Aggressive hospital discharge policies adopted in the 1990s led to an influx of patients recovering from acute illness accessing post-acute home care services. Performance of the post-acute home care program in the Saskatoon Health Region was examined using formative program evaluation methods. Brief surveys of clients and nurse providers captured: care objectives and service outcomes; patient-centeredness; trust in providers; health improvement/decline; emotional/social functioning; functional status; injury avoidance; and overall quality. For clients, perceptions of quality were significantly affected by patient centeredness and experiencing unexpected health complications, which accounted for 83.0% of the variation. For nurse providers, overall quality of care was significantly related to patient centeredness, service outcomes, team communication and injury avoidance. Analysis revealed for clients with complex needs, the service period could be extended from 60 to 97 days which would cover 50.0% of clients. The research examining administrative data predicted the dependent variable Log of Total Care Hours (TCH) to enable analysis using General Linear Modelling. The results showed post-acute home care clients referred from Emergency Departments received approximately 84.2 % more TCH; post-acute home care clients referred from Surgical wards received approximately 42.1% more TCH; and post-acute home care clients referred from Cardiology received approximately 66.3% more TCH than clients referred from the community. Furthermore, single clients received more TCH than married clients. Nursing chart reviews of post-acute home care clients with wound care also predicted the Log of TCH to enable analysis using General Linear Modelling. Post-admission, 11.3% of post-acute home care clients receiving wound care displayed clinical signs and symptoms of emerging infection, while 19.7% displayed clinical signs and symptoms of acquired infection. Post-acute home care clients receiving wound care experiencing injury, trauma or harm while admitted to home care received approximately 53.3% TCH; and post-acute home care clients who acquired an infection after admission received approximately 70.2% TCH. The implications of this research suggest there is room to improve post-acute home care services to address client re-hospitalisation, unexpected health symptoms/complications, and wound care.

Introdução: As doenças cardiovasculares são atualmente a principal causa de mortalidade no país e também o conjunto de doenças que provoca o maior gasto no sistema de saúde. Dentre elas, há uma que merece especial atenção por estar vinculada a diversas origens e ser fator de agravamento para outras patologias: a hipertensão arterial. O modelo assistencial vigente caracteriza-se por ações curativas, pelo atendimento ao paciente com patologia já instalada e visão extremamente limitada em especificidades dos problemas. O Programa de Saúde da Família propõe um modo diferente de atendimento, estruturada no atendimento ambulatorial contínuo e integral, se valendo da interação com a comunidade o que permite ações mais efetivas na promoção da saúde. A presença de um programa de atenção farmacêutica no PSF promove um maior trânsito, riqueza e percepção de informações a respeito de medicamentos, fazendo com que a terapia medicamentosa seja mais efetiva, com a promoção do uso correto. Objetivos: Desenvolver uma metodologia que permita identificar e analisar práticas terapêuticas medicamentosas anti-hipertensivas (Momento terapêutico ? MT). Estimar resultados e tendências na evolução da pressão arterial dos pacientes hipertensos acompanhados pelo NSF-III. Estimar o nível de adesão ao tratamento anti-hipertensivo e a influência desse fator no resultado terapêutico dos pacientes. Casuística e Métodos: População - Indivíduos cadastrados no Núcleo de Saúde da Família III (NSF-III) do PSF de Ribeirão Preto, com diagnóstico de hipertensão arterial e acompanhamento da patologia realizado no referido núcleo. Amostra: prontuários de 73 pacientes. Métodos - Foram coletados dados retrospectivos dos prontuários dos indivíduos, relativos ao período de 1.º de julho de 2001 a 30 de junho de 2005. Foram avaliados ?Conduta Diagnóstica? e os valores de pressão arterial. Resultados: Observou-se a redução de MT nos quais nenhum anti-hipertensivos (AH) foi utilizado, redução no uso de um AH isoladamente e aumento no número médio de AH por MT anos após ano (1,35 no Ano 1 até 1,89 no Ano 4). Analisando-se o percentual de MT de acordo com a classe de AH envolvida, verificou-se a predominância de prescrição da classe dos IECA (58,8%), seguida pelos diuréticos (54,4%) e BBloq e BloqCa em proporções próximas (19% e 18,2%, respectivamente). Foram encontradas indicações de uso irregular da medicação nos prontuários de 35 (48%) pacientes. O percentual médio de pacientes com controle de PA adequado foi de 34,2% no