From: <Salvo pelo Microsoft Internet Explorer 7>
Subject: Artigo em HTML
Date: Thu, 3 Jan 2008 16:00:59 -0300
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<META http-equiv=3DContent-Type content=3D"text/html; =
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<P><B><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D4><A=20
name=3Dtop10></A>Terapias alternativas/complementares: o saber e o fazer =
das=20
enfermeiras do distrito administrativo 71 - Santo Amaro - S=E3o Paulo<A=20
href=3D"http://www.ee.usp.br/reeusp/upload/html/164/body/02.htm#back10"><=
SUP>*</SUP></A>=20
</FONT></B></P>
<P>&nbsp;</P>
<P><B><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D3>Alternative or=20
complementary therapies: knowledge and action of the nurses at the 71st=20
administrative district - Santo Amaro, S=E3o Paulo, =
Brazil</FONT></B></P>
<P>&nbsp;</P>
<P><B><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D3>Ter=E1pias=20
alternativas /complementarias: el saber y el hacer de las enfermeras del =

distrito administrativo n. 71 - Santo Amaro- San =
Paulo-Brasil</FONT></B></P>
<P>&nbsp;</P>
<P>&nbsp;</P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D2><B>Helena Maria=20
Fekete Nu=F1ez<SUP>I</SUP>; Suely Itsuko =
Ciosak<SUP>II</SUP></B></FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif"=20
size=3D2><SUP>I</SUP>Enfermeira do Programa da Sa=FAde da Fam=EDlia, Jd =
Monte Azul,=20
Vila das Belezas, DS S=E3o Luiz, S=E3o Paulo; Mestre em Enfermagem na =
=E1rea de Sa=FAde=20
Coletiva (EEUSP)<BR></FONT><FONT face=3D"Verdana, Arial, Helvetica, =
sans-serif"=20
size=3D2><SUP>II</SUP>Profa Dra do Departamento de Enfermagem em Sa=FAde =
Coletiva da=20
EEUSP; Diretora do Departamento de Enfermagem do Hospital Real e =
Benem=E9rito da=20
Sociedade Portuguesa de Benefic=EAncia</FONT></P>
<P>&nbsp;</P>
<P>&nbsp;</P>
<HR noShade SIZE=3D1>

<P><B><FONT face=3D"Verdana, Arial, Helvetica, sans-serif"=20
size=3D2>RESUMO</FONT></B></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Este =
estudo=20
objetivou verificar o saber e o fazer das enfermeiras que atuam nas =
unidades=20
municipais de Sa=FAde do Distrito Administrativo 71-Santo Amaro -S=E3o =
Paulo, frente=20
=E0s Terapias Alternativas/Complementares(TA/C). A pesquisa, de =
abordagem=20
quantitativa com an=E1lise qualitativa dos dados, permitiu evidenciar =
que 89% dos=20
enfermeiros acreditam nas TA/C por=E9m, apenas 22,2% t=EAm conhecimento =
do respaldo=20
legal e 5,5% t=EAm cursos nesta =E1rea; 44,4% aplicam em si mesma e =
11,1% aplicam=20
nos pacientes, sete TA/C distintas, classificadas em cinco grupos de =
HILL.=20
Desvendou-se que h=E1 necessidade de buscar novos saberes como =
op=E7=F5es de=20
assist=EAncia =E0 promo=E7=E3o da sa=FAde da popula=E7=E3o.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D2><B>Palavras-chave:=20
</B>Enfermagem hol=EDstica. Terapias alternativas. Terapias =
complementares.=20
Promo=E7=E3o da sa=FAde. Pesquisa em enfermagem.</FONT></P>
<HR noShade SIZE=3D1>

<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif"=20
size=3D2><B>ABSTRACT</B></FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>The =
purpose of this=20
study is to investigate the nurses knowledge and actions taken regarding =

alternative or complementary therapies (AT or CT) at the County =
(municipal)=20
Health Units of the 71<SUP>st</SUP> Administrative District, in Santo =
Amaro, SP.=20
The research use a quantitative aproach and a qualitative analysis of =
the field=20
data that showed that 89% of the nurses have confidence in AT/CTs but =
only 22,2%=20
know the legal basis for its use and 5,5% had courses on the techniques. =
44,4%=20
use these therapies on themselves and 11,1% on their patients. =
Altogether 7=20
diferent AT/CTs were listed and classified in 5 Hill's groups. It was =
found that=20
there is a need for including new knowledge as a complementary option =
for the=20
promotion of the population's health.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D2><B>Keywords:=20
</B>Holistic nursing. Alternative therapies. Complementary therapies. =
Health=20
promotion. Research on nursing.</FONT></P>
<HR noShade SIZE=3D1>

