Pol??tica de humaniza????o na aten????o b??sica: uma metass??ntese

Este estudo aborda o tema da humaniza????o na sa??de, o qual integra a agenda da pol??tica de sa??de no Brasil desde 2003. A Pol??tica Nacional de Humaniza????o - PNH coincide com os pr??prios princ??pios do Sistema ??nico de Sa??de -SUS, destacando a necessidade de garantir aten????o integral ?? popula????o e estrat??gias de amplia????o da condi????o de direito e de cidadania das pessoas. Essa pol??tica tem como base os princ??pios da transversalidade, indissociabilidade entre a aten????o e a gest??o e o protagonismo, co-responsabiliza????o e autonomia dos sujeitos e coletivos envolvidos no processo de produ????o de sa??de. Este estudo teve como objetivo discutir as pr??ticas de humaniza????o na aten????o b??sica na rede p??blica do SUS a partir dos tr??s princ??pios da Pol??tica Nacional de Humaniza????o. Para atingir tal objetivo realizamos uma revis??o sistem??tica da literatura seguida de metass??ntese utilizando as seguintes bases de dados: BDENF- Base de dados de enfermagem, BDTD- Biblioteca Digital Brasileira de Teses e disserta????es, BVS- ??rea tem??tica Humaniza????o, BVS-Psi-Brasil- Biblioteca Virtual em Sa??de Psicologia- Brasil, CATHEDRA- Biblioteca Digital de Tese e disserta????es da UNESP, CINAHL- Cumulative Index to Nursing and Allied Health Literature, DEDALUS- Global- Sistema Integrado de Biblioteca da Universidade de S??o Paulo, LILACS-Literatura Latino-Americana e do Caribe em Ci??ncias da Sa??de, LUME- Reposit??rio Digital da Universidade Federal do Rio Grande do Sul, MEDLINE-Literatura Internacional em Ci??ncias da Sa??de, PAHO- Biblioteca da Organiza????o Pan-Americana da Sa??de, PubMed- U. S. National Library of Medicine, SBU- Sistema de bibliotecas da UNICAMP, SciELO-Scientific Electronic Library Online e SiBI- Sistema de Biblioteca e disserta????es da UFRJ. Foram inclu??dos artigos de pesquisa, relatos de experi??ncias, disserta????es, teses e cap??tulos de livros, escritos em l??ngua portuguesa, inglesa ou espanhola, publicados a partir da cria????o da PNH, sendo, portanto, de 2003 a 2011. Cada estudo foi lido, e as principais caracter??sticas sistematizadas em um instrumento para levantamento das informa????es. Foram inclu??dos 40 estudos das 4.127 publica????es encontradas sobre o tema. Como resultados da metass??ntese foram identificadas tr??s categorias centrais: a primeira refere-se a organiza????o e infra-estrutura dos servi??os b??sicos de sa??de, a segunda compreende o processo de trabalho na aten????o b??sica e a terceira categoria refere-se as tecnologias das rela????es. A metass??ntese pode ser considerada uma ferramenta essencial para conhecer ??s pr??ticas de humaniza????o realizadas na aten????o b??sica, apontando para a necessidade de usu??rios, trabalhadores e gestores investirem esfor??os ainda maiores na implementa????o dessa pol??tica nas Estrat??gias de Sa??de da Fam??lia e Unidades de Sa??de de um modo geral.This study addresses to the theme of humanization in health care, which has been part of the political agenda of health in Brazil since 2003. The National Humanization Policy (NHP) coincides with the very principles of the public Brazilian Health System (SUS), highlighting the need of securing full attention in health care for the population as well as strategies to increase people???s conditions to rights and citizenship. Such policy is based on the principles of transverseness and indissolubility between the attention and the management, and the leading role, co-responsibility and autonomy of the individuals and the collective involved in the process of producing health. The present study had the objective of debating the practices in the humanization of primary health care in the public Brazilian health system (SUS) under the three principles of the National Humanization Policy (NHP). In order to achieve such a goal, we have done a systematic review of the literature followed by a Meta-Synthesis using the following databases: BDENF- Nursing database, BDTD- Brazilian Digital Library of Theses and Dissertations, BVS- Theme area of Humanization, BVS-Psi-Brasil- Virtual Library in Psychology and Health, CATHEDRA- Digital Library of Theses and Dissertations of UNESP, CINAHL- Cumulative Index to Nursing and Allied Health Literature, DEDALUS- Global- S??o Paulo University???s Library Integrated System, LILACS- Latin-American and Caribbean Literature in Health Sciences, LUME- Digital Repository of Universidade Federal do Rio Grande do Sul, MEDLINE- International Literature in Health Sciences, PAHO- Panamerican Health Organization Library, PubMed- U.S.National Library of Medicine, SBU- System of Libraries of UNICAMP, SciELO-Scientific Electronic Library Online and SiBI- Library and Dissertations System of UFRJ. Included herein were articles of research, case studies, reports of experiences, dissertations, theses, and book chapters, written in Portuguese, English or Spanish, published from the beginning of the policy; hence, from 2003 to 2011.Each study was read, and the main characteristics were arranged in a tool for the collection of data. We included 40 studies form the 4.127 publications found on the subject. As results of the Meta-Synthesis, three main categories were identified: the first one referring to the organization and infrastructure of primary health care; the second one encompasses the work process in primary health care; and the third one being about the technologies of relations. Meta-Synthesis can be considered an essential tool for one to experience the humanization practices in primary health care, which put in perspective the need for user, professionals, and managers to make even bigger efforts as to the implementation of NHP in Strategies for Family health and Health Centers as a whole