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.
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TL;DR: In the analysis, the Curricular Directories contribution, besides facilitative strategies in the teaching of the humanized care, is identified, for the development of that competence it is fundamental emphasis in that dimension in the academic formation and the permanent education.
Abstract: RESUMODesde a divulgacao das Diretrizes Curriculares de Enfermagem os cursos de graduacao tem missao de formar enfermeiros generalist as,criticos, reflexivos e humanistas, o que requer esforcos das instituicoes formadoras na busca de estrategias que viabilizem des envolvimentodessas habilidades. Estudo descritivo, exploratorio de natureza bibliografica, teve objetivo de analisar a producao cientifica em periodicosnacionais sobre ensino do cuidado humanizado na graduacao em enfermagem entre 1990/2008. A ocorrencia dessa producao nosperiodicos estudados sinaliza tendencia de expansao do ensino do cuidado humanizado na formacao do enfermeiro. Na analise ident ificamosa contribuicao das Diretrizes Curriculares, alem de estrategias facilitadoras no ensino do cuidado humanizado. Para o desenvolv imentodessa competencia e fundamental enfase nessa dimensao na formacao academica e a educacao permanente.Descritores:Descritores: Educacao em enfermagem; Estudantes de enfermagem; Humanizacao da assistencia; Recursos humanos em saude.ABSTRACTFrom the divulgation of the Curricular Directories of Nursing the degree courses have the mission of to form generalist, critic al, reflexiveand humanist nurse, what requests efforts of the education institutions in the search of strategies that make possible the deve lopment ofthose abilities. Descriptive study of exploratory of bibliographical nature, had as objective to analyze scientific production in nationalsperiodic about teaching of the humanized care on the graduation in nursing, among 1990/2008. The occurrence of the production t hestudied newspapers us allows to affirm that there is a tendency each time bigger about the nurse formation in what he concerns theteaching of the humanized care. In the analysis we identified the Curricular Directories contribution, besides facilitative str ategies in theteaching of the humanized care. For the development of that competence it is fundamental emphasis in that dimension in the acad emicformation and the permanent education.Descriptors:Descriptors: Education, nursing; Students, nursing; Humanization of the attendance; Health manpower.RESUMENDesde la divulgacion de los Directorios Curriculares de Enfermeria los cursos de graduacion tienen la mision de formar el enfermerogeneralista, critico, reflexivo y humanista, lo que pide esfuerzos de las instituciones de educacion en la busqueda de estrategias quehacen posible el desarrollo de esas habilidades. La ocurrencia de esta en los periodicos estudiados senaliza una tendencia de e xpansionde la ensenanza del cuidado humanizado en la formacion del enfermero. En el analisis nosotros identificamos la contribucion de losDirectorios Curriculares, ademas de las estrategias que facilitan la ensenanza del cuidado humanizado. Para el desarrollo de esacompetencia es fundamental enfasis en esa dimension en la formacion academica y la educacion permanente.Descriptores:Descriptores: Educacion en enfermeria; Estudiantes de enfermeria; Humanizacion de la asistencia; Recursos humanos en salud.Submissao: 04/07/2008 Aprovacao:ovacao: 22/11/2008REVISAORevistaBrasileirade Enfermagem
2 citations
Cites background from "Perspectivas da avaliação na Políti..."
...Texto Contexto Enferm 2007; 16(3): 439-44....
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...Porém o envolvimento do profissional com a doença e com os procedimentos necessários em sua decorrência muitas vezes leva a priorização do problema em detrimento da pessoa que apresenta o problema, o que acarreta a despersonalização da pessoa cuidada(2-4)....
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...Texto Contexto Enferm 2005; 14(3): 427-34....
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...Neste sentido, a implementação dessa nova diretriz apresenta condições favoráveis para que os acadêmicos de enfermagem tenham uma formação humanista de fato, e que isso possa refletir que a assistência à saúde seja humanizada(10) conforme hoje preconiza o Sistema Único de Saúde(1, 3)....
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...Rev Esc Enferm USP 2006; 40(3): 321-8....
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24 Nov 2014
TL;DR: In this paper, the authors present the construction process of research methodology "Training in SUS Humanization: effects evaluation of training processes from institutional supporters on health production in Rio Grande do Sul, Santa Catarina and Sao Paulo territories."
