Perspectivas da avaliação na Política Nacional de Humanização em Saúde: aspectos conceituais e metodológicos
01 Jul 2007-Ciencia & Saude Coletiva (ABRASCO - Associação Brasileira de Saúde Coletiva)-Vol. 12, Iss: 4, pp 999-1010
TL;DR: Reforcar tais especificidades e perspectivas de aproximacao, buscou-se nao somente registrar a amplitude e complexidade dos dispositivos e acoes propostos no âmbito do HumanizaSUS, como tambem fazer uma breve revisao of conceitos e componentes englobados na area of monitoramento e avaliacao.
Abstract: The purpose of this paper is to prompt discussions of the perspectives of the Evaluation of Brazil's National Health Humanization Policy being implemented by the Ministry of Health (PNH/HumanizaSUS). It strives to systemize some Health Evaluation benchmarks, distinguishing two key aspects of this evaluation: one examines methodologies for the definition of Humanization actions monitoring indicators; the other analyzes evaluatory surveys measuring the impacts of these actions. Both aspects were scored, highlighting specific characteristics that must be recognized in the approach and use of evaluation methodologies under the aegis of this Policy. In order to strengthen such specific characteristics and approach perspectives, it explores the extent and complexity of the tools and actions proposed in the field covered by this Policy, while also offering an brief review of the concepts and components encompassed by the Monitoring and Evaluation area.
Citations
More filters
21 Mar 2016
TL;DR: The PET-Saude as discussed by the authors ) is a formacao for humanizacao at the Universidade Estadual do Ceara (UECE) in Brazil.
Abstract: Este estudo objetiva analisar como ocorre a insercao da humanizacao na formacao dos alunos participantes do PET – Saude da Universidade Estadual do Ceara (UECE), na perspectiva da articulacao ensino-servico-comunidade. E um estudo de caso com abordagem qualitativa, desenvolvido junto aos participantes do PET- Saude Fortalecendo a Rede de Assistencia a Saude da Gestante e da Crianca em Maracanau, perfazendo um total de 13 sujeitos. Os instrumentos de coleta de dados a entrevista semiestruturada e o grupo focal. Os dados foram examinados com base na Analise de Conteudo, numa perspectiva critico-reflexiva. Os resultados evidenciaram a pluralidade de percepcoes sobre a humanizacao, o que denota a polissemia deste termo. Os entrevistados entendem a humanizacao como integrante das relacoes intersubjetivas no âmbito do trabalho em saude mediante uma relacao profissional-usuario sinalizando interface com a integralidade. Embora problematizem a humanizacao em saude, por a entenderem como intrinseca a natureza do humano. No âmbito especifico da formacao em saude, apontam que a insercao da humanizacao na graduacao se da modo heterogeneo nos distintos cursos, em que na Medicina e na Enfermagem ha aparentemente maior inclusao na matriz curricular, sendo que Biologia e Medicina Veterinaria, por exemplo, ainda nao incluiram a humanizacao na matriz curricular. No âmbito das praticas formativas desenvolvidas, apontam o desenvolvimento de grupos de discussao sobre a humanizacao e a mudanca nos servicos de saude por meio da implementacao de principios e diretrizes da Politica Nacional de Humanizacao. Por outro lado, ocorreu fragilidade na integracao ensino-servicos, expressa na baixa insercao dos monitores nas unidades de saude, limitando a formacao pelo trabalho, bem como a possibilidade de mudancas do modelo de atencao fomentada pelas contribuicoes da Universidade. Contudo, o PET-Saude se mostrou como espaco de formacao sobre humanizacao, com potencia para a reorientacao da formacao em saude, por meio da inclusao da tematica em questao. Por fim, entende-se que para consolidar o PET-Saude e reafirma-lo como campo fertil para a entrada dos estudos sobre humanidades em saude, recomenda-se: uma acao politico-administrativa das instâncias governamentais competentes e das instituicoes formadoras no sentido de consolidar o PET-Saude como estrategia para efetivar a reorientacao da formacao em saude, principalmente fortalecendo a integracao ensino-servico; a insercao da humanizacao no projeto politico pedagogico de todos os cursos da saude da Universidade Estadual do Ceara, de forma abrangente; a insercao de conteudos referentes a humanizacao e sua politica n projeto pedagogico do PET-Saude como contribuicao para a formacao humanistica dos monitores e, concomitantemente, promover acoes humanizadas nos servicos; formacao pedagogica e educacao permanente para preceptores, incluindo a humanizacao em saude, com vistas a qualificacao das praticas de saude em seus locais de trabalho.
5 citations
TL;DR: In this paper, a trabalho avaliou a qualidade dos indicadores utilizados no Questionario do Estudante (QE) for a avaliacao das BUs.
