O papel das Residências em Saúde na qualificação e expansão da Atenção Primária: saberes e impressões na perspectiva do usuário.

Abstract

The objective of the study was to discuss the role of professional health training during the expansion process of the Family Health Strategy in the city of Rio de Janeiro, reflecting specifically on the role of Health Residencies in this teaching process in service, from the SUS user's point of view. Specifically, the study sought to analyze the contribution of the Health Residency models to the qualification of the professionals inserted in the Primary Health Care network, considering the recent expansion of the Family Health Strategy in the municipality, as well as discussing the education in health, in the Residency in Health model, from the perspectives of the users taken care by teams with and without reeident professionals in a health service of the city. Thus, the study was carried out in a Health Unit of the northern zone of the municipality, which has the Residency model in health with the presence of nursing and medical centers in the service. In this study, 12 semi-structured interviews were carried out with the patients followed by teams with and without the established Residency process, followed by a thematic content analysis. In front of the interviews, the lack of clarity and understanding about the work performed by the Family Health Strategy teams and the different occupational groups included in the interviews were verified in the users' speeches, as well as the presence of the hegemonic and fragmented biological logic, relating the quality of care to the presence of technologies or prescriptions, or to the need of follow-up through different specialists. The users attended by teams with residents mentioned better listening, reception and integral healthcare coordination, in comparsion to the team without professionals in education proccess. In this sense, it is believed that the in-service teaching model proposed by the Residencies in Health is an important strategy of the qualification of professionals to achieve the adequate profile for action in SUS, but still presents many limitations, especially in relation to the multiprofissional performance, interdisciplinary and connected to social control. Therefore, it is important to implement dialogic and user-centered practices in order to reverberate in effective and humanized care practices, valuing users perceptions of the services in the legitimation of their rights.