geral, 42.1% nos pacientes Aderentes e 25,7% nos Não Aderentes. Conclusões: A metodologia dos momentos terapêuticos se mostrou adequada na caracterização do padrão de prescrição do NSF-III, que segue as recomendações de tratamento de hipertensão baseada nos consensos, ou seja, a terapêutica medicamentosa praticada tende a ser racional. A maioria dos pacientes do PSF que faz acompanhamento em hipertensão arterial apresenta valores de pressão arterial fora dos limites internacionalmente estabelecidos. O presente trabalho também permitiu demonstrar que o problema de adesão ao tratamento no NSF-III é similar ao que já foi descrito na literatura mas a tendência a indiferenciação entre os grupos de pacientes aderentes e não aderentes indica que abordagem do programa tem conseguido resultados positivos / Introduction: Cardiovascular diseases are the currently leading cause of mortality in Brazil and also the set of illnesses that is the largest expense in health system. Amongst them, there is one that deserves special attention for being tied the diverse origins and to be factor of aggravation for other pathologies: hypertension. The actual model of care is characterized for curative actions and vision extremely limited in specificities of the problems. The Family Health Care Program (FHCP) considers a different way of care, structured in continuous and integral ambulatory care, considering the interaction with community as crucial for more effective actions on health promotion. The presence of a pharmaceutical care program in the FHCP promotes a better flow, quality, and perception of information regarding medicines, making drug therapy more effective with the promotion of the correct use. Objectives: To develop a methodology that allows to identify and analyze therapeutical pratices of antihypertensive drugs (Therapeutic Moment - TM). Esteem results and trends in the evolution of the blood pressure (BP) of the hypertensive patients followed by the NFHCIII. Esteem the level of adherence to the hypertension treatment and the influence of this factor in the therapeutic result of the patients. Casuistry and Methods: Population - Individuals registered in the Nucleus of Family Health Care III (NFHC-III) of the FHCP of Ribeirão Preto, with diagnosis of hypertension and accompaniment of the pathology. Sample: medical records of 73 patients. Methods - Data had been retrospectively collected relative to the period of 1.º of July of 2001 to 30 of June of 2005. Results: It was observed TM reduction in which no antihypertensives (AH) were used, reduction in the use of one single AH and increase in the average number of AH for TM (1,35 in Year 1 up to 1,89 in Year 4). Analyzing the percentage of TM in accordance with the class of AH involved, verified it predominance of prescriptions on the class of ACE (58.8%), followed for diuretics (54.4%), with betablockers and calcium channel blockers in next (19% and 18.2%, respectively). Indications of irregular use of medication in medical records of 35 (48%) patient had been found. Average percentage of the 73 patients with adequate control of BP was of 34,2%, 42,1% in the Adherent group of patients and 25.7% in Not Adherent. Conclusions: The methodology of therapeutic moments showed adequate results in the characterization of the practices of AH prescribing in the NFHC-III. This health care facility follows the recommendations of treatment of hypertension based on the Brazilian guidelines, suggesting that the drug practices tends to be rational. The majority of the patients of the NFHC-III that makes accompaniment in hypertension present values of blood pressure above of the limits internationally established. The present work also demonstrate that the problem of adherence to the treatment in the NFHC-III is similar of the already described in literature but trends of BP reduction values between the groups of adherent and not adherent patients indicates the approach of the program has obtained positive results

The Social/HMO Demonstration evaluates the feasibility of expanding Medicare Supplemental Insurance benefits to cover a limited amount of ICF and community based long-term care (LTC) services provided under a comprehensive HMO benefit package for capitated Medicare beneficiaries. The policy research question addressed by this study is whether adding an Expanded Care Benefit (ECB) to the capitated HMO benefit package offered by Kaiser Permanente (KP) changes utilization patterns and costs of ICF services, and the probability of becoming Medicaid eligible. This study provides descriptive information regarding this policy research question. The research goal of this study is to measure the extent to which collective ICF use rates and expenditure patterns for S/HMO members are consistently the same, greater or less than baseline data of Risk HMO Medicare members who do not have the S/HMO ECB. The purpose of such measurement