Educación participativa con enfermeros: potencialidades y vulnerabilidades en el rastreo del cáncer de mama y colon

Soares, Lidia Santos; Silva, Maria da Anunciação; Alves, Hayda Josiane; Queiroz, Ana Beatriz Azevedo; Brito, Irma da Silva

doi:10.1590/0034-7167-2019-0692

Brasil

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EXPERIENCE REPORT • Rev. Bras. Enferm. 73 (suppl 6) • 2020 • https://doi.org/10.1590/0034-7167-2019-0692 linkcopiar

Educación participativa con enfermeros: potencialidades y vulnerabilidades en el rastreo del cáncer de mama y colon

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivos: sistematizar experiencia de educación permanente participativa con enfermeros de la Atención Primaria sobre rastreo del cáncer de mama y colon, identificando potencialidades y vulnerabilidades.

Métodos: relato sistematizado conforme Holliday, en cinco tiempos: punto de partida, preguntas iniciales, recuperación del proceso vivido, reflexión de fondo y puntos de llegada. Ha sido producto de dos talleres con 96 enfermeros y analizado a la luz de las directrices ministeriales y concepto de vulnerabilidad de Ayres.

Resultados: las potencialidades se relacionan al trabajo del enfermero implementando los principios del Sistema Único de Salud. Las dificultades son complejas y exponen vulnerabilidades individuales, contextuales y programáticas en la práctica del rastreo.

Consideraciones finales: la educación permanente y las estrategias pedagógicas participativas permitieron cambio amplio y lúdico de aprendizajes y participación de número expresivo de profesionales. Se señala la necesidad de estudios sobre institucionalidad de las directrices programáticas y espacio del enfermero para ser instituidor de nuevas prácticas en el ámbito de la Atención Primaria.

Descriptores: Educación Permanente; Vulnerabilidad en Salud; Programas de Rastreo; Neoplasias de la Mama; Neoplasias del Cuello Uterino

Difficulties	Potentialities	Challenges
🗸 Failure of women to return to seek test results; 🗸 Shame, embarrassment and fear when carrying out the exams; 🗸Difficulty in approaching religious women and a history of violence; 🗸 Non-acceptance of the nurse's prescription. 🗸 Low autonomy to perform some screening actions (screening mammography); 🗸 Nurses' work overload; 🗸 Inadequate infrastructure of some basic health units, making it difficult to carry out screening and educational activities; 🗸 Failure to perform clinical breast examination by some nurses concurrently with the collection of the preventive; 🗸 Ignorance of the coverage targets proposed by the programs within the units and the municipality; 🗸 Difficulties in the active search of women; professional time in the unit; 🗸 Conflict between the programmatic recommendations and the health needs of the population assigned to the services attended by nurses - for example, the recommended age groups for screening; 🗸 Absence of municipal and/or regional protocols for nursing care; 🗸 Difficulties in accessing the specialized service; 🗸 Absence or scarcity of materials for carrying out the preventive; 🗸 Long wait for mammography and Pap smear results; 🗸 Repetitive and unreliable Pap smear results.	🗸 Good bond and trusting relationship between health team and community; 🗸 Recognition of the team's work by the population. 🗸 Carrying out educational practices in the unit; 🗸 Holistic view of the nurse; 🗸 Autonomy to carry out the preventive; 🗸 Professional time in the unit; 🗸 Teamwork; 🗸 Reception; effective interinstitutional communication; 🗸 Material made available for the collection of the preventive; 🗸 Intersectoral partnerships; 🗸 Active search; 🗸 Easy access of the population to the unit's nurse; 🗸 Resolutivity; 🗸 Interest in continuing the process of continuing education; 🗸 Sensitive and loving reception of novice nurses.	🗸 Insert service managers involved in future workshops

Dimensions	Individual dimension	Social/contextual dimension	Programmatic dimension
Aspects of practice	Individual dimension	Social/contextual dimension	Programmatic dimension
Difficulties	🗸 Failure by women to return for exam results; 🗸 Shame, embarrassment and fear when carrying out the exams; 🗸 Difficulty in approaching religious women and a history of violence; 🗸 Non-acceptance of the nurse's prescription.	🗸 Low autonomy to perform some screening actions (screening mammography); 🗸 Nurses' work overload; 🗸 Failure to perform clinical breast examination by some nurses concurrently with collection of the preventive; 🗸 Ignorance of the coverage targets proposed by the programs within the units and the municipality. 🗸 Difficulties in the active search of women; 🗸 Conflict between programmatic recommendations and the health needs of the population assigned to the services attended by nurses, -for example, the recommended age groups for screening.	🗸 Absence of municipal and/or regional protocols for nursing care; 🗸 Difficulties in accessing the specialized service; 🗸 Inadequate infrastructure of some basic health units making it difficult to carry out screening and educational activities; 🗸 Absence or scarcity of materials for carrying out the preventive; 🗸 Long wait for mammography and Pap smear results; 🗸 Repetitive and unreliable Pap smear results.

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Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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