Acompanhamento coletivo do crescimento e desenvolvimento infantil: uma an?lise da pr?tica e expans?o no munic?pio de Natal/RN

Autor: Medeiros, Ilana Barros Gomes
Jazyk: portugalština
Rok vydání: 2014
Předmět:
Zdroj: Repositório Institucional da UFRNUniversidade Federal do Rio Grande do NorteUFRN.
Druh dokumentu: masterThesis
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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.
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