A presente pesquisa for desenvolvida junto a pacientes hipertensos cadastrados em um Programa de Exercício Aeróbio de um Centro de Saúde do Município de Toluca - México, tendo por objetivo caracterizá-los de acordo com as variáveis do Modelo de Campo de Saúde de Lalonde: biologia humana, meio ambiente, estilo de vida e organização dos serviços de saúde e, analisar o sentir e o pensar destes pacientes sobre sua doença e os cuidados com a mesma. Participaram da pesquisa quarenta e oito pacientes, cujos dados foram obtido em duas fases; primeiramente obteve-se os dados referentes aos quatro elementos do Modelo de Campo de Saúde de Lalonde em seguida, por meio de cinco questões orientadoras foi possível identificar a experiência dos hipertensos com a doença, enfocando o pensar e o sentir destes pacientes, desde o diagnóstico até as mudanças e cuidados impostos pela doença; após a obtenção dos valores da PA, os pacientes, foram classificados em dois grupos: aqueles com PA controlada e aqueles de PA não controlada, de acordo com as recomendações do JNC-7 (2006). Entre os pacientes do grupo de PA controlada 77,08% eram mulheres: 54,16% tinham idade superior a 60 anos; 81,25% estavam com a PA controlada; 27,08% apresentavam sobrepeso e 68,75% possuíam RCQ maior que 90; 45,83% não sabiam indicar antecedentes familiares para a doença; 20,83% indicaram ser hipertensos há mais de dez anos; 72,91% faziam tratamento para a hipertensão arterial, 43,73% indicaram conhecer os valores de PA; 39,59% eram viúvos; 52,08% procediam do meio urbano; 68,75% possuíam nível de escolaridade baixo; 54,16% ocupavam-se dos afazeres domésticos; 70,83% indicaram realizar exercício físico, sendo a caminhada indicada por 66,67% deles; 75,0% não fumavam e 68,75% não consumiam bebida alcoólica; 66,67% indicaram apresentar estresse, sendo este mais freqüente em função de problemas familiares e no lar; 72,91% indicam fazer em média três refeições diárias e consumir alimentos com pouco sal (68,75%); 68,75% indicaram usar os serviços de saúde do sistema público, sendo que 54,16% indicaram procurar o serviço somente quando não se sentissem bem. Em relação ao que pensavam sobre sua doença e o cuidado, pode-se identificar que os hipertensos percebem como necessária a mudança de comportamento a partir da descoberta da doença, embora o início da doença não tenha gerado nenhuma mudança significativa. Os resultados deste estudo são importantes para o universo dos serviços de saúde do México, uma vez que demanda a necessidade de aprofundar estudos que gerem novos conhecimentos que possam contribuir para a melhoria do cuidado ao hipertenso. / This study was developed with hypertensive patients registered in an Aerobic Exercise Program in a Health Care Center in the city of Toluca-Mexico. The study objective is to characterize these individuals according to the Lalonde\'s Health Field Model variables: human biology, environment, life style, and health service organization. The study also aimed to analyze these patients\' feelings and considerations regarding their illness and their care towards it. Forty-eight patients took part in the study. Patient data was obtained in two phases: first, the data regarding the four Lalonde\'s Health Field Model elements were obtained, and, then, using five guiding questions, it was possible to identify the hypertensive patients\' experience with the illness, focusing on their thoughts and feelings from the moment of diagnosis to the changes imposed by the illness. After obtaining the patients\' blood pressure (BP) values, they were classified in two groups, according to JNC-7 (2006) recommendations: those with BP under control, and those with uncontrolled BP. Among patients in the controlled BP group, 77.08% were women, 54.16% were aged above 60 years, 81.25% did not have the BP under control, 27.08% were overweight, and 68.75% had a waist-hip ration (WHR) above 90. Among the hypertensive patients, 45.83% were unable to report any family history for the illness, 20.83% reported being hypertensive for over 10 years, 72.91% were under hypertension treatment, 43.73% reported knowing their BP values, 39.59% were widowed, 52.08% originated from the urban environment, 68.75% had a low educational level, 54.16% performed household chores, 70.83% reported doing physical exercises, with 66.67% reporting walking regularly, 75.0% are non-smokers, 68.75% do not drink alcoholic beverages, 66.67% reported having stress, which is rather often due to family problems, 72.91% reported eating at least three meals a day and eating foods with littlesalt (68.75%), 68,75% indicated using the public system\'s health care service, of which54.16% reported seeking the service only when they did not feel well. Regarding what the patients considerations about the illness and health care, is was possible to identify that they perceived that the change in behavior as something necessary for the change in behavior from as of the moment the illness is identified, regardless if the onset has not yet caused any significant change. The study results are important for the universe of health services in Mexico, since the requires the need for more profound studies that would generate new knowledge that could enhance the care offered to hypertensive individuals.

