This project examines the medical management of pain and injury in British Olympic sport. By drawing upon the perspectives of health-care providers, it explores key developments such as the professionalisation, formalisation and bureaucratisation of sports medicine and the consequences of such developments on doctors' and physiotherapists' working practices, relationships with each other and on athlete care. A questionnaire about the backgrounds (e.g. the qualifications, experience and methods of recruitment and appointment) was sent to members of the British Olympic Association's Medical Committee and Physiotherapy Forum in November 2007 and in-depth, semi-structured interviews were conducted with 14 doctors and 14 physiotherapists between January and June 2008. Data indicate that attempts to professionalise sports medicine into a medical speciality have created fragmentation and resistance among the various groups involved in athlete care at this level. Whilst clinicians were committed by multi-disciplinary practice overall, data reveal qualitative differences between practitioners who have established themselves within bureaucratic organisations such as the English Institute of Sport (EIS) compared to those who provide largely voluntary medical services via National Governing Bodies of Sport (NGBs). Thus, practitioners in positions of managerial authority were constrained to negotiate the underlying amateur values of numerous sports medicine staff at the same time as striving for a professional ethos. Processes of professionalisation have also impacted upon the inter-professional relations between doctors and physiotherapists and the social organisation of athlete-care. As a consequence of their work setting, clinicians were constrained to adhere to the performance-motivated demands of their athlete and coach clients over longer-term health concerns. Because of their greater orientation towards performance, physiotherapists were able to effectively "compete" with doctors in a number of practice contexts and so claim considerable professional autonomy. This project adds to the existing body of knowledge on the medical practices of sports medicine clinicians in elite level sport and demonstrates the heterogeneity within this area of practice. Furthermore, the thesis highlights the importance of understanding clinicians working practices as a consequence of their particular work setting.

Bakgrund: En neutral och direkt kommunikation är en av de mest avgörande faktorerna för en persons upplevelse av bemötande i samhället. Samhället idag bygger på en heteronorm vilket bidrar till ett exkluderande av personer som inte ingår i denna norm, exempelvis HBTQ-personer. Forskning har visat på att detta fenomen även förekommer inom sjukvården. Syftet:  Analysera homosexuella, bisexuella, trans- och queerpersoners (HBTQ-personers) upplevelser av bemötande från vårdpersonal inom vården samt att analysera om en sexuell minoritetsgrupp som HBTQ påverkas av stigma och diskriminering inom vården. Metod: Sammanställning av kvantitativ- och kvalitativ forskning för att sammanfatta kunskapsläget såsom det ser ut idag. Huvudresultaten: Ett heterosexuellt antagande hade en inverkan på vården och patienternas upplevelser av bemötande på olika sätt. Vidare påverkades HBTQ-personer som en utsatt minoritetsgrupp av direkt och indirekt stigma och diskriminering i varierande utsträckning. Slutsats: Genom en neutral framtoning från vårdgivare kan en stabil patient-vårdgivare relation växa fram. Detta möjliggör en större öppenhet och acceptans inom vården. Slutsatsen visar även att ett holistiskt helhetstänk där varje människa ses med unika behov och egenskaper möjliggör en trygg vård för HBTQ-personer. Som sjuksköterska är det i kliniken viktigt att visa på ovanstående kunskap och förståelse för olika sexuella läggningar och könsvariationer. / Background: A neutral and direct communication is one of the key factors of a person´s experience of attitudes within the society. Society today is based on a heteronorm which contributes to an exclusion of people whom are not a part of this norm, such as LGBTQ-people. Previous research has shown that this phenomenon also exists within the health care. The aim: To analyze LGBTQ-people’s experiences of attitude from caregivers within the health care and analyze if Lesbian, gay, bisexual, transsexual and queer (LGBTQ-people), as a minority group, were affected by stigmatization and discrimination within the health care. Method: for the review was to through quantitative and qualitative data summarize the knowledge of today. Results: The study showed that a heterosexual assumption had an impact of the health care and  LGBTQ-people’s experiences of attitudes from caregivers in different ways. Furthermore the LGBTQ-people were more or less affected by direct- or indirect stigmatization and discrimination. Conclusion:A neutral appearance from caregivers could create a stable patient-caregiver relation. This will enable a greater openness and acceptance within the health care. A holistic attitude, where every human being is seen with unique needs and characteristics, will lead to safer care for LGBTQ-people. As a nurse it is important to show knowledge and understandings of different sexual orientations and gender variations to make the health care a safe place for everyone.

