Navegando por Assunto "Primary health care"

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Acesso aberto (Open Access)
Abordagem nutricional em pessoas com Diabetes Mellitus Tipo 2: protocolo para nutricionistas da atenção primária à saúde
(Universidade Federal do Pará, 2023-12-13) QUEIROZ, Samara da Silva; CARVALHAL, Manuela Maria de Lima; http://lattes.cnpq.br/0708921042608519; HTTPS://ORCID.ORG/0000-0003-1397-0471; GOMES, Daniela Lopes; http://lattes.cnpq.br/0014255351015569
The nutritionist plays an important role in Primary Health Care (PHC) to promote Food and Nutritional Education (FNE) to users with DM2, aiming to achieve better glycemic management, mitigate complications arising from the disease and offer an improvement in the quality of life of these people. Therefore, this work aims to develop a protocol for nutritional management with a focus on DM2 to be used by nutritionists working in PHC. This is a methodological, developmenttype study, divided into three phases: bibliographical survey; preparation of illustrative material and validation of content, appearance and applicability of the material by expert judges and APS nutritionists. To prepare the protocol, an integrative review was carried out to define the content based on the needs found by PHC nutritionists. For validation, two instruments were used in electronic format: a form for content validation and another for apparent validation. The data obtained was compiled and stored in the Microsoft Office Excel version 2016 program. For data analysis, the Content Validity Index (CVI) was applied to the panel of experts. In the analysis of data judged by the target audience, items with a minimum level of agreement of 75% in positive responses were considered validated. This study is part of the project entitled “Creation and validation of protocols for associated interventions to control Diabetes Mellitus in primary health care” and all ethical aspects were respected, in accordance with Resolution 466/12, of the National Health Council. In validation content, the overall CVI average was 0.92, indicating an excellent degree of agreement among experts. Regarding validation with the target audience, a degree of agreement greater than 75% was obtained. At the end, the material was reviewed, adapting the protocol and creating illustrations. Given the above, it is concluded that the tool was validated, which attests to the effectiveness, relevance and applicability of the technology.
Acesso aberto (Open Access)
Assistência pré-natal e puerpério no âmbito da atenção básica no Brasil
(Universidade Federal do Pará, 2023-07-10) SOUSA, Dimauro Soares de; RODRIGUES, Diego Pereira; http://lattes.cnpq.br/8470989067617455; https://orcid.org/0000-0001-8383-7663; CUNHA, Carlos Leonardo Figueiredo; http://lattes.cnpq.br/9603271880856443; https://orcid.org/0000-0002-1891-4201
Recognizing Primary Care as the preferential gateway to public health services and its role in organizing care, investigating prenatal and puerperal care is essential for measuring its reach and quality, in order to provide subsidies for making decisions based on the results. Objectives: To analyze prenatal and postpartum care within the scope of Primary Care in Brazil. Methodology: This is a research with a quantitative and analytical approach. Brazil is the reference for this study. The variables related to the External Evaluation of the third cycle of the National Program for Improving Access and Quality of Primary Care were used for the research, Module II – Interview with the professional, coordinated by the ministry of health, from 2017 to 2018, which includes interviews with key informants. Teams were categorized by federative units and geographic regions, and data analysis were done using descriptve statistics, using absolute and relative frequency. All analyzes were done in IBM SPSS Statistics Software, version 20.0, and presented in the form of charts, graphs and figures. Results: The collection of data for the External Assessment that make up the second phase of the third cycle of the National Program for Improving Access and Quality in Primary Care, had the adhesion of 5.324 cities (95,6%). A total of 38,865 primary care teams in Brazil were evaluated, of these 36.702 (98,30%) teams perform prenatal consultations, 35.771(97,50%) presente a document proving the prenatal consultation, 36.433 (99,3%) of the primary care teams use the pregant woman’s handbook to monitor the pregnat women and 34.096(92,90) of those teams have a copymirror of the pregnant women’s handbook, or another form with equivalent information, at the Basic Health Unit. Regarding to the actions carried out by the team to guarantee the postpartum consultation up to one week after the childbirth, all of the brazilian regions have low rates of consultation at special times, in which any day of the week, with 65.4% adherence in this aspect. Conclusion: The results suggest that there are differences in prenatal and puerperal care in Brazilian regions. These results can be useful for other studies and for strengthening reginal planning actions. For managerial practice, the assistance during the prenatal and postpartum period must be repeatedly discussed.
