Percepções dos profissionais de saúde da atenção primária sobre qualidade no processo de trabalho

Abstract

This article describes the cores of social significance identified in the speeches of primary healthcare professionals regarding the quality of the actions performed. This is a case study carried out in two services organized according to different models: a "traditional" unit, with community agents, and one for family healthcare. The interviews and observations are analyzed based on the framework proposed by Vigotsky, dialogically with the literature on the working processes in health care. The results point as the main cores of quality in basic care: reception as interaction between professional and user of the Brazilian National Health System (SUS); diversity of multi-professional and intersectoral offers; community agents as a link between healthcare team and community; and teamwork and democratic management. Even though these aspects are socially understood as cores for quality in primary health care among professionals, there are tensions and contradictions between the legitimized and the instituted as practices.

Vivências Singulares De Profissionais De Saúde Na Rede E Apoio Social À Criança Com Paralisia Cerebral

“…No processo de trabalho em saúde, os sujeitos da ação (os profissionais de saúde) configuram-se como agentes responsáveis pela integração em ato dos elementos constituintes desse processo, intermediando as relações entre os instrumentos e os sujeitosobjetos da intervenção e assim realizando um projeto que é mediado pela intersubjetividade dos sujeitos envolvidos (25) .…”

“…Ainda segundo os mesmos autores, acolhimento como interação profissional e usuário é um atributo de qualidade no cuidado em saúde, mas sua execução no sistema é limitada em função da falta de compreensão dos usuários e da elevada demanda por consultas médicas, não favorecendo o processo de trabalho da equipe multiprofissional (25) .…”

Integralidade na Atenção Primária: análise do discurso acerca da organização da oferta do teste rápido anti-HIV

“…Thus, the waiting room constitutes an optimizing space for users to report their daily experiences, reflect on the health-disease process and be sensitized to perform anti-HIV testing. 24 The active search present in G12's discourse alludes to patients seeking unity, that is, spontaneous demand, in which the textual mark is sharpened in the discourse constructed by the memory of the senses "[...]the day is scheduled and, sometimes, also spontaneous demand, is offered in those units which are references [...]". This organizational arrangement refers to the unscheduled service, since it only contemplates momentary needs, referring to a work process focused on biomedical assistance, whose interventions are only carried out when the user seeks the health unit.…”

Nutritionists and the comprehensive care of overweight individuals in primary care

“…The way the team relates -criticism, professional devaluation, low management commitment -, and the resources available to perform work impact how the professional will act. A study on the perception of primary healthcare professionals in a municipality of São Paulo on the organization of teamwork shows that, despite efforts to seek the logic of comprehensiveness, biomedical care is still predominantly focused on clinical diagnosis and treatment, medication, difficulty in organic integration of some professionals in the team and individualization of performance of different professionals, which shows a distance between "desirable" practice and what is effectively in practice [31].…”