Bakgrund: Den vanligaste smittvägen för hepatit C är genom intravenöst drogmissbruk. Smittöverföring kan även ske via blodtransfusioner eller stickskador i vården. Det finns många fördomar förknippade med sjukdomen och risken är stor att dessa färgar mötet med patienter. Det är viktigt att som vårdpersonal vara medveten om hur den egna synen på sjukdomen kan påverka bemötandet. Syfte: Syftet var att belysa vilka erfarenheter patienter med hepatit C har av bemötandet i vården. Metod: Studien utformades som en allmän litteraturöversikt av tolv kvalitativa artiklar. Manifest innehållsanalys användes. Resultat: Patienter med HCV hade blandade erfarenheter av mottagandet: välkomnande, avvisande eller otryggt. Vidare ledde detta till erfarenheter av stöd eller diskriminering. Patienter kunde ha erfarenheter av professionellt stöd eller brist på professionellt stöd. Diskriminering kunde orsakas av antingen vårdpersonal eller organisation. Slutsats: På grund av stigmatisering kring sjukdomen är patienter med hepatit C en utsatt grupp i samhället. Vårdpersonalens kunskap är en viktig del i bemötandet. Det krävs utbildning för att kunna erbjuda en mer holistisk vård vid hepatit C än i dagsläget. Genom ökad kunskap kring både sjukdom och bemötande kan bemötandet påverkas positivt, det vill säga: mottagandet blir bättre, stödet ökar och diskrimineringen minskar. / Background: The most common route of transmission of hepatitis C is through intravenous drug abuse. Transmission can also occur through blood transfusion. There are many prejudices associated with hepatitis C. Chances are that this colors interactions with patients. It is important that healthcare professionals are aware of how their own perception of the disease may affect the encounter.  The Objective was to highlight the experiences patients with hepatitis C have of the encounter in the healthcare. Method: The study was designed as a general literature review of twelve qualitative articles. Manifest content analysis was used. Results: Patients with hepatitis C had mixed experiences of receipt: welcoming, rejecting or unsafe. This led to experiences of support or discrimination. Patients experienced professional support or lack of professional support. Discrimination could be caused either by healthcare professionals or the organization. Conclusion: Because of stigma surrounding the disease patients with hepatitis C are a vulnerable group in society. The knowledge of healthcare professionals is an important part of the encounter. It requires training to provide holistic care for hepatitis C. Increased knowledge about both the disease and patient-professional relation can positively affect the encounter: the reception gets better, support increases and discrimination is reduced.

The starting point of the present thesis is nurses’ reported experiences of disagreements with physicians for pushing life sustaining treatment too far. The overall aim was to describe and compare nurses’ and physicians’ perspectives on the boundaries for life-sustaining treatment and to evaluate whether ethics rounds could promote mutual understanding and stimulate ethical reflection. A mixed methods design with qualitative and quantitative data was used, including interviews and questionnaires. The health professionals’ experiences/perceptions were based on known patients foremost from general wards, but also intensive care units, at four Swedish hospitals. The first two studies treated the perspective on boundaries for life-sustaining treatment and the last two evaluated philosopher- ethicist led ethics rounds. Analysis of data was performed using a phenomenological approach and content analysis as well as comparative and descriptive non-parametric statistics. In the first study, the essence of the physicians’ decision-making process to limit life-sustaining treatment for ICU patients, was a process of principally medical considerations in discussions with other physicians. In the second study, there were more similarities than differences between nurses’ and physicians’ opinions regarding the 714 patients studied. The physicians considered limited treatment as often as the nurses did. The ethics rounds studies generated mixed experiences/perceptions. It seemed that more progress was made toward the goal of promoting mutual understanding than toward the goal of stimulating ethical reflection. Above all, the rounds seemed to meet the need for a forum for crossing over professional boundaries. The most salient finding was the insight to enhance team collaboration, that the interprofessional dialogue was sure to continue. Predominating new insights after rounds were interpreted as corresponding to a hermeneutic approach. One of nurses’ negative experiences of the ethics rounds was associated with the lack of solutions. Based on the present findings, one suggestion for improvement of the model of ethics rounds is made with regard to achieving a balance between ethical analyses, conflict resolution and problem solving. In conclusion, the present thesis provides strong evidence that differences in opinions regarding boundaries for life-sustaining treatment are not associated with professional status. The findings support the notion of a collaborative team approach to end-of-life decision-making for patients with diminished decisionmaking capacity. There is an indication that stimulation of ethical reflection in relation to known patients may foremost yield psychosocial insights. This could imply that social conflicts may overshadow ethical analysis or that ethical conflicts and social conflicts are impossible to distinguish.

