scholarly journals Assessment of Follow-Up Care Received by Patients with Hypertension at Primary Health Care Facilities in Tshwane District of Gauteng Province, South Africa

2021 ◽  
Author(s):  
Julia Manyelo ◽  
Debbie Habedi

To extend the life expectancy of all South Africans to at least 70 years by 2030, hypertension follow-up care needs to be strengthened so that patients do not develop complications while in care. The aim of this study was to evaluate the follow-up care received by patients with hypertension at primary health care (PHC) facilities in Tshwane district. The study setting was ten PHC facilities in the aforesaid district. Quantitative, descriptive and retrospective methods were adopted, and simple random sampling was used to select ten PHC facilities from which ten files were conveniently sampled. Data were captured in Microsoft Excel 2010 and exported to IBM Statistical Package for the Social Sciences (SPSS) software version 21 in which data coding, outlier detection, missing value analysis and statistical data analysis were performed. In line with the study aim, frequency tables in SPSS were used to produce frequency statistics, and the chi-square test was used to test for the presence of association between compliance by nurses to clinical guidelines and categories of attributes, and further determine if there was a significant difference between adherence and non-adherence. The study found a significant proportion (93.4%) of non-adherence to hypertension guidelines among consulting nurses at selected PHC facilities.

Author(s):  
Sandy Yasmine Bezerra e Silva ◽  
Eliabe Rodrigues de Medeiros ◽  
Sérgio Balbino da Silva ◽  
Maria Nazaré Chacon de Matos Neta ◽  
Nilba Lima de Souza ◽  
...  

O objetivo do estudo é analisar a participação de enfermeiros em capacitações sobre Tuberculose e a sua associação com as competências desenvolvidas no controle da doença na Atenção Primária à Saúde. Estudo analítico, de abordagem quantitativa, desenvolvido no município de Natal, realizado com 80 enfermeiros da Atenção Primária à Saúde, utilizando questionário com 62 questões, entre novembro de 2017 a março de 2018. Os dados foram analisados através da estatística descritiva e inferencial (Testes Qui-quadrado e Exato de Fisher). Verificou-se associação estatística entre a participação dos enfermeiros em capacitações e o acompanhamento clínico das pessoas com Tuberculose; a existência de um responsável pelo controle da Tuberculose na unidade; a busca ativa de pessoas com Tuberculose e a solicitação de exames para os contatos. A participação em capacitações está associada a competências importantes no controle da tuberculose, sendo necessárias no processo de trabalho dos profissionais que assistem pessoas com a doença.Descritores: Atenção Primária à Saúde, Tuberculose, Enfermeiras e Enfermeiros. Tuberculosis training and association with developed skills in disease controlAbstract: The objective of the study is analyze the participation of nurses in training on tuberculosis and its association with the developed skills in the control of the disease in Primary Health Care. Analytical study, quantitative, developed in Natal city, conducted with 80 nurses from Primary Health Care, using a questionnaire with 62 questions, from November 2017 to March 2018. Data were analyzed using descriptive and inferential statistics (Chi-square and Fisher's Exact Tests). There was a statistical association between the participation of nurses in training and the clinical follow-up of people with tuberculosis; the existence of a responsible for tuberculosis control in the unit; the active search for people with tuberculosis and the request for exams for contacts. Participation in training is associated with important skills in tuberculosis control, being necessary in the work process of professionals who assist people with the disease.Descriptors: Primary Health Care, Tuberculosis, Nurses. Asociación de capacitación en tuberculosis con habilidades desarrolladas en el control de enfermedadesResumen: El objetivo del estudio es analizar la participación de enfermeras en la capacitación sobre tuberculosis y su asociación con las competencias desarrolladas en el control de la enfermedad en Atención Primaria de Salud. Estudio analítico, con enfoque cuantitativo, desarrollado en la ciudad de Natal, realizado con 80 enfermeras de Atención primaria de salud, utilizando un cuestionario con 62 preguntas, de noviembre de 2017 a marzo de 2018. Los datos se analizaron mediante estadísticas descriptivas e inferenciales (Chi-cuadrado y pruebas exactas de Fisher). Hubo una asociación estadística entre la participación de enfermeras en la capacitación y el seguimiento clínico de las personas con tuberculosis; la existencia de responsables del control de la tuberculosis en la unidad; la búsqueda activa de personas con tuberculosis y la solicitud de exámenes para contactos. La participación en la capacitación se asocia con habilidades importantes en el control de la tuberculosis, siendo necesaria en el proceso de trabajo de los profesionales que ayudan a las personas con la enfermedad.Descriptores: Atención Primaria de Salud, Tuberculosis, Enfermeras y Enfermeros.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elaine Thumé ◽  
Marciane Kessler ◽  
Karla P. Machado ◽  
Bruno P. Nunes ◽  
Pamela M. Volz ◽  
...  

