O olhar do profissional em formação sobre a atenção domiciliar
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Data
2023-02-16
Autores
Souza, Ana Carolina de
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Universidade Estadual Paulista (Unesp)
Resumo
A Atenção Domiciliar (AD) na perspectiva do Sistema Único de Saúde, vem se destacando como uma importante estratégia frente às mais diversificadas necessidades de saúde demandadas pela população brasileira. Suas ações emergem dos preceitos da Clínica Ampliada e se fortalecem através da atuação interprofissional. A visita domiciliar compõe a AD. No contexto da Atenção Primária à Saúde (APS), a visita domiciliar possibilita a aproximação entre a unidade de saúde e o território. Este estudo tomou como campo a AD dentro de uma unidade básica de saúde o Centro de Saúde Escola (CSE) e teve como objetivos: analisar uma experiência de formação profissional em AD no cenário da APS, conhecer a percepção dos profissionais em formação da área da saúde sobre a prática da AD; descrever o processo de trabalho do grupo de atenção domiciliar e o processo de elaboração de um instrumento interprofissional no campo da AD. Esta pesquisa se caracteriza como um estudo de caso e de caráter exploratório utilizando-se da metodologia qualitativa. Foram entrevistados 24 profissionais residentes e especializandos inseridos no grupo de AD no CSE. As entrevistas foram gravadas e transcritas, tiveram duração média de 40-60 minutos. A produção e análise dos dados ocorreu em três momentos: Descrição densa do grupo de AD, com apresentação da história de sua implementação, atividades desenvolvidas, composição da equipe e processo de trabalho, estes dados foram resgatados do Trabalho de Conclusão de Residência e do diário de campo da pesquisadora, a partir do registro etnográfico e observações das práticas do grupo. Caracterização das situações acompanhadas pelo grupo. Conhecimento da percepção dos profissionais sobre a AD através da entrevista semiestruturada. As entrevistas foram analisadas com base no referencial teórico e da análise temática do conteúdo. O conjunto do material produzido possibilitou a definição de três grandes eixos temáticos: o percurso até aqui; conhecendo a prática da atenção domiciliar e o papel do grupo na minha formação. Essa investigação permitiu reconhecer as potencialidades e contribuições do grupo de atenção domiciliar na formação profissional dos residentes e especializandos, em um contexto fragilizado pela pandemia de Covid-19. A pesquisa também nos trouxe o conhecimento das lacunas existentes no processo de formação na área da saúde. A experiência com visita domiciliar, o trabalho interprofissional, o desenvolvimento do Projeto Terapêutico Singular e as discussões de caso foram vivenciadas pela maioria dos entrevistados durante a pós-graduação, sobretudo, no grupo de atenção domiciliar. A ideia ao descrever as atividades do grupo e toda sua história, significa trazer esta experiência como referência de prática colaborativa para outros serviços que busquem a AD na perspectiva da APS. A apropriação dos conceitos que permeiam a prática da atenção domiciliar foi alcançada durante as atividades do grupo. Foi possível identificar a evolução destes profissionais do início ao fim do seu ciclo. Percebemos a importância do contato com o instrumento interprofissional e o seu papel norteador no contexto domiciliar, A prática interprofissional possibilitou o compartilhamento dos saberes, aproximando o profissional do seu núcleo e dos demais campos de atuação. Pode-se concluir, que a relevância do grupo se estende para além das contribuições no processo de formação profissional na saúde, contemplando os demais atores envolvidos, sobretudo os usuários, o serviço, e os profissionais da unidade.