La thèse porte sur le système tripartite de relations professionnelles du Grand Duché de Luxembourg, regroupant les autorités publiques ainsi que les organisations syndicales et patronales. Elle se pose deux questions. Dans quelle mesure on peut parler d’un modèle de relations professionnelles propre au Luxembourg ? Ce modèle relève-t-il ou non du type consociatif tel que théorisé par Arendt LIJPHART ? Il s’agit d’une étude de cas portant sur un seul pays.La thèse est divisée en six chapitres. Le premier présente le Luxembourg et ses relations professionnelles. Le second porte sur l’évolution de deux institutions importantes des relations professionnelles. Le troisième présente les théories mobilisées dans le cadre de la thèse. Les chapitres 4, 5 et 6 consistent en une analyse des principaux éléments de la théorie de LIJPHART appliquée aux relations professionnelles tripartites luxembourgeoises. Les conclusions répondent aux questions posées ci-dessus. / The thesis is about the tripartite system of professional relations of the Grand Duchy of Luxembourg, amalgamating the public authorities as well as the trade-union and employers’ organisations. The thesis asks itself two questions. To which extend can we speak of a model of professional relations proper to Luxembourg ? Is this model answerable or not to the consociative type as theorized by Arend LIJPHART ? It is about a case study concerning one single country. The thesis is devided into six chapters. The first one presents Luxembourg and its professional relations. The second one is about the evolution of two important institutions of the professional relations. The third one presents the theories mobilized in the scope of the thesis. The chapters 4, 5, and 6 are composed of an analysis of the main elements of the LIJPHART theory applied to the tripartite professional relations of Luxembourg. The conclusions answer the above-mentioned questions.

Magistro darbe pateikti konkretaus švietimo vadybos diagnostinio tyrimo rezultatai. Apibūdintos pagrindinės sąvokos, apžvelgti ir išanalizuoti darbuotojų valdymo ypatumai, sudarytas teorinis modelis, kuriuo remiantis sudarytas tyrimo instrumentas. Remiantis tyrimo objekto operacionalizacija, buvo parengta struktūruota, uždaro tipo, anketa. Anketa gali būti naudojama profesinių santykių švietimo įstaigoje kokybei nustatyti. Pagrindinis empirinės informacijos šaltinis tyrime buvo Mažeikių miesto ir rajono švietimo ugdymo įstaigų vadovų, pedagogų ir specialistų (229 respondentai) nuomonė apie profesinių santykių įtaką mokyklos veiklai. Tyrimo metu buvo suformuluoti šie probleminiai klausimai: koks psichologinis klimatas vyrauja mokyklose, kokia yra valdymo situacija ir kokią įtaką turi mokyklos veiklai; ar mokytojams sudaromos galimybės tobulėti, kelti kvalifikaciją; ar mokyklose vyksta vidinė komunikacija, užduočių delegavimas, darbuotojų įtraukimas į sprendimų priėmimą. Atlikta tyrimo analizė parodė, jog labiausiai profesiniams santykiams mokyklose daro įtaką konkurencija tarp kolegų, darbų ir užduočių paskirstymo problemos, taikoma kontrolės sistema, bendruomenės narių charakterio savybės, motyvavimo stoka. Apibendrinant atlikto tyrimo ir gautų rezultatų duomenis galima teigti, kad mokyklose yra sudaromos palankios sąlygos profesinių santykių plėtrai ir jų efektyvinimui. / The results of a specific diagnostic research into education management are presented in the paper. The key concepts are described, the peculiarities of personnel management are reviewed and analyzed, a theoretical model for designing the research instrument was developed. With reference to the operationalization of the research object a structured and closed-response type questionnaire was prepared. Such a questionnaire may be applied for the evaluation of the quality of professional relations in an educational institution. In the research, the main source of empirical data was the opinion of the heads, educators and specialists of the educational institutions of Mažeikiai town and Mažeikia region (229 respondents) regarding the impact of professional relations on the activity of a school. Research questions include the following: 1) what psychological climate is dominant in schools? 2) what is the situation in school management and what impact does it have on the activity of a school? 3) is there internal communication, task assignment and the involvement of personnel in decision-making in a school? The results of the research showed that professional relations in schools are mostly impacted by competition among colleagues, problems in work and task assignment, the control system applied, personal traits of the community members, lack of motivation. To summarize the data and the results of the research, it is possible to claim that favourable conditions for the development... [to full text]

