scholarly journals Avaliação dos atributos da atenção primária à saúde nas ações de controle da hanseníase [Assessment of the attributes of primary health care in leprosy control actions] [Evaluación de los atributos de la atención primaria a la salud en las acciones de control de la lepra]

2018 ◽  
Vol 26 ◽  
pp. e31925 ◽  
Author(s):  
Nayara Figueiredo Vieira ◽  
Fernanda Moura Lanza ◽  
Francisco Carlos Félix Lana ◽  
José Ramón Martínez-Riera

Objetivo: avaliar a presença e extensão dos atributos da atenção primária nas ações de controle da hanseníase, na visão dos profissionais de saúde. Método: estudo transversal, envolvendo 251 profissionais da atenção primária de Betim. Utilizou-se o Instrumento de avaliação de desempenho da atenção primária nas ações de controle da hanseníase, mediante entrevistas, sendo o escore calculado por meio da média das respostas dadas pelas Escala de Likert. Foi aprovado pelo Comitê de Ética e Pesquisa da Universidade Federal de Minas Gerais. Resultados: forte orientação do serviço (≥6,6) nos atributos porta de entrada, integralidade dos serviços disponíveis e prestados, e orientação familiar; e fragilidades (<6,6) no acesso, orientação comunitária e profissional. Conclusão: ao avaliar a presença e extensão dos referidos atributos, os profissionais constataram deficiências que prejudicam a qualidade das ações de controle da hanseníase. Torna-se necessário integrar as ações da endemia na atenção primária para eliminar esse grave problema de saúde pública.ABSTRACTObjective: to evaluate the presence and extent of the attributes of primary health care in leprosy control measures in the view of health professionals. Method: this cross-sectional study involved 251 primary health care personnel in Betim. The Assessment Instrument primary care performance in leprosy control measures was used through interviews, with scores calculated as means of Likert Scale responses. The study was approved by the research ethics committee of Minas Gerais Federal University. Results: strengths (≥ 6.6) were service orientation to gateway attributes, comprehensiveness of services available and provided, and the family; and weaknesses (<6.6) were access, and orientation towards the community and health professionals. Conclusion: when evaluating the presence and extent of the attributes, the health professionals found deficiencies that impaired the quality of leprosy control measures. Measures to address the endemic must be integrated into primary care in order to eliminate this serious public health problem.RESUMENObjetivo: evaluar la presencia y extensión de los atributos de la atención primaria en las acciones de control de la lepra desde el punto de vista de profesionales de salud. Método: estudio transversal, involucrando a 251 profesionales de la atención primaria de Betim. Se utilizó el Instrumento de evaluación de rendimiento de la atención primaria en las acciones de control de la lepra, a través de entrevistas, siendo la puntuación calculada a través del promedio de las respuestas dadas por la escala de Likert. Estudio aprobado por el Comité de Ética en Investigación de la Universidad Federal de Minas Gerais. Resultados: fuerte orientación del servicio (≥6,6) en los atributos puerta de entrada, integralidad de los servicios disponibles y ofrecidos, orientación familiar y fragilidades (<6,6) en el acceso, orientación comunitaria y profesional. Conclusión: al evaluar la presencia y extensión de los mencionados atributos, los profesionales constataron deficiencias que perjudican la calidad de las acciones de control de la lepra. Se hace necesario integrar las acciones de la endemia en la atención primaria para eliminar este grave problema de salud pública.

