A ação humana como determinante para a efetividade dos tratamentos de saúde

Abstract

Human action as a determinant for the effectiveness of treatment in healthcare This edition deals with a fundamental topic for health services and care, namely the 'soft technologies'. From a systematic standpoint, technologies are targeted human actions: tools and resources developed by societies to resolve their problems and promote welfare, though they can also be used to oppress or dominate. Being human creations, these technologies assume the direction and orientation that the individuals and societies give them. In both the positive and negative sense, there are the so-called 'hard' technologies that correspond to products, materials, artifacts and instruments; and the so-called 'soft technologies' that can be defined as practices involving relations, communication, promotion, support, management and evaluation that are discussed, tried and assessed, incorporating experiences and advances in scientific knowledge in the social and human sciences. In any society, the scientific and technological systems-taken as a whole-form an extensive network of material, cultural and symbolic objects. In the case of the health sector, heavily inundated with chemical and biological machinery and products, the soft technologies are especially fundamental in two senses: (1) to mediate artifacts of all kinds which stand between the healthcare professional and the patient in a humane way, and (2) to make healthcare more efficient, efficacious and effective. Although for handling of equipment and products and the care given by professionals, the logic of the system requires the presence of technically qualified people, the incorporation of soft technologies and enhancement thereof are undervalued in comparison with the value attributed to machines. The lack of attention given to soft technologies is due to the accumulation of added value-which is nothing more than objective human labor subsumed in the goods-in the medical-hospital complex: this is one of the most dynamic economic sectors worldwide. Its imposing presence and ability to generate wealth blind both the system and society per se with respect to the indisputable and indispensable role of human and relationship participation in healthcare dissemination. Indeed, best practices are always demanded, especially by the population, but they are generally represented as an attribute of a more or less sensitive individual, and far less as a field for technological development. In this thematic issue, it is understood that soft technologies, albeit less visible, are essential for the management of artifacts and products and for going far beyond what machines can do. Therefore, it is argued that one should never consider the sphere of mechanical, electronic, chemical and biological technologies separately from those which ensure the effectiveness of planning, management, doctorpatient relations, reception and evaluation, among others. Readers will find various approaches to the topic in question in this issue. In addition to the debate article written by Gastão Wagner, which ad...

Avaliação de efetividade da atenção domiciliar de uma cooperativa médica de Belo Horizonte, Minas Gerais, Brasil

“…Minayo 21,22 , ao analisar os desafios colocados para o setor saúde diante do vertiginoso crescimento da população idosa, que requer elevados recursos financeiros e cuidados humanos, destaca a baixa valorização das tecnologias leves em saúde, como os cuidados oferecidos por profissionais tecnicamente preparados. A utilização de outra tecnologia leve, como o aumento da cobertura das equipes de saúde da família do Sistema Único de Saúde (SUS), esteve associada à diminuição das internações por condições sensíveis à atenção primária dos idosos 23 .…”

Significados psicológicos atribuídos por pacientes com câncer de cabeça e pescoço ao processo de adoecimento e tratamento durante a radioterapia

“…Optamos pela amostragem intencional e sequencial, ou seja, o pesquisador principal buscou por pacientes que cumpriam os critérios de inclusão e os convidou sequencialmente para a realização de entrevistas qualitativas. Não houve necessidade de cálculo amostral para representatividade em relação à população total, pois tal procedimento não dá suporte ao desenho metodológico utilizado nessa pesquisa (141,(150)(151)(152).…”

“…A intencionalidade na construção amostral é eficaz e coerente com o MPCQ. Não ambicionamos generalizações a priori, mas explorar em profundidade vivências e significados atribuídos na perspectiva da singularidade dos sujeitos, de modo a favorecer um maior acesso aos conteúdos expressos em fala ou outros recursos de comunicação, o que pode ser de grande valia para subsidiar verificações a posteriori (141,150,151,153,154).…”