Revista Brasileira de Geriatria e Gerontologia

Este estudo teve por objetivo identificar contradicoes e desafios que se apresentam atualmente no trabalho de enfermagem em saude mental, no contexto da Reforma Psiquiatrica, tendo por referencia a construcao historico-social desse processo de trabalho. A Reforma Psiquiatrica pressupoe um novo desenho de objeto e instrumentos de trabalho, que sao ainda pouco visiveis na pratica dos enfermeiros, e a possibilidade de se alcancar a condicao de sujeito-cidadao para o portador de sofrimento mental - modo de ser e finalidade do trabalho - que esta diretamente relacionada a consciencia de sujeito-cidadao do trabalhador de enfermagem.

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O trabalho de enfermagem em saúde mental: contradições e potencialidades atuais

This paper briefly re-examines the historical conditions that permitted the emergence of methodological approaches that question the relation between researcher and the act of researching. And proposes a comparison between the purposes of action research and intervention research. Sustained on theoretical contributions from the institutionalist movement and philosophy of difference, it indicates the notion of analysis of implication as the key concept that allows a more nuanced approach to the debate. In line with Lourau's thinking, it defends the idea that what confers scientific status to research work is the consideration of the whole set of conditions that encompass the act of researching.

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A análise de implicação como ferramenta na pesquisa-intervenção

OBJECTIVE: To know the strategies of resistance adopted by nursing staff, facing situations of moral distress, from an ethical perspective. METHOD: The authors conducted qualitative research through semi-structured interviews, with fifteen nursing staff members of a university hospital in the extreme south of Brazil, using textual discourse analysis and the theoretical reference of Foucault. RESULTS: Two categories were constructed: denial of oneself and the other - in which one perceives that the nursing staff can perform actions that are governed predominantly by immobility and conformism, avoiding confrontations with whoever represents power in situations that provoke moral distress in them; possibility to care for oneself and for the other - in which nursing workers in situations that provoke moral distress for them exercise power and endurance. CONCLUSION: it was perceived that some professionals seem to use ethical coping strategies, in order to ensure and preserve their professional values. However, often the choice of some nursing professionals may be to relapse into immobility and the absence of building strategies of endurance. This situation may represent their reduced exercise of power and insufficient resistance in the face of ethical problems, contributing to the intensification of their invisibility in the area of health.

Moral distress in everyday nursing: hidden traces of power and resistance

A condicao de precariedade da populacao adulta de rua e tratada no âmbito da saude e das intervencoes sociais visando levantar subsidios para a implementacao de politicas publicas de saude para essa populacao. A conceituacao dessa populacao e sua relacao com a exclusao social, a cidade, as economias paralelas, a globalizacao, as estrategias e os circuitos de sobrevivencia desenvolvidos se inserem num contexto de oposicao aos mecanismos de apartacao social e rompimento dos vinculos familiares, bem como na forma de tratamento institucional. A precariedade e insalubridade das ruas, culminando em exposicao e riscos cumulativos requerem intervencoes e formas de tratamento orientadas, segundo a sua especificidade, desafiando os conceitos gerais de universalidade, integralidade e equidade do Sistema Unico de Saude.

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Roberto Machado

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