scholarly journals Nursing practices in the primary health care context: a scoping review

Author(s):  
Rosangela Barbiani ◽  
Carlise Rigon Dalla Nora ◽  
Rafaela Schaefer

ABSTRACT Objective: to identify and categorize the practices performed by nurses working in Primary Health Care and Family Health Strategy Units in light of responsibilities established by the profession's legal and programmatic frameworks and by the Brazilian Unified Health System. Method: a scoping review was conducted in the following databases: LILACS, IBECS, BDENF, CINAHL and MEDLINE, and the Cochrane and SciELO libraries. Original research papers written by nurses addressing nursing practices in the primary health care context were included. Results: the review comprised 30 studies published between 2005 and 2014. Three categories emerged from the analysis: practices in the service; practices in the community; and management and education practices. Conclusion: the challenges faced by nurses are complex, as care should be centered on the population's health needs, which requires actions at other levels of clinical and health responsibility. Brazilian nursing has achieved important advancements since the implementation of policies intended to reorganize work. There is, however, a need to shift work processes from being focused on individual procedures to being focused on patients so that an enlarged clinic is the ethical-political imperative guiding the organization of services and professional intervention.

2021 ◽  
Vol 3 (2) ◽  
pp. 95-101
Author(s):  
Minéia da Costa Figueiredo ◽  
Fabiana Lopes de Paula

Este artigo irá abordar a vivência em uma unidade de Estratégia Saúde da Família (ESF) no município de Canto do Buriti-PI sobre os aspectos relacionados ao processo de matriciamento e a gestão do cuidado. A descrição será feita a partir da análise da gestão do cuidado e articulações com o Núcleo de Apoio à Saúde da Família (NASF) e suas ações de apoio matricial desenvolvidas na unidade. O NASF tem fundamental importância na resolução de casos mais complexos e na efetivação de cuidado integral, bem como para a assistência humanizada aos usuários na Atenção Primária à Saúde. O relato traz como contribuição a análise do processo de trabalho entre eSF e NASF, com uma visão que traz subsídios para a reflexão; tendo a intenção de cooperar para o aperfeiçoamento, progresso das ações na APS e a concretização das políticas públicas. Palavras-chave: Atenção Primária à Saúde; Estratégia Saúde da Família; Equipe de Assistência ao Paciente; Integralidade em Saúde; Sistema Único de Saúde.   Abstract This article will address the experience in a Family Health Strategy (ESF) unit in the city of Canto do Buriti-PI on aspects related to the matrix support process and care management. The description will be made from the analysis of care management and articulations with the Family Health Support Center (NASF) and its matrix support actions developed in the unit. The NASF is of fundamental importance in solving more complex cases and in providing comprehensive care, as well as in providing humanized assistance to users in Primary Health Care. The report contributes to the analysis of the work process between eSF and NASF, with a a vision that supports reflection; with the intention of cooperating for the improvement, progress of actions in the PHC and the implementation of public policies. Keywords: Primary Health Care; Family Health Strategy; Patient Care Team; Integrality in Health; Unified Health System.


2021 ◽  
Vol 3 (2) ◽  
pp. 102-109
Author(s):  
Lucas Gaspar Ribeiro ◽  
Daiane Marcondes

