Made available in DSpace on 2014-12-17T14:13:45Z (GMT). No. of bitstreams: 1 MariaMO_Dissert.pdf: 391752 bytes, checksum: b84c0386ed11293a707513fe2dc06145 (MD5) Previous issue date: 2009-08-14 / Investigar os fatores relacionados ? percep??o que os profissionais das equipes do Programa de Sa?de da Fam?lia (PSF) possuem frente ? realidade da pol?tica de aten??o ? sa?de do idoso nas Unidades B?sicas de Sa?de dos munic?pios litor?neos do Estado da Para?ba. Trata-se de um estudo observacional descritivo com uma amostra constitu?da por 120 profissionais de sa?de de tr?s categorias distintas (enfermeiro, m?dico e odont?logo), sendo 104 respondentes como profissionais e 16 respondentes como coordenadores de equipes. A coleta de dados foi realizada atrav?s de um question?rio auto-aplic?vel de avalia??o fechada e de quest?es de m?ltiplas escolhas. Os dados foram processados e armazenados no Programa Estat?stico SPSS vers?o 15.0 e analisados ? luz da estat?stica descritiva. Os resultados indicaram que os profissionais tiveram dificuldade em perceber a realidade da pol?tica integral e integrada de sa?de do idoso junto aos servi?os de sa?de em que atuam. O estudo revelou ainda a necessidade de uma defini??o de estrat?gias para qualifica??o dos profissionais garantindo ? aten??o integral ? sa?de do idoso sob uma nova vis?o de atua??o

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-02-03T22:33:28Z No. of bitstreams: 1 AnaKarineMacedoTeixeira_TESE.pdf: 1004456 bytes, checksum: 72965874210be85665f508d9fa19aca4 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-02-04T23:28:08Z (GMT) No. of bitstreams: 1 AnaKarineMacedoTeixeira_TESE.pdf: 1004456 bytes, checksum: 72965874210be85665f508d9fa19aca4 (MD5) / Made available in DSpace on 2016-02-04T23:28:08Z (GMT). No. of bitstreams: 1 AnaKarineMacedoTeixeira_TESE.pdf: 1004456 bytes, checksum: 72965874210be85665f508d9fa19aca4 (MD5) Previous issue date: 2015-03-03 / A trajet?ria de vida percorrida pelo indiv?duo determina sua forma de adoecer e manter-se saud?vel; al?m disso, os determinantes sociais da sa?de influenciam a sa?de da popula??o ao longo do seu curso de vida. O objetivo deste trabalho foi investigar a sa?de bucal e seus fatores determinantes ao longo do curso de vida dos jovens no munic?pio de Sobral, Cear?. Tratou-se de um estudo de coorte, com tr?s ondas: 2000, 2006 e 2012. Foram examinados e entrevistados 482 indiv?duos nas tr?s ondas, atualmente, na faixa et?ria de 17 a 21 anos. Investigaram-se a c?rie dent?ria, m? oclus?o, doen?a periodontal, edentulismo e traumatismo dent?rio. As vari?veis independentes coletadas na ?ltima onda foram as caracter?sticas sociodemogr?ficas, utiliza??o de servi?os e a??es de sa?de bucal, autopercep??o de sa?de bucal e h?bitos e comportamentos de sa?de bucal. Foi analisada a incid?ncia de c?rie de 2006 para 2012, a trajet?ria da c?rie dent?ria, a trajet?ria da assist?ncia odontol?gica e a trajet?ria da condi??o socioecon?mica familiar. Os dados foram analisados no programa SPSS vers?o 20, no qual foram utilizados os testes t de student, ANOVA e regress?o de Poisson. A incid?ncia m?dia de c?rie de 2006 para 2012 foi de 2,95 dentes. As condi??es socioecon?micas apresentaram-se como fatores de risco para todos os desfechos investigados nas diferentes ondas. A participa??o em grupos de adolescentes apresentou-se como fator de prote??o para sa?de bucal, enquanto a utiliza??o dos servi?os de sa?de bucal implicou no aumento da recidiva de c?rie e mutila??o dent?ria. As teorias explicativas do life course (per?odo cr?tico, mobilidade socioecon?mica e acumula??o de risco) foram comprovadas neste estudo. Aqueles que nunca foram pobres apresentaram melhores condi??es de sa?de bucal, enquanto empobrecer acarretou uma piora no quadro de sa?de bucal. Por?m, o risco foi maior para aqueles que permaneceram sempre pobres e com maior experi?ncia de pobreza ao longo da vida. Verificou-se a presen?a de iniquidades em sa?de bucal e de assist?ncia odontol?gica na popula??o investigada. / The life pathway determines the way of getting sick and staying healthy and the social determinants of health influence population health throughout their life course. The aim of this study was to investigate the oral health and its determinants throughout the life course of young people in Sobral, Cear?. This was a cohort study with three waves: 2000, 2006 and 2012. 482 individuals aged 17-21 years were examined and interviewed in the three waves. Were investigated tooth decay, malocclusion, periodontal disease, tooth loss and dental trauma. The independent variables collected in the last wave were: sociodemographics factors, use of dental services and actions, self-perceived oral health and habits and oral health behaviors. Caries incidence from 2006 to 2012, the trend of dental caries, the trajectory of dental care and the trajectory of family socioeconomic status was analyzed. Data were analyzed using SPSS version 20, where the student t test, ANOVA and Poisson regression were used. The average incidence of caries from 2006 to 2012 was 2.95 teeth. Socioeconomic conditions presented themselves as risk factors for all outcomes investigated in different waves. The social capital is presented as a protective factor for oral health, while the use of oral health services implied an increase of recurrent caries and mutilation. Explanatory theories of life course (critical period, socioeconomic mobility and accumulation of risk) were proven in this study. Those who were never poor had better oral health conditions, while downwardly mobile entails a worsening in the context of oral health. However, the risk was higher for those who have always remained poor and have had most experienced poverty throughout life. There was the presence of inequalities in oral health and at the utilization of dental services.