Abstract:
:The aim was to analyze the peregrination of families of children treated in a Center for Psychosocial Care for Children and Adolescents in their search for mental health care. The study included participant observations at the clinic and focus groups with the children's families. The qualitative study used institutional analysis as the theoretical and methodological reference, and the material was discussed in light of the approach to psychosocial care. The families' search in the face of the child's psychological distress is a prime indicator for assessing strengths and weaknesses in building the network of care, and for revealing the families' understanding of their children's mental health problems and treatments. The study found contradictory forces at play in daily care, demonstrating both the provider's transformative force and occasionally the user's crystallization and maintenance. In this sense, the hegemonic model - disease-centered, fragmenting patients and their care - has been challenged by the instituting force that proposes to reposition the patient and incorporate psychological distress as part of overall health, linking services and actions in a model of care. Despite the tangled maze that families face in their peregrination for care, strides have been made in psychosocial care, while highlighting challenges. Such progress has been anchored in relational technologies (shelter, bonding, trust, and accountability) with the various actors involved in the care. :O objetivo foi analisar o itinerário percorrido por famílias de crianças atendidas em um Centro de Atenção Psicossocial Infantojuvenil na busca por tratamento em saúde mental. Foram realizadas Observações Participantes do serviço estudado e Grupos Focais com familiares de crianças atendidas. A pesquisa qualitativa usou como aporte teórico-metodológico a Análise Institucional e o material foi discutido tendo em vista o modo de atenção psicossocial. A busca dos familiares quando se confrontam com o sofrimento psíquico de uma criança é um indicador privilegiado para aquilatar potencialidades e fragilidades na construção da rede de atenção, bem como para revelar o entendimento dos familiares a respeito dos problemas de saúde mental e seus tratamentos. Verificou-se a presença de forças contraditórias nas ações cotidianas de atenção, demonstrando ora a força transformadora do instituinte, ora a cristalização e manutenção do instituído. Nesse sentido, o modelo hegemonicamente instituído - focado na doença, fragmentando o sujeito e a atenção a ele dirigida - tem sido tensionado por uma força instituinte que propõe reposicionar o sujeito, bem como incorporar o sofrimento psíquico como integrante da saúde geral, articulando serviços e ações em um modelo de rede. A despeito do novelo de embaraços com os quais os familiares se deparam em sua peregrinação por cuidados, existem avanços que caminham na direção da atenção psicossocial e apontam para desafios a serem enfrentados. Tais avanços têm ancoragem nas tecnologias relacionais - acolhimento, vínculo, confiança e responsabilização entre os diversos atores envolvidos no cuidado. :El objetivo de este estudio fue analizar el itinerario recorrido por las familias de niños atendidos en un Centro de Atención Psicosocial Infantojuvenil, en búsqueda de un tratamiento de salud mental. Se realizaron Observaciones Participantes del servicio estudiado y Grupos Focales con familiares de niños atendidos. La investigación cualitativa utilizó como aporte teórico-metodológico el Análisis Institucional y el material se discutió, teniendo en vista la forma de atención psicosocial. La búsqueda de los familiares, cuando se enfrentan al sufrimiento psíquico de un niño, es un indicador privilegiado para aquilatar potencialidades y fragilidades en la construcción de la red de atención, así como para revelar la compresión de los familiares respecto a los problemas de salud mental y sus tratamientos. Se verificó la presencia de fuerzas contrapuestas en las acciones cotidianas de atención, bien sea la fuerza transformadora del instituyente, bien sea la cristalización de la atención y mantenimiento del instituido. En este sentido, el modelo hegemónicamente instituido -enfocado en la enfermedad, fragmentando al sujeto y la atención a él dirigida- ha sido tensionado por una fuerza instituyente, que propone reposicionar el sujeto, así como incorporar el sufrimiento psíquico, como integrante de la salud general, coordinando servicios y acciones en un modelo de red. A pesar del conjunto de situaciones embarazosas a las que se tienen que enfrentar los familiares en su peregrinación por los cuidados, existen avances que van en la dirección de la atención psicosocial y apuntan a desafíos que deben enfrentarse. Tales avances están anclados en las tecnologías de las relaciones -acogida, vínculo, confianza y responsabilización entre los diversos actores involucrados en el cuidado.
