Processo de trabalho do cirurgião-dentista na estratégia saúde da família sob a perspectiva da integralidade

Abstract

The insertion of oral health into the Family Health Strategy (FHS) made it possible to reorganize the work process of the professionals involved, bringing the professional closer to the territory, making possible new forms of care production. For quality oral health care, it is necessary that the organization of the work process is in harmony with SUS principles, with a focus on integrality. The objective of this study was to analyze the work process of the dental surgeons (CD) of the ESF of the Cataguases / Leopoldina health micro-region in Minas Gerais, facing the integral care perspective. It is an exploratory descriptive study, qualitative approach. Thirteen CD of the Cataguases / Leopoldina health micro-region in Minas Gerais, comprised of ten municipalities, participated in this study. For the data collection, individual interviews were used with semistructured guiding script and observation with records in a field diary. Data analysis was based on dialectical hermeneutics that made it possible to understand the consensus in the discourses and the dialectic made it possible to perceive dissent and contradictions. After exhaustive reading of the data, seven nuclei of meaning emerged that resulted in three categories: the organization of the dental surgeons' work process in the FHS; knowledge and practices of dental surgeons in the FHT from the perspective of integrality; the daily routine of dental surgeons in the ESF: potentialities and challenges for integral care. It was noticed that oral health care was organized in a programmed and spontaneous demand. The programmed demand identified teamwork, home visits, educational activities for health promotion and disease prevention, administrative activities and participation in team meetings. It was noticed that the majority of the CDs understood the integrality towards the professional practices, reporting the vision of the patient as a whole, besides the understanding of the social multidetermination of the health-disease process of the individuals and their needs. Some professionals understand completeness beyond the practical sense, glimpsing the political and organizational dimension of integrality. Most CDs understand that completeness is achieved through teamwork and broadening the look beyond dental issues, understanding the needs of individuals. Among the potentialities are the possibility of referring to the Center of Dental Specialties (CEO), the guidelines of the ESF and the professional integration. Challenges include insufficient quotas for referrals to the CEO, excessive demands for clinical care, infrastructure and poor working conditions and deficiencies in the network. The study showed an approximation with the assistance model proposed by the FHS. Changes in the care model are noticed, with the evolution in the CD's performance of a clinical only vision for prevention, promotion, cure and rehabilitation. It is emphasized that integrality influenced the forms of work organization of the participants.