Father involvement benefits children, mothers, and themselves in a number of ways. Swedish legislation and Swedish society have promoted father involvement. At the same time, the Swedish child health field has also unequivocally states that both parents should feel welcomed and supported within that sphere. Despite these statements and policies, fathers feel neglected and invisible within and throughout the Swedish child health field, which includes prenatal clinics, birth and labor wards, postnatal clinics, child health centers, and parent support programs. Less is known however about the factors that influence father involvement in the child health centers, especially from the child health nurses’ perspective and the influence of the built environment. Additionally, parent support programs are another way through which parents receive support regarding their young child’s mental health, but very little research has focused on why fathers participate or the thoughts parents have regarding their participation, especially within a Swedish context. The overall aim of this dissertation was to better understand some of the barriers fathers have when trying to participate in the female-dominated world of the Swedish child health field, especially during the child’s preschool years. In Study I, 17 child health nurses were interviewed regarding their thoughts on fathers, and in Study II, 31 child health centers’ built environments were assessed to see how inclusive they were of fathers. In Study III, a parent support program was assessed to see if mothers and fathers had different background characteristics for participating, and Study IV sought to understand the extent to which parents appreciated and used the information from the program. These studies showed that child health nurses welcomed fathers, but did not actively invite them to participate. In addition, 75% of the child health centers did not have representations of fathers, but most child health centers had representations of mothers and/or children. Paternal behaviors positively changed if they were in an environment with either explicit paternal representations or only child representations. Mothers participated in the parent support program for several reasons, including if their child had perceived behavior problems, while fathers participated if they were stressed and perceived their child as having emotional problems. Parents believed the information they learned in the parent support program was valuable, and they continued using some strategies a year after the intervention. Swedish family policies can affect parental involvement within the child health field, but the child health field is less inclusive of fathers than mothers, and it fails to meet the needs of fathers, which can then, in turn, negatively affect maternal, paternal, and child outcomes. Therefore, the Swedish child health field needs to continue working on improving their practices of treating both parents equally.

