การวจยเชงคณภาพ เปนเครองมอสำคญอยางหนงสำหรบทำความเขาใจสงคมและพฤตกรรมมนษย การวจยแบบการสรางทฤษฎจากขอมล กเปนหนงในหลายระเบยบวธการวจยเชงคณภาพทกำลงไดรบความสนใจ และเปนทนยมเพมสงขนเรอยๆ จากนกวชาการ และนกวจยในสาขาสงคมศาสตร และศาสตรอนๆ เชน พฤตกรรมศาสตร สงคมวทยา สาธารณสขศาสตร พยาบาลศาสตร จตวทยาสงคม ศกษาศาสตร รฐศาสตร และสารสนเทศศกษา ดงนน หนงสอเรอง “ConstructingGrounded Theory: A Practical Guide through Qualitative Analysis” หรอ “การสรางทฤษฎจากขอมล:แนวทางการปฏบตผานการวเคราะหเชงคณภาพ” จะชวยใหผอานมความรความเขาใจถงพฒนาการของปฏบตการวจยแบบสรางทฤษฎจากขอมล ตลอดจนแนวทาง และกระบวนการปฏบตการวจยอยางเปนระบบ จงเปนหนงสอทควรคาแกการอานโดยเฉพาะนกวจยรนใหม เพอเปนแนวทางในการนำความรความเขาใจไประยกตในงานวจยของตน อกทงนกวจยผเชยวชาญสามารถอานเพอขยายมโนทศนดานวจยใหกวางขวางขน

Constructing Grounded Theory: A Practical Guide through Qualitative Analysis

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O desafio do conhecimento: pesquisa qualitativa em saúde

Analysis and Evaluation of Contemporary Nursing Knowledge: Nursing Models and Theories by Jacqueline Fawcett, PhD, RN, FAAN; Philadelphia: FA. Davis, 2000; 688 pages, $49.95 I have several responses to the argument that nursing models and theories are historical relics that have no place in our future because they have little, if any, relevance for contemporary nursing practice and research. My first response is sadness, that nurses continue to devalue the burgeoning knowledge of our own discipline at a time when our world needs it most. Another reaction is anger, that in applying the theories from other disciplines to our research and practice activities, we are expanding the knowledge base of those disciplines rather than our own. Finally, I am incredulous that the deepening and broadening base of nursing knowledge is not widely known and is not studied as the primary substance of nursing within our educational programs. But now, I have another response: it is to point with pride to Jacqueline Fawcett's comprehensive volume, Analysis and Evaluation of Contemporary Nursing Knowledge, as evidence that these conceptual models and theories are alive and well. Fawcett's latest book is a testimony to the maturity of our discipline that illuminates the growing body of scholarly work related to nursing models and theories. The author reminds us that we must continue this expansion: "This author is convinced that the discipline of nursing can survive and advance only if nurses celebrate their own heritage and acknowledge their own knowledge base by adopting explicit nursing discipline-specific C-T-E (conceptual-theoretical-empirical) systems to guide their activities." Fawcett has been a guardian of nursing's theoretical heritage. She has been a consistent and persistent voice to a professional discipline wandering in the wilderness, calling us to gather around the strength of our disciplinary knowledge as articulated within our conceptual models and theories. This text is a tribute to those who have developed conceptual models and theories, tested and developed them through research, and generated and evaluated nursing theory-guided practice models. Rather than create a fourth edition of Analysis and Evaluation of Conceptual Models of Nursing, first published in 1984, and a second edition of Analysis and Evaluation of Nursing Theories, first published in 1993, Fawcett has combined both volumes into this new book. I applaud this decision. This new text is a valuable resource for undergraduate students learning the breadth of nursing models and theories, master's students building depth in nursing theory-guided advanced practice, and doctoral students expanding nursing knowledge through theory-based research. In addition, it is a reference for nursing scholars working within any of the models and theories and a guide for nursing administrators and practitioners seeking to apply the models and theories to nursing practice as entrepreneurs or within health care systems. This book has four parts. In Part 1, an introduction to the structure and nature of contemporary nursing knowledge, the reader is introduced to theoretical language. Fawcett describes the relationship between her identified nursing metaparadigm, philosophy, conceptual models, grand theories, middle-range theories, and empirical indicators as the C-T-E system, referring to the necessary linkages among the philosophical, theoretical, and operational indicators related to both research and practice. She then focuses on the application of nursing models and theories to nursing practice. In Part 2, Fawcett describes her framework for analyzing and evaluating conceptual models, then applies this framework to seven conceptual models: Johnson's Behavioral System Model, Kings' General Systems Framework, Levine's Conservation Model, Neuman's Systems Model, Orem's Self-Care Framework, Rogers' Science of Unitary Human Beings, and Roy's Adaptation Model. …