<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif"=20
size=3D2><B>RESUMEN</B></FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Este =
estudio tuvo=20
por objetivo verificar el saber y el hacer de las enfermeras que =
trabajan en las=20
unidades municipales de Salud del Distrito Administrativo n. 71, de =
Santo Amaro=20
-San Paulo - Brasil, en relaci=F3n a las Terapias =
Alternativas/Complementarias=20
(TA/C). La investigaci=F3n, de abordaje cuantitativo con an=E1lisis =
cualitativo de=20
los datos, demonstr=F3 que el 89% de las enferrmeras creen en las TA/C, =
sin=20
embargo apenas 22,2% tienen conocimiento del fundamento legal y 5,5% =
hicieron=20
cursos en esta area; 44,4% aplican en s=ED mismas y 11,1% aplican en los =
pacientes=20
siete TA/C distintas, clasificadas en cinco grupos de HILL. Se =
constat=F3 la=20
necesidad de buscar nuevos conocimientos como opciones de asistencia =
para la=20
promoci=F3n de la salud de la poblaci=F3n.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D2><B>Palabras-clave:=20
</B>Enfermer=EDa hol=EDstica. Ter=E1pias alternativas; Ter=E1pias =
complementares;=20
Promoci=F3n de la salud; Investigaci=F3n en enfermeria.</FONT></P>
<HR noShade SIZE=3D1>

<P>&nbsp;</P>
<P>&nbsp;</P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif"=20
size=3D3><B>INTRODU=C7=C3O</B></FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Na =
=E9poca da minha=20
forma=E7=E3o profissional, na d=E9cada de setenta, pouco se falava sobre =
tratamentos=20
alternativos =E0 medicina tradicional, tamb=E9m conhecidos como terapias =

alternativas ou complementares (TA/C).</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Ap=F3s =
muitos anos de=20
experi=EAncia na enfermagem alop=E1tica, em 1998, prestei servi=E7os de =
enfermagem=20
numa cl=EDnica formada por uma equipe multidisciplinar, onde os =
pacientes, na=20
grande maioria oncol=F3gicos, ou portadores de doen=E7as imunol=F3gicas, =
recebiam al=E9m=20
de tratamentos convencionais, tratamentos complementares como: =
homeop=E1ticos,=20
antropos=F3ficos, fitoter=E1picos, imunoter=E1picos, toque =
terap=EAutico, Reiki,=20
desbloqueio e alinhamento dos chakras, terapia art=EDstica, euritmia =
curativa,=20
relaxamento, visualiza=E7=E3o, troca de viv=EAncia em grupo, =
medita=E7=E3o e trabalho=20
biogr=E1fico antropos=F3fico, que visavam torn=E1-los mais conscientes e =
colaboradores=20
na promo=E7=E3o, preven=E7=E3o e recupera=E7=E3o da sua =
sa=FAde.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Percebi =
que com=20
esta atua=E7=E3o mais integral, no cuidar, o paciente relatava grande =
melhora na=20
qualidade de vida durante seu processo de doen=E7a.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Silva,=20
Gimenes<SUP>(1)</SUP> afirmam que</FONT></P>
<BLOCKQUOTE>
  <P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>o =
paradigma=20
  emergente, tamb=E9m chamado de hol=EDstico (etimologicamente, =
hol=EDstico e holismo=20
  derivam do grego holik=F3s, que significa todo, inteiro, completo e na =
filosofia=20
  =E9 a s=EDntese de unidades em totalidades organizadas), evita tratar =
de forma=20
  isolada o processo sa=FAde-doen=E7a, que tende a ser visualizado com =
um continuum,=20
  em que a sa=FAde deixa de ser um estado est=E1tico de perfeito bem =
estar,=20
  subentendendo-se mudan=E7a cont=EDnua aos desafios ambientais e ao =
equil=EDbrio=20
  din=E2mico do organismo, que envolve aspectos f=EDsicos, =
psicol=F3gicos, mentais,=20
  sociais e espirituais.</FONT></P></BLOCKQUOTE>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Nas =
Teorias que=20
fundamentam a Enfermagem, de Martha Rogers e Myra E. Levine, o Homem =E9 =
visto=20
como um ser hol=EDstico <SUP>(2)</SUP>.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Com a =
expans=E3o do=20
modelo mecanicista newtoniano da F=EDsica pela vis=E3o einsteiniana da =
F=EDsica=20
Qu=E2ntica, os seres humanos passam a ser vistos n=E3o mais apenas como =
m=E1quinas=20
<SUP>(3,4)</SUP> e sim, como campos de energia que se interpenetram e se =

