A integralidade da atenção à saúde como eixo da organização tecnológica nos serviços

Abstract

Despite the marked achievements of the Unified Health System (SUS), implementation of its principles and guidelines has not yet been fully achieved. Therefore, this article reflects on comprehensiveness and technology reorganization based on soft technologies and expanded clinical care, not only as guidelines, but as core elements for a new way of thinking about health. It involves a literature review that not only seeks an overview of ideas about the subject, but also attempts to establish a dialogue between the authors in reference to reflect on daily services, especially in hospital. We found that most of the obstacles to improvement of the services of the SUS are related to the predominance of curative medical care in the thinking process of health professionals. Breaking with that logic, comprehensive care, technological reorganization and expanded clinical care can foster closer approximation between professionals and users, at the same time as actions come to be dictated by the individuals and the community, breaking with the vertical imposition of conduct. Thus, the traditional 'biologicist' approach to clinical care needs to be deconstructed to break with the logic of manifest suffering and "treat 'em and street 'em" philosophy.

Integrality of care: challenges for the nurse practice

“…Each professional is responsible for the path of the user in the network, based on the assumption that all of them are aware of the local reality in order to provide orientation regarding the services available (1) . Therefore, Integrality of Care is the final product of the relations established between the multiple professionals and the plans of care offered to the user.…”

“…Brazil's Constitution of 1988 presented new outlines for the health system, establishing that the individual's health needs (1) must be attended through integrality of care operating in a local and hierarchical network with integrated services and technologies (2) . The health care model advocated by the Unified Health System (SUS) suggests that the responsibility for the integrality of care is responsibility of health service providers in the different levels of care, including teaching hospitals, that have reconfigured their management models (3) .…”

Atenção centrada no paciente na prática interprofissional colaborativa

“…Comprehensiveness may be conceptualized as a principle in a quest for a PCC, as it is a critique to the fragmentation of actions that patients receive, and it proposes an array of practices that look beyond the biological limits, beyond the procedure-centered intervention and oblivious of the insertion of the individual in a collective environment 40 . Patient-centered care is therefore to see the patient as a singular individual inside a collective entity, that interact in their individual and collective dimensions as can be also conceptualized in comprehensive care.…”

Rede de cuidado em saúde mental: visão dos coordenadores da estratégia saúde da família

“…The movement that resulted in the Brazilian Health and Psychiatric Reform has made it possible to establish a health care network guided by the principles of universality, equity and integrality, with practices targeted to thee resolution of social needs such as lack of resources for health, difficult family relationships, lack of employment and housing, among other determinants of the health-disease process of the population (12) . The Brazilian Psychiatric Reform Movement supported the fight for rights and social reintegration of people with mental disorders, by creating an extra-hospital care network.…”