Práticas coletivas de cuidado na Atenção Primária à Saúde durante a pandemia da covid-19: Collective care practices in Primary Health Care during the COVID-19 pandemic

Roberta de Pinho Silveira; Fernanda Carlise Mattioni; Priscila Tadei Nakata Zago; Michele Neves Meneses; Tiago Sousa Paiva; Cristianne Maria Famer Rocha

doi:10.17765/2176-9206.2025v18e12886

Authors

Roberta de Pinho Silveira Federal University of Rio Grande do Sul https://orcid.org/0000-0003-4136-9253
Fernanda Carlise Mattioni Federal University of Rio Grande do Sul https://orcid.org/0000-0003-3794-6900
Priscila Tadei Nakata Zago Federal University of Rio Grande do Sul https://orcid.org/0000-0001-6181-8381
Michele Neves Meneses Federal University of Rio Grande do Sul https://orcid.org/0000-0002-0933-7051
Tiago Sousa Paiva Alvorada Municipal Health Department https://orcid.org/0000-0001-7765-2355
Cristianne Maria Famer Rocha Federal University of Rio Grande do Sul https://orcid.org/0000-0003-3281-2911

DOI:

https://doi.org/10.17765/2176-9206.2025v18e12886

Keywords:

Primary Health Care, Nursing Care, Pandemic

Abstract

Collective care practices are essential nursing care interventions. This study aimed to analyze how collective care practices nurses performed during the pandemic in Primary Health Care were established. Methods: This qualitative research was inspired by Michel Foucault’s genealogical method, which adopted semi-structured interviews from 59 nurses working in Primary Health Care as a data production instrument. Results: Collective practices were discontinued during the pandemic, and we identified PHC’s precariousness. Discussion: We live in a biopolitical situation in which several populations are subject to “precariousness”. Conclusion: Preserving collective health practices in PHC strengthens the confrontation of life precariousness. By occupying the public space of Primary Health Care, collective care practices conjure deindividualization, weakening social medicalization.

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Author Biographies

Roberta de Pinho Silveira, Federal University of Rio Grande do Sul

PhD student in Nursing at the Federal University of Rio Grande do Sul - UFRGS (2020), Master in Public Health at the Federal University of Rio Grande do Sul - UFRGS (2018), graduated in Physiotherapy at the Porto Alegre Institute of the Methodist Church - IPA - Faculty of Health Sciences (2000). Specialization in Acupuncture at the Faculty of Health Sciences of São Paulo (FACIS) and Higher Education Center for Homeopathy - IBEHE (2003). Researcher at the Health Promotion Study Group - GPES in the Postgraduate Program in Nursing at the Federal University of Rio Grande do Sul - PPGEnf / UFRGS.

Fernanda Carlise Mattioni, Federal University of Rio Grande do Sul

Mother of Luiza. Professor of the Public Health Course at the Federal University of Rio Grande do Sul. PhD in Nursing from the Federal University of Rio Grande do Sul (2021) and Master in Public Health from the National School of Public Health Sérgio Arouca/FIOCRUZ (2010). Specialist in pedagogical management of SUS Technical Schools, from the Federal University of Minas Gerais and Specialist in Nursing Care Lines - chronic non-communicable diseases, from the Federal University of Santa Catarina. Researcher at the Health Promotion Research Group, linked to UFRGS. She has experience in the area of Public Health, working mainly on the following topics: Health Promotion, Basic Care/Primary Health Care, Family Health, Health Care, Nursing and Worker Training for the SUS.

Priscila Tadei Nakata Zago, Federal University of Rio Grande do Sul

Health specialist at the Rio Grande do Sul State Health Department. Nurse at the Partenon Sanatorium Hospital. Nurse at the Mobile Emergency Care Service (SAMU) at the Porto Alegre Municipal Health Department. Master's degree in Nursing from the Postgraduate Program in Nursing at the School of Nursing of the Federal University of Rio Grande do Sul (PPGENFUFRGS). Specialization in Public Health with an emphasis on Family Health from Uninter. PhD student at PPGENFUFRGS. Member of the Health Promotion Study Group (GEPS) since March 2028, registered in the CNPq Research Groups Directory (www.ufrgs.br/geps).

