Erika Simone Galvão Pinto

Situação de trabalho dos profissionais da Estratégia Saúde da Família em Ceará-Mirim

O objetivo deste estudo foi analisar as situacoes de trabalho vivenciadas pelos profissionais da Estrategia Saude da Familia (ESF). Estudo descritivo realizado em Ceara-Mirim, Rio Grande do Norte, em 2007. A populacao constituiu-se de 190 profissionais da ESF, na qual foi aplicada um questionario com questoes fechadas. Os resultados apontaram que o conhecimento da area geografica adstrita pelos profissionais da ESF foi considerado como um aspecto positivo para a realizacao das atividades executadas por 83,2% dos profissionais, e o numero de familias acompanhadas por equipe foi considerado como uma dificuldade por 40,5%. Em relacao as condicoes de trabalho, 93,2% referiram a presenca de profissionais com perfil em saude publica, e 86,8%, indisponibilidade de equipamentos e instrumentos. Dos profissionais que trabalham exclusivamente na ESF, 74% sao agentes comunitarios de saude. O compromisso e a responsabilidade para substituir as praticas tradicionais de assistencia devem ser de todos, havendo a necessidade de interacao de fatores historicos, politicos, sociais, economicos e culturais.The purpose of this study was to analyze the work situations experienced by Family Health Strategy (FHS) professionals. This descriptive study was performed in Ceará-Mirim, Rio Grande do Norte state, in 2007. The population consisted of 190 FHS professionals, in which a questionnaire with closed-questions was applied. The results showed that 83.2% of the professionals consider that knowing the geographical area under their responsibility is a positive aspect that helps performing their activities, while 40.5% consider the number of families that each team has to follow to be a difficulty. Regarding work conditions, 93.2% reported the presence of professionals with a public health profile and 86.6% reported there is a lack of equipment and instruments. Of professionals who work exclusively with the FHS, 74% are community health agents. The commitment and responsibility to replace the traditional care practices should concern everyone, and there is a need for an interaction between historical, political, social, economic, and cultural factors.

Atraso na busca por serviço de saúde para o diagnóstico da tuberculose em Ribeirão Preto (SP)

The scope of this paper is to analyze delays in locating health services for the diagnosis of tuberculosis in Ribeirao Preto in 2009. An epidemiological and cross-sectional study was conducted with 94 TB patients undergoing treatment. A structured questionnaire, based on the Primary Care Assessment Tool adapted for TB care was used. A median (15 days or more) was established to characterize delay in health attendance. Using the Prevalence Ratio, the variables associated with longer delay were identified. The first healthcare services sought were the Emergency Services (ES) (57.5%). The longest period between seeking assistance occurred among males, aged between 50 and 59, who earned less than five minimum wages, had pulmonary TB, were new cases, were not co-infected with TB/HIV, did not consume alcohol, had satisfactory knowledge about TB before diagnosis (with a statistically significant association with delay) and who did not seek healthcare close to home before developing TB. There is a perceived need for training healthcare professionals about the signs and symptoms of the disease, reducing barriers of access to timely diagnosis of TB and widely disseminating it to the community in general.

Effectiveness in the diagnosis of tuberculosis in Foz do Iguaçu, the triple-border area of Brazil, Paraguay and Argentina

