PROMOVING SPACES FOR THE COLLECTIVE CONSTRUCTION OF KNOWLEDGE IN THE FAMILY HEALTH STRATEGY PROGRAM 1 QUADROS, Jacqueline Silveira de²; MUNHOZ, Cloris Ineu 3 ; COLOMÉ, Juliana Silveira 4. ABSTRACT This paper aims to socialize the experience of nursing students in promoting opportunities for continuing education in health, through the collective construction of knowledge, together with the community health workers. It is an experience account of some students of the Nursing Major during the Supervised Apprenticeship I, carried out in the second semester of 2011. From the insertion into the theoretical and practical scenario, the continuing health education proved to be a necessary device for inducing changes in the working process of the health team. To this end, educational spaces represent important tools for the share of knowledge, for the collective discussion about community issues and reflections about the implications of the role of the community health agent in the Family Health Strategy Program. KEYWORDS: Nursing; Community Health Workers; Continuing Education in Health. 1. INTRODUCTION 1 Relato de Experiência. Centro Universitário Franciscano (UNIFRA). 2 Apresentador. Curso de Enfermagem do Centro Universitário Franciscano (UNIFRA). Membro do Grupo de Estudos e Pesquisa em Empreendedorismo Social da Enfermagem e Saúde (GEPESES/UNIFRA). Santa Maria, RS, Brasil. E-mail: jacqueline_quadros@hotmail.com. 3 Acadêmica do Curso de Enfermagem do Centro Universitário Franciscano (UNIFRA), Santa Maria, RS, Brasil. 4 Docente do Curso de Enfermagem do Centro Universitário Franciscano - UNIFRA. Doutoranda em Enfermagem da Universidade Federal do Rio Grande - FURG. Membro do Grupo de Estudos e Pesquisa em Empreendedorismo Social da Enfermagem e Saúde (GEPESES/UNIFRA). Santa Maria, Rio Grande do Sul, Brasil. E-mail: julianacolome@yahoo.com.br. 1
The community health agents (CHA) have proved to be a revolutionary actor in terms of being inserted in an environment of exchanges between popular knowledge of health and scientific knowledge. It is possible to say that as the CHA is a person who faces the reality and health practices of the neighborhood where he lives and works, and being a graduated person with references on health. Then, this person becomes an actor who carries the contradictions and, at the same time, carries the possibility of a dialogue between these different kinds of knowledge and practices 1. In this perspective, the Continuing Education in Health brings a pedagogic definition directed to an educational process that sets the day-to-day work - or training - of health in analysis, which becomes permeable due to the concrete relations that operate realities and allows the construction of collective spaces for reflection and evaluation of the produced effect in the daily acts The interest for this research came from the academic experience during the Supervised Apprenticeship I of the seventh period of the Nursing Major at the Franciscan University - UNIFRA. During this experience, it was possible to experience the daily life of Family Health Strategy (FHS), its implications and repercussions of their actions in the community. Then, in this research, it is aimed to socialize the experience of nursing students in promoting opportunities for continuing education in health, through the collective construction of knowledge, together with the community health agents. 2-3. 2. METHODOLOGY This is a report of an experience of a Nursing student during the Supervised Apprenticeship I, carried out in the second semester of 2011. The scenario of this experience was the Family Health Strategy - Unit Dr. Roberto Binato, which is located in the west region of Santa Maria. This unit is characterized as a productive area for training in health, in which students of Nursing, Physiotherapy and Nutrition of the Franciscan University - UNIFRA, have their practices, as well as residents of the Multidisciplinary Residency of the Federal University of Santa Maria - UFSM. In order to promote permanent education actions in health with the community health agents, it tried to provide favorable conditions for the development of the meetings. In 2
addition to planning and implementation of these actions, the nursing students tried to get inserted into other activities carried out by nurses who work in that scenario. The actions were carried out in a systematic manner, with the participation of health staff and faculty supervisor. For this reason, the following steps were organized: Scenario Approach, Planning Actions in Health, Health Effectiveness of Actions and Evaluation of Actions. 3. DETERMINING SPACES FOR THE CONSTRUCTION OF COLLECTIVE KNOWLEDGE In a first moment, we had the Scenario Approach as an aim, where we started to live with the daily life of the FHS and, as the time was passing, we were getting to know the health staff. The physical area of the unit has recently undergone renovations, but it still has some difficulties to house all health professionals in their particular circumstances. During home visits, carried out with the CHA, we could approach the reality of this community being possible to analyze their needs. We found a very receptive and collaborative population to healthcare professionals and people who attend the health unit. During the Supervised Apprenticeship, it was possible to make Planning of Health actions, together with the nurses of the basic unit, and also to plan some of the necessities in the health service. In addition, it was possible to discuss the actions of theorizing meetings that we had with the faculty supervisor, in which we separate and reorganize our strategies to develop health actions. Among the identified necessities, it is possible to mention: greater interaction between health professionals, where we noted the need to work with the community health agents - they reported that they felt abandoned. Such non motivation, according to these professionals, occurs because of some gaps related to the interaction with the other members of the nursing group, as they were hired for a short period (one year) and they are in an adjustment phase, and after it will occur other alteration in the professionals staff. Later, it occurred the Effectiveness of Actions in Health, it was found the need to promote permanent education actions in health, it was set some meetings with them in which they discussed the following topics: motivation, study of the difficulties that were faced during their work with the community and some clinical cases. During the meetings, discussions were also conducted on clinical cases brought by CHA, as well as some problems in the community. It was observed that the meetings started 3
to represent moments of extended reflections on the making of the CHA, their implications and their impact on promoting the health of the patients. In the meetings, the main used resources were group dynamics, reflections and concerns from the following question "what is to be a community health agent in your opinion?" The Evaluation of Actions was performed continuously throughout the stage, but can be specifically cited as moments with emphasis on the evaluation process: the final moments of the groups with the CHA, where each one exposed their perceptions about the meetings, the meetings with the nurses of the Apprenticeship area, faculty supervisor and other students. It was presented an integrative seminar, held at the Institution of Higher Education, to share experiences and reflections on the theoretical and practical scenarios. 4. CONSIDERATIONS This work enabled effective actions based on dialogue and exchange of knowledge, which might help in the consolidation of spaces for reflection that point to the qualification of care. It is important to mention that the involved professionals acted in a responsible way in the meetings, they expressed their difficulties to achieve resolution of problems found in the area of working and for the attention in humanized health care. In relation to the insertion into the theoretical and practical scenario, the continuing education in health proved to be a necessary device for inducing changes in the working process of the health team. To this end, educational spaces represent important tools for sharing knowledge, for the collective discussion about community issues and reflections on the implications of the role of community health agent in the Family Health Strategy Program. REFERENCES 1- Viana ALD, Poz MRD. A reforma do Sistema de saúde no Brasil e o Programa de Saúde da Família. PHYSIS: Rev. Saúde Coletiva. Rio de janeiro. 1998; 8(2): 11-48. 2- Rocha PM. No limiar do século XXI: globalização e saúde, desafios da proteção social no Brasil dos anos 90. Rio de Janeiro: [s.n.],1997. 145p. Tese (Doutorado) - IMS-UERJ, 1997. 3- Tomaz, J.B.; O agente comunitário de saúde não deve ser um super-herói. Interface - Comunicação, Saúde, Educação. 2002; 6(10):75-94. 4
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