Um marco para a saúde no Brasil foi a implantação do Programa Saúde da Família (PSF) em 1994, com a reorientação das práticas assistenciais pelos princípios doutrinários e organizacionais do Sistema Único de Saúde. Esse sistema também oferta as práticas integrativas e complementares, abordando o indivíduo na sua multidimensionalidade, estimulando os mecanismos naturais de cura. Elas foram inseridas como política pública em 2006, no mesmo ano que o PSF foi modificado para estratégia. Ambas possuem relevantes afinidades e pontos que fortalecem o cuidado. O objetivo desse artigo é apresentar essa aproximação teórico-prática através de uma revisão narrativa, encontrando diversas premissas e ferramentas de cuidado compartilhados pela abordagem da Atenção Primária à Saúde (APS) e pelas práticas integrativas e complementares, além das práticas contribuindo para a desmedicalização, acesso e resolutividade da APS com o trabalho interprofissional, individualmente e coletivamente.       Palavras-chave: atenção primária à saúde, práticas integrativas e complementares, estratégia saúde da família, políticas públicas em saúde, sistema único de saúde.   Abstract A milestone for health in Brazil was the implementation of the Programa Saúde da Família (PSF) in 1994, with the reorientation of care practices based on doctrinal and organizational principles of the Unified Health System. This system also offers integrative and complementary practices, addressing the individual in its multidimensionality, stimulating the natural healing mechanisms. They were inserted as public policy in 2006, at the same year that the PSF was changed to strategy. Both contain affinities and points that strengthen care. The objective of the article is to present this theoretical-practical approach of a narrative review, finding several premisse and tools of care shared by the approach of Primary Health Care (PHC) and by integrative and complementary practices, in addition to the practices contributing to demedicalization, access and resolution of PHC with interprofessional work, individually and collective Keywords: primary health care, integrative and complementary practices, family health strategy, public health policy, unified health system.


Author(s):  
Carine Vendruscolo ◽  
Fabiane Ferraz ◽  
Charles Dalcanale Tesser ◽  
Letícia de Lima Trindade

ABSTRACT Objective: to identify the space in which the Family Health Support Center is structured in the services and how it works within the scope of the Unified Health System. Method: a conceptual study based on partial results of a multicenter, descriptive-exploratory study with a qualitative approach, carried out in 2017, in the State of Santa Catarina, with managers and professionals from the Family Health Support Center. Content thematic analysis was used with the data from semi-structured interviews with professionals and individual interviews with managers, totalling 18 participants. Results: the professionals of the Family Health Support Center are identified as specialists who work in or close interaction with Primary Health Care, in the context of matrix support, in order to assist in the planning of the Health Care Network, which strengthens the general practice in Family Health. In addition to primary health care, they can act in intercessory spaces and perform secondary health care; set forth possibilities for intervention and enhance inter-sectoriality and co-responsibility. Conclusion: the Family Health Support Center was recognized as an important articulator of interdisciplinarity in health work, cabable of promoting comprehensive and intersectoral care, in addition to its initial proposal of supporting the Family Health Strategy, which could help in the coordination and fulfillment of secondary health care in the Brazilian Unified Health Care System, thus being an intersecting space between primary and secondary health care.


2019 ◽  
Vol 72 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Leonardo Barbosa Rolim ◽  
Janássia Gondim Monteiro ◽  
Anya Pimentel Gomes Fernandes Vieira Meyer ◽  
Sharmênia de Araújo Soares Nuto ◽  
Márcio Flávio Moura de Araújo ◽  
...  

ABSTRACT Objective: To evaluate the Primary Health Care attributes of Fortaleza city, Ceará State. Method: Evaluative study carried out at 97 Primary Health Care Units, from August 2015 to June 2016. 451 professionals from the Family Health Strategy participated in the study. We used the Primary Care Assessment Tool - Brazil, which evaluates the attributes, assigning scores on a scale of zero to ten. We adopted as a cut-off point, to consider high Primary Care score, attributes with a value of 6.60 or higher. Results: Among the eight attributes evaluated the First Contact Access and the Coordination - Information System were the ones that obtained the lowest and highest scores, (2.98) and (7.82), respectively. The Overall Score, calculated by means of a mean of the attributes, was 6.34. Conclusion: The Primary Care evaluated had a low score, showing the need to discuss mechanisms to boost the attributes that obtained low scores.


