Beatriz Rosana Gonçalves de Oliveira Toso

Resolutividade na atenção à saúde da criança: percepção de pais e cuidadores

OBJECTIVE: Understand how the health problems of a child are solved in the perspective of parents and caregivers, based on the attributes of primary health care. METHODS: Qualitative study using a hermeneutic-dialectic approach involving 16 caregivers of children younger than one year old, assisted at an emergency unit. RESULTS: Lack of access, absence of bonding and coordination, and comprehensive care deprivation contribute to the lack of resolvability, leading to a search for alternatives to solve the health problems of children. CONCLUSION: As observed, primary health care services demonstrate no problem-solving capacity in childrens health problems, as the essential attributes for the effectiveness of such care were not present.

Avaliação dos atributos de orientação familiar e comunitária na saúde da criança

Objetivo Identificar a extensao dos atributos da orientacao familiar e orientacao comunitaria na atencao a saude da crianca nos servicos de atencao primaria. Metodos Estudo quantitativo, transversal, do tipo avaliativo. Foram aplicados 548 questionarios PCATool - Instrumento de Avaliacao da Atencao Primaria - Brasil versao crianca aos familiares e/ou cuidadores de criancas menores de 12 anos atendidas em 24 unidades de saude, sendo os dados analisados no programa SPSS 17.0. Resultados Os servicos basicos de saude publica do municipio estudado possuem um percentual abaixo do considerado ideal para a atencao primaria a saude nos atributos de orientacao familiar e orientacao comunitaria. O escore desses atributos foram 4,4 e 5,1, respectivamente, sendo considerados satisfatorios valores de escore ≥ 6,6. Conclusao Identificou-se a dificuldade dos servicos em integrarem a familia e a comunidade no processo de cuidado, fortalecendo a cultura de assistencia curativa e centrada no individuo.

Avaliação da longitudinalidade em unidades de Atenção Primária à Saúde

Estudo para avaliar a efetividade da Atencao Primaria a Saude direcionada a criancas, por meio do atributo longitudinalidade, em unidades de saude com e sem Estrategia Saude da Familia em municipio do Oeste do Parana. Pesquisa quantitativa, descritiva, com utilizacao do instrumento de coleta de dados PCATool-Brasil, versao crianca, aplicado a 61 familiares de criancas menores de 12 anos. A longitudinalidade foi mais bem avaliada na Unidade Basica de Saude no tocante a saude da familia, demonstrando a necessidade de mudancas profundas no processo de trabalho das Unidades de Saude da Familia para melhoria da qualidade da atencao e efetiva implementacao das diretrizes propostas pela Estrategia.

Caregivers and implications for home care

Investigacion exploratoria descriptiva de abordaje cualitativo, con el objetivo de aprehender la experiencia de los cuidadores, la practica de los equipos de atencion domiciliaria y la contribucion de asistencia domiciliaria a la continuidad de la atencion. Los datos fueron colectados por medio de entrevista semiestructurada, aplicada a diez cuidadores. Los testimonios fueran sometidos a un analisis de contenido en la modalidad de analisis tematica, acerca de la cual se emergio tres tematicas: decision para el cuidado, cotidiano de los cuidados y la dimension social del cuidado en el contexto de la atencion domiciliaria. Entre los cuidadores se identifico baja renta y escolaridad, dependencia severa de los sujetos cuidados y dificultades de los equipos de Atencion Domiciliaria para suministrar los recursos materiales. Hubo sobrecarga moderada y de moderada a severa en 60% y 40% de los cuidadores, respectivamente, y privacion de actividades sociales. Por las condiciones socioeconomicas el cuidado presento fragilidades y falta de dominios.

O acesso e a dificuldade na resolutividade do cuidado da criança na atenção primária à saúde

ObjectiveTo learn how access is conducted in two primary care units, traditional and family health strategy, and assess whether there was resoluteness of assistance to child health.MethodsThis is a qualitative study, we used hermeneutic for understanding the data. The research instrument was non-participant observation technique; the data were analyzed using thematic analysis method.ResultsThere are four sub-categories: children, their family members and the first contact in primary care; the service organization and its influence on access; the therapeutic itinerary of the family and child in search of health care; scheduled access to health care.ConclusionAccess to health services showed weaknesses regarding the child health care and the proposed care service could build stable relationships and humanized care to child demand in primary health care.