influenciam reciprocamente. Com isso, Gerber<SUP>(3)</SUP> introduziu na =

medicina convencional um sistema de pensamentos que estuda o =
funcionamento corpo=20
humano a partir de uma perspectiva que considera ser ele constitu=EDdo =
por=20
m=FAltiplos sistemas energ=E9ticos que se influenciam reciprocamente e =
que nossos=20
pensamentos e emo=E7=F5es afetam nossa fisiologia e que terapias =
simples, como=20
ervas, =E1gua, ess=EAncias florais, por exemplo, podem ser agentes de =
cura muito=20
eficazes.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>=C9 =
baseado neste=20
conceito que as TA/C s=E3o consideradas, pois elas podem ser definidas=20
como</FONT></P>
<BLOCKQUOTE>
  <P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>um =
amplo dom=EDnio=20
  de recursos de cura que engloba todos os sistemas de sa=FAde, =
modalidades e=20
  pr=E1ticas e suas teorias e cren=E7as acompanhantes; inclui todas as =
pr=E1ticas e=20
  id=E9ias auto-definidas por seus usu=E1rios como prevenindo ou =
tratando as doen=E7as=20
  ou promovendo a sa=FAde e bem-estar. =
<SUP>(5)</SUP></FONT></P></BLOCKQUOTE>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Nesta =
pesquisa=20
foram adotados os termos terapias alternativas e terapias =
complementares,=20
indicando a mesma pr=E1tica, embora n=E3o sejam sin=F4nimos, mas porque =
o termo=20
alternativas =E9 o mais divulgado.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Na =
organiza=E7=E3o de=20
Hill<SUP>(6)</SUP>, as correntes terap=EAuticas b=E1sicas das medicinas =
alternativas=20
s=E3o classificadas em quatro: Medicina Oriental, Hindu ou Ayurv=E9dica, =
Homeop=E1tica=20
e a Medicina ampliada pela Antroposofia e as t=E9cnicas ou pr=E1ticas =
complementares=20
nem sempre pertencem apenas a uma corrente de medicina =
alternativa/complementar;=20
por exemplo, tanto a medicina chinesa quanto ayurv=E9dica, homeop=E1tica =
e=20
antropos=F3fica, fazem uso da fitoterapia, mas cada uma com o enfoque de =
sua=20
corrente. A popula=E7=E3o, que faz uso das TA/C, procura em geral as =
pr=E1ticas que=20
lhe fazem bem, n=E3o se importando na maioria dos casos em seguir uma =
determinada=20
linha de medicina. A autora, classifica as TA/C em sete grupos =
distintos:=20
terapias f=EDsicas, hidroterapias, fitoterapias, terapias nutricionais, =
terapias=20
mentais-espirituais, e terapias de exerc=EDcios individuais.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Existem =
ainda=20
outras terapias que n=E3o s=E3o mencionadas por Hill<SUP>(6)</SUP>, =
por=E9m s=E3o=20
relatadas por muitos profissionais da sa=FAde e terap=EAutas, tais como =
a Calatonia,=20
Cura Pr=E2nica, Reiki, Toque Terap=EAutico, Neuroling=FC=EDstica, =
Terapia Biogr=E1fica=20
Antropos=F3fica, Tai-Chi-Chuan, Lian-Gong, Do-In.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>No =
Brasil, podemos=20
destacar como enfermeiras pioneiras nos estudos na =E1rea de TA/C, Dra =
Maria=20
Jacyra Nogueira <SUP>(7)</SUP> e Dra Maria Alves Barbosa=20
<SUP>(8)</SUP>.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Para =
sedimentar as=20
TA/C, o pr=F3prio COFEN apoiou, atrav=E9s do Parecer Normativo n=BA =
004/95, o=20
reconhecimento das pr=E1ticas alternativas (Acupuntura, Iridologia, =
Fitoterapia,=20
Reflexologia, Quiropraxia, Massoterapia, dentre outras), como atividade=20
profissional vinculada =E0 sa=FAde e n=E3o estando vinculados a qualquer =
categoria=20
profissional; e atrav=E9s da Resolu=E7=E3o COFEN-197/97 que</FONT></P>
<BLOCKQUOTE>
  <P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D2>estabelece e=20
  reconhece as Terapias Alternativas como especialidade e/ou =
qualifica=E7=E3o do=20
  profissional de Enfermagem, desde que o profissional de Enfermagem =
conclua e=20
  tenha sido aprovado em curso reconhecido por institui=E7=E3o de ensino =
ou entidade=20
  cong=EAnere, com uma carga hor=E1ria m=EDnima de 360 horas=20
<SUP>(9)</SUP>.</FONT></P></BLOCKQUOTE>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Segundo =