Michele Neves Meneses, Federal University of Rio Grande do Sul

Mother. Leader in Defense of the SUS. Popular Educator. Nurse. Reikiana and Shamanic Spiritualist. Graduated from the Federal University of Rio Grande-FURG, with a sandwich degree in Portugal. Specialist in Chemical Dependency from the Federal University of Rio Grande-FURG. Specialist in Health Management from the Federal University of Rio Grande do Sul - UFRGS. Specialist in Environmental Health Surveillance from UFRJ. Specialist in Continuing Education in Health - UFRGS. Master in Health Education - UFRGS. PhD student at PPGENF-UFRGS. Member of the Popular Education, Art and Health Collectives - Povaréu and Povaréu Sul - Popular Health Movement (MOPS), working on the creation of Tents of Popular Affection. Member of the National Articulation of Movements and Practices of Popular Education in Health - ANEPS. Also a member of the International Movement for the Health of the People - MSP. Member of the GT of Popular Education and Health of ABRASCO. She did an exchange program for 6 months in the city of Faro - Portugal, working at the Drug Addiction Support Center (CAT) and at the Faro Hospital in the Psychiatry Service (2008-2009). She worked as a Nurse in the Hospital Infection Control Service (SCIH) of the Portuguese Charitable Society, in Pelotas-RS, being a member of the Internal Accident Prevention Committee (CIPA) and also served as president of the Waste Management group in Health Services (2009-2010). She worked as a professor of the Nursing Technician Course at the National Service of Attention to Commerce - Pelotas and of the Nursing Technician and Medical Radiology Technician Courses at the Dimensão Educational Institute-Pelotas (2010). She worked as Municipal Coordinator of Immunizations - Epidemiological Surveillance at the City Hall of Rio Grande (2011). Coordinated the Municipal Emergency and Urgency Service of the city of Rio Grande (2012). Coordinated Environmental Health Surveillance 2012-2017. Participant of the Municipal Center for Education in Public Health - NUMESC / RG and Regional Representative in the Teaching-Service Integration Commission - CIES - 3CRS from 2012-2017. Professor at Faculdade Anhanguera Educacional, responsible for the subjects Public Health Policies, Public Health I and II, Communicable Diseases, Health Surveillance I and II and Nursing and Science. Coordinator of the Extension Projects of Popular Education and Integrative and Popular Practices from 2012 to 2017. Superintendent of Health Surveillance (2017-2020). Coordinator of NUMESC / RG (2016-2018). Member of the Health Research Ethics Committee - CEPAS Santa Casa/Rio Grande (2017-2020). Management representative on the Municipal Health Council (2017-2020). Also currently a member of CEPICS/State Health Council (2019-2023). She is currently a municipal health councilor in Rio Grande/RS. Supporter of Fiocruz Brasília and Fiocruz Ceará and part of the CPP for Specialization in Popular Health Education in Healthy and Sustainable Territories.

Tiago Sousa Paiva, Alvorada Municipal Health Department

PhD student in Nursing in the line of research in Public Health at the Federal University of Rio Grande do Sul (UFRGS). Master in Health Education from the Federal University of Health Sciences of Porto Alegre (UFCSPA). Specialist in Family Health from the Open University of SUS (UNA - SUS/UFCSPA). Has experience in developing research projects in the area of Health and managing undergraduate courses in the area of Biological Sciences, Health and Humanities. Has experience in the development of teaching materials for the training of health professionals at technical and higher levels. Currently, she is a professor at the Ritter dos Reis University Center (UniRitter). Areas of interest: Public Health Policies; HIV/AIDS; Public Health.

Cristianne Maria Famer Rocha, Federal University of Rio Grande do Sul

Mother and activist for women in science. PhD and Master in Education from the Federal University of Rio Grande do Sul (PPGEDU/UFRGS). She completed a postdoctoral internship at the Pan American Health Organization (PAHO/WHO) in 2005 and at the National University of Distance Education (UNED) in 2013. She is currently Associate Professor III at the School of Nursing at the Federal University of Rio Grande do Sul (UFRGS). She works at the Bachelor's Degree in Public Health. She has been a Permanent Professor of the Postgraduate Program in Nursing (PPGENF/UFRGS) since 2017 and of the Postgraduate Program in Education (PPGEDU/UFRGS) since 2019. She is the Leader of GEPS - Health Promotion Study Group, registered in the CNPq Research Groups Directory. She was a Permanent Professor of the Postgraduate Program in Public Health (PPGCOL/UFRGS), from 2012 to 2017. She was a Collaborating Professor of the Postgraduate Program in Child and Adolescent Health (PPGSCA/UFRGS), from 2007 to 2018. She was a Visiting Professor (2008) and Collaborating Professor (2009-2010) at the Institute of Hygiene and Tropical Medicine of the Universidade Nova de Lisboa (IHMT/UNL), in Portugal. And, from 2006 to 2013, she was a Guest Professor at the Universidad para la Cooperación Internacional (UCI), in Costa Rica. Since 2006, she has worked as a Consultant for the Pan American Health Organization (PAHO/WHO), in different projects, in Brazil and abroad. Her areas of activity are Health Education, Health Communication and Health Promotion.

References

Rossetto M, Grahl F. Educational groups in Primary Care: an integrative literature review from 2009 to 2018. Research Society and Development. 2021;10(10):e174101018561. https://doi.org/10.33448/rsd-v10i10.18561

Menezes ES, Kantorski LP, Ramos CI, Couto MLO, Ubessi LD. Atividades grupais na perspectiva de enfermeiros da Atenção Psicossocial. Vínculo. 2022;19(1):86-97. https://doi.org/10.32467/issn.19982-1492v19n1a9

Portaria n. 2.436 de 21 de setembro de 2017 (BR). Aprova a Política Nacional de Atenção Básica, estabelecendo a revisão de diretrizes para a organização da atenção básica, no âmbito do Sistema Único de Saúde (SUS), Diário Oficial da União (Brasília). 2017. Disponível em: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2017/prt2436_22_09_2017.

