scholarly journals Hipertensão secundária: abordagem nos cuidados de saúde primários

2021 ◽  
Vol 37 (6) ◽  
pp. 535-548
Author(s):  
Tiago Costa ◽  
◽  
Diana Catarina Coelho Leitão ◽  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Task Force ◽  
Preventive Services ◽  
Secondary Hypertension ◽  
Cochrane Library ◽  
Primary Health ◽  
The Cochrane Library ◽  
De Medicina

Objetivos: Identificar situações sugestivas de hipertensão secundária (HS). Rever a fisiopatologia, manifestações clínicas e/ou laboratoriais, diagnóstico e tratamento das principais formas de HS, bem como estabelecer o papel do médico de família na sua abordagem à luz da evidência mais recente. Fontes de dados: MEDLINE/PubMed, The Cochrane Library, UpToDate, U.S. Preventive Services Task Force e normas de orientação clínica da Direção-Geral da Saúde. Métodos: Foi realizada a pesquisa de artigos científicos em plataformas online de medicina baseada em evidência utilizando as palavras-chave Secondary Hypertension e Primary Health Care. A pesquisa foi realizada em julho de 2019, sendo a seleção dos artigos feita com base no título, conteúdo do resumo e data de publicação. Foram também consultadas normas de orientação clínica e guidelines. Resultados: A HS deve ser suspeita em contexto de hipertensão resistente, início de hipertensão antes dos 30 anos num utente sem fatores de risco, elevação súbita ou instabilidade da pressão arterial basal, hipertensão maligna ou acelerada, início de hipertensão diastólica em idosos, hipertensão associada a distúrbios hidro-eletrolíticos ou hipertensão associada a clínica sugestiva de determinada etiologia específica. Em crianças e adolescentes, as principais causas de HS são as doenças do parênquima renal, ao passo que nos adultos as etiologias mais comuns incluem a síndroma da apneia obstrutiva do sono, doenças do parênquima renal, estenose da artéria renal, hiperaldosteronismo primário e feocromocitoma. O reconhecimento de manifestações clínicas e/ou laboratoriais sugestivas da etiologia da HS deve orientar a realização dos testes de rastreio para posterior tratamento ou referenciação. Conclusão: Avaliar em todos os utentes hipertensos a existência de causas secundárias não é custo-efetivo, pelo que apenas devem ser estudados os utentes com características sugestivas de HS. A realização e interpretação dos testes de rastreio de forma adequada é fundamental para a referenciação e tratamento dos utentes com HS.

scholarly journals Capitation-Based Financing Hampers the Provision of Preventive Services in Primary Health Care

2016 ◽  
Vol 4 ◽  
Author(s):  
János Sándor ◽  
Karolina Kósa ◽  
Magor Papp ◽  
Gergő Fürjes ◽  
László Kőrösi ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Preventive Services ◽  
Primary Health

scholarly journals Drug-Related Problems of Patients in Primary Health Care Institutions: A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiao-Feng Ni ◽  
Chun-Song Yang ◽  
Yu-Mei Bai ◽  
Zi-Xian Hu ◽  
Ling-Li Zhang
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Health Care ◽  
Primary Health Care ◽  
Cochrane Library ◽  
Drug Related Problems ◽  
Primary Health ◽  
Health Care Institutions ◽  
The Future ◽  
Primary Health Care Institutions