Acesso aberto (Open Access)
Enfermeiros da região amazônica brasileira e o acesso à informação na atenção primária à saúde
(Universidade Federal do Pará, 2023-11-09) FERREIRA, Evellyn de Paula Moraes; OLIVEIRA, Marília de Fátima Vieira de; http://lattes.cnpq.br/7030765721580568; https://orcid.org/0000-0003-4303-9434
The study aims to analyze the access to information on Primary Health Care (PHC) by nurses from the Brazilian Amazon Region. The research is part of the macro project Nursing Practices in the Context of Primary Care: a national study of mixed methods and its data were collected from November 2019 to August 2021. The participants were 626 nurses, who work in PHC in the Northern Region. For data collection, an electronic questionnaire was used, with closed questions, whose data were stored in the Microsoft Excel program. The chi-square test was used to evaluate differences in the proportion of access to information between the states of the North Region, by which the two states with lower coverage (Amapá and Pará) were compared to each other and then to the others. Also, the chi-square partition test was applied and, for the variables that presented statistical significance, the residue test was used, considering a residual value equal to or greater than 1.96 for p < 0.05. These analyzes were performed using the program bioestatₒ and the resulting data were presented in the form of tables. The study was approved by the Research Ethics Committee (CEP) of the University of Brasília under opinion no. 4.263.831 and CEP of the Federal University of Pará under opinion no: 4.520.687. When comparing the states of the Northern Region with Pará and Amapá, which have lower PHC coverage, the following results: Roraima has a higher proportion of nurses who access information on Primary Health Care by printed means (p = 0.0177); Amazonas (p < 0.0001), Rondônia (p = 0.0049), Roraima (p = 0.0288) and Tocantins (p = 0.0014) have higher proportions of nurses who access information in the workplace; Amazonas nurses access less information published in scientific journals (p = 0.0388); nurses in Roraima have a higher proportion of access to information from specialized books (p = 0.0247); and nurses in Rondônia (p = 0.0373) and Roraima (p = 0.0357) have greater access to information from government sources. The access to information and resources by the nurses of the PHC of the Brazilian Amazon participating in the research, involve a combination of specific training, cooperation with health networks, partnerships with organizations and access to online portals and specialized publications, elements that contribute to the continuous training of nurses and that improve the quality of health care offered in the Brazilian Amazon.
Acesso aberto (Open Access)
Hanseníase e atenção primária à saúde: uma avaliação de estrutura do programa
(Centro Brasileiro de Estudos de Saúde, 2017-03) SOUSA, Gutembergue Santos de; SILVA, Rodrigo Luis Ferreira da; XAVIER, Marília Brasil
Objective: to evaluate the structure of the municipal program of leprosy control in Canaã dos Carajás (Pará), in the context of Primary Health Care. Methods: this is an assessment of health programs, focusing on leprosy, targeting managers of the leprosy program and managers of health facilities of primary care. Two different questionnaires, developed specifically for this purpose, were used. Conclusion: the municipality in question has a structure classified between poor and regular, showing several weaknesses in the assessed program for the care of leprosy.