Analysis and Evaluation of Contemporary Nursing Knowledge: Nursing Models and Theories

Home visits have become increasingly widespread in Brazil since the emergence of the Family Health Program. The present study deals with users' perceptions of these visits, focusing on comprehensiveness and humanization of care. The study was exploratory and qualitative. Twenty-one interviews were performed with users from the six administrative health districts of Fortaleza, capital of Ceara State, Brazil. Analysis of the interviews revealed the existence of three core themes: (1) health professional-user relationships, i.e. users' perceptions of completeness and humanization of care during visits; (2) characterization of visits, with emphasis on operational aspects; and (3) user-health facility interaction, focusing on integration with other service. This theme was divided into three items: health facility management, equity, and integration of care. In conclusion, the study suggests that home visiting practices can be improved by enhancing the aspects of intersubjectivity, dialogue, and negotiation between health professionals, users, and the community.

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Visita domiciliar no âmbito da Estratégia Saúde da Família: percepções de usuários no Município de Fortaleza, Ceará, Brasil

The variety of existing studies addressing the Family Health Strategy (ESF) and its role in the reorientation of the model of care in the country has motivated the systematization of the advances and limitations described in these studies. Thus, this study, from a review of the scientific production on this theme, analyzed if the ESF has been able to modify the model of care. Forty-one articles from the Scielo database published between 2002 and 2010 that fulfilled the inclusion criteria were analyzed. They were fully analyzed in terms of political-institutional, organizational or technical-care dimensions. The results show that despite the improvement in the work process in primary care, its replacement aspect was not seen in the majority of the studies. Universal expansion of access to the health services, extension of coverage and focus were predominant. The changes are observed when analyzed in light of the demand, with better attendance and connectivity. The most evident limits are in the lack of focus on health needs, as in the territorial issue, community participation and the social determinants addressed in an intersectoral way. Different degrees of the implementation of strategy were identified, though they have not yet resulted in system reorganization at local level.

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A produção científica brasileira sobre a Estratégia Saúde da Família e a mudança no modelo de atenção

A assistencia domiciliar a saude tem sido integrada ao exercicio da Estrategia de Saude da Familia (ESF) como forma de acesso da atuacao profissional em saude a comunidade e ao domicilio, ambiente de vida dos pacientes e familiares. Assim, realizou-se esta pesquisa qualitativa, visando reconhecer como a assistencia domiciliar a saude na ESF e realizada pelos profissionais das equipes. Os dados foram coletados por meio de questionarios aplicados a 8 profissionais de saude atuantes na assistencia domiciliar a saude na ESF. Observou-se que esse tipo de assistencia e reconhecido em sua importância e em suas diferentes dimensoes pelos profissionais, que a exercem de modo a buscar a integracao e continuidade de suas acoes desempenhadas.

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A prática da assistência domiciliar dos profissionais da estratégia de saúde da família

