ABSTRACT
Mexican policymakers instituted community-based health programs in the 1940s and 1950s to encourage rural participation in state-sponsored health and economic development initiatives. The Tepalcatepec Commission (1947-1961) united previously independent government programs into a multi-tiered collaboration that addressed regional development through national, state, and local networks. While national policymakers and state officials designed plans to improve agricultural production, promote industrialization, utilize the area's natural resources, and expand communication channels, health workers established unprecedented relationships with indigenous community members by introducing the Commission's projects in culturally relevant ways. They used their on-the-ground experiences to learn local languages, customs, and beliefs, and incorporated these factors into their health education and disease treatment campaigns. The result serves as an example of short-term cooperative relationships between healthcare workers and indigenous groups that not only reduced the major health risks in the area, but also paved the way for collective economic development.
Subject(s)
Advisory Committees/history , Community Health Services/history , Indians, North American/history , Patient Care Team/history , Poverty/history , Public Health/history , Rural Health/history , Social Change/history , History, 18th Century , History, 19th Century , History, 20th Century , Humans , MexicoABSTRACT
Este artigo descreve e analisa a dinâmica da clínica de dor enquanto um "artefato complexo" do sistema terapêutico biomédico, explorando as múltiplas vozes e as relações dialógicas sobre dor e a interdisciplinaridade no cotidiano clínico de duas clínicas de dor situadas em hospitais-escola nas cidades de Salvador e São Paulo. Foi realizado estudo etnográfico orientado pela antropologia interpretativa, na qual se buscou a descrição de situações singulares e expressivas da dinâmica da clínica de dor (considerada enquanto um serviço, constituído no interior da Biomedicina, destinado ao cuidado da dor crônica). Tais situações expressam tensões e soluções construídas a partir do enfrentamento da dor crônica enquanto objeto complexo que impõe, a todos, flexibilidade. Essa experiência etnográfica focalizou quatro espaços terapêuticos: a sala de espera, o corredor, a consulta médica e as discussões de caso clínico. A descrição produzida ilumina as múltiplas vozes sobre dor e interdisciplinaridade no cotidiano da clínica. Os sentidos da circulação nos espaços terapêuticos, representado no texto a partir da metáfora "circuloterapia", orientam essa discussão em torno dos limites e possibilidades da constituição e funcionamento deste serviço.
This paper describes and analyzes the pain clinic's dynamics as a "complex product" of the biomedical therapy system, exploring the many discussions about the meaning of pain and the interdisciplinary collaboration in the therapeutic daily routines of two pain clinics, located in university hospitals in the cities Salvador and São Paulo. An ethnographic approach guided by interpretative anthropology was used to search for the description of singular and expressive situations of the pain clinic's dynamics (considered as a service, established within Biomedicine, intended for care of chronic pain). Such situations express tensions and solutions created from the confrontation of the chronic pain as a complex object that imposes flexibility to all. This ethnography focuses on four therapeutic spaces: the waiting-room, the hall, the medical consultation and the clinical case discussion. The resulting description enlightens the multiple voices on pain and interdisciplinary collaboration in the clinic's daily routines. The directions of circulation within therapeutic spaces guided this reflection around the limits and possibilities of the establishment and operation of this service.