Abstract: Este texto visa apresentar o processo de construcao da metodologia da pesquisa “Formacao em Humanizacao do SUS: avaliacao dos efeitos dos processos de formacao de apoiadores institucionais na producao de saude nos territorios do Rio Grande do Sul, Santa Catarina e Sao Paulo”. Nesta investigacao, buscou-se desenvolver uma praxis avaliativa adequada aos processos de formacao em foco, uma metodologia que, em vez de avaliar sobre, avaliou com os apoiadores que participaram da formacao-intervencao, uma metodologia participativa. Para tanto, a constituicao do Grupo de Interesse da Pesquisa foi uma eminente ferramenta. Os apoiadores formados compuseram a equipe da pesquisa para ampliar as possibilidades participativas de um grupo amplo e disperso, produzindo interferencias na conducao do processo investigativo, descritas e analisadas neste artigo. Suas vivencias, ao mesmo tempo, interferiam nas compreensoes que tinham ate entao acerca do que haviam experimentado nas formacoes-intervencao e nos efeitos produzidos em seus cotidianos, passados quase quatro anos. Assim, o percurso metodologico esteve intrinsecamente vinculado a construcao de um plano diferenciado de subjetivacao, necessariamente coletivo, que buscou o deslocamento da posicao dos apoiadores envolvidos de meros fornecedores de dados para uma posicao de lateralidade aos demais atores. A experimentacao proporcionada pelas estrategias participativas permitiu que pesquisadores e apoiadores passassem a interferir e compor o cenario avaliativo com atuacoes mais protagonistas ao longo do processo investigativo. A pesquisa se configurou como uma aposta numa dada arquitetura metodologica que, ao buscar a superacao da logica avaliador-avaliado, produziu informacoes para (retro)alimentar a intervencao por ela desencadeada. Em sua dimensao formativa, atravessou, ainda, os processos de trabalho analisados pelos apoiadores resgatando o carater indissociavel que todo fazer em saude mobiliza entre intervir-formar-avaliar. ABSTRACT - The study presents the construction process of research methodology "Training in SUS Humanization: effects evaluation of training processes from institutional supporters on health productionin Rio Grande do Sul, Santa Catarina and Sao Paulo territories." There was a search for developing an appropriate evaluative practice to the training processes, a methodology that instead of evaluating on something, assessed along with the supporters who attended the training-intervention, a participatory methodology.Therefore, the constitution of the Research Interest Group was an eminent tool. Trained supporters comprised the research team to expand participatory possibilities of a large and dispersed group, producing interferences in the investigative process conduction, described and analyzed in the study.At the same time, their experiences interfered in the understandings they had until then about the intervention-training experiences and effects on their daily lives, after almost four years.Thus, the methodological approach was intrinsically linked to the construction of a subjectivity differentiated plan and necessarily collective, which shifted the position of supporters involved from mere data suppliers to a lateralityposition in relation to other actors.The trial afforded by participatory strategies allowed researchers and supporters to interfere and compose the evaluation scenario with remarkable performances throughout the investigative process.The survey configuration was like a bet on a given methodological architecture that, in seeking to overcome evaluator-evaluated logic produced information for (retro) feedingthe intervention triggered by it. In the formative dimension, it also went through working processes analyzed by supporters rescuing the indissoluble characteristic that health activities mobilize among intervening, training and reviewing. Keywords: Health Humanization; Qualitative Research; Methodology; Health Services Assessment; Public Health Policies.
2 citations
20 Dec 2013
TL;DR: Uma pesquisa do tipo revisao de literatura e estudo descritivo-qualitativo, analisando a integracao entre as politicas nacionais de humanizacao (teoria) e os profissionais that atuam na atencao primaria (pratica) no trato aos pacientes portadores de HIV/aids.
