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[巴西亚马孙地区原住民医疗保健子系统(SASI-SUS)中的问题解决:一项参考服务分析]

[Problem-solving in the Indigenous Health Care Subsystem (SASI-SUS): analysis in a reference service in Amazonas, Brazil].

作者信息

Ahmadpour Bahiyyeh, Turrini Ruth Natalia Teresa, Camargo-Plazas Pilar

机构信息

Departamento de Saúde Coletiva, Faculdade de Medicina, Universidade Federal do Amazonas. R. Afonso Pena 1053, Centro. 69020-160 Manaus AM Brasil.

Departamento de Enfermagem Médico-cirúrgica, Escola de Enfermagem, Universidade de São Paulo. São Paulo SP Brasil.

出版信息

Cien Saude Colet. 2023 Jun;28(6):1757-1766. doi: 10.1590/1413-81232023286.13672022. Epub 2022 Nov 11.

Abstract

Problem-solving is one of the principles of the Unified Health System (SUS) in Brazil, with its ability to solve the health problems of the population at different levels of complexity. The Indigenous Health Care Subsystem (SASI-SUS) is part of this service, respecting the specificities of indigenous populations. The scope of this article is to analyze the perception of professionals and managers of an Indigenous Health Center (CASAI) regarding its ability to cope with the circumstances of the pandemic. It involved qualitative and descriptive research under the National Health Care Policy for Indigenous Peoples (PNASPI) and Paul Ricoeur's hermeneutic theory. Interviews were conducted with participants in order to record the experiences in the work process of the actors who assist the indigenous people housed at CASAI. Four essential themes were identified in the interviews: cultural care; permanent education in health & health education; negotiation & improvisation; and reception & infrastructure. CASAI is an institution that is more than a support center or accommodation, being a crossover point between the different levels of care and knowledge production of the indigenous people, as well as a place for establishing a relationship, resulting in a problem-solving space.

摘要

解决问题是巴西统一卫生系统(SUS)的原则之一,它有能力解决不同复杂程度的民众健康问题。土著卫生保健子系统(SASI - SUS)是这项服务的一部分,尊重土著居民的特殊性。本文的范围是分析一家土著健康中心(CASAI)的专业人员和管理人员对其应对疫情情况能力的看法。它涉及在《国家土著人民卫生保健政策》(PNASPI)和保罗·利科的诠释学理论下的定性和描述性研究。为记录协助居住在CASAI的土著居民的行为者在工作过程中的经历,对参与者进行了访谈。访谈中确定了四个基本主题:文化关怀;健康与健康教育方面的持续教育;协商与即兴发挥;以及接待与基础设施。CASAI是一个不仅仅是支持中心或住所的机构,它是不同层面的土著居民护理和知识生产之间的交叉点,也是建立关系的场所,从而形成一个解决问题的空间。

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