Abstract Background The Bagé Cohort Study of Ageing is a population-based cohort study that has recently completed the first follow-up of a representative sample of older adults from Bagé, a city with more than 100,000 inhabitants located in the state of Rio Grande do Sul, Brazil. This is one of the first longitudinal studies to assess the impact of primary health care coverage on health conditions and inequalities. Our aim is to investigate the prevalence, incidence and trends of risk factors, health behaviours, social relationships, non-communicable diseases, geriatric diseases and disorders, hospitalisation, self-perceived health, and all-cause and specific-cause mortality. In addition, we aim to evaluate socioeconomic and health inequalities and the impact of primary health care on the outcomes under study. Methods/design The study covers participants aged 60 or over, selected by probabilistic (representative) sampling of the urban area of the city of Bagé, which is covered by Primary Health Care Services. The baseline examination included 1593 older adults and was conducted from July 2008 to November 2008. After eight to nine years (2016/2017), the first follow-up was conducted from September 2016 to August 2017. All participants underwent an extensive core assessment programme including structured interviews, questionnaires, cognitive testing (baseline and follow-up), physical examinations and anthropometric measurements (follow-up). Results Of the original participants, 1395 (87.6%) were located for follow-up: 757 elderly individuals (47.5%) were re-interviewed, but losses in data transfer occurred for 22. The remaining 638 (40.1%) had died. In addition, we had 81 (5.1%) refusals and 117 (7.3%) losses. Among the 1373 older adults who were followed down, there was a higher proportion of female interviewees (p=0.042) and a higher proportion of male deaths (p=0.001) in 2016/2017. There were no differences in losses and refusals according to gender (p=0.102). There was a difference in average age between the interviewees (68.8 years; SD ±6.5) and non-interviewees (73.2 years; SD ±9.0) (p<0.001). Data are available at the Department of Social Medicine in Federal University of Pelotas, Rio Grande do Sul, Brazil, for any collaboration.


2017 ◽  
Vol 70 (5) ◽  
pp. 949-957 ◽  
Author(s):  
Claudia Nery Teixeira Palombo ◽  
Elizabeth Fujimori ◽  
Áurea Tamami Minagawa Toriyama ◽  
Luciane Simões Duarte ◽  
Ana Luiza Vilela Borges

ABSTRACT Introduction: Nutritional counseling and growth follow-up are priorities when providing care to children; however, these have not been completely incorporated into primary health care. Objective: To know the difficulties for providing nutritional counseling and child growth follow-up, from a professional healthcare perspective. Method: Qualitative study, using Donabedian as theoretical framework, developed by 53 professionals in the field of primary health care. Data was obtained from focal groups and submitted to content analysis. Results: The main difficulties for nutritional counseling were clustered in the category of ‘perceptions and beliefs related to child feeding’. The ‘problems of infrastructure and healthcare’ and ‘maintenance of the hegemonic medical model’ are the main difficulties for following-up growth. Final considerations: Besides investments in infrastructure, healthcare training is indispensable considering beliefs and professional experiences, so in fact, nutritional counseling and child growth follow-up are incorporated in primary health care.


2010 ◽  
Vol 15 (1) ◽  
Author(s):  
Zelda Wasserman ◽  
Susanna C.D. Wright ◽  
Todd M. Maja