Introduction: Drug-related problems (DRPs) are not only detrimental to patients' physical health and quality of life but also lead to a serious waste of health care resources. The condition of DRPs might be more severe for patients in primary health care institutions.Objective: This systematic review aims to comprehensively review the characteristics of DRPs for patients in primary health care institutions, which might help find effective strategies to identify, prevent, and intervene with DRPs in the future.Methods: We searched three English databases (Embase, The Cochrane Library, and PubMed) and four Chinese databases (CNKI, CBM, VIP, and Wanfang). Two of the researchers independently conducted literature screening, quality evaluation, and data extraction. Qualitative and quantitative methods were combined to analyze the data.Results: From the 3,368 articles screened, 27 met the inclusion criteria and were included in this review. The median (inter-quartile range, IQR) of the incidences of DRPs was 70.04% (59%), and the median (IQR) of the average number of DRPs per patient was 3.4 (2.8). The most common type of DRPs was “treatment safety.” The causes of DRPs were mainly in the prescribing section, including “drug selection” and “dose selection”, while patients' poor adherence in the use section was also an important cause of DRPs. Risk factors such as the number of medicines, age, and disease condition were positively associated with the occurrence of DRPs. In addition, the medians (IQR) of the rate of accepted interventions, implemented interventions, and solved DRPs were 78.8% (22.3%), 64.15% (16.85%), and 76.99% (26.09%), respectively.Conclusion: This systematic review showed that the condition of DRPs in primary health care institutions was serious. In pharmaceutical practice, the patients with risk factors of DRPs should be monitored more closely. Pharmacists could play important roles in the identification and intervention of DRPs, and more effective intervention strategies need to be established in the future.

scholarly journals Usability and utility of eHealth for physical activity counselling in primary health care: a scoping review

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Apichai Wattanapisit ◽  
Titiporn Tuangratananon ◽  
Sanhapan Wattanapisit
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Primary Health Care ◽  
Scoping Review ◽  
Health Behaviours ◽  
Cochrane Library ◽  
Technical Problems ◽  
Primary Health ◽  
Wide Range ◽  
Full Text Review

Abstract Background Physical activity (PA) counselling is an effective approach to promote PA in primary health care (PHC). Barriers to PA counselling in PHC include time constraints, lack of knowledge and skills of providers, and systemic barriers. Using electronic health (eHealth) has the potential to promote PA. This scoping review aimed to identify usability and utility of eHealth for tailored PA counselling introduced in PHC settings. Methods A scoping review included primary research articles. The authors systematically searched six databases (Cochrane Library, CINAHL Complete, Embase, PubMed, Scopus and Web of Science) from the inception of the databases. The search terms consisted of three search components: intervention (PA counselling), platform (eHealth), and setting (PHC). Additional articles were included through reference lists. The inclusion criteria were research or original articles with any study designs in adult participants. Results Of 2501 articles after duplicate removal, 2471 articles were excluded based on the title and abstract screening and full text review. A total of 30 articles were included for synthesis. The eHealth tools had a wide range of counselling domains as a stand-alone PA domain and multiple health behaviours. The included articles presented mixed findings of usability and utility of eHealth for PA counselling among patients and providers in PHC settings. Technical problems and the complexity of the programmes were highlighted as barriers to usability. The majority of articles reported effective utility, however, several articles stated unfavourable outcomes. Conclusions eHealth has the potential to support PA counselling in PHC. Facilitators and barriers to eHealth usability should be considered and adapted to particular settings and contexts. The utility of eHealth for promoting PA among patients should be based on the pragmatic basis to optimise resources.

Processo de trabalho: sua importância na organização da prática assistencial de enfermagem na saúde coletiva

2008 ◽  
Vol 2 (4) ◽  
pp. 438
Author(s):  
Helen Cardoso de Magalhães ◽  
Lívia Ferreira de Abreu ◽  
Wasley De Souza Novaes ◽  
Maristela De Moura Mendonça ◽  
Eduardo Augusto dos Santos Moreira-Silva ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Literature Review ◽  
Medical Assistance ◽  
Primary Health ◽  
Analysis And Synthesis ◽  
Real Importance ◽  
Nursing Roles ◽  
De Medicina