This study sought to assess the effectiveness of health services in the diagnosis of tuberculosis in Foz do Iguaçu-PR, the triple border region of Brazil, Paraguay, and Argentina. In this epidemiologic, cross-sectional study, 101 persons with tuberculosis were interviewed in 2009 by using an instrument based on the Primary Care Assessment Tool . The analysis was based on proportions and respective 95% confidence intervals (95%) and means. Emergency units (37%) and primary health care units (26%) were the most sought units. Access to medical consultation on the same day reached 70%, but tuberculosis was suspected in less than 47% of patients; bacilloscopy was conducted in 50% of patients. We conclude that although these services provide rapid care, they do not determine the true diagnosis and lead the patient to seek specialized services. Specialty services are more effective in establishing the correct diagnosis. In the triple border region, seeking care at a primary health care unit led to extra time and more returns to the hospital for a tuberculosis diagnosis.Este estudio tuvo como objetivo evaluar la efectividad de los servicios de salud en el diagnostico de la tuberculosis en Foz de Iguazu - Parana. Se realizo una investigacion evaluativa con un diseno epidemiologico transversal. Fueron entrevistados 101 pacientes con tuberculosis en el 2009, utilizando un instrumento basado en la Herramienta de Evaluacion de la Atencion Primaria . El analisis se produjo a partir de proporciones y los respectivos intervalos de confianza (95%) y la mediana. La atencion de emergencia (37%) y la Atencion Primaria de Salud (ABS) (36%) fueron los locales mas buscados. El acceso a la consulta en el mismo dia llego a 70%, pero la sospecha de la enfermedad fue menor que 47%; baciloscopia fue realizada en el 50% de los pacientes. Se concluyo que, si bien estos servicios atienden rapidamente, eso no determino el alcance del diagnostico, llevando al paciente a buscar los Servicios Especializados mas efectivos en la deteccion de los casos. La busqueda de la ABS genero mayor tiempo y numero de retornos para el diagnostico de la tuberculosis en la triple frontera.

Efetividade no diagnóstico da tuberculose em Foz do Iguaçu, tríplice fronteira Brasil, Paraguai e Argentina

This study sought to assess the effectiveness of health services in the diagnosis of tuberculosis in Foz do Iguaçu-PR, the triple border region of Brazil, Paraguay, and Argentina. In this epidemiologic, cross-sectional study, 101 persons with tuberculosis were interviewed in 2009 by using an instrument based on the Primary Care Assessment Tool . The analysis was based on proportions and respective 95% confidence intervals (95%) and means. Emergency units (37%) and primary health care units (26%) were the most sought units. Access to medical consultation on the same day reached 70%, but tuberculosis was suspected in less than 47% of patients; bacilloscopy was conducted in 50% of patients. We conclude that although these services provide rapid care, they do not determine the true diagnosis and lead the patient to seek specialized services. Specialty services are more effective in establishing the correct diagnosis. In the triple border region, seeking care at a primary health care unit led to extra time and more returns to the hospital for a tuberculosis diagnosis.Este estudio tuvo como objetivo evaluar la efectividad de los servicios de salud en el diagnostico de la tuberculosis en Foz de Iguazu - Parana. Se realizo una investigacion evaluativa con un diseno epidemiologico transversal. Fueron entrevistados 101 pacientes con tuberculosis en el 2009, utilizando un instrumento basado en la Herramienta de Evaluacion de la Atencion Primaria . El analisis se produjo a partir de proporciones y los respectivos intervalos de confianza (95%) y la mediana. La atencion de emergencia (37%) y la Atencion Primaria de Salud (ABS) (36%) fueron los locales mas buscados. El acceso a la consulta en el mismo dia llego a 70%, pero la sospecha de la enfermedad fue menor que 47%; baciloscopia fue realizada en el 50% de los pacientes. Se concluyo que, si bien estos servicios atienden rapidamente, eso no determino el alcance del diagnostico, llevando al paciente a buscar los Servicios Especializados mas efectivos en la deteccion de los casos. La busqueda de la ABS genero mayor tiempo y numero de retornos para el diagnostico de la tuberculosis en la triple frontera.

