scholarly journals Construction and Validation of a Tool for the Assessment of the Oral Health in Primary Health Care Through the Perspective of Patients

2020 ◽  
Vol 12 (4) ◽  
pp. 37
Author(s):  
Heriberto Fiuza Sanchez ◽  
Raquel Conceição Ferreira ◽  
Andrea Maria Duarte Vargas ◽  
Marcos Azeredo Furquim Werneck ◽  
Efigênia Ferreira e Ferreira
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Factor Analysis ◽  
Primary Health Care ◽  
Oral Health ◽  
Focus Group ◽  
Health Services ◽  
Health Unit ◽  
Primary Health ◽  
Oral Health Services

OBJECTIVE: To construct and validate a questionnaire to evaluate the quality of oral health services in primary health care, from patients. METHODS: Initially a theoretical model of evaluation of Primary Health Care was elaborated, based on the evaluation of primary care and integrality in primary care. This model served as the basis for the script of a focus group with patients, aiming to verify the attributes perceived as important for such evaluation. The focus group results substantiated the first version of the questionnaire. Content validation was performed through a committee of experts (five teachers/researchers) and face validation in two pre-tests (37 patients each pre-test). For construct validation, factor analysis was performed and reliability (Kappa coefficient) and internal consistency (Cronbach's alpha) were verified. RESULTS: Thirty questions were considered for exploratory factor analysis. The anti-image matrix of covariances showed the need to exclude fourteen questions (values <0.5). After this initial analysis, 16 questions remained in the questionnaire. The KMO test, considering the 16 questions, presented a value of 0.84. Cronbach's alpha was 0.919. The final version contains 16 questions divided into two dimensions: my health unit and the care in my health unit. CONCLUSIONS: The questionnaire allows a strategy that easily evaluates oral health services in primary care, based on the perception of patients.

scholarly journals Presence and extension of the attributes of primary health care in public dental services in Porto Alegre, Rio Grande do Sul State, Brazil

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Débora Deus Cardozo ◽  
Juliana Balbinot Hilgert ◽  
Caroline Stein ◽  
Lisiane Hauser ◽  
Erno Harzheim ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Oral Health ◽  
Health Services ◽  
Assessment Tool ◽  
Evaluation Instrument ◽  
Primary Health ◽  
Care Assessment ◽  
Oral Health Services

The objective was to compare the presence and extension of primary health care (PHC) in oral health services using the PHC attributes according to three different types of PHC organizational arrangements: Family Health Strategy (FHS), Community Health Service (CHS) and Traditional Primary Care (TPC). This is a cross-sectional study carried out between 2011-2013, following a cluster random sampling strategy. Adult users were interviewed from 15 health services of that 6 were managed by the CHS, 4 by the FHS and 5 by the TPC and which had the same oral health team for at least two years. The final sample was 407 users interviewed using the Primary Care Assessment Tool - Oral Health of Adults evaluation instrument and a sociodemographic questionnaire. PHC scores were calculated and transformed on a scale ranging from 0 to 10. For high scores, the cut-off point > 5.5 was used. Most of the interviewees were females, for the three types of services. The performance of CHS and FHS was higher than those of TPC in almost all attributes (p < 0.05). The extent of PHC attributes in services was poor (overall highest score was 5.75 in CHS). The CHS was the only service witch half of the users (83; 49.1%) rated oral health services as having a high overall score for PHC. It is concluded that there were differences among the organizational arrangements of PHC oral health services, however, there is much to be improved in the orientation of dental care services for PHC. More studies are necessary to evaluate the differences in PHC services considering oral health.

scholarly journals A Survey About Dental Instruments at the Primary Health Care in Brazil

2018 ◽  
Vol 29 (5) ◽  
pp. 500-506
Author(s):  
Joyce Lopes ◽  
Andréa Clemente Palmier ◽  
Marcos Azeredo Furquim Werneck ◽  
Antônio Thomaz Gonzaga da Matta-Machado ◽  
Mauro Henrique Nogueira Guimarães de Abreu
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Oral Health ◽  
Health Services ◽  
Social Issues ◽  
Organizational Characteristics ◽  
Care Organization ◽  
Dental Instruments ◽  
Primary Health ◽  
Oral Health Services

Abstract This study describes the structure of oral health services in primary health care in Brazil and the instruments available for the provision of oral health care and to compare the number of instruments according to organizational characteristics of health services and among the macroregions. Of the 23,251 oral health teams (OHTs) in the Public Health System, 17,513 (75.3%) participated in this study. Trained researchers observed the structures of the health services and determined the presence of and whether a sufficient quantity of 36 dental instruments existed. The score of each oral health service was determined by the sum of the number of dental instruments present in sufficient quantity (0 to 36). Central tendency measures were compared along with the variability in these scores according to the organizational characteristics of the services and according to the Brazilian macroregion. No instrument was found to be present in all evaluated services. Basic, surgical and restorative instruments were the most frequently found. Periodontal, endodontic and prosthetic instruments exhibited the lowest percentages. The mean and median numbers of dental instruments were higher for teams that operated over more shifts, those with an oral health technician and those in the South and Southeast regions. The oral health services were equipped with basic, surgical and restorative instruments. Instruments designed for periodontal diagnosis, emergency care and denture rehabilitation were less frequently found in these services. The worst infrastructure conditions existed in the OHTs with the worst forms of care organization and in regions with greater social issues.

