The Influence of Nursing in the Development of Popular Education in Health

Method: It is an integrative review of current literature, descriptive of quantitative approach. It was used as LILACS database, the SCIELO Virtual Library and Database of Nursing BDENF, with the following Health Sciences Descriptors (DECs): Health Education; Health Promotion; Community Health Nursing. For article selection criteria: be related to health education; authorship of health professionals; and have been published between the years 2007 to 2017. 09 articles were selected.


Introduction
Brazil is a country that has been suffering for a long time with its way of dealing with health.This has been evident since colonization and persists through a society in which there is still a certain exploitation and inequality towards the poor, women, children and the elderly, especially when it comes to subjects belonging to a less favored class.However, currently Popular Education in Health presents itself as having an interrelationship between social and theoretical/methodological participation, in order to transform the traditional practices of Health Education, thus helping to overcome the realities encountered and resulting in a better quality of life for all [1].
The Ministry of Health, in its 2007 Popular Health Education Notebook, affirms that health education is a practice in which there is active community participation, which provides training, health education and enhances the attitudes essential to life [2].
It is known that improvements in the quality of life of communities can be organized through actions that aim at maintaining health, providing nursing care, experiencing an interdisciplinary work experience in a collective health team [3].
The nursing aims at the protection, promotion and optimization of health and abilities, prevention of diseases and damages, alleviation of suffering through the diagnosis and treatment of human response, besides defending the care of individuals, families, communities and populations in general [4].
The promotion of Popular Education in Health (EPS) is a strategic positive way to contribute to the construction of the Unified Health System (SUS).In this way, Popular Education (PE) is understood as a conception of education, developed through continuous and permanent processes of formation, which has the intention of transforming reality from the protagonism of the subjects through different forms of communication, Especially dialogue.
Therefore, it is in this sense that nursing contributes to EPS, through activities that involve the promotion and prevention of health, in order to reduce the process of sickness of communities.
Discuss EPS not only as a field of knowledge and of health in constitution in Brazil, but as an integral policy of SUS, requires reflections on issues that emerge in the process of institutionalizing a policy, by highlighting different actors, conceptions, tactics and strategies that, despite the diversity, converge in the sense of facing the determinants of health conditions, that is, transforming the conditions of life [5].
The EP emerged from popular movements, intellectuals, health professionals and militants committed to changes in the conditions of life and health of the population.Its foundation began with Paulo Freire in 1964 through the National Literacy Program in which he preached liberation and emancipation practices, as well as problematizing health issues, with the following animators: students, university professors (participants in university extension projects), and popular leaderships [6].
The EP happened in the informality.In the meetings, the knowledge and actions of popular culture were affirmed through the booklets and manuals thus encouraging a fight and conscious participation by an improvement in the conditions of life and health, through the exchange of knowledge, resulting also in a transformation in relations of subordination and oppression, in favor of autonomy.
In this way, the EPS is understood as a movement that is expressed in the practices of care, in the production of shared knowledge and in the constitution of subjects who become political actors/protagonists in the health field, thus placing the EPS as an indispensable strategy for the transformation projects of society.And in a way, Nursing is participating, in particular, through university extension projects [6].
Therefore, it is questioned: what is the influence of nursing in the development of popular education in health?
In view of the above, the objective of the study was to analyze the publications with guidance

Method
It is an integrative review of the current literature, by approaching the definitions of concepts, revision of theories and evidences and analysis of methodological problems.Integrative study, explicit and reproducible, serving to guide the development of future scientific investigations [7].
An accurate search strategy was used, including strict criteria for inclusion and exclusion of the quality of the selected scientific material [7].
The search for the scientific literature was carried out in January 2017, in direct consultation with the VHL, of the LILACS collection, of the Scielo library and Database of Nursing (BDENF), using Descriptors: Health Education.Health Promotion.Community Health Nursing.
The selection of the empirical material was based on the following inclusion criteria: 1º Studies that addressed the theme "Health Education", "Health Promotion" and "Community Health Nursing", 2º Be within the period from 2007 to 2017; 3º Available in Portuguese and English and 4º Availability of full or summary article query.
Search resulted in 322 articles, however 12 articles were selected, these studies that were selected correspond to the objective proposed by this research.The obtained data were organized and presented in the frame modality, using absolute frequencies.We selected only relevant literature for the present study.

