The aim of this study was to analyze what contributions the Family Health Strategy has made towards the development of primary healthcare in Brazil, and what challenges it faces. A literature review was conducted and articles were analyzed from three dimensions: political/institutional, organizational, and technical/healthcare. In the first dimension, the Family Health Strategy was found to have helped expand primary healthcare, the institutionalization of evaluations, and the promotion of equity. The main challenges identified were funding, the training, education, and management of personnel, and cross-sectoral action. In terms of organization, the benefits include a broader supply of services, access to health services through organized initiatives for specific diseases or age groups, and more comprehensive healthcare. The challenges involve access, the entry point, integration with the healthcare network, planning, and social participation. As for technical/healthcare considerations, the main benefits identified were the fostering of multidisciplinary working practices, family focus, reception, rapport, humanization, community orientation, production of care, and performance. The challenges for its improvement are associated with complex factors and require greater political/institutional effort.

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Contribuições e desafios da Estratégia Saúde da Família na Atenção Primária à Saúde no Brasil: revisão da literatura

PIMENTEL, A.V. The perception of the vulnerability to the disease among women with delayed diagnosis of uterine cervical cancer. Ribeirão Preto, 2010. 66p. Thesis (Master) – University of São Paulo at Ribeirão Preto College of Nursing. This cross-sectional, descriptive, exploratory and qualitative study aimed to identify and evaluate the perception of the vulnerability to the disease among women with delayed diagnosis of uterine cervical cancer. The theoretical framework used was the vulnerability, based in the concept proposed by Ayres et al. (2003). The subjects of the study were twelve women who were under follow-up at the Hospital das Clínicas of the University of São Paulo at Ribeirão Preto Medical School, for treatment of advanced uterine cervical cancer, between April 08 and May 28 2009. Data were collected by interviews. The data analysis was done according to the presuppositions of content analysis, proposed by Bardin (2006). Two central categories emerged from the results: “Perceiving yourself vulnerable” and “Facing the disease and the treatment”. The vulnerability arose to the participants of this study through the emergence of the first signs and symptoms of the disease, increasing as the diagnosis was determined and treatment was needed, bringing difficulties and suffering. At the same time, women had the opportunity to find ways to face and overcome problems, to the extent possible. The individual, social and programmatic compounds of the vulnerability, included in the concept proposed by Ayres et al. (2003), were shown in the factors related to clients, professionals and services, among others, and made the women susceptible to the problems and damages of their health, related to the uterine cervical cancer, aggravating their vulnerability to the disease. The need to overcome some deficiencies in the model of care and in the humanization of care was evidenced, as well as in the level of commitment and in the quality of the institutions, resources, management, and monitoring of the programs of prevention and detection of uterine cervical cancer, in the different levels of care.

Universidade de são paulo escola de enfermagem de ribeirão preto

Objetivou-se analisar a producao cientifica da Enfermagem brasileira, de 1979 a 2007, sobre as praticas do cuidador informal do idoso no domicilio. Trata-se de revisao bibliografica, com abordagem qualitativa, desenvolvida em junho e julho de 2009, que estudou teses e dissertacoes publicadas nos catalogos do Centro de Estudos e Pesquisas em Enfermagem (CEPEn). Utilizou-se o sistema de categorizacao tematica para a analise dos dados. Dos onze trabalhos levantados, chegou-se a quatro categorias: atividades realizadas pelo cuidador, dificuldades no cotidiano do cuidar, sentimentos vivenciados pelo cuidador e conhecimentos e experiencias do cuidador. O conhecimento da atuacao desses cuidadores e de fundamental importância para as acoes do enfermeiro e da equipe de saude, dirigindo o cuidado nao so ao idoso, mas tambem ao seu cuidador.

Prácticas del cuidador informal del anciano en el domicilio

The task of taking care of patients with Cerebral Palsy (CP) is often difficult and may impact on the health and family quality of life. The aim of this study is to characterize the profile of people responsible for the daily care of children with CP and to assess their levels of overhead.. Data were collected through formularies of characterization of the sample (n = 21) and the overload Zarit Inventory instrument. The results showed that the majority of caregivers had maternal bond with the children (only one grandmother) and dedicated more than 12 hours to taking care activity (95.2%); household income stayed from 1 to 2 minimum wages. There were found varying Overload levels, that were evaluated in all mothers, and 52.4% showed intense overload. The findings of this study showed that caregivers of children with cerebral palsy have excessive burden related to the task of taking care. The burden negative impact on caregivers health suggest further research about the subject, aimed at improving the quality of life of caregivers and their families.

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Avaliação da sobrecarga dos cuidadores de crianças com paralisia cerebral - doi: 10.4025/cienccuidsaude.v9i3.9405

By conducting a qualitative study of phenomenological approach, in order to understand what is caring for the dependent elderly in their relatives' viewpoint, it was possible to observe several aspects of this experience. Among them, we highlight that these caregivers are subjected to physical and mental overload. Objective: to present the results related to this overload, in order to provide information that contributes positively to complement the work of health staff towards dependent elderly people, considering that it must care for the family caregivers. METHOD: this is a descriptive, exploratory, qualitative study of phenomenological approach. Interviews were conducted with family caregivers of dependent elderly people. Data was collected through semi-structured interviews based on a guiding question. The interviews were taped and transcribed to further analysis. RESULTS: the family caregiver of dependent elderly people is an overloaded person, both physically and mentally, due to the accumulation of functions and tasks that takes. The chronic stress related to this experience can change their health. CONCLUSION: the fact that the family caregivers are women, with advanced age, and have to be responsible alone for all the cares, and also the level of functional capacity of the elderly, are factors that influence this overload.

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Cuidar de um familiar idoso dependente no domicílio: reflexões para os profissionais da saúde

O acidente vascular cerebral (AVC) esta entre as principais causas de morte no mundo. Diante das incapacidades impostas pelo AVC, surge o cuidador familiar. O objetivo desta pesquisa foi analisar o significado e as implicacoes de se tornar cuidador de um individuo sequelado de AVC. Trata-se de um estudo qualitativo, realizado com cinco cuidadores, em Londrina-PR, no periodo de agosto a dezembro de 2005. Os dados foram coletados por meio de entrevistas semi-estruturadas e submetidos a analise de discurso proposta por Martins e Bicudo. Da analise das entrevistas emergiram sete categorias: voltando-se para o Ser cuidado, descrevendo os cuidados, apresentando as mudancas, o apoio da espiritualidade, compreendendo o significado do cuidado, expressando as necessidades para cuidar e perspectivas para o futuro. Os resultados revelaram que ser cuidador familiar e um fenomeno complexo, que gera nos sujeitos sentimentos de alegria e felicidade concomitantes aos sentimentos de medo, ansiedade e revolta.

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Vera Lúcia Martins

Papers

Cuidador familiar de seqüelados de acidente vascular cerebral: significado e implicações