Author(s):  
Mikaela Lopes de Caldas ◽  
Francisco Das Chagas Cardoso Filho

A tuberculose (TB) é uma doença infecciosa e transmissível, causada pelo Mycobacterium tuberculosis. A detecção de casos figura entre as principais medidas de controle da tuberculose, embora grandes avanços tenham ocorrido no que se relaciona ao diagnóstico, tratamento e prevenção da doença, a mesma ainda requer atenção especial, por parte dos profissionais da saúde (equipe multiprofissional) e da sociedade como um todo. A Atenção Básica se caracteriza como ferramenta primordial na suspeição e na detecção dos casos de tuberculose na comunidade. O objetivo geral do presente trabalho é identificar produções científicas que avaliem o desempenho da Atenção Básica no controle da tuberculose. Os objetivos específicos foram: ressaltar a importância da Atenção Básica na detecção dos casos suspeitos; expor a relevância da Atenção Básica como fator indispensável no controle da tuberculose. Caracteriza-se como uma pesquisa bibliográfica explicativa e explorativa, realizada no recorte histórico de 1998 a 2011, período esse definidor para a implementação de medidas de controle da tuberculose. Encontraram-se 29 referências, das quais 19 obedeciam aos critérios de inclusão. Portanto, a Atenção Básica caracterizada como principal porta de entrada ao acesso à saúde, proporciona a aproximação do cidadão às medidas de controle da tuberculose, assim como promove a educação em saúde, que visa a prevenção dos agravos e proporcionam autonomia e autoconhecimento que são indispensáveis para a manutenção da saúde frente às doenças preveníveis como a tuberculose, porém que se configuram como problemas de saúde pública. Palavras-chave: Tuberculose. Atenção Básica. Controle. AbstractTuberculosis (TB) is an infectious and communicable disease caused by mycobacterium tuberculosis. The case detection is one of the main control  measures of tuberculosis, although major advances have occurred regarding the diagnosis, treatment and prevention of the disease, the same still requires special attention on the part of health professionals (multidisciplinary team) and society as a whole. The primary care is characterized as a primary tool in suspicion and detection of tuberculosis cases in the community. The overall objective of this study is to identify scientific production to assess the performance of primary health care in tuberculosis control. The specific objectives were to highlight the importance of primary care in the detection of suspected cases; expose the relevance of primary health care as an essential factor in tuberculosis control. It is characterized as an explanatory and exploratory literature survey, conducted in historical period from 1998 to 2011, a period defined for the implementation of tb control measures. It was found 29 references, 19 of which obeyed the inclusion criteria. Therefore, the primary care characterized as the main gateway to access to health, provides the citizen’s approach to tuberculosis control measures and promotes health education aimed at prevention of injuries and provides autonomy and self-knowledge that are essential for maintenance health against preventable diseases such as tuberculosis, but which are seen as  the main  public health problems. Keywords: Tuberculosis. Primary Care. Control. 


2019 ◽  
Vol 40 ◽  
Author(s):  
Carla Silvia Neves da Nova Fernandes ◽  
Wallace Borges Costa dos Santos ◽  
Wanderson Carneiro Moreira ◽  
Divane de Vargas ◽  
Maria do Perpétuo Socorro de Sousa Nóbrega

Abstract Objective: To identify the opinions of primary care nurses regarding mental illness and the care provided to this population. Methodology: Cross-sectional, quantitative study with the participation of 328 nurses of primary health care in Porto, Portugal. Data collected between April and August of 2018 through the scale "Opinions about Mental Illness" and socio demographic and labor questionnaire. Descriptive and correlational statistics were applied. Results: A total of 50% of the nurses presented positive opinions about the mental illness. Regarding the assistance provided in their unit of action, 53.4% considered inadequate and 50.3% recognized as adequate their knowledge about the role that primary health care has in assisting the person with mental illness. Conclusion: Positive opinions and recognition of the importance of primary care to people with mental illness are important indicators for qualified mental health care outside the field of specialty.


2019 ◽  
Vol 28 ◽  
Author(s):  
Luciana Camargo de Oliveira Melo ◽  
Ana Márcia Spanó Nakano ◽  
Juliana Cristina dos Santos Monteiro ◽  
Maria Cândida de Carvalho Furtado

ABSTRACT Objective: TO analyze the presence and extent of the Primary Health Care attributes in the breastfeeding process based on the experience of the health professionals in the services certified by the Amamenta Brasil Network in comparison with non-certified services. Method: cross-sectional and descriptive study with a quantitative approach, using the PCATool-Brazil - version for professionals, which was applied to 53 health professionals, physicians and nurses, from a city in the State of São Paulo, Brazil. Descriptive and inferential statistical analysis was applied, using Student’s t-test and the Mann-Whitney test. Results: the services certified by the Amamenta Brasil Network scored higher on Longitudinality(6.7)and Coordination-information systems (8.3).The professionals who were trained by the Amamenta Brasil Network scored higher on Coordination-information systems(8.4)and on Comprehensiveness - available services (7.0).These two groups also gave more positive answers to the other attributes. Conclusion: the services certified by and the professionals who were trained by the Amamenta Brasil Network demonstrated a higher degree of orientation towards Primary Health Care. The data appoint that the better performance on the attributes is related, among other factors, to the professionals’ being better qualified to develop practices that value the promotion, protection and support of breastfeeding, in accordance with the principles of Primary Health Care.