A presente pesquisa for desenvolvida junto a pacientes hipertensos cadastrados em um Programa de Exercício Aeróbio de um Centro de Saúde do Município de Toluca - México, tendo por objetivo caracterizá-los de acordo com as variáveis do Modelo de Campo de Saúde de Lalonde: biologia humana, meio ambiente, estilo de vida e organização dos serviços de saúde e, analisar o sentir e o pensar destes pacientes sobre sua doença e os cuidados com a mesma. Participaram da pesquisa quarenta e oito pacientes, cujos dados foram obtido em duas fases; primeiramente obteve-se os dados referentes aos quatro elementos do Modelo de Campo de Saúde de Lalonde em seguida, por meio de cinco questões orientadoras foi possível identificar a experiência dos hipertensos com a doença, enfocando o pensar e o sentir destes pacientes, desde o diagnóstico até as mudanças e cuidados impostos pela doença; após a obtenção dos valores da PA, os pacientes, foram classificados em dois grupos: aqueles com PA controlada e aqueles de PA não controlada, de acordo com as recomendações do JNC-7 (2006). Entre os pacientes do grupo de PA controlada 77,08% eram mulheres: 54,16% tinham idade superior a 60 anos; 81,25% estavam com a PA controlada; 27,08% apresentavam sobrepeso e 68,75% possuíam RCQ maior que 90; 45,83% não sabiam indicar antecedentes familiares para a doença; 20,83% indicaram ser hipertensos há mais de dez anos; 72,91% faziam tratamento para a hipertensão arterial, 43,73% indicaram conhecer os valores de PA; 39,59% eram viúvos; 52,08% procediam do meio urbano; 68,75% possuíam nível de escolaridade baixo; 54,16% ocupavam-se dos afazeres domésticos; 70,83% indicaram realizar exercício físico, sendo a caminhada indicada por 66,67% deles; 75,0% não fumavam e 68,75% não consumiam bebida alcoólica; 66,67% indicaram apresentar estresse, sendo este mais freqüente em função de problemas familiares e no lar; 72,91% indicam fazer em média três refeições diárias e consumir alimentos com pouco sal (68,75%); 68,75% indicaram usar os serviços de saúde do sistema público, sendo que 54,16% indicaram procurar o serviço somente quando não se sentissem bem. Em relação ao que pensavam sobre sua doença e o cuidado, pode-se identificar que os hipertensos percebem como necessária a mudança de comportamento a partir da descoberta da doença, embora o início da doença não tenha gerado nenhuma mudança significativa. Os resultados deste estudo são importantes para o universo dos serviços de saúde do México, uma vez que demanda a necessidade de aprofundar estudos que gerem novos conhecimentos que possam contribuir para a melhoria do cuidado ao hipertenso. / This study was developed with hypertensive patients registered in an Aerobic Exercise Program in a Health Care Center in the city of Toluca-Mexico. The study objective is to characterize these individuals according to the Lalonde\'s Health Field Model variables: human biology, environment, life style, and health service organization. The study also aimed to analyze these patients\' feelings and considerations regarding their illness and their care towards it. Forty-eight patients took part in the study. Patient data was obtained in two phases: first, the data regarding the four Lalonde\'s Health Field Model elements were obtained, and, then, using five guiding questions, it was possible to identify the hypertensive patients\' experience with the illness, focusing on their thoughts and feelings from the moment of diagnosis to the changes imposed by the illness. After obtaining the patients\' blood pressure (BP) values, they were classified in two groups, according to JNC-7 (2006) recommendations: those with BP under control, and those with uncontrolled BP. Among patients in the controlled BP group, 77.08% were women, 54.16% were aged above 60 years, 81.25% did not have the BP under control, 27.08% were overweight, and 68.75% had a waist-hip ration (WHR) above 90. Among the hypertensive patients, 45.83% were unable to report any family history for the illness, 20.83% reported being hypertensive for over 10 years, 72.91% were under hypertension treatment, 43.73% reported knowing their BP values, 39.59% were widowed, 52.08% originated from the urban environment, 68.75% had a low educational level, 54.16% performed household chores, 70.83% reported doing physical exercises, with 66.67% reporting walking regularly, 75.0% are non-smokers, 68.75% do not drink alcoholic beverages, 66.67% reported having stress, which is rather often due to family problems, 72.91% reported eating at least three meals a day and eating foods with littlesalt (68.75%), 68,75% indicated using the public system\'s health care service, of which54.16% reported seeking the service only when they did not feel well. Regarding what the patients considerations about the illness and health care, is was possible to identify that they perceived that the change in behavior as something necessary for the change in behavior from as of the moment the illness is identified, regardless if the onset has not yet caused any significant change. The study results are important for the universe of health services in Mexico, since the requires the need for more profound studies that would generate new knowledge that could enhance the care offered to hypertensive individuals.

