INTEGRAL HEALTH CARE FOR MEN ' S HEALTH : MILITARY POLICE ADHERENCE ATENÇÃO

Objective: to identify the reasons that lead military police officers to non-adherence to the National Policy of Integral Attention to Human Health. Method: this is a quantitative, field, exploratory, descriptive study with 181 military policemen. A questionnaire was used to collect data and statistical analysis was performed by SPSS, version 21, presented in absolute and relative tables. Results: married (73.5%), with children (79%), most with high school (59.1%). Of these, 70.7% also reported that the information offered by the Health Service is not sufficient; 77.9% reported difficulty with care at the Health Service; 92.3% do not know a Health Service that offers one day a week to the care of men. Conclusion: the inferences of this study showed that the imaginary of being a man can imprison the masculine in cultural ties making difficult the adoption of practices of self-care. Descriptors: Primary Care; Police; Primary Prevention; Health Promotion; National Health Program; Men's Health.

Disease is regarded as a sign of fragility that men do not recognize as inherent in their own biological condition.The man thinks himself invulnerable, which ends up helping him to take care less of himself and expose himself more to situations of risk.Added to this is the fact that the individual is afraid that the doctor will discover that something goes wrong with their health, which puts their belief in invulnerability at risk. 3 It is pointed out that Brazil is the first country in Latin America and the second in the American continent to implement a National Policy for Integral Men's Health Care (NPIMHC). 4The policy is inserted in the context of the "More Health: All, "launched in 2007 by the Ministry of Health, with the objective of promoting a new pattern of development focused on the growth, wellbeing and improvement of the living conditions of the Brazilian citizen. 5 It is noticed that, for the most part, men use health services only when the disease is more advanced.Thus, instead of being treated at the Basic Health Units (BHU) near their home, they need to look for a specialist, which generates higher costs for the Unified Health System (UHS) and, above all, physical and emotional suffering to the patient and your family. 8 is argued that the working hours of the health services coincide with the work hours 9 and a question pointed out by men not to seek primary care services is related to their position as provider.It is a great challenge for professionals because it is a group of individuals that rarely seek the primary health care service for various cultural, social and personal issues that are based on the idea that the man is strong and unshakable and the disease does not these standards set by society. 6 is known that the male population, in general, needs to be inserted within health promotion actions, but the military police class (MPs) deserve to be highlighted, since these professionals are responsible for maintaining the well-being of all the population putting their own lives at risk, fighting crime, ensuring security and law enforcement.The work of the MPs requires great physical effort and good health because they always have to maintain an upright and firm posture in view of the situations that arise in the daily life of the profession, with a greater probability of occupational diseases.
The military police officer, because of the nature of his function, is exposed to all kinds of danger and he is read, often under tension, 10 attending to the most diverse forms of occurrence, with the submission and confrontation of: domestic violence, threats, thefts, traffic accidents with victims, armed robberies, drug trafficking, conflicts, trawlers, among others.Therefore, the policeman, in his day to day, is exposed to all type of violence and danger even risking his own life.The police officer must always be motivated and with good working conditions to perform his / her operational and administrative functions, as this will produce more.
It is revealed that society requires and needs competent, honest and committed police officers with the ideals of the organization to which they belong.These professionals also need to be monitored and better evaluated in relation to their health conditions, especially to the psychosomatic aspects, where the variable stress has an enormous power to destroy the work capacity of individuals. 11 is intended to contribute, due to the relevance of this research, to a better understanding of the military about NPIMHC, its rights, the importance of the search for services and that are contemplated in basic health promotion actions.This will ensure the adequacy of care with the new guidelines advocated by the Ministry of Health thus