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-03-12T20:18:44Z No. of bitstreams: 1 LayanneCristiniMartinSousa_DISSERT.pdf: 1742028 bytes, checksum: 9edd9252e78cba594579c04e160087da (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-03-16T19:49:44Z (GMT) No. of bitstreams: 1 LayanneCristiniMartinSousa_DISSERT.pdf: 1742028 bytes, checksum: 9edd9252e78cba594579c04e160087da (MD5) / Made available in DSpace on 2018-03-16T19:49:44Z (GMT). No. of bitstreams: 1 LayanneCristiniMartinSousa_DISSERT.pdf: 1742028 bytes, checksum: 9edd9252e78cba594579c04e160087da (MD5) Previous issue date: 2017-12-20 / A Vigil?ncia em Sa?de ? caracterizada como um conjunto articulado de a??es com foco na promo??o da sa?de e preven??o de doen?as, sob a ?tica da integralidade do cuidado. O objetivo deste estudo foi analisar a Vigil?ncia em Sa?de sob a perspectiva de seus trabalhadores, utilizando uma abordagem qualitativa. Foram entrevistados 28 profissionais lotados no n?vel central da Vigil?ncia em Sa?de, dos quais 12 da secretaria de sa?de de Natal e 16 da secretaria de sa?de do Rio Grande do Norte. As entrevistas semi-estruturadas foram realizadas entre novembro e dezembro de 2016. O material produzido foi analisado a luz do referencial te?rico de Bardin, utilizando a t?cnica de An?lise de Conte?do. Emergiram da an?lise quatro categorias tem?ticas: concep??o sobre Vigil?ncia em Sa?de; articula??o intr?nseca e extr?nseca ? Vigil?ncia em Sa?de; potencialidades e desafios. Os resultados mostraram que os trabalhadores t?m uma concep??o ampliada sobre a Vigil?ncia em Sa?de, entretanto a vis?o tecnicista ainda se encontra presente. As a??es desenvolvidas por eles apresentam-se fragmentadas, tanto entre as vigil?ncias como entre estas e os servi?os de sa?de, deixando evidente a desarticula??o entre os processos cotidianos. Os trabalhadores demonstraram satisfa??o e comprometimento no exerc?cio de suas fun??es, configurando-se como potencialidades, no entanto se traduzem em caracter?sticas conflitantes diante do cen?rio de dificuldades e limita??es relatado por eles. Apontaram como desafios a serem superados: maiores investimentos no setor; valoriza??o dos profissionais e maior suporte e apoio por parte da gest?o. Observa-se, portanto, a necessidade de se imprimir novos avan?os na Vigil?ncia em Sa?de, que perpasse, necessariamente, pela redefini??o do modelo de aten??o, e que adote o planejamento coletivo de forma genu?na, a ressignifica??o de processos de trabalho e de forma??o profissional al?m de uma gest?o participativa com controle social, objetivando a efetividade de suas a??es e a integralidade do cuidado. / Health Surveillance is characterized as an articulated set of actions focused on health promotion and disease prevention, from the point of view of integral care. The objective of this study is to analyze the Health Surveillance from the perspective of its workers using a qualitative approach. A total of 28 central-level Health Surveillance professionals were interviewed, of which 12 of the Secretariat of health of Natal and 16 of the Department of health of Rio Grande do Norte. The semi-structured interviews were carried out between November and December 2016. The material produced was analyzed using the Content Analysis technique in light of the theoretical reference of Bardin. Four thematic categories emerged: conception of Surveillance in Health; intrinsic and extrinsic articulation of Health Surveillance; Health Surveillance?s potential; and, conversely, it?s challenges. The results showed that the workers have an expanded concept of Health Surveillance, although the technician?s view is still present. Consequently, their actions developed a fragmented result, both between surveillance and health services, leaving clear the disarticulation between the everyday processes. The workers demonstrated satisfaction and commitment in the performance of their duties, configuring itself as potential, however result in conflicting characteristics before the backdrop of difficulties and limitations reported by them. Pointed as challenges to be overcome: greater investment in the sector; recovery of professionals and greater support on the part of management. There is therefore the need to print new advances in health surveillance, which circulates, necessarily, by redefining the model of attention, and to adopt the collective planning of genuine form, the ressignification of work processes and training Professional plus a participatory management with social control, aiming at the effectiveness of its actions and the completeness of the care.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-05-08T23:23:44Z No. of bitstreams: 1 IlanaBarrosGomesMedeiros_DISSERT.pdf: 11041280 bytes, checksum: 0b0603616a969c799fa4b0b4aeb36253 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-05-08T23:32:51Z (GMT) No. of bitstreams: 1 IlanaBarrosGomesMedeiros_DISSERT.pdf: 11041280 bytes, checksum: 0b0603616a969c799fa4b0b4aeb36253 (MD5) / Made available in DSpace on 2017-05-08T23:32:51Z (GMT). No. of bitstreams: 1 IlanaBarrosGomesMedeiros_DISSERT.pdf: 11041280 bytes, checksum: 0b0603616a969c799fa4b0b4aeb36253 (MD5) Previous issue date: 2014-12-12 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / O acompanhamento coletivo do Crescimento e Desenvolvimento (CD) da crian?a desponta como reorienta??o do modelo assistencial biom?dico e busca incentivar o uso de tecnologias leves e a melhoria da qualidade de vida dos usu?rios. Esta forma de cuidado constitui uma a??o em constru??o e expans?o para outras Unidades, o que o torna vulner?vel a um fazer aleat?rio, j? que n?o h? garantia de sistematiza??o que assegure sua legitima??o. Al?m disso, o pr?prio trabalho com grupo, na rede b?sica, de modo geral, corre o risco de centralizar suas a??es na doen?a, como reflexo ainda do modelo biom?dico vigente. O acompanhamento coletivo pode estar vulner?vel a estes problemas, o que demanda a necessidade de conhecer a sua operacionaliza??o. Objetivou-se analisar a pr?tica e a expans?o do acompanhamento coletivo do CD da crian?a em Estrat?gias de Sa?de da Fam?lia (ESF) do munic?pio de Natal/RN. Trata-se de uma pesquisa qualitativa, tendo como m?todo a pesquisa-a??o. Envolveu onze enfermeiras de quatro ESF do munic?pio de Natal, no per?odo de abril a outubro de 2014. Os dados foram coletados atrav?s de entrevista grupo focal e observa??o participante, e analisados de acordo com o direcionamento da an?lise tem?tica de Paulo Freire. O estudo foi aprovado pelo Comit? de ?tica em Pesquisa da UFRN, parecer n? 562.315, seguindo a Resolu??o N? 466/2012 do Conselho Nacional de Sa?de. Na etapa do diagn?stico situacional, que investigou a operacionaliza??o do acompanhamento coletivo do CD da crian?a pelas enfermeiras, percebeu-se que estas buscam realiz?