is to determine if an empirical basis exists for postulating an ICF utilization and expenditures outcome effect which is influenced by the S/HMO ECB. Utilization and financial data are collected from all SNF and ICF level nursing homes in Multnomah County for all Medicare beneficiaries enrolled in KP between June 1, 1986 and July 31, 1988. Eligibility data are assembled on all Medicare beneficiaries enrolled in KP during the same time period who were residents of Multnomah County. Nursing home use rates and rates for related expenditures are determined for all nursing home residents (1, 331) by their eligibility status in KP during the time of each nursing home stay. Days in an ICF are censored by transfers between Cost, Risk and S/HMO enrollment status. Rates are standardized by the age and gender distribution of research population members (19, 261) to adjust use rates for differences in age cohort distribution of Risk members and S/HMO members. Risk rates and S/HMO rates are compared and differences in utilization and expenditures are evaluated. Conclusions about such patterns are used to formulate hypotheses for testing and confirming descriptive observations. Findings show that overall S/HMO member rates are less than Risk member rates for five of the six Research Questions addressed in this study. Specifically, the probability of admission to an ICF is substantially greater for S/HMO members than for Risk members. However, S/HMO members remained in ICFs fewer days than Risk members, over the two year study period, as measured by age adjusted rates for ICF days per member year of eligibility during the study period. Difference in the mean length of ICF stay is statistically significant between Risk and S/HMO. The rate of total payments received by nursing homes for S/HMO ICF residents per 1000 S/HMO members was substantially less than that for Risk members. The rate of spend-down to welfare status was substantially lower for S/HMO members than for Risk members who became ICF residents. Higher proportions of S/HMO members were discharged from ICFs to home than were Risk members, which is consistent with S/HMO Expanded Care Benefit objectives.

Bakgrund: Beroendeproblematik är utbrett i samhället, och orsakar mycket ohälsa och lidande. Synen på personer med beroendeproblematik är skiftande. Skalan går från att se beroende som en sjukdom, till att se de drabbade som moraliskt bristfälliga personer som har sig själva att skylla. Vården styrs via riktlinjer och policydokument. Vilken människosyn som uttrycks i dokument som vårdprogram inom beroendevård är sällan problematiserad. Det finns risk för att omvårdnaden kan påverkas beroende på hur synen på personer med beroendeproblematik signaleras från regional nivå. Syfte: Syftet med studien var att undersöka hur personer med beroendeproblematik framställs i regionala vårdprogram inom beroendevård. Metod: En kritisk diskursanalys utfördes på regionala vårdprogram inom beroendevård. Resultat: Flera diskurser framträdde i materialet, dessa rörde bland annat kriminalitet, utanförskap, kontroll, motivation, samt omvårdnad. Frekvent förekommande nyckelord identifierades och problematiserades. Slutsats: Regionala vårdprogram är inte undantagna tendensen att stigmatisera denna patientgrupp. Ett omvårdnadsperspektiv saknas ofta i dokumenten. Inte sällan uttrycks att personerna får rätta sig i ledet och försöka bevisa sin skötsamhet. Undantag finns, och de behöver bli fler för att detta synsätt ska kunna utmanas. / Background: Substance dependence is widespread in society and causes considerable suffering and ill health. Attitudes towards persons with substance use disorder (SUD) are diverse, and range from the concept of addiction as a disease to the view that persons with SUD are morally lacking and only have themselves to blame. Health services are governed by guidelines and policy documents. The views expressed in documents such as care programs within addiction medicine, are seldom assessed. Nursing is at risk of being affected, depending on how attitudes towards persons with SUD are communicated from a county council. Aim: The aim of this study was to examine how persons with substance use disorder are depicted in regional care programs within addiction health care. Method: A critical discourse analysis was applied to regional care programs in addiction health care. Results: Several discourses were identified, regarding criminality, marginalisation, control, motivation, and nursing. Frequently used keywords were identified and problematised. Conclusions: Regional care programs are not exempt from the tendency to stigmatise persons with SUD. A nursing perspective is often missing from these documents. Persons with SUD have to toe the line and try to prove that they are well-behaved. There are exceptions to these representations, and more exceptions are needed to challenge the prevailing perspective.

