Atributos da atenção primária à sáude: a teoria e a prática em uma unidade de saúde da família na perspectiva de acadêmicos de medicina / Attributes of primary health care: theory and practice in a family health unit from the perspective of medical students / Atributos de la atención primaria de salud: teoría y práctica en una unidad de salud familiar desde la perspectiva de los estudiantes de medicina

A Atenção Primária à Saúde (APS), definida a partir da Declaração de Alma- Ata, e, identificada mundialmente como uma estratégia de organização dos serviços de saúde, caracteriza-se como o primeiro nível de contato dos indivíduos, da família e da comunidade com o sistema nacional de saúde. Este trabalho constitui um relato de experiência desenvolvido a partir de uma atividade teórico-prática, que se propôs a analisar os atributos e os processos de trabalho da Atenção Primária à Saúde no contexto de uma Unidade de Saúde da Família (USF), no município de Foz do Iguaçu-PR, com o objetivo de relacionar a teoria com a prática, por meio de questionários, elaborados com base na literatura e, aplicado aos profissionais e usuários do sistema de saúde. Ademais, contou com a observação da rotina do processo de trabalho na unidade. A vivência oportunizou a identificação dos desafios e fragilidades referentes aos atributos da APS e dos elementos constituintes do processo de trabalho em saúde. Por fim, conclui-se que, no cotidiano dos serviços, a APS enfrenta muitas dificuldades em se estabelecer como previsto na literatura e, por isso, faz-se premente a participação social para sua efetivação e consagração como primeiro nível de contato com o sistema de saúde.

Primary Health Care (PHC), defined from the Declaration of Alma-Ata, and identified worldwide as a strategy for organizing health services, is characterized as the first level of contact of individuals, family and community with the national health system. This paper is an experience report developed from a theoretical-practical activity, which proposed to analyze the attributes and work processes of Primary Health Care in the context of a Family Health Unit (USF) in the municipality of Foz do Iguaçu-PR, with the objective of relating theory to practice, through questionnaires, prepared based on the literature and applied to professionals and users of the health system. In addition, there was observation of the routine of the work process in the unit. The experience made it possible to identify the challenges and weaknesses related to the attributes of PHC and the constituent elements of the health work process. Finally, it is concluded that, in the daily life of services, PHC faces many difficulties in establishing itself as predicted in the literature and, therefore, social participation is necessary for its effectiveness and consecration as the first level of contact with the health system.

La Atención Primaria de Salud (APS), definida a partir de la Declaración de Alma-Ata, e identificada mundialmente como una estrategia de organización de los servicios de salud, se caracteriza por ser el primer nivel de contacto de los individuos, la familia y la comunidad con el sistema nacional de salud. Este trabajo es un relato de experiencia desarrollado a partir de una actividad teórico-práctica, que se propuso analizar los atributos y procesos de trabajo de la Atención Primaria de Salud en el contexto de una Unidad de Salud de la Familia (USF) en el municipio de Foz do Iguaçu- PR, con el objetivo de relacionar la teoría con la práctica, a través de cuestionarios, elaborados con base en la literatura y aplicados a profesionales y usuarios del sistema de salud. Además, hubo observación de la rutina del proceso de trabajo en la unidad. La experiencia permitió identificar los desafíos y debilidades relacionados con los atributos de la APS y los elementos constitutivos del proceso de trabajo en salud. Finalmente, se concluye que, en el día a día de los servicios, la APS enfrenta muchas dificultades para establecerse como predice la literatura y, por lo tanto, es necesaria la participación social para su eficacia y consagración como primer nivel de contacto con el sistema de salud. PALABRAS CLAVE: Atención Primaria de Salud; Sistema Único de Salud; Políticas de Salud.

Mídias sociais como ferramentas para a extensão remota: um relato de experiência de uma liga acadêmica de enfermagem / Social media as tools for remote extension: an experience reportof an academic nursing league / Las redes sociales como herramientas de extensión a distancia: relato de experiencia de uma liga académica de enfermería

O Coronavírus da Síndrome Respiratória Aguda Grave 2 (SARS-CoV-2), causador da pandemia de COVID-19, tem causado problemas mundiais para além da doença, como na Educação, que, na impossibilidade da promoção de encontros presenciais, precisou encontrar formas de oportunizar a continuidade dos processos de ensino-aprendizagem. Desse modo, a Liga de Enfermagem em Saúde da Família, considerando o cenário pandêmico e a necessidade de seguir com as atividades, teve que se adequar ao formato remoto e usar da sua criatividade para transpor as barreiras físicas da sala de aula.Objetivo:Relatar as ações extensionistas desenvolvidas virtualmente pela Liga de Enfermagem em Saúde da Família, demonstrando sua importância para a formação acadêmica em Enfermagem.Metodologia:Trata-se de um estudo descritivo, do tipo relato de experiência,sobre atividades desenvolvidas por acadêmicos de Enfermagem na Liga de Enfermagem em Saúde da Família vinculada ao Curso de Enfermagem da Universidade Estadual Vale do Acaraú, Sobral, Ceará.Resultados:A extensão foi desempenhada de forma onlinepor meio do Instagrame Youtube, com a criação de vídeos, imagens educativas e eventos com temas atuais e relevantes para a promoção da saúde, considerando a realidade sanitária, divididos em eixos: cooperação social, integração interprofissional, acadêmica e comunitária, politização acadêmica, datas comemorativas e vacinação.Conclusões:Esse relato reforça a interação universidade-sociedade frente a momentos de reestruturação, e a relevância das Ligas como estratégias extracurriculares de ensino, integrando-se à pesquisa e à extensão (AU).

The Coronavirus (SARS-CoV-2) of Severe Acute Respiratory Syndrome, which caused the COVID-19 pandemic, has been causing worldwide problems beyond the disease itself, for instance in Education, which became unable to provide face-to-face meetings, it had tofind ways to make possible to continue the teaching-learning processes. Considering the pandemic scenario and the need to continue their activities, the members of Academic Nursing League in Family Healthhad to adapt to a remote format and use their creativity to bridge the physical barriers of a classroom. Objective:To report academic extension actions developed virtually by members of the Nursing League in Family Health, demonstrating its importance for college education in nursing.Methodology:This is a descriptive study, an experience report developed from the activities performed by members of theAcademic Nursing League in Family Health, bounded to the Nursing College of Vale do Acaraú State University, in Sobral city, Ceará state.Results:Extension actions were performed using Instagramand Youtubeplatforms, by creating videos, educational images, and events approaching current and relevant topics for health promotion. Taking into consideration the sanitary reality of the population, topics werecategorized in the following groups: social cooperation; professional, academic, and community integration; academic politization; special dates; and vaccination.Conclusions:This report reinforces the university-society interaction facing restructuring moments and the relevance of academic leagues as an extracurricular strategy of teaching, integrating it to research and extension actions (AU).