Made available in DSpace on 2014-12-17T14:20:04Z (GMT). No. of bitstreams: 1 ClidenorBSF_DISSERT.pdf: 414431 bytes, checksum: 9d70a6bf3c1b428bf9218a18430167ef (MD5) Previous issue date: 2011-11-22 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The reality experienced by many families and individuals who seek and require the services of the Unified Health System - SUS, the relationships between users, health professionals, and political representatives, establishes the core of the issue that guides the choice and interest of this study concerning the prominence of clientelist practices and gifts that permeate the health field. The research is based on the analysis and reflection of the intrinsic relationship between the health and political fields. It analyses the health field and its relationship with the dynamics and developments of the local political scenario relating it to the implementation of the Family Health Program and Community Health Agents Program (PACS/PSF health programs) in the city of Mossor?, State of Rio Grande do Norte which refers to the period 1991-2010; and falls into a methodological perspective of qualitative approach. The methodological tools and techniques used were based on semi-structured interviews, direct observation of the field, journalistic texts and documentary sources. The construction and questioning of the object of the research were based on theoretical contributions from authors discussing the social field and symbolic power: Bourdieu (2005); clientelist relationships and gifts from asymmetric exchanges: Rouland (1997), Lanna (1995), Martins (1999), Carvalho (1999), Diniz (1982); exercise of hegemony and political strategy from authors who analyse this subject: Gramsci (1995), Coutinho (1981), and Gruppi (1978). Furthermore, the research has established dialogues with authors who address the dynamics of Brazilian politics such as Baquero (2001) and Weffort (1993). The collected data were subjected to qualitative content analysis. The results showed that with the implementation of the PACS/PSF programs in the aforementioned city, the health field has established itself as a key scenario for the exercise of political hegemony of the factions that dominate this socio-political context, resizing clientelist practices, however, without modifying the power structures within this social scenario / A realidade vivenciada por in?meras fam?lias e indiv?duos que buscam e necessitam dos servi?os do Sistema ?nico de Sa?de SUS, as rela??es entre usu?rios, profissionais de sa?de, e representantes pol?ticos, instituem o cerne da problem?tica que norteia ? escolha e o interesse deste estudo sobre a proemin?ncia das pr?ticas clientelistas e d?divas que permeiam o campo da sa?de. A pesquisa se pauta na an?lise e reflex?o da rela??o intr?nseca entre o campo da sa?de e o campo pol?tico. Analisa o campo da sa?de e sua rela??o com a din?mica e os desdobramentos do cen?rio pol?tico local relacionando-o a implanta??o dos programas de sa?de PACS/PSF no munic?pio de Mossor?-RN que remete ao per?odo entre 1991-2010. Inscreve-se em uma perspectiva metodol?gica de abordagem qualitativa. Os instrumentos metodol?gicos e t?cnicas utilizadas pautaram-se em entrevistas semi-estruturadas, observa??o direta do campo, textos jornal?sticos e fontes documentais. A constru??o e problematiza??o do objeto da pesquisa fundamentou-se em aportes te?ricos de autores que discutem o campo social e poder simb?lico: Bourdieu (2005); rela??es clientelistas e d?divas a partir de trocas assim?tricas: Rouland (1997), Lanna (1995), Martins (1999), Carvalho (1999), Diniz (1982); exerc?cio da hegemonia e estrat?gia pol?tica em autores que analisam essa tem?tica: Gramsci (1995), Coutinho (1981) e Gruppi (1978). Ademais, a pesquisa estabeleceu di?logos com autores que versam sobre a din?mica da pol?tica brasileira como Baquero (2001) e Weffort (1993). Os dados coletados foram submetidos a uma an?lise qualitativa de conte?do. Os resultados evidenciaram que com a implanta??o dos programas PACS/PSF no munic?pio supracitado o campo da sa?de consolidou-se como um cen?rio essencial para o exerc?cio da hegemonia pol?tica das fac??es que dominam esse contexto sociopol?tico, redimensionando as pr?ticas clientelistas, entretanto, sem modificar as estruturas de poder no ?mbito deste cen?rio social