nÃo hà / O presente estudo tem como objetivo avaliar a PolÃtica de AssistÃncia Social voltada para crianÃas e adolescentes que estÃo em Acolhimento Institucional, especificamente, aquelas extintas do poder familiar, destituÃdos do poder familiar ou em processo de destituiÃÃo do poder familiar e tambÃm fora dos âpadrÃesâ vigentes de adoÃÃo, na perspectiva do direito à convivÃncia familiar e comunitÃria. Para realizar tal estudo desenvolveu-se uma pesquisa de campo no desenho de um estudo de caso, tendo em vista que o universo a ser avaliado foi a entidade de acolhimento institucional para crianÃas e adolescentes â Sociedade para o Bem Estar da FamÃlia â SOBEF, localizada no municÃpio de Maracanaà - CE. Foram utilizadas as seguintes tÃcnicas: entrevista formal e aberta aplicada a trÃs profissionais; observaÃÃo participante com crianÃas e adolescentes acolhidos; questionÃrio aplicado com a gestora do equipamento; levantamento nos registros da instituiÃÃo e participaÃÃo em rodas de conversas com os acolhidos. A pesquisa bibliogrÃfica contribuiu para o aprofundamento das categorias analÃticas e fundantes da pesquisa; a pesquisa documental para formataÃÃo do histÃrico institucional e a pesquisa de campo, qualiquantitativa como forma de traÃar um perfil dos meninos e meninas acolhidos. Neste sentido, a avaliaÃÃo proposta foi quali-quantitativa. Especificamente quanto à anÃlise qualitativa, esta foi do tipo formativa e/ou de processo, tendo em vista o foco abordado neste trabalho. Jà o mÃtodo a ser utilizado foi o de interpretaÃÃo de sentidos, verificando a anÃlise da implementaÃÃo da PolÃtica de AssistÃncia Social referente à execuÃÃo do Programa de Acolhimento Institucional para crianÃas e adolescentes. Quanto à pesquisa quantitativa, houve uma anÃlise estatÃstica descritiva dos acolhidos, contribuindo para a caracterizaÃÃo do pÃblico alvo. As conclusÃes podem ser descritas da seguinte maneira: as crianÃas e adolescentes acolhidos, mesmo diante de vÃrios avanÃos legais estÃo ou continuam imersos em uma realidade contraditÃria de (des) garantias de direitos versus o sonho de possuir uma famÃlia e com isso sair da situaÃÃo de acolhimento institucional. / This study aims assess Assistance Policy Social facing Children and Adolescents are Reception Institutional specifically those extinct power family, destitute power family or process disempowering familiar and also outside "patterns "existing adoption in perspective right to familiar and communitarian. To accomplish such will held fieldwork where will considered will: case study considering that universe being evaluated will municipality Maracanaà primarily entity host institutional Child and adolescents - Sociedade for Wellness of Family - SOBEF which composes network provider service referred municipality and System Guaranteeing Rights; interview formal and open applied three professionals serve for collecting information, concerning activities developed in present, as about future prospects perceived by these actors; participant observation with children and adolescents welcomed assuming here one active participation researcher in meanders activities; the administered questionnaire with managing equipment help at outlining children and adolescents welcomed and own institution together abstracting thereof not understanding and appropriation of normative existing, towards warranty conviviality family and community of welcomed; bibliographical research that help deepening categories analytical and founding research; documental research for possible formatting history institutional; besides analyzing quantitative data also be harvested by documental analysis available by institution as way to chart profile boys and girls welcomed as also through data sites official dealing object and their contexts social-familial. This sense evaluation proposal is quali-quantitative and will performed evaluation process in view focus approached this work. Already method utilized be to interpreting senses checking analysis implementation Policy Welfare regarding executing programs host institutional juveniles; measuring quali-quantitatively as running service host institutional performed by SOBEF, municipality MaracanaÃ; assess knowledge and implementing strategies that professionals are finding social inclusion children and adolescents welcomed; verify compliance new laws about programs host institutional; assess whether teenagers welcomed being prepared for shutdown institution; and finally evaluate effectiveness skills among network actors attendance involving host institutional conducted by SOBEF in reference direction and counter. The conclusion can be described in this way: The sheltered children and adolescents, even facing a lot of legal advances are or continue immersed in a contradictory reality of non-guarantees of right against the dream of having a family and leave this situation.