Subject(s)
Humans , Male , Female , Pain Clinics/ethics , Pain Clinics , Chronic Disease/prevention & control , Chronic Disease/therapy , Pain/diagnosis , Patient Care Team/ethics , Patient Care Team/history , Patient Care Team/standards , Patient Care Team/organization & administration , Patient Care Team/trends , Ambulatory Care/ethics , Ambulatory Care/methods , Ambulatory Care/psychology , Ambulatory Care , Delivery of Health Care/ethics , Delivery of Health Care/methods , Delivery of Health Care , Complementary Therapies , Humanization of AssistanceABSTRACT
O objetivo desse trabalho é analisar a singularidade das estratégias terapêuticas introduzidas pelo modelo das Clínicas da Dor, através de um estudo genealógico desse projetoterapêutico e sua contextualização no âmbito da racionalidade científica moderna. Mais especificamente, pretende-se analisar as transformações na racionalidade médica que permitiram, sucessivamente, a apreensão da dor pelo discurso médico, a concepção da dorcomo uma doença e a construção e a consolidação do modelo terapêutico das Clínicas da Dor. Para tal, inicialmente, analisamos o modelo terapêutico desenvolvido pelo médico anestesista John Bonica, idealizador do modelo das Clínicas da Dor, destacando as ferramentas conceituais que possibilitaram a compreensão da dor crônica como doença e como fenômenobiopsicossocial. Num segundo momento, realizamos uma descrição e análise dos principais eventos que permitiram a consolidação da medicina da dor como uma prática específica e multidisciplinar, dando destaque à inserção deste modelo no contexto do Sistema Único de Saúde Brasileiro. Finalmente, a partir de uma experiência clínico-institucional buscamos refletir sobre os limites e possibilidades da aplicação prática deste modelo, lançando luz sobre os impasses da clínica e tensões oriundas da problematização do dualismo mente e corpo e das práticas terapêuticas interdisciplinares.
Subject(s)
Humans , Male , Female , Palliative Care/history , Cost of Illness , Chronic Disease/therapy , Pain, Intractable/history , Pain, Intractable/therapy , Pain/history , Pain/prevention & control , Pain/therapy , Clinical Medicine/history , Clinical Medicine/trends , Complementary Therapies , Pain Clinics/history , Pain Clinics/trends , Patient Care Team/history , Patient Care Team/trends , Critical Pathways/historyABSTRACT
En este trabajo nos acercamos al área de nuestro interés, el de la salud, para tratar de instalar la reflexión en torno a la problemática de la interdisciplinariedad. Pretendemos lograr que, sobre esta base, se dé un proceso de concientización para el abordaje de cuestiones complejas en este campo. Entendiendo que la súper especialización constituye una traba, tanto para la adquisición de nuevos conocimientos como para una mejor atención a los pacientes, apuntamos a encontrar los medios para su superación, vislumbrando que la misma podría ser posible mediante el trabajo interdisciplinario. Entendemos que es preciso desarrollar capacidades nuevas para realizar este trabajo. Proponemos algunas de estas capacidades como respuesta a la pregunta de ¿cuál es el camino?
Subject(s)
Specialties, Dental/trends , Patient Care Team/trends , Patient-Centered Care/trends , Comprehensive Dental Care/methods , Communication , Patient Care Team/history , Patient Care PlanningABSTRACT
En este trabajo nos acercamos al área de nuestro interés, el de la salud, para tratar de instalar la reflexión en torno a la problemática de la interdisciplinariedad. Pretendemos lograr que, sobre esta base, se dé un proceso de concientización para el abordaje de cuestiones complejas en este campo. Entendiendo que la súper especialización constituye una traba, tanto para la adquisición de nuevos conocimientos como para una mejor atención a los pacientes, apuntamos a encontrar los medios para su superación, vislumbrando que la misma podría ser posible mediante el trabajo interdisciplinario. Entendemos que es preciso desarrollar capacidades nuevas para realizar este trabajo. Proponemos algunas de estas capacidades como respuesta a la pregunta de ¿cuál es el camino? (AU)
Subject(s)
Patient Care Team/trends , Specialties, Dental/trends , Patient-Centered Care/trends , Patient Care Planning , Comprehensive Dental Care/methods , Patient Care Team/history , CommunicationABSTRACT