Home health care is increas ing all around Brazil andemerges as a new work place for health professionals,in public and in the private services. In Brazil homehealth care includes different kinds of assistance, fourof those were studied in this project. Each one of theconcepts or branches of home health care has specificpurposes, objectives and activities. A review of the lite-rature was undertaken in order to identify and to ana-lyze these concepts. It is important that health profes-sionals know thes e concepts because they will proba-bly face them, even when they do not act directly inhome care. This knowledge is also relevant for the qua-lity and appropriateness of t he provision of the servi-ces considering the inherent specificities.Keywords: Home Care; Home Care Services; Deliveryof Health Care. Introducao A atencao a saude abrange dois modelos: o hospitalare o domiciliar, sendo este ultimo denominado de aten-cao domiciliar a saude. O modelo domiciliar (re)surgeem funcao das diversas alteracoes que a sociedadebrasileira sofreu no decorrer dos anos como um mode-lo para o desenvolvimento de mudancas sociais e nosistema de saude.Dentre estas alteracoes, Duarte e Diogo(2000)apontam: a transicao demografica, que demonstra umenvelhecimento populacional cada vez mais acentua-do; a mudanca no perfil epidemiologico da populacao,no qual se evidencia um aumento das doencas croni-co-nao transmissiveis; os custos do sistema hospitalarcada vez mais elevado; o desenvolvimento de equipa-mentos tecnologicos, que tem possibilitado maior ta-xa de sobrevida das pessoas; o aumento da procurapor cuidados de saude; o interesse dos profissionaisde saude por novas areas de atuacao; a exigencia pormaior privacidade, individualizacao e humanizacaoda assistencia a saude, alem da necessidade de maiorintegracao da equipe profission al com o cliente e suafamilia.Este modelo de atencao a saude tem sido ampla-mente difundido no mundo e tem como pontos funda-mentais o cliente, a familia, o contexto domiciliar, ocuidador e a equipe multiprofissional.Por se tratar de um modelo recente no Brasil, hamuitos termos utilizados para su a designacao, como:“home health care”, “domiciliary care”, atendimentodomiciliar a saude, atencao domiciliar, enfermagemdomiciliar, visita domiciliaria, “nursing home”, “nur-sing care”, “home care nursing”, enfermagem residen-cial, cuidado domiciliar, internacao domiciliar, cuida-dos medicos domiciliares, cuidados de saude no domi-cilio, atendimentos medicos domiciliares e outros tan-tos. Muitos sao utilizados como sinonimos, devido atraducao e a interpretacao dos vocabulos “home care”ou “home health care” em portugues. Todavia, a ofertade servicos no domicilio, bem como a realizacao de ati-vidades neste contexto, tem diferencas significativas.Embora a atencao domiciliar a saude esteja emprocesso de ascensao nas praticas de saude, ela ain-da nao esta completamente inserida nos sistemas deatendimento a saude e na formacao e/ou capacitacaodos profissionais de saude. Comporta diferentes mo-

Atenção à Saúde no Domicílio: modalidades que fundamentam sua prática Home Health Care: modalities that ground its practice

A atencao domiciliar a saude e um modelo em processo de expansao por todo o Brasil e desponta como um novo espaco de trabalho para os profissionais de saude, tanto no âmbito publico quanto no privado. Abrange quatro diferentes modalidades que foram selecionadas para estudo: atencao domiciliar, atendimento domiciliar, internacao domiciliar e visita domiciliar. Cada uma dessas modalidades possui finalidades, objetivos e atividades especificas, o que torna necessaria sua explicitacao. Dessa forma, realizou-se esta revisao de literatura com o objetivo de identificar a bibliografia existente acerca dos termos utilizados para designar as modalidades. Considera-se necessario que os profissionais de saude conhecam estas modalidades, pois provavelmente deparar-se-ao com elas, mesmo que nao estejam atuando diretamente na atencao domiciliar a saude. Reputa-se ainda que esse conhecimento seja importante para que a assistencia prestada se de de maneira mais adequada e correta, considerando as especificidades inerentes.

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Atenção à saúde no domicílio: modalidades que fundamentam sua prática

This is a thought-provoking essay to identify the family caregiver. Patients’ labour constraints as well as awareness constraints about their condition can take them to dependence, that is when the family caregiver comes into play, working for patients’ partial or full recovery. Some aspects in the family context must be considered, such as family caregivers’ level of education as well as their previous experience with situations of care, and the context itself. These elements underpin nurse – family-caregiver relationship towards care guidance. Thus, family caregivers suffer along with their family members’ disabilities, being unique sensitive figures, often forgotten and ignored, who need attention to meet their duties as family caregivers.

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Refletindo sobre quem é o cuidador familiar

This literature review aims to offer elements to broaden discussion on the construction of male identity and its relation
with mens health injuries. The health-disease process is also determined by the individuals behavior in society, thus understanding
the construction of a male identity from cultural elements, can contribute for the reflection on the existing relation between man and his
health. Researchers and public policy makers have not considered the socialization process as a factor that increases mens vulnerability.
Nurses should get closer to men considering them as allied, partners and holders of a cultural inheritance that can offer (if creatively
and wisely used) strategies to deconstruct negative aspects and rebuild or reinforce positive aspects of masculinity.

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Maria Ribeiro Lacerda

Papers

A prática da assistência domiciliar dos profissionais da estratégia de saúde da família

Atenção à Saúde no Domicílio: modalidades que fundamentam sua prática Home Health Care: modalities that ground its practice

Atenção à saúde no domicílio: modalidades que fundamentam sua prática

Refletindo sobre quem é o cuidador familiar

Gênero masculino e saúde