Este artigo discute questões relacionadas ao uso de métodos qualitativos e quantitativos em pesquisa social na área da saúde. Tem como objetivo apontar algumas estratégias que possibilitem a integração desses métodos e, para esse fim, apresenta considerações teóricas de diferentes autores que têm trabalhado nos últimos trinta anos para superar a contraposição entre as duas perspectivas. Aborda também as especificidades de cada método, identificando a melhor adequação de cada um, considerados o objeto do estudo e sua aplicabilidade nos diferentes momentos da investigação. Por fim, evidencia a existência de preconceitos e falsos dilemas no debate sobre os métodos e propõe a superação da incomunicabilidade entre pesquisadores qualitativos e quantitativos.

Health literacy, a more complex concept than knowledge, is a required capacity to obtain, understand, integrate and act on health information [1], in order to enhance individual and community health, which is defined by different levels, according to the autonomy and personal capacitation in decision making [2]. Medium levels of Health literacy in an adolescent population were found in a study conducted in 2013/2014, being higher in sexual and reproductive health and lower in substance use. It was also noticed that the higher levels of health literacy were in the area adolescents refer to have receipt more health information. The health literacy competence with higher scores was communication skills, and the lower scores were in the capacity to analyze factors that influence health. Higher levels were also found in younger teenagers, but in a higher school level, confirming the importance of health education in these age and development stage. Adolescents seek more information in health professionals and parents, being friends more valued as a source information in older adolescents, which enhance the importance of peer education mainly in older adolescents [3]. As a set of competences based on knowledge, health literacy should be developed through education interventions, encompassing the cultural and social context of individuals, since the society, culture and education system where the individual is inserted can define the way the development and enforcement of the health literacy competences [4]. The valued sources of information should be taken into account, as well as needs of information in some topics referred by adolescents in an efficient health education. Schizophrenia is a serious and chronic mental illness which has a profound effect on the health and well-being related with the well-known nature of psychotic symptoms. The exercise has the potential to improve the life of people with schizophrenia improving physical health and alleviating psychiatric symptoms. However, most people with schizophrenia remains sedentary and lack of access to exercise programs are barriers to achieve health benefits. The aim of this study is to evaluate the effect of exercise on I) the type of intervention in mental health, II) in salivary levels of alpha-amylase and cortisol and serum levels of S100B and BDNF, and on III) the quality of life and selfperception of the physical domain of people with schizophrenia. The sample consisted of 31 females in long-term institutions in the Casa de Saúde Rainha Santa Isabel, with age between 25 and 63, and with diagnosis of schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Physical fitness was assessed by the six-minute walk distance test (6MWD). Biological variables were determined by ELISA (Enzyme-Linked Immunosorbent Assay). Psychological variables were assessed using SF-36, PSPP-SCV, RSES and SWLS tests. Walking exercise has a positive impact on physical fitness (6MWD -p = 0.001) and physical components of the psychological test...

A crise do Estado de Bem-Estar Social tem contribuído para a redescoberta da família, das redes primárias e da comunidade como atores fundamentais na efetivação das políticas sociais. A família é cada vez mais objeto de atenção das instituições governamentais e dos cientistas sociais pela grande quantidade de atividades de proteção, ajuda e cuidado que ela desenvolve. Atualmente, há várias propostas de políticas sociais baseadas na concepção de "cuidado comunitário", que objetivam co-responsabilizar a comunidade em relação aos problemas sociais e de saúde. Uma das estratégias é o Programa de Saúde da Família, que visa oferecer serviços de atenção básica às famílias e às comunidades. Observa-se, porém, uma profunda transformação na organização da família, na sua composição e estrutura e sua função. O desenvolvimento de uma política mais efetiva nessa área deve promover um processo de educação continuada dos profissionais, aprofundando sua formação quanto à abordagem familiar e comunitária. Os planejadores de políticas sociais dispõem de várias possibilidades para introduzir novas e criativas iniciativas em nível de comunidade, que oferecem a oportunidade de valorizar o papel do cuidado informal, em particular o cuidado subministrado pelo parentesco, e para integrá-lo às atividades realizadas pelos serviços institucionais.

Background In 1994, the region of Emilia-Romagna recognized the importance of citizensÕ participation in the regional health-care system and recommended the institution of Mixed Advisory Committees in the health districts and hospitals with the objective of monitoring and assessing health-care quality from the usersÕ perspective.

Resumo Este artigo apresenta resultados de estudo sobre conselhos locais de saúde, ressaltando suas modalidades de atuação e as dificuldades enfrentadas em sua defesa e na promoção dos direitos dos usuários. Trata-se de estudo de caso, de abordagem qualitativa, sobre dois conselhos locais da cidade de Ribeirão Preto (SP), com utilização de entrevistas semiestruturadas, observação direta e análise de atas. Identificaram-se três categorias temáticas: invisibilidade dos conselhos; desconhecimento, descrença e dependência nos órgãos competentes; e alternativas para sair do anonimato. A baixa divulgação das reuniões, funções e atividades dos conselhos locais de saúde colaboram para a produção de sua invisibilidade. A sociologia das ausências auxiliou na compreensão de como as monoculturas hegemônicas podem reforçar essa invisibilidade. O ponto a ser ressaltado neste estudo diz respeito às alternativas apontadas pelos próprios conselheiros para se tornarem “visíveis” e fomentarem uma maior participação social, como: a capacitação de conselheiros e profissionais de saúde; maior interação com o Conselho Municipal de Saúde; maior divulgação das ações e realizações dos conselhos locais; e a criação de mecanismos que facilitem a identificação dos conselheiros.

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The themes of citizen participation and citizenship have assumed great relevance in public policy in most countries of the world. In this article, after briefly summarizing the main stages of development of the concept of citizenship, the prominence of social participation as a practice of citizenship will be depicted. Next, the potential and limits of deliberative approaches established to promote new strategies of citizens' participation in health will be analyzed. The paper will then focus on critical aspects that contribute to reducing or hindering the exercise of citizenship rights, including: the issue of representation underpinning the citizen participation methods; the issue of the influence of participatory devices in decision-making processes; and the limited experience and interest in assessing the effectiveness of citizen participation in the health sector.

a b s t r a c tParticipation has featured in political agendas in recent decades and the domain of healthcare has not been indifferent to its appeal. Although emerging later than in other European regions, the involvement of civil society in healthcare decision-making procedures has proved one of the biggest challenges facing Southern European health systems. The health systems of the countries considered in this analysis e Italy, Portugal and Spain e underwent reforms that brought citizen participation to the forefront of the health system. Through national laws or health plans, each of these countries has recognised the need to promote participation in order to 'give a voice' to citizens in the health sector. Accordingly, a range of significant activities have been implemented in the region, although they have been developed unequally within national territories, at different paces and involving the mobilisation of different actors. This article focuses on the most relevant experiences of citizen participation designed and implemented in the three selected countries, describing their key features and potential, as well as the main critical issues and contradictions that have emerged over time. Particular emphasis is given to the impact of the current financial crisis on Southern European national health systems, especially in terms of participatory methods, the way in which citizen participation is progressing and civil society's reaction to these important changes.