Heidemann Ivonete Teresinha Schulter Buss, Cypriano Camilla da Costa, Gastaldo Denise, Jackson Suzanne, Rocha Carolina Gabriele, Fagundes Eloi
Universidade Federal de Santa Catarina, Florianópolis, Brazil.
University of Toronto, Toronto, Canada.
Cad Saude Publica. 2018;34(4):e00214516. doi: 10.1590/0102-311x00214516. Epub 2018 Apr 23.
The study aimed to compare the experiences with the organization of universal public healthcare systems in relation to health promotion in primary care units in Florianópolis, Santa Catarina State, Brazil, and Toronto, Ontario, Canada. This was a descriptive exploratory study with a qualitative approach in primary care units. Data were collected with semi-structured interviews containing questions on health promotion practices, with 25 health professionals in Florianópolis and 10 in Toronto. The data were discussed using thematic analysis, identifying the practices, difficulties, and facilities in health promotion. In the two cities, 60% of health professionals and health administrators had not received any specific knowledge on health promotion during their training. As for health promotion skills, health professionals in Toronto identified them with autonomy and social determinants, while in Florianópolis they were related to health education and community participation. In both cities, health promotion practices are targeted to individual and collective activities. The motivation to act comes from interdisciplinarity and the demands raised by the population. Health promotion is a relevant form of care and stimulus for individual and community autonomy, in light of social determinants. Such practices aim at comprehensive health for the community, but there are limits in the teams that still conduct disease-centered activities. Resources are limited, requiring inter-sector actions to improve quality of life. Healthcare centers on the hegemonic model, and progress is needed to achieve a positive approach to health and social determinants.
该研究旨在比较巴西圣卡塔琳娜州弗洛里亚诺波利斯市和加拿大多安大略省多伦多市基层医疗单位在全民公共医疗体系组织方面与健康促进相关的经验。这是一项针对基层医疗单位的定性描述性探索性研究。通过半结构化访谈收集数据，访谈问题涉及健康促进实践，在弗洛里亚诺波利斯市采访了25名卫生专业人员，在多伦多市采访了10名。使用主题分析法对数据进行讨论，确定健康促进中的实践、困难和便利条件。在这两个城市，60%的卫生专业人员和卫生管理人员在培训期间未接受过任何关于健康促进的具体知识。至于健康促进技能，多伦多的卫生专业人员将其与自主性和社会决定因素联系起来，而在弗洛里亚诺波利斯，它们与健康教育和社区参与有关。在这两个城市，健康促进实践针对个人和集体活动。行动的动力来自跨学科性和民众提出的需求。鉴于社会决定因素，健康促进是一种相关的护理形式和对个人及社区自主性的激励。此类实践旨在实现社区的全面健康，但仍以疾病为中心开展活动的团队存在局限性。资源有限，需要跨部门行动来提高生活质量。医疗保健以霸权模式为中心，需要取得进展以实现对健康和社会决定因素的积极态度。