2018 ◽  
Vol 52 ◽  
pp. 78
Author(s):  
Luciano José Arantes ◽  
Helena Eri Shimizu ◽  
Edgar Merchán-Hamann

OBJECTIVE: To describe the rate of ambulatory care sensitive hospitalizations in groups of cities according to population size and to analyze its association with the coverage of the Family Health Strategy after the implementation of the Master Plan for Primary Health Care in Minas Gerais, Brazil. METHODS: This is an ecological study with 452 cities grouped according to population size, with data from 2004 to 2007 and 2010 to 2013. We used the Kolmogorov-Smirnov test to verify the distribution of the data in the groups. We used the Wilcoxon test for paired data or the paired Student’s t-test to compare the rate of ambulatory care sensitive hospitalizations before and after the Master Plan for Primary Health Care. We used the simple linear regression test to analyze the association between variables. We performed statistical analyses using the Statistical Package for the Social Sciences, with a significance level of 5%. RESULTS: The rate of ambulatory care sensitive hospitalizations decreased significantly after the Master Plan for Primary Health Care in the large and mid-sized groups (p < 0.05). There were positive correlations between coverage with Family Health Strategy and the rate of ambulatory care sensitive hospitalizations in the mid-sized and large groups (p < 0.05). CONCLUSIONS: Actions were carried out to implement the Master Plan for Primary Health Care. However, more investments are needed to improve the effectiveness of the Primary Health Care, with permanent confrontation of complex issues that affect the quality of services, which can lead to a significant reduction of the rates of ambulatory care sensitive hospitalizations.


2020 ◽  
Vol 37 (5) ◽  
pp. 648-654
Author(s):  
Patricia S Chueiri ◽  
Marcelo Rodrigues Gonçalves ◽  
Lisiane Hauser ◽  
Lucas Wollmann ◽  
Sotero Serrate Mengue ◽  
...  

Abstract Background Primary health care (PHC) delivery in Brazil has improved in the last decades. However, it remains unknown whether the Family Health Strategy teams are meeting the health needs of the population. Objectives To describe the reasons for encounter (RFEs) in PHC in Brazil and to examine variations in RFEs according to sex, age and geographic region. Methods This descriptive study is part of a national cross-sectional study conducted in 2016. The sample was stratified by the number of PHC physicians per geographic region. Physicians who had been working for at least 1 year in the same PHC unit were included. For every participating physician, 12 patients aged ≥18 years who had attended at least two encounters were included. Patients were asked about their RFEs, which were classified according to the International Classification of Primary Care. Results In 6160 encounters, a total of 8046 RFEs were coded. Seven reasons accounted for 50% of all RFEs. There was a high frequency of codes related to test results, medication renewal and preventive medicine. RFEs did not vary significantly by sex or geographic region, but they did by age group (P &lt; 0.001). The rates of prescriptions, requests for investigations and referrals to specialized care were 71.1%, 42.8%, and 21.3%, respectively. Conclusion This novel study opened the ‘black box’ of RFEs in PHC in Brazil. These findings can contribute to redefining the scope of PHC services and reorienting work practices in order to improve the quality of PHC in Brazil.


Bionorte ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 134-142
Author(s):  
Ludmila Cotrim Fagundes ◽  
Caio Fagundes Quadros Lima ◽  
Luciana Cristine Dias ◽  
Maria Alice Miranda Fortes ◽  
André Augusto Dias Silveira ◽  
...  

Objective:to evaluate the essential attributes of primary care in a Family Health Strategy in the city of Montes Claros -MG from the perspective of the assisted population. Materials and Methods:this is a quantitative and descriptive study, with a sample of 130 patients. The Sociodemographic Questionnaire and the Questionnaire for the Evaluation of the Attributes of Primary Care were applied between the months of September and October 2018. The results were tabulated in an Excel spreadsheet. Results:the four Essential Attributes of Primary Care were mostly answered with a reasonable level of satisfaction or above. Overall average satisfaction was 6.8 points. Conclusion:the reduction of waiting time for appointments with general practitioners and the absence of specialists in the FHS were the main demands. However, in the eyes of users, it was evident that the four Essential Attributes of Primary Health Care, in general, are well exerted.


2019 ◽  
Vol 13 ◽  
Author(s):  
Josué Souza Gleriano ◽  
Priscila Corrêa da Luz Zaiaz ◽  
Angélica Pereira Borges ◽  
Grasiela Cristina Lucietto ◽  
Priscila Balderrama ◽  
...  

