RESUMO Este ensaio discute as diferentes abordagens da promoção da saúde e da participação e suas implicações no sentido de contribuir para a construção de novas práticas e compromissos em torno da produção social da saúde. Defende a ideia de que práticas de promoção da saúde podem ser ativadoras de potência de ação para construir medidas que resultem em fortalecimento dos sujeitos e das coletividades, na ampliação da autonomia e no fomento da participação e das redes. A intenção deste artigo é compartilhar ideias, além de ser um convite a afastarmo-nos das receitas e das reproduções, a fim de inventarmos nossos próprios modos de construir a promoção da saúde.PALAVRAS-CHAVE Promoção da saúde; Participação social; Autonomia. ABSTRACT This essay discusses the various approaches to health promotion and participation and its implications in the sense of contributing to the construction of new practices and undertakings around the social production of health. It defends the idea that health promotion practices can be power activators of actions to construct measures which result in the strengthening of subjects and collectivities, in the increase of autonomy and in the increasing of participation and networks. The intention of this article is to share ideas, as well as being an invitation to move away from revenues and reproductions, in order to invent our own methods of constructing health promotion.
This article discusses the broadening of the meaning of intervention as a pathway for research in health promotion
Ao Professor Paulo Antonio de Carvalho Fortesmeu mestrepela orientação atenciosa, pelo respeito e compreensão que demonstrou ao longo dessa trajetória. Em especial, por me permitir e incentivar a trilhar caminhos além fronteiras, me ajudar a perseguir meus sonhos profissionais e pelas oportunidades de trabalho conjunto que me tem propiciado na vida acadêmica. Aos Professores Maria Rita Bertolozzi, Lauro César Ibanhes, Sueli G. Dallari e Oswaldo Y. Tanaka, pela dedicação e leitura atenta, crítica e reflexiva que permitiu enriquecer esta tese com suas valiosas e precisas contribuições. Aos Coordenadores do fórum saúde no Mercosul da Argentina, do Brasil, do Paraguai e do Uruguai, pela acolhida e por partilharem comigo suas inquietações, conquistas e desafios. Aos queridos hermanos, companheiros de residência em Saúde Internacional na OPAS, Sebastián Tobar e Pasionaria Ramos, eternos amigos com quem partilhei momentos de intenso aprendizado, alegrias e tristezas.
The economic crisis that has been affecting Europe in the 21st century has modified social protection systems in the countries that adopted, in the 20th century, universal health care system models, such as Spain. This communication presents some recent transformations, which were caused by changes in Spanish law. Those changes relate to the access to health care services, mainly in regards to the provision of care to foreigners, to financial contribution from users for health care services, and to pharmaceutical assistance. In crisis situations, reforms are observed to follow a trend which restricts rights and deepens social inequalities.
Based on the analysis of a set of interviews with leaders of terreiro communities, this paper discusses the possibilities of an "ecology of lore and knowledge" in health and, more specifically, the possibilities for interaction between the African matrix knowledge and Western scientific medicine knowledge. Along the way, through the engagement in a dialogue between the "conceptual imagination" of authors and the one of their African matrix interlocutors, the paper explores the possible results of an "ecologizing" process between those two types of knowledge, its presuppositions and the barriers to its fulfillment. In this sense, rather than a onesided theoretical approach to the subject, the article seeks to make visible and valuable the conceptual elaboration of the interviewed leaders, building its argument from a transcultural imaginative effort.Keywords: Ecology of knowledge in health. African matrix. Health equity. Brazilian National Health System.To Margot Moraes, filha de Xangô, in memoriam (d) (d) Margot Soares, the daughter-of-saint of Iyá Vera de Oyá Laja, was an interlocutor of this project. A woman-warrior, daughter of Xangô, won our admiration and appreciation.
Resumo O artigo analisa percepções de profissionais de uma unidade básica de saúde a respeito das relações entre religião e saúde para apreender como os modos de considerar a religião nas práticas de saúde podem produzir equidades ou iniquidades. Trata-se de um estudo exploratório de abordagem qualitativa desenvolvido a partir de entrevistas estruturadas individuais, analisadas com o intuito de detectar práticas de sentido relevantes para a discussão de equidade em saúde. Os resultados destacam: uma concepção negativa da influência da religião dos usuários sobre os cuidados e as agências interessadas na redução dessa interferência da religião; as dificuldades e desconfortos relacionados ao modo de o profissional lidar com a própria religião no exercício do cuidado e na relação interprofissional; que o Sistema Único de Saúde não considera a dimensão religiosa, fazendo-se necessárias políticas públicas específicas ou transformações culturais profundas; e a falta de conhecimento de características das religiões afro-brasileiras que demandem cuidados específicos. Tais resultados sugerem que a negligência em relação à questão religiosa mantém oculta uma prática proativa de apagamento das diferenças, conduzindo a uma reflexão sobre o que, em se tratando de equidades e iniquidades, tem produzido a epistème moderna no âmbito das práticas instituídas na atenção básica.
The article "For an ´ecology of knowledge´ in health: an invitation from the terreiros to dialogue", (1) brought many results of the research Práticas Populares de Cuidado à Saúde em Comunidades de Terreiros [Popular Health Care Practices in Terreiro Communities], carried out under the responsibility of the Center of Studies, Research, and Documentation in Healthy Cities (CEPEDOC), and financed by the
Health care for patients with serious illnesses usually implies the need to make a large number of decisions, ranging from how information is shared to which diagnostic or therapeutic procedures will be adopted. The method of such decision-making has important implications from an individual and collective point of view and may contribute to either relieving or aggravating suffering. In this consensus document, the Bioethics Committee of the Brazilian National Academy of Palliative Care (ANCP) and the Permanent Committee on Palliative Care of the Brazilian Geriatrics and Gerontology Society (SBGG) adopt the principles of compassionate listening proposed by Saunders, of the nature of suffering proposed by Cassel, of dignity-preserving care proposed by Chochinov, and of cultural humility as a starting point for the construction of an official position of ANCP and SBGG on shared decision-making in palliative care. The position statement posits that, unlike paternalistic and consumerist models, the decision-making process in the sphere of palliative care must follow the mutualistic model of shared decision, where decisions are built based on dialogue between healthcare professionals and patients/family. The document sets forth the assumptions of this process, the limits of autonomy of patients/family and healthcare professionals and the distinction between futile and potentially inappropriate treatments, besides ratifying its incompatibility with any forms of coercion and conflict of interest foreign to the best interests of patients.
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