Qualitative Evidence for Best Nursing Practices in Primary Health Care

  • Rosa Maria Godoy Serpa da Fonseca
  • Emiko Yoshikawa Egry
  • Lucimara Fabiana Fornari
  • Rafaela Gessner Lourenço
Keywords: Collective Health; Qualitative Research; Best Practice; Primary Health Care; Evidence-Based Nursing

Abstract

Developing professional skills to identify health needs and coping with vulnerabilities is crucial to delivering qualified interventions in Primary Health Care. Professionals require the development of criticality to introduce transformative and scientifically grounded actions. The scientific problem of this study was: what basic topics can develop the criticality to introduce transformative and scientifically based actions in the Primary Health Care? Objective: to unveil the basic topics for best Nursing practices in Primary Health Care. Method: qualitative research, based on the Theory of Praxical Intervention of Nursing in Collective Health. This empirical study has three publications selected for convenience: a) Science, Collective Health and Nursing: highlighting the categories gender and generation in the episteme of praxis; b) The collective as an object of nursing care: a qualitative approach; and c) A glance at the Good Nursing Practices in Primary Care. We used the webQDA software for extracting and encoding empirical categories. Results: the three publications show that the care process of Nursing in Collective Health needs theoretical support to subsidize interventions thought in a critical and participatory way between being-care and being-caregiver. They emphasize that praxis, a dialectical unit theory-practice, directed to the collective consists in the object of Nursing care and aims at the transformation of objective reality from its contradictions. The understanding of the objective reality presents the territory as the primary focus for the identification of the processes of production and social reproduction, responsible for the individual and collective wear and strengthening processes. The understanding of the territory must be uncovered through the totalities-part that compose the social phenomena (individual dimension - individual and family; particular dimension - social groups; and structural dimension - process of social production and reproduction). The field of Collective Health presents the conception of the social determination of the health-disease process. To understand the collective, it is necessary to resort to the social categories gender, generation, race/ethnicity and social class. Through social categories it is possible to find social groups that are homogeneous in themselves and heterogeneous among themselves. In this sense, the dialectical method is shown as fundamental to explain the contradictions of health-disease phenomena and that result in the health needs and vulnerabilities expressed in the collective. Faced with this, praxis is considered as fruitful for the understanding of objective reality in order to promote the criticality of professionals and to introduce health interventions aimed at their transformation. Qualitative research emerges as a potential in what concerns the understanding of the health-disease process and the ways of living of social groups on geopolitical spaces, considering the historicity and dynamicity of the social processes that are concretized as expressions of health or disease. On the other hand, the quantitative methodology is limited as it generalizes the individuals and consequently disregards the complexity of social phenomena according to the specificities of groups and territories. Conclusions: The construction and implementation of good nursing practices in Primary Health Care find in the qualitative scientific evidences a promising space for the development of ethical-professional competencies.

Published
2018-10-02