Author(s):  
Carolina Lou de Melo ◽  
Maria Angélica Tavares de Medeiros

Abstract Objective: to characterize and analyze Nutritional Care (NC) for older adults in Primary Health Care (PHC), identifying how food and nutrition actions (F&N) were performed and the conceptions that guided them. Methods: a cross-sectional, quantitative and qualitative study was performed in PHC in Santos, São Paulo, Brazil, in two phases: i) a census study was carried out of health units, N=28 (100%), with managers who answered a structured interview to assess NC; followed by descriptive analysis. ii) a deeper investigation of this diagnosis was performed, using semi-structured interviews with key informants (interviewees) of care for older adults; being a nutritionist was not a criteria, as there were only three such professionals throughout the entire PHC, and one of the health regions studied was not served by a nutrition professional. The concept of theoretical saturation was used for the sampling plan; content analysis was carried out and the inferences were supported by references of integrality and aging. Results: NC for older adults was highlighted by individual care, predominant in all the services studied (28) (100%); nutritionists participated in this activity in just nine units (32.1%). Theoretical saturation was achieved with nine interviews. According to the discourse analysis, F&N actions were generic, focused on the treatment of diseases, influenced by negative aspects attributed to aging, there was no planning based on the needs of the territory, and health professionals identified themselves as information transmitters, leaving the responsibility of acting on such information to the older adults themselves. Conclusion: F&N actions were guided by the biomedical paradigm, fragmented, restricted to disease management, imputing the responsibility for health to the individual themselves. Thus, NC distanced itself from the promotion of healthy aging, weakening its strategic role in the quest for integrated care.


2014 ◽  
Vol 62 (2) ◽  

The role of regular physical activity for population health has been clearly documented. Improvements in population levels of physical activity require long-term implementation of a combination of measures, including the evidence based approaches described in the “seven best investments for physical activity” (www.globalpa.org.uk): whole-of-school programmes, transport, urban planning, integration of physical activity promotion into primary health care systems, public education, community-wide programmes, sport for all. The health care setting has a particular role in this context, particularly in its access to physically inactive individuals. Switzerland has seen a number of successful research projects in this field, but there has been no wide adaptation of these approaches in the medical community. In recent years, a group of institutions including the Swiss College of Primary Care Medicine, the Policlinique Médicale Universitaire in Lausanne, the Ligue Vaudoise contre les Maladies Cardiovasculaires and the Institute of Social and Preventive Medicine of the University of Zurich have therefore focussed on the development of a physical activity counselling approach based on international evidence as well as on established tools, but streamlined to the specific demands of primary health care providers in Switzerland. PAPRICA (Physical Activity Promotion in Primary Care, www.paprica.ch) has been the result of these developments, and nearly 300 health professionals, most of them primary care physicians, have been successfully trained so far. PAPRICA is implemented together with the Swiss Society for Sports Medicine and a number of regional partners. The development of a national programme structure is currently under preparation. This will allow Switzerland to explore and better use the potential of physicians and other health professionals in the promotion of physical activity and in the fight against non-communicable diseases.