Thesis (Ph.D.)--University of Melbourne, Faculty of Arts, 2007. / Typescript. Includes bibliographical references (leaves 327-345).

Submitted by Cristiane Shirayama (cristiane.shirayama@fgv.br) on 2011-06-03T16:34:55Z No. of bitstreams: 1 66080100250.pdf: 761789 bytes, checksum: 0b97a63d6719bb112df542f196c7627a (MD5) / Approved for entry into archive by Vera Lúcia Mourão(vera.mourao@fgv.br) on 2011-06-03T16:55:10Z (GMT) No. of bitstreams: 1 66080100250.pdf: 761789 bytes, checksum: 0b97a63d6719bb112df542f196c7627a (MD5) / Approved for entry into archive by Vera Lúcia Mourão(vera.mourao@fgv.br) on 2011-06-03T17:04:33Z (GMT) No. of bitstreams: 1 66080100250.pdf: 761789 bytes, checksum: 0b97a63d6719bb112df542f196c7627a (MD5) / Made available in DSpace on 2011-06-03T19:07:14Z (GMT). No. of bitstreams: 1 66080100250.pdf: 761789 bytes, checksum: 0b97a63d6719bb112df542f196c7627a (MD5) Previous issue date: 2011-01-19 / The purpose of this study is to analyze the impact of primary health care programs in Brazil on some quality health service indicators, including a preliminary assessment of this policy with respect to economic efficiency. Other researchers have conducted similar studies, such as Peixoto and Rocha (2009) and Rocha and Soares (2008 and 2010). This study differs from previous ones in at least some aspects as the analysis period, geographical coverage, the variables used and the methodological approach, but is closer to the first study of the methodological point of view. The period of analysis covers the years between 1999 and 2005 and considers all the municipalities in Brazil. The results support many of those obtained by Peixoto and Rocha (2009) for the Southeast region and the assumptions made by these authors because they were found significant impacts of the Programa Saúde da Família (PSF) in term of reducing child mortality and not the case with respect to mortality rates in other age groups. Furthermore, we found a positive and significant effect of PSF coverage on the rate of population access to health care, reinforcing the idea that the PSF had the effect of structuring the network of primary care, the rate of population access to health care, increasing the range of network services and toward more of the population. We have also found some evidence that the beneficial effects of PSF coverage occurred not only via increased spending but also by increasing the efficiency of services. / O objetivo deste trabalho é avaliar o impacto dos programas de atenção básica à saúde no Brasil sobre alguns indicadores de qualidade do serviço de saúde, incluindo uma avaliação preliminar dessa política com relação à eficiência econômica. Outros pesquisadores já realizaram estudos semelhantes, como Peixoto e Rocha (2009) e Rocha e Soares (2008 e 2010). Este estudo difere dos anteriores em pelo menos alguns aspectos como o período de análise, a cobertura geográfica, as variáveis utilizadas e a abordagem metodológica, porém aproxima-se mais ao primeiro estudo do ponto de vista metodológico. O período da análise compreende os anos entre 1999 e 2005 e considera todos os municípios do Brasil. Os resultados corroboram em grande parte aqueles obtidos por Peixoto e Rocha (2009) para a região Sudeste e as hipóteses levantadas por estes autores, pois foram encontrados impactos significativos do Programa Saúde da Família (PSF) em termos de redução da mortalidade infantil, não acontecendo o mesmo com relação às taxas de mortalidade em outras faixas etárias. Além disso, foi encontrado um efeito positivo e significativo da cobertura do PSF sobre a taxa de acesso da população ao sistema de saúde, reforçando a idéia de que o PSF teve o efeito de estruturar a rede de atenção básica, aumentando o alcance dessa rede de serviços e aproximando-a da população. Também foram encontradas algumas evidências de que os efeitos benéficos da cobertura do PSF não ocorreram somente via aumento de gastos, mas também via aumento da eficiência dos serviços.

