Estudo do trabalho e do trabalhar no Núcleo de Apoio à Saúde da Família

Abstract

OBJECTIVE:To understand the organization of and the working conditions in family health care support centers, as well as subjective experiences related to work in two of these centers. METHODS:This was a case study carried out during 2011 and 2012 in two family health care support centers in Sao Paulo, Southeastern Brazil. Data were collected and analyzed using two theoretical-methodological references from ergonomics and work psychodynamics influenced, respectively, by ergonomic work analysis, developed based on open observations of a variety of tasks and on interviews and in practice in work psychodynamics, carried out using think tanks about the work. RESULTS:The work of the Family Health Care Support Centers in question is constituted on the bases of complex, diversified actions to be shared among the various professionals and teams involved. Innovative technological tools, which are not often adopted by primary health care professionals, are used and the parameters and productivity measures do not encompass the specificity and the complexity of the work performed. These situations require constant organizational rearrangement, especially between the Family Health Care Support Centers and the Family Health Care Teams, causing difficulties in carrying out the work as well as in constituting the identity of the professionals studied.

Physical therapists role in Family Health Support Center

“…Resources and materials were also presented as some of the difficulties in carrying out the work, and they reported to use their personal materials and resources in services (22). This fact differs from the National Primary Care Policy (18) on the proposal that the Municipal Health Department is responsible for resources required for the development of minimum activities described in the scope of FHSC actions.…”

“…Another significant difficulties are the restricted quantitative view of care. While it is expected to carry out about 400 monthly visits by the FHT physicians; the FHSC prioritizes collective qualitative actions (22).…”

“…The limitation network services in many of health care levels are an obstacle to solve problems in primary care (22). Thus, there are obstacles to the role of the physical therapist in FHSC, and essential changes occur both in the organization of services and in the behaviour of health professionals conducts (5).…”

Práticas de saúde e modelo de atenção no âmbito do Núcleo de Apoio à Saúde da Família em Salvador (BA)

“…Os problemas na relação com as EqSF persistem, em menor grau, ainda hoje em algumas realidades locais, e estão diretamente ligados ao fato de o Nasf não aceitar suprir a demanda de atendimentos clínicos ambulatoriais solicitada pelas EqSF, o que também foi constatado por Lancman et al (2013). As concessões feitas de modo a lidar com os tensionamentos iniciais e construir algum vínculo com as EqSF acabaram por tornar esta prática central no trabalho, o que precisa ser revisto.…”

Núcleos de apoio à saúde da família e o cuidado da saúde da pessoa com deficiência

“…Contrapondo-se a lógica predominante de encaminhamentos fundamentados exclusivamente em procedimentos de referência e contrarreferência, o NASF compõe as Redes de Atenção promovendo o cuidado integral, ampliado e continuado 16,17,20 . A complexidade do cuidado em determinados casos relatados pelas equipes, pressupõe a interligação da rede em seus diversos pontos de atenção, sem perder a coordenação da referência de responsabilidade da EqSF na atenção primária.…”