Educação permanente em saúde por teleducação: o caso do Programa Telessaúde Brasil Redes sob a perspectiva dos usuários.

Abstract

The concept of Permanent Health Education was appropriated by the Brazilian Unified Health System, as a category capable of meeting the qualification demand of the professionals that are part of the Family Health Strategy in order to concretize the reorganization institutional model of public health, whose structuring model is that of Basic Health Care. Among the guiding principles of Unified Health System is that of integral care synthesized in the term integrality, a comprehensive concept that is oriented to the organization of care services and the humanization of health care practices. The State of Amazonas, as part of the Brazilian Amazon, intensifies the challenges of covering the health of its population, characterized by peculiar demographic rarefaction, but the existence of a rich sociodiversity (caboclos, riverine, indigenous ethnic groups and quilombolas). The Telehealth Brazil Networks Program results from the efforts of the Ministry of Health to create a model of telehealth aimed at sharing knowledge and practices, focusing on the multiprofessional teams of the Family Health Strategy in the interior of the country. The actions of tele consulting, tele diagnosis, second formative opinion and teleducation constitute the set of basic actions to be developed by the current Telehealth Brazil Program. The study is of the qualitative-evaluative type, based on the Ethnographic Case Study method. In this research the techniques of documentary research, observation and recording of teleducation practices and semi-structured interviews were applied. The interviews were conducted with the subjects, who interact in the supply and demand of the tele-education activities, particularly their direct users, the health workers that integrate the Family Health Strategy teams in the selected municipalities. The organization, analysis and interpretation of the data collected in the interviews were carried out based on the Data Grounded Theory, which aims to generate a 'theory' based on the perception and knowledge of the subjects participating in the processes under study. The study revealed the validation of the model of telehealth by the Family Health Strategy workers, participants of the research, highlighting as strong points the possibility of exchanging information focused on the resolution of the attention through tele consulting s and the permanent qualification through teleducation activities. As limiting aspects of these practices were highlighted their non-integration into the context of the programmatic actions, which creates conflicts of interest due to the obligation to fulfill the assignments already established for the teams, and the still poor quality of connectivity available in the Network Telehealth Amazonas, which results in web conferencing with frequent signal loss. Suggestions are also made for the integration between the State Coordination, the Amazonas Telehealth Coordination and the municipal health managers in order to carry out planning actions articulated in state and municipal plans of PHE, in which the actions of telehealth are an integral part, in view of the institutionalization of its use and access to health services and the integral care of its users, the population of the hinterland of Amazonas State.