitney test was applied to verify differences between the samples of CHA and covered users. The same test was used in the comparison between the two samples of users. To identify interference of the level of education on the users knowledge of covered, the Kruskal Wallis test was used. The cut-off point for statistical significance was of 5%. Results: In relation to the first purpose, the knowledge about oral health of CHA came similar to other studies, when the comparison was made previously to specific trainings. In relation to the second purpose, CHA did not demonstrate to exercise influence on the knowledge of users of their health care service. Conclusion: It was clear that the CHA need of specific training courses about buccal health or the insert of that theme in the training programs already existent. Besides, it should be found mechanisms to guide ACS to deal the buccal health education during their home visits.

Este trabalho tem como objetivo compreender a percepção e os sentidos que portadores de sofrimento psíquico, familiares deles e agentes comunitários, que os atendem, têm do Acompanhamento Terapêutico para tratamento da pessoa em sofrimento mental. Colaboraram nesta pesquisa seis indivíduos que foram atendidos por um acompanhante terapêutico, um familiar de cada um desses indivíduos e cinco agentes comunitárias que visitaram as casas dos colaboradores. Foi realizado por meio de entrevista com uma questão norteadora. Os relatos foram gravados e transcritos na íntegra e analisados sob a perspectiva da metodologia qualitativa fenomenológica, fundada na Fenomenologia de Martin Heidegger, por autores que se aprofundaram nesse enfoque filosófico e estudiosos da Psicologia Fenomenológico-Existencial. Como resultados, os colaboradores mostraram um aumento qualitativo nas interações dos pacientes com os familiares, com a equipe de saúde e com a comunidade e, também, menor isolamento e maior independência em comportamentos de autocuidado, cuidado com seu espaço doméstico, maior adequação à sua proteção e desenvolvimento de habilidades. Com este estudo é possível reafirmar a importância do Acompanhamento Terapêutico para o tratamento de pessoas em sofrimento psíquico, bem como da equipe, no Programa de Saúde da Família. / This study\'s objective is to understand the perception and the feeling of persons enduring psychic suffering, their family, and community carer agents about Therapeutic Accompaniment it stops treatment of a person in mental distress. Six individuals that were seen to by therapeutic carers, one family member of each of these individuals and five community agents that visited the collaborator\'s houses collaborated in this research. It was carried out through an interview guided by a guiding question. The answers were recorded and fully transcribed and analyzed under the perspective of the phenomenological qualitative methodology, based on the Martin Heidegger\'s Methodology, by authors that specialized in this philosophical focus and followers of the Phenomenological-Existencial Psychology. As results, the collaborators showed that there was a qualitative raise in patients interactions with family members, with health team and with the community and, as well as a less isolation and more independence in self-care behaviors, care with their domestic space, more adequate behaviors regarding their protection, and development of abilities. Through this study, it is possible to reaffirm the importance of Therapeutic Accompaniment for the treatment of people in psychic distress, as well as the team, in the Family Health Program.

Magister Chirurgiae Dentium (MChD) / This study was undertaken to examine the preventive dental and medical attendance behaviour of mothers of young children. The 'Theory of Reasoned Action' used to predict intention to visit the dentist and the doctor, failed to account for more than 11% of the variance in dental behaviour and 9t in the variance in medical behaviour in all the subjects. However, on assessing these behaviours for the 2 different age groups, for the younger age group, the prediction improved to 19% for the dental intention in terms of the total attitude and subjective norm score, and to 45% and 34% respectively for the individual attitudes and subjective norms. In the older age group, the prediction improved to 20% for the dental intention in terms of the total attitude and subjective norm score, and to 39% and 30% respectively for the individual attitude and subjective norms. This finding is further supported by factor analysis of the data, whereby using a principal components analysis structure, other patterns to the data were found which indicates that preventive dental and medical behaviour is a complex behavioural category, consisting of more than one action. Two dimensionso of affect accounted for 59% of dental attitudinal data and 57.9% of the dental subjective norm data, whereas three dimensions of affect accounted for 64.5% of the medical attitudinal data and 64.8% of the medical subjective norm data. The mothers had positive attitudes to both the two dental and three medical actions highlighted by the principal components analysis. The younger mothers showed stronger attitudes associated with the treatment outcome action, whereas the older mothers showed a more positive preventive orientation by the dental data. Although two-thirds of the young mothers received dental advice from the health visitors, they were highly selective on what information to accept and put into effect. An indication here is that health messages including dental health are perceived differently by the 2 age groups even though they are from the same social class group. This finding holds in important implications for the method, approach and content of dental heath of education. In terms of the medical data, the three actions highlighted, indicated that while a health directed behaviour, in terms of a healthy outcome e.g. normal growth is important, an expectation as well as a more emotional, love and tender care factor were also implicated. A healthy baby may however not be the only factor of importance to the mother, but also the mechanisms of achieving such a state of health, matters not only in terms of the convenience but also, greatly depend on the love and level of care the mother gives the child. This aspect may even be more accentuated in one parent families, in which especially the young mother is under enormous socia-economic pressure to take up employment, foresaking time she would otherwise have spend with the child. The effect of subjective norms on preventive health behaviour shows evidence of a 'inner cicle' or 'kinship' as reference group to the mother, which mediates between and modifies the influence of the health profession in as far as compliance with health care is expected from the mother. It therefore appears that in the lower social classes, there exists an intricate social network, exercising an important effect on the way of life of the mother, and since this network may be one of the few supports she has, its influence will be exerted in various dimensions of the mothers' life including health. There appears to be a hidden pathway or code of conduct, defined by these social norms and to which the mother feels she owes her allegiance. The level of communality between the social networks and preventive dental behaviour should be further investigated. This study has clearly indicated that some of the dental and medical attitudes and subjective norms under consideration, has a marked independent yet related effect on preventive health behaviour whereas other attitudes and subjective norms acted independently or sometimes not at all. The dental health educator, must therefore determine for each community and individual which action is the most appropiate target for behavioural change. Furthermore, this study has shown that if beliefs are to be modified, referents to support such a behaviour change, must therefore be appropiate to attaining this objective. since preventive medical and dental behaviour consists of various actions, the application of the Azjen and Fishbein model, should be to a specific action of the behaviour, which assumes importance in the target community, important others. associated with Baric (20) has emphasised the role of the family as an important influence on attitude and behaviour, while Boothroyd- Broóks (39) has pointed to the contribution of society as important mediators in secular life. The results from this study would tend to support the views of Suchman(193), Baric(20) and Boothroyd-Brooks(39) that, kinship, family and social norms were important in the development of behaviour but, to sustain such a behaviour, a deeper understanding is required of the social forces operative through the social network, which shapes the mothers' health behaviour into action. be this medical or dental attendance for herself or for that of her children.