Submitted by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2018-07-30T19:24:15Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) ana_paula_campos_barbosa_silva.pdf: 1261920 bytes, checksum: 745fbfc83a27d78f80dd346ad35d219a (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2018-10-05T19:09:52Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) ana_paula_campos_barbosa_silva.pdf: 1261920 bytes, checksum: 745fbfc83a27d78f80dd346ad35d219a (MD5) / Made available in DSpace on 2018-10-05T19:09:52Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) ana_paula_campos_barbosa_silva.pdf: 1261920 bytes, checksum: 745fbfc83a27d78f80dd346ad35d219a (MD5) Previous issue date: 2017 / O N?cleo de Apoio ? Sa?de da Fam?lia (NASF) foi criado com o objetivo de ampliar as a??es das Estrat?gias de Sa?de da Fam?lia (ESF), atuando de forma interdisciplinar alicer?ado primordialmente no apoio matricial. Por?m, observa-se uma fragilidade na incorpora??o dessa ferramenta no processo de trabalho das equipes da ESF e do NASF do munic?pio de Itamarandiba ? MG. Nesse contexto, a identifica??o das representa??es sociais dos profissionais da Aten??o Prim?ria ? Sa?de (APS) sobre assist?ncia ? sa?de visou ? compreens?o do impacto das mesmas na operacionaliza??o do apoio matricial exercido pelo NASF do munic?pio em quest?o. Para isso, este estudo recorreu ao desenho metodol?gico de estudo de caso, com natureza explorat?ria e abordagem qualitativa. Para o alcance dos dados usou-se an?lise documental, entrevistas semiestruturadas e observa??o do campo. Participaram como sujeitos deste estudo: dois m?dicos, dois enfermeiros, um cirurgi?o dentista, um auxiliar de sa?de bucal, dois Agentes Comunit?rios de Sa?de (ACS), dois t?cnicos em enfermagem, e os tr?s profissionais do NASF, perfazendo um total de treze profissionais, todos pertencentes ? rede de APS do munic?pio de Itamarandiba. O corpus primeiramente foi submetido ? an?lise pelo software IRAMUTEQ (Interface de R pourles Analyses Multidimensionnelles de Textes et de Questionnaires), atrav?s da Classifica??o Hier?rquica Descendente (CHD), com o objetivo de verificar as classes de palavras e sua organiza??o. Na sequ?ncia, submeteu-se o corpus ? an?lise tem?tico-categorial evidenciando os temas ?Assist?ncia? e ?Pr?ticas profissionais?. Como resultados deste estudo, verificou-se a presen?a de conceitos de assist?ncia ? APS tanto convergentes como divergentes com as diretrizes do SUS e normativas ministeriais da APS, j? as pr?ticas revelaram que, em sua maioria, afastavam-se do modelo de promo??o da sa?de, demonstrando, pois, representa??es sociais ancoradas no modelo biom?dico. Al?m disso, a investiga??o dos processos hist?ricos e culturais de organiza??o da APS, em especial do NASF, em Itamarandiba, esclareceu o contexto de produ??o das representa??es sociais, permitindo a compreens?o do quanto o mesmo favorece ? perman?ncia de condutas ancoradas em um modelo de assist?ncia verticalizado, com pr?ticas fragmentadas e isoladas que dificultam a intersetorialidade e se afastam da compreens?o do instrumento apoio matricial. Percebe-se a exist?ncia de pr?ticas pautadas no modelo de promo??o da sa?de, mas que precisam ser fortalecidas. Espera-se que este trabalho fomente reflex?es, entre os profissionais das equipes da APS, os coordenadores e gestores de Itamarandiba, de modo a problematizar o quanto o processo de trabalho e a organiza??o das a??es e servi?os de sa?de do munic?pio precisam ser reavaliados e reconfigurados, visando ao fortalecimento da APS. Com isso, viabilizar a atua??o do NASF em parceria com as equipes de ESF, sob a l?gica do apoio matricial e equipes de refer?ncia, visando ? organiza??o do sistema municipal de sa?de, e, consequentemente, a melhoria da qualidade de vida dos usu?rios. / Disserta??o (Mestrado) ? Programa de P?s-gradua??o em Ensino em Sa?de, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2017. / The Family Health Support Center (NASF) was created with the aim of expanding the actions of the Family Health Strategies (ESF), acting in an interdisciplinary way based primarily on the support of the matrix. However, there is a weakness in the incorporation of this tool in the work process of the ESF and NASF teams of the municipality of Itamarandiba - MG. In this context, the identification of the social representations of Primary Health Care (APS) professionals on health care aimed at understanding the impact of these on the operationalization of the matrix support exercised by the NASF of the municipality in question. For this, this study used the methodological design of case study, with exploratory nature and qualitative approach. For data coverage, we used document analysis, semi-structured interviews and field observation. Two physicians, two nurses, one dental surgeon, one oral health assistant, two community health agents (ACS), two nursing technicians, and the three NASF professionals, comprising a total of thirteen professionals, all belonging to the APS network of the municipality of Itamarandiba. The corpus was first submitted to analysis by the software IRAMUTEQ (Interface of Multidimensional Analyzes of Textes et de Questionnaires), by the method of Classification Hierarchical Descending (CHD), with the objective of verifying word classes and their organization. Subsequently, the corpus was submitted to the thematic - categorial analysis highlighting the themes "Assistance" and "Professional Practices". As results of this study, was verifyed the presence of concepts of PHC assistance both convergent and divergent with SUS guidelines and mini-ministerial PHC regulations, but the data revealed practices that, for the most part, deviated from the health promotion model, thus evidencing, social representations anchored in the biomedical model. In addition, the investigation of the historical and cultural processes of organization of the APS, especially the NASF in Itamarandiba, clarified the context of production of the social representations, allowing the understanding of how much the same favors the permanence of anchored ducts in a model of assistance vertical, with fragmented and isolated practices that hinder the intersectoriality and distance themselves from the understanding of the instrument matrix support. It is noticed the existence of practices based on the model of health promotion, but that need to be strengthened. It is hoped that this work will foster reflections among the professionals of the PHC teams, the coordinators and managers of Itamarandiba, in order to problematize how much the work process and the organization of the actions and health services of the municipality need to be re-evaluated and reconfigured aimed at strengthening PHC. With this, to enable NASF to act in partnership with the ESF teams, under the logic of matrix support and reference teams, aiming at the organization of the municipal health system, and, consequently, improving the quality of life of users.