Results
It was noticed that of the 12 articles selected some were found in Nursing periodicals, but others in journals of other more distinct areas.But all contemplating EPS.For the analysis of the information, the organization of the content found regarding the periodical/year/country, title/ authors, objective and conclusion among the published articles was carried out, as shown in the table below.(Table 1) It is generally observed that the Southeast Region (Minas Gerais and Rio de Janeiro) was the region The curricular experience had to be enhanced in the actions based on solidarity, justice and social participation, as well as the popular know can be seen as structuring axis in the organization of the services and graduation curriculum that made the publication of articles on the topic more visible with 64.6%, followed by the Northeast region (Ceara and Paraiba) with 20, 2%.The Central-West Region (Brasília) and the South Region (Rio Grande do Sul) published two publications equivalent to 14.1% of the total samples collected.The most prevalent journals were the Nursing Journal of the Federal University of Santa Maria (REUFSM) and the Brazilian Journal of Nursing (ReBen) (32.0%), followed by the other journals We found 32 authors and co-authors, 32% of whom were physicians, 38% were academics; 23% are masters, 4% have postdoctoral degrees and 3% have specialization.
Regarding Nursing, 36% of the authors and coauthors are nurses (24% are PhDs, 26% are masters, and 14.6% are specialists).Analyzing the articles it was observed that some nurses had more than one degree presented.

Discussion
Health education is classified as one of the potentially decisive interventions in the promotion of health, since it is based on the analysis, problematization and proposition of the team and community itself, who constitute themselves as subjects of the process [8].
Although scarce, in Brazil we still have Nursing professionals committed to Health Education, but often EPS experiences are only developed at the initiative of these professionals through university extension projects (by professors of higher education institutions and academics), without there being a specific policy of induction on the part of the municipal managers, even coming to exist resistances on the part of these.There are still the free, democratic spaces where there are exchanges and practices of knowledge in the academic events of nursing (Tents of Popular Education in Health) [9,10,11].
The popular education in health problematized the health issues, having as animators the participants of the projects of university extension (students and university professors) and popular leaderships [12].Today, popular health education in nursing gains visibility in academic events.They are presented at round tables, conferences, theses, experiences, arguments and justifications, as well as producing events such as the Tents of Popular Education in Health [6,13].
The attempt to incorporate popular education into health care has faced both the dominant political and economic power, hegemonic in the functioning logic of health services, and the unfair distribution of resources by the State, which in most cases does not privilege the social sectors [14,15].
Analyzing the articles, it was verified that if the three spheres of government together with the workers in the health service valued more Popular Education would have an advance in the actions of Popular Education in Health [16,17].Another point to think about is that Popular Education is carried out by academics and University Teachers during the graduation period, that is, on the basis of informality.It is necessary that Popular Education be more valued, it is expected that there will be more public policies focused on this theme.
The rescue of the popular education, in the institutional plan, is constituted in the construction of SUS with universality, integrality, equity and social participation.These guiding principles of Sanitary Reform have a sense in the daily lives of people as a political and methodological strategy of the Ministry of Health.Popular education works in the perspective of "integrality of knowledge and practices, as it provides the encounter with other spaces, with other agents and with technologies that stand for life, dignity and respect for others [18].
It represents another culture of relationship with the popular classes that overcomes the authoritarian and normative aspects of traditional health education.Popular education advocates that knowledge can be constructed in a shared way with people, communities and health services [18].
In this sense, nursing students in the context of popular health education can perceive the relationships between the terms education, health education and popular education in health, glimpsing the potentialities of popular education while helping to recreate and reinvent practices in health services, valuing the knowledge of the population.Thus knowledge can be understood as a strategy used by the workers in the services, transforming health actions into educational actions, based on the understanding of the Education as a process of collective construction [18,19].
In the context in the field of health, Popular Education acts as a strategy of overcoming the great distance which exists between the health service and scientific knowledge, on the one hand, and on the other, the dynamics that involve sickness and cure.It has meant an important theoretical and methodological reference for the reorientation of health care from the shared and dialogical construction of health care and promotion practices, with the various individuals and social groups involved in the issues dealt with [19].
Thus, it has been considered a construction tool for health that is more integral and adequate to the life of the population.Popular Education brings to work in health, through problematization of the situations faced, an expansion of the actions of care, prevention and health promotion, integrating them in the struggle for better living conditions and for a more fair and supportive [19].
The practices of Popular Education have been incorporated in the university formation in health, mainly through extension activities.The extension has represented the institutional university life that has succeeded in supporting and organizing many of the emerging initiatives which express pedagogical proposals and practices that criticize what is dominant and well established and who seek new forms of social action [19].
It has important significance for institutional strengthening of the renovating movement present in the university, generating questions, proposals, research, knowledge and movements that radiate for undergraduate and postgraduate education [19].
With the evolution of public health policies, alternative health collective participation could be provided to the users of the health system through the development of actions still in the undergraduate nursing courses involving popular education.Such spaces enabled nurses to use pedagogical tools in their "know-how in nursing", such as the proposal of popular education in health [20].
The incorporation of this proposal allows nurses to potentiate health and care propositions, guiding/ reorienting their health practices.For this, it is important that this professional considers the way of being of the individual and of the collectivities, respecting the conceptions and practices that they adopt in the health-disease process [20].
The possibility of using popular health education as a care against traditional education, for promoting ruptures of vertical knowledge to horizontal.In this way it is possible to contemplate the exchange of knowledges and experiences, no longer perpetuating a monological discourse "[...] in which a person speaks to the other and not 'with' the other" [18,20].

