qualitative paper (data collection) INTRODUCTION The complexity of the health/disease process of diabetes mellitus (DM), which is noted for its significant prevalence, high morbidity and mortality, and immense costs to sufferers, family members, society and health systems, requires providing people with knowledge to enable adequate management of the disease.1-3 Among the public policies for DM and international consensuses, one important duty of health professionals, especially those in primary health care (PHC), is carrying out health education activities, both individually and collectively for people with DM.2,4,5 This requires breaking away from traditional pedagogical concepts and approaches that have prevailed in educational processes. The most recommendedapproach in public health education policies is sociocultural, where human beings are understood within their context; are the agents of their own care, and develop through a constructive process of action-reflectionaction. This empowers people to learn through seeing the need for concrete action based on recognition of their social reality, and targets extreme situations and overcoming contradictions. qualitative paper (data collection) This education must be based on dialogue, in a horizontal relationship, as an essential aspect for turning into a process that encourages the action-reflection praxis.6 Health education for managing and preventing chronic complications of DM in PHC encompasses various systems which are in constant interaction, such as among professionals, family health teams, family health support centers, local management, municipal management, local structure and health policies, in a dynamic process that enables the formation of networks within networks. The complexity of these networks involves constant relations marked by intense interlinks, interrelations, interconnections and multiple possibilities provided by these systems, in an integrative vision that is able to engender numerous possibilities.7 In the context of health education for people with DM in PHC, in order to help understand how health professionals organize themselves in this regard, a self-organization concept was sought, in which individuals are self-organizing beings that do not stop self-producing. qualitative paper (data collection) To this end, they expend energy to maintain their autonomy; they need to extract energy, information, and organization from their environment; and their autonomy is inseparable from this dependence. They are viewed as eco-selforganizing beings.7 Therefore, the objective of the present study was to understand how the members of family health teams organize themselves for health education on the management and prevention of chronic complications of DM in PHC. METHOD This was a qualitative study that used complex thought as the theoretical framework and qualitative evaluation, from
the perspective of evaluative research, as the methodological framework. Data was gathered using three techniques: interview, observation, and analysis of medical records. The interviews were guided by questions related to care and how it was planned, carried out, monitored and directed by members of family health teams, family health support centers and managers. Observation occurred during individual and collective consultations with health professionals. The medical records examined were selected by family health team nurses, with the prerequisite that they correspond to people with DM receiving care from these professionals. The investigation focused on records involving follow-up, tests ordered, referrals, identification of chronic complications, guidance given, and the quality of the data recorded. Twenty-five medical records were analyzed and there were 18 observations of care activities with people suffering from DM in PHC. Thirty-eight professionals participated in the study, divided into three sample groups: the first, with 29 professionals from five family health teams; the second with six members from three family health support center teams; and the third group, with two directors of basic health units and one municipal manager.
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