Basic Family Health Unit Research Articles

Waiting room group: an experience report on Occupational Therapy as an in-service teaching modality in Primary Health Care

The present article describes teaching-learning interventions in the context of a mandatory curricular internship in Occupational Therapy conducted at a Family Health Basic Unit. This work is justified by the importance of presenting the outcomes of occupational therapy through the description of a concrete activity. The objective is to reflect on the practice and present the possibilities of action in primary care with a health education group. This is a descriptive study, in the form of an experience report, developed during the implementation of a waiting room group in a service located in the interior of São Paulo/SP, from August to December 2022. Data collection was carried out based on the field diaries of the interns and group coordinators, as well as reports reviewed by the faculty member and internship supervisor. The analytical phase considered the group experience, encompassing the participants, their histories, knowledge, cultures, and emotions, but also the narratives and experiences of the interns. The results indicate the transformation of the waiting room into a productive space, a redefinition of habits, and reflections on daily life, relationships, healthcare, through the sharing and construction of knowledge and wisdom, legitimizing the right to health information.

Organization of health services in the family health strategy: perspectives of basic unit managers

To analyze the organization of services offered in the Family Health Strategy, from the perspective of Basic Units managers. Analytical, qualitative study, carried out through a focus group, with the participation of 25 managers of Basic Family Health Units in a pole city in the West of Santa Catarina. For systematization and data analysis, the Discourse of the Collective Subject was used, based on the theory of social representations, which resulted in three Central Ideas. Three Central Ideas emerged: ‘The influence of Structural Factors for the Development of Services in the Family Health Strategy’, ‘Care and management organization of work in the Family Health Strategy’ and ‘Access and user’s satisfaction from the perspective of Basic Health Units managers’. Some challenges were evidenced in management practices, such as inadequate infrastructure, professional turnover and conduct based on the medical-hegemonic model. The difficulty in offering comprehensive, individualized, and longitudinal care was emphasized, which directly influences user’s satisfaction. The health care model and the articulation of the network determine the forms of care and management organization of services, which impact on guaranteeing access and resolution in the care provided to users.

MOURNING FAMILIES: The process of working out of grief as a result of death from COVID-19

The objective of this study was to investigate how families who lost a family member as a result of COVID-19 have structured themselves in the resilient process of mourning. This is a qualitative research, which used the Episodic Interview technique as a research instrument. Five family members of patients who died from COVID-19 participated in the study, invited by recommendation from the Social Assistance Reference Center and Basic Family Health Units in the municipality; with the study approved by CEP/FPM, under opinion number 5,977,311. Among the reports from the sample of interviewees, it was unanimous among those interviewed that religion was an element that could serve as a source of emotional support in the face of loss. It was observed that all these losses occurred in public hospitals in the city of Patos de Minas, and psychotropic medications were used as a result of grief. Finally, limitations of the study included reluctance to participate due to the painful nature of the subject and a lack of understanding about the academic research process, as the initially proposed sample was larger than those who actually participated in the research. In view of this study, new reflective research is suggested on the elaboration of grief in pandemic consequences and methods for professional psychologists to clinically help bereaved patients.

Nursing assistance systematization: understanding the care implementation process

Introduction: the Systematization of Nursing Care is one of the main tools for the development and organization of services for nursing professionals, its application guides the planning of individualized care and focuses on the specific needs of each individual. Objective: the study’s general purpose is to analyze primary health nursing care in light of the basic human needs theory. Methods: this is a descriptive study with a qualitative approach, developed in the city of Rio Branco, Acre, Brazil, with nurses from the Basic Family Health Units. As a method for organization and interpretation, we opted for the content analysis proposed by Bardin. Results: the Systematization of Nursing Care is perceived by nurses as an instrument for organizing care, but in practice, they think it is focused on assistance directed to the use of ministerial protocols. In this context, it was also evidenced that they focus on aid for health problems and complaints, indicating the anamnesis as a phase of the implemented nursing process with the other stages focused on the diagnosis of the disease and specific interventions. Conclusion: our findings showed that professionals in primary health care end up directing their care only to momentary complaints, failing to broaden their look as a whole. In this way, assistance occurs in a fragmented way, failing to meet the real needs of the population.

