The production of care in the routine of Family Health Teams

ABSTRACT Objective: To identify the factors interfering in the production of care in the daily work of health professionals from the Primary Health Care. Method: Qualitative research carried out with Family Health Strategy (FHS) teams, in the health units of Rocinha (Rocinha is a favela located in the South Zone of the city of Rio de Janeiro, Brazil). To analyze the data, the thematic network proposed by Attride-Stirling was used. Results: The routine of Teams in the Production of Care was the denomination of the network formed by the following themes: scales of services of the teams; structural problems of Family Health Units; standardization of protocols; challenges for the production of care; and collections of micro and macro management. Final considerations: The production of care by Family Health Teams is challenged when they take care beyond what is imposed in the organizational protocols of the FHS, reflecting the complexity of working and caring in territories with social disparities.

摘要
研究目的：旨在明确初级卫生保健（Primary Health Care）体系内卫生专业人员日常工作中干扰照护服务产出的相关影响因素。
研究方法：本研究为质性研究，研究对象为巴西里约热内卢南区贫民区罗西尼亚（Rocinha）卫生单元的家庭健康策略（Family Health Strategy, FHS）团队；数据分析采用阿特里德-斯特林（Attride-Stirling）提出的主题网络分析框架。
研究结果：本研究构建的主题网络以“家庭健康团队照护服务产出日常工作”为核心主题，该网络由以下5个子主题构成：团队服务规模、家庭健康单元（Family Health Units）结构性问题、诊疗规程标准化、照护服务产出面临的挑战，以及微观与宏观管理范畴。
研究结论：当家庭健康团队的服务范畴超出家庭健康策略既定的组织规程时，其照护服务产出将面临挑战，这也凸显了在存在社会不平等的地域开展工作与提供照护服务的复杂性。