2009 ◽  
Vol 1 (3) ◽  
pp. 190 ◽  
Author(s):  
Kyle Eggleton ◽  
Tim Kenealy

INTRODUCTION: Care Plus is a New Zealand chronic care initiative. It provides funding for extra primary care visits for patients with chronic diseases and aims to improve chronic care management, primary health care team work and reduce inequalities in health care. This mixed methodology study aimed to explore characteristics within practices that may contribute to improved clinical outcomes for Care Plus. METHODS: A focus group interview was conducted with a group of health professionals involved in Care Plus in a North Island Primary Health Organisation (PHO). Participants were selected because of their ‘expert status’. Interview analysis used a general inductive approach. A questionnaire was sent to all practice nurses to determine prevalence of characteristics derived from the focus group. FINDINGS: Seven primary care workers involved in Care Plus participated in a focus group from which three major themes emerged: nursing factors, practice organisation factors and general practitioner (GP) factors. Sub-themes identified as patient-centredness, assertive follow-up, nursing knowledge, referral to other health professionals, dedicated appointment times, long consultation time, low cost, GP commitment and teamwork were all considered to be characteristics that could lead to improved clinical outcomes. Questionnaire responses from 18 practice nurses suggest that GPs are under-involved with Care Plus. DISCUSSION: Patients with chronic conditions have complex needs. Care Plus is a nationwide initiative providing funding for chronic care. Some characteristics of nurses, practice organisation and GPs may lead to improved clinical outcomes in Care Plus. A number of these characteristics are supported in the literature. KEYWORDS: Chronic disease; primary health care; primary nursing care; disease management; patient care team


2020 ◽  
Author(s):  
Suneela Garg ◽  
Saurav Basu ◽  
Ruchir Rustagi ◽  
Amod Borle

BACKGROUND Primary health centers (PHCs) represent the first tier of the Indian health care system, providing a range of essential outpatient services to people living in the rural, suburban, and hard-to-reach areas. Diversion of health care resources for containing the coronavirus disease (COVID-19) pandemic has significantly undermined the accessibility and availability of essential health services. Under these circumstances, the preparedness of PHCs in providing safe patient-centered care and meeting the current health needs of the population while preventing further transmission of the severe acute respiratory syndrome coronavirus 2 infection is crucial. OBJECTIVE The aim of this study was to determine the primary health care facility preparedness toward the provision of safe outpatient services during the COVID-19 pandemic in India. METHODS We conducted a cross-sectional study among supervisors and managers of primary health care facilities attached to medical colleges and institutions in India. A list of 60 faculties involved in the management and supervision of PHCs affiliated with the community medicine departments of medical colleges and institutes across India was compiled from an accessible private organization member database. We collected the data through a rapid survey from April 24 to 30, 2020, using a Google Forms online digital questionnaire that evaluated preparedness parameters based on self-assessment by the participants. The preparedness domains assessed were infrastructure availability, health worker safety, and patient care. RESULTS A total of 51 faculties responded to the survey. Each medical college and institution had on average a total of 2.94 (SD 1.7) PHCs under its jurisdiction. Infrastructural and infection control deficits at the PHC were reported in terms of limited physical space and queuing capacity, lack of separate entry and exit gates (n=25, 49%), inadequate ventilation (n=29, 57%), and negligible airborne infection control measures (n=38, 75.5%). N95 masks were available at 26 (50.9%) sites. Infection prevention and control measures were also suboptimal with inadequate facilities for handwashing and hand hygiene reported in 23.5% (n=12) and 27.4% (n=14) of sites, respectively. The operation of outpatient services, particularly related to maternal and child health, was significantly disrupted (<i>P</i>&lt;.001) during the COVID-19 pandemic. CONCLUSIONS Existing PHC facilities in India providing outpatient services are constrained in their functioning during the COVID-19 pandemic due to weak infrastructure contributing to suboptimal patient safety and infection control measures. Furthermore, there is a need for effective planning, communication, and coordination between the centralized health policy makers and health managers working at primary health care facilities to ensure overall preparedness during public health emergencies.


2019 ◽  
Vol 53 ◽  
pp. 45
Author(s):  
Mônica V Andrade ◽  
Kenya Noronha ◽  
Clareci S Cardoso ◽  
Claudia D L Oliveira ◽  
Júlia A Calazans ◽  
...  

