Conhecimento clínico do enfermeiro na atenção primária à saúde: aplicação de uma matriz filosófica de análise

Abstract

RESUMO:Neste estudo analisa-se a constituição do conhecimento clínico que orienta a prática do enfermeiro, na Atenção Primária à Saúde, para operar no objeto/sujeito da ação. Estudo exploratório com abordagem qualitativa e análise temática dos dados. Foram realizadas entrevistas semi-estruturadas com 65 enfermeiros da rede pública de saúde da família, no extremo sul do Rio Grande do Sul, Brasil. Os dados foram analisados a partir de uma matriz que sustenta a ciência clínica da enfermagem em uma base populacional, constituída por três núcleos -o indivíduo e a família, a comunidade e o sistema de saúde. Evidenciou-se que o conhecimento clínico organiza a prática do enfermeiro com o foco predominante no indivíduo e na família. Sem, contudo, subsumir à sua raiz de origema base populacional, por meio da forma como o conhecimento clínico faz apreender/conhecer o objeto da ação. Acredita-se que tais achados possam subsidiar uma releitura do potencial organizativo do conhecimento clínico da enfermagem. DESCRITORES:Atenção primária à saúde. Serviços de saúde. Enfermagem em saúde pública. NURSE CLINICAL KNOWLEDGE IN THE HEALTH PRIMARY ATTENTION: APPLICATION OF AN ANALYSIS PHILOSOPHICAL MATRIXABSTRACT: In the present study, the constitution of the clinical knowledge which guides the nurse practice, in the health primary attention, is analyzed, in order to use it on the object / subject of the action. Exploratory study with qualitative approach and thematic analysi of data. Semi-structured interviews were made with 65 nurses from the family health public services, in te southern part of Rio Grande do Sul state, Brazil. The data was analyzed based on a matrix which sustains the nursing clinical science in a populational basis, constituted by three topics -the individual and the family, the community and the health system. It was made clear that the clinical knowledge organizes the nurse practice in the predominant focus of the individual and the family. Without, however, connecting to the origin -the populational base, through the way the clinical knowledge enables learning/knowing the object of the action. It is believed that these findings may subsidize a new reading of the organizational potential of the nursing clinical knowledge. DESCRIPTORS:Primary health care. Health services. Public health nursing. EL CONOCIMIENTO CLÍNICO DEL ENFERMERO EN LA ATENCIÓN PRIMARIA DE LA SALUD: APLICACIÓN DE UNA MATRIZ DE ANÁLISIS FILOSÓFICORESUMEN: En este estudio se analiza la constitución del conocimiento clínico que guía la práctica del enfermero en la Atención Primaria de la Salud, para el funcionamiento del objeto/sujeto de la acción. Es un estudio exploratorio con enfoque cualitativo y análisis temático de los datos. Se realizaron entrevistas semiestructuradas con 65 enfermeros del área de salud pública familiar, en el sur de Rio Grande do Sul, Brasil. Los datos fueron analizados utilizando una matriz que se apoya en la ciencia clínica de la enfermería con base en la población, constituída por tres núcleos: el individuo y la familia...

The purpose of the communication process of group activities in the Family Health Strategy

“…Nevertheless, the education constructed by the connection between workers and patients in the FHS is a method to grasp the cultural and social differences of individuals and their families. Nurses can use such differences to acquire knowledge and skills to better deal and cure diseases in the community (17) .…”

“…The organization of actions within Family Health is focused on the individual and the family, designed to prevent disease and also alleviate the suffering related to them while coping with a disease situation (17) . The work process is conditioned by the production of material conditions and health needs of the subjects of action, bringing together the needs and capabilities of those who seek through their work to satisfy the patients' needs.…”

“…In this context, the authors identify the capacity of triggering individual or collective reflections as the purpose of the work process from the perception of nurses and physicians (17) .…”

Desafios para a enfermagem no alcance das metas da atenção primária

“…When the family is the subject of the practical action it is related to the physical environment (housing) and with a focus on helping the individual (family member) that requires care (15) . Faced with individuals in society, the collective face of these individuals and its insertion in the social space are demonstrated.…”

“…Thus, by the successive approximations with the social, nurses incorporate into their practice the need to include the collective face, or at least to accept it in their care processes. In this context, in the pursuit of their professional practice nurses become the conflictions representative of the clinical knowledge as they are capable of organizing clinical knowledge and relate it to the social needs triggered by the epidemiological profile, even being those limited to the public policies (15) .…”