-lo com base na organiza??o e planejamento pr?vios, de forma a ser o mais qualitativo poss?vel. Compreendem a import?ncia e os benef?cios desta atividade, sobretudo no tocante ao emponderamento dos usu?rios. Entretanto, identificou-se a falta de sistematiza??o deste acompanhamento em virtude dos modos distintos de sua operacionaliza??o por parte das profissionais. Percebeu-se ainda a aus?ncia do apoio da equipe de sa?de, o que gera insatisfa??o nas mesmas. Mediante a necessidade de mudan?a desta realidade, decidiu-se, conjuntamente, a constru??o de um instrumento que sistematizasse as a??es, bem como a realiza??o de capacita??es para sensibilizar o apoio por parte das equipes. Na etapa de implementa??o, as enfermeiras demonstraram grande interesse pelo check-list constru?do atrav?s de roda de conversa, entretanto, em rela??o ?s capacita??es, a pesquisadora n?o conseguiu implement?-las de maneira satisfat?ria, devido a indisponibilidade das equipes e de algumas enfermeiras. Constatou-se que estas avaliaram positivamente sua participa??o na pesquisa, a qual favoreceu a troca de experi?ncias e a mudan?a nos pontos negativos, al?m de ter instigado a parceria entre os cuidadores e os profissionais. Como sugest?es para o futuro, as enfermeiras elencaram o incentivo ? realiza??o de mais pesquisas nesse campo e o constante apoio da UFRN, e reivindicaram uma especializa??o em sa?de da crian?a. Como principais dificuldades, destacam-se o alto ?ndice de enfermeiras faltosas nos grupos focais; a pouca motiva??o de algumas participantes, bem como da diretoria de uma ESF e a falta de participa??o da equipe de sa?de na a??o de capacita??o. Assim, constata-se que diante das expans?es desordenadas desta abordagem grupal, pesquisas nesta ?rea devem ser constantemente incentivadas para o seu maior aperfei?oamento. / The collective monitoring of the child?s growth and development (GD) stands out as redirection of the biomedical health care model and seeks to encourage the use of soft technologies and improve the quality of life of users. This way of care is an action for construction and expansion to other units, which makes it vulnerable to a random practice, since there is no guarantee of systematization to ensure its legitimization. In addition, the group work itself, within the primary network, in general, runs the risk of of focusing its actions on the disease by reflecting the biomedical model still prevailing. The collective monitoring may be vulnerable to these problems, which requires the need to know its operationalization. This study had the objective of analyzing the practice and expansion of the collective monitoring of the GD of children in Family Health Strategies (FHS) from the municipality of Natal/RN. This is a qualitative research that had the research-action as its method. It encompassed eleven nurses of four FHS from the municipality of Natal in the period between April and October 2014. Data were collected through focus group and participant observation, and they were analyzed in accordance with the direction of the thematic analysis of Paulo Freire. The study was approved by the Research Ethics Committee from the UFRN, Opinion n? 562.315, and met the Resolution n? 466/2012 of the National Health Council. At the stage of situational diagnosis, which investigated the operationalization of the collective monitoring of the GD of children by nurses, we realized that they seek to accomplish it with basis on prior planning and organization, in such a way as to make it as qualitative as possible. They understand the importance and benefits of this activity, especially concerning the empowerment of users. Nevertheless, the lack of systematization of this monitoring has been identified because of the different modes of its operationalization on the part of professionals. Furthermore, the lack of support from the health team was realized, which leaves them unsatisfied. Due to the need to change this reality, we have decided to jointly construct an instrument able to systematize the actions, as well as to conduct training courses to sensitize the support on the part of teams. At the stage of the implementation, the nurses showed great interest in the check-list constructed through conversation circles; however, regarding training courses, the researcher has failed to implement them in a satisfactory way because of the unavailability of teams and of some nurses. We have found that they rated their participation in the survey in a positive manner, which fostered the exchange of experiences and the change of negative points, besides having instigated the partnership between caregivers and professionals. As suggestions for future, the nurses have listed the encouragement of further researches in this field and the constant support on the part of the UFRN, and called for a specialization in child?s health. As main difficulties, one should highlight the high rate of faults among nurses belonging to the focus groups; the little motivation of some participants, as well as of the board of directors of a FHS and the lack of participation of the health team in training actions. Accordingly, one can find that, given the disorganized expansion of this group approach, the researches in this area should be constantly encouraged to achieve a greater improvement.