scholarly journals A Atuação dos Profissionais da Atenção Primária Acerca das Práticas de Promoção e dos Determinantes Sociais da Saúde

2018 ◽  
Vol 86 (24) ◽  
Author(s):  
Camilla Costa Cypriano Schmitz ◽  
Ivonete Teresinha Shulter Buss Heinemann ◽  
Michelle Kuntz Durand

Pesquisa qualitativa, exploratório-descritiva que objetiva desvelar a atuação dos profissionais da Atenção Primáriaà Saúde acerca dos Determinantes Sociais de Saúde das práticas de promoção da saúde. A coleta de dados foirealizada de julho a outubro de 2015, com entrevistas semiestruturadas. Participaram 25 profissionais queatuavam na rede de Atenção Primária em Saúde do Município de Florianópolis, SC. Os dados foram analisados apartir da análise temática de Minayo e discutidos à luz da Promoção da Saúde e dos Determinantes Sociais. Osresultados indicaram que, tanto a academia quanto os gestores estão investindo na formação para a promoçãoda saúde, porém, ainda muito focada nos estilos de vida e pouco articulada com os Determinantes Sociais deSaúde. Os profissionais relataram atuar muito pouco sobre os dados determinantes e alguns não sabem o conceitode Determinação Social da Saúde. Observa-se que há carência de métodos que auxiliem a avaliação e efetividadeda atuação sobre a promoção da saúde, porém, os profissionais já conseguem visualizar mudanças positivas nasaúde da população. Conclui-se que os trabalhadores da Atenção Primária à Saúde têm consciência da necessidadede realizar e manter as práticas de promoção em sua rotina diária, a partir da interdisciplinaridade eintersetorialidade, considerando os Determinantes Sociais de Saúde da população.Palavras-chave: Promoção da Saúde; Determinantes Sociais da Saúde; Atenção Primária à Saúde; Estratégia Saúdeda Família.AbstractExploratory-descriptive qualitative research, which aims to reveal the performance of Primary Health Careprofessionals about the Social Determinants of Health promotion practices. Data collection was carried out fromJuly to October 2015, with semi-structured interviews. Participated 25 professionals who acted on the network ofPrimary Health Care in the city of Florianópolis, SC. Data were analyzed from the thematic analysis of Minayo anddiscussed in the light of the health promotion and social determinants. The results indicated that both theAcademy and managers, are investing in training for the health promotion, however, still very focused on lifestylesand little coordinated with the Social Determinants of Health. The professionals have reported too little acting ondeterminants data and some do not know the Social Determination of Health concept. It is observed that there isa lack of methods to aid the evaluation and effectiveness of action on health promotion, however, professionalscan show positive changes in the population’s health. It is concluded that the Primary Health Care workers areaware of the need to achieve and maintain promotional practices in your daily routine, from the interdisciplinaryand intersectoral approach, considering the Social Determinants of Health of the population.Keywords: Health Promotion; Social Determinants of Health; Primary Health Care; Family Health Strategy

2019 ◽  
Vol 13 ◽  
Author(s):  
Carolina Gabriele Gomes da Rocha ◽  
Ivonete Heideman Teresinha Schulter Buss Heidemann ◽  
Pamela Camila Fernandes Rumor ◽  
Fabiano Oliveira Antonini ◽  
Michelle Kuntz Durand ◽  
...  