HEALTH EDUCATION AS A PRACTICE IN MATERNAL AND CHILD CARE

This is an experience report with pregnant women, accompanied by the Basic Family Health Unit of Jardim Noroeste – Campo Grande/MS, in partnership with the Education Program for Work for Health. The proposed objective relates the experience of academics from undergraduate courses in Psychology and Nursing at Centro Universitário Unigran Capital in carrying out educational practices with pregnant women. Finally, the intervention fulfilled its objective of interacting with the pregnant women in a playful and relaxed way in order to raise their awareness regarding childhood vaccination.

Psychometric properties and reliability of the Brazilian version of Parent Attitudes about Childhood Vaccine (PACV-BR).

To evaluate the psychometric properties and reliability of the Brazilian version of the tool Parent Attitudes about Childhood Vaccine (PACV-BR). The sample included 110 parents of children up to two years old served by Family Health Basic Units. The tool's internal consistency and factor validity were respectively assessed by Cronbach's alpha and exploratory factor analysis (EFA). The test-retest reliability was assessed by the intraclass correlation coefficient (ICC). The EFA results indicated a proper structural adequacy of the PACV-BR (15 items and two factors). The reliability generated Cronbach's alpha values between 0.715 and 0.854 for the items, of 0.918 for the tool as a whole, of 0.877 for factor 1 and of 0.825 for factor 2, in addition to an ICC of 0.984. The PACV-BR showed evidence of construct validity and reliability.

Use of an evidence-based health portal to improve teaching and learning in primary care: a mixed methods evaluation

BackgroundWorldwide, primary care is for most people the gateway into many health systems. Offering solutions to the demands of the communities served requires the constant preparation of professionals, especially doctors and medical undergraduate students. We analyze and propose ways to improve the teaching and learning processes facilitated by the Basic Family Health Units (BFHUs) based on the use of electronic portals with evidence-based medicine criteria.MethodFirst phase: The authors conducted a qualitative-quantitative study on students and instructors of primary care (PC) medicine by administering a survey of open- and closed-ended questions at medical schools. The closed-ended questions were studied with descriptive statistics, and open-ended questions were analyzed via the creation of categories. Perceptions of major teaching and learning problems were then identified.Second phase: Meetings were held with students and their instructors for 6 months and involved the use of electronic portals and the application of new questionnaires using a Likert scale for pre- and postevaluation.ResultsIn the first phase, 40% of the students considered local instructor training levels a problem. A similar result was found regarding teachers’ lectures, revealing a lack of adequate PC training and performance.Building on our results, we focused on BFHUs to apply new strategies for teaching and learning, such as the use of the Evidence-Based Health (SBE) Portal, which includes several databases with clinical evidence criteria. In the second phase, the authors identified an improvement in the quality of learning among instructors and students. This outcome improved safety in daily clinical practice in PC, possibly with better results for its users.ConclusionsThe use of electronic portals can facilitate BFHU teaching and learning and promote the health of users.

Processo de trabalho de enfermeiras na consulta ginecológica

OBJETIVO: desvelar o processo de trabalho de enfermeiras na consulta ginecológica na estratégia saúde da família. MÉTODO: Trata-se de uma pesquisa descritiva, exploratória e qualitativa realizada com doze enfermeiras de Unidades Básicas de Saúde da Família de um Distrito Sanitário de um município baiano. Utilizou-se um roteiro de entrevista semiestruturado contendo perguntas abertas e fechadas. A análise dos dados foi realizada através da técnica de Análise de Conteúdo de Bardin. RESULTADOS: após a análise e interpretação dos dados emergiram duas categorias: Abordagens sobre a consulta de enfermagem ginecológica na ESF; O processo de trabalho de enfermeiras na consulta de enfermagem