Estudos de avaliação das intervenções de saúde na escola: revisão integrativa de literatura

1 Doutorando, Departamento de Enfermagem, Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil. Bolsista do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brasil. 2 Especialista em Cardiologia e Hemodinâmica, Aluna do curso de Especialização em Saúde Pública: Enfermagem Oncológica, Escola da Assembleia Legislativa do Rio Grande do Norte, Natal, RN, Brasil. 3 Especialista em Enfermagem do Trabalho, Aluna do curso de Especialização em Docência no Ensino Superior, Escola de Saúde, Universidade Potiguar, Natal, RN, Brasil. 4 Especialista em Enfermagem em Urgência, Emergência e Trauma, Aluna do curso de Especialização em Saúde Pública, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil. 5 Mestranda, Departamento de Enfermagem, Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil. 6 PhD, Professor Adjunto, Departamento de Enfermagem, Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil. Estudos de avaliação das intervenções de saúde na escola: revisão integrativa de literaturaABSTRACT Objective: to identify and analyze the available evidence on the strategies used in the studies evaluating health interventions at school. Method: this is an integrative review searching in LILACS, CINAHL, CUIDEN, ScienceDirect, and PubMed. From the pre-defined inclusion and exclusion criteria, there were 121 articles chosen to compose the sample. Results: english studies (97.5%), with a quantitative approach (80.2%), related to the interventions carried out in the Region of the Americas (54.6%) and the European Region (23.1%) predominated. For the most part, they are interventions as programs (70.2%), interested in evaluating results (73.5%) from the value judgment (83.4%). Prevalence of interventions focused on efficacy, effects or impact, and activities carried out on interventions were focused on physical activity, healthy eating, sexual and reproductive health, mental health, and use of tobacco, alcohol, and other drugs. They are worked through activities of clinical monitoring, health promotion and disease prevention. Conclusion: the evidence indicates that the evaluations of health interventions in the school focus the results produced in programs through the judgment of value. The topics most addressed were healthy eating, physical activity, prevention of alcohol and other drugs, among others.

Experience and professional training in the School Health Program

OBJECTIVE To analyze the association between experience and professional training in the School Health Program. METHOD Descriptive, inferential, quantitative and normative study. The data were collected from May to July 2017 through a questionnaire based in the School Health Program, with the participation of professionals from the Family Health Strategy. RESULTS 105 professionals participated in the study. The average time working in the Family Health Strategy and in the School Health Program is 12.1 and 7.2 years, respectively. 94.3% of the professionals feel qualified to perform the activities of the School Health Program, although only 30.5% have participated in training. There is statistical association between experience and professional training. CONCLUSION The professionals who conduct activities in the School Health Program undergo few training processes, but feel qualified to carry out the activities proposed.

Coordination of health care with the community in the clinical management of tuberculosis

OBJECTIVE determine the coordination of Primary Health Care with community resources in the clinical management of tuberculosis. METHOD descriptive study, of quantitative approach, with participation of one hundred health professionals. Part of a questionnaire was used in evaluating local institutional capacity for the model of chronic conditions care, adapted for tuberculosis care. RESULTS the coordination between health units, individuals with tuberculosis, and community organizations; the partnerships between institutions and local health councils/committees showed limited capacity. On the other hand, the component for the participation of the Community Health Agent presented more favorable capacity. CONCLUSION the municipality has unfavorable capacity for coordination of health units and the community. It is reinforced the need to promote these coordinations in search of symptomatic cases in the communities, in the directly observed treatment, and in promoting the association between different social actors.

Clinical information systems for the management of tuberculosis in primary health care