ABSTRACTObjectives: to present a broad review of the known nursing roles and correspondent medical assistance practices with emphasis on collective health. Methodology: literature review which includes 1741 articles along with their most prominent references, carefully chosen from specialized scientific magazines over the last decades. After, analysis and synthesis of these materials, 13 articles was selected and, a retroactive search of the references of consulted articles was done to extend the research sources. Results: the nurse’s notable difficulty in both prioritizing their actions and elaborating solutions to complex chores undermine any possibility of tackling simple duties successfully. Conclusion: notwithstanding, in order to lay bare some old paradigms (biomedical, hegemonic) and to give nurses a better consciousness comprehension of their real importance in society, we ought to find new tools that will allow them not only reach autonomy as qualified professionals but also  act motivated  individuals. Descriptors: nurse’s role; primary health care; public health.RESUMOObjetivo: analisar o processo de trabalho da enfermagem e discutir a importância do enfermeiro, em sua prática assistencial, em desvelar o seu objeto e instrumentos de trabalho para então compreender o seu processo de trabalho e, a sua real identidade profissional, com ênfase na saúde coletiva. Metodologia: pesquisa realizada na Biblioteca Regional de Medicina (BIREME), na qual foram obtidos 1741 artigos. Após, análise e síntese desses materiais foram selecionados 13 artigos e, também foi realizada uma busca retroativa das referências dos artigos consultados a fim de ampliar as fontes de pesquisa. Resultados: a partir dessa pesquisa, verificou-se que é crucial que a enfermagem se liberte desse velho paradigma (biomédico, hegemônico) e, busque novas concepções que permitam alcançar autonomia e autogoverno do profissional enfermeiro. Conclusão: o enfermeiro necessita clarificar as suas ferramentas de trabalho em sua prática profissional para que possa compreender o seu processo de trabalho. Descritores: papel do enfermeiro; atenção primária à saúde; saúde pública.RESUMENObjetivos: analizar el proceso de trabajo de enfermería y discutir la importancia del enfermero en su práctica asistencial, en revelar su objeto y instrumentos de trabajo y su verdadera identidad profesional con énfasis en la salud colectiva. Retrata la dificultad del enfermero en la identificación de su  función y su atribución y ele extremo valor en la delineación de su proceso de trabajo para la organización de suyos actos en su práctica profesional. Metodologia: el método fue basado en una búsqueda que ocurrió en la BIREME en que fueron obtidos 1741 artículos. Tras el análisis y la síntesis de estos materiales se seleccionaron 13 artículos, también se llevó a cabo una búsqueda de referencias de los artículos consultados con carácter retroactivo con el fin de ampliar las fuentes de la investigación. Resultados: es fundamental que la enfermería líbrese del viejo modelo biomédico y encuentre nuevas concepciones que permitan alcanzar autonomía y autogobierno del profesional enfermero. Conclusione: es importante decir que el enfermero necesita aclarar su herramientas de trabajo en su práctica profesional para comprender su proceso de trabajo. Descriptores: rol de la enfermera; atención primaría de la salud; salud pública. 

scholarly journals The approach intersectoral for medical education in primary health care

2017 ◽  
Vol 50 (1) ◽  
pp. 58
Author(s):  
Aldaísa C. Forster ◽  
Janise B. B. Ferreira ◽  
Nereida Kilza da Costa Lima ◽  
Priscila Mina Galati ◽  
Renata Farche
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Primary Health Care ◽  
Sao Paulo ◽  
São Paulo ◽  
Primary Health ◽  
De Medicina

Introdução: O processo de criação do Sistema Único de Saúde (SUS) como um modelo de atenção à saúde, mais humanizado, abrangente, eficaz e resolutivo tem a intersetorialidade como um de seus instrumentos para a transformação. No entanto, há escassez de artigos que abordem a intersetorialidade no contexto da educação médica e da organização das práticas, principalmente na atenção primária. Objetivo: Trazer à luz o conceito de intersetorialidade e o princípio da orientação comunitária na organização das práticas na realidade das equipes de saúde da família, no âmbito do SUS. Método: Análise documental realizada para discutir o conceito de intersetorialidade na obra de autores da Atenção Primária à Saúde (APS), na documentação oficial do Ministério da Saúde e em publicações selecionadas sobre a intersetorialidade. Discutiu-se também a orientação comunitária nas ações prestadas de APS segundo a percepção do médico e da equipe de saúde da família, no Brasil. Foi descrita a evolução do antigo Programa de Saúde da Família para a Estratégia de Saúde da Família como modelo de reorganização da atenção primária à saúde no SUS e no cenário de ensino das Unidades de Saúde da Família (USF) ligadas à Faculdade de Medicina de Ribeirão Preto- Universidade de São Paulo, no período de 1999 a 2014. Resultados: A documentação oficial e científica consultada mostrou avanço das transformações nos serviços de Saúde da Família, como modelo de organização da APS no país. O cenário das USF orientado para a APS vem contribuindo para a adequação da formação médica e dos profissionais de saúde nessa área. Considerações finais: Não obstante, percebendo-se as potencialidades das práticas intersetoriais e orientadas para a comunidade na mudança do paradigma da saúde, há muito o que fazer no sentido amplo da intersetorialidade, que compreende a abordagem dos determinantes sociais da saúde no planejamento integrado local

scholarly journals Supporting recommendations for childhood preventive interventions for primary health care: elaboration of evidence synthesis and lessons learnt