journal_name
Cad Saude Publicajournal_title
Cadernos de saude publicaauthors
Delfini PSS,Bastos IT,Reis AOAdoi
10.1590/0102-311X00145816subject
Has Abstractpub_date
2017-12-18 00:00:00pages
e00145816issue
12eissn
0102-311Xissn
1678-4464pii
S0102-311X2017001205009journal_volume
33pub_type
杂志文章abstract::The present paper reports data on secular trends in the stature of Brazilian Navy recruits born from 1940 to 1965. The final sample included 3269 individuals aged 18.00-18.99. Statistics performed were: ANOVA (one-way and two-way), Sheffe test, simple linear regression between stature and year of birth, and multiple l...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x1998000300013
更新日期:1998-07-01 00:00:00
abstract::This study aimed to identify the median duration of breastfeeding and associated factors in a cohort of 531 infants in two municipalities in the Recôncavo region, Bahia State, Brazil. Breastfeeding duration was estimated by survival analysis and its associations by the Cox multivariate model. Median duration of exclus...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2012000400004
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abstract::Highly active antiretroviral therapy (HAART) has led to a substantial increase in the survival of people living with AIDS, despite heterogeneities among individuals from different socioeconomic strata. The present paper analyzes AIDS deaths in Brazil during a period in which HAART became a key treatment regimen, explo...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2007001500012
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abstract::The aim of this study was to assess the association between prenatal exposure to air pollutants and low birth weight in a medium-sized city. An ecological study was performed, using live birth data from São José dos Campos, São Paulo State, Brazil. The environmental data were obtained from the São Paul State Environme...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2009000800015
更新日期:2009-08-01 00:00:00
abstract::The act of crossing an international border for healthcare is a reality in border areas and the flow is in the direction of the city with more human and healthcare resources. Although several prognostic factors related to HIV+ patients are known, the prognostic value of this type of mobility for long term care is stil...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00184918
更新日期:2019-09-09 00:00:00
abstract::The aim of this study was to determine smoking prevalence and associated factors among older adults (> 60 years). The study was conducted in Greater Metropolitan Belo Horizonte and Bambuí town, both located in Minas Gerais, Brazil. In the former, 1,774 subjects were selected, and in the latter, 1742. In Belo Horizonte...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2006000900024
更新日期:2006-09-01 00:00:00
abstract::This paper describes antimicrobial prescription, clinical indications, and seasonal characteristics in primary health care. We performed a cross-sectional study in family health units in Bagé, Rio Grande do Sul State, Brazil, in July 2005 and January 2006. All medical prescriptions (n = 2,877) were analyzed, and the p...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2008000800008
更新日期:2008-08-01 00:00:00
abstract::A prevalence study on smoking habits was carried out in 1991, among 864 school children from eight municipal schools in Sapiranga, in the State of Rio Grande do Sul, Brazil, from the 6th through 8th grade of primary school. Data was collected in class, using a questionnaire applied by trained teachers. Among students,...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x1993000200010
更新日期:1993-04-01 00:00:00
abstract::The purpose of this article is to describe several chronological milestones in institutionalizing the evaluation of public programs and policies in France from a governmental perspective and in the health sector, situating such references in the international context. The institutional nature of evaluation implies int...
journal_title:Cadernos de saude publica
pub_type: 历史文章,杂志文章
doi:10.1590/s0102-311x1999000200002
更新日期:1999-04-01 00:00:00
abstract::The objectives of this study were to describe the demand for health services by adolescents and to identify associated factors. The study analyzed data from the National School Health Survey 2012 and calculated prevalence rates and 95% confidence intervals (95%CI). Data analysis used age-adjusted logistic regression. ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00165214
更新日期:2015-08-01 00:00:00
abstract::In the past year, the Brazilian Federal Government and society have reported and acted on a crack use epidemic, which has been exacerbated by the media. This study hypothesized that crack use has not increased at the rate suggested by the Brazilian media. A cross-sectional survey was carried out in 2010 using a multis...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2012000900004
更新日期:2012-09-01 00:00:00
abstract::This paper describes a health education project targeting a rural community and health professionals from counties undergoing epidemiological surveillance for Chagas disease vectors in the State of Paraná, Brazil. A group of technicians from the Brazilian National Health Foundation (FUNASA) was trained, together with ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2002000600007
更新日期:2002-11-01 00:00:00
abstract::The dynamics of the spread of the AIDS epidemic ranges according to the characteristics of each geographical region in different population groups. The aim of this study was to evaluate spatial and temporal trends of the AIDS epidemic among the elderly in the State of Rio de Janeiro, Brazil. A retrospective study usin...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00152914
更新日期:2015-08-01 00:00:00
abstract::This study aimed to assess the dimensional structure and internal consistency of the Brazilian version of the Functional Activities Questionnaire (FAQ-BR) for measurement of functional capacity in the elderly, based on the informant's report. This was a cross-sectional study with 525 non-institutionalized elderly info...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00209917
更新日期:2018-11-08 00:00:00