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-06-02T23:06:55Z No. of bitstreams: 1 MariaIsabelSilvaGuilherme_DISSERT.pdf: 906758 bytes, checksum: 2058c4d8b9fe0b47dfd03949f5c1c402 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-06-12T19:19:54Z (GMT) No. of bitstreams: 1 MariaIsabelSilvaGuilherme_DISSERT.pdf: 906758 bytes, checksum: 2058c4d8b9fe0b47dfd03949f5c1c402 (MD5) / Made available in DSpace on 2017-06-12T19:19:54Z (GMT). No. of bitstreams: 1 MariaIsabelSilvaGuilherme_DISSERT.pdf: 906758 bytes, checksum: 2058c4d8b9fe0b47dfd03949f5c1c402 (MD5) Previous issue date: 2016-08-30 / O cuidado na Aten??o B?sica ? estrat?gico devido sua abrang?ncia no contexto do SUS na organiza??o dos sistemas de sa?de, ? medida que se constitui a principal porta de entrada dos usu?rios, demandando uma imprescind?vel articula??o com a aten??o de m?dia e alta complexidade e com a??es de vigil?ncia em sa?de, facilitando o acesso das equipes aos usu?rios e vice-versa. Por esta caracter?stica, ? comum que os profissionais de Sa?de se encontrem rotineiramente com pessoas em situa??o de sofrimento ps?quico, uma vez que a sa?de mental n?o est? dissociada da sa?de geral, fazendo-se necess?rio reconhecer que estas demandas est?o presentes em diversas queixas dos usu?rios da Aten??o B?sica. Desse modo, aos profissionais da Aten??o B?sica, demanda-se o desafio de perceber e intervir sobre essas quest?es, que mais recentemente, contam com o apoio da prerrogativa do apoio matricial em sa?de mental e da refer?ncia poss?vel de ser articulada atrav?s dos N?cleos de Apoio ? Sa?de da Fam?lia (NASF) em localidades que disp?em desse dispositivo de aten??o. O objetivo do presente estudo foi investigar possibilidades e limites de a??es de sa?de mental na Estrat?gia Sa?de da Fam?lia (ESF) em um contexto de zona rural. Trata-se de uma pesquisa descritiva-explorat?ria com abordagem qualitativa, realizada nas ESF localizadas na zona rural do munic?pio de Ass? no estado do Rio Grande do Norte. Utilizou-se a entrevista semiestruturada para coleta e registro sobre a problem?tica investigada. No contexto estudado, verificamos que as dificuldades vivenciadas pelas equipes de sa?de da fam?lia as colocam frente ao impasse de efetivar e garantir na pr?tica os princ?pios norteadores do SUS e basilares da Reforma Psiqui?trica. Observamos uma fragmenta??o da rede de assist?ncia ? sa?de e do processo de trabalho, onde o pouco investimento na qualifica??o/capacita??o dos profissionais incide sobre o despreparo das equipes para lidar com a sa?de mental dos usu?rios. Assim, ? imprescind?vel a expans?o do apoio matricial em sa?de mental para maior e melhor possibilidades da Rede de Aten??o Psicossocial (RAPS) no contexto do estado do Rio Grande do Norte, particularmente, no munic?pio de Ass?-RN. / Care in Primary Care is strategic because of its scope in the context of SUS in the organization of health systems, as it is the main gateway for users, requiring an indispensable link with the attention of medium and high complexity and actions health surveillance, making it easier for teams to users and vice versa. For this feature, it is common for health professionals routinely meet with people in psychological distress, since mental health is not separated from general health, making it necessary to recognize that these demands are present in several complaints from users Primary Care. Thus, professionals of primary care, demand is the challenge to understand and intervene on these issues, which more recently have the support of the prerogative of matrix support in mental health and possible reference to be articulated through the Support Centers Family Health (NASF) in locations that have such attention device. The aim of this study was to investigate the possibilities and limits of mental health actions in the Family Health Strategy (FHS) in a context of countryside. This is a descriptive and exploratory research with a qualitative approach, carried out in the ESF located in rural Ass? municipality in the state of Rio Grande do Norte. We used a semi-structured interview to collect and record on the issue investigated. In the context studied, we found that the difficulties experienced by family health teams put forward the deadlock effect and ensure in practice the guiding principles of the NHS and basic of the Brazilian Psychiatric Reform. We observed a fragmentation of care network to health and work process, where the little investment in the qualification / training of professionals focuses on the unpreparedness of the teams to deal with the mental health of users. Thus, it is essential to expand the matrix support in mental health for bigger and better possibilities of Psychosocial Care Network (RAPS) in the context of the state of Rio Grande do Norte, particularly in the municipality of Ass?-RN.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-08-01T14:46:43Z No. of bitstreams: 1 EvaEmanuelaLopesCavalcanteFeitosa_DISSERT.pdf: 1416642 bytes, checksum: 07ed51ca5827795a2f98e99bb5ed0bd6 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-08-08T14:46:47Z (GMT) No. of bitstreams: 1 EvaEmanuelaLopesCavalcanteFeitosa_DISSERT.pdf: 1416642 bytes, checksum: 07ed51ca5827795a2f98e99bb5ed0bd6 (MD5) / Made available in DSpace on 2017-08-08T14:46:47Z (GMT). No. of bitstreams: 1 EvaEmanuelaLopesCavalcanteFeitosa_DISSERT.pdf: 1416642 bytes, checksum: 07ed51ca5827795a2f98e99bb5ed0bd6 (MD5) Previous issue date: 2017-06-26 / A Vigil?ncia em Sa?de faz parte do arcabou?o das propostas do Sistema ?nico de Sa?de (SUS), contemplando as a??es da Vigil?ncia Epidemiol?gica, Vigil?ncia Sanit?ria, Vigil?ncia Ambiental e Vigil?ncia em Sa?de do Trabalhador, com foco na preven??o de doen?as e na promo??o da sa?de. Nesse sentido, esta pesquisa teve como objetivo analisar as concep??es e as pr?ticas da Vigil?ncia em Sa?de, sob a ?tica dos gestores. Trata-se de um estudo com abordagem qualitativa, realizado junto a 11 gestores, por meio de entrevistas com roteiro semiestruturado, no per?odo de outubro a dezembro de 2016. A partir do material coletado, foram constitu?dos dois corpus para an?lise. O primeiro foi submetido ao programa Iramuteq e gerou tr?s classes. O segundo corpus foi submetido ? an?lise de conte?do de Laurence Bardin e originou duas categorias tem?ticas: ?Concep??es sobre Vigil?ncia em Sa?de? e ?Pr?ticas da Vigil?ncia em Sa?de?, discutidas ? luz do referencial te?rico adotado. Os resultados demonstram que os gestores compreendem Vigil?ncia em Sa?de como um modelo indispens?vel para o SUS, al?m de apontar para a realiza??o de planejamento coletivo. Contudo, verificam-se contradi??es ao mencionarem que as a??es desenvolvidas s?o desarticuladas entre os setores e, portanto, necessitam da implanta??o de estrat?gias capazes de impactar sobre a