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On-line version ISSN 1807-5762
Interface (Botucatu) vol.16 no.42 Botucatu July/Sept. 2012
The invitation to produce a presentation for Interface issue number 42 is yet another of those challenges that is put before us and initially leaves us with a feeling of impotence given the magnitude of the task. A further challenge is that articles relating to the field of healthcare education predominate, which signifies taking on the responsibility to move between one discipline and one field to another, thus facing the complexity of both of them and the difficulty in identifying the respective limits. The articles, thesis abstracts and reviews in this issue fulfill this role significantly and bring important contributions to the field.
A study on the scientific production indexed in the Lilacs database (Casotti, 2009)1, using the descriptor healthcare education and covering the period 2000-08 revealed imported data on this field. The following points were highlighted: 1) in assessing the articles overall, with regard to methodology, there was weakness in the approach, with many reports on experiences without in fact having any reflective processing on the data observed and collected in the practical activities, i.e. without any explicit theoretical methodological marker; and 2) taking the indirect reference point of the fact that the production is located in periodicals that are institutionally well regarded, it is unquestionable that there have been advances over recent decades, which indicates that there has been a movement towards aggregation and qualification in this field, thus supplanting its aspect of exclusively social practice and creating questions within the sphere of science. In summary, the study shows that the current state of the art of the scientific field of healthcare education, taking into consideration its incipient and emerging nature, is still a space filled with many question marks and undefined points. Despite a substantial number of published papers, the sparse production on the constitution of the discipline still lacks investment that would enable greater integration of the epistemological, conceptual and methodological domains.
What, then, can we highlight from the material presented that might add value to the field of healthcare education?
The article that discusses health promotion through the bias of the subjects' notion of hyposufficiency brings important information regarding representations of the menopause, experiences and care processes relating to this phase of life that serve as reflections to be included in the field. Along the lines of concern about the body, the article on the use of methylphenidate as an "object of short-term quick consumption that is a connectable and disconnectable partner within easy reach, thus becoming an agent for ephemeral pleasure that is manufactured and put on the market as a medication" deals with an issue that could become a public health problem. Furthermore, along the same line of representations about body changes of the menopause, there are articles dealing with transsexuals that "exhibit discordance between biological sex and gender" and who consequently seek harmony with their bodies; and with obese individuals and the struggle that they have between their body representation and "the imperatives of body esthetics carried in the contemporary world". The real possibility of yoga practice within the Brazilian National Health System (SUS) is dealt with as one of the ways out for attending to the expanded concept of healthcare. According to Scliar (2007)2, this "reflects a social, economic, political and cultural setting. In other words, health does not represent the same thing to all people. It will depend on the time, place and social class", and no longer on the absence of disease, as it was understood for a long time. In fact, these texts move in little-explored spaces that are nonetheless important in that they translate relationships between subjects in healthcare production processes, thereby revealing identities and differences, which are fundamental elements for comprehending the field of healthcare education. Moreover, questions relating to body, gender, sexuality and diversity return in "Images of diversity".
The set of articles relating to healthcare professionals' training reveals the effervescence of the field: medicine, dentistry, occupational therapy, interdisciplinary bachelor's degree in healthcare (BIS) and naturology are some of the professions that are analyzed from the point of view of their curricula, pedagogical projects, objectives and methods, especially the discussion on scenarios for learning beyond teaching hospitals. This is not only from the point of view of teaching and learning processes, but also from the point of view of practicing the profession and, in some cases, the consequences of the conditions or even of declining security of work in the field, during the training (which is the case of nursing students) and in the working environment (which is the case of community health agents).
In the field of mental health, the articles bring contributions to work in clinics: presenting the results from a proposal for matrix support in different clinics in the municipality of Campinas; and describing innovative experiences relating to dealing with mental distress in primary healthcare units. Also in this field, family support for patients who are readmitted to hospital is discussed: this is an important topic that is relatively little discussed in the literature.
In "Open Space" we have an important discussion on an issue that is considered to be a "critical knot" in healthcare professionals' training: the fragmentation between practices developed in healthcare clinics and knowledge produced within an academic context. This is an issue that has been present in debates on curricular innovations, especially in relation to places students in different learning scenarios.
In this manner, we leave this set of texts in readers' hands. Even if they are not linked to a single topic, they end up forming a kind of web in which concepts and practices that give substance to the field of healthcare education are mixed together.
1 CASOTTI, E. Educação em saúde: reflexão preliminar sobre a constituição do campo. In: ENCONTRO NACIONAL DE PESQUISADORES EM EDUCAÇÃO EM CIÊNCIAS, 7., Florianópolis, 2009. Anais... Florianópolis, 2009. 1 cd-rom.
2 SCLIAR, M. História do conceito de saúde. Physis, v.17, n.1, p.29-41, 2007.
2 SCLIAR, M. História do conceito de saúde. Physis, v.17, n.1, p.29-41, 2007. [ Links ]