Abstract: As funcoes das bibliotecas universitarias (BUs) sao de fornecer a infraestrutura bibliografica, documentaria e informacional para subsidiar as atividades cientificas, alem de divulgarem o conhecimento produzido por seu corpo academico para a sociedade. Para alcancarem a sua missao as BUs precisam ser avaliadas e, no Brasil, essa avaliacao e feita pelo Exame Nacional de Desempenho de Estudantes (ENADE) por meio do Questionario do Estudante (QE). O presente trabalho avaliou a qualidade dos indicadores utilizados no QE para a avaliacao das BUs. Essa qualidade foi avaliada quanto a presenca das seguintes propriedades essenciais para os bons indicadores: estabilidade, validade e importância dos parâmetros. Para a analise da estabilidade, foi analisada a repeticao das perguntas do QE no periodo de 2004 a 2014. Quanto a validade, foi feita a analise de correlacao entre os resultados obtidos no QE com outro indicador teoricamente relacionado. Ja para a analise da importância, foi formado um grupo de especialistas, composto por bibliotecarios com experiencia na gestao de BUs e, por meio do metodo Delfos, foram avaliados os indicadores quanto a sua relevância. O trabalho constatou que os indicadores utilizados pelo ENADE sao considerados importantes, porem nao possuem estabilidade e validade.
5 citations
01 Jan 2010
TL;DR: In this paper, a qualitative study was carried out in the municipality of Florianopolis, Southern Brazil, in 2001, where four groups were evaluated, over a total of 24 sessions at primary healthcare units, by means of the technique of enunciative-pragmatic discourse analysis.
Abstract: OBJECTIVE: To analyze the model for actions by health promotion group coordinators, in primary healthcare units with links to professional training. METHODOLOGICAL PROCEDURES: A qualitative study was carried out in the municipality of Florianopolis, Southern Brazil, in 2001. Four groups were evaluated, over a total of 24 sessions at primary healthcare units. Participant observation was performed to start the fi eldwork. The reports were analyzed by means of the technique of enunciative-pragmatic discourse analysis. ANALYSIS OF RESULTS: The types of action among the coordinators that were congruent with the preventive model were: oppression, bench teaching, biologism and higienism, prescription of approaches, blame apportionment, infantilization, reduction of collective problems, denigration of group settings and use of monologue. The types of action consonant with the new promotion model were: facilitation of free expression and autonomy, empathetic communication, constructivism, receptiveness, active listening and promotion of overcoming of violence and alienation.
4 citations
01 Jan 2007
TL;DR: This exploratory descriptive study to study how the nurses from a hospital school see the family as care participants found that the nurses had only little knowledge of the family’s thematic during graduation, making the relationship with the accompanying families very difficult.
Abstract: The family of a chronically ill patient: a consideration of nurses from a school hospital. This exploratory descriptive study, of qualitative nature had the purpose to study how the nurses from a hospital school see the family as care participants. Six nurses from clinics of chronically ill patients were interviewed. The data analysis allowed to infer that the nurses had only little knowledge of the family's thematic during graduation, making the relationship with the accompanying families very difficult. Daily care during hospitalization period is marked by easy moments when members are willing to participate in the process, and by difficulties when they attempt to break institutional rules. It was suggested that new nurses have theoretical foundation to attend the family in several scenarios of care. It was considered the need of investments in professional training, and that the advance of humanization of services implies in exchange and integration of knowledge among patients, family members, health professionals, support staff and managers beyond the science field.
4 citations
Cites background from "Perspectivas da avaliação na Políti..."
...…de educação permanente objetivando o aumento da capacidade profissionais/trabalhadores de saúde para analisar e intervir em seu processo de trabalho e que os usuários/famílias possam “ter voz”, para democratizar os processos decisórios em coresponsabilidade com os gestores (Santos-Filho, 2007)....
[...]
01 Jan 2009
TL;DR: In this article, a rede de contatos como estrategia metodologica da Politica Nacional de Humanizacao (PNH) was investigated in the Hospital de Clinicas de Porto Alegre (HCPA).
Abstract: Este estudo enfoca a rede de contatos como estrategia metodologica da Politica Nacional de Humanizacao (PNH). Trata-se de um relato de experiencia, instituido no Hospital de Clinicas de Porto Alegre (HCPA), que buscou identificar as acoes de humanizacao suscitadas pela formacao da Rede de Contatos no âmbito da instituicao. O Grupo de Trabalho de Humanizacao do HCPA procurou estruturar uma Rede que abrangesse o maior numero possivel de areas no hospital, iniciando um trabalho de sensibilizacao dentro dos setores e buscando promover acoes convergentes com as propostas pela PNH. Observou-se que, desde 2005 ate agora, varias acoes humanizadoras aconteceram nas diversas areas envolvidas, demonstrando que o dispositivo das redes e ferramental precioso para a instituicao, pois oferece indicadores para a PNH e favorece a inter-relacao entre os diferentes atores que buscam, para alem das dificuldades de um cotidiano hospitalar, a promocao de outros modos de fazer em saude.
3 citations
References
More filters
TL;DR: In this article, the authors discuss the relationship between quality of life and health by applying the discourses emerging in the health sector to other fields and other disciplines, which constitute social representation based on subjective parameters such as satisfaction of basic needs and of the needs created by the degree of economical and social development of a given society.