efetividade da articula??o. H?, tamb?m, relatos de precariedade das condi??es de trabalho, de n?mero insuficiente de recursos humanos e de fragilidade no setor da sa?de do trabalhador. Com vistas a superar tais limita??es, sugere-se o engajamento de apoiadores, gestores, profissionais e controle social em torno de um amplo debate, na perspectiva de promover novos saberes e fazeres capazes de transformar o atual modelo de aten??o no tocante ? Vigil?ncia em Sa?de. / The Health Surveillance is part of the proposals framework of the Health Unique System (Sistema ?nico de Sa?de, SUS), contemplating the actions of the Epidemiological Surveillance, Sanitary Surveillance, Environmental Surveillance, Occupational Health Surveillance, focusing in disease prevention and the health promotion. This research aims to analyze conceptions and practices of the Health Surveillance, from the conceptions of the managers. For the study, we used a qualitative approach, carried out with 11 managers, from the interviews with semi-structured script, carried out during October and December 2016. From the material collected, two corpus were constituted to analysis. The first was submitted to the program Iramuteq and was generated three categories. The second corpus was submitted the analysis of the Laurence Bardin's content and was originated two thematic categories: ?Conceptions about the Health Surveillance? and ?Practices of the health in Surveillance?, discussed from the theoretical framework. The results demonstrate that the managers understand Health Surveillance as an indispensable model to SUS, in addition pointing to the realization of the collective planning. However, there are contradictions when the managers mentioning that the developed actions are disarticulated between the sectors and, thus, they need the implementation of strategies capable of the impacts about the effectiveness of the articulation. There are also, reports of precarious working conditions, insufficient human resources and fragility in the worker health sector. From this reality, it?s necessary the support of the supporters, managers, professionals and social control around a broad debate, with the perspective of promoting new knowledge and actions capable of transforming the current model of care in relation to Health Surveillance.

Made available in DSpace on 2015-04-14T13:20:25Z (GMT). No. of bitstreams: 1 437536.pdf: 695335 bytes, checksum: f14dffac19a678ce211d71b30cdee9ad (MD5) Previous issue date: 2012-12-20 / This study aims to analyze how the insertion occurs in the process of multidisciplinary team working CERESTs in Rio Grande do Sul and what are the challenges for ensuring the policy of Health Workers from this integration. Methodologically, the investigation paths of research followed the trajectory of the qualitative study, using as an instrument to collect data the interview with 21 workers of the CERESTS RS. Using qualitative assessment, data were analyzed by the method of content analysis, through thematic analysis. Through the contact with workers, three categories emerged, with the specific objectives of analyzing the insertion of the multidisciplinary team in the process of working CERESTs the RS, which are: the organizational aspects, emphasizing the intermediate categories of the study, which concerns the management and sharing of knowledge, attention to health, with emphasis on actions in health and health surveillance, and, finally, advances and challenges for effectiveness of Occupational Health policy, from the insertion of the multidisciplinary team in the working process of CERESTs. As a result, the study reveals that CERESTs have not been actually effected, according to the legislation in the RS, particularly with regard to surveillance in the workplace and the network organization of local health services. In some CERESTs teams are formed without the minimum recommended professionals in accordance with the ordinance. It should be noted, though, in this study, the difficulty of the manager to have an understanding the effectiveness of Occupational Health policy in the counties of scope and mainly in the county seat, but it is already possible to say that there are some advances in the implementation of the System Information (SYS) as an own resource. / Neste estudo tem-se por objetivo analisar como ocorre a inser??o da equipe multiprofissional no processo de trabalho dos CERESTs do Rio Grande do Sul e quais s?o os desafios para a efetiva??o da pol?tica da Sa?de do Trabalhador a partir desta inser??o. Metodologicamente, os caminhos da investiga??o da pesquisa seguiram a trajet?ria do estudo qualitativo, utilizando como instrumento para a coleta de dados a entrevista com 21 trabalhadores das equipes dos CERESTS do RS. Utilizando-se da avalia??o qualitativa, os dados foram analisados ? luz do m?todo de An?lise de Conte?do, por meio da an?lise tem?tica. Do contato com os trabalhadores, emergiram tr?s categorias, com os objetivos espec?ficos de analisar a inser??o da equipe multiprofissional no processo de trabalho dos CERESTs do RS, quais sejam: os aspectos organizacionais, dando ?nfase ?s categorias intermedi?rias do referido estudo, no que diz respeito ao gerenciamento e compartilhamento de saberes; a aten??o ? sa?de, com ?nfase nas a??es em sa?de e vigil?ncia em sa?de; e, por ?ltimo, os avan?os e os desafios para a efetiva??o da pol?tica de Sa?de do Trabalhador, a partir da inser??o da equipe multiprofissional no processo de trabalho dos CERESTs. Como resultado, o estudo revela que os CERESTs ainda n?o se efetivaram de fato, conforme a legisla??o no RS, principalmente no que diz respeito ? vigil?ncia nos ambientes de trabalho e ? organiza??o da rede de servi?os locais de sa?de. Em alguns CERESTs as equipes est?o constitu?das sem ter o m?nimo de profissionais preconizados de acordo com a portaria. Ressalta-se, ainda, neste estudo, a dificuldade de o gestor ter a compreens?o da efetiva??o da Pol?tica da Sa?de do Trabalhador nos munic?pios de abrang?ncia e principalmente no munic?pio sede, mas j? ? poss?vel dizer que existem alguns avan?os, com a implanta??o do Sistema de Informa??o (SIST) como recurso pr?prio.

