Comunicação em saúde junto a crianças: perspectiva de enfermeiros/enfermeiras do Programa Saúde na Escola

Abstract

The child is in a period of life, largely experienced at school, of intense development and very promising for the promotion of healthy lifestyles. Nurses in Brazil have worked in schools since the end of the 19th century, modifying the communicational approach throughout history. The School Health Program stands out, which aims to promote the comprehensive health of children and advocates humanized communication; individual-centered; in partnership with the family and school; based on dialogue, social interaction, respect, understanding, whose teaching-learning generates voluntary movement to adopt healthy habits, promoting health and quality of life, as well as preventing diseases. Communication is a skill of nurses used in health work, a link between education and health and with varied dimensions. As a theoretical reference, it was based on the assumptions of communicative action, by Jürgen Habermas. Therefore, this research aimed to analyze health communication with children at school, according to the perception of nurses from the Family Health Strategy who carry out actions linked to the School Health Program. It is a descriptive study, with a qualitative approach, carried out in a municipality in Triângulo Mineiro, with 29 nurses. For data collection, semi-structured interviews were carried out guided by a validated script, audio recorded and transcribed in full. The first question was aimed at collecting meanings and questions two and three sought to raise Critical Incidents, as a primary data collection technique. Data analysis was based on content analysis. For the interviewees, the meanings of health communication are a light technology materialized in health care, issuing communications and teamwork. From the interviews, 28 situations emerged, of which 18 (64.4%) received negative references and 10 (35.5%) positive ones; 274 behaviors, 201 (73.4%) positive and 73 (26.6%) negative; in addition to 35 consequences that received 28 (80.0%) positive and seven (20.0%) negative. Positive references indicate aspects that facilitate health communication and negative ones, those that make it difficult. The use of ludic and the process of teamwork and in partnership with family members were considered facilitators of health communication. It is clear that ludic is an appropriate language for communicating with children, belonging to their world of life and guaranteeing their consent to the practices. And teamwork facilitates horizontal, participatory and articulated communication. Aspects such as direct interaction with children, with emphasis on relationships with children with disabilities and victims of violence; lack of physical structure and support/participation of education professionals during actions; and fragmented work process make health communication difficult. It is concluded that the meanings of health communication are based on the biomedical perspective, guided by the transmission of information, through the verticalization of speech, asymmetry of power, themes and preventive actions for diseases and injuries, and a curative emphasis. Furthermore, despite the predominance of negative situations, the emphasis on positive behaviors and consequences, favorable to health communication, demonstrate the dedication and effort of nurses in partnership with others involved to overcome difficulties, from the perspective of the power of health communication as a lightweight technology present throughout the healthcare work process. It is noteworthy that aspects of communicative action are favorable to overcoming the biomedical model in children's health care, stimulating autonomy and greater adherence to self-care that promotes health and prevents diseases, through interaction in appropriate language, scientifically based dialogue and free from the imposition of ideas and power asymmetry, strengthening bonds between different actors, and teamwork. The limitations of the study are the turbulent period for Brazilian nursing. Based on the results, it is believed that aspects related to the training of nurses and the organization/municipal management of the Program need to promote health communication, aiming to fully meet the health of children at school. Still as a contribution, it points to the possibility of expanding the discussion on communication based on communicative action, beyond the Program, extrapolating to the approach of people in different age groups, in Primary Health Care, and with other health professionals, in addition to nurses.