Antunes<SUP>(10)</SUP>,</FONT></P>
<BLOCKQUOTE>
  <P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>a =
implanta=E7=E3o do=20
  Sistema =DAnico de Sa=FAde no Brasil, trouxe um grande desafio para a =
enfermagem:=20
  redirecionar suas pr=E1ticas para o atendimento integral =E0 sa=FAde =
coletiva e=20
  individual da popula=E7=E3o brasileira,</FONT></P></BLOCKQUOTE>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>o que =
poderia ser=20
amparada pelas TA/C, por=E9m a falta de uma pesquisa voltada =E0 =
aten=E7=E3o prim=E1ria =E0=20
sa=FAde com as TA/C, levou =E0 presente investiga=E7=E3o, cujo objetivo =
principal =E9=20
verificar o saber e o fazer das enfermeiras, que atuam nas unidades de =
sa=FAde do=20
Distrito Administrativo-71 Santo Amaro, do Munic=EDpio de S=E3o Paulo, =
sobre as=20
TA/C, e os objetivos espec=EDficos s=E3o: caracterizar as enfermeiras =
que atuam nas=20
unidades de sa=FAde, junto =E0 popula=E7=E3o, identificar quais s=E3o as =
TA/C conhecidas e=20
utilizadas pelas enfermeiras, verificar os resultados obtidos com as =
TA/C, as=20
facilidades e dificuldades encontradas pelas enfermeiras, nas Unidades =
de Sa=FAde,=20
para exercerem as TA/C.</FONT></P>
<P>&nbsp;</P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D3><B>MATERIAL E=20
M=C9TODOS</B></FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>O =
projeto recebeu=20
parecer favor=E1vel do Comit=EA de =C9tica em Pesquisa (CEP/EEUSP), sob =
o parecer n.=20
148/2001.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Ap=F3s =
autoriza=E7=E3o=20
escrita de cada diretor das nove unidades de sa=FAde, foi solicitando =
anu=EAncia=20
das(os) enfermeiras(os), atrav=E9s do consentimento livre, em participar =
do=20
presente estudo, sendo assegurado o anonimato.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Foi =
realizado um=20
estudo explorat=F3rio prospectivo, sobre o conhecimento e a pr=E1tica =
que as=20
enfermeiras t=EAm sobre as TA/C, atrav=E9s da aplica=E7=E3o de um =
question=E1rio =E0 todas=20
as enfermeiras que atuam diretamente com us=E1rios, nas unidades =
municipais de=20
sa=FAde do Distrito Administrativo=9671 (DA-71) Santo Amaro.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Os nove =
Servi=E7os de=20
Sa=FAde do DA Santo Amaro que possuem enfermeiras e atendem diretamente =
a=20
popula=E7=E3o em assist=EAncia prim=E1ria e secund=E1ria, e que s=E3o =
foco desta=20
investiga=E7=E3o, encontram-se na <A=20
href=3D"http://www.ee.usp.br/reeusp/upload/html/164/body/02.htm#tab1">Tab=
ela=20
1</A>, a seguir:</FONT></P>
<P align=3Dcenter><A name=3Dtab1></A></P>
<P align=3Dcenter>&nbsp;</P>
<P align=3Dcenter><IMG height=3D374=20
src=3D"http://www.ee.usp.br/reeusp/upload/html/164/img/02t1.gif" =
width=3D544></P>
<P align=3Dcenter>&nbsp;</P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif"=20
size=3D3><B>RESULTADOS</B></FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D2>Percorrendo as nove=20
Unidades de Sa=FAde do DA-71 Santo Amaro, foram entrevistadas 18 =
enfermeiras, que=20
correspondem ao total dos profissionais destas unidades, sendo 17(94,4%) =
do sexo=20
feminino e 1(5,6%), do sexo masculino. Os mesmos resultados foram =
tamb=E9m=20
constatados por Bezerra<SUP>(11)</SUP>,Oguisso<SUP>(12,13)</SUP> e=20
Ciosak<SUP>(14)</SUP>, confirmando mais uma vez que esta profiss=E3o =
continua=20
sendo predominantemente feminina (cerca de 95%).</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Como =
algumas=20
pr=E1ticas religiosas ou filosofias de vida condenam ou refor=E7am =
algumas pr=E1ticas=20
alternativas, buscou-se entre as entrevistadas conhecer esta pr=E1tica e =