Objetivo: conhecer como são trabalhados os Determinantes Sociais da Saúde na consulta de Enfermagem do pré-natal na Atenção Primária à Saúde. Método: trata-se de um estudo qualitativo, descritivo, exploratório, com 15 enfermeiras, mediante a realização de entrevistas semiestruturadas, prosseguindo-se com a análise temática dos dados. Resultados: limita-se a compreensão sobre os Determinantes Sociais da Saúde a fatores relacionados à situação socioeconômica e à rede familiar da gestante. Revelou-se a atuação da equipe multiprofissional e enfatizou-se a necessidade de envolver ações intersetoriais. Identificaram-se limites e dificuldades relacionados à atuação dos enfermeiros sobre os determinantes e condicionantes que interferem na vida das gestantes. Conclusão: revela-se que, apesar de os enfermeiros não compreenderem o conceito de modo amplo, a atuação mostra-se como uma realidade durante o pré-natal. Acrescenta-se, no entanto, que são múltiplas as barreiras enfrentadas pelas gestantes e são muitos os limites e dificuldades encontrados pelos profissionais para atuar amplamente sobre os Determinantes Sociais de Saúde. Descritores: Promoção da Saúde; Determinantes Sociais da Saúde; Atenção Primária à Saúde; Enfermagem; Cuidado Pré-natal; Equidade em Saúde.ABSTRACTObjective: to know how the Social Determinants of Health are dealt with in the Prenatal Nursing consultation in Primary Health Care. Method: this is a qualitative, descriptive, exploratory study, with 15 nurses, through semi-structured interviews, continuing with the thematic analysis of the data. Results: the understanding about the Social Determinants of Health is limited to factors related to the socioeconomic situation and the pregnant woman's family network. The performance of the multiprofessional team was revealed and the need to involve intersectoral actions was emphasized. Limits and difficulties related to the performance of nurses on the determinants and conditions that interfere in the lives of pregnant women were identified. Conclusion: it is revealed that, although nurses do not understand the concept broadly, acting is a reality during prenatal care. However, there are multiple barriers faced by pregnant women and there are many limits and difficulties encountered by professionals to act broadly on the Social Determinants of Health. Descriptors: Health Promotion; Social Determinants of Health; Primary Health Care; Nursing; Pré-natal Care; Health Equity.RESUMENObjetivo: conocer cómo se abordan los Determinantes Sociales de la Salud en la consulta de Enfermería Prenatal en Atención Primaria de Salud. Método: estudio cualitativo, descriptivo, exploratorio, con 15 enfermeras, a través de entrevistas semiestructuradas, continuando con el análisis temático de los datos. Resultados: la comprensión de los Determinantes Sociales de la Salud se limita a factores relacionados con la situación socioeconómica y la red familiar de la mujer embarazada. Se reveló el desempeño del equipo multiprofesional y se enfatizó la necesidad de involucrar acciones intersectoriales. Se identificaron los límites y las dificultades relacionadas con el desempeño de los enfermeros sobre los determinantes y las condiciones que interfieren en la vida de las mujeres embarazadas. Conclusión: se revela que, aunque los enfermeros no entienden el concepto en general, la actuación es una realidad durante la atención prenatal. Sin embargo, las mujeres embarazadas enfrentan múltiples barreras y los profesionales enfrentan muchos límites y dificultades para actuar ampliamente sobre los Determinantes Sociales de la Salud. Descriptores: Promoción de la Salud; Determinantes Sociales de la Salud; Atención Primaria de Salud; Enfermería; Atención Prenatal; Equidad en Salud.


2017 ◽  
Vol 6 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Lauren Kennedy

Various definitions of health and mental health exist, however there is a generally persistent inclusion and acknowledgement of the importance of holistic elements such as environment and relationships. Integration of the physical, social, and mental aspects of an individual, through the social determinants of health is an important component in establishing the effective delivery of optimal mental health care. With increasing numbers of collaborative care teams, and mental health promotion strategies, primary health care is increasingly building its capacity to help respond to these holistic mental health care needs, with increased and more purposeful attention to the social determinants of health. Despite these steps in the right direction, a gap continues to exist in the delivery of mental health care and many people continue to struggle in accessing adequate treatment. In order to determine how best to proceed, it is important to understand what mental health is, what mental health care in primary health care looks like, what the existing challenges to the delivery of mental health care in primary health care are, and what other models have been successful in integrating the social determinants of health and mental health into the primary health care system.


2014 ◽  
Vol 48 (spe) ◽  
pp. 119-125 ◽  
Author(s):  
Celia Maria Sivalli Campos ◽  
Bárbara Ribeiro Buffette Silva ◽  
Deisi Cristine Forlin ◽  
Carla Andréa Trapé ◽  
Iara de Oliveira Lopes

Objective Identify nurses’ emancipatory practices in primary care, to contribute to the improvement of health care. Method A case study type social research of qualitative nature, in which nurses of a primary health care service unit in São Paulo were interviewed. Results The home visit was identified as a nursing practice possible to be expanded in order to identify social determinants of health, triggering emancipatory practices in the service. This expansion occurred because the design of health care labour intended by the service team changed its focus from the traditional object of health services, the disease. Conclusion First, it is advocated that social policies lead projects with the purpose of improving health needs. On the other hand, the daily labour needs to provide opportunities for reflection and discussion of healthcare projects, leading workers to propose labour-processes targeted to both the social determinants of health and people’s illness.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
O. Pearson ◽  
◽  
K. Schwartzkopff ◽  
A. Dawson ◽  
C. Hagger ◽  
...  

