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[专科医院中的本土健康:巴西南马托格罗索州一家参考医院医护人员的视角]

[Indigenous health in specialized care: perspective of healthcare professionals in a reference hospital in Mato Grosso do Sul State, Brazil].

作者信息

Casagranda Fabiana, Luz Verônica Gronau, Martins Catia Paranhos, Dias-Scopel Raquel Paiva, Fernandes Ricardo, Fonseca Wanaline

机构信息

Universidade Federal da Grande Dourados, Dourados, Brasil.

Instituto Leônidas & Maria Deane, Fundação Oswaldo Cruz, Manaus, Brasil.

出版信息

Cad Saude Publica. 2024 Jul 29;40(6):e00094622. doi: 10.1590/0102-311XPT094622. eCollection 2024.

Abstract

This cross-sectional study aims to identify the perspective of healthcare professionals and residents regarding the challenges faced in providing care to Indigenous users in a reference hospital in Mato Grosso do Sul, a Brazilian state with the second-largest Indigenous population in the country. The study used a semi-structured online questionnaire emailed to each worker between June and August 2020. The discrete variables were summarized as mean and standard deviation and median and interquartile range (5% significance level). Two hundred thirty healthcare professionals and 29 residents participated in the study. Among the findings, only 14.7% of participants knew the ethnicities served, and 60.2% had never witnessed traditional practices in the hospital, indicating low articulation between biomedical and Indigenous forms of care. When comparing responses from residents and professionals, residents were noted to have a more positive view of approaching the Indigenous context, suggesting that they consider it essential to improve this articulation. When comparing professional categories, some differences of opinion among the medical category stand out concerning assistance. In addition, professionals and residents demonstrated some level of difficulty in caring for the Indigenous population. The results highlight the centrality of the biomedical model, the professionals' lack of knowledge about the context of the communities served, and the devaluation of their practices. The findings contribute to discussions about healthcare policies at different levels of care and management and the qualification of hospital care for Indigenous people.

摘要

这项横断面研究旨在确定医疗保健专业人员和住院医师对于在南马托格罗索州一家参考医院为原住民用户提供护理时所面临挑战的看法,该州是巴西原住民人口第二多的州。该研究使用了一份半结构化在线问卷,于2020年6月至8月通过电子邮件发送给每位工作人员。离散变量总结为均值和标准差以及中位数和四分位间距(显著性水平为5%)。230名医疗保健专业人员和29名住院医师参与了该研究。在研究结果中,只有14.7%的参与者了解所服务的种族,60.2%的人从未在医院目睹过传统习俗,这表明生物医学护理和原住民护理形式之间的衔接程度较低。在比较住院医师和专业人员的回答时,发现住院医师对接触原住民情况的看法更为积极,这表明他们认为改善这种衔接至关重要。在比较专业类别时,医学类别在援助方面存在一些意见分歧。此外,专业人员和住院医师在照顾原住民人口方面表现出一定程度的困难。结果突出了生物医学模式的核心地位、专业人员对所服务社区情况的缺乏了解以及对其习俗的贬低。这些发现有助于在不同护理和管理层面讨论医疗保健政策以及为原住民提供医院护理的资质问题。

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