verificamos que embora 15(83,3%) enfermeiras referem ter uma filosofia =
de vida=20
ou uma religi=E3o, existe uma grande heterogeneidade quanto =E0 sua =
pr=E1tica:=20
4(22,2%) enfermeiras s=E3o Cat=F3licas; 3(16,7%) s=E3o Adventistas e 3=20
Kardecistas.Tamb=E9m foram referidas o Budismo, Messi=E2nica, Batista e =
Protestante,=20
a filosofia de vida de "amar ao pr=F3ximo", mostrando existir oito =
diferentes=20
religi=F5es ou filosofias e um ate=EDsmo entre as enfermeiras =
entrevistadas; 2=20
(11,1%) n=E3o responderam, neste quesito (<A=20
href=3D"http://www.ee.usp.br/reeusp/upload/html/164/img/02qua1.gif">Quadr=
o=20
1</A>).</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Fez-se =
um=20
levantamento das Escolas de Enfermagem, buscando, ainda, apreender a =
influ=EAncia=20
da forma=E7=E3o no conhecimento, percep=E7=E3o e aceita=E7=E3o das TA/C; =
as Escolas de=20
Enfermagem foram classificadas em p=FAblicas (EEP=FA) e privadas ( EEPr) =
(<A=20
href=3D"http://www.ee.usp.br/reeusp/upload/html/164/img/02qua1.gif">Quadr=
o=20
1</A>).</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>As =
enfermeiras se=20
graduaram em 11 diferentes Escolas de Enfermagem das quais 5(45,4%) =
s=E3o EEP=FA, e=20
6(54,6%) s=E3o EEPr; a maioria da enfermeiras, 12(66,7%) =E9 oriunda de =
EEPr e 6=20
(33,3%) de EEP=FA (<A=20
href=3D"http://www.ee.usp.br/reeusp/upload/html/164/img/02qua1.gif">Quadr=
o=20
1</A>).</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Foi =
realizado,=20
tamb=E9m, um levantamento sobre as P=F3s Gradua=E7=F5es (PG) cursadas =
pelas enfermeiras,=20
para averiguar quais os cursos ou tend=EAncias que as enfermeiras =
buscaram, para=20
complementar sua forma=E7=E3o b=E1sica e se algumas j=E1 demonstravam =
interesse nas=20
=E1reas de TA/C. Verificou-se que as enfermeiras do DA-71, frequentaram =
um total=20
de 27 cursos de PG, sendo 23(85%) cursadas pelas enfermerias de EEPr. =
Chama=20
aten=E7=E3o, ainda, que nenhuma das enfermeiras entrevistadas cursou PG =
em TA/C (<A=20
href=3D"http://www.ee.usp.br/reeusp/upload/html/164/img/02qua1.gif">Quadr=
o=20
1</A>).</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Das =
enfermeiras do=20
DA-71, 17(94,4%) tem mais de 35 anos de idade e 8(44,4%) tem de 15 a 20 =
anos de=20
formada, sugerindo estar no mercado de trabalho h=E1 muitos anos, =
confirmados=20
pelos dados seguintes: 13(72,2%) enfermeiras tem mais de dez anos de =
trabalho no=20
Servi=E7o P=FAblico, revelando ser um grupo de enfermeiras est=E1vel no =
sistema de=20
trabalho, acrescentando assim ao saber acad=EAmico, um saber enriquecido =
pela=20
pr=E1tica da profiss=E3o. Das 18 enfermeiras, 11(61,1%), atuam h=E1 =
menos de cinco=20
anos na unidades atuais.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Quanto =
ao modo como=20
as enfermeiras percebem e reagem frente =E0s TA/C, 16(89%) acreditam nas =
TA/C,=20
mostrando n=E3o haver interfer=EAncia da religi=E3o nem da forma=E7=E3o =
acad=EAmica e=20
8(44,4%) t=EAm experi=EAncia na =E1rea(<A=20
href=3D"http://www.ee.usp.br/reeusp/upload/html/164/body/02.htm#fig1">Fig=
ura=20
1</A>).</FONT></P>
<P align=3Dcenter><A name=3Dfig1></A></P>
<P align=3Dcenter>&nbsp;</P>
<P align=3Dcenter><IMG height=3D317=20
src=3D"http://www.ee.usp.br/reeusp/upload/html/164/img/02f1.gif" =
width=3D579></P>
<P align=3Dcenter>&nbsp;</P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Chama a =
aten=E7=E3o o=20
fato de apesar do COREN ter promulgada a Resolu=E7=E3o COFEN-197 em =
1997, 14 (77,8%)=20
do total das enfermeiras referem n=E3o conhecer o respaldo legal e 16 =
(89%) n=E3o=20
conhecem cursos que as tornariam especialistas em TA/C. Somente um =
profissional=20
disse ter feito curso na =E1rea de TA/C, com carga hor=E1ria de 20hs, =
durante a=20
gradua=E7=E3o (FAE) ( <A=20
href=3D"http://www.ee.usp.br/reeusp/upload/html/164/body/02.htm#fig1">Fig=
ura=20
1</A>).</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Podemos =
constatar=20
na popula=E7=E3o desta pesquisa, que estas enfermeiras, n=E3o tiveram =
forma=E7=E3o para=20
conhecerem as TA/C e assim, poderem us=E1-las, recomend=E1-las, =
distingui-las dentre=20
as que realmente contribuem no atendimento e sem riscos =E0 =
popula=E7=E3o.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Foram =
levantadas as=20
experi=EAncias com as TA/C que as enfermeiras t=EAm consigo mesmas, com =
seus=20
familiares, usu=E1rios/clientes e funcion=E1rios de sua unidade de =
sa=FAde e outros=20
que as procuram.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Quanto =
=E0 aplica=E7=E3o=20
em si pr=F3prias, mais da metade, ou seja, 10(55,6%) n=E3o responderam a =
esta=20
quest=E3o, o que mostra, talvez, uma certa resist=EAncia em aceitar e =
adotar estas=20
pr=E1ticas. De uma forma coerente, verificamos que 12(66,7%) n=E3o =
responderam,=20
tamb=E9m, as quest=F5es relativas =E0s aplica=E7=F5es em seus familiares =
15(83,3%), em=20
usu=E1rios e funcion=E1rios e 16(89,9%) em outros (<A=20
href=3D"http://www.ee.usp.br/reeusp/upload/html/164/body/02.htm#fig2">Fig=
ura=20
2</A>).</FONT></P>
<P align=3Dcenter><A name=3Dfig2></A></P>
<P align=3Dcenter>&nbsp;</P>
<P align=3Dcenter><IMG height=3D238=20
src=3D"http://www.ee.usp.br/reeusp/upload/html/164/img/02f2.gif" =
width=3D541></P>
<P align=3Dcenter>&nbsp;</P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D2>Oito(44,4%)=20
enfermeiras mencionaram usar para si mesmas: medita=E7=E3o, fitoterapias =
com ch=E1s,=20
alho, lim=E3o, pr=F3polis, recebiam acupuntura, do-in, florais de Bach, =
homeopatia,=20
dietoterapia, e alguns tratamentos naturais; 6(33,3%) enfermeiras =
utilizam para=20
seus familiares: medita=E7=E3o, ch=E1s de plantas, com alho, cebola, =
lim=E3o,=20
maracujina, capim santo, ch=E1 de chuchu, do-in, florais, homeopatia, =
dietoterapia=20
e alguns tratamentos naturais; 2(11,1%), enfermeiras aplicam em =
usu=E1rios e=20
clientes da unidade: do-in e dietoterapia em gestantes e alguns =
tratamentos=20
naturais; 2(11,1%) empregam em funcion=E1rios a dietoterapia, alguns =
tratamentos=20
naturais e Lian Gong, e para outros que as procuram 2(11,1%) enfermeiras =

