Regina Rigatto Witt

Competências dos profissionais de saúde no referencial das funções essenciais de saúde pública: contribuição para a construção de projetos pedagógicos na enfermagem

The development of competencies among health professionals in relation to the Essential Public Health Functions (EPHF) is part of a number of initiatives that are meant to face the need for services that can lead to the resolution of health problems, considering the transformations occurred in the health sector and in the workplace. This articles objective is to make a theorical reflection on the theme of professional competencies, so that we can contribute to the development of political-pedagogical projects for health training and primarily for nursing training. For that matter, we introduce the competency-based model. These competencies are in accordance with the EPHF and with the competencies proposed so far, and are aimed at contributing to the development of interdisciplinary, critical, and reflexive education models..

A maneira criativa e sensível de pesquisar

This experience report describes the application of Creative Sensitive Method in a qualitative exploratory-descriptive research. Its theoretical foundation and the way this method was applied objectively presented through the following stages: introduction, production, presentation, discussion and evaluation. Finally, one can argue that the method, among others pathways, is a good alternative methodology for generating data in collective spaces for application in qualitative research related to nursing or others health contexts.This experience report describes the application of Creative Sensitive Method in a qualitative exploratory-descriptive research. Its theoretical foundation and the way this method was applied objectively presented through the following stages: introduction, production, presentation, discussion and evaluation. Finally, one can argue that the method, among others pathways, is a good alternative methodology for generating data in collective spaces for application in qualitative research related to nursing or others health contexts.

Participação e controle social: percepção dos trabalhadores da saúde da família

This is a qualitative, exploratory-descriptive study that aimed at analyzing the perceptions of a family health team regarding participation and social control in health. The study was developed with workers of a Family Health Team in southern Santa Catarina. Data were collected using the Sensitive Creative Method and analyzed through the process of thematic content analysis. Regarding participation in health, two empirical categories were identified: passive participant in health; and dialogical process as participation in the Family Health Team. As for social control in health, the categories identified were: institutionalized space as a social control in health; and disease monitoring as social control in health. The results showed perceptions related to the reflections on the health model and others that indicate the possibility of advancements in the discussions with local contribution for participation and social control in health. DESCRIPTORS: Social participation. Policies of social control. Family health. Unified Health System. Right to health.Esto es un estudio cualitativo, exploratorio-descriptivo, con el objetivo de analizar las percepciones del equipo de salud de la familia sobre la participacion y control social en salud. Se trata de un estudio realizado con trabajadores en un Equipo de Salud de la Familia en el sur de Santa Catarina. Los datos fueron recogidos con el Metodo Creativo Sensible y se analizaron mediante analisis de contenido tematico. Sobre la participacion en salud se identificaron dos categorias empiricas: la pasividad de la participacion en salud y el proceso dialogico como participacion en el Equipo de Salud de la Familia. Para el control social en salud, las categorias fueron: el espacio institucionalizado como control social en salud y el monitoreo de la enfermedad como control social en salud. Los resultados mostraron percepciones relacionadas con las reflexiones del modelo de salud y otros que indican la posibilidad de avance de las conversaciones con el aporte local para la participacion y control social en salud.

Competencies for Preceptorship in the Brazilian Health Care System

BACKGROUND Preceptorship is an emerging component of the Brazilian health care system for human resources education. This study attempted to identify competencies for preceptorship in this system. METHODS An exploratory descriptive study was conducted with the Delphi technique. The participants were primary health care professionals from the South of Brazil who were working in nine professional areas, including nursing. The participants had served as preceptors in an educational program promoted by the Ministries of Education and Health. RESULTS Forty-three competencies were identified and classified into nine domains: education, professional values, basic public health sciences, management, health care, teamwork, communication, community orientation, and professional development. CONCLUSION The findings showed that preceptors were committed to the education of future health care professionals. The development of pedagogical skills was emphasized, as was the necessity of education before preceptorship. These competencies constitute a useful reference for continuing professional education.

Professional competencies in primary health care for attending to older adults

OBJECTIVE To identify and analyze the necessary competencies in primary health care for attending to older adults. METHOD An exploratory, descriptive, and quali-quantitative study was developed. Three rounds of the Delphi Technique were conducted with participants from primary health care services and a multidisciplinary committee. The first questionnaire asked participants to indicate the competencies needed for attending to older adults in primary health care. They were compiled into a list and added to a Likert Scale (from 1 to 5) for the second and third questionnaires. A consensus criterion of 70% was adopted. RESULTS Twenty eight competencies were reached by consensus and were classified into twelve domains. CONCLUSION The competencies reflect Brazilian health care policy and constitute a reference for professional health practice and education when caring for the older adult in primary health care.Objetivo Identificar e analisar as competencias profissionais necessarias para o atendimento de idosos em cuidados primarios de saude. Metodo Estudo exploratorio descritivo quali-quantitativo. Foi utilizada a Tecnica Delphi em tres rodadas, com a participacao de profissionais da rede basica e um grupo multidisciplinar de especialistas. O primeiro questionario solicitou que os participantes indicassem competencias necessarias para o atendimento de idosos em cuidados primarios. Estas foram compiladas em uma lista, que adicionada de uma Escala de Likert (de 1 a 5) compos o segundo e terceiro questionarios. O criterio de consenso adotado foi 70%. Resultados Vinte e oito competencias alcancaram o consenso, tendo sido classificadas em 12 areas de dominio. Conclusao As competencias refletem as politicas brasileiras de saude e constituem uma referencia para a pratica e a formacao dos profissionais de saude para o atendimento do idoso na atencao primaria a saude.