El Síndrome Respiratorio Agudo Severo Coronavirus 2 (SARSCoV-2), provocador de la pandemia del COVID-19, ha ocasionado a nivel mundial problemas más allá de la enfermedad, como por ejemplo en la Educación, que, ante la imposibilidad de ofrecer citas presenciales, ha necesitado encontrar formas de generar oportunidades para la continuidad de los procesos de enseñanza-aprendizaje. De esa forma, la Liga de Enfermería en Salud de la Familia, considerando el escenario de la pandemia y la necesidadde seguir con las actividades, ha tenido que adaptarse al formato remoto y a echar creatividad para rebasar las barreras físicas del aula. Objetivo:Informar las acciones de extensión desarrolladas virtualmente por la Liga de Enfermería en Salud de la Familia, demostrando su relevancia para la formación académica en el curso de Enfermería. Metodología: Se trata de un estudio descriptivo, del tipo relato de experiencia, desarrollado a partir de las actividades de los estudiantes de Enfermería de la Liga de Enfermería en Salud de la Familia vinculada al Curso de Enfermería de la Universidad Estatal Vale do Acaraú, Sobral, Ceará. Resultados: Se ha realizado la extensión en línea a través de Instagramy Youtube, con la creación de videos, imágenes educativas y eventos con temas actuales y relevantes para la promoción de la salud, considerando la realidad de la salud, divididos en ejes: cooperación social, interprofesional, académica e integración comunitaria, politización académica, fechas conmemorativas y vacunación.Conclusiones: Este informe refuerza la interacción universidad-sociedad frente a momentos de reestructuración, y la relevancia de lasLigas como estrategias de enseñanza extracurricular, integrándose con la investigación y la extensión (AU).

Títeres online para promover la salud familiar en pandemia: Alcance global de una innovación en enfermería / Online puppets to promote family health in pandemic: Global range of an innovation in family nursing

El contexto global de la pandemia por coronavirus demandó un número creciente de enfermeras para cubrir las necesidades en el ámbito asistencial. También exigió abarcar sus otros roles, como el de educación y promoción de la salud en una población que requería ser empoderada en su autocuidado. Académicos de Enfermería con experticia, usando títeres en educación sanitaria, diseñaron un programa de obras online con el propósito de promover la salud de las familias reunidas, prevenir el COVID-19 y difundir el rol de Enfermería, apoyados por la Universidad Católica de la Santísima Concepción (Chile), Colegio de Enfermeras de Chile y Servicio de Salud Talcahuano (Chile). Los procedimientos básicos, consistieron en escribir y transmitir 14 obras originales, las que fueron visualizadas por público familiar de cinco continentes; en vivo y en su versión grabada, con cobertura de medios nacionales e internacionales. Durante el proceso el equipo debió sortear diversas limitaciones relacionadas con el confinamiento y el manejo de la tecnología para generar el streaming. Los principales hallazgos destacaron más de 27.000 reproducciones y 4000 comentarios. El público consultado consideró positivo el mensaje de las obras y que la universidad transmita conocimiento usando títeres. La experiencia se presentó en eventos académicos y artísticos. Se concluye que los títeres permiten educar en salud de forma entretenida y permiten captar la atención del público de todas las edades. Las redes sociales facilitaron la cobertura de las obras, para una promover la salud y el rol de Enfermería sin fronteras.

The global context of the coronavirus pandemic demanded a growing number of nurses to cover the needs in the healthcare field. It also required covering their other roles, such as education and health promotion in a population that needed to be empowered in their self-care. Nursing academics with experience using puppets in health education, designed a program of online works with the purpose of promoting the health of reunited families, preventing COVID-19 and disseminating the role of nursing, supported by the Universidad Católica de la Santísima Concepción (Chile), College of Nurses of Chile and Talcahuano Health Service (Chile). The basic procedures consisted of writing and transmitting 14 original works, which were viewed by family audiences from five continents; live and in its recorded version, with national and international media coverage. During the process, the team had to overcome various limitations related to confinement and the management of technology to generate streaming. Key findings highlighted more than 27,000 views and 4,000 comments. The consulted public considered the message of the works positive, and that the university transmits knowledge using puppets. The experience was presented at academic and artistic events. It is concluded that the puppets allow health education in an entertaining way and allow to capture the attention of the public of all ages. Social networks facilitated the coverage of the works, to promote health and the role of nursing without frontiers.

A dimensão técnico-pedagógica do apoio matricial no Núcleo de Ampliado de Saúde da Família e Atenção Básica (Nasf-AB) / The technical-pedagogical dimension of matrix support in expanded family health units (NASF-AB) / La dimensión técnico-pedagógica del apoyo matricial en el Núcleo Ampliado de Salud de la Familia (NASF-AB)

O apoio matricial, organizador do trabalho do Núcleo de Ampliado de Saúde da Família e Atenção Básica (Nasf-AB), possui uma dimensão assistencial e outra técnico-pedagógica. Este estudo objetivou analisar a dimensão técnico-pedagógica no Nasf-AB. Trata-se de uma pesquisa-intervenção participativa, em que foram realizadas observações participantes e grupos de reflexão. Pela análise temática, constatou-se que os profissionais não reconhecem prontamente a dimensão técnico-pedagógica, mas ela está presente nas práticas. Dificuldades para operar a dimensão técnico-pedagógica são relacionadas à priorização da assistência individual pelo Nasf-AB; à gestão da demanda; à participação dos ACS nas reuniões; à gestão e à gerência do processo de trabalho; às concepções sobre ensinar e aprender no matriciamento. A construção do conhecimento fora dos espaços instituídos das reuniões matriciais pode alargar possibilidades pedagógicas para ampliação da clínica.(AU)

Matrix support, which organizes the work of expanded family health units (NASF-AB), has care and technical-pedagogical dimensions. This study analyzed the technical-pedagogical dimension in a NASF-AB. We conducted a participatory intervention study using participant observation and reflection groups. The results of the thematic analysis showed that although professionals did not readily recognize the technical-pedagogical dimension, it was present in everyday practice. Difficulties in incorporating the technical-pedagogical dimension are related to the prioritization of individual care by the NASF-AB; demand management; participation of community health workers in meetings; management of work processes; and conceptions of teaching and learning in matrix support. Knowledge construction outside the spaces established for matrix support meetings could enhance pedagogical possibilities for expanding clinical care.(AU)

El apoyo matricial, organizador del trabajo Núcleo de Ampliado de Salud de la Familia (NASF-AB), tiene una dimensión asistencial y otra técnico-pedagógica. El objetivo de este estudio es analizar la dimensión técnico-pedagógica en el NASF-AB. Se trata de una investigación-intervención participativa en la que se realizaron observaciones participantes y grupos de reflexión. Por medio del análisis temático se constató que los profesionales no reconocen inmediatamente la dimensión técnico-pedagógica, pero ella está presente en las prácticas. Las dificultades para operar la dimensión técnico-pedagógica se relacionan a la priorización de la asistencia individual por parte del NASF-AB, a la gestión de la demanda, a la participación de la ACS en las reuniones, a la gestión y gerencia del proceso de trabajo y a las concepciones sobre enseñar y aprender en la organización matricial. La construcción del conocimiento fuera de los espacios instituidos de las reuniones matriciales puede ensanchar posibilidades pedagógicas para ampliación de la clínica.(AU)