2021 ◽  
Vol 21 (S1) ◽  
Author(s):  
Sophie Jullien ◽  
Gottfried Huss ◽  
Ralf Weigel
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Systematic Reviews ◽  
Evidence Synthesis ◽  
The United States ◽  
Cochrane Library ◽  
Preventive Interventions ◽  
Primary Health ◽  
Pocket Book ◽  
Starting Point

Abstract Background Recommendations to prevent morbidity and mortality in children was a high priority for the editorial group of a WHO pocket book for primary health care in the European region. However, the benefit of preventive interventions is not always clear and recommendations differ across countries and institutions. Here, we summarize the existing recommendations and the most recent evidence on ten selected preventive interventions applied to children under five years to inform this group. In addition, we reflect on the process and challenges of developing these summaries. Methods For each intervention, we systematically searched for current recommendations from the WHO, the United States Preventive Services Task Force, the workgroup PrevInfad from the Spanish Association of Primary Care Pediatrics, the Centers of Disease Control and Prevention, and the National Institute for Health and Care Excellence. Then, we systematically searched the sources above and the Cochrane library for relevant systematic reviews. For each topic, we reported the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported. Categorising the ten preventive interventions in three groups allowed narrative comparisons between similar types of interventions and between groups. Results and discussion For the single interventions of providing vitamins D and K and topical fluoride there is overall a high degree of consensus between institutions for the evidence of their effectiveness. For the multiple interventions to prevent sudden infant death syndrome and unintentional injuries consensus was more variable as evidence of effectiveness is harder to ascertain. For the screening interventions the summaries of recommendations and evidence varied too. While institutions generally agreed in recommending for vision screening and against universal screening for language and speech delay and iron deficiency, they had some differences for pulse oximetry and autism. The transparent and independent process shed light upon how institutions use existing evidence in their settings – common and different positions were accounted for and became visible. We also identified gaps and duplications of research. Our approach was a crucial starting point for developing the respective sections in the pocket book.

scholarly journals Advances and challenges in oral health after a decade of the “Smiling Brazil” Program

2015 ◽  
Vol 49 (0) ◽  
Author(s):  
Charleni Inês Scherer ◽  
Magda Duarte dos Anjos Scherer
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Oral Health ◽  
Health Care Services ◽  
Health Care Policy ◽  
Monitoring And Evaluation ◽  
Management Training ◽  
Cochrane Library ◽  
Health Work ◽  
Primary Health

ABSTRACT OBJECTIVE To analyze oral health work changes in primary health care after Brazil’s National Oral Health Policy Guidelines were released. METHODS A literature review was conducted on Medline, LILACS, Embase, SciELO, Biblioteca Virtual em Saúde, and The Cochrane Library databases, from 2000 to 2013, on elements to analyze work changes. The descriptors used included: primary health care, family health care, work, health care policy, oral health care services, dentistry, oral health, and Brazil. Thirty-two studies were selected and analyzed, with a predominance of qualitative studies from the Northeast region with workers, especially dentists, focusing on completeness and quality of care. RESULTS Observed advances focused on educational and permanent education actions; on welcoming, bonding, and accountability. The main challenges were related to completeness; extension and improvement of care; integrated teamwork; working conditions; planning, monitoring, and evaluation of actions; stimulating people’s participation and social control; and intersectorial actions. CONCLUSIONS Despite the new regulatory environment, there are very few changes in oral health work. Professionals tend to reproduce the dominant biomedical model. Continuing efforts will be required in work management, training, and permanent education fields. Among the possibilities are the increased engagement of managers and professionals in a process to understand work dynamics and training in the perspective of building significant changes for local realities.

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