MARINHO, Luciana Gomes. Avaliação da política de assistência social para crianças e adolescentes afastados do ambiente familiar: um estudo de caso da Sociedade para o Bem Estar da Família - SOBEF no Município de Maracanaú-CE. 2012. 202f. – Dissertação (Mestrado) – Universidade Federal do Ceará, Programa de Pós-graduação em Avaliação de Políticas Públicas, Fortaleza (CE), 2012. / Submitted by Márcia Araújo (marcia_m_bezerra@yahoo.com.br) on 2013-10-01T16:28:16Z No. of bitstreams: 1 2012-DIS-LGMARINHO.pdf: 6270343 bytes, checksum: aa904c167ac6619f987bf6fced3787a2 (MD5) / Approved for entry into archive by Márcia Araújo(marcia_m_bezerra@yahoo.com.br) on 2013-10-01T16:37:58Z (GMT) No. of bitstreams: 1 2012-DIS-LGMARINHO.pdf: 6270343 bytes, checksum: aa904c167ac6619f987bf6fced3787a2 (MD5) / Made available in DSpace on 2013-10-01T16:37:58Z (GMT). No. of bitstreams: 1 2012-DIS-LGMARINHO.pdf: 6270343 bytes, checksum: aa904c167ac6619f987bf6fced3787a2 (MD5) Previous issue date: 2012 / This study aims assess Assistance Policy Social facing Children and Adolescents are Reception Institutional specifically those extinct power family, destitute power family or process disempowering familiar and also outside "patterns "existing adoption in perspective right to familiar and communitarian. To accomplish such will held fieldwork where will considered will: case study considering that universe being evaluated will municipality Maracanaú primarily entity host institutional Child and adolescents - Sociedade for Wellness of Family - SOBEF which composes network provider service referred municipality and System Guaranteeing Rights; interview formal and open applied three professionals serve for collecting information, concerning activities developed in present, as about future prospects perceived by these actors; participant observation with children and adolescents welcomed assuming here one active participation researcher in meanders activities; the administered questionnaire with managing equipment help at outlining children and adolescents welcomed and own institution together abstracting thereof not understanding and appropriation of normative existing, towards warranty conviviality family and community of welcomed; bibliographical research that help deepening categories analytical and founding research; documental research for possible formatting history institutional; besides analyzing quantitative data also be harvested by documental analysis available by institution as way to chart profile boys and girls welcomed as also through data sites official dealing object and their contexts social-familial. This sense evaluation proposal is quali-quantitative and will performed evaluation process in view focus approached this work. Already method utilized be to interpreting senses checking analysis implementation Policy Welfare regarding executing programs host institutional juveniles; measuring quali-quantitatively as running service host institutional performed by SOBEF, municipality Maracanaú; assess knowledge and implementing strategies that professionals are finding social inclusion children and adolescents welcomed; verify compliance new laws about programs host institutional; assess whether teenagers welcomed being prepared for shutdown institution; and finally evaluate effectiveness skills among network actors attendance involving host institutional conducted by SOBEF in reference direction and counter. The conclusion can be described in this way: The sheltered children and adolescents, even facing a lot of legal advances are or continue immersed in a contradictory reality of non-guarantees of right against the dream of having a family and leave this situation. / O presente estudo tem como objetivo avaliar a Política de Assistência Social voltada para crianças e adolescentes que estão em Acolhimento Institucional, especificamente, aquelas extintas do poder familiar, destituídos do poder familiar ou em processo de destituição do poder familiar e também fora dos “padrões” vigentes de adoção, na perspectiva do direito à convivência familiar e comunitária. Para realizar tal estudo desenvolveu-se uma pesquisa de campo no desenho de um estudo de caso, tendo em vista que o universo a ser avaliado foi a entidade de acolhimento institucional para crianças e adolescentes – Sociedade para o Bem Estar da