ELEMENTOS SOCIOAMBIENTAIS CONSTITUTIVOS DO ACOLHIMENTO NO PROCESSO DE TRABALHO EM SAÚDE DA FAMÍLIA / Social-Environmental Elements of Embracement in the Family Health Work Process

AUTOR(ES)
DATA DE PUBLICAÇÃO

2005

RESUMO

The objective of the present study is to identify the social-environmental elements that comprise embracement in the work process of the Family Health staff, in southern Rio Grande do Sul state. The understanding of social-environmental elements was conduted based on Leffs environmental rationality (1993, 2001), constituted of four rationality spheres: substantive; theoretical; instrumental; and cultural. In this approach, environmental rationality is understood as an organized way to define new values and meanings for the health production process. Used as a conceptual tool, it has provided the identification of elements present in embracement. The main theoretical tools encompass topics such as embracement, seeing such concept through the work process; the family health program, as a public policy for reorganizing health actions; and the work process of the family health strategy, allowing for the collective context of the health work to be characterized. The study group was formed through selection criteria considering: time of work in the program; populational coverage; town location relative to the city where the regional district office is located; and the health management form according to NOAS/2002. Data were collected through semi-structured interview. Twenty-seven participants were interviewed, family-health personnel (physicians, nurses, nursing assistants and community health agents) in seven towns from the Third State Health District/RS. Through a dialectic-based, qualitative analysis proposal, it was possible to visualize the work process of the family health staff and to identify the main social-environmental elements present in the process. Two analysis categories were used, the work process in the Family Health Program and the Constitutive Elements of Embracement in the family health strategy. In the first category, the actions developed by each professional category were identified by the work subjects, highlighting individual, collective, and management activities. As instruments used, extended clinic, household visitation, and health education were highlighted, in order for the subject/collective of the produced action to be apprehend. Through the staffs work, it was possible to identify staff interdisciplinarity and interaction as instruments, allowing for a collective work to be developed, which emerged as an effective construction, in a relationship of approximation and commitment that takes place through embracement and bonding. Three social-environmental elements were identified as constituting embracement in the work process of the staff: popular participation, constituted by the cultural rationality promoting staff/community approximation; work process management; and co-accountability towards instrumental rationality, developing essential instruments (planning, referral and counter-referral, and intersectoriality) for the continuity and integrality of care; and bonding, as a social-environmental element related to theoretical rationality, which emerges as a new value, based on new practices and meanings for the work process. It may thus be concluded that embracement has been characterized as an instrumental process that provides the guiding of health actions, contemplating the principles of the Unified Health System (SUS), and effectively contributing to the consolidation of the Health Family Program.

ASSUNTO(S)

saúde pública saúde da família serviços básicos de saúde ambiente acolhimento enfermagem public health family health basic health services environment embracement

ACESSO AO ARTIGO

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