A integralidade no ensino da atenção à saúde da criança em cursos de Graduação em Enfermagem

Abstract

Introduction: The training of professionals is a challenge for the transformation of practices and improving the health of the population. Comprehensive health care is a guiding principle of the health policy. It is therefore; necessary to question whether the teachings of child health care in the context of graduation, contemplates the full training of nurses. Objective: To consider whether the teaching of child health care incorporates the principle of comprehensive in the training of nurses. Method: A qualitative study with 16 teachers involved in the teaching of child health care, primary and hospital care, in 8 public institutions of undergraduate nursing, located in 4 states in southeastern and northeastern Brazil. Data recording was performed through consultation of educational plans and analysis of teaching plans as well as through semi-structured interviews. Recorded and transcribed interviews were subjected to content analysis of the thematic type. The analytical categories were supported in the framework of theoretical comprehensive. Results: The teaching of child health care includes determinants and risks of illness, promotion and preventive health care and attention for a sick child, so that the aspects related to the theoretical content, contemplate the principle of comprehensive. Analysis of the interviews led to the construction of 6 categories. Four teaching approaches demonstrated the principle of comprehensive, ‘working with the issue of public safety’; ‘performance in primary care, in hospitals and other care settings’; ‘reference and counter-reference is still a goal, however the student most know that there is’; ‘a child in the family and historical, social and epidemiological context’. Two referred to distance learning with the principle of comprehensive in health care of the child: ‘first was the theoretical content followed by the practice content’; ‘we have to integrate’. It can be understood from the testimony that teaching is inserted in diverse fields of practice including primary care, hospital care, day care and home visits, thus allowing the students to take care of sick and healthy children at different levels of complexity and in different contexts, which also brings in more in line to the reality of the child and the family, and favors the incorporation of the principle of comprehensive. However, it was discovered that theoretical and practical training are fragmented, ad hoc, with virtually no integration between the various disciplines, thus jeopardizing the understanding of the overall approach in addressing the needs of the child, as relevant to comprehensive. The educators refer to the inclusion of practical exercises after the theoretical teaching, so that the students have experience and acquire skills as well. The idea that the students must first master the theory before going on the practical, revels that the practical field being used to prove the theory and not as a challenge to its sources. Also the insertion point of the student into the field interferes with their articulation with the routine of services and social context, compromising the incorporation of the integral training of nurses. Conclusion: The courses studied showed that the health education of the child incorporates the principle of comprehensive in the theoretical aspects related to the content. However, it can be stated that there is contradiction between what is proposed in the documents and what is effective teaching in the classroom. Thus, conclude that the pedagogical practice of teaching children’s health, approaches and distances in the principle of comprehensive hinder its incorporation in training.