Validação de protocolo de posicionamento de recém-nascido em Unidade de Terapia Intensiva

RESEARCH OBJECTIVE to verify the positioning indications of newborn sand build a standard operating procedure protocol for newborn positioning in Neonatal Intensive Care Unit (NICU). METHOD for protocol validation, the Delphi technique was used ,in which expert nurses in the field reviewed the proposed procedure. RESULTS we present the results of this validation in a protocol form, to contribute to the discussion about newborn positioning in NICU and standardization of nursing care related to positioning. We evaluated ten indicators, in which there was agreementof100.0% in seven, and of80% in three, above the 60% recommended by the validation technique. CONCLUSION given the importance of newborn positioning in NICU for its neuromuscular development, this study contributes to the adoption of an evidence-based practice for nursing.

Orientação familiar e comunitária segundo três modelos de atenção à saúde da criança

Objective To assess the attributes family-centeredness and community orientation according to three Primary Health Care models for children. Methods Cross-sectional and quantitative assessment study, involving 1,484 family members and/or caregivers of children younger than ten years of age attended in different primary health care models. The attributes family-centeredness and community orientation were assessed using the Primary Care Assessment Tool - Brazil, child version. For comparative analysis, Kruskal-Wallis and Dunnett’s test were used. Results Separately, all Primary Health Care models scored unsatisfactorily for the attributes assessed. When compared, a statistically significant difference was found for the attributes derived, favoring the Family Health Strategy models over the traditional model. Conclusion The Family Health Strategy models scored higher for family-centeredness and community orientation. Their principles can contribute to reorient primary health care in the mixed model.

Longitudinality in childcare provided through Family Health Strategy

OBJECTIVE To evaluate the longitudinality attribute in childcare provided through the Family Health Strategy. METHOD Quantitative survey performed with 344 caregivers of children below 10 years old, registered in the family health strategy of Distrito Sanitario III in João Pessoa, Paraiba. Data were collected from July to December, 2012, from the Brazil PCATool child version form and analyzed using descriptive statistics. RESULTS Among the aspects evaluated, it is highlighted that 89.5% of caregivers said they were consulted by the same professionals, and 81.9% felt good talking to the professional. The average score for the longitudinality component was satisfactory, with a 6.6 value. CONCLUSION The health facilities assessed are guided towards the longitudinality attribute, however, the target mean score was exactly the cutoff value, implying the need for a thoughtful look at the improvement of the attribute in the care of children under ten years.

Validação da escala Índice de Estresse Parental para o português do Brasil

Objective : To present the cultural adaptation and validation of the Parenting Stress Index for Brazilian Portuguese. Methods : Methodological research. For the validation, the scale was applied to 53 mothers of premature infants at the outpatient monitoring clinic of a public teaching hospital in Parana between November 2013 and July 2014. For the data analysis, descriptive and inferential statistics were used. Results : The reliability was satisfactory for the complete scale (α=0.91) and the domains: Child domain (α=0.87) and parents’ domain (α=0.88). The principal components explained 64.57% of total item variation, being 45.16% from the child’s domain and 17.80% from the parents’ domain. Conclusion : The scale was appropriate to assess maternal stress after hospital discharge, endorsing its use in the Brazilian context in new studies to enhance its reliability and validity.

A integralidade na assistência à saúde da criança na visão dos cuidadores

O artigo identifica o atributo integralidade e elementos do cuidado integral para resolucao de problemas de saude das criancas na percepcao de seus cuidadores. Pesquisa qualitativa, baseada na hermeneutica-dialetica, composta por 16 entrevistas e mapas falantes. Verificou-se: a assistencia a saude da crianca com um olhar focado na doenca, mas que o olhar para alem do biologico comeca a emergir; o cuidado centrado no exito tecnico em busca do sucesso pratico; a inexistencia de tecnologias leve-duras e duras para o cuidado. A parcialidade da integralidade levou a nao resolutividade dos problemas de saude infantil, demonstrando a necessidade de transformar o modo de pensar e fazer saude.