La thèse porte sur le système tripartite de relations professionnelles du Grand Duché de Luxembourg, regroupant les autorités publiques ainsi que les organisations syndicales et patronales. Elle se pose deux questions. Dans quelle mesure on peut parler d’un modèle de relations professionnelles propre au Luxembourg ? Ce modèle relève-t-il ou non du type consociatif tel que théorisé par Arendt LIJPHART ? Il s’agit d’une étude de cas portant sur un seul pays.La thèse est divisée en six chapitres. Le premier présente le Luxembourg et ses relations professionnelles. Le second porte sur l’évolution de deux institutions importantes des relations professionnelles. Le troisième présente les théories mobilisées dans le cadre de la thèse. Les chapitres 4, 5 et 6 consistent en une analyse des principaux éléments de la théorie de LIJPHART appliquée aux relations professionnelles tripartites luxembourgeoises. Les conclusions répondent aux questions posées ci-dessus. / The thesis is about the tripartite system of professional relations of the Grand Duchy of Luxembourg, amalgamating the public authorities as well as the trade-union and employers’ organisations. The thesis asks itself two questions. To which extend can we speak of a model of professional relations proper to Luxembourg ? Is this model answerable or not to the consociative type as theorized by Arend LIJPHART ? It is about a case study concerning one single country. The thesis is devided into six chapters. The first one presents Luxembourg and its professional relations. The second one is about the evolution of two important institutions of the professional relations. The third one presents the theories mobilized in the scope of the thesis. The chapters 4, 5, and 6 are composed of an analysis of the main elements of the LIJPHART theory applied to the tripartite professional relations of Luxembourg. The conclusions answer the above-mentioned questions.

Este trabalho tem como objetivo conhecer os desafios da assistência a saúde de lésbicas, gays, bissexuais, travestis e transexuais (LGBTs) no âmbito da saúde pública no Brasil e elaborar recursos relacionais para ampliação da inclusão desta população e para a qualificação da assistência prestada. Sustenta-se portanto, na premissa de que a assistência à saúde desta população apresenta necessidades de qualificação que, se respondidas, contribuiriam na construção de um projeto de saúde pública equânime, integral, inclusivo e sensível às diferenças. Para a construção do campo no qual este estudo se insere, apresento o contexto das mudanças políticas brasileiras em saúde destacando a congruência entre a Política de Atenção Integral à Saúde LGBT e a Política Nacional de Humanização. Também articulo o meu argumento dentro de um cenário histórico que contribui com a compreensão do deslocamento das descrições das identidades sexuais LGBTs de patológicas para oprimidas. De mesmo modo, delineio uma trajetória histórica das práticas em saúde que, na atualidade, tomam a forma de um sistema de saúde fundado na igualdade e equidade e preocupado em considerar os determinantes sociais das doenças. Por fim, articulo minhas reflexões em um cenário científico permeado por discussões que salientam uma mudança paradigmática - da modernidade a pós-modernidade - e que sustentam a passagem de uma ênfase objetiva e tecnicista para uma abordagem relativista e relacional. A investigação foi realizada em uma Unidade Básica de Saúde de uma cidade de médio porte, na qual conduzi 8 encontros de grupo com uma equipe profissional multidisciplinar. Os encontros de grupo foram gravados em áudio. Realizei a transcrição temática das gravações dos encontros de grupo e organizei seu conteúdo segundo núcleos de sentidos. Estes núcleos deram suporte para a construção de uma narrativa que apresenta os encontros de grupo ao mesmo tempo em que discute aspectos relevantes da assistência à população LGBT em articulação com a literatura científica disponível. A partir desta narrativa, escolhi desenvolver uma argumentação que salienta a responsividade como um recurso para o trabalho em saúde com esta população. Inicialmente apresento uma definição operacional deste recurso e posteriormente, articulo esta definição com uma experiência da pesquisa. Finalmente, apresento algumas considerações acerca do potencial generativo deste recurso para o trabalho em saúde com a população LGBT. / This study aims to understand the challenges of public healthcare