Acesso aberto (Open Access)
Práticas de enfermagem no processo de trabalho na atenção primaria à saúde: desafios no contexto da pandemia da COVID-19 na região norte do Brasil
(Universidade Federal do Pará, 2023-11-01) REIS, João Paulo Monteiro dos; FERREIRA, Glenda Roberta Oliveira Naiff; http://lattes.cnpq.br/7459094802051187; https://orcid.org/0000-0002-8206-4950
Objective: To understand the challenges related to the work process and nursing practices in PHC faced by nurses during the covid-19 pandemic in the Amazon region. Methods: Observational study, with a qualitative cross-sectional design carried out in four states in the northern region: Pará, Acre, Rondônia and Roraima, located in the Brazilian Amazon. The collection instrument was a semi-structured interview where the participants were nurses who worked in care or management in primary health care units. The interview data were processed using Bardin's content analysis and the IRaMuTeQ software version 0.7 alpha 2. Results: The average age of the research participants was 40.8 years, the majority were women, 66.7% were mixed race , 30% white, 3.3% black and one nurse did not declare their color. Based on the analysis carried out by the software, the corpus was fragmented into 651 text segments, representing 84.94% of the interview content, resulting in three thematic categories and one subcategory: category 1- The impact of covid- 19 in the assistance of professional nurses; Subcategory 1: nursing care for priority groups during covid-19 category; 2- Nurse care in PHC during covid-19; Category 3- the challenges and biopsychosocial aspects of professional nurses in facing Covid-19. Conclusion: Nurses faced several challenges during the covid-19 pandemic period, such as a substantial increase in demand for healthcare, placing an intense workload on nurses who worked during this period in the Amazon region. There was a need to quickly adapt to new care protocols, including screening, testing and monitoring of patients with Covid-19. A significant transformation was triggered in the way nurses carried out their work, with the internet playing a crucial role in this new work process. There was a significant impact on the biopsychosocial health of nurses.
Acesso aberto (Open Access)
Práticas individuais e coletivas dos enfermeiros na atenção primária à saúde: um panorama da região norte do Brasil
(Universidade Federal do Pará, 2023-10-31) VELOSO, Caroline de Morais Zanchin; FERREIRA, Glenda Roberta Oliveira Naiff; http://lattes.cnpq.br/7459094802051187; https://orcid.org/0000-0002-8206-4950
INTRODUCTION: territorial characteristics, with an emphasis on the geography of the North region, require individual and collective practices in the work of Primary Health Care nurses that meet the peculiarities of the populations that inhabit this territory. OBJECTIVE: to analyze individual and collective practices that are associated with the dificulties of nurses working in Primary Health Care in the North region. METHOD: mixed methods study carried out with Primary Health Care nurses in the North region, between November 2019 and August 2021, using an electronic form and interview. The data were analyzed using the Bioestat program and the IRaMuTeQ® software, using Bardin's thematic content analysis. RESULTS: 626 nurses participated in the quantitative stage and 31 in the qualitative stage. Difficulty in carrying out practices was described by 15.7% (98/626) of nurses. Four categories were identified in the qualitative analysis: professional autonomy in their activities; need for a prescription from another professional to complete a service; work facilities; difficulties at work. Among collective practices, there was an association between difficulty and participation in the management of inputs (p = 0.03), but it was evident from the interviews that the nurse participates in the request for technical material, but does not receive it as requested. In individual practices, there was an association between the difficulty in carrying out a consultation (p = 0.03) and the prescription of medications (p = 0.02). The qualitative analysis demonstrates that the nurse needs a prescription from another professional to complete a service he started. The association between difficulty and resolution showed significance between prenatal consultation (p = 0.000), activities to monitor child growth and development (p= 0.001; 25%) and family planning (p= 0.000; 25.7%) . However, these are practices that nurses report that they exercise with greater autonomy. The association of difficulty with caring for hypertensive patients (p <0.0001) and diabetics (p<0.0001) also showed insufficient resolution. In these activities, the nurse describes needing the doctor to prescribe medications and complete the care. CONCLUSION: The work carried out by primary health care nurses requires the continuous improvement of these professionals' skills and abilities, especially with regard to nursing consultations and medication prescriptions. The implementation of nursing protocols and continuing education help in the development of professional autonomy, aiming at the quality of the service and the resolution of the assistance provided to users.