abstract::Serum creatinine (sCr) is usually higher among black people in the United States due to increased muscle mass, justifying the addition of race adjustment in creatinine-based formulas to estimate glomerular filtration rate (eGFR). We aimed to assess if sCr levels are different in low-income communities in Brazil accord...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00150814
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journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2012000200013
更新日期:2012-02-01 00:00:00
abstract::Thirteen years after the Unified National Health System was implemented in Brazil, the Federal government increased the use of norms and regulations aimed at rationalizing resources and prioritizing basic care within the system. In other words, although actions and services are the responsibility of Municipal governme...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract::Passive smoking causes severe and lethal effects on health. Since 1996 Brazil has been moving forward in the implementation of anti-smoking legislation in enclosed public spaces. This article aims to evaluate the perceived enforcement of anti-smoking legislation in the cities of Porto Alegre (Rio Grande do Sul State),...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
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abstract::This study describes HIV-related behaviors recorded through a questionnaire applied to 570 individuals in Porto Alegre, Rio Grande do Sul, Brazil, who were not regular drug users. Mean age was 30.3 years, 51.1 % were male, and most were low-income (59.1%). The HIV seropositive rate was 9.9% (13.1% for males, 6.9% for ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2005000100029
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abstract::Among the ten leading causes of disability-adjusted life years, seven are mental disorders. Primary health care centers are crucial to public mental health policies, according to the World Health Organization. This study aimed to verify the prevalence of mental disorders among individuals seeking care at the referral ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2008000900010
更新日期:2008-09-01 00:00:00
abstract::[This corrects the article doi: 10.1590/0102-311X00050818]. ...
journal_title:Cadernos de saude publica
pub_type: 已发布勘误
doi:10.1590/0102-311XER050818
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abstract::The goals of this study were to identify how community-dwelling elderly deal with the prospect of disability/functionality and to understand how the sociocultural context modulates this process. The study adopted a qualitative approach in which the signs, meanings, and actions model was used in the data collection and...
journal_title:Cadernos de saude publica
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abstract::Information on fruits and vegetables consumption in Brazil in the three levels of dietary data was analyzed and compared. Data about national supply came from Food Balance Sheets compiled by the FAO; household availability information was obtained from the Brazilian National Household Budget Survey (HBS); and actual i...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2010001100018
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abstract::The obesity epidemic is a global phenomenon that does not respect geographic or socio-demographic boundaries. Thus, research on factors related to the obesity epidemic has focused on social and economic characteristics of modern societies. This article discusses obesity in Spain and trends in several associated factor...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2003000700011
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abstract::The aim of this study was to evaluate public knowledge on the role of physical activity in the prevention and treatment of diabetes and hypertension, and the factors associated with such knowledge. A population-based cross-sectional study was conducted in Pelotas, southern Brazil, including 972 adults aged 20 to 69 ye...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2009000300006
更新日期:2009-03-01 00:00:00
abstract::Rio Grande do Sul State has the highest suicide rates in Brazil. Previous studies have suggested a possible role of agricultural activities, especially tobacco farming, where pesticide use is intensive. An ecological study was designed to assess associations between age-adjusted suicide rates based on death certificat...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2006001200011
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abstract::Diarrhea is an important cause of hospitalization among infants. There are many complex factors that influence hospital use: socioeconomic and cultural characteristics, access, medical needs, and supply. The objective was to measure hospitalization rates from diarrhea among infants in Rio de Janeiro in 1996 and the as...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:
更新日期:2002-05-01 00:00:00
abstract::This study focuses on conditions in the public health centers providing comprehensive care to the adolescent population in the city of Rio de Janeiro. A structured questionnaire was administered to the coordinators of 70 public health centers (70/78). Based on the data, the public health centers were stratified accord...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
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abstract::The study aimed to: (1) describe the work process in Brazil's oral health teams, based on the essential attributes of primary health care, according to geographic region, type of team, and the municipality's socioeconomic characteristics and (2) verify whether the data in the work process of the oral health teams in t...
journal_title:Cadernos de saude publica
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abstract::This article presents the results of a study in the city of São Paulo, Brazil, aimed at estimating the frequency of induced abortion among women 15 to 49 years of age. The objective was to characterize the occurrence of induced abortion by comparing the ideal number of children, age, and contraceptive use between marr...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2009000100019
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