assistance to lesbian, gay, bisexual, transvestite and transgender people in Brazil (LGBTs). In addition, it also aims at elaborating relational resources for enhancing available assistance and the inclusion of this population in care services. Therefore, this study is built upon the premise that healthcare assistance to LGBT population presents necessities of improvement that, if adequately met, could contribute to the construction of a public health project that is equitable, integral, inclusive and culturally sensitive. In order to delineate the field in which this study is situated, I present the changes in Brazilian healthcare policies and highlight the Politics of Integral Attention to LGBT as well as the National Politics of Humanization. I also develop my argument within an historical scenario that contributes to our understanding of the shift in LGBT identity descriptions: from pathological to oppressed. Likewise, I introduce the history of healthcare practices that has led to the formulation of the contemporary Brazilian healthcare model in which equity and justice are organizing principles and health is not disconnected from its social determinants. Finally, I develop my argument within a scientific scenario permeated by discussions that emphasize a paradigmatic shift from modernism to post-modernism and lays the groundwork for movement from a technique-oriented and objective emphasis to a relativistic and relational approach.The investigation took place in a Basic Healthcare Center of a middle size city in which I facilitated 8 group meetings with a multidisciplinary team of health professionals. Meetings were audio-recorded. I kept a journal with field notes throughout the research process. I performed a thematic transcription and organized the contents of the transcripts according to groups of meanings. This organization allowed me to create a narrative in which I present each group meeting and, at the same time, discuss relevant aspects of LGBT health assistance as it relates to available literature. From this narrative, I chose to develop an argument that emphasizes responsivity as a resource for healthcare professionals. Initially, I present a definition of responsivity and later I articulate it with the research experience. Finally, I present some considerations about the generative potential of this resource to LGBT healthcare assistance.

INTRODUÇÃO: Este estudo tem como foco a educação de profissionais da saúde. Para responder às complexas necessidades dos fazeres e saberes em saúde deve haver a superação do modelo curricular fragmentado e exclusivamente uniprofissional. Políticas e programas de educação e saúde têm reorientado o processo de formação dos profissionais que atuam no cuidado em saúde a partir da ênfase na integralidade da atenção à saúde, participação no controle social e de currículos integrados e comprometidos com a melhoria das condições de vida da população. OBJETIVO: Compreender os significados da vivência multiprofissional na atividade de ensino ‘Práticas Integradas em Saúde I’ em cenários de prática do Sistema Único de Saúde (SUS)/Atenção Primária à Saúde (APS), analisando seu potencial para a educação interprofissional. METODOLOGIA: Trata-se de um estudo de caso de abordagem qualitativa, cujo campo de investigação foi a atividade de ensino integradora dos cursos da saúde – disciplina Práticas Integradas em Saúde I – da Universidade Federal do Rio Grande do Sul (UFRGS). A produção de dados foi constituída pela análise documental, formulário online, entrevistas individuais semiestruturadas com egressos, estudantes de graduação e gestor universitário (n=24), grupo focal com professores (n=11) e observação participante com registros em diário de campo. A amostra foi intencional definida pelo critério da saturação e densidade do material textual. Os dados foram interpretados pela análise temática de conteúdo de Bardin com o apoio do software ATLAS.ti (Visual Qualitative Data Analysis). O estudo teve aprovação do Comitê de Ética em Pesquisa da UFRGS e da Prefeitura Municipal de Porto Alegre. RESULTADOS: A disciplina integradora é um movimento contra-hegemônico ao modelo de formação uniprofissional. Seu aspecto inovador está expresso pelo caráter multiprofissional, oportunizando a convivência entre estudantes de graduação, professores universitários e profissionais da saúde de diferentes núcleos profissionais em cenários de prática do SUS. Essa inte(g)ração possibilitou aprendizagens sobre as diferentes profissões da saúde, organização de um trabalho em equipe pautado na colaboração , reconhecimento do trabalho na Estratégia de Saúde