INTRODUCTION
English/Portuguese J Nurs UFPE online., Recife, 12 (10):2635-42, Oct., 2018 2637 ensuring the promotion of health and prevention of preventable diseases.Thus, with the search of men for health services, the evolution in care will eventually promote changes in the posture of this population.
• To identify the reasons that lead military police officers to non-adherence to the National Policy for Integral Men's Health Care.This is a quantitative, field, exploratory, descriptive study carried out in Alto Sertão Paraibano, Brazil, from May to June 2015, with military police officers incorporated into the Military Police of the State of Paraíba, which currently has 369 military personnel, of these, 354 are males.
A convenience sample was drawn up by state military personnel in Alto Sertão Paraibano.
As a data collection instrument, a questionnaire was developed, developed by the researchers, based on the National Policy for Integral Attention to Human Health and on the sociodemographic profile.This instrument was formulated with 16 questions that respond, coherently, to the objective of the study.
The sample selection was defined in a simple random way, in which a sample of 181 participants was obtained, with 95% confidence and 5% margin of error, by means of lottery.
They were listed as inclusion criteria: effective professionals, who have been working for more than a year and have accepted to participate in the research.Exclusion criteria were: all professionals working in neighboring districts and cities because of the difficulty of the researcher to find them and those who were on vacation, paternity leave or who, for any other reason, were not present at the moment of collection.Most of the interviewees are in the age range of 45 to 55 years (42%).Thus, the National Policy for Integral Men's Health Care established, through a strategic cut of the population of men, a focus on men in the range of 20 to 59 years, who correspond to the preponderant portion of the productive force and, moreover, exercise a significant sociocultural and political role. 4 It can be observed, when asked about the level of schooling, that 59% of the interviewees have completed high school and 22% have the complete upper level.These data corroborate a research carried out with military police officers of two battalions of the State of São Paulo-SP, whose objective was to evaluate the perception of military police of the tactical and street force on the aspects that permeate their mental health, where 54.2 % of study participants had completed high school and 41.7% had completed tertiary education. 4th the excess of the workload, it contributes to the high contingent of the surveyed public, whose workload exceeds 40 hours a week, which in turn suggests that the number of police officers is still low, that is, insufficient to meet the demand , which presupposes the need for new hires to remedy the problem of police shortages and the consequent overload of work for the existing ones.This overload will possibly lead to the appearance of new changes in the health of military man.

A database was created in
It is pointed out, as far as the man does not take care of health, that one of the justifications for men to take care less of their health concerns the world of work.The