Made available in DSpace on 2015-04-14T13:22:18Z (GMT). No. of bitstreams: 1 456113.pdf: 759751 bytes, checksum: e615c642846b03f23356fb7c530a205e (MD5) Previous issue date: 2014-01-21 / This study aimed at investigating the work process called Matrix Support in Mental Health in Primary Health Care by taking into account the guidelines issued by the Brazilian Unified Health System and Psychiatric Reform so that its guidelines, professional principles and values could be identified. This qualitative study was carried out with both experts in mental health and generalist professionals who work in Family Health in Gravata?, RS, Brazil. Tools were semi-structured interviews and focal groups. Results show that the work gets support on collective work carried out between the expert and the generalist, through personalized relations developed among supporters and generalists, on immaterial resources and on assistance broadening. The psychosocial paradigm as well as the one that deals with life production was also identified. The systematicity of meetings, experts‟ bias in public health, identification with the work itself and decentralization as a life ideal were considered the elements that lever work. One of the findings, in agreement with literature published worldwide, is the existence of leadership in mental health; it has been acknowledged by Primary Health Care peers and professionals who deal with people and mediate relations with other services in the network. Complexity results from different wishes, interests and forces expressed by all agents involved in the process; thus, structural, organizational and managerial issues, which may become obstacles, also have to be addressed. Factors that boost the process are professionals‟ personalized relations, availability, commitment, clear communication and co-responsibilization. Professional principles that underlie the practice trigger the wish to work in a community, to decentralize positions, to know the network, to know how to listen and to reach consensus. Values found in the relations and interaction are based on reception, on care relations among professionals in their teams, with other teams and users, on humbleness, on generosity regarding knowledge sharing and on commitment. Concerning Primary Health Care professionals, knowledge and background assistance contribute to solve cases collectively, rather than take them to specialized services, as before. It must be highlighted that this methodology qualifies interventions in mental health because, when experience and knowledge are shared, care is provided as a whole. Boosting factors were the bond with the supporter, communication, the structure of the Family Health teams, the systematicity of meetings, the longitudinality, the co-responsibilization and the support itself. An obstacle to the work is the imposition of barriers to access the Psychosocial Care Center after the Matrix Support was institutionalized. Results of both groups under investigation show that the focus is on the people involved in the process, rather than on the process itself. Data infer that the quality of relations, the professionals‟ characteristics and the personal and professional principles and values involved in the process support this practice which has such specific features. / A pesquisa teve por objetivo geral investigar o processo de trabalho Apoio Matricial em Sa?de Mental na Aten??o Prim?ria, levando em conta as diretrizes do Sistema ?nico de Sa?de e da Reforma Psiqui?trica, com vistas ? identifica??o das diretrizes, princ?pios profissionais e valores que permeiam o processo. O delineamento do estudo ? qualitativo. Os participantes foram profissionais especialistas em sa?de mental e generalistas da Estrat?gia Sa?de da Fam?lia de Gravata?/RS, Brasil. Os instrumentos utilizados foram entrevistas semiestruturadas e grupos focais. Os resultados evidenciam que o trabalho sustenta-se no trabalho relacional em ato, mediante as rela??es personalizadas institu?das entre apoiadores e generalistas; nos recursos imateriais; e na amplia??o da cl?nica. Dois outros paradigmas foram identificados, o psicossocial e o de produ??o de vida. A sistematicidade dos encontros, o vi?s de sa?de p?blica dos especialistas, a identifica??o com o trabalho, a descentraliza??o como um ideal de vida foram identificados como elementos que subsidiam o trabalho. descentraliza??o como um ideal de vida foram identificados como elementos que subsidiam o trabalho. Um achado, que encontra resson?ncia na literatura internacional, ? a exist?ncia de lideran?a em sa?de mental, reconhecida pelos pares e profissionais da APS, que mobiliza pessoas e intermedia as rela??es com os demais servi?os da rede. A complexidade decorre em raz?o dos diferentes desejos, interesses e for?as dos distintos agentes envolvidos, que remete ?s quest?es de ordem estrutural, organizacional e de gest?o. Estes podem atuar como obst?culos ao processo. Dentre os fatores facilitadores est?o as rela??es personalizadas entre os profissionais; a disponibilidade; o comprometimento; a comunica??o fluida e dial?gica; e a corresponsabiliza??o. Os princ?pios profissionais que subjazem ?s pr?ticas organizam-se em torno do desejo de trabalhar na comunidade; n?o centralizar fun??es; conhecer a rede; ter habilidades de escuta; e de construir consensos. Os valores presentes nas rela??es e intera??es pautam-se no acolhimento; nas rela??es de cuidado intra e interequipes e com os usu?rios; na humildade; na generosidade de partilhar o saber; e no comprometimento. Com rela??o aos profissionais da APS, o aporte de conhecimentos e a retaguarda assistencial contribuem para a abordagem conjunta e resolu??o de casos, que anteriormente eram referenciados a servi?os especializados. Evidencia-se que esta metodologia qualifica as interven??es em sa?de mental, mediante a troca de experi?ncias e saberes, colaborando para a integralidade da aten??o. O v?nculo com o apoiador, a comunica??o, a estrutura das equipes de Sa?de da Fam?lia, a sistematicidade dos encontros, a longitudinalidade e a corresponsabiliza??o foram apontadas como fatores facilitadores. Um obst?culo ao trabalho diz respeito ? imposi??o de barreiras de acesso ao Centro de Aten??o Psicossocial, ap?s a institui??o do Apoio Matricial. Os resultados dos dois grupos investigados evidenciam que o enfoque n?o ? sobre o processo propriamente dito, mas primordialmente sobre as pessoas envolvidas nele. Os dados permitem inferir que a qualidade das rela??es, as carater?sticas dos profissionais, os princ?pios e valores profissionais e pessoais envolvidos sustentam uma pr?tica com contornos singulares.