utilizam: ch=E1s de erva cidreira, capim santo, hortel=E3, dietoterapia =
e alguns=20
tratamentos naturais.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D2>Sintetizando o=20
fazer das enfermeiras e, considerando a Classifica=E7=E3o de =
Hill<SUP>(6)</SUP>,=20
verificamos que as TA/C foram citadas de formas variadas. Averiguamos, =
tamb=E9m,=20
que algumas enfermeiras utilizavam mais de uma pr=E1tica. Pudemos notar =
que, foram=20
mencionadas no total, nove diferentes pr=E1ticas de TA/C: acupuntura, =
florais de=20
Bach, do-in, medita=E7=E3o, dietoterapia, ervas medicinais, Lian Gong, =
(homeopatia e=20
"alguns tratamentos naturais", n=E3o foram classificados nos grupos de =
TA/C) ,=20
fazendo parte de um total de cinco grupos distintos de TA/C, ou sejam: =
terapias=20
f=EDsicas (meridianas), mentais e espirituais, fitoterapia, nutri=E7=E3o =
e de=20
exerc=EDcios individuais. (<A=20
href=3D"http://www.ee.usp.br/reeusp/upload/html/164/body/02.htm#tab2">Tab=
ela=20
2</A>).</FONT></P>
<P align=3Dcenter><A name=3Dtab2></A></P>
<P align=3Dcenter>&nbsp;</P>
<P align=3Dcenter><IMG height=3D413=20
src=3D"http://www.ee.usp.br/reeusp/upload/html/164/img/02t2.gif" =
width=3D578></P>
<P align=3Dcenter>&nbsp;</P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Nos =
dados=20
encontrados por Barbosa<SUP>(8)</SUP> e Souza<SUP>(5),</SUP> podemos =
observar=20
que os quatro grupos de TA/C de maior incid=EAncia, utilizadas pelas =
enfermeiras=20
tamb=E9m foram, em ordem decrescente, a Fitoterapia, Nutri=E7=E3o, =
Terapias=20
F=EDsicas=96meridianas e Terapias Mentais e Espirituais, refor=E7ando os =
dados desta=20
pesquisa.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Ao =
conceituar TA/C,=20
11(61,1%) das enfermeiras afirmaram que "=E9 um =
tratamento<I>"</I>:</FONT></P>
<BLOCKQUOTE>
  <P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D2>ministrado ao=20
  paciente sem medicamentos tradicionais, que o profissional pode =
utilizar junto=20
  ou n=E3o =E0 medicina propriamente dita, com terapias complementares =
;qualquer=20
  a=E7=E3o de interven=E7=E3o natural ou comportamental nos h=E1bitos, =
que verifiquem na=20
  alimenta=E7=E3o, repouso, lazer, ou em todas as necessidades humanas =
b=E1sicas; e=20
  tem como objetivos a cura, a melhora da qualidade de vida ou minimizar =
o=20
  sofrimento dos pacientes.</FONT></P></BLOCKQUOTE>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>A =
maioria, ou seja,=20
15(83,3%) mesmo sem ter experi=EAncia com TA/C, apoiam a sua pr=E1tica,=20
principalmente: a dietoterapia, fitoterapia, acupuntura, do-in, florais =
de Bach,=20
toque terap=EAutico e a medita=E7=E3o.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Poucas =
foram as=20
facilidades e muitas as dificuldades encontradas para aplicar TA/C, =
sendo que:=20
11(61,1%) descreveram sobre facilidades aquelas relacionadas =E0 =
aquisi=E7=E3o de=20
ervas medicinais, demanda espont=E2nea para atendimento com TA/C, =
oportunidade de=20
maior aproxima=E7=E3o com o usu=E1rio/ cliente e favorecimento da =
introdu=E7=E3o das TA/C=20
na unidade de sa=FAde, por ser p=FAblica.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D2>Quinze(83,3%)=20
referiam dificuldades para exercer as TA/C, relacionadas em quatro =
grupos:=20
<I>quanto a recursos f=EDsicos e humanos</I> da unidade de sa=FAde: =
espa=E7o f=EDsico=20
restrito, escassez de enfermeiras para demanda de pacientes na unidade, =
falta de=20
credibilidade nas TA/C; <I>capacita=E7=E3o</I>: pouqu=EDssimo material =
escrito, de=20
pesquisa e audio-visual, falta de cursos e reciclagem, e desconhecimento =
dos=20
profissionais de sa=FAde; <I>equipe de trabalho</I>: n=E3o aceita=E7=E3o =
da pr=E1tica por=20
enfermeiros, chefia, m=E9dicos, necessidade de ter aprova=E7=E3o da =
Diretoria, falta=20
de contribui=E7=E3o, pouca disponibilidade de tempo e <I>quanto aos=20
usu=E1rios/clientes</I> da unidade de sa=FAde: falta de =
conscientiza=E7=E3o e=20
dilvulga=E7=E3o para a popula=E7=E3o em geral, baixa compreens=E3o, =
pouca cren=E7a,=20
relacionar TA/C com fatos sobrenaturais. Estes dados refor=E7am os =
achados de=20
Barbosa<SUP>(8)</SUP>, que relatou as facilidades e dificuldades =
encontradas=20
pelos enfermeiros ao utilizarem as TA/C, referindo-se ao</FONT></P>
<BLOCKQUOTE>
  <P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D2>tr=EDduo=20
  apoio-aceita=E7=E3o-rejei=E7=E3o, tanto institucional quanto da equipe =
de trabalho=20
  destes profissionais, falta de amparo legal, e aus=EAncia de =
disciplinas=20
  oficializadas nos curr=EDculos das escolas.</FONT></P></BLOCKQUOTE>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>A =
investiga=E7=E3o=20
mostrou o qu=E3o grande =E9 o interesse da enfermeiras sobre as TA/C, e =
o quanto se=20
encontram limitadas pela falta de informa=E7=E3o e =
forma=E7=E3o.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D2>Realizar esta=20
investiga=E7=E3o foi gratificante, pois o fato de estar averiguando o =
saber e o=20
fazer das enfermeiras na =E1rea das TA/C, despertou em muitas delas o =
sentimento=20
de utilidade, interesse em ampliar seus conhecimentos e aplic=E1-los =
para melhorar=20
a qualidade de vida individual e da comunidade.</FONT></P>
<P>&nbsp;</P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif"=20
size=3D3><B>CONCLUS=D5ES</B></FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Tendo =
em vista os=20
objetivos propostos os resultados obtidos com a investiga=E7=E3o das 18 =
enfermeiras,=20
lotadas nas unidade de sa=FAde municipais do DA-71, permitem as =
seguintes=20
conclus=F5es:</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>1. na =
popula=E7=E3o=20
predomina o sexo feminino (94,4%); 83,3% referem ter uma filosofia de =
vida ou=20
religi=E3o, 66,7% das enfermeiras graduaram em Escolas de Enfermagem =
privadas;=20
frequentaram um total de 27 cursos de p=F3s gradua=E7=E3o; 94,4% possuem =
faixa et=E1ria=20
acima dos 35 anos; 77,8% se formaram h=E1 mais de 15 anos, 72,2% t=EAm =
mais de dez=20
anos de trabalho no Servi=E7o P=FAblico, e 61,1% atuam h=E1 menos de =
cinco anos na=20
unidades de sa=FAde atuais. Essa diversidade de caracter=EDsticas n=E3o =
influenciou no=20
saber e fazer nas TA/C.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>2. =
quanto aos=20
grupos de TA/C conhecidas e utilizadas, foram: 36,4% Fitoterapia =
(Florais de=20
Bach, ervas medicinais); 27,3% Nutri=E7=E3o (inespec=EDfica); 22,7% =
Terapias=20
f=EDsicas-meridianas (Acupuntura e Do-In); 9,1% mentais e espirituais =
(Medita=E7=E3o)=20
e 4,5% Terapias de exerc=EDcios individuais (Lian Gong).</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>3. =
quanto aos=20
resultados obtidos com a aplica=E7=E3o das TA/C: 89% acreditam nas suas =
a=E7=F5es; 44,4%=20
t=EAm experi=EAncia; somente 22,2% conhecem a legisla=E7=E3opertinente; =
94,5% n=E3o=20
fizeram nenhum curso relacionado; 89% n=E3o conhecem cursos que a tornam =

