Humanização na saúde: um novo modismo?
01 Aug 2005-Vol. 9, Iss: 17, pp 389-394
TL;DR: The idea of humanizacao, qualidade, and atencao in the context of saude was introduced by the Programa Nacional de Humanizeacao da Atencao Hospitalar (PNHAH) as discussed by the authors.
Abstract: Ainda que timidamente, este tema se anuncia desde a XI Conferencia Nacional de Saude, CNS (2000), que tinha como titulo “Acesso, qualidade e humanizacao na atencao a saude com controle social”, procurando interferir nas agendas das politicas publicas de saude. De 2000 a 2002, o Programa Nacional de Humanizacao da Atencao Hospitalar (PNHAH) iniciou acoes em hospitais com o intuito de criar comites de humanizacao voltados para a melhoria na qualidade da atencao ao usuario e, mais tarde, ao trabalhador. Tais iniciativas encontravam um cenario ambiguo em que a humanizacao era reivindicada pelos usuarios e alguns trabalhadores e, no minimo, secundarizada (quando nao banalizada) pela maioria dos gestores e dos profissionais. Os discursos apontavam para a urgencia de se encontrar outras respostas a crise da saude, identificada por muitos como falencia do modelo SUS. A fala era de esgotamento. De fato, cada posicao neste debate se sustenta com as suas razoes. Por um lado, os usuarios por reivindicarem o que e de direito: atencao com acolhimento e de modo resolutivo; os profissionais, por lutarem por melhores condicoes de trabalho. Por outro lado, os criticos as propostas humanizantes no campo da saude denunciavam que as iniciativas em curso se reduziam, grande parte das vezes, a alteracoes que nao chegavam efetivamente a colocar em questao os modelos de atencao e de gestao instituidos. Vale destacar que entre os anos 1999 e 2002, alem do PNHAH, algumas outras acoes e Programas foram propostos pelo Ministerio da Saude voltados para o que tambem ali ia se definindo como campo da humanizacao contornado pelo debate sobre busca da qualidade na atencao ao usuario. Apenas para citar alguns, destacamos a instauracao do procedimento de Carta ao Usuario (1999), Programa Nacional de Avaliacao dos Servicos Hospitalares – PNASH (1999); Programa de Acreditacao Hospitalar (2001); Programa Centros Colaboradores para a Qualidade e Assistencia Hospitalar (2000); Programa de Modernizacao Gerencial dos Grandes Estabelecimentos de Saude (1999); Programa de Humanizacao no Pre-Natal e Nascimento (2000); Norma de Atencao Humanizada de Recem-Nascido de Baixo Peso – Metodo Canguru (2000), dentre outros. Ainda que a palavra humanizacao nao apareca em todos os Programas e acoes e que haja diferentes intencoes e focos entre eles, podemos acompanhar uma tenue relacao que vai se estabelecendo entre humanizacao-qualidade na atencao-satisfacao do usuario.
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TL;DR: In this paper, the authors present a theoretical exercise regarding health care evaluation in an effort to define several concepts, including the multi-dimensional aspects of quality in health, in addition to the differences between quality evaluation and qualitative evaluation.
Abstract: The paper presents a theoretical exercise regarding health care evaluation in an effort to define several concepts. The multi-dimensional aspects of quality in health are emphasized in addition to the differences between quality evaluation and qualitative evaluation. The implications of not distinguishing between these two concepts are also discussed. Health care is analyzed as a material expression of interpersonal relations in this field and as an object of evaluation, highlighting its intricate relation with integrality and humanization. It is affirmed that quality evaluation and qualitative evaluation are not interchangeable labels, but rather political choices connected to health policies that can not be juxtaposed. Therefore, understanding this distinction is necessary for constructing evaluation proposals that surpass traditional and exclusionary perspectives.
89 citations
TL;DR: In this paper, a critical analysis of the bibliographical output in Brazil from 1989 to 2009 was conducted regarding acceptance of implementation and qualification of SUS in primary healthcare (PHC).
Abstract: The public policies adopted by the Unified Health System (SUS) in Brazil have gone through successive transformations, striving to reassert health as a universal right. The user acceptance of the guidelines of the National Humanization Policy for Care and Management of the SUS - Humanize SUS - is taking shape and relevance in Primary Healthcare (PHC) to ensure humanized access and resolution of the health demands of users and communities in Brazil. A critical analysis of the bibliographical output in Brazil from 1989 to 2009 was conducted regarding acceptance of implementation and qualification of SUS in PHC. The databases consulted were SciELO, Lilacs and Medline. The results revealed progress in broadening access to PHC services and health professionals more sensitive to the needs of users and communities. However, lack of coordination in integrated networks, excess demand, the hegemonic biomedical model, lack of training and democratic and reflexive spaces to reorganize the work process have been raising increasingly more incisive questions about the potential of this guideline for the implementation and qualification of SUS.