O fazer das enfermeiras da estratégia de saúde da família na atenção domiciliária

Este estudo objetivou conhecer o fazer das enfermeiras da Estrategia de Saude de Familia (ESF) na atencao domiciliaria. Trata-se de um estudo exploratorio, descritivo, com abordagem qualitativa. Foram entrevistadas seis enfermeiras atuantes da ESF de um distrito sanitario de Porto Alegre, Rio Grande do Sul, Brasil. As informacoes foram submetidas a analise de conteudo tematica, resultando em tres categorias: a visita domiciliaria (VD) na ESF, avaliacao das demandas de VD e interacao com a equipe de saude na atencao domiciliaria. A visita domiciliaria (VD) tem oportunizado a identificacao das necessidades por meio do conhecimento do contexto de vida dos usuarios. Esta tem sido realizada no atendimento de doentes cronicos, acamados e idosos, efetuada a partir das informacoes trazidas pelos agentes comunitarios de saude. Todas as enfermeiras relataram realizar VD, sendo que gostariam de ter mais tempo para se dedicar a essa atividade.

Indicators and Measurement Tools for Health Systems Integration: A Knowledge Synthesis

Background: Despite far reaching support for integrated care, conceptualizing and measuring integrated care remains challenging. This knowledge synthesis aimed to identify indicator domains and tools to measure progress towards integrated care. Methods: We used an established framework and a Delphi survey with integration experts to identify relevant measurement domains. For each domain, we searched and reviewed the literature for relevant tools. Findings: From 7,133 abstracts, we retrieved 114 unique tools. We found many quality tools to measure care coordination, patient engagement and team effectiveness/performance. In contrast, there were few tools in the domains of performance measurement and information systems, alignment of organizational goals and resource allocation. The search yielded 12 tools that measure overall integration or three or more indicator domains. Discussion: Our findings highlight a continued gap in tools to measure foundational components that support integrated care. In the absence of such targeted tools, “overall integration” tools may be useful for a broad assessment of the overall state of a system. Conclusions: Continued progress towards integrated care depends on our ability to evaluate the success of strategies across different levels and context. This study has identified 114 tools that measure integrated care across 16 domains, supporting efforts towards a unified measurement framework.

Participation and social control: perception of family health workers

This is a qualitative, exploratory-descriptive study that aimed at analyzing the perceptions of a family health team regarding participation and social control in health. The study was developed with workers of a Family Health Team in southern Santa Catarina. Data were collected using the Sensitive Creative Method and analyzed through the process of thematic content analysis. Regarding participation in health, two empirical categories were identified: passive participant in health; and dialogical process as participation in the Family Health Team. As for social control in health, the categories identified were: institutionalized space as a social control in health; and disease monitoring as social control in health. The results showed perceptions related to the reflections on the health model and others that indicate the possibility of advancements in the discussions with local contribution for participation and social control in health. DESCRIPTORS: Social participation. Policies of social control. Family health. Unified Health System. Right to health.Esto es un estudio cualitativo, exploratorio-descriptivo, con el objetivo de analizar las percepciones del equipo de salud de la familia sobre la participacion y control social en salud. Se trata de un estudio realizado con trabajadores en un Equipo de Salud de la Familia en el sur de Santa Catarina. Los datos fueron recogidos con el Metodo Creativo Sensible y se analizaron mediante analisis de contenido tematico. Sobre la participacion en salud se identificaron dos categorias empiricas: la pasividad de la participacion en salud y el proceso dialogico como participacion en el Equipo de Salud de la Familia. Para el control social en salud, las categorias fueron: el espacio institucionalizado como control social en salud y el monitoreo de la enfermedad como control social en salud. Los resultados mostraron percepciones relacionadas con las reflexiones del modelo de salud y otros que indican la posibilidad de avance de las conversaciones con el aporte local para la participacion y control social en salud.

Nurses’ competencies in primary health care: a Delphy technique study

An investigation on nurses´ primary health care practice was developed to identify and analyze nurses’ general and specific competencies at the Brazilian Health System. This quantitative-qualitative research adopted the Delphi Technique as a method of study. Two groups of participants were selected. Fifty-two nurses and fifty-seven specialists accepted to participate in the study. Questionnaires were developed for data collection, including a Likert scale. A 75 percentage was adopted as a consensus criterion for scores 4 or 5 of this scale. Results showed 17 general and 8 specific competencies for the nursing group and 19 general and 9 specific competencies for the specialist group. These competencies were classified into ten areas of domain. This paper presents and discusses health care competencies found in this investigation.

Competências da enfermeira para a triagem clínica de doadores de sangue

This investigation aimed at identifying nurses competencies necessary to screen blood donors, from those recommended by the International Council of Nurses. A qualitative, descriptive case study was developed at the Hemotherapy Service blood bank of a teaching hospital in Porto Alegre, RS, Brazil. Twenty Five interviews performed by five nurses hired by the service were observed. For observations analysis standard adequacy was used. Six competencies of the professional, ethics and legal area and eleven from care provision and management were identified. Competencies identified in this study will serve as a basis for practice and to prepare generalist nurses to perform clinic screening of blood donors.This investigation aimed at identifying nurses competencies necessary to screen blood donors, from those recommended by the International Council of Nurses. A qualitative, descriptive case study was developed at the Hemotherapy Service blood bank of a teaching hospital in Porto Alegre, RS, Brazil. Twenty Five interviews performed by five nurses hired by the service were observed. For observations analysis standard adequacy was used. Six competencies of the professional, ethics and legal area and eleven from care provision and management were identified. Competencies identified in this study will serve as a basis for practice and to prepare generalist nurses to perform clinic screening of blood donors.