Home Care (HC) from the perspective of the Unified Health System, has been highlighted as an important strategy in face of the most diverse health needs demanded by the Brazilian population. Its actions emerge from the precepts of the Expanded Clinic and are strengthened through interprofessional action. Home visits make up home care. In the context of Primary Health Care (PHC), home visits make it possible to bring the health unit closer to the territory. This study focuses on home care within a basic health unit, the Centro de Saúde Escola (CSE). This works aims to analyze an experience of professional training in home care in the PHC scenario, to know the perception of professionals in training in the health area about the practice of HC; to describe the work process of the home care group and the process of creating an interprofessional instrument in the field of HC. This research is a case study and exploratory in field using qualitative methodology. A total of 24 resident professionals and specialists included in HC group were interviewed. The interviews were recorded and transcribed, with an average duration of 40-60 minutes. Data production and analysis took place in three moments: Dense description of the home care group with presentation of the history of its implementation, activities developed, team composition and work process, these data were rescued from the Residency Completion Work and from the diary from the researcher's fieldwork, based on the ethnographic record and observations of the group's practices. Characterization of the situations monitored by the group. Knowledge of the professionals' perception of home care through semi-structured interviews. The interviews were analyzed based on the theoretical framework and thematic content analysis and define three major thematic axes: the journey up to here; knowing the practice of HC and the role of the group in my training. This investigation made it possible to recognize the potential and contributions of the home care group in the professional training of residents and specialization students, in a context weakened by the Covid-19 pandemic. The research also brought us knowledge of the existing gaps in the training process in the health area. The experience with home visits, interprofessional work, the development of the Singular Therapeutic Project and case discussions were experienced by most of the interviewees during postgraduate studies, especially in the home care group. The idea, when describing the group's activities and its entire history, means bringing this experience as a reference for collaborative practice for other services that seek home care from the PHC perspective. The appropriation of the concepts that permeate the practice of home care was achieved during the group's activities. It was possible to identify the evolution of these professionals from the beginning to the end of their cycle. We realized the importance of contact with the interprofessional instrument and its guiding role in the home context. The interprofessional practice enabled the sharing of knowledge, bringing professionals closer to their core and other fields of activity. It can be concluded that the relevance of the group extends beyond the contributions in the process of professional training in health, contemplating the other actors involved, especially the users, the service, and the professionals of the unit.
Home Care (HC) from the perspective of the Unified Health System, has been highlighted as an important strategy in face of the most diverse health needs demanded by the Brazilian population. Its actions emerge from the precepts of the Expanded Clinic and are strengthened through interprofessional action. Home visits make up home care. In the context of Primary Health Care (PHC), home visits make it possible to bring the health unit closer to the territory. This study focuses on home care within a basic health unit, the Centro de Saúde Escola (CSE). This works aims to analyze an experience of professional training in home care in the PHC scenario, to know the perception of professionals in training in the health area about the practice of HC; to describe the work process of the home care group and the process of creating an interprofessional instrument in the field of HC. This research is a case study and exploratory in field using qualitative methodology. A total of 24 resident professionals and specialists included in HC group were interviewed. The interviews were recorded and transcribed, with an average duration of 40-60 minutes. Data production and analysis took place in three moments: Dense description of the home care group with presentation of the history of its implementation, activities developed, team composition and work process, these data were rescued from the Residency Completion Work and from the diary from the researcher's fieldwork, based on the ethnographic record and observations of the group's practices. Characterization of the situations monitored by the group. Knowledge of the professionals' perception of home care through semi-structured interviews. The interviews were analyzed based on the theoretical framework and thematic content analysis and define three major thematic axes: the journey up to here; knowing the practice of HC and the role of the group in my training. This investigation made it possible to recognize the potential and contributions of the home care group in the professional training of residents and specialization students, in a context weakened by the Covid-19 pandemic. The research also brought us knowledge of the existing gaps in the training process in the health area. The experience with home visits, interprofessional work, the development of the Singular Therapeutic Project and case discussions were experienced by most of the interviewees during postgraduate studies, especially in the home care group. The idea, when describing the group's activities and its entire history, means bringing this experience as a reference for collaborative practice for other services that seek home care from the PHC perspective. The appropriation of the concepts that permeate the practice of home care was achieved during the group's activities. It was possible to identify the evolution of these professionals from the beginning to the end of their cycle. We realized the importance of contact with the interprofessional instrument and its guiding role in the home context. The interprofessional practice enabled the sharing of knowledge, bringing professionals closer to their core and other fields of activity. It can be concluded that the relevance of the group extends beyond the contributions in the process of professional training in health, contemplating the other actors involved, especially the users, the service, and the professionals of the unit.
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Palavras-chave
Atenção Primária à Saúde, Assistência Domiciliar, Educação Interprofissional, Equipe de Assistência ao Paciente.