Pelo direito à saúde: vulnerabilidades, percepções e práticas de cuidado na atenção básica à saúde no contexto rural

• Ano de defesa: 2019
• Autor(a) principal: Souza, Lidianny Braga de
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal da Paraíba; Brasil; Psicologia Social; Programa de Pós-Graduação em Psicologia Social; UFPB
• Palavras-chave em Português: Direito à saúde; Percepção; Vulnerabilidades; Contexto rural; Atenção básica à saúde; Right to health; Perception; Vulnerabilities; Rural context; Primary health care; CNPQ::CIENCIAS HUMANAS::PSICOLOGIA
• Link de acesso: https://repositorio.ufpb.br/jspui/handle/123456789/19445

The guarantee of the right to health in Brazil was ensured in the Federal Constitution of 1988 and operationalized with the Law 8080/90 that implemented the Unified Health System (UHS), demanding commitment from the State to social welfare. Since then, many challenges have been faced for its consolidation, making it important to know and discuss the "Living UHS", which happens in the relations established within the services, where the process of production of health care occurs. With the theoretical contribution of the conceptual framework of Vulnerability and Human Rights (V&HR) and Social Perception, this study aimed to investigate the vulnerabilities and health care practices in the context of primary care that affect the guarantee of the right to health and effectiveness of this as such in the rural environment of Paraiba. For this purpose, two interdependent studies were proposed, the first based on the users perceptions and the second of the health professionals. Method: Study 1: The sample, for convenience, consisted of 689 primary care users from 37 rural municipalities in Paraíba, representing the health regions of the state, the majority of females (75.2%), with ages ranging from 21 to 85 years (M = 43.5; SD = 14.7), with low schooling (59.9%), with agriculture being the most mentioned activity (24.2%). A questionnaire was used with 47 questions, including sociodemographic data, which were analyzed through descriptive statistics using SPSS 18.0. Study 2: The sample, for convenience, consisted of 122 professionals from 36 primary care services from 17 municipalities selected from study 1. The majority of females (81%), with ages ranging from 20 to 72 years (M = 37.1; DP = 10.2), with a higher course (56.6%), from the nursing area (52.4%), with a good working time in the current service (53.6%), as well as in primary care (60.8%). A structured questionnaire was used with 57 questions, including socio-demographic and labor aspects, analyzed through descriptive statistics; Also used open questions, as well as the technique of free association of words from the stimuli "SUS" and "health", categorized and after analyzed by Iramutech. We also conducted 45 semi-structured interviews, which went through content analysis. Results: Study 1: Users health perceptions emphasized the individual aspects, attributing responsibility for their health. The demand for the UBS happened more in acute situations, such as emergency care, being pointed out by them the delay or bad care as the greatest difficulty. Overall, the health situation of the municipality and the UBS was positively evaluated, with more complaint regarding the lack of a physician daily, appearing as a central figure in health care in the users ' perception. Study 2: Health professionals presented perceptions about health and UHS more focused on programmatic aspects. When evaluating the local health, the UBS and the work itself, they emphasized the light technologies that permeate the relationships of health care, such as team relationships, humanization and professional commitment. They also presented a high level of satisfaction with work, despite the nuances that involve work in the rural context. Final considerations: Thus, it was verified that the perceptions that users and health professionals have repercussions in the way the production process of health care occurs, and can produce new vulnerabilities in health. It is essential to consider the vulnerabilities and health needs of the rural context, as well as the relational aspects that permeate the supply of care when it seeks to understand how the "Living UHS" happens and, consequently, how the right to health is guaranteed to this population.