Characterization of the professional physical education field in Brazilian multiprofessional health residency programs / Caracterização da área profissional da educação física nos programas de residências multiprofissionais em saúde do Brasil

ABSTRACT Multiprofessional residencies in the professional health field (MHR) are intersectoral cooperation programs to qualify health professionals. This study aimed to characterize the offer of vacancies meant for the professional Physical Education field in Brazilian MHR programs. It is a descriptive study of a documentary nature on the offer of training vacancies in MHR for the professional Physical Education field in 2022. The characterization of the programs considered: federative unit, proposing institution, total number of general vacancies, vacancies offered for Physical Education, focus of intervention of the programs, and other professional fields presented in the identified programs. A total of 184 vacancies offered by 77 MHR programs that include Physical Education in Brazil were identified. The Northeast region had the highest number of programs (n=29) and vacancies offered (n=89). Family Health was the major focus as to vacancies, while nursing appeared as the most frequent professional field among the identified programs (97.4%). This research work presented the characterization of the offer of vacancies intended for Physical Education in Brazilian MHR programs. Additionally, it evidences the need for a more equitable distribution of vacancies for Physical Education in the country.

RESUMO As residências multiprofissionais em área profissional de saúde (RMS) constituem-se em programas de cooperação intersetorial para qualificação de profissionais de saúde. Este estudo objetivou caracterizar a oferta de vagas destinadas à área profissional da Educação Física nos programas de RMS no Brasil. Estudo descritivo de natureza documental sobre a oferta de vagas de formação em RMS para a área profissional da Educação Física no ano de 2022. A caracterização dos programas considerou: unidade federativa, instituição proponente, total de vagas gerais, vagas ofertadas para a Educação Física, ênfase de atuação dos programas e demais áreas profissionais apresentadas nos programas identificados. Foram identificadas 184 vagas ofertadas por 77 programas de RMS que contemplam a Educação Física no Brasil. A região Nordeste apresentou o maior número de programas (n=29) e de vagas ofertadas (n=89). A ênfase mais apresentada com vagas foi a Saúde da Família enquanto a enfermagem apareceu é área profissional mais frequente entre os programas identificados (97,4%). Este trabalho apresentou a caracterização da oferta de vagas destinadas à Educação Física nos programas de RMS no Brasil. Além disso, evidencia a necessidade de uma distribuição mais equitativa das vagas destinadas à Educação Física no país.

Inserção e atuação do profissional de educação física nos núcleos de apoio à saúde da família em Santos-SP / The insertion and performance of the physical education professional in the family health support centers in Santos-SP / Inserción y desempeño del profesional de educación física en los centros de apoyo a la salud familiar de Santos-SP

O objetivo deste estudo foi compreender a inserção e a atuação do profissional de Educação Física no NASF em Santos-SP. Trata-se de uma pesquisa de abordagem qualitativa, na qual participaram 3 profissionais de Educação Física. A coleta de dados se deu por entrevista semiestruturada, e os dados foram interpretados à luz da análise de conteúdo. Como resultado, compreende-se que a inserção dos profissionais no NASF é inerente ao cargo ocupado. A atuação se dá num cenário limitante em número de profissionais e legitimação, trabalho anterior isolado e uma prática pedagógica instrumental, entretanto, aberta aos ideários críticos. Assim, embora haja um potencial alinhamento da atuação em relação às diretrizes do NASF, conclui-se que ainda existem limites a superar (AU)

The aim was to comprehend the insertion and performance of the Physical Education professional in the Family Health Support Centers (NASF) in the city of Santos-SP. It is a qualitative research in which three Physical Education professionals participated as volunteers. For this, semi-structured interviews were carried out and the data were analyzed through content analysis. As a result, the insertion of these professionals in the NASF is inherent to the position held. The performance is developed in a limiting context in terms of number of professionals and legitimacy, previous separate work, and an instrumental pedagogical practice; however, it opens to critical framework. Although the performance is potentially aligned with the NASF, we concluded there are limits to surpass yet (AU).

El objetivo de este estudio fue conocer la inserción y desempeño del profesional de Educación Física en el NASF en Santos-SP. Se trata de una investigación cualitativa, en la que participaron 3 profesionales de la educación física. La recolección de datos se realizó a través de entrevistas semiestructuradas y los datos se interpretaron a la luz del análisis de contenido. Como resultado, se entiende que la inserción de profesionales em el NASF es inherente al cargo que ocupan. La actuación se desarrolla en un escenario que limita el número de profesionales y la legitimidad, un trabajo previo aislado y una práctica pedagógica instrumental, sin embargo, abierta a ideas críticas. Así aunque existe una potencial alineación de desempeño en relación con las directrices del NASF, se concluye que aún quedan límites por supera (AU).

Experiencia de aprendizaje mediante el modelo integral de salud familiar y comunitario: opiniones de estudiantes de Enfermería de Chile / Learning experience using the comprehensive family and community health model: Chile's nursing students' opinions

Introducción: La práctica en centros de salud constituye un eje fundamental en la formación profesional del enfermero/a y es necesario propiciar instancias de aprendizaje favorables. El objetivo del estudio fue explorar la percepción de estudiantes de quinto año de la carrera de Enfermería de la Universidad Santo Tomás, Chile, en relación con su experiencia de aprendizaje durante su formación de pregrado, mediante el modelo integral de salud familiar y comunitario. Material y método: Investigación cualitativa, exploratoria, descriptiva, interpretativa, a través de un estudio intrínseco de casos. Es una muestra no probabilística, intencionada por criterios y a conveniencia (16 estudiantes). Se utilizó un grupo focal con análisis a partir de la reducción de datos. La validez se vigiló con los criterios de rigor, triangulando por investigadores. El estudio fue aprobado por el comité ético científico de la institución y se consideró la firma del consentimiento informado. Resultados: Se identificaron 353 unidades de significado, que originaron cuatro núcleos temáticos: ‘conceptualización del modelo en pregrado'; ‘aportes de los estudiantes en el proceso enseñanza-aprendizaje para internalizarlo'; ‘componentes asociados a factores que facilitan y dificultan su aplicabilidad' y ‘cualidades adquiridas por la práctica del modelo'. Finalmente, emergen dos dominios cualitativos: ‘aportes de los estudiantes en el proceso de formación' y ‘beneficios del modelo en el proceso de formación para la adquisición de competencias genéricas'. Conclusiones: Los estudiantes conocen el significado del modelo integral de salud familiar y comunitario, identifican mayoritariamente la estructura curricular como factor obstaculizador, reconocen que aprenden a través de metodologías centradas en el estudiante y describen las competencias genéricas declaradas en el perfil de egreso.(AU)