Low literacy can be described as the inability to read, write or use numbers effectively. The limited ability to read and understand health care instructions directly translates into poor health outcomes.The aim of this study was to assess the English literacy levels of primary health care patients using the Learning Ability Battery (LAB) and the adapted Rapid Estimate of Adult Literacy, Revised(REALM-R) and to determine how the results of the adapted REALM-R correlate with those of the LAB. Data were collected by means of a self-report whereby the participants had to answer the questions that were posed in the LAB and read the words out loud for the adapted REALM-R.The data analysis was performed by means of descriptive and inferential statistics, including the chi-square test and Spearman’s rho.The result of the study indicated that in South Africa, school grades achieved and the reading levels of primary health care patients differ with four grades.In terms of the correlation between the results of the adapted REALM-R and those of the LAB, a correlation of r = 0.43 (p < 0.001) could be established. Depending on the cut-off point used for the adapted REALM-R, 67% of the participants had low literacy levels. The study provides evidence of the importance of a validated, quick and easy-to-administer literacy screening tool. The effective assessment of patients’ literacy levels will assist registered professional nurses to provide health education on an appropriate level to improve patients’ health literacy. OpsommingLae geletterdheidsvlakke kan beskryf word as ’n persoon se onvermoë om doeltreffend te lees, te skryf of syfers te gebruik. Die beperkte vermoë om te lees en gesondheidsorgvoorskrifte te verstaan,gee direk tot swak gesondheidsuitkomste aanleiding. Die doel van hierdie studie was om die Engelse geletterdheidsvlakke van primêregesondheidsorg-pasiënte deur middel van twee instrumente,naamlik die Learning Ability Battery (LAB) en die aangepasde Rapid Estimate of Adult Literacy, Revised(REALM-R) te assesseer. Daar is voorts ook bepaal hoe die resultate van die aangepaste REALM-R met die LAB korreleer. Data is deur self-rapportering ingesamel, waar die deelnemers vrae uit die LAB-instrument moes beantwoord en spesifieke woorde vir die aangepaste REALM-R hardop te lees. Die data is ontleed deur gebruik te maak van beskrywende en inferensiële statistiek, met inbegrip van ’n chikwadraat-toets en Spearman se rho. Die resultate dui daarop dat die skoolgraad bereik en die leesgeletterdheid van die deelnemers in Suid-Afrika met vier grade verskil. Die korrelasie tussen die resultate van die LAB en die aangepaste REALM-R was r = 0.43 (p < 0.001).Na gelang van die afsnypunt wat vir die aangepaste REALM-R gebruik word, dui die resultate daarop dat 67% van die deelnemers lae geletterdheidsvlakke het. Die studie toon die belang van ’n geldige, vinnige instrument vir geletterdheidsifting. Die doeltreffende assessering van pasiënte se geletterdheidsvlakke kan geregistreerde verpleegkundiges help om gesondheidsonderrig op ’n toepaslike vlak aan te bied ten einde pasiënte se gesondheidsgeletterdheid te verbeter.


2018 ◽  
Vol 71 (suppl 1) ◽  
pp. 646-651 ◽  
Author(s):  
Dândara Nayara Azevêdo Dantas ◽  
Bertha Cruz Enders ◽  
Déborah Raquel Carvalho de Oliveira ◽  
Caroline Evelin Nascimento Kluczynic Vieira ◽  
Ana Angélica Rêgo de Queiroz ◽  
...  

ABSTRACT Objective: To identify social, clinical and behavioral factors of tuberculosis patients that are associated with delay in the search for primary health care. Method: This is a cross-sectional, quantitative study conducted with 56 people on treatment for pulmonary tuberculosis in the city of Natal, in the state of Rio Grande do Norte, Brazil. The data were collected through a structured instrument. The Chi-square and Fisher tests were applied to test the association between independent and dependent variables (search time). A value of p <0.05 was set as statistically significant. Results: No social or clinical variables were statistically associated with patient delays in the search for primary health care. Among the behavioral variables, self-medication and the first health service sought had a statistically significant association with the time for seeking care (p = 0.020, and p = 0.033, respectively). Conclusion: Self-medication contributes to the delay in the search for primary health care by tuberculosis patients.


2020 ◽  
Vol 54 ◽  
pp. 103
Author(s):  
Marco Antonio Vieira da Silva ◽  
Thaís Moreira São-João ◽  
Marilia Estevam Cornelio ◽  
Fábio Luiz Mialhe

OBJECTIVE: To evaluate the effect of implementation intentions as an intervention strategy to promote walking in adults with type 2 diabetes mellitus (T2DM). METHODS: We conducted a controlled and randomized trial, with 12 months of follow-up, involving 65 people with T2DM recruited from primary health care units and allocated them in the control group (CG, n = 32) and intervention group (IG, n = 33). The IG received the implementation intention strategy to promote walking and the CG remained in follow-up for conventional treatment in primary health care. The researchers were blinded by anthropometric measurements and the filling of the instruments. RESULTS: After twelve months of follow up, the IG presented a statistically significant increase in the leisure time physical activity when compared with the CG (p = 0.0413) and showed a significant decrease in waist circumference (p = 0.0061). No significant difference was observed regarding body mass index and glycated hemoglobin among groups. CONCLUSIONS: Implementation intention was effective in promoting walking and improving clinical indicators in adults with T2DM.


