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家庭健康战略中的道德困境:日常生活中表达的经历

Moral Distress in Family Health Strategy: experiences expressed by daily life.

作者信息

Cardoso Cecília Maria Lima, Pereira Maria Odete, Moreira Danielle de Araújo, Tibães Hanna Beatriz Bacelar, Ramos Flávia Regina Souza, Brito Maria José Menezes

机构信息

Centro Universitário de Sete Lagoas - UNIFEMM, Faculdade Ciências da Vida, Sete Lagoas, MG, Brazil.

Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

出版信息

Rev Esc Enferm USP. 2016 Jun;50 Spec:89-95. doi: 10.1590/S0080-623420160000300013.

DOI:10.1590/S0080-623420160000300013
PMID:27384281
Abstract

OBJECTIVE

Understanding the Moral Suffering experiences expressed in the daily life of the Family Health Strategy.

METHOD

This is a case study with a qualitative approach, conducted between August and October 2014 in a municipality of Minas Gerais. The sample was represented by 28 professionals of family health teams. Data were collected through interviews with semi-structured questionnaires, observation, projective technique and submitted to thematic content analysis.

RESULTS

The results indicate that routine issues of the health care system lead professionals to experience a challenging practice in dealing with daily situations that contradict their ethical precepts and can compromise the quality of work, becoming triggers of Moral Distress.

CONCLUSIONS

Social vulnerabilities such as domestic violence, poor socioeconomic conditions and organizational weaknesses of the health system were the main triggers of Moral Distress. Therefore, it is necessary to amplify this reflection by workers of the Family Health Strategy, aiming to encourage the minimization of suffering experiences, considering their ethical values.

OBJETIVO

Compreender as vivências de Sofrimento Moral expressas no cotidiano da Estratégia de Saúde da Família.

MÉTODO: Trata-se de um estudo de caso com abordagem qualitativa, realizado entre os meses de agosto a outubro de 2014, cujo cenário foi um município de Minas Gerais. Participaram 28 profissionais das equipes de saúde da família. Os dados foram coletados por meio de entrevistas com roteiro semiestruturado, observação, técnica projetiva e, submetidos à análise de conteúdo temática.

RESULTADOS

Os resultados apontaram que as questões rotineiras do serviço de saúde levam os profissionais a vivenciarem uma prática desafiadora ao lidarem diariamente com situações que contradizem seus preceitos éticos capazes de comprometer a qualidade do trabalho tornando-se disparadores de Sofrimento Moral.

CONCLUSÃO: As vulnerabilidades sociais, como violência doméstica e condições socioeconômicas precárias, além das fragilidades organizacionais do Sistema de Saúde, foram os principais geradores de Sofrimento Moral. Assim, considera-se necessária a reflexão ampliada sobre a temática por parte dos trabalhadores da Estratégia de Saúde da Família, com intuito de propiciar a minimização de vivências de sofrimento e uma prática profissional em consonância com seus valores éticos.

摘要

目的

了解家庭健康战略日常生活中所表达的道德痛苦经历。

方法

这是一项采用定性方法的案例研究,于2014年8月至10月在米纳斯吉拉斯州的一个市进行。样本由28名家庭健康团队的专业人员组成。数据通过半结构化问卷访谈、观察、投射技术收集,并进行主题内容分析。

结果

结果表明,医疗保健系统的日常问题导致专业人员在应对与他们的道德准则相矛盾、可能损害工作质量并成为道德困扰触发因素的日常情况时,经历具有挑战性的实践。

结论

家庭暴力、社会经济条件差和卫生系统组织薄弱等社会脆弱性是道德困扰的主要触发因素。因此,家庭健康战略的工作人员有必要扩大对此主题的思考,旨在鼓励将痛苦经历最小化,同时考虑他们的道德价值观。

目的

理解家庭健康战略日常生活中所表达的道德痛苦经历。

方法

这是一项采用定性方法的案例研究,于2014年8月至10月进行,其场景为米纳斯吉拉斯州的一个市。28名家庭健康团队的专业人员参与其中。数据通过半结构化问卷访谈、观察、投射技术收集,并进行主题内容分析。

结果

结果指出,卫生服务的日常问题使专业人员在每日应对与他们的道德准则相矛盾、可能损害工作质量并成为道德困扰触发因素的情况时,经历具有挑战性的实践。

结论

社会脆弱性,如家庭暴力和社会经济条件差,以及卫生系统的组织薄弱环节,是道德困扰的主要产生因素。因此,家庭健康战略的工作人员有必要对该主题进行更深入的思考,以便促成痛苦经历的最小化,并使专业实践与其道德价值观保持一致。

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