Introduction: The practice in Health Centers constitutes a fundamental axis in the professional training of nurses, being necessary to promote favorable learning instances. The objective of the study was to explore the perception of fifth-year nursing students at Santo Tomás University, Chile, in relation to their learning experience during their undergraduate training, using the Comprehensive Family and Community Health Model. Material and method: Qualitative, exploratory, descriptive, interpretive research, through intrinsic study of cases. Sample, non-probabilistic, intentional by criteria and convenience (16 students). A focus group was used; analysis from data reduction. Validity was ensured with rigorous criteria, triangulated by researchers. It was approved by the Scientific Ethics Committee of the Institution; it was considered the signing of the informed consent. Results: 353 units of meaning were identified, originating four thematic nuclei: ‘Conceptualization of the Model in undergraduate'; ‘Student contributions in the teaching-learning process to internalize it'; ‘Components associated with factors that facilitate and hinder its applicability' and ‘Qualities acquired by the practice of the Model'. Finally, two qualitative domains emerge: ‘Contributions of the students in the training process' and ‘Benefits of the Model in the training process for the acquisition of generic competences'. Conclusions: Students know the meaning of the Comprehensive Family and Community Health Model, mostly identify the curricular structure as an impeding factor, recognize that they learn through student-centered methodologies and describe the generic competencies declared in the Graduate Profile.(AU)

Influencia del funcionamiento familiar y bienestar psicológico en padres de familia ecuatorianos / Influence of the family functioning and psychological well-being in Ecuadorian patresfamilias

RESUMEN Introducción: la presente investigación surge motivada por el estudio de las variables de funcionamiento familiar y bienestar psicológico en padres de familia. Objetivo: determinar la influencia del funcionamiento familiar en el bienestar psicológico de los padres de familia pertenecientes al Ministerio de Compasión Internacional, de las iglesias del Nazareno en Ecuador. Materiales y métodos: se hizo un estudio observacional, transversal y cuantitativo de 405 padres de familia de las ciudades de Riobamba, Guaranda, Puyo y Montalvo, en Ecuador, entre agosto y octubre de 2020. Se realizó una encuesta mediante Google Forms. Los datos del funcionamiento familiar y bienestar psicológico se procesaron en Microsoft Excel, y el cálculo del coeficiente de correlación de Spearman se realizó mediante el software SPSS 25. Resultados: se evidenció la prevalencia de una familia moderadamente funcional (50,9 %) y de bienestar psicológico bajo (61,5 %). La correlación entre las dos variables de estudio fue de rho = 0,215. Las familias fueron mayormente nucleares y predominó el estado civil casado. Conclusiones: se determinó que los resultados no fueron concluyentes, ya que no existió una correlación entre las variables de estudio: funcionamiento familiar y bienestar psicológico. Se infirió que existieron otras variables intervinientes que merecieron ser analizadas (AU).

ABSTRACT Introduction: the current research arises motivated by the study of the variables of family functioning and psychological well-being in patresfamilias. Objective: to determine the influence of family functioning on the psychological well-being of patresfamilias who belong to the Ministry of International Compassion of the churches of the Nazarene in Ecuador. Materials and method: an observational, cross-sectional and quantitative study was carried out, in 405 patresfamilias from the cities of Riobamba, Guaranda, Puyo and Montalvo, in Ecuador, in the period August-October 2020. An inquiry was applied through Google Forms. Data on family functioning and psychological well-being were processed in Microsoft Excel, and the SPSS 25 software was used for working Spearman correlation out. Results: the prevalence of a moderately functional family (50.9%) and low psychological well-being (61.5%) were evidenced. The correlation between the two study variables was rho=0.215. Families were mostly nuclear and married marital status predominated. Conclusions: it was determined that results were not conclusive, because there was not a correlation between the study variables: family functioning and psychological well-being. The authors inferred that there were other involved variables that need to be analyzed (AU).

Estrategias comunitarias para la seguridad alimentaria en indígenas wayuu, La Guajira, Colombia / Community strategies for food security in indigenous wayuu, la guajira, colombia

Fundamentos: La desnutrición infantil como problema de inseguridad alimentaria aflige principalmente a las poblaciones más vulnerables, entre ellas las comunidades indígenas. El objetivo fue dar a conocer los microproyectoscreados con tres comunidades indígenas Wayuu sobre su seguridad alimentaria y evaluar la implementación de dichas estrategias. Métodos: investigación participativa basada en la comunidad (Community Based Participatory ResearchCBPR), incluyó la participación de 46 familias (204 personas). Se aplicaron técnicas de recolección como foros comunitarios, círculos de saberes, fotovoz, observación participante y recorridos del territorio. Resultados: La seguridad alimentaria de estas comunidades está atravesada por estrategias como a) creación dehuertas comunitarias como una alternativa sostenible para su autonomía y el rescate de sus prácticas ancestrales, b) educación nutricional intercultural al propiciar una articulación de saberes propios y académicos alrededor de la alimentación y la nutrición y c) fortalecimiento comunitario que a partir de los planes de vida fomenta el equilibrio, la armonía y el bienestar dentro del territorio. Conclusiones: La seguridad alimentaria debe ser concebida como un pilar en el plan de vida de las comunidades indígenas en tanto fomenta su autonomía y la restauración de sus vidas en el territorio, en su cultura y en sus conocimientos. (AU)

Background: Child malnutrition as a problem of food insecurity mainly afflicts the most vulnerable populations among them, indigenous communities. The objective was to publicize the microprojects created with three Wayuuindigenous communities on their food security and to evaluate the implementation of these strategies.Methods: Community Based Participatory Research (CBPR), included the participation of 46 families (204 people).Collection techniques such as community forums, circles of knowledge, photo voice, participant observation and tours ofthe territory were applied. Results: The food security of these communities is crossed by strategies such as a) creation of community gardens as a sustainable alternative for their autonomy and the rescue of their ancestral practices, b) intercultural nutritional educationby promoting an articulation of their own and academic knowledge about food and nutrition and c) community strengthening that, based on life plans, promotes balance, harmony and well-being within the territory. Conclusions: Food security must be conceived as a pillar in the life plan of indigenous communities as it fosters their autonomy and the restoration of their lives in the territory, in their culture and in their knowledge. (AU)

"Landpartie 2.0" - Conceptual development and implementation of a longitudinal priority program to promote family medicine in rural areas.