2022 ◽  
Vol 99 (12) ◽  
pp. 14-21
Author(s):  
L. V. Slogotskaya ◽  
E. M. Bogorodskaya ◽  
L. F. Shamuratova ◽  
T. A. Sevostyanova

The objective: to evaluate effectiveness of mass screening for tuberculosis infection in children aged 1 to 7 years in different periods – before and after the use of tuberculosis recombinant allergen skin test (TRA) in primary health care as an additional diagnostic method.Subjects and Methods. The study was designed as continuous observational prospective-retrospective study. Two different periods were assessed: the first one was 2014-2016 when screening for tuberculosis infection was performed in all children from 1 to 17 years (inclusive) using Mantoux test with 2 TU PPD-L in pediatric primary health care, and then children suspected to have a positive reaction were referred to TB dispensary where they were examined with a skin test with TRA if necessary. The second period was from 2018 to 2020 when children of 1-7 years old were given Mantoux test and if tuberculosis infection was suspected, a skin test with TRA was done both in primary health care network and TB units. In the first 3 years, 1,864,137 children were examined and in the second 3 years, 2,078,800 children from 1 to 7 years old were examined.Results. Among children of 1-7 years old who were screened by two stages (initial Mantoux test, and then in those who had a positive reaction, the TRA test was used), only 10-12% of those referred to a phthisiologist were subject to dispensary follow-up. Thus, with the implementation of the new edict on screening for tuberculosis infection in children with two tests, this proportion has not changed compared to previous years, when screening was carried out only with one Mantoux test. The reason why almost 90% of the children who were referred to TB Dispensary were not subject to dispensary follow-up is the following: children who have had previous conversion of tuberculin tests, along with everyone else are again screened with Mantoux test despite being previously followed up by TB dispensary due to the primary infection.Recommendations:Currently, there is no division of Group VI into Subgroups A, B, C in the dispensary follow up grouping. Why should conversion of Mantoux test reaction from negative into positive not be considered an infection, and the increase in the reaction must be at least 6 mm.Since Order No. 124n of the Russian Ministry of Health allows testing with TRA in the primary health care in case of suspected infection, it is advisable to refer those who have already had this test to a phthisiologist.A child with conversion of Mantoux test should not be re-screened with Mantoux test but the TRA test should be used. If a positive reaction to the TRA test occurs for the first time, it should be considered as conversion of this test, and in this case the child should be examined by computed tomography (CT), and preventive therapy should be prescribed. If in subsequent years the TRA reaction increases by at least 6 mm after previous preventive therapy, the child should be re-referred for CT to rule out the development of active tuberculosis.


2021 ◽  
Author(s):  
Melchor Riera ◽  
Adria Ferre ◽  
Alfredo Santos-Pinheiro ◽  
Helem Hayde Vilchez ◽  
Maria Luisa Martin-Peña ◽  
...  

Abstract Background: There are few shared assistance programs with Primary Health Care (PHC) in PLWH. The aim was to develop a Pilot Program of shared HIV care in PLWH ensuring proper HIV control. Methods: Design: Prospective pilot project of a shared care intervention.Setting: HIV specialized outpatient consultations for HIV infection at Son Espases University Hospital which serves 2000 patients. Subjects: Patients who attended HIV specialized consultation between January 1st and June 30th, 2017. Intervention: Basal questionnaire on health services used by patients. HIV Training Program on HIV in Primary Health Care (PHC). Pilot Program of shared assistance (PPAC) with PHC. Main Outcomes: Maintenance of undetectable HIV viral load, antiretroviral therapy (ART) adherence, AIDS and non-AIDS events, loss of follow up, and satisfaction questionnaire. Results: The basal questionnaire was filled out by 918 patients, with 108 (11.7%) patients reporting neither knowing nor having been visited by their GP. A total of 93 patients were included in the PPAC, with a mean age of 49.9 years (SD 11.7), and an average of 14.6 years since the HIV diagnosis. Eleven patients were followed up for less than six months and were excluded from the analysis. Median follow-up during the PPAC of the remaining 82 patients was 728 days (IQR 370-1070). Sixteen patients dropped out of the PPAC (19.5%), three died, three were lost to follow up, one was withdrawn due to medical criteria, and nine withdrew voluntarily.No patient presented any AIDS defining events, although eight patients presented non-AIDS events. All the patients had undetectable viral load (VL) and average ART adherence was 99.4% (SD1.4). The patient’s satisfaction score with PPAC was 8.64 (SD2.5).Conclusion: It is possible to establish shared care programs with PHC in selected patients with HIV infection, thereby reducing hospital visits while maintaining good adherence and virological control and achieving high patient satisfaction.


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