Organização Panamericana da Saúde. Atenção primária à saúde; 2024. Disponível em: https://www.paho.org/pt/topicos/atencao-primaria-saude

Giovanella L. Atenção básica ou atenção primária à saúde? Cadernos de Saúde Pública. 2018;34(8):e00029818. https://doi.org/10.1590/0102-311x00029818

Mendonça FF, Lima LD, Pereira AMM, Martins CP. As mudanças na política de atenção primária e a (in)sustentabilidade da Estratégia Saúde da Família. Saúde Debate. 2023;47(137):13-30. https://doi.org/10.1590/0103-1104202313701

Barreto ACO, Rebouças CBA, Aguiar MIF, Barbosa RB, Rocha SR, Cordeiro LM, Melo KM, Freitas RWJF. Perception of the Primary Care multiprofissional team on health education. Revista Brasileira de Enfermagem. 2019;(72):266–273. https://doi.org/10.1590/0034-7167-2017-0702

Kanno, Natália de Paula et al. A colaboração interprofissional na atenção primária à saúde na perspectiva da ciência da implementação. Cadernos de Saúde Pública. 2023;39(10):e00213322. https://doi.org/10.1590/0102-311XPT213322

Mattioni FC, Rocha CMF. Promoção da saúde na atenção primária: efeitos e limitações em tempos de neoliberalismo conservador. Ciênc saúde coletiva. 2023;28(8):2173–82. https://doi.org/10.1590/1413-81232023288.05752023

Ferreira, SR, Périco LAD, Dias VRFG. The complexity of the work of nurses in Primary Health Care. Revista Brasileira de Enfermagem. 2018;(71):704–709. https://doi.org/10.1590/0034-7167-2017-0471

Rocha SMM, Almeida MCP. O processo de trabalho da enfermagem em saúde coletiva e a interdisciplinaridade. Revista Latino-Americana de Enfermagem. 2000;8(6):96–101. https://doi.org/10.1590/S0104-11692000000600014

Moraes DR, Castiel LD. O salutarismo de Robert Crawford e as atualizações do autoritarismo sanitário nosso de cada dia. Reciis – Rev Eletron Comun Inf Inov Saúde. 2019;13(1). https://doi.org/10.29397/reciis.v13i1.1731

Dall’alba R, Rocha CMF, Silveira RP, Dresch LSC, Vieira LA, Germano MA. Covid-19 in Brazil: far beyond biopolitics. Lancet (London, England). 2021;397(10274):579-580. https://doi.org/10.1016/S0140-6736(21)00202-6

Butler, J. Corpos em aliança e a política das ruas: notas para uma teoria performativa de assembleia. Rio de Janeiro: Civilização Brasileira; 2019.

Foucault, M. Nietzsche, a genealogia e a história. Ditos e Escritos II. Rio de Janeiro: Forense Universitária; 2000.

Sousa MF. Práticas de Enfermagem no Contexto da Atenção Primária à Saúde (APS): Estudo Nacional de Métodos Mistos [Relatorio final]. Brasília: Editora ECoS; 2022.

Instituto Brasileiro de Geografia e Estatística. Classificação e caracterização dos espaços rurais e urbanos do Brasil: uma primeira aproximação. Rio de Janeiro: Diretoria de Geociências; 2017.

Medina MG, Giovanella L, Bosquat A, Mendonça MHM, Aquino R. Atenção primária à saúde em tempos de COVID-19: o que fazer? Cad. Saúde Pública. 2020;36(7). https://doi.org/10.1590/0102-311X00149720

Daumas RP. O papel da atenção primária no enfrentamento da covid-19. Cad. Saúde Pública. 2020;36(6). https://doi.org/10.1590/0102-311X00104120

Foucault M. Microfísica do poder. 28 ed. São Paulo, SP (BR): Paz e Terra; 2014.

Silveira R de P, Rocha CMF. Verdades em (des)construção: uma análise sobre as práticas integrativas e complementares em saúde. Saude Sociedade. 2020;29(1):e180906. https://doi.org/10.1590/S0104-12902020180906

Zorzanelli RT, Ortega F, Bezerra Júnior B. Um panorama sobre as variações em torno do conceito de medicalização entre 1950-2010. Ciênc saúde coletiva. 2014;19(6):1859–68. https://doi.org/10.1590/1413-81232014196.03612013

Mbembe A. Necropolítica. 3 ed. São Paulo: N1-edições; 2018.

Damascena, DM.; Vale, PRLF. Tipologias da precarização do trabalho na Atenção Básica: estudo netnográfico. Trabalho, Educação e Saúde. 2020;1:e00273104. http://dx.doi.org/10.1590/1981-7746-sol00273

Seixas CT, Merhy EE, Feuerwerker LCM, Santo TB do E, Slomp Junior H, Cruz KT da. A crise como potência: os cuidados de proximidade e a epidemia pela Covid-19. Interface (Botucatu). 2021;25:e200379. https://doi.org/10.1590/interface.200379