Objective: This article reports on the conceptual development and subsequent implementation of a targeted and attractive general practice teaching program in a rural area for students of human medicine at the medical faculty of Goethe University, Frankfurt am Main. Project description: Since the 2016/2017 winter semester, usually up to 15 interested students a year have had the opportunity to participate in the longitudinal priority program "Landpartie 2.0". The program runs for six semesters during the clinical stage of medical studies and consists of regular internships during which the students receive one-to-one support in a family practice, and participate in a series of seminars and an annual one-day excursion. The aim is to enable students, early on in their studies and without any obligations, to gain uninterrupted experience of providing patient care, and to find out what it means to pursue a career in family medicine. Results: Since the beginning of the annual program, 62 students have been included in it. The initial results show that the different elements of the program fulfil the expectations and requirements of participants and that their overall level of satisfaction is high. Almost 95% of students reported that they felt their knowledge had increased as a result of the internships, and they rated them as a useful part of their medical education. Despite the rural focus of the program, around half of the participants were of urban origin. Conclusion: The "Landpartie 2.0" provides students with the opportunity to familiarize themselves with family health care in a rural area. Further studies should investigate to what extent the program encourages students to continue their training with a view to pursuing a career in family medicine.

Effectiveness of an educational intervention on vulvo-vaginal discharge for family healthcare workers: A nonrandomized controlled trial.

Women's delay in seeking medical advice for abnormal vaginal discharge can cause serious effects such as infertility, ectopic pregnancy, and advanced cervical cancer. Family healthcare workers are in a unique position to help in the promotion of vaginal health. A nonrandomized controlled trial was conducted among a sample of family healthcare workers in the intervention (n = 37) and a control (n = 37) group to assess the effectiveness of an educational intervention, which was a 2-day intensive workshop combining reading materials. Data were analyzed using SPSS software (version 20), and the effectiveness of the intervention was determined using a mixed between-within subjects analysis of variance. The total knowledge and attitude scores were significantly greater for family healthcare workers in the intervention group immediately and at 3 and 6 months after the educational intervention, compared to the control group. A substantial main effect was observed concerning the time, showing an increase in family healthcare workers' knowledge and attitude scores across the four time periods. A statistically significant difference in the median overall health education competency score across the two groups was also observed. The mean score differences in all sub-competencies in health education were significantly higher among the intervention group, compared to the control group between second postintervention and the baseline. The educational intervention had revealed successful and sustainable improvements in family healthcare workers' knowledge, attitude on vaginal discharge, and health education competency. This can be implemented as an in-service program for family healthcare workers to improve health education practices.

CHARCTERIZATION OF FEEDING OF CHILDREN UNDER 24 MONTHS IN UNITS CARED BY THE FAMILY HEALTH STRATEGY.

OBJECTIVE: To describe the median age of introduction and regular food intake by young children in units of the Family Health Strategy. METHODS: Cross-sectional study with 283 young children chosen by uniform stratified cluster sampling. Socio-demographic data on the mother and the child's food intake were collected (age of food introduction and weekly frequency). Foods were grouped into in natura/minimally processed (G1); culinary ingredients (G2); processed (G3) and ultra-processed (G4). The survival analysis was applied to define the median age of food introduction and the chi-square test was used to compare the frequency of food intake, according to the age range (0-5.9; 6-11.9; and 12-23.9 months old). RESULTS: The median duration of exclusive breastfeeding and breastfeeding were three and 19 months, respectively. The age of median food introduction of G1 was six months, except for eggs, milk and coffee (12 months). For oil and salt (G2), the median was 6 months, and for sugar (G2), seven months. The median age of introduction of most food of G4 was 12 months; for infant formulas, it was seven months; cookies and baby food, eight months. Most food had not yet been introduced for children under six months old. For children from six to 11.9 months old, the regular consumption of G4 (≥5 days/week) was higher for cookies (23.8%), bread (21.2%), infant formulas (21.2%) and baby food (35%); and for children from 12 to 23.9 months old, it was higher for cookies (31.2%), bread (57.5%) and baby food (48.7%). CONCLUSIONS: Food introduced and consumed on a regular basis was mainly in natura, at all ages. Processed and ultra-processed food presented a higher frequency of consumption after 12 months old.

Infant illness severity and family adjustment in the aftermath of NICU hospitalization.

Up to 15% of parents have an infant who will spend time in a neonatal intensive care unit (NICU). After discharge, parents may care for a medically fragile infant and worry about their development. The current study examined how infant illness severity is associated with family adjustment. Participants included parents with infants who had been discharged from the NICU 6 months to 3 years prior to study participation (N = 199). Via a Qualtrics online survey, parents reported their infants' medical history, parenting stress, family burden, couple functioning, and access to resources. Multivariable regression analyses revealed that more severe infant medical issues during hospitalization (e.g., longer length of stay and more medical devices) were associated with greater family burden, but not stress or couple functioning. Infant health issues following hospitalization (i.e., medical diagnosis and more medical specialists) were associated with greater stress, poorer couple functioning, and greater family burden. Less time for parents was associated with increased stress and poorer couple functioning. Surprisingly, parents of infants who were rehospitalized reported less stress and better couple functioning, but greater family burden. Family-focused interventions that incorporate psychoeducation about provider-patient communication, partner support, and self-care may be effective to prevent negative psychosocial sequelae among families.

Hasta un 15% de progenitores tiene un infante que pasará un tiempo en una Unidad de Cuidado Intensivo Neonatal (NICU). Después de la salida, los progenitores deben cuidar de un infante médicamente débil y preocuparse por su desarrollo. El presente estudio examinó cómo la severidad de la enfermedad del infante se asocia con la adaptabilidad familiar. Los participantes eran progenitores con infantes que habían salido de la Unidad de Cuidado Intensivo Neonatal entre 6 meses y 3 años antes de participar en el estudio (N = 199). Por medio de una encuesta electrónica tipo Qualtrics, los progenitores reportaron el historial médico de su infante, el estrés de la crianza, la carga familiar, el funcionamiento como pareja y el acceso a recursos. Los análisis de regresión de variables múltiples revelaron que asuntos médicos más severos del infante durante la hospitalización (v.g. período más largo de hospitalización, más aparatos médicos) se asociaban con mayor carga familiar, aunque no así con estrés o el funcionamiento como pareja. Los asuntos de salud infantil posteriores a la hospitalización (v.g. diagnóstico médico, más médicos especialistas) se asociaron con mayor estrés, un más pobre funcionamiento como pareja y mayor carga familiar. Menos tiempo para los progenitores se asoció con un aumento en el estrés y un más pobre funcionamiento como pareja. De modo sorprendente, los progenitores de infantes que habían sido hospitalizados otra vez reportaron menos estrés y mejor funcionamiento como pareja, pero mayor carga familiar. Las intervenciones con enfoque familiar que incorporan educación sicológica acerca de la comunicación entre proveedor y paciente, apoyo a la propia pareja y el cuidado propio pudieran ser eficaces para prevenir la secuela sicosocial entre familias.

