Mestrado em Saúde Coletiva

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http://repositorio.ufes.br/handle/10/17586

Nível: Mestrado Acadêmico
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Navegando Mestrado em Saúde Coletiva por Assunto "Access"

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    Acesso às práticas integrativas e complementares em saúde no sus: uma análise sob a ótica dos usuários
    (Universidade Federal do Espírito Santo, 2019-05-16) Magalhaes, Fabiola Fernandes Bersot; Andrade, Maria Angelica Carvalho; https://orcid.org/0000000236906416; http://lattes.cnpq.br/5427520110626795; https://orcid.org/0000-0002-2979-1120; http://lattes.cnpq.br/4986617159665050; Esposti, Carolina Dutra Degli; https://orcid.org/0000000181027771; http://lattes.cnpq.br/7465412734380334; Sarti, Thiago Dias; https://orcid.org/0000000215456276; http://lattes.cnpq.br/7489127535403969; Tesser, Charles Dalcanale; https://orcid.org/; http://lattes.cnpq.br/0146180240654049
    It is increasingly evident the use of alternative and complementary medicine for health treatment in the world. Integrative and Complementary Practices in Health (PICS), as they are known in Brazil, seek to stimulate natural mechanisms for health promotion, disease prevention and health recovery, with an emphasis on welcoming listening, developing the therapeutic link and integrating the being with the environment and society. The implementation of the National Policy on Integrative and Complementary Practices (PNPIC) in the country since 2006 is considered an advance and an important landmark in the introduction of unconventional practices in the Unified Health System (SUS). However, the existing problems that hinder the development of this policy mean that implementation remains at the periphery of SUS, with little prospect of entering the center of the system. The present study aims to analyze the access to these practices, based on listening to users of the public health system of the city of Vitória-ES. Understanding that access is an imprecise, complex term, with little clarity in its relation to the use of health services, the research will discuss this perspective based on Frenk's theoretical framework, which proposes, in an extended analysis, to systematize the flow of events between the moment when the health need is perceived until the effectiveness of the care, besides the determination of the demand and entrance in the health services and the continuity of this care. It is a qualitative study of exploratory character that is defined in the encounter with the users involved in a municipal APS. Sampling occurred randomly, totaling 29 USF users. Data were collected through semi-structured interviews and participant observation. After the saturation of the data, the analysis was carried out in the perspective of access to Integrative and Complementary Practices in Health and how a certain phenomenon manifests itself in the desires, activities, procedures and daily interactions. It was verified, when reaching the singularities of the therapeutics observed, that even with the proposal of an extended access model, it is not possible to contemplate all the peculiarities of the access to the PICS. It was possible to understand that this access depends on the organization of the service and the type of offer available, related to the degree of institutionalization of the PICS in the public health network, and that the user's access to the service will depend, in addition to the social characteristics, of individual characteristics and subjective aspects.
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    O acesso do usuário ao diagnóstico da tuberculose no município de Vitória/ES
    (Universidade Federal do Espírito Santo, 2011-03-22) Fávero, Juliana Lopes; Maciel, Ethel Leonor Noia; Zandonade, Eliana; Motta, Maria Catarina Salvador da
    The patient's access to health services is a key strategy for tuberculosis control. The purpose of this study is to assess access to tuberculosis diagnosis professionals' view on health in Vitória/ES. Cross-sectional study. We interviewed 61 doctors, 45 nurses and 70 nurse technicians working in the Family Health Unit (FHU), Basic Health Unit (BHU), Emergency Health Care (EHC) and Tuberculosis Control Program (TCP), Vitoria/ES, from August to November 2009. Was performed chi-square test. Results: 76% of the sample consisted of women. With regard to training, 83% of physicians have residence, 55% of nurses have expertise and 11% of nurses have master's degree. 64% have up to 5 years experience in function, 22% of professionals have never done a training related to TB (p = 0.004), 79% reported difficulty filling in forms for ordering tests (p = 0.001). 65% considered good professional service time for each user (p = 0.052). 53% of nurses often do not request examinations (p = 0.001). 72% of doctors often deal with social problems (p = 0.019). At FHU, 64% carry out an active search for symptoms frequently (p = 0.005). Home visits to deliver pot of sputum collection (54%, p = 0.016), and educational programs about TB during the year (67%, p = 0.047) are infrequent. 47% of health professionals consider themselves the main responsible for delayed diagnosis of tuberculosis (p = 0.001).The hours of operation of the service was considered good for most professionals (89%), but at the FHU 72% (p = 0.001) considered the bad times. 42% report being frequent users lose the shift to be serviced, which is more frequent in EHC (43%, p = 0.001). 43% of BHU practitioners do not respect the user's difficulties in shifting to the health service, but at the FHU 45% sometimes there is this difficulty (p = 0.001). FHU at BHU and 89% are infrequent use of motorized transport for travel to the health service, being common to the EHC and TCP (70%, p = 0.001). 44% evaluate how bad the place for sputum collection (p = 0.001). At FHU/BHU, often (90%) users seeking the service closer to home, as for the professionals of EHC and TCP, there is sometimes (77%, p = 0.001). The health service provides a basic framework for the care, but responds in part to population expectations. Inputs for the service and human resources are the main barriers in access to tuberculosis diagnosis.