?rea de concentra??o: Multidisciplinar. / Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-09T16:41:29Z No. of bitstreams: 2 Vania_maria_fernandes_nunes.pdf: 4796742 bytes, checksum: 26285373e915a717cb2cd90d41846b4e (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-09T16:42:16Z (GMT) No. of bitstreams: 2 Vania_maria_fernandes_nunes.pdf: 4796742 bytes, checksum: 26285373e915a717cb2cd90d41846b4e (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Rejected by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br), reason: alterar nome do arquivo on 2015-01-09T16:42:51Z (GMT) / Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-09T16:53:19Z No. of bitstreams: 2 vania_maria_fernandes_nunes.pdf: 4796742 bytes, checksum: 26285373e915a717cb2cd90d41846b4e (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-09T16:54:00Z (GMT) No. of bitstreams: 2 vania_maria_fernandes_nunes.pdf: 4796742 bytes, checksum: 26285373e915a717cb2cd90d41846b4e (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-09T16:54:29Z (GMT) No. of bitstreams: 2 vania_maria_fernandes_nunes.pdf: 4796742 bytes, checksum: 26285373e915a717cb2cd90d41846b4e (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Made available in DSpace on 2015-01-09T16:54:32Z (GMT). No. of bitstreams: 2 vania_maria_fernandes_nunes.pdf: 4796742 bytes, checksum: 26285373e915a717cb2cd90d41846b4e (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) Previous issue date: 2013 / O objetivo deste estudo foi verificar a implementa??o da Pol?tica de Aten??o ? Sa?de e Seguran?a do Trabalho do Servidor P?blico Federal (PASS) nos ?rg?os referenciados ? Unidade do Subsistema Integrado de Aten??o ? Sa?de do Servidor (SIASS) da Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM) e em outras institui??es p?blicas federais localizadas em cidades que acolhem a UFVJM, um dos campi do CEFET/MG, as ger?ncias e ag?ncias do INSS de Diamantina e Te?filo Otoni. Para tanto, foi realizado um estudo descritivo transversal com 205 indiv?duos (201 servidores ativos e quatro gestores de recursos humanos e, ou diretores), que, em rela??o aos servidores ativos, teve como objetivo conhecer as demandas relacionadas aos planos de sa?de, caracteriz?-los quanto ao absente?smo/doen?a ou acidentes em servi?o e ainda quanto ? insalubridade/periculosidade, al?m de verificar o conhecimento desses servidores em rela??o ?s a??es propostas pela PASS j? implantadas nos referidos ?rg?os. Junto aos gestores de recursos humanos e, ou diretores procurou-se identificar as dificuldades enfrentadas para a implementa??o das a??es propostas por essa pol?tica. Este estudo demonstra a necessidade de cria??o de canais de comunica??o que possibilitem manter os servidores das institui??es envolvidas atualizados em rela??o ?s a??es propostas pela PASS. Aponta a import?ncia do benef?cio da sa?de suplementar e ratifica a relev?ncia da a??o de acompanhamento da qualidade e aprimoramento da assist?ncia prestada pelos planos de sa?de. Confirma que a coopera??o t?cnica entre os ?rg?os p?blicos pode favorecer a resolu??o de quest?es periciais de servidores e aponta que os dados de absente?smo/doen?a s?o similares aos de outros estudos realizados. Apresenta informa??es relacionadas com promo??o e vigil?ncia nos ?rg?os envolvidos e recomenda novos estudos para melhor entendimento dessas a??es. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2013. / ABSTRACT The aim of the current study was to verify the implementation of the Policy of Attention to the Health and Safety of Work of Federal Workers (PASS) in public agencies referenced to the SIASS Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM) and other federal institutions located in cities that host UFVJM, as well as one of the campuses of CEFET/MG and the INSS agencies in Diamantina and Te?filo Otoni. A descriptive transversal study was done with 205 individuals (201 active public servants and four human resource managers) which, in regard to the public servants, had the following aims: to find out about demands related to healthcare plans; to characterize the plans as to absenteeism/illness or on-the-job accidents and, further, to examine issues of unwholesomeness and danger in the workplace; and lastly, to verify awareness of these plans in relation to proposed PASS actions already introduced into the abovementioned public agencies. Together with human resource directors, the study sought to identify the difficulties faced in implementing PASS proposals. This study demonstrates the need to establish channels of communication in order to keep public servants updated and involved in regard to any actions proposed by PASS. It also points out the importance of supplementary health benefits and of being aware of the quality of the healthcare plans and any proposed changes to them. Furthermore, the study confirms that technical cooperation among public agencies could aid in the resolution of issues related to public servants and that data regarding absenteeism and illness are similar to other studies. The study presents data related to public agency oversight of these matters and recommends further studies aimed at improving understanding of healthcare-related actions.