Integralidade na prática assistencial da equipe de enfermagem: a relação da escuta na interação usuário e profissional no município de Paranavaí-PR

Abstract

This study aims to analyze the performance of the nursing staff in primary care, aiming to characterize the interactions with the user, and prioritizing listening as a condition of integral care. For health professionals understand, identify the suffering of the user, there must be greater interaction between them, that is, dialogue. For the exercise of a good dialogue, there must be an attentive listening, seeking details that can be hidden in the speeches, in addition to receptiveness and link, attributes responsible for the health care practice. The reduction of the subject to object has been the reality of basic health units, noting that users who seek health services have a life outside, with varied styles. The manner of speaking, the care, vary according to the routine of each. The research was theoretically supported by integral care as exercise of good practice and production of care, emphasizing listening. This is a qualitative study with an ethnographic approach, which allows the researcher to do a detailed reading of reality. Data were collected from January to May 2009, through participant observation and monitoring of the activities performed by the nursing staff of two basic units of Paranavaí city, state of Paraná, and the findings were duly recorded in the field diary. After observations, the professionals were interviewed. Seven practical nurses and an administrative professional participated in this research. The materials were subjected to content analysis, which comprised the following stages: pre-analysis, which refers to the initial reading of all the content and organization of data, and analysis, that includes categorization and treatment of the material. We identified critical issues during the observation, the lack of receptiveness, disorganization, lack of exercise of listening and mechanized work. In the interviews, it was possible to develop categories with the reports collected, highlighting the "sensitivity to the patient," "seeking the best", "lack of time" and "sense of listening". It follows that integral care is still a utopia in the reality of health services, listening is rarely used and its meaning so little known. The disruption of services in local health units and self-indulgence of professionals in their activities are predisposing factors for the non-exercise of listening, hindering even more integral care. It is essential that professionals reflect on and solve the problems that arise, through awareness and sensitization, modifying assistance through the reorganization of work.