OBJECTIVE: To address the implementation of the Lab for Innovation in Chronic Conditions in Santo Antonio do Monte, indicating the main challenges and lessons of a new chronic condition model. METHODS: This is an observational study based on two sources of data: 1) two cross-sectional household surveys, 2013 (2012 as reference year) and 2015 (2014 as reference year), representative for the entire population and four target groups (pregnant women; children under two years old; individuals with hypertension and diabetes); medical records of individuals who self-reported having hypertension or diabetes in the household survey of 2013. A descriptive statistics analysis was performed. RESULTS: The main findings showed that the public health system is the main provider of health services, mainly primary care, in Santo Antonio do Monte. Besides, the implementation of Lab for Innovation in Chronic Conditions showed the importance of building a Primary Health Care network in small municipalities. CONCLUSIONS: Community health agents and health managers played a fundamental role in the Primary Health Care network. The case study of Santo Antonio do Monte poses some challenges and lessons that clarify future interventions on building a Primary Health Care network that is essential to provide an adequate and longitudinal care to chronic conditions.


2020 ◽  
Vol 35 (2) ◽  
pp. 152-159
Author(s):  
José Antonio Cernuda Martínez ◽  
Rafael Castro Delgado ◽  
Pedro Arcos González

AbstractIntroduction:Within out-of-hospital emergencies, Primary Health Care (PHC) pediatricians will likely be the first to provide health care at the scene of a life-threatening emergency (LTE) in children. Pediatricians should be trained to initially intervene, safely and effectively the LTEs, including the activation of Emergency Medical Systems (EMS), an adequate stabilization of patients and transport to the hospital.Study Objectives:The aims of this study are to know the training received for out-of-hospital LTEs by PHC pediatricians of the Principality of Asturias (Spain) and the perception they have about their own theoretical knowledge and practical skills in a series of emergency procedures used in LTEs; also, to analyze the differences according to the geographical context of their work.Methods:This was a cross-sectional, descriptive, and observational study of a sample of 27 PHC pediatricians from PHC Service of Asturias, Spain, from among the total of 88 pediatricians who make up the staff of pediatricians, conducted from April through May 2019. The survey was designed ad hoc using the Curriculum in Primary Care Pediatrics (CPCP) proposed by the European Confederation of Primary Care Pediatricians (ECPCP; Europe), which indicates the theoretical and practical procedures that must be acquired by the PHC pediatricians. It is composed of 30 procedures or techniques employed in LTEs using a 11-point Likert scale rating to detect their self-perception about theoretical knowledge and practical skills from zero (“Minimum”) to 10 (“Maximum”).Results:There are significant differences in the mean of theoretical knowledge and practical skills in many procedures or techniques studied, depending on the different areas of work.Conclusion:Asturian pediatricians are generally well-prepared to solve LTEs with a few exceptions. The degree of self-perception and acquisition of general theoretical knowledge and general practical skills in LTEs is heterogeneous, with differences according to the scope of work.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Sessa ◽  
C Milani ◽  
G Occhini ◽  
G Marini ◽  
A Sarro

Abstract Sustainability of the National Health Systems (NHS) has been facing different challenges. A community-oriented Comprehensive Primary Health Care (CommOr C-PHC) could help its survival. Such a framework, focused on health promotion, primary prevention, not communicable disease management, requires new capabilities among health professionals. Considering teamwork and interprofessional collaboration (IPC) as PHC core elements, there is growing recognition of the need of interprofessional education (IPE). Nevertheless, italian medical education is distant from other disciplines and mainly based on hospital care settings. Since this situation represents an obstacle to implement a CommOr C-PHC model of health service, new ways of training students and retraining actual health workers should be developed. The aim of the project is to design IPE programs and to improve IPC within the C-PHC framework, shared learning environments placed in the community were developed. At the end of 2017 a group of young italian health professionals (public health resident, young general practitioner, social assistant, nurse, medical anthropologist, etc) founded the Campaign “2018 Primary Health care: Now or never”, a cultural movement of public health advocacy. Its goals are: The creation of a common cultural background through the study of PHC evidence and best italian and international practices. Organization of workshops all over Italy: peer education training session, site-visits, lectures with Italian and foreigner health professionals, based on need assessment methods. Individuation of learning environments placed in the community and in a primary care setting where students can apprehend social determinants of health, exercise critical thinking and develop transprofessional knowledge. Key messages Young health professionals from Italy, starting from the need for a different educational framework, based on IPE, created a movement to defend the NHS and promote PHC principles. The success and large participation of a national campaign sustaining PHC and aimed at promoting interprofessional education shows the need for a change in the medical education field.


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