Objetivo: descrever a percepção de uma equipe multiprofissional da Estratégia Saúde da Família sobre a organização do processo de trabalho na sua unidade. Método: trata-se de estudo qualitativo, descritivo, desenvolvido numa unidade de saúde com 11 profissionais, utilizando a técnica de grupo focal, norteada pela Autoavaliação para Melhoria do Acesso e da Qualidade da Atenção Básica na dimensão de organização do processo de trabalho. Submeteu-se os dados à técnica de Análise de Conteúdo. Resultados: aponta-se que, na organização dos dados, emergiram duas categorias: Aspectos organizacionais e Aspectos relacionais. Enfatizam-se a importância do enfermeiro para a coordenação das ações e a necessidade de se fomentar o trabalho colaborativo para a integralidade das ações. Conclusão: constata-se a necessidade de se instituir, no âmbito da equipe de saúde, a reflexão rotineira sobre a organização dos processos de trabalho pautada nos atributos da atenção primária à saúde, além da prática de avaliação como ferramenta para melhorar a qualidade da atenção. Descritores: Organização e Administração; Atenção Primária à Saúde; Saúde da Família; Equipe de Assistência ao Paciente; Serviços Básicos de Saúde; Serviços de Saúde.Abstract Objective: to describe the perception of a multiprofessional Family Health Strategy team about the organization of the work process in their unit. Method: this is a qualitative, descriptive study, developed in a health unit with 11 professionals, using the focus group technique, guided by the Self-Assessment for Improving Access and Quality of Primary Care in the dimension of work process organization. The data was submitted to the technique of Content Analysis. Results: it is pointed out that, in the data organization, two categories emerged: Organizational Aspects and Relational Aspects. Emphasize the importance of nurses for the coordination of actions and the need to encourage collaborative work for the integrality of actions. Conclusion: there is a need to establish, within the health team, routine reflection on the organization of work processes based on the attributes of primary health care, in addition to the practice of evaluation as a tool to improve the quality of care. Descritores: Organization and Administration; Primary Health Care; Family Health; Patient Care Team; Basic Health Servicesb; Health Services. Resumen Objetivo: describir la percepción de un equipo multiprofesional de Estrategia de Salud Familiar sobre la organización del proceso de trabajo en su unidad. Método: este es un estudio cualitativo, descriptivo, desarrollado en una unidad de salud con 11 profesionales, utilizando la técnica de grupo de enfoque, guiado por la Autoevaluación para mejorar el acceso y la calidad de la atención primaria en la dimensión de la organización del proceso de trabajo. Los datos fueron sometidos a la técnica de Análisis de Contenido. Resultados: se señala que, en la organización de datos, surgieron dos categorías: Aspectos organizacionales y Aspectos relacionales. Se enfatiza la importancia de las enfermeras para la coordinación de las acciones y la necesidad de fomentar el trabajo colaborativo para la integralidad de las acciones. Conclusión: es necesario establecer, dentro del equipo de salud, una reflexión rutinaria sobre la organización de los procesos de trabajo basados en los atributos de la atención primaria de salud, además de la práctica de la evaluación como una herramienta para mejorar la calidad de la atención. Descritores: Organización y Administración; Atención Primaria de Salud; Salud de la Familia; Grupo de Atención al Paciente; Servicios Básicos de Salud; Servicios de Salud.


2019 ◽  
Vol 13 (2) ◽  
pp. 371
Author(s):  
Mila Cristian Ferreira ◽  
Geovana Brandão Santana Almeida ◽  
Heloisa Campos Paschoalin ◽  
Denicy De Nazaré Pereira Chagas ◽  
Luiza Vieira Ferreira