Abstract Background Indigenous populations globally are continually striving for better health and wellbeing due to experiencing significant health and social inequities. The social determinants of health are important contributors to health outcomes. Comprehensive primary health care that is governed and delivered by Indigenous people extends beyond the biomedical model of care to address the social determinants of health. Aboriginal Community Controlled Health Organisations (ACCHOs) are known to provide culturally informed, holistic health services that directly and indirectly address the social determinants of health. The range and extent of their activities in addressing the social determinants of health, however, is not well documented. Methods The most recent ACCHO annual reports were retrieved online or by direct correspondence. For coding consistency, a dictionary informed by the World Health Organization’s Conceptual Framework for Action on the Social Determinants of Health was developed. A document and textual analysis of reports coded ACCHO activities and the determinants of health they addressed, including intermediary determinants, socio-economic position and/or socio-political context. Summary statistics were reported. Representative quotes illustrating the unique nature of ACCHO service provision in addressing the social determinants of health were used to contextualise the quantitative findings. Results Sixty-seven annual reports were collected between 2017 and 2018. Programs were delivered to population groups across the life span. Fifty three percent of reports identified programs that included work at the socio-political level and all annual reports described working to improve socioeconomic position and intermediary determinants of health through their activities. Culture had a strong presence in program delivery and building social cohesion and social capital emerged as themes. Conclusions This study provides evidence of the considerable efforts of the ACCHO sector, as a primary health care provider, in addressing the social determinants of health and health inequity experienced by Indigenous communities. For the Aboriginal and Torres Strait Islander population, ACCHOs not only have an essential role in addressing immediate healthcare needs but also invest in driving change in the more entrenched structural determinants of health. These are important actions that are likely to have an accumulative positive effect in closing the gap towards health equity.


2020 ◽  
Author(s):  
Odette Pearson ◽  
Kate Schwartzkopff ◽  
Anna Dawson ◽  
Christina Hagger ◽  
Agape Karagi ◽  
...  

Abstract Background: Indigenous populations globally are continually striving for better health and wellbeing due to experiencing significant health and social inequities. The social determinants of health are important contributors to health outcomes. Comprehensive primary health care that is governed and delivered by Indigenous people extends beyond the biomedical model of care to address the social determinants of health. Aboriginal Community Controlled Health Organisations (ACCHOs) are known to provide culturally informed, holistic health services that directly and indirectly address the social determinants of health. The range and extent of their activities in addressing the social determinants of health, however, is not well documented. Methods: The most recent ACCHO annual reports were retrieved online or by direct correspondence. For coding consistency, a dictionary informed by the World Health Organization’s Conceptual Framework for Action on the Social Determinants of Health was developed . A document and textual analysis of reports coded ACCHO activities and the determinants of health they addressed, including intermediary determinants, socio-economic position and/or socio-political context. Summary statistics were reported. Representative quotes illustrating the unique nature of ACCHO service provision in addressing the social determinants of health were used to contextualise the quantitative findings. Results: Sixty-seven annual reports were collected between 2017 and 2018. Programs were delivered to population groups across the life span. Fifty three percent of reports identified programs that included work at the socio-political level and all annual reports described working to improve socioeconomic position and intermediary determinants of health through their activities. Culture had a strong presence in program delivery and building social cohesion and social capital emerged as themes. Conclusions: This study provides evidence of the considerable efforts of the ACCHO sector, as a primary health care provider, in addressing the social determinants of health and health inequity experienced by Indigenous communities. For the Aboriginal and Torres Strait Islander population, ACCHOs not only have an essential role in addressing immediate healthcare needs but also invest in driving change in the more entrenched structural determinants of health. These are important actions that are likely to have an accumulative positive effect in closing the gap towards health equity.


2019 ◽  
Vol 13 (4) ◽  
pp. 943
Author(s):  
Daniella Santos Figueredo ◽  
Ivonete Teresinha Schulter Buss Heidemann ◽  
Gisele Cristina Manfrini Fernandes ◽  
Aline Megumi Arakawa-Belaunde ◽  
Lays Souza De Oliveira ◽  
...  