La presente investigación, realizada entre diciembre de 1998 y marzo de 2000, pretende comprender los significados que los adultos mayores atribuyen a la atención recibida en el Programa Adulto Saludable del Centro Alameda de la Pontificia Universidad Católica de Chile, el cual es implementado por un equipo interdisciplinario de atención en salud. El camino metodológico escogido fue realizar un estudio exploratorio de naturaleza cualitativa, lo que permite describir más exhaustivamente las percepciones de los usuarios. Para ello se entrevistó a cinco adultos mayores realizando preguntas abiertas dirigidas a explorar nueve temas previamente establecidos. La información obtenida se analizó a través del método de Análisis de Contenido Temático de Theophilus Riffiottis. De las respuestas de los usuarios se obtienen nuevos temas, por lo que para describirlos se reagrupan en seis categorías: Percepción que tienen los adultos mayores de sí mismos y su salud, Razón para atenderse en el Centro Alameda, Percepción de la atención recibida en el programa Adulto Saludable, Percepción sobre el costo de la atención, Expectativas de una buena atención de salud en general e Imagen de la Enfermera. De lo expresado por los usuarios se plantean temas considerados como relevantes, los cuales se discuten con la literatura y la postura de las autoras:"Pero, en mi interior sigo siendo la misma persona", "Me gusta el centro...", "El tiempo: un acuerdo que no se respeta","Salud: un gasto que hay que hacer", ¿Relación? médico-paciente e imagen de la enfermera: afectividad, procedimiento, y subordinación
Subject(s)
Aged , Humans , Male , Female , Patient Care Team/trends , Aged/physiology , /physiology , Comprehensive Health Care/history , Nursing/methods , Patient Care Team/history , Evaluation Studies as TopicABSTRACT
The development of public health and primary care in Jamaica is examined with particular reference to the historical events which paved the way for their development: notably, the collaborative work undertaken by the Rockefeller Foundation (Commissions on hookworm, tuberculosis, malaria, yams); recommendations of the Moyne Commission (leading to the establishment of the West Indies School of Public Health); and the Irvine Commission which recommended the establishment of the University College of the West Indies. A confluence of political, social and international activity in the 1970s proved catalytic in the development of the current ethos of primary health care, and the Department of Social and Preventive Medicine was instrumental in the training of the most innovative addition to the primary care health team, the community health aide. Undergraduate and postgraduate training programmes of the Department are highlighted as it celebrates its fortieth anniversary.(AU)
Subject(s)
Humans , History, 20th Century , Public Health/history , Jamaica , Education, Medical, Graduate/history , Education, Medical, Undergraduate/history , Patient Care Team/history , Preventive Medicine/history , Primary Health Care/history , Public Health/education , Schools, Medical/history , Social Medicine/history , West IndiesABSTRACT
The development of public health and primary care in Jamaica is examined with particular reference to the historical events which paved the way for their development: notably, the collaborative work undertaken by the Rockefeller Foundation (Commissions on hookworm, tuberculosis, malaria, yaws); recommendations of the Moyne Commission (leading to the establishment of the West Indies School of Public Health); and the Irvine Commission which recommended the establishment of the University College of the West Indies. A confluence of political, social and international activity in the 1970s proved catalytic in the development of the current ethos of primary health care, and the Department of Social and Preventive Medicine was instrumental in the training of the most innovative addition to the primary care health team, the community health aide. Undergraduate and postgraduate training programmes of the Department are highlighted as it celebrates its fortieth anniversary.
Subject(s)
Humans , History, 20th Century , Public Health/history , Primary Health Care/history , Education, Medical, Graduate/history , Patient Care Team/history , Schools, Medical/history , Preventive Medicine/history , Social Medicine/history , Public Health/education , West IndiesABSTRACT
The development of public health and primary care in Jamaica is examined with particular reference to the historical events which paved the way for their development: notably, the collaborative work undertaken by the Rockefeller Foundation (Commissions on hookworm, tuberculosis, malaria, yaws); recommendations of the Moyne Commission (leading to the establishment of the West Indies School of Public Health); and the Irvine Commission which recommended the establishment of the University College of the West Indies. A confluence of political, social and international activity in the 1970s proved catalytic in the development of the current ethos of primary health care, and the Department of Social and Preventive Medicine was instrumental in the training of the most innovative addition to the primary care health team, the community health aide. Undergraduate and postgraduate training programmes of the Department are highlighted as it celebrates its fortieth anniversary.