La integralidad desde la perspectiva del cuidado en salud: una experiencia del Sistema Único de Salud en Brasil

Abstract

Starting with a discussion of the biomedical model and its implications in the shaping of healthcare professionals and health practices, this article analyzes the concept of integrality as associated with the Unified Health System (SUS) [Sistema Único de Salud] in Brazil. Particular attention is paid to the disputes regarding the meaning of integrality and the ways of putting the concept into practice in everyday health care work. Based in a research study conducted at the national level, the authors suggest two aspects crucial to fostering integrality: an ethical-political project founded in the recognition that other people's lives are worthwhile and enriching; as well as the existence of additional spaces conducive to discovering diverse ways of producing life, in which integrality in health care is also possible and powerful. The authors affirm the relevance of this process as a contribution to the continual construction of the SUS in Brazil.

Use of health technology in primary health care in approach to hypertension / Uso das tecnologias em saúde na atenção básica às pessoas em condições de hipertensão arterial sistêmica

“…21 This work process reveals a relationship where the disciplinary power 22 operates defining spaces, relationships and where scientific knowledge and professional decision are sovereign, reducing drastically and dramatically the possibility of user participation in the design of their therapeutic plan. 14 A study conducted in a city of Bahia has also identified the high consumption of light-hard and hard technologies practices in attention to hypertensive patients and noted a certain weakness of PHC professionals in performing sensitive listening to the person with hypertension, giving voice to their demands and needs, a result that, for authors 5 , continues as one of the main challenges to change care practices for hypertension: focus care on the user and not on procedures. 14 The organization of "live in action" work is directly influenced by micropolitics 10-1 issues and it is necessary that health professionals identify new senses in care production, taking light technologies as guides for the use of light-hard and hard technologies.…”

“…28 A study corroborates the results of this research showing that the main issues discussed in educational groups are: 1) drug treatment, 2) physical activity and 3) the pathophysiology of hypertension and diabetes, disregarding psychospiritual factors and knowledge sharing between participants, revealing that the minority uses interactionists methods that allow greater involvement of users and stimulate their selfcare. 29 This shows that health education is carried out in a prescriptive way, "disguised as care", with poor solutions across the health needs as it requires, as a doctrine, life habits that should be adopted by the user 14 as shown in quoted saying: "soft water in hard rock both hits until it sticks" (I1).…”

Del dicho al hecho: el derecho a la salud en Río Negro, Argentina

“…De ahí que sea importante destacar el potencial creativo del trabajo de atención primaria, cuando los equipos de salud logran despegarse de "menúes de productos y servicios que se ofrecen a través de acciones programáticas" que actúan como corsets que definen problemas y formas de atención al tiempo que invisibilizan y desatienden a quienes no se ajustan a dichas definiciones" 14 . El trabajo interdisciplinario, la implementación de colores en las historias clínicas, la forma de circular por el CS, el trabajo en distintos grupos sostenidos a lo largo de años, el "animarse" a cuidar y a su vez "correrse" reconociendo los saberes que los propios pacientes tienen y pueden transmitir a otros, así como también la articulación en niveles de atención siguiendo una lógica inversa, a partir de rutinizar que el segundo nivel de atención vaya al primero constituyen ejemplos de prácticas que han construido espacios de libertad en los cuales algunas dimensiones del derecho a la salud se efectivizan, a partir de la construcción de nuevas institucionalidades en y desde el territorio 15 .…”

Percepção de familiares de crianças e adolescentes com alteração de linguagem utilizando a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF-CJ)

“…Today, the emergence of new discourses in health care is seen from a perspective of thorough care and health promotion (1,2) . This study turns its focus on the health of children and adolescents with language impairments, from the perspective of their family members.…”