Acesso aberto (Open Access)
Programa de controle do tabagismo na Amazônia brasileira, Castanhal-PA: contexto interdisciplinar, efetividade e adesão
(Universidade Federal do Pará, 2023-12-29) BRAGA, Luane Rafaela Barbosa; CUNHA, Janice Muriel Fernandes Lima da; http://lattes.cnpq.br/4027012189701116
This study analyzes the effectiveness of the National Tobacco Control Program (NTCP)'s effectiveness in Castanhal-PA, a Brazilian Amazon city. The program was implemented in 2006 and underwent decentralization in 2018. However, in the context of the Unified Health System (SUS) in the Amazon study, the effective implementation of the tobacco control program is filled with difficulties. So, we analyze the program's offering and retention rates, smoking cessation, population of smoking clients, treatment initiation and completion percentage, and association between sociodemographic variables and treatment outcomes. The study analyzed smoking users through FORMSUS forms from 32 Health Units that had anti-smoking treatment from January 2021 to December 2022. We used linear regression and retrospective descriptive statistical analysis. We also apply the chi-square test to check for differences. We visualized and analyzed the data using Microsoft Office® Excel. A sample of 227 individuals was studied in 2021 and 2022. Most participants were female (60.9%) and 60 or older (40.0%). About 47.9% reported having 02 to 03 minimum wages. Smoking was prevalent, with 40% smoking more than 04 cigarettes per day and 116 individuals smoking for more than 20 years. There was a high dropout rate from the NTCP in both years (71.87% and 70.99%). The variables "family income" and "race/color" were statistically associated (p-value = 0.0001). Implementing the NTCP varies by location, and units with the highest success rates can be used as best practice examples to improve access and achieve smoking cessation goals across the municipality. Regional peculiarities and logistical obstacles impact the success of the PNAB and PNCT in the Amazon context.
Acesso aberto (Open Access)
Projeto (s) indutor (es) da integração ensino e serviço: impacto no processo de formação e no cotidiano do trabalho
(Universidade Federal do Pará, 2021-06-16) ROSA, João Victor Moura; LOPES, Márcia Maria Bragança; http://lattes.cnpq.br/6740484061412959
The teaching-learning process established from the integration between teaching and service through the insertion of students in the health service can lead to new ways of work organization in health, favoring a better qualification for the service. In this context, the Training Program in Child Health Care - Multicampi Health Internship in the Federal University of Pará - UFPA is inserted, which seeks the qualification of management processes in training for care, teaching-service-community integration, in an articulated manner between the Sistema Único de Saúde – SUS and the educational institution, whose objective was to identify the impacts observed in the daily work and in the training of nursing students who participate in projects that promote the integration of teaching and service. It was used as theoretical support Yin, Strauss; Corbin. The guidance for analyzing the collected material was given through interpretive readings on Integration Teaching and Service Yin (2015). The analysis of interviews was based on Strauss and Corbin, (2008) where they were based on Teoria Fundamentada nos Dados (TFD). The results showed the contribution of the inductor project object of this research to the education of nursing students, as the experience acquired in the service strengthened their education. Being inserted in Inductor Projects reinforced the practice of Nursing Course at UFPA, which introduces its students early in the field of practice, contributing positively to their training. In general, there is a positive impact on the training process and on the daily work, understanding the inductive role and why not say transformative of the Multicampi health Project, considering its impact on the quality of education and care provided to the user, as well as its power of reflection, on part of professional preceptor, as to the importance of praxis in the quality of life of the assisted population. Regarding the contribution of this research, it is believed that its realization will contribute both to the educational Institution, particularly the Nursing Course at UFPA, as to the Municipal Health Department of Belém, since it brings in its result, indicators that demonstrate the positive impact effect of Inductor Projects in the quality of care, involving educational institutions, health services and users of the Sistema Único de Saúde, providing an important indicator for the expansion of strategies such as the Multicampi Health Project in other municipalities and regions of the State of Pará.