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| Author(s): |
Rafael Luis Castillo Duranza
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | Ribeirão Preto. |
| Institution: | Universidade de São Paulo (USP). Escola de Enfermagem de Ribeirão Preto (PCARP/BC) |
| Defense date: | 2010-05-28 |
| Examining board members: |
Silvana Martins Mishima;
Maria do Carmo Gullaci Guimarães Caccia Bava;
Amaury Lelis Dal Fabbro;
Aldaísa Cassanho Forster;
Maria Lucia Zanetti
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| Advisor: | Silvana Martins Mishima |
| Abstract | |
This study, in the field of collective health, looks at the technological organization in health care. The objective is to analyze and interpret the development of the Primary Health Care (PHC) giving process for adult carriers of Type 2 Diabetes (DM2). DM is an important public health problem with epidemic dimensions in Brazil and the world. The World Health Organization and the Ministry of Health have encouraged the adoption of strategies and policies to develop health care standards for the carriers of DM within a PHC framework. This study is based on the theoretical contributions of organizational services and health systems from a PHC perspective on DM as a Chronic Condition, and the role of work in health. The research was conducted at the Family Health Center in the municipality of Ribeirao Preto SP. Data was collected from January, 2007 until April, 2008. A qualitative methodology was used with different techniques for obtaining empirical evidence: participant observation; semi-structured interviews; individual clinical histories; official information systems from the Ministry of Health, seeking to deepen the analysis/interpretation of a health care process that involves a group of technologies (hard, soft/hard and soft). In the analysis of the empirical evidence three themes were identified: The municipal health policies for Basic Medical Attention, The Program of Chronic Degenerative DiseasesDiabetes, and the health care provided to the diabetic in the Nucleus of Family Health (NFH). Among the main results we find that Basic Attention proposed for the period between 2010-2013 a 50% increase in coverage for the population by the Family Health Strategies (FHS), 100% by the Community Health Agents Strategies (EACS) and 50% by the Dental Health Strategy (ESB); but it has found limitations in relation to contracting human resources and a lack of secure structure in the units. In relation to the program of Chronic and Degenerative DiseasesDiabetes, the mid level technicians considered as a main activity the registration program in SisHIPERDIA, where difficulties persist with a 22.2% of registered carriers of DM in the municipality. The analysis of the health care process with regard to the diabetic in the NFH revealed the importance of the family and administrative group meetings for the working relationship in the unit, the poor methodologies in carrying out of activities for health education, as well as care provided at home and a work process that is still focused on the actions of the physician - fulfilling procedures and health complaints - more than on the needs of the patient. Nevertheless, potential points to follow through were made evident, once the team focuses on the possibility of reflecting and placing in action another logic that is centered on the care process, establishing with it collective decision making spaces, and the creation of ties amongst family and medical staff, keeping in mind the principles and values of a renewed Primary Care. (AU) | |