da Família, com destaque para o processo de trabalho do Agente Comunitário de Saúde, expressando valores da educação interprofissional (EIP). A disciplina integradora fomenta espaços de aproximação com o SUS, por meio da vivência nos territórios com equipes multiprofissionais da APS. Desafios pedagógicos de organização das atividades nos cenários de prática (planejamento das tutorias) e limitação de tempo e de espaços institucionalizados para o compartilhamento das experiências entre os estudantes que representam diferentes profissões foram destacados. CONSIDERAÇÕES FINAIS: A disciplina integradora apresenta-se como um potente cenário para o desenvolvimento da EIP na graduação. Para a consolidação da proposta de inte(g)ração da disciplina, momentos presenciais para o compartilhamento das percepções sobre a vivência no território entre os estudantes e professores devem ser garantidos, assim como espaços de educação permanente e continuada para os professores que dela participam. É fundamental que a Universidade invista na ampliação das atividades de ensino compartilhadas entre os cursos da saúde, e que a comunidade acadêmica se comprometa e se envolva na inte(g)ração. / INTRODUCTION: The present study aims the Health Professionals Education. To respond the complex needs of health practices and knowledge there must be an overcoming of the fragmented and exclusively uni professional curriculum model. Education and health policies and programs have redirected the process of training the different professions that work with health care giving emphasis on the integrality of attention to health, participation in social control, also with committed and integrated pedagogical programs, in order to improve the living conditions of the population. OBJECTIVE: To understand the meanings of multi professional experience in the teaching activity – ‘Integrated Practices in Health I’ - in practical scenarios of the Unified Health System/ Primary Health Care, analyzing its potential for inter professional education. METHODOLOGY: It is a case study with a qualitative approach whose field of research was the integrated teaching activity of the Health Courses - discipline ‘Integrated Practices in Health I’ - of the Federal University of Rio Grande do Sul (UFRGS). Data production consisted of documentary analysis, online forms, individual semi- structured interviews with graduates, undergraduate students and University manager (n=24), focus group with professors (n=11) and participant observation with field diary registration. The sample was intentional defined by the standard of saturation and density of the textual data. The data were interpreted by Bardin thematic analysis of content with support of the software ATLAS.H (Visual Qualitative Data Analysis). The study was approved by Research Ethics Committee of the Federal University of Rio Grande do Sul (UFRGS) and Porto Alegre City Hall. RESULTS: The integrative discipline is a counter-hegemonic movement to the uniprofessional training model. Its innovative aspect is expressed by the multi professional character allowing the coexistence between undergraduate students, university professors and health professionals from different professional backgrounds of the Unified Health System practice scenarios. This integration made it possible for students to learn about different health professions, the organization of a teamwork based on collaboration, the recognition of teamwork in the Family Health Strategy with emphasis on the work process of the Community Health Agent, expressing values of the inter professional education. In addition the integrative discipline encourages approaching spaces with the Unified Health System through living in territories with Primary Health Care multi professional teams. Pedagogical challenges of organizing activities in practice scenarios (planning the tutorials) and limitation of time and institutionalized spaces to share experiences among students, representing different professions were highlighted. FINAL CONSIDERATIONS: Integrative discipline presents itself as a potent scenario for the development of Inter professional education. For the consolidation of the proposal of a integrative discipline, face-to-face moments for sharing the living perceptions in the territory between students and professors must be assured, as well as spaces of permanent and continued education for the professors that are part in the project. It is essential that the University make investments in the expansion of teaching activities shared among the Health Courses, and that the academic community engages and engages with interaction.