Jusqu'à 15% des parents ont un bébé qui passera du temps en Unité Néonatale de Soins Intensifs. A la sortie de l'hôpital les parents peuvent se retrouver à prendre soin d'un bébé fragile du point de vue médical et s'inquiéter de son développement. Cette étude a examiné comment la sévérité de la maladie du bébé est liée à l'ajustement de la famille. Les participants ont inclu des parents avec des bébés étant sortis de l'Unité Néonatale de Soins Intensifs 6 mois à trois ans avant la participation à l'étude (N = 199). Au travers d'un questionnaire Qualtrics en ligne, les parents ont fait état de l'histoire médicale des bébés, du stress de parentage, du poids sur la famille, du fonctionnement du couple et de l'accès aux ressources. Des analyses de régression multivariables ont révélé que les problèmes médicaux du bébé durant l'hospitalisation les plus graves (i.e. durée plus longue du séjour, plus de dispositifs médicaux) étaient liés à un poids sur la famille plus fort, mais pas au stress ni n'affectait le fonctionnement du couple. Les problèmes de santé du bébé après l'hospitalisation (soit un diagnostic médical, plus de spécialistes médicaux) étaient liés à un stress plus élevé, à un fonctionnement du couple moins bon, et à un poids sur la famille plus fort. Moins de temps pour les parents était lié à un stress supplémentaire et à un fonctionnement du couple moins bon. Avec surprise, les parents de bébés qui étaient réhospitalisés ont fait état de moins de stress et d'un meilleur fonctionnement de couple, mais d'un poids plus fort sur la famille. Les interventions centrées sur la famille qui incorporent une psychoéducation sur la communication médecin-parent, le soutien du partenaire et le soin de soi peut s'avérer efficace afin d'éviter des séquelles psychosociales négatives chez les familles.

An effectiveness study of a wearable device (Clouclip) intervention in unhealthy visual behaviors among school-age children: A pilot study.

INTRODUCTION: The study aimed to determine the effectiveness of an intervention for unhealthy visual behaviors of school-age children using a wearable device (Clouclip). METHOD: The design was a self-controlled prospective study. Clouclip, with the vibration alert disabled, was first applied to measure baseline near-work behaviors in the first week. The vibration alert was then enabled to signal unhealthy visual behaviors (near-work distance < 30 cm and >5 seconds, or near-work distance <60 cm for >45 minutes) for 3 weeks. Near-work behaviors were measured again at the first week and the first month after intervention, respectively. The changes in behaviors between the baseline and the first week and the first month after intervention were analyzed. RESULTS: Sixty-seven subjects were eligible for this experiment (the mean age 10.45 ±â€Š0.50 years, 34 boys). Children who logged sufficient wearing time (12.30 ±â€Š0.18 hours on weekdays and 12.16 ±â€Š0.23 hours on weekends) were included for analysis. The average daily near-work distance was significantly increased after the vibration intervention. The time ratio of near-work activity <30 cm to the total <60 cm and the frequency of continuous near-work (distance <60 cm and continuous time >30 minutes) were significantly decreased after the intervention. Although some of the effects were reversed with time following the intervention, some were observed to be maintained until the end of the observation period, and the improvement of the behaviors was more prominent in children who had a shorter near-work distance (<30 cm) at baseline. CONCLUSIONS: In conclusion, Clouclip can significantly modify near-work behaviors in school-age children and it can last a certain period of time. If these behaviors are causes of myopia development and progression, Clouclip might provide a strategy for managing myopia.

A formação do enfermeiro na atenção integral às crianças com necessidades especiais de saúde e suas famílias / Nursing training in integral care for children with special health care needs and their families

Formar enfermeiros capazes de responder às demandas da sociedade exige um ensino contextualizado e consistente que os prepare para enfrentar os desafios do dinamismo do mundo moderno e das condições de exercício profissional. A acelerada modernização científica e tecnológica tem garantido maior sobrevivência a muitas crianças, ao passo que faz emergir uma clientela portadora de condições que requerem transformações de vida importantes: as Crianças com Necessidades Especiais de Saúde (CRIANES). Frente ao atual perfil epidemiológico infantil, delineou-se como objeto do estudo: o desenvolvimento de competências no processo de formação do enfermeiro na atenção integral às CRIANES e suas famílias. Definiu-se como objetivo geral: analisar como se organiza o ensino da atenção à saúde da criança nos cursos de graduação em enfermagem com vistas ao desenvolvimento de competências para o cuidado às CRIANES e suas famílias, na perspectiva dos docentes; e específicos: apreender a concepção dos docentes dos cursos de graduação em enfermagem sobre as CRIANES; identificar os conteúdos programáticos e os aspectos metodológicos do ensino referentes à atenção à saúde das CRIANES e suas famílias nos cursos de graduação em enfermagem; descrever, na perspectiva dos docentes, como acontece o ensino da saúde da criança de forma a desenvolver nos alunos as competências necessárias para o cuidado às CRIANES e suas famílias. Pesquisa qualitativa, descritivo-exploratória, com 17 docentes da área de saúde da criança de cursos de graduação em enfermagem de três Instituições de Ensino Superior (IES) públicas federais, na região metropolitana do estado do Rio de Janeiro. Aprovada pelo Comitê de Ética em Pesquisa da instituição proponente e das instituições coparticipantes. A coleta de dados foi realizada através de entrevista semiestruturada. Através da análise de conteúdo temático-categorial de Bardin, construíram-se quatro categorias, interpretadas e discutidas à luz do referencial teórico de Philippe Perrenoud: 1) As CRIANES e suas famílias na perspectiva docente; 2) A abordagem da temática das CRIANES nos cursos de graduação em enfermagem; 3) Estratégias de ensino e o processo de avaliação na abordagem das CRIANES nos cursos de graduação em enfermagem: desenvolvimento de competências; 4) Aspectos valorizados no desenvolvimento da competência de atenção à saúde das CRIANES e suas famílias na formação de enfermeiros. Evidenciou-se um processo de incorporação da temática nos cursos de graduação em enfermagem, reflexo da apropriação do conceito de CRIANES pelos próprios docentes. Tema ainda pouco explorado em seus aspectos particulares, com uma abordagem assistemática e pontual sob a ótica do modelo biomédico e hospitalocêntrico. Entretanto, valorizou-se a abordagem centrada na família e a articulação das redes de atenção à saúde, traduzindo a busca pela atenção integral. Os resultados reforçam o desafio e a importância de incluir a temática nos programas curriculares e nas práticas pedagógicas para ampliar as discussões na graduação de enfermagem. Trouxe subsídios para embasar e auxiliar o planejamento do ensino com relação à problemática das CRIANES e suas famílias, para formar enfermeiros que sejam atores sociais no cenário da saúde da criança no país.