Conclusion
The integrative experience of Nursing Undergraduate students made possible the inclusion of a curricular experience in the reality of organized social movements and was supported by the coordinator of the project itself, the nursing students, and the staff of the ESF team that the project is linked.It promoted a deepening on the thematic the importance of the nursing in the development of the popular education in health, especially in the initial periods of the graduation.Popular education is a process that involves social commitment to the transformation of pedagogical strategies, from the inclusion of the population as educator, taking into account the local needs of the population.
During the course of the analysis of the articles, it was noticed that although there are few, there are researches in EP developed by nurses, but we can not accommodate ourselves to this situation.Nurses need to produce much more scientific articles and value EPS, which is most often done by university professors and academics, that is, it is limited to the academic universe and university walls.
It is necessary to value more the plurality of knowledge and to encourage education as a process of self-formation of society through the creation of public policies focused on this theme.
Another point would be the one of greater social participation and governmental participation, after all, health promotion depends on collective participation and strategies involving local micropolitics, without losing sight of the need to maintain a network.This is what nursing wants and intends to: improve the quality of life through dialogue and human EPS, sharing different knowledge, as well as social transformation, contributing to the practice of the subject's autonomy and dialogue.

Table 1 .
Articles selected for the sample of the present study.
Four pillars of popular education are identified in his work: valuing the plurality of knowledges; the interpersonal relationship as the milieu for teaching-learning, and basis of social transformation; the knowledge of reality from an emancipative perspective as a political act; and education as selfformative process of society This article is available at: www.intarchmed.comandwww.medbrary.com4Theobjective of this study is to understand popular education in health in Brazilian cities.It was concluded that Popular Education in Health as a movement and social practice that is organized in the construction of a political project for health in the perspective of the popular classes; And as a subject of claim, as a specific policy to be integrated in the SUS by the collectives that organize around popular education in health.