DISCUSSION
English/Portuguese J Nurs UFPE online., Recife, 12 (10):2635-42, Oct., 2018 2640 preoccupation with being responsible for providing the family, faced with an economically unequal society, indicates that to remain active and productive in this society has a high price, including self-destruction, for the "high rates of male sickness due to the use of drugs and or problems at work ". 12 According to the data obtained, 63% of the interviewees were already distant due to health problems, and some reported that the removal was related to the physical effort in the work performance.The dynamics of production and relation of labor activities can both produce health, physical and emotional well-being, as well as the inverse.In studies carried out, it has been verified that there is a greater personal and collective risk of health problems with military police officers, since it is an ostensive activity that is focused on the preservation and maintenance of public order and which are not only the factors related to the risk of this work activity that caused the reported problems.
It is understood that the MP profession contributes to the emergence of health complications, as well as the physical factors, the pressure and even the collections, since it is an institution that has, as base, the hierarchy and the discipline, contributing, therefore, to that some health problems can be triggered. 13The activities developed by the MPs are exhausting, as it is a profession that constantly deals with situations of violence and imminent risk, working hours are usually nocturnal, there are irregular feeding times, exposure to the sun, to the wind, in addition to the prolonged stay in the orthostatic position, factors that can cause physical and emotional problems to the professional, including, with repercussion in the family and social interaction interfering in their quality of life and in their health. 14 is reported, when asked about the knowledge of the National Policy for Integral Men's Health Care, that 53% are unaware of its existence.Referring to the literature on Public Health and Public Health, it is verified that the difficulty of men's access to health services is a relevant issue 9,16 as one of the main objectives of the NPIMHC.
It is necessary that the health teams strengthen the link for the care of this population, considering that Primary Health Care (PHC) -the main gateway to health services -is prevention and health care are socially characterized as essentially female tasks.This same logic structures the services, actions and interlocutions between health professionals and users, reproducing traditional gender relations. 9, It evident that 24% of the military attend health services, whether they attend health services or not.When called to explain the reasons that distance them from the health services, besides being careful to be represented as female social practice par excellence, several men emphasize, as main reasons, the difficulty of absent from work at the times usually scheduled for consultation and lack of specific units aimed at addressing male health problems. 17eeking to understand what is called "invisibility" of men in the daily life of PHC, starting from the gender perspective, it is necessary to know the mechanisms of work in access to health services that promote inequalities. 2 is added that the survey also showed that 54% sought health services in less than a year.In this way, the characteristics of a traditional masculinity are reiterated, based on the idea of a nature that provides unshakeable physical force to men, naturally predisposing them to work, in general, and to certain labor activities, in particular, those that demand greater physical effort. 18It is clear that male "low demand" for health services does not necessarily refer to a calculation of the supply-demand relationship, but rather to the preventive habits that are more associated with the female world. 4 is stated, as regards the information offered by the health services, that 70% of the military say that the information is insufficient to solve the problems of human health.In 2004, the Ministry of Health proposed the National Policy on Continuing Education in aiming at transforming professional practices, through the problematization of the work process, taking into account the health needs of people, populations, sectorial management and of social control in health. 4However, a study after the implementation of this policy revealed that the number of educational activities implemented is not adequate, as well as the significant percentage (31.7%) of health professionals who did not participate in any educational activity. 19 was also observed in the study in question that the lack of improvement and qualification of the health team fails to meet the needs of the male population, be it military or community.This target audience is scarce due to the absence of skilled and trained professionals, but it is one of the reasons why men do not seek health services.In addition to gender issues, research indicates that other factors inherent in the functioning of health services that can impede men's access to these services can coexist. 20nglish/Portuguese J Nurs UFPE online., Recife, 12(10):2635-42, Oct., 2018 2641 Men do not recognize themselves as targets for health care programs due to preventive actions almost exclusively for women and children.This feeling would provoke, in men, the sensation of not belonging to that space. 21e results of 70% of the military, coupled with the difficulties faced by men in demonstrating their own health needs, were also revealed by the difficulties in health care faced by men, since, in exposing their health problems, they reveal a demonstration of fragility, associated with feminization, jeopardizing their virility and the condition of provider, aspects that are valued too much in the construction of hegemonic masculinity even in the present day. 18 is revealed, in what is said about the military know about health services specific to human health, that 92% report that they do not know and 27% of the military speak that, even without knowing it, would indicate.The man perceives the health unit as a purely feminine environment, although this has contributed to the improvement of the living conditions of a good part of the population, since the woman is historically responsible for her family when it comes to matters such as children, home and care of family members. 19hus, the proposal to sensitize men with regard to their health needs runs through the subject's speech demonstrating that joint actions with the various sectors of society can be a valuable tool for the achievement of health spaces for the population masculine. 20 is concluded that the inferences of this study showed that the imaginary of being a man can imprison the masculine in cultural ties making difficult the adoption of practices of self-care, because, as man is seen as virile, invulnerable and strong, to seek the service of health, in a preventative perspective, could associate it with weakness, fear and insecurity and, therefore, could bring it closer to the representations of the feminine universe, possibly implying mistrust about this socially instituted masculinity.

Table 3 .
Description of data on access to health care.Cajazeiras (PB), Brazil, 2015.

Table 4
shows the age between the categories of access to health care.There was a statistically significant difference in mean age only among those who did not know the man's health policy (M = 39.25 years, SD = 8.14).

Table 4 .
Age comparison between categories related to access to health care.