Família – SOBEF, localizada no município de Maracanaú - CE. Foram utilizadas as seguintes técnicas: entrevista formal e aberta aplicada a três profissionais; observação participante com crianças e adolescentes acolhidos; questionário aplicado com a gestora do equipamento; levantamento nos registros da instituição e participação em rodas de conversas com os acolhidos. A pesquisa bibliográfica contribuiu para o aprofundamento das categorias analíticas e fundantes da pesquisa; a pesquisa documental para formatação do histórico institucional e a pesquisa de campo, qualiquantitativa como forma de traçar um perfil dos meninos e meninas acolhidos. Neste sentido, a avaliação proposta foi quali-quantitativa. Especificamente quanto à análise qualitativa, esta foi do tipo formativa e/ou de processo, tendo em vista o foco abordado neste trabalho. Já o método a ser utilizado foi o de interpretação de sentidos, verificando a análise da implementação da Política de Assistência Social referente à execução do Programa de Acolhimento Institucional para crianças e adolescentes. Quanto à pesquisa quantitativa, houve uma análise estatística descritiva dos acolhidos, contribuindo para a caracterização do público alvo. As conclusões podem ser descritas da seguinte maneira: as crianças e adolescentes acolhidos, mesmo diante de vários avanços legais estão ou continuam imersos em uma realidade contraditória de (des) garantias de direitos versus o sonho de possuir uma família e com isso sair da situação de acolhimento institucional.

Made available in DSpace on 2016-08-18T18:55:03Z (GMT). No. of bitstreams: 1 Dissertacao_KAREN BEATRIZ TAVEIRA BARROS.pdf: 883871 bytes, checksum: 92e5af990dcf6311e3af9bfb925d5154 (MD5) Previous issue date: 2015-03-13 / This study analyzes the Foster Care Program in São Luís, between 2012 and 2013, in the light of the provisions of the Child and Adolescent Statute, the National Plan for the Protection and Defense of the Right of Children to Family and Community life and Technical Guidelines of the CONANDA. It presents an exhibition of the historical trajectory of children and adolescents in Brazil. It discusses the right to family and community life as the effort to overcome the institutionalization of children and adolescents. It addresses the national policy of promotion and defense of family and community life and its implementation in a National Plan and child and adolescents care policy. It analyzes the Foster Care Program in São Luís, in 2012 and 2013, in its design and development. This analysis seeks to compare what is provided for in National Policy of promotion and defense of family and community life and what, indeed, has been operated in the local community through this program, at all stages, is so far the children or adolescents inserted either with respect to selected families. Thus, this study sought to investigate from the moment of reception , entry into the program , the monitoring and the departure of children , adolescents and families / Este trabalho analisa o Programa Família Acolhedora, na cidade de São Luís, nos anos de 2012 e 2013, à luz dos preceitos do Estatuto da Criança e do Adolescente, do Plano Nacional de Proteção e Defesa do Direito de Crianças e Adolescentes à Convivência Familiar e Comunitária e Orientações Técnicas do CONANDA. Apresenta uma exposição da trajetória histórica da infância e adolescência no Brasil. Discorre sobre o direito à convivência familiar e comunitária como busca da superação da institucionalização de crianças e adolescentes. Aborda a Política nacional de promoção e defesa da convivência familiar e comunitária e sua concretização num Plano Nacional e na política de atendimento à criança e ao adolescente. Analisa o Programa Família Acolhedora em São Luís, nos anos de 2012 e 2013, no seu desenho e desenvolvimento. Essa análise de viés avaliativo busca cotejar o que é previsto na Política nacional de promoção e defesa à convivência familiar e comunitária e o que, de fato, vem sendo operacionalizado na realidade local através deste Programa, em todas as fases, seja no que diz às crianças ou adolescentes inseridas, seja no tocante às famílias selecionadas. Assim é que se buscou investigar desde o momento do acolhimento, a entrada no Programa, o acompanhamento e a saída das crianças, adolescentes e famílias

No description available.