The primary healthcare articulators practice: communication and healthcare model change.

Author(s)

Giovanna Cabral Doricci

• Document type: Master's Dissertation
• Press: Ribeirão Preto.
• Institution: Universidade de São Paulo (USP). Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto (PCARP/BC)
• Defense date: 2014-12-16

Examining board members

Carla Guanaes Lorenzi; Sueli Terezinha Ferrero Martin; Maria José Bistafa Pereira

• Advisor: Carla Guanaes Lorenzi

Abstract

The Articulators of Primary Healthcare Program, an initiative by the Health State Secretary of São Paulo (SES-SP), aims to support the qualification process of Primary Healthcare in the state area, and to offer technical support to the municipalities in the reorientation of the healthcare model. The Program established a new professional function the articulator of primary healthcare. Communication and negotiation abilities are highlighted as requirements for the carrying out of this function. This study was designed because of the scarcity of information about this Program on scientific literature and because of a lack of clarity regarding the role that these professionals play in practice. The study aims to understand and to analyze how articulators of primary healthcare signify their professional work. We seek, at the same time, to offer contributions from Psychology about the communication process and its relations to this new proposal. Thirteen articulators participated in this study. They work in four Regional Departments of Health (DRS) that compound the Healthcare Network number XIII of the state of São Paulo (Ribeirão Preto, Araraquara, Franca and Barretos DRS). Individual and semi structured interviews were audio recorded and later fully transcribed. The analysis of the research corpus is a qualitative design, theoretically supported by the contributions of the social constructionist movement in Psychology. The analysis was carried out in the following stages: 1st) interview transcription; 2nd) deep reading of the transcripts; 3rd) thematic organization and meaning making. The results are presented in two moments. In the first moment, we analyze the articulators practice from two themes: a) Implementation of the Program; and b) The articulators practice. In the second moment we present the analysis of the communication process that is part of this practice. This moment is divided in three main themes: a) What they do, a theme that describes their activities; b) How they do it, a theme that analyzes the communication involved from the standpoint of two models of communication (transmissional and social constructionist); and c) Reflections about the changes in the healthcare model and the primary healthcare articulators practice. In general, we concluded that the Articulators Program has a great potential to promote positive changes that make the transformation of the healthcare model possible, at the same time that it takes into consideration the local reality. However, in practice, the work of the professionals is still found under construction, coming back and forth between the roles of informant and change maker. The ways how the professionals understand their practices and how they communicate with each other design their objectives and the results their work bring about. In describing the main theoretical and technical resources required by this professional function, we expect to contribute to the understanding of the practice of the articulators of primary, as well as to contribute to the participation of Psychology in the field of health policies. (FAPESP, grant number 2012/17264-8). (AU)

• FAPESP's process: 12/17264-8 - Meanings constructed by Primary Care Articulators about their professional practice
• Grantee: Giovanna Cabral Doricci
• Support Opportunities: Scholarships in Brazil - Master