ABSTRACT Objective: to analyze the clinical information systems used in the management of tuberculosis in Primary Health Care. Method: descriptive, quantitative cross-sectional study with 100 health professionals with data collected through a questionnaire to assess local institutional capacity for the model of attention to chronic conditions, as adapted for tuberculosis care. The analysis was performed through descriptive and inferential statistics. Results: Nurses and the Community Health Agents were classified as having fair capacity with a mean of 6.4 and 6.3, respectively. The city was classified as having fair capacity, with a mean of 6.0 and standard deviation of 1.5. Family Health Units had higher capacity than Basic Health Units and Mixed Units, although not statistically relevant. Clinical records and data on tuberculosis patients, items of the clinical information systems, had a higher classification than the other items, classified as having fair capacity, with a mean of 7.3 and standard deviation of 1.6, and the registry of TB patients had a mean of 6.6 and standard deviation of 2.0. Conclusion: clinical information systems are present in the city, mainly in clinical records and patient data, and they have the contribution of professionals linked with tuberculosis patients.Objetivo: analizar los sistemas de información clínica utilizados en el manejo de la tuberculosis em la Atención Primaria de Salud. Método: estudio transversal, descriptivo y cuantitativo, realizado con 100 profesionales de salud con datos recogidos a partir de un cuestionario para evaluar la capacidad institucional local para el modelo de atención a las condiciones crónicas, adaptado para la atención a la tuberculosis. El análisis fue realizado a través de la estadística descriptiva e inferencial. Resultados: los Enfermeros y los Agentes Comunitarios de Salud tuvieron una clasificación razonable con un promedio de 6,4 y 6,3, respectivamente. El municipio fue clasificado con capacidad razonable, con promedio 6,0 y desviación estándar de 1,5. Las Unidades de Salud de la Familia obtuvieron una capacidad superior a las Unidades Básicas de Salud y Unidades Mixtas, a pesar de no haber presentado relevancia estadística. Las historias clínicas y los datos sobre portadores de tuberculosis, ítems de los sistemas de información clínica, obtuvieron mayor clasificación, razonable, con un promedio de 7,3 y desviación estándar de 1,6 y registro de portadores de TB, con promedio de 6,6 y desviación estándar de 2,0. Conclusión: los sistemas de información clínica están presentes en el municipio, principalmente en las historias clínicas y los registros de los pacientes, y cuentan con la contribución de profesionales con vínculo con los portadores de tuberculosis.

Vaccination Situation in the First Month of Life of Children of Childhood Education

Introduction: The Brazilian vaccination schedule is a strategy used in disease prevention by providing immunobiologicals to the population and the BCG and Hepatitis B vaccines are the first to be administered shortly after birth. Objective: Describe the vaccination status of BCG and Hepatitis B vaccines in the first month of life of children of childhood education. Methodology: Epidemiological, descriptive and retrospective study, with quantitative approach, conducted from data available in 1,434 copies of childrens immunization cards enrolled in childhood education in the municipality of Natal/RN, Brazil. Data were collected through checklist, categorized by Microsoft Office Excel 2013, exported to statistical software and presented in tables and graphs through simple descriptive statistics. Results: The BCG vaccine showed 98.5% of children with full immunization schedule, 1.2% unvaccinated and 0.8% had record failures. In the case of the hepatitis B vaccine, 98.9% had complete vaccination schedule, 0.6% for unvaccinated children and 0.4% had flaws that prevented their analysis. Final thoughts: The vaccination status of the children had complete immunization schedule rates higher than the target set by the National Immunization Program, but the presence of registry errors prevented the analysis of cards.

Self Care Assisted In People With Tuberculosis Treatment

Introduction: In supported self-care, health professionals encourage individuals to take care of themselves from the adoption of healthy habits. In the case of patients with TB, self-care is important because it can contribute to the reduction of treatment abandonment. Objective: To analyze self-care in treating people with tuberculosis assisted in health facilities of primary care and compare the scores of self-care supported by the type of service and the professional health function. Method: a Cross-sectional study in a city in northeastern Brazil, with 100 professionals (nurses, nursing technicians, medical and health community agents) working in the health units of primary care. Data collection was conducted from November 2013 to January 2014, using a structured questionnaire proposed by MacCooll Institute for Health Care Innovation, specifically the area of supported self-care. Descriptive and inferential statistics were used for the analysis. The study was approved by the Research Ethics Committee, by the protocol: 456,332. Results: the four items of supported self-care were identified (support, records, reception and behavior change interventions), most of the health facilities, a reasonable capacity of attention to people with TB. When it was assessed among professionals and the types of units, it was also rated with a reasonable capacity, statistical difference. Conclusion: it was found that the self-care supported practiced by primary health care professionals is effective in helping the individuals with tuberculosis, having in view the homogeneity found in capacity classified as reasonable between the various units of the municipality, the types of unit and the categories of professionals.