Abstract: This paper discusses the relationships between quality of life and health by applying the discourses emerging in the health sector to other fields and other disciplines. These relationships constitute social representation based on subjective parameters (well-being, happiness, love, pleasure, personal satisfaction), and on objective ones such as satisfaction of basic needs and of the needs created by the degree of economical and social development of a given society. The text presents the main instruments which have been constructed during the last years for measuring quality of life, as well as the debate they cause. It also debates the semantic field where the representations and actions in favour of quality of life - such as the concept of development, democracy, quality, way and conditions of life - develop. In relation to the field of health, this article discusses the tendency to restrict the concept of quality of life to the biomedical area, associated with an economic assessment. It shows the variety of instruments created for measuring quality of life in accordance with the concept. Health promotion is considered one of the most relevant strategies in this field in order to avoid medical reductionism and to develop an interdisciplinary dialogue. It is argued that this proposal, however, still needs to be refined and tested in sanitary practices.
964 citations
TL;DR: It is argued that the answer to this question is essential for choosing an appropriate evaluation design, drawing upon examples from the fields of health and nutrition, and a framework is proposed for deciding upon appropriate evaluation designs.
Abstract: The question of why to evaluate a programme is seldom discussed in the literature. The present paper argues that the answer to this question is essential for choosing an appropriate evaluation design. The discussion is centered on summative evaluations of large-scale programme effectiveness, drawing upon examples from the fields of health and nutrition but the findings may be applicable to other subject areas. The main objective of an evaluation is to influence decisions. How complex and precise the evaluation must be depends on who the decision maker is and on what types of decisions will be taken as a consequence of the findings. Different decision makers demand not only different types of information but also vary in their requirements of how informative and precise the findings must be. Both complex and simple evaluations, however, should be equally rigorous in relating the design to the decisions. Based on the types of decisions that may be taken, a framework is proposed for deciding upon appropriate evaluation designs. Its first axis concerns the indicators of interest, whether these refer to provision or utilization of services, coverage or impact measures. The second axis refers to the type of inference to be made, whether this is a statement of adequacy, plausibility or probability. In addition to the above framework, other factors affect the choice of an evaluation design, including the efficacy of the intervention, the field of knowledge, timing and costs. Regarding the latter, decision makers should be made aware that evaluation costs increase rapidly with complexity so that often a compromise must be reached. Examples are given of how to use the two classification axes, as well as these additional factors, for helping decision makers and evaluators translate the need for evaluation--the why--into the appropriate design--the how.
739 citations
TL;DR: In this article, a debate metodologico em processo at the Escola Nacional de Saude Publica, Brasil, sobre as duas formas de abordagem mais correntes nas investigacoes da area de saude was conducted.
Abstract: Este trabalho resume um debate metodologico em processo na Escola Nacional de Saude Publica, Brasil, sobre as duas formas de abordagem mais correntes nas investigacoes da area de saude: o metodo quantitativo e o metodo qualitativo. Os autores - uma antropologa sanitarista e um bioestatistico - demonstram, com argumentacoes teoricas e praticas, que esses metodos sao de natureza diferenciada, mas se complementam na compreensao da realidade social. Num mundo onde o que distingue o ser humano e a linguagem comunicativa, o acento deste debate recai sobre a possibilidade, o significado e os limites da linguagem matematica e da linguagem de uso comum na experiencia cotidiana.
589 citations
TL;DR: The incorporation of evaluative procedures in health planning or health policy-making and administration is still limited in Brazil, particularly at the local level, and recent implementation of projects for the reorganization of the health services system raises the need for more appropriate strategies aimed at health care evaluation.
Abstract: This is a literature review of theoretical and methodological issues on health care evaluation of research and technical reports. Conceptual frameworks, approaches, subject matter, strategies, and study designs are identified and analyzed. Evaluative research designs are compared with epidemiological ones. A diverse terminology was encountered, and many methodological problems in the literature were examined. The incorporation of evaluative procedures in health planning or health policy-making and administration is still limited in Brazil, particularly at the local level. Recent implementation of projects for the reorganization of the health services system based on the administrative autonomy of Local Health Units raises the need for more appropriate strategies aimed at health care evaluation. Perspectives for the development of alternative strategies are indicated.
200 citations
TL;DR: Nuclear criteria involved in the organization of all evaluation processes are identified, and articulated with the existing institutionalized evaluation practices in developed countries, that is, program evaluation, quality assessment and management and technology assessment.
Abstract: The field of program, services and technology evaluation in general, and in health care in particular, is going through an important growth and conceptual and methodological diversification. It is also the object of an increasing demand for its participation as an effective supportive instrument in the decision-making process, and a constant need in the dynamics of health systems and services. In this paper, based on literature review, nuclear criteria involved in the organization of all evaluation processes are identified, and articulated with the existing institutionalized evaluation practices in developed countries, that is, program evaluation, quality assessment and management and technology assessment. In conclusion, the incipient development of a methodological evaluation output in Brazil is analyzed.
192 citations