Análise dos enfoques pedagógicos em ações de educação em saúde desenvolvidas por enfermeiros: estudo de caso

Abstract

The present research is a case study that has as object the education actions in health developed by nurses and driven to the clientele bearer of arterial hypertension. Starting from preliminary investigations it was possible to establish as a central presupposition for the work the absence of a uniform practice and of a defined pedagogic tendency capable to guide such educational actions. At the same time, the first surveys indicated a practice type and the professionals' performance in which a group of diffuse or generalists ideas, based on the old traditional conceptions of education, served as support for the maintenance of the hegemony of the biomedical model. Based on that evidence, I tried to analyze the educational practice of the nurses to the light of the foundations of the predominant pedagogic tendencies in Brazil. In a more specific way, I tried to propose educational activities in health, having as referential the criticai conceptions of the education that have their origin in Brazil, in the educator's Paulo Freire theoretical and practical works. The research was accomplished in the ambulatory of a public hospital, located in Fortaleza, in the State of Ceará, specialized in the treatment of cardiopulmonary diseases. Five nurses that work in the above mentioned ambulatory participated in the study. The evidences were collected by interviews, direct observation and analysis, of documents in the period of October of 2001 to January of 2002 and they were organized in three themes: the nurses' perspective in relation to the education in health; planning and development of the educational activities and evaluation of the education process in health. Through the analysis of the obtained data it was evidenced, in consonance with the initial presuppositions, that the actions of ducation in health were, in general, not systematic, without planning and characterized by the absence of an adequate theoretical and methodological support. The disregard was verified to the context of the client1 s life, as well as in the lack of uniformity of the procedures that caused significant divergences in the professionals' performance. Finally, the investigation revealed that, although the researched nurses recognized the importance of the process of education in health, they had their performances endangered in quality and efficiency, which provoked a type of professional intervention marked by the centralization and individualism. I chose, then, to point out the need of reorienting the practice of education in health based in more current and suitable didactic and pedagogical conceptions with the social and cultural context, seeking to tum it more effective, participating and democratic.