Training nurses capable of responding to the demands of society requires a contextualized and consistent training that prepares them to face the challenges of the dynamism of the modern world and the conditions of professional practice. The accelerated scientific and technological modernization has ensured greater survival for many children, while a clientele with conditions that require important life transformations has risen: Children with Special Health Care Needs (CSHCN). In view of the current epidemiological profile of children, the following object of study was outlined: the development of competences in the process of nursing education in integral care for CSHCN and their families. It was defined as general objective: to analyze how the teaching of child health care is organized in undergraduate nursing courses with a view to developing competencies for the care of children and their families from the professors' perspective; and the specific objetives were: to capture the conception of the professors of undergraduate nursing courses on CSHCN; to identify the program contents and methodological aspects of teaching related to the health care of CSHCN and their families in undergraduate nursing courses; to describe, from the professors' perspective, how child health teaching occurs in order to develop in students the necessary competences for the care of CSHCN and their families. Qualitative, descriptive and exploratory research with 17 professors of child health care from undergraduate nursing courses of three federal public higher education institutions (HEIs) in the metropolitan region of Rio de Janeiro state in Brazil. Approved by the Research Ethics Committee of the proposing institution and co-participating institutions. Data collection was conducted through semi-structured interview. Through the thematic-categorical content analysis of Bardin, four categories were constructed, interpreted and discussed in the light of the theoretical referential of Philippe Perrenoud: 1) CSHCN and their families in the professors' perspective; 2) The approach to the subject of CSHCN in undergraduate nursing courses; 3) Teaching strategies and the evaluation process in the approach to CSHCN in undergraduate nursing courses: competence development; 4) Valued aspects in the development of the competence of attention to the health of CSHCN and their families in the training of nurses. A process of incorporation of this theme in the undergraduate nursing courses was evidenced, reflecting the appropriation of the concept of CSHCN by the professors themselves. This theme is still under explored in its particular aspects, showing an unsystematic and punctual approach from the perspective of the biomedical and hospital-centric model. However, the family-centered approach and the articulation of health care networks were valued, reflecting the search for integral care. The results reinforce the challenge and importance of including the theme in curricular programs and pedagogical practices to broaden discussions in undergraduate nursing. It brought important cobtributions to support and assist the education plannning related to the problem of CSHCN and their families, in order to train nurses who will become social actors in the child health scenario in the country.

Charcterization of feeding of children under 24 months in units cared by the family health strategy / Caracterização da alimentação de crianças menores de 24 meses em unidades da estratégia saúde da família

ABSTRACT Objective: To describe the median age of introduction and regular food intake by young children in units of the Family Health Strategy. Methods: Cross-sectional study with 283 young children chosen by uniform stratified cluster sampling. Socio-demographic data on the mother and the child's food intake were collected (age of food introduction and weekly frequency). Foods were grouped into in natura/minimally processed (G1); culinary ingredients (G2); processed (G3) and ultra-processed (G4). The survival analysis was applied to define the median age of food introduction and the chi-square test was used to compare the frequency of food intake, according to the age range (0-5.9; 6-11.9; and 12-23.9 months old). Results: The median duration of exclusive breastfeeding and breastfeeding were three and 19 months, respectively. The age of median food introduction of G1 was six months, except for eggs, milk and coffee (12 months). For oil and salt (G2), the median was 6 months, and for sugar (G2), seven months. The median age of introduction of most food of G4 was 12 months; for infant formulas, it was seven months; cookies and baby food, eight months. Most food had not yet been introduced for children under six months old. For children from six to 11.9 months old, the regular consumption of G4 (≥5 days/week) was higher for cookies (23.8%), bread (21.2%), infant formulas (21.2%) and baby food (35%); and for children from 12 to 23.9 months old, it was higher for cookies (31.2%), bread (57.5%) and baby food (48.7%). Conclusions: Food introduced and consumed on a regular basis was mainly in natura, at all ages. Processed and ultra-processed food presented a higher frequency of consumption after 12 months old.

RESUMO Objetivo: Descrever a idade mediana de introdução e consumo regular de alimentos por crianças menores de 24 meses em unidades da Estratégia Saúde da Família. Métodos: Estudo transversal realizado com 283 crianças selecionadas por amostragem por conglomerado estratificada uniforme. Foram coletados dados sociodemográficos da mãe e do consumo alimentar da criança (idade de introdução e frequência semanal). Os alimentos foram agrupados em: in natura/minimamente processados (G1); ingredientes culinários (G2); processados (G3) e ultraprocessados (G4). Utilizou-se análise de sobrevida para definição da idade mediana de introdução dos alimentos e teste do qui-quadrado para comparação da frequência de consumo segundo a faixa etária (0 a 5,9; 6 a 11,9; e 12 a 23,9 meses). Resultados: A duração mediana do aleitamento materno exclusivo foi de três meses e do aleitamento materno, de 19 meses. A mediana de introdução dos alimentos do G1 foi de seis meses, exceto para ovo, leite e café (12 meses). Para óleo e sal (G2), a mediana foi de 6 meses e para o açúcar (G2), de sete meses. A mediana da maioria dos alimentos do G4 foi de 12 meses, para fórmulas foi de sete meses, biscoitos e alimentos infantis, oito meses. A maioria dos alimentos ainda não tinha sido introduzida para crianças menores de seis meses. Para crianças de seis a 11,9 meses, o consumo regular (≥5 dias/semana) de G4 foi superior para biscoitos (23,8%), pão (21,2%), fórmulas (21,2%) e alimentos infantis (35,0%); e para crianças de 12 a 23,9 meses foi para biscoitos (31,2%), pão (57,5%) e alimentos infantis (48,7%). Conclusões: Os alimentos introduzidos e consumidos regularmente foram principalmente alimentos in natura, em todas as idades. Alimentos processados e ultraprocessados apresentaram maior frequência de consumo após os 12 meses.

Propuesta de intervención sicoeducativa para modificar comportamientos de violencia intrafamiliar / A proposal of psychoeducational intervention to modify domestic-violence behaviors

RESUMEN Fundamento: La violencia intrafamiliar afecta a niveles crecientes la salud física, sicológica, emocional y social de quienes la padecen. Objetivo: Elaborar una propuesta de intervención sicoeducativa para modificar comportamientos de violencia intrafamiliar. Metodología: Se realizó una investigación cualitativa, la población estuvo conformada por 40 familias disfuncionales con presencia de violencia intrafamiliar. De ellas se seleccionó una muestra de 14 familias. Para la obtención de los datos se utilizaron las técnicas: entrevista familiar, entrevista a informantes claves, test de percepción de funcionamiento familiar (FF-SIL), observación participante, dibujo de la familia y entrevista a profundidad a los miembros adultos. Para la evaluación de la estrategia se seleccionaron 14 profesionales y se emplearon los métodos: criterios de expertos a través de un cuestionario y la técnica Delphi. Resultados: Los resultados permitieron elaborar la estrategia sicoeducativa a partir de la prevalencia en las familias de violencia sicológica, la existencia de inadecuados estilos de comunicación y educativos, mayor incidencia de violencia en niños, adolescentes y adultos mayores con el fin de modificar comportamientos de violencia intrafamiliar. El 100 % de los profesionales evidenció un consenso generalizado en la valoración de la propuesta y con ello la aplicabilidad de la intervención. Conclusiones: Se elaboró la propuesta de intervención sicoeducativa, en la que se evaluaron de pertinentes las acciones de la intervención.

