OBJECTIVE:To analyze home care practices of outpatient and hospital services and their constitution as a substitute healthcare network.

The article presents results of the research that identified to causes of disease-related absenteeism, justified by medical license, among nursing employees of a public hospital in Montes Claros, MG, Brazil. This is a descriptive-exploratory study. Results indicate that the main reasons for absenteeism are related to musculoskeletal problems and to respiratory diseases; mainly between married female nurse aides, with age between 25 and 45 years, that works in day shift and with more than one employment. It was concluded that there is a necessity to develop prevention actions for controlling the absenteeism as a strategy for the quality of life of nursing workers.

RESUMENEl estudio tiene como objetivo entender la formación de las enfermeras para el cuidado integral. Los datos fueron obtenidos de entrevistas con profesores, estudiantes y enfermeras del servicio sometidos a análisis de discurso. Fue reconocida la comprensión de la integralidad del cuidado en la perspectiva de un modelo de atención a la salud que tiene como orientación el cuidado centrado en el usuario. Suscitaron reflexiones sobre las tecnologías y la forma de organización del trabajo, expresadas por una tensión permanente: Clínica versus Salud Colectiva, como desafío para la integralidad del cuidado. Se identificó que construir la integralidad en la formación implica asumir el actuar en salud como principio educativo en una nueva forma de aprender-enseñar en salud, que rompe con el saber formateado y descontextualizado. Se concluye que la integralidad se toma como objeto de reflexión en el movimiento de cambio en las prácticas pedagógicas y que se refleja en la atención a la salud. DESCRIPTORESAtención integral de salud. Educación en enfermería. Atención a la Salud. ABSTRACTThis study has the objective of understanding the training of nurses for comprehensive health care. It used data from interviews with teachers, students and service nurses submitted to discourse analysis. There is an understanding of comprehensive care in the training of nurses from the perspective of establishing a healthcare model in which care is directed to the patient. There are reflections regarding the technologies and the form of organization of the work, expressed in a permanent tension: Clinical versus Collective Health as a challenge for comprehensive care. It was identified that building completeness in the formation implies assuming acting in health as an educative principle in a new form of learning-teaching in health, which breaks up with pre-formed, out-of-context knowledge. The conclusion is that comprehensive health care is taken as an object of reflection in the movement for change in the pedagogical practices, and that it is reflected in health attention. KEY WORDS

Gonçalves AM, Sena RR. A reforma psiquiátrica no Brasil: contextualização e reflexos sobre o cuidado com o doente mental na família. Rev Latino-am Enfermagem 2001 março; 9 (2): 48-55.O presente trabalho analisa as conseqüências da reforma psiquiátrica brasileira sobre o cuidado do doente mental na família. Trata-se de um estudo descritivo-exploratório de abordagem qualitativa, cuja fundamentação teórico-metodológica foi orientada pelo materialismo histórico-dialético. Os sujeitos da pesquisa foram onze mulheres que cuidam de doente mental em família. A análise de seus discursos revelou singularidades do cuidar de um doente mental na família e as dificuldades decorrentes deste processo acentuadas pela desinstitucionalização do doente mental. Concluiu-se que a mulher, cuidadora do doente mental, cumpre um papel social importante e indispensável na consolidação da reforma psiquiátrica no país. UNITERMOS: psiquiatria, cuidadores, relações familiares PSYCHIATRIC REFORM IN BRAZIL: CONTEXTUALIZATION AND CONSEQUENCES REGARDING THE CARE FOR THE MENTALLY ILL IN THEIR FAMILY ENVIRONMENTThis work analyzes the consequences of the Brazilian psychiatric reform to the care provided to the mentally ill in their family environment. It is a descriptive and exploratory study based on a qualitative approach, using the historical-dialectic materialism as its theoretical and methodological framework. The subjects of the research were 11 women that provided care to mentally ill persons. The analysis of their discourses revealed unique aspects related to caring for the mentally ill in their family environment and the difficulties resulting from the process of institutionalization of the mentally ill. The conclusion is that women who provide care for the mentally ill have an important social role that is indispensable to the consolidation of the psychiatric reform in the country.KEY WORDS: psychiatric reform, care givers LA REFORMA PSIQUIÁTRICA EN BRASIL: CONTEXTO Y REFLEJOS SOBRE EL CUIDADO CON EL ENFERMO MENTAL EN LA FAMILIAEl presente trabajo analiza las consecuencias de la reforma psiquátrica basileña sobre el cuidado del enfermo mental en la familia. Se trata de un estudio descriptivo-exploratorio de abordaje cualitativo, cuya fundamentación teórico-metodológica fue orientada por el materialismo histórico-dialéctico. Los sujetos de la investigación fueron once mujeres cuidadoras de enfermos mentales. El análisis de sus discursos reveló las singularidades del cuidar de un enfermo mental. Se concluye que la mujer cuidadora del enfermo mental cumple un papel social importante e indispensable en la consolidación de la reforma psiquiátrica en el país.

Oferta e demanda na atenção domiciliar em saúdeSupply and demand in home health care