Este trabalho tem como objetivo conhecer os desafios da assistência a saúde de lésbicas, gays, bissexuais, travestis e transexuais (LGBTs) no âmbito da saúde pública no Brasil e elaborar recursos relacionais para ampliação da inclusão desta população e para a qualificação da assistência prestada. Sustenta-se portanto, na premissa de que a assistência à saúde desta população apresenta necessidades de qualificação que, se respondidas, contribuiriam na construção de um projeto de saúde pública equânime, integral, inclusivo e sensível às diferenças. Para a construção do campo no qual este estudo se insere, apresento o contexto das mudanças políticas brasileiras em saúde destacando a congruência entre a Política de Atenção Integral à Saúde LGBT e a Política Nacional de Humanização. Também articulo o meu argumento dentro de um cenário histórico que contribui com a compreensão do deslocamento das descrições das identidades sexuais LGBTs de patológicas para oprimidas. De mesmo modo, delineio uma trajetória histórica das práticas em saúde que, na atualidade, tomam a forma de um sistema de saúde fundado na igualdade e equidade e preocupado em considerar os determinantes sociais das doenças. Por fim, articulo minhas reflexões em um cenário científico permeado por discussões que salientam uma mudança paradigmática - da modernidade a pós-modernidade - e que sustentam a passagem de uma ênfase objetiva e tecnicista para uma abordagem relativista e relacional. A investigação foi realizada em uma Unidade Básica de Saúde de uma cidade de médio porte, na qual conduzi 8 encontros de grupo com uma equipe profissional multidisciplinar. Os encontros de grupo foram gravados em áudio. Realizei a transcrição temática das gravações dos encontros de grupo e organizei seu conteúdo segundo núcleos de sentidos. Estes núcleos deram suporte para a construção de uma narrativa que apresenta os encontros de grupo ao mesmo tempo em que discute aspectos relevantes da assistência à população LGBT em articulação com a literatura científica disponível. A partir desta narrativa, escolhi desenvolver uma argumentação que salienta a responsividade como um recurso para o trabalho em saúde com esta população. Inicialmente apresento uma definição operacional deste recurso e posteriormente, articulo esta definição com uma experiência da pesquisa. Finalmente, apresento algumas considerações acerca do potencial generativo deste recurso para o trabalho em saúde com a população LGBT. / This study aims to understand the challenges of public healthcare assistance to lesbian, gay, bisexual, transvestite and transgender people in Brazil (LGBTs). In addition, it also aims at elaborating relational resources for enhancing available assistance and the inclusion of this population in care services. Therefore, this study is built upon the premise that healthcare assistance to LGBT population presents necessities of improvement that, if adequately met, could contribute to the construction of a public health project that is equitable, integral, inclusive and culturally sensitive. In order to delineate the field in which this study is situated, I present the changes in Brazilian healthcare policies and highlight the Politics of Integral Attention to LGBT as well as the National Politics of Humanization. I also develop my argument within an historical scenario that contributes to our understanding of the shift in LGBT identity descriptions: from pathological to oppressed. Likewise, I introduce the history of healthcare practices that has led to the formulation of the contemporary Brazilian healthcare model in which equity and justice are organizing principles and health is not disconnected from its social determinants. Finally, I develop my argument within a scientific scenario permeated by discussions that emphasize a paradigmatic shift from modernism to post-modernism and lays the groundwork for movement from a technique-oriented and objective emphasis to a relativistic and relational approach.The investigation took place in a Basic Healthcare Center of a middle size city in which I facilitated 8 group meetings with a multidisciplinary team of health professionals. Meetings were audio-recorded. I kept a journal with field notes throughout the research process. I performed a thematic transcription and organized the contents of the transcripts according to groups of meanings. This organization allowed me to create a narrative in which I present each group meeting and, at the same time, discuss relevant aspects of LGBT health assistance as it relates to available literature. From this narrative, I chose to develop an argument that emphasizes responsivity as a resource for healthcare professionals. Initially, I present a definition of responsivity and later I articulate it with the research experience. Finally, I present some considerations about the generative potential of this resource to LGBT healthcare assistance.