ABSTRACT Background: Domestic violence affects the physical, psychological, emotional and social health of those who suffer from it at increasing levels. Objective: To develop a proposal of psychoeducational intervention to modify domestic-violence behaviors. Methodology: A qualitative investigation was carried out; the population was made by 40 dysfunctional families with the presence of domestic violence. A sample of 14 families was selected. The techniques used to obtain the data were: family interview, interview to key informants, family functioning perception test (FF-SIL), participant observation, family drawing and in-depth interview to adult members. For the evaluation of the strategy, 14 professionals were selected and the methods used were: expert criteria through a questionnaire and the Delphi technique. Results: The results allowed the elaboration of the psychoeducational strategy based on the prevalence of psychological violence in families, the existence of inadequate communication and educational styles, a greater incidence of violence in children, adolescents and the elderly in order to modify domestic violence behaviors. 100 % of the professionals showed a general consensus in the evaluation of the proposal and with it the applicability of the intervention. Conclusions: The proposal of psychoeducational intervention was elaborated, in which the intervention actions were evaluated as pertinent.

Desarrollo de materiales educativos para pacientes crónicos y familiares / Development of educational materials for chronic patients and families

Un nivel bajo de alfabetización puede dificultar la comprensión de la información necesaria para tomar decisiones apropiadas en relación con la propia salud. Esta situación está relacionada con una peor adherencia a los tratamientos, un peor estado de bienestar y una mortalidad más elevada, sobre todo en personas de edad avanzada. Resulta esencial que la información pueda ser comprendida por el paciente y su familia. Este artículo tiene como objetivo presentar las recomendaciones internacionales existentes para el diseño y la elaboración de materiales o recursos educativos para pacientes crónicos y familiares. Se describen aspectos metodológicos que engloban la inclusión de los pacientes en distintos puntos durante el proceso de desarrollo del material, la adaptación del formato y el contenido al nivel de comprensión del paciente, así como su participación en una prueba piloto antes de la publicación de los mismos. Los materiales educativos que se han elaborado con la colaboración de los pacientes resultan más adaptados a su contexto y promueven cambios positivos en su salud

Low literacy can difficult the use of information needed to take appropriate decisions in healthcare. This situation is associated with poorer treatment adherence, lower health outcomes and higher mortality among the population and, specifically, the elderly. It is essential that information can be understood by patients and families. This article aims to present the existing international recommendations for the design and development of educational materials and resources to chronic patients and families. This process encompasses the involvement of patients at various levels during the development process of the materials, the adaptation of the format and content to the level of understanding of the patient as well as their participation in the evaluation process. Educational materials that have been developed in collaboration with patients are more adapted to their context and promote positive changes in their health

Propuesta de intervención sicoeducativa para modificar comportamientos de violencia intrafamiliar / A proposal of psychoeducational intervention to modify domestic-violence behaviors

RESUMEN Fundamento: La violencia intrafamiliar afecta a niveles crecientes la salud física, sicológica, emocional y social de quienes la padecen. Objetivo: Elaborar una propuesta de intervención sicoeducativa para modificar comportamientos de violencia intrafamiliar. Metodología: Se realizó una investigación cualitativa, la población estuvo conformada por 40 familias disfuncionales con presencia de violencia intrafamiliar. De ellas se seleccionó una muestra de 14 familias. Para la obtención de los datos se utilizaron las técnicas: entrevista familiar, entrevista a informantes claves, test de percepción de funcionamiento familiar (FF-SIL), observación participante, dibujo de la familia y entrevista a profundidad a los miembros adultos. Para la evaluación de la estrategia se seleccionaron 14 profesionales y se emplearon los métodos: criterios de expertos a través de un cuestionario y la técnica Delphi. Resultados: Los resultados permitieron elaborar la estrategia sicoeducativa a partir de la prevalencia en las familias de violencia sicológica, la existencia de inadecuados estilos de comunicación y educativos, mayor incidencia de violencia en niños, adolescentes y adultos mayores con el fin de modificar comportamientos de violencia intrafamiliar. El 100 % de los profesionales evidenció un consenso generalizado en la valoración de la propuesta y con ello la aplicabilidad de la intervención. Conclusiones: Se elaboró la propuesta de intervención sicoeducativa, en la que se evaluaron de pertinentes las acciones de la intervención.

ABSTRACT Background: Domestic violence affects the physical, psychological, emotional and social health of those who suffer from it at increasing levels. Objective: To develop a proposal of psychoeducational intervention to modify domestic-violence behaviors. Methodology: A qualitative investigation was carried out; the population was made by 40 dysfunctional families with the presence of domestic violence. A sample of 14 families was selected. The techniques used to obtain the data were: family interview, interview to key informants, family functioning perception test (FF-SIL), participant observation, family drawing and in-depth interview to adult members. For the evaluation of the strategy, 14 professionals were selected and the methods used were: expert criteria through a questionnaire and the Delphi technique. Results: The results allowed the elaboration of the psychoeducational strategy based on the prevalence of psychological violence in families, the existence of inadequate communication and educational styles, a greater incidence of violence in children, adolescents and the elderly in order to modify domestic violence behaviors. 100 % of the professionals showed a general consensus in the evaluation of the proposal and with it the applicability of the intervention. Conclusions: The proposal of psychoeducational intervention was elaborated, in which the intervention actions were evaluated as pertinent.

Tips for permanent education in mental health in primary care guided by the Institutional Socio-clinic.

OBJECTIVE: to analyze a process of Permanent Education in Health about mental health with Family Health teams. METHOD: research-intervention performed with 20 workers from two teams of the Family Health Strategies. Semi-structured interviews and 12 reflection meetings were carried out with each team. The principles of Institutional Socio-clinic were used to guide the meetings and the analysis of the data. RESULTS: seven beaconing tips were identified for the Process of Permanent Education in Health: effects produced from the choices of inclusion of the management in the planning of the meetings, revealing established ways of working; attention to non-control in training movements; use of restitution at meetings, reducing stiffness and tensions; attention to the institutions that cross us; analysis of the facilitator's involvement in the training, redirecting behaviors and attitudes; problematization about the object, instrument and purpose, which favored the reflection about the mental health care and to learn to facilitate and experience the Permanent Education in Health in the act of making. CONCLUSIONS: socio-clinic assisted the experience of facilitating in-service training, pointing out tips for the collective construction of contextualized, reflexive and problematizing knowledge.