especialistas; 44,4% aplicam-na em si mesmas; 33,3% aplicam em seus =
familiares;=20
11,1% a aplicam em: usu=E1rios/ clientes, funcion=E1rios e em outros que =
as=20
procuram.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>4. As =
dificuldades=20
apontadas por 15(83,3%) enfermeiras foram: a falta de capacita=E7=E3o em =
TA/C, tabus=20
e preconceitos das equipe e dos usu=E1rios de sua unidade e recursos=20
f=EDsicos.</FONT></P>
<P>&nbsp;</P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D3><B>CONSIDERA=C7=D5ES=20
FINAIS</B></FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif"=20
size=3D2>Nogueira<SUP>(7)</SUP> colocou, h=E1 quase 20 anos, que a =
enfermeira =E9=20
um</FONT></P>
<BLOCKQUOTE>
  <P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D2>"profissional que=20
  vem sendo subutilizado pelos sistemas de assist=EAncia prim=E1ria. Sua =
fun=E7=E3o=20
  terap=EAutica ainda n=E3o =E9 bem aceita. Uma das provid=EAncias =
necess=E1rias =E9 que as=20
  enfermeiras reconhe=E7am a import=E2ncia de sua atua=E7=E3o e aceitem =
o seu novo papel=20
  e redefinam suas a=E7=F5es nos servi=E7os de =
sa=FAde".</FONT></P></BLOCKQUOTE>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>Essa =
situa=E7=E3o ainda=20
n=E3o se reverteu. A enfermeira deve abrir este novo espa=E7o, =
amparar-se com o=20
respaldo legal, associar-se a entidades, participar de forma=E7=E3o =
nesta =E1rea. A=20
popula=E7=E3o tem utilizado muitas TA/C para sua sa=FAde, e pelas =
dificuldades em=20
encontrar nos servi=E7os de sa=FAde um atendimento integral, cada vez =
mais, t=EAm=20
buscado outros terapeutas, nem sempre profissionais da sa=FAde, para =
sanar seus=20
problemas. As enfermeiras desta investiga=E7=E3o mostraram-se =
interessadas nas=20
TA/C,sendo que a maioria acredita que elas podem auxiliar na melhoria da =
sa=FAde,=20
por=E9m o desconhecimento da legisla=E7=E3o, a falta de capacita=E7=E3o =
te=F3rico- pr=E1tica,=20
as limita na experi=EAncia.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D2>Concordamos com Dra=20
Taka Oguisso que, em uma de suas aulas na disciplina de Hist=F3ria da =
Enfermagem,=20
coloca com propriedade: "precisamos ser enfermeiras capazes de ousar", =
para=20
buscar o saber e ocupar os espa=E7os com o fazer, efetivo, cient=EDfico =
e=20
consciente, pois n=F3s somos enfermeiras agentes ativas da =
transforma=E7=E3o e do=20
desenvolvimento da Enfermagem deste mil=EAnio.</FONT></P>
<P>&nbsp;</P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif"=20
size=3D3><B>REFER=CANCIAS</B></FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>(1) =
Silva MJP,=20
Gimenes OMPV. Florais: uma alternativa saud=E1vel- pesquisas revelam =
tratamentos e=20
resultados dessa terapia. S=E3o Paulo: Gente;1999.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>(2) =
Almeida MCP,=20
Rocha JSY. O saber de enfermagem e sua dimens=E3o pr=E1tica S=E3o Paulo: =

