A prática da integralidade em modelos assistenciais distintos: estudo de caso a partir da saúde da criança

Abstract

RESUMO:Avaliou-se a prática da integralidade, a partir da saúde da criança. Estudo de caso exploratóriodescritivo (natureza transversal, abordagem quantitativa) que foi desenvolvido em duas unidades de saúde: uma, cujo eixo estruturante da assistência era o Programa de Saúde da Família e outra que organizava a assistência no modelo tradicional. Os dados foram levantados por entrevista com pais/responsáveis pelas crianças (n=195) e analisados com teste qui-quadrado e t-student. Constatou-se que o acesso era difícil em ambas às unidades, com média de 2-3 idas ao serviço para marcação de consulta. Acesso a medicamento e o sistema de referência/contra-referência foi mais bem garantido na unidade de saúde da família. O princípio da integralidade não se mostrou incorporado, mesmo na unidade de saúde da família. Assim, ainda permanecem como desafios, a busca de modelos assistenciais que contemplem o acesso aos serviços de saúde e a integralidade da atenção. ABSTRACT:The practice of integrality was analyzed, parting from children's health. This exploratorydescriptive case study (cross sectional study, quantitative approach) was developed in two public health care units: one unit had the Family Health Program as its basis for health care, and the other unit organized assistance within the traditional health care model. The data was obtained by home interviews with children's parents/responsible (n=195) and statistical analysis was performed using chi-square and t-student tests. The results show that access was difficult in both public health care units, with an average of 2-3 visits to the health care service to schedule a consultation. Access to medicine and the reference system were better in the unit with Family Health Program. We verified that the principle of integrality wasn't incorporated, even in the unit with Family Health Program. So, the search for care models that contemplate access to the health care system, as well the practice of integrality remain as challenges. RESUMEN:En esta investigación se evaluó la práctica de la integralidad a partir de la salud del niño. Es un estudio de caso exploratorio-descriptivo (de naturaleza transversal, con abordaje cuantitativo), desarrollado en dos unidades de salud: una cuyo eje estructural era el Programa Salud de la Familia, y, otra, que organizaba la asistencia según el modelo tradicional. Los datos fueron recolectados mediante entrevistas con padres/responsables por los niños (n=195), y analizados con el teste qui-cuadrado y t-student. El acceso en las dos unidades era difícil, con un promedio de 2 a 3 idas al servicio para pedir consulta. El acceso a los medicamentos y el sistema de referencia/contra-referencia fue mejor garantizado en la unidad de salud de la familia. El principio de la integralidad no se mostró incorporado, ni mismo en la unidad de salud de la familia. Siendo así, aún permanecen como desafíos, la búsqueda de modelos asistenciales que incorporen el acceso a los servicios de salud y la práctica de la integralidad.

Vulnerabilidade da criança diante de situações adversas ao seu desenvolvimento: proposta de matriz analítica

“…It is the implementation of structural strategies in healthcare systems, which aim to redirect the model of health care and establish a new dynamic in the organization of health services and actions (7,10) . Policy guidelines formed in health programs arouse important questions about health needs, vulnerabilities, citizenship and human rights (27) .…”

“…The political-programmatic implementation is guided by the structure of programs for the care and protection of maternal and child health (18,(26)(27)(28) , the ability of services to provide comprehensive care (10) with equity of actions (10) , multi and interdisciplinary actions (10) , technoscientific capacity (30) , as well as commitment and responsibility of the professionals (10) .…”

“…As vulnerability in child development is complex and influenced by adverse multidimensional situations, the interventions for its reduction should combine multi and interdisciplinary approaches and different theoreticalmethodological contributions (4,8,10) .…”

“…These instruments are considered care technologies (9) , because they systematize knowledge that supports the staff in identifying adverse situations to child development, and allow to understand the magnitude of health phenomena, enabling intervention propositions that are more specific and targeted to the condition of each child (6,8) . Thus, the health technology proposed here may contribute to the operationalization of the concept of vulnerability, allowing to overcome the probabilistic model of health diagnosis by a gaze directed to the needs of children and their families (7)(8)10) . Therefore, this paper aims to propose a conceptual matrix to analyze the vulnerability of children in adverse situations to their development.…”

Comprehensiveness in child healthcare teaching in Undergraduate Nursing: perspective of teachers

“…This approach, nonetheless, remains far from being achieved in professional practice due to the fragility and fragmentation of the actions implemented by service network professionals (9)(10)(11)(12) . On the other hand, there is clear evidence that in nursing education, the teaching plans regarding child healthcare include the principle of comprehensiveness (13) .…”