Abstract: O presente artigo tem como objetivo demonstrar a importância da humanizacao no atendimento ao paciente, analisando a integracao entre as politicas nacionais de humanizacao (teoria) e os profissionais que atuam na atencao primaria (pratica), especialmente no trato aos pacientes portadores de HIV/aids, com enfoque na aplicacao dos principios da etica e bioetica. Cuida-se de um tema relativamente novo na literatura. Sao abordadas, de forma sucinta, as principais caracteristicas da Politica Nacional de Humanizacao (PNH) do Sistema Unico de Saude (SUS), os fundamentos da etica e bioetica e sua aplicacao aos profissionais da saude no trato com pacientes em geral, sobretudo naqueles portadores de HIV/aids. Trata-se de uma pesquisa do tipo revisao de literatura e estudo descritivo-qualitativo.
2 citations
TL;DR: The evaluations of the Brazil’s Primary Health Care are still very limited and localized and deserve to be expanded and effectively applied continuously to increase the results obtained.
Abstract: Objective: nowadays, when the reorganization of health services in Brazil is being discussed, the theme of Primary Health Care Evaluation, in its broadest terms, becomes relevant. In order to contribute to this area, this paper describes a systematic review that characterizes and analyzes the evaluation processes of Primary Health Care in Brazil. Methods: we searched PubMed, Lilacs and SciELO databases using the descriptors “Primary Health Care AND Health Evaluation AND Brazil”, restricted to the period of the last five years (2009-2013). Results: with this configuration, we identified 42 articles about Primary Health Care in Brazil that focused on the evaluation of services and programs. We noted a variety of methodologies and objectives: 38.1% focused on the evaluation of health programs in Brazil’s Family Health Strategy, 61.9% on the evaluation of health services, 9.5% on the users’ point of view and 76% in quantitative surveys. The studies were conducted primarily in the Northeast (n=15) and Southeast (n=13). Conclusion: the evaluations of the Brazil’s Primary Health Care are still very limited and localized. They deserve to be expanded and effectively applied continuously to increase the results obtained.
2 citations
01 Jan 2008
TL;DR: In this article, an etno-avaliacao etnografico of a paciente internado in hospital publico (HPU) and privateado (HPR) no Nordeste Brazil has been investigated.
Abstract: Este estudo etnografico investiga a experiencia vivida do paciente internado em hospital publico (HPU) e privado (HPR) no Nordeste brasileiro. Os participantes da pesquisa foram 28 pacientes adultos atendidos nas diversas clinicas. Os dados foram estudados pelo metodo O Percurso do Paciente , consistindo de uma combinacao complementar e articulada de tecnicas - observacao livre, observacao participante, entrevista etnografica e narrativas do paciente, coletadas prospectivamente durante a hospitalizacao, desde a sua chegada ate a alta. A analise ocorreu conforme a Tecnica de Analise Categorial Tematica e os dados foram interpretados a luz dos referenciais teoricos da Antropologia Medica, humanizacao do cuidado e promocao da saude. Foram observados os principios eticos da Resolucao 196/96. O hospital humano, revelado pelo paciente, destaca a importância da subjetividade. Das 411 unidades de significados desveladas, 225 (54,7%) foram no hospital publico (HPU) e 186 (45,3%) no hospital privado (HPR). Os resultados indicam que o paciente etnoavalia no HPU e no HPR aspectos da competencia humana e tecnica do profissional da saude, a estrutura e funcionamento hospitalar, o acesso e a etica na conducao das financas; e desenvolve estrategias de superacao da hospitalizacao. Esta etnoavaliacao e mediada por diversos fatores: condicao socioeconomica, personalidade, religiosidade, discurso ironico, diagnostico sombrio e necessidades atendidas, experiencia anterior de hospitalizacao e condicoes da entrevista. Uma proposta pedagogica para humanizacao hospitalar devera vincular-se as mudancas estruturais, gerenciais e organizacionais dos servicos; utilizar-se de metodologias ativas que visem a politizacao, a problematizacao das situacoes concretas de trabalho e a inclusao dos afetos e intersubjetividades; alem de constituir-se em aprendizagem coletiva. O estudo mostra a importância de a etnoavaliacao do usuario ser incorporada ao projeto da gestao e atencao hospitalar como orientadora de decisoes e acoes clinicas, consistindo em promotora de praticas que levem a um cuidado resolutivo, digno e humanizado. A multidisciplinaridade da pesquisa permitiu ampla apreensao da perspectiva do usuario como etnoavaliador critico social
2 citations
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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.
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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