The supervisors’ perspective on comprehensiveness among the Cuban doctors participating in the Mais Médicos Program (More Doctors)

ABSTRACT Supervision in the Mais Médicos Program (PMM) contemplates clinical-pedagogical actions, with the aim to qualify care, and articulates with the relevant strategy of doctors’ fixation in primary care. This article analyzes the supervisors’ perspective about Cuban doctors of the PMM in the city of Rio de Janeiro regarding the comprehensiveness of practices, explored in its dimensions of the biopsychosocial approach of care with community orientation and the expanded range of promotion, prevention and care actions. Thematic analysis of the monthly reports of supervision were carried out, between 2013 and 2015, and focus group with supervisors. Results show that Cuban doctors in PMM develop a wide range of actions, with community insertion, preventive approach, planning of activities and good interpersonal relationship. Challenges that were not restricted to the PMM, in many cases, were related to an approach focused on the person, on the mental health and in the insufficient performance of certain procedures.

【摘要】Mais Médicos项目（PMM）的督导工作涵盖临床-教学联动行动，旨在优化照护质量，并与基层医疗医师留任相关战略形成衔接。本文以里约热内卢市PMM项目中的古巴医生为研究对象，围绕其实践的全面性展开分析，从以社区为导向的生物-心理-社会医学模式（biopsychosocial approach）照护维度，以及拓展后的健康促进、疾病预防与照护行动范畴两大层面，探讨督导员对该群体的看法。研究于2013至2015年间开展了督导月度工作报告的主题分析，并组织督导员进行焦点小组访谈。结果显示，参与PMM的古巴医生开展了涵盖社区融入、预防性照护、活动规划及良好人际互动在内的多元实践活动。此外，诸多并非仅局限于PMM本身的挑战，多与以个体为中心的照护思路、心理健康相关工作，以及部分操作执行不充分有关。