86 citations
TL;DR: In this article, the authors present the context of the emergence and implementation of the National Policy of Humanization (NPH), which was devised as a public policy to address and overcome the challenges perceived by Brazilian society regarding the quality and dignity of healthcare.
Abstract: This article presents the context of the emergence and implementation of the National Policy of Humanization (NPH), which was devised as a public policy to address and overcome the challenges perceived by Brazilian society regarding the quality and dignity of healthcare. The aims include redesigning and joint initiatives for the humanization of care, and providing solutions for problems in the field of management and organization of the health workforce. Highlighting it as a public policy, the authors analyze the main focus and theoretical and methodological approaches to cope with problems in management and practice of healthcare, signaling the need to combine strategies in both macro and micro policy areas. The analysis focuses on changes in the composition and strategies of action, which include social mobilization, support to management systems, services and health teams and the development of training processes for institutional stakeholders. The article presents results obtained in the first five years, as well as its limitations and prospects, especially the challenge facing NPH to be seen as a public policy, which cannot be achieved without the mobilization of social forces beyond the State.
73 citations
TL;DR: Although many practices were cited as humanizing they do not produce changes in the health services because of the lack of more profound analysis of the work processes and ongoing education in thehealth care services.
Abstract: OBJETIVO : Analisar as praticas de humanizacao na atencao basica na rede publica do sistema de saude brasileiro com base nos principios da politica nacional de humanizacao do Brasil. METODOS : Procedeu-se a revisao sistematica da literatura seguida de metassintese, usando as bases de dados: BDENF (Base de dados da enfermagem), BDTD (Biblioteca digital brasileira de teses e dissertacoes), CINAHL ( Cumulative Index to nursing and allied health literature ), LILACS (Literatura Latino-americana e do Caribe em ciencias da saude), MedLine (Literatura Internacional em ciencia da Saude), PAHO (Biblioteca da Organizacao Pan-Americana da Saude) e SciELO ( Scientific Electronic Library Online ). Foram selecionados os seguintes descritores de assunto: Humanizacao; Humanizacao da Assistencia; Acolhimento; Cuidado humanizado; Humanizacao em saude; Vinculo; Programa de Saude da Familia; Atencao Basica; Saude Coletiva e Sistema Unico de Saude. Para analise, foram incluidos artigos de pesquisa, estudos de caso, relatos de experiencias, dissertacoes, teses e capitulos de livros, escritos em lingua portuguesa, inglesa ou espanhola, publicados de 2003 a 2011. RESULTADOS : Das 4.127 publicacoes recuperadas sobre o tema, foram avaliadas e incluidas 40, chegando a tres categorias centrais. A primeira, infraestrutura e organizacao dos servicos basicos de saude, evidenciou insatisfacao com a estrutura fisica e material e com os fluxos de atendimento que podem facilitar ou dificultar o acesso. A segunda refere-se ao processo de trabalho, que apresentou questoes relacionadas ao numero insuficiente de profissionais, fragmentacao dos processos de trabalho, perfil e responsabilizacao profissional. A terceira consistiu das tecnologias das relacoes e apontou o acolhimento, vinculo, escuta, respeito e dialogo com os usuarios. CONCLUSOES : Embora muitas praticas sejam citadas como humanizadoras, nao conseguem produzir mudancas nos servicos de saude por falta de uma analise mais aprofundada nos processos de trabalho e de uma educacao permanente no servico.
39 citations
01 Jan 2013
TL;DR: To analyze humanization practices in primary health care in the Brazilian Unified Health System according to the principles of the National Humanization Policy, research articles, case studies, reports of experiences, dissertations, theses and chapters of books written in Portuguese, English or Spanish were included.
Abstract: OBJECTIVE: To analyze humanization practices in primary health care in the Brazilian Unified Health System according to the principles of the National Humanization Policy. METHODS: A systematic review of the literature was carried out, followed by a meta-synthesis, using the following databases: BDENF (nursing database), BDTD (Brazilian digital library of theses and dissertations), CINAHL (Cumulative Index to nursing and allied health literature), LILACS (Latin American and Caribbean health care sciences literature), MedLine (International health care sciences literature), PAHO ( Pan-American Health Care Organization Library) and SciELO (Scientific Electronic Library Online). The following descriptors were used: Humanization; Humanizing Health Care; Reception: Humanized care: Humanization in health care; Bonding; Family Health Care Program; Primary Care; Public Health and Sistema Unico de Saude (the Brazilian public health care system). Research articles, case studies, reports of experiences, dissertations, theses and chapters of books written in Portuguese, English or Spanish, published between 2003 and 2011, were included in the analysis.
32 citations