RESUMOObjetivo: identificar de que forma os agentes comunitários de saúde contribuem para o desenvolvimento das ações de combate ao tabagismo na atenção primária à saúde.  Método: trata-se de um estudo qualitativo, descritivo e exploratório, realizado com 20 agentes comunitários de saúde. Utilizou-se uma entrevista semiestruturada para a obtenção dos depoimentos. Realizou-se a análise de conteúdo temática das entrevistas, identificando as palavras-chave, e discutiram-se os resultados em categorias. Resultados: evidenciaram-se duas categorias de análise: as estratégias utilizadas pelos agentes comunitários de saúde para a divulgação das ações de controle do tabagismo e as ações dos agentes comunitários de saúde voltadas aos usuários que não cessaram com o tabagismo. Conclusão: inferiu-se que o profissional capacitado é capaz de estabelecer um vínculo com o usuário da atenção primária à saúde, o que favorece a resolubilidade das ações, contribuindo para a qualidade de vida dos usuários que procuram por atendimento no serviço de saúde. Descritores: Atenção Primária à Saúde; Estratégia Saúde da Família; Agentes Comunitários de Saúde; Enfermagem; Educação em Saúde; Tabagismo. ABSTRACT Objective: to identify how community health agents contribute to the development of actions to combat smoking in primary health care. Method: this is a qualitative, descriptive and exploratory study carried out with 20 community health agents. A semi-structured interview was used to obtain the testimonies. The thematic content analysis of the interviews was carried out, identifying the keywords, and the results in categories were discussed. Results: two categories of analysis were presented: the strategies used by community health agents to publicize smoking control actions and the actions of community health agents directed at users who did not stop smoking. Conclusion: it was inferred that the trained professional is able to establish a link with the primary health care user, which favors the resolubility of the actions, contributing to the quality of life of users who seek care in the health service. Descritores: Primary Health Care; Family Health Strategy; Community Health Workers; Nursing; Health Education; Tobacco Use Disorder. RESUMEN Objetivo: identificar de qué forma los agentes comunitarios de salud contribuyen al desarrollo de las acciones de combate al tabaquismo en la atención primaria a la salud. Método: se trata de un estudio cualitativo, descriptivo y exploratorio, realizado con 20 agentes comunitarios de salud. Se utilizó una entrevista semiestructurada para la obtención de los testimonios. Se realizó el análisis de contenido temático de las entrevistas, identificando las palabras clave, y se discutieron los resultados en categorías. Resultados: se evidenciaron dos categorías de análisis: las estrategias utilizadas por los agentes comunitarios de salud para la divulgación de las acciones de control del tabaquismo y las acciones de los agentes comunitarios de salud dirigidas a los usuarios que no cesaron con el tabaquismo. Conclusión: se ha inferido que el profesional capacitado es capaz de establecer un vínculo con el usuario de la atención primaria a la salud, lo que favorece la resolución de las acciones, contribuyendo a la calidad de vida de los usuarios que buscan atención en el servicio de salud. Descritores: Atención Primaria de Salud; Estrategia de Salud Familiar; Agentes Comunitarios de Salud; Enfermería; Educación em Salud; Tabaquismo.


2021 ◽  
pp. e1-e10
Author(s):  
Marciane Kessler ◽  
Elaine Thumé ◽  
Michael Marmot ◽  
James Macinko ◽  
Luiz Augusto Facchini ◽  
...  

Objectives. To investigate the role of the Family Health Strategy (FHS) in reducing social inequalities in mortality over a 9-year follow-up period. Methods. We carried out a population-based cohort study of individuals aged 60 years and older from the city of Bagé, Brazil. Of 1593 participants at baseline (2008), 1314 (82.5%) were included in this 9-year follow-up (2017). We assessed type of primary health care (PHC) coverage and other variables at baseline. In 2017, we ascertained 579 deaths through mortality registers. Hazard ratios and their 95% confidence intervals modeled time to death estimated by Cox regression. We also tested the effect modification between PHC and wealth. Results. The FHS had a protective effect on mortality among individuals aged 60 to 64 years, a result not found among those not covered by the FHS. Interaction analysis showed that the FHS modified the effect of wealth on mortality. The FHS protected the poorest from all-cause mortality (hazard ratio [HR] = 0.59; 95% confidence interval [CI] = 0.36, 0.96) and avoidable mortality (HR = 0.46; 95% CI = 0.25, 0.85). Conclusions. FHS coverage reduced social inequalities in mortality among older adults. Our findings highlight the need to guarantee universal health coverage in Brazil by expanding and strengthening the FHS to promote health equity. (Am J Public Health. Published online ahead of print March 18, 2021: e1–e10. https://doi.org/10.2105/AJPH.2020.306146 )


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