A atenção ao adolescente na Estratégia de Saúde da Família: percepção de profissionais e usuários

Abstract

The Family Health Strategy (FHS), an assistential model in expansion aimed at primary care developed by the Municipal Health of the city of Rio de Janeiro, is the state government program used nowadays to respond to the demands of various age groups, in a very broad and integrated perspective. In accordance with the paremeters stablished by the Ministry of Health (2010), the work process of the FHS crews incorporates in its daily routine characteristics that serve well a complete and solution-purposed approach in the care of adolescents and youngsters. This research had as its main goal the analysis of the FHS actions towards adolescents, evaluated both by themselves and by health professionals. The data was collected in all three of the Family Clinics in the Rocinha neighborhood. We chose a qualitative approach made possible by not-rigidly structured interviews with 9 professionals nurses and doctors and 23 adolescents of both genders, with ages ranging from 15 to 19. We noticed that the crew´s work process is hindered by the excessive number of appointments in each shift, the demand overload and the frequent substitution of professionals. This situation has a negative impact on the planning, the execution and the assessment of the assistance. The difficulty in finding adolescents willing to participate in the activities either individually or as a group was brought up by the professionals. The latter consider themselves well prepared technically, but demonstrated a lack of specific capacitation to deal with health issues related to this age group. As for the adolescents, they generally show up spontaneously and recognize the crew´s technical skills. The long wait, the lack of attention and support by some of the professionals, the lack of secrecy and confidentiality in some situations and the lack of information about the actions developed are factors perceived as relevant to avoid health services. In terms of educational activities aimed at the prevention and promotion of health towards adolescents, they are not well implemented. There must be an intensification of the communication between sectors, for it wasn´t highlighted by our interviewees. Both professionals and adolescents value the action of the health community agents, but they lack autonomy and technical support. We have concluded that the care of adolescents offered by the Family Health Strategy does not respond satisfactorily to the guidelines stablished by the Ministry of Health. However, we have found professionals that feel motivated to look for alternatives to make the care of adolescents viable in a thorough approach.