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-04-01T20:00:18Z No. of bitstreams: 1 ElaineCristinaAlves_DISSERT.pdf: 1400791 bytes, checksum: 733a0735d7cf09c94748695b815cb1a5 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-04-07T23:12:22Z (GMT) No. of bitstreams: 1 ElaineCristinaAlves_DISSERT.pdf: 1400791 bytes, checksum: 733a0735d7cf09c94748695b815cb1a5 (MD5) / Made available in DSpace on 2016-04-07T23:12:22Z (GMT). No. of bitstreams: 1 ElaineCristinaAlves_DISSERT.pdf: 1400791 bytes, checksum: 733a0735d7cf09c94748695b815cb1a5 (MD5) Previous issue date: 2015-04-29 / Os Programas de Resid?ncia Multiprofissional em Sa?de da Universidade Federal do Rio Grande do Norte (PRMS/UFRN) tem como pilares orientadores o processo de aprendizagem do ensino em servi?o, o trabalho multiprofissional interdisciplinar e seguir os princ?pios e diretrizes do Sistema ?nico de Sa?de (SUS). Embora os PRMS/UFRN tenham sido idealizados com foco na aten??o hospitalar, o processo de forma??o na inser??o dos residentes na Aten??o Prim?ria ? Sa?de (APS) ocupa importante papel, pois esses necessitam vivenciar todos os n?veis de aten??o, j? que o processo de educa??o pelo trabalho a que se prop?e a Resid?ncia ? baseado na integralidade da aten??o ? sa?de. Diante disso, a presente pesquisa buscou elucidar a inser??o desses residentes nos servi?os de APS, atrav?s de uma abordagem qualitativa de estudo de caso, onde a coleta dos dados foi realizada em dois momentos distintos: no primeiro momento, foi realizado um question?rio, mediante um roteiro semiestruturado, com os residentes dos PRMS/UFRN, Campus Natal; na segunda etapa, foi realizada a t?cnica de grupo focal com um grupo de nove residentes, e os dados foram analisados a partir da an?lise de conte?do tem?tica categorial. A partir do processo de categoriza??o emp?rica, emergiram categorias e subcategorias, dentre as quais, os aspectos positivos e as potencialidades da inser??o dos residentes na APS. Foi detectada a articula??o de a??es de promo??o, preven??o e recupera??o da sa?de; forma??o na integralidade do cuidado ? sa?de, atividades multiprofissionais e de integra??o ensino-servi?o-comunidade. Em rela??o ?s dificuldades encontradas nessa viv?ncia, nos deparamos com a organiza??o e o planejamento das atividades do rod?zio, a preceptoria, o processo de trabalho encontrado nas Unidades B?sicas de Sa?de (UBS), al?m de fatores externos ? pr?tica educacional, como a quest?o da seguran?a nessas comunidades. Assim, com esse diagn?stico situacional, foi poss?vel perceber que os residentes identificaram a import?ncia deste rod?zio para a sua forma??o profissional, j? que esses est?o inseridos em programas de p?s-gradua??o na aten??o hospitalar. Como produto imediato deste estudo, ser? apresentado um relat?rio que promover? um espa?o para a discuss?o e avalia??o deste rod?zio pelas coordena??es dos PRMS/UFRN, em busca de adequa??es organizacionais e pedag?gicas, al?m da proposi??o de capacita??es para os atores envolvidos com esse processo, visando ? implanta??o de melhorias no rod?zio da APS, em prol da forma??o qualificada de profissionais para o SUS. / The Health Multiprofessional Residency Program of the Federal University of Rio Grande do Norte (PRMS/UFRN) adopts as guiding keystones the learning process of in-service teaching, the interdisciplinary multiprofessional work and the compliance with the principles and guidelines of the Brazilian Unified Health System (SUS). Although PRMS/UFRN have been idealized with a focus on hospital care, the training process in the insertion of residents in the Primary Health Care (PHC) has an important role because they need to experience all levels of care, taking into account that the educational process through work proposed by the Residence is based on the comprehensiveness of health care. In light of the foregoing, the present research has sought to elucidate the insertion of these residents in PHC services, through a qualitative approach of case study, where data collection was held in two different moments: firstly, a questionnaire was accomplished, through an semi-structured script, with the residents of PRMS/UFRN, Natal Campus; subsequently, the focus group technique was accomplished with a group of nine residents, and data were analyzed from the categorical thematic content analysis. From the process of empirical categorization, categories and subcategories were raised, among which, the positive aspects and potentialities of insertion of residents in PHC. We detected the articulation of actions for promoting, preventing and recovering health; training in comprehensiveness of health care, multiprofessional activities and activities aimed at doing the integration among teaching-service-community. Regarding the difficulties found in this experience, we dealt with the organization and planning of rotation activities, the preceptorship, the process of work found in the Basic Health Units (BHU), in addition to factors external to educational practice, such as the issue of safety within these communities. Accordingly, with this situational diagnosis, we became able to realize that residents have identified the importance of this rotation for their vocational training, since these are inserted in post-graduate programs in hospital care. As an immediate product of this study, we will present a report that will provide a space for discussion and assessment of this rotation by the coordination bodies of PRMS/UFRN, in order to seek organizational and pedagogical adaptations, besides the proposition of qualification courses for the actors involved with this process, aiming the implementation of improvements in the rotation of PHC toward the qualified training of professionals for SUS.