Cortez;1986.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>(3) =
Gerber R.=20
Medicina vibracional: uma medicina para o futuro. S=E3o=20
Paulo:Cultrix;1988.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>(4) =
Barbosa MA. A=20
Utiliza=E7=E3o de terapias altenativas por enfermeiros brasileiros, =
[tese] S=E3o Paulo=20
(SP): Escola de Enfermagem da USP;1994.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>(5) =
Souza VT,=20
Enfermeiros que trabalham com terapias complementares: conhecendo sua =
pr=E1tica.=20
[Disserta=E7=E3o] S=E3o Paulo (SP): Escola Paulista de Medicina da =
UNIFESP;=20
2000.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>(6) =
Hill A,=20
organizador. Guia das Medicinas alternativas: todos os sistemas de cura=20
natural.S=E3o Paulo: Hemus; [ s.d.].</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>(7) =
Nogueira MJC.=20
Fitoterapia popular e enfermagem comunit=E1ria. [livre doc=EAncia =
].S=E3o Paulo (SP):=20
Escola de Enfermagem da USP; 1983.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>(8) =
Barbosa MA,=20
Egry EY, Queiroz VM. Reflex=F5es sobre a mudan=E7a de paradigmas e a =
ado=E7=E3o das=20
terapias alternativas no Brasil no s=E9culo XX. Texto Contexto Enferm, =
1993; 2=20
(2):33-44.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>(9) =
Conselho=20
Regional de Enfermagem de S=E3o Paulo. Documentos b=E1sicos de =
Enfermagem:=20
principais leis e resolu=E7=F5es que regulamentam o exerc=EDcio =
profissional de=20
Enfermeiros, T=E9cnicos e Auxiliares de Enfermagem. S=E3o Paulo: =
Escrituras;=20
2001.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>(10) =
Antunes MJM. O=20
Enfermeiro e a integralidade da assist=EAncia de enfermagem na rede =
b=E1sica do=20
Sistema =DAnico de Sa=FAde. [disserta=E7=E3o], Belo Horizonte (MG): =
Escola de=20
Enfermagem, Universidade Federal de Minas Gerais; 1996.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>(11) =
Bezerra ALQ. O=20
contexto da educa=E7=E3o continuada em enfermagem na vis=E3o dos =
gerentes de=20
enfermagem e enfermeiros d e educa=E7=E3o continuada. [tese] S=E3o Paulo =
(SP): Escola=20
de Enfermagem da USP; 2000.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>(12) =
Oguisso T. A=20
mulher na for=E7a de trabalho: o trabalho da mulher enfermeira.Rev =
Enferm UERJ=20
1998; 6 (1): p 309-16</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>(13) =
Oguisso T.=20
Assist=EAncia prim=E1ria de sa=FAde no INAMPS em S=E3o Paulo e no Rio de =
Janeiro:=20
contribui=E7=E3odo enfermeiro. [tese] S=E3o Paulo (SP): Faculdade de =
Sa=FAde P=FAblica da=20
USP; 1984.</FONT></P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2>(14) =
Ciosak SI.=20
Avalia=E7=E3o de desempenho e o aprimoramento de enfermeiros: =
expectativas do=20
avaliador e do avaliado. [tese] S=E3o Paulo (SP): Escola de Enfermagem =
da USP;=20
1994.</FONT></P>
<P>&nbsp;</P>
<P>&nbsp;</P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" =
size=3D2>Recebido:=20
15/08/2002<BR>Aprovado: 07/05/2003</FONT></P>
<P>&nbsp;</P>
<P>&nbsp;</P>
<P><FONT face=3D"Verdana, Arial, Helvetica, sans-serif" size=3D2><A=20
name=3Dback10></A><A=20
href=3D"http://www.ee.usp.br/reeusp/upload/html/164/body/02.htm#top10">*<=
/A>=20
Trabalho extra=EDdo da Disserta=E7=E3o de Mestrado em Enfermagem =
intitulada "Terapias=20
alternativas/complementares: o saber e o fazer das enfermeiras do =
Distrito=20
Administrativo 71- Santo Amaro - S=E3o Paulo<I>"</I> do Programa de =
P=F3s-Gradua=E7=E3o=20
em Enfermagem de Sa=FAde Coletiva-Escola de Enfermagem da USP (EEUSP),=20
2002.</FONT></P></BODY></HTML>

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