RESUMO Objetivo: conhecer as práticas de promoção da saúde articuladas aos determinantes sociais e desenvolvidas por profissionais da Atenção Primária à Saúde. Método: trata-se de estudo qualitativo, descritivo, exploratório. Realizaram-se 19 entrevistas semiestruturadas com profissionais de saúde inseridos em duas Unidades Básicas de Saúde. Avaliaram-se os dados a partir da técnica de Análise de Conteúdo na modalidade Análise Temática. Resultados: desenvolvem-se as práticas de Promoção da Saúde, em sua maioria, em grupos de educação em saúde, com orientações sobre mudança de estilo de vida durante as consultas agendadas. Apontaram-se, como potencialidades, o adequado processo de trabalho das equipes de saúde, o apoio e o incentivo da gestão atual e o vínculo com a comunidade. Citaram-se, como principais desafios, a demanda excessiva de usuários para consultas individuais e a falta de recursos humanos, apontando algumas fragilidades da gestão. Conclusão: ressalta-se a pertinência da Promoção da Saúde na Atenção Primária como forma de cuidado e autonomia do indivíduo e da comunidade, considerando os determinantes sociais, mas requerendo investimentos na educação permanente frente aos desafios apontados. Descritores: Promoção da Saúde; Estratégia Saúde da Família; Determinantes Sociais da Saúde; Atenção Primária à Saúde; Enfermagem; Equidade em Saúde.ABSTRACT Objective: to know the practices of health promotion articulated to social determinants and developed by Primary Health Care professionals. Method: this is a qualitative, descriptive, exploratory study. Nineteen semi-structured interviews were conducted with health professionals enrolled in two Basic Health Units. Data were evaluated using the Content Analysis technique in the Thematic Analysis modality. Results: health promotion practices are developed, mostly in health education groups, with orientations on lifestyle changes during the scheduled consultations. As potentialities, the adequate work process of the health teams, the support and the incentive of the current management and the bond with the community were pointed out. The main challenges were the excessive user demand for individual consultations and the lack of human resources, pointing out some management weaknesses. Conclusion: the relevance of Health Promotion in Primary Care as a form of care and autonomy of the individual and of the community, considering the social determinants, but requiring investments in the permanent education facing the challenges pointed out. Descriptors: Health Promotion; Family Health Strategy; Social Determinants of Health; Primary Health Care; Nursing; Equity in Health.RESUMEN Objetivo: conocer las prácticas de promoción de la salud articuladas a los determinantes sociales y desarrolladas por profesionales de la Atención Primaria a la Salud. Método: se trata de un estudio cualitativo, descriptivo, exploratorio. Se realizaron 19 entrevistas semiestructuradas con profesionales de salud insertados en dos Unidades Básicas de Salud. Se evaluaron los datos a partir de la técnica de Análisis de Contenido en la modalidad Análisis Temático. Resultados: se desarrollan las prácticas de Promoción de la Salud, en su mayoría, en grupos de educación en salud, con orientaciones sobre cambio de estilo de vida durante las consultas programadas. Se señalaron, como potencialidades, el adecuado proceso de trabajo de los equipos de salud, el apoyo y el incentivo de la gestión actual y el vínculo con la comunidad. Se citaron, como principales desafíos, la demanda excesiva de usuarios para consultas individuales y la falta de recursos humanos, apuntando algunas debilidades de la gestión. Conclusión: se resalta la pertinencia de la Promoción de la Salud en la Atención Primaria como forma de cuidado y autonomía del individuo y de la comunidad, considerando los determinantes sociales, pero requiriendo inversiones en la educación permanente frente a los desafíos señalados. Descriptores: Promoción de la Salud, Estrategia de la Salud Familiar; Determinantes Sociales de la Salud; Enfermería; Equidad en Salud.


2020 ◽  
Author(s):  
Odette Pearson ◽  
Kate Schwartzkopff ◽  
Anna Dawson ◽  
Christina Hagger ◽  
Agape Karagi ◽  
...  

Abstract Background Indigenous populations globally are continually striving for better health and wellbeing due to experiencing significant health and social inequities. The social determinants of health are important contributors to health outcomes. Comprehensive primary health care that is governed and delivered by Indigenous people extends beyond the biomedical model of care to address the social determinants of health. Aboriginal Community Controlled Health Organisations (ACCHOs) are known to provide culturally informed, holistic health services that directly and indirectly address the social determinants of health. The range and extent of their activities in addressing the social determinants of health, however, is not well documented.Methods The most recent ACCHO annual reports were retrieved online or by direct correspondence. For coding consistency, a dictionary informed by the World Health Organization’s Conceptual Framework for Action on the Social Determinants of Health was developed. A document and textual analysis of reports coded ACCHO activities and the determinants of health they addressed, including intermediary determinants, socio-economic position and/or socio-political context. Summary statistics were reported. Representative quotes illustrating the unique nature of ACCHO service provision in addressing the social determinants of health were used to contextualise the quantitative findings.Results Sixty-seven annual reports were collected between 2017 and 2018. Programs were delivered to population groups across the life span. Fifty three percent of reports identified programs that included work at the socio-political level and all annual reports described working to improve socioeconomic position and intermediary determinants of health through their activities. Culture had a strong presence in program delivery and building social cohesion and social capital emerged as themes.Conclusions This study provides evidence of the considerable efforts of the ACCHO sector, as a primary health care provider, in addressing the social determinants of health and health inequity experienced by Indigenous communities. For the Aboriginal and Torres Strait Islander population, ACCHOs not only have an essential role in addressing immediate healthcare needs but also invest in driving change in the more entrenched structural determinants of health. These are important actions that are likely to have an accumulative positive effect in closing the gap towards health equity.


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