scholarly journals Structural characteristics of oral health services in Brazilian Primary Health Care

2021 ◽  
Vol 35 ◽  
Author(s):  
Maria Tereza Abreu SCALZO ◽  
Antônio Thomaz Gonzaga MATTA-MACHADO ◽  
Mauro Henrique Nogueira Guimarães ABREU ◽  
Renata Castro MARTINS
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Oral Health ◽  
Health Services ◽  
Structural Characteristics ◽  
Primary Health ◽  
Oral Health Services

Factors Influencing Access to Primary Health Care via School Health Services

PEDIATRICS ◽  
1980 ◽  
Vol 65 (3) ◽  
pp. 585-591
Author(s):  
Philip R. Nader ◽  
Susan Gilman ◽  
David E. Bee
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
School Health ◽  
Preventive Health Care ◽  
School Health Services ◽  
Family Status ◽  
Primary Health ◽  
Poor Access

The school health and community primary health care contacts were studied for a group of elementary school children who have sociodemographic characteristics often associated with poor access to primary health services. The school system is engaged in a demonstration project that attempts to link the home with community and school services. Visits to the school health room accounted for 85% of all contacts. A visit rate of 1.13 visits/child/year occurred at primary care sites. Ethnicity is the single most important predictor of use of school health services, followed by family status and number of visits for primary health care in the community. In contrast, use of community primary care facilities is best predicted by socioeconomic status (SES), family status, and sex. The patterns of care received by the population were characterized. Children whose care was initiated, referred, or facilitated by the school were designated as receiving "interactive" care, which occurred mostly among minority and lower SES children. The data suggest that the school provides access to preventive health care for all children and facilitates care for segments of the population that usually have difficulty achieving access to the health care system.

scholarly journals The Role of Primary Health Care Toward Healthy Aging

2021 ◽  
Vol 4 (1SP) ◽  
pp. 10
Author(s):  
Dhanasari Vidiawati ◽  
Yuda Turana ◽  
Tonny Sundjaya
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Healthy Aging ◽  
The Elderly ◽  
Preventive Health ◽  
Care Services ◽  
Primary Health

Background: According to the World Health Organization, healthy aging is the process of developing and maintaining functional abilities that make the elderly happy. The increase in the elderly population requires more attention. In particular, health services at the primary health care level face problems related to the limited capacity of overall health services, especially in terms of health promotion and preventive health issues. It is necessary to improve the quality of health care services for the elderly to prevent greater health problems among the elderly population.Objectives: Understand the need to provide holistic health services for healthy aging and use their capabilities, and strengthen cooperation among health professionals in achieving healthy aging.Discusion: Primary health care is pointed out that primary health care should provide comprehensive services in a holistic manner to support a healthy aging process. Therefore, a well-structured, integrated, and cross-industry collaborative primary care system is needed. The system should include changes in professional behavior, coordination of care, and participation of patients' families and communities in comprehensive health care. This can be achieved through inter-professional education, continuous training and education of primary health care professionals, as well as primary health care services and cross-level health care technology innovation.Conclusions: Healthy aging is not just the absence of disease. Everyone in health and social care at all levels can play a role to help improve healthy aging. To make the elderly healthy, starting from the prevention of young health problems, it requires collaboration between health workers, primary health care and other health service levels, and health care that cooperates with patients, families, and communities.Keywords: healthy aging, primary care, preventive, health worker

scholarly journals What makes Care Plus effective in a provincial Primary Health Organisation? Perceptions of primary care workers

2009 ◽  
Vol 1 (3) ◽  
pp. 190 ◽  
Author(s):  
Kyle Eggleton ◽  
Tim Kenealy
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Focus Group ◽  
Clinical Outcomes ◽  
Health Professionals ◽  
Chronic Care ◽  
Practice Nurses ◽  
Primary Health ◽  
Care Workers

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

scholarly journals Integrating Mental Health into Primary Care Using a Population Based Approach: Six Years Outcome of Aro Primary Care Mental Health Programme for Ogun State, Nigeria

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Workers ◽  
Population Based ◽  
Ogun State ◽  
Primary Health

Introduction: Integration of mental health services into Primary Health Care (PHC) is a proven way of reducing the treatment gap in developing countries. A major constraint to scaling up mental health services in developing countries is scarcity of mental health professionals. A practical solution is to adopt task shifting and task sharing strategies involving Primary Health Care Workers (PHW). One of the major challenges of such integrative services is their long term outcomes and sustainability. The Neuropsychiatric Hospital Aro, Abeokuta, Nigeria embarked on mental health services provision across primary health care facilities in Ogun state six (6) years ago. Objective: This report describes the development, challenges of the programme and presents a post-implementation evaluation after 6 years of its commencement. Methods: Applying a population based expansion of pilot- tested integration model of Aro Primary Care Mental Health Programme (APCMHP) for Ogun State, 80 PHC workers were trained using an adapted mental health Gap Action Programme (mhGAP) intervention guide to assess and treat/refer 5 priority conditions: Psychosis, Depression, Epilepsy, Alcohol and Substance abuse and Other Significant Emotional Complaints (OSEC).There was mental health service provision in 40 designated PHC centers across Ogun state. There was support and supervision of the trained health workers by field supervisors, supplementary training and re-training for skill sustenance, periodic stakeholders meeting with Local Government Service Commission, zonal consultants’ review, financial and other resources commitment by the hospital, monthly programme evaluation and monitoring by the faculty members. We reviewed caseload of patients managed by trained PHC Workers since commencement of the programme in November 2011 till October 2017 (6 years period) using descriptive statistics. Appropriate ethical approval was obtained. Results: During the six-year period (November 2011-October 2017), 2194 cases (average of 366 new cases yearly) were identified and treated by Trained Health Workers (THWs). About 90% of cases were Psychosis and Epilepsy. There was a steady attrition of THWs and at the end of the sixth year only 29% of the THWs remained within the programme. Treatment outcomes were fair as over 50% of patients had ≥ 3 follow-up visits, symptom remission of ≥ 30% and a subjective improvement in Global Ratings. Conclusion: Our project has demonstrated that it is feasible, practicable and cost effective with community acceptance to scale up mental health services at primary care setting in Nigeria using adapted mhGAP-IG document. The need to understand the dynamics and econometrics of sustainable primary mental health services is indicated.

scholarly journals Validity and reliability of the Brazilian Primary Care Assessment Tool: Oral Health of Adults

2020 ◽  
Vol 23 ◽  
Author(s):  
Débora Deus Cardozo ◽  
Caroline Stein ◽  
Lisiane Hauser ◽  
Liége Teixeira Fontanive ◽  
Erno Harzheim ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Oral Health ◽  
Assessment Tool ◽  
Validity And Reliability ◽  
Dental Services ◽  
Primary Health ◽  
Care Assessment ◽  
Primary Care Assessment Tool

ABSTRACT: Objective: To test the factorial validity and reliability of the Primary Care Assessment Tool adapted to Oral Health, adult patient version, an instrument used to verify the presence and extent of attributes in Primary Health Care services. Methods: Population-based cross-sectional study using conglomerate random sample carried out in Primary Health Care Dental services in Porto Alegre between 2011 and 2013. We interviewed 407 adult patients who used Primary Health Care Dental services. Construct validity was tested through factorial validity and reliability of the Primary Care Assessment Tool, that comprises 81 items distributed throughout Primary Health Care attributes. Equamax orthogonal rotation method was used in the factorial analysis; and, in order to assess reliability of each component, we used the item-total correlation and the ratio of success of the scale. Results: In the factorial analysis, 10 factors were retained, explaining 53.3% of the total variation. This result demonstrates the multidimensional structure of the instrument. The reliability assessment showed Cronbach’s alpha values ranging from 0.39 to 0.89. For the success of the scale most of the results (eight of nine attributes) were greater than 85%. Conclusions: The instrument is valid for the assessment of oral health services in Primary Health Care from the perspective of adult patients, as well as for monitoring and evaluation of oral health services in Primary Health Care attributes and comparative studies.

scholarly journals Innovation in primary health care responses to COVID-19 in Sub-Saharan Africa

2021 ◽  
Vol 22 ◽  
Author(s):  
Sunanda Ray ◽  
Robert Mash
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Family Medicine ◽  
Health Services ◽  
Primary Care Providers ◽  
Sub Saharan Africa ◽  
Care Providers ◽  
Primary Health ◽  
Lessons Learnt

Abstract Background: In May 2020, the African Journal of Primary Health Care and Family Medicine invited submissions on lessons learnt from responses to the COVID-19 pandemic from primary care providers in Africa. This included descriptions of innovations and good practices, the management of COVID-19 in district health services and responses of communities to the outbreak. Aim: To synthesise the lessons learnt from the COVID-19 pandemic in the Africa region. Methods: A thematic document analysis was conducted on twenty-seven short report publications from Botswana, Ghana, Nigeria, South Africa, Uganda and Zimbabwe. Findings: Eight major themes were derived from the data: community-based activities; screening and testing; reorganisation of health services; emergency care for COVID-19; maintenance of essential non-COVID-19 health services; caring for the vulnerable; use of information technology; and reframing training opportunities. Community health workers were a vital community resource, delivering medications and other supplies to homes, as well as following up on patients with chronic conditions. More investment in community partnerships and social mobilisation was proposed. Difficulties with procurement of test kits and turn-around times were constraints for most countries. Authors described how services were reorganised for focused COVID-19 activities, sometimes to the detriment of essential services and training of junior doctors. Innovations in use of internet technology for communication and remote consultations were explored. The contribution of family medicine principles in upholding the humanity of patients and their families, clear leadership and planning, multidisciplinary teamwork and continuity of care was emphasised even in the context of providing critical care. Conclusions: The community-orientated primary care approach was emphasised as well as long-term benefits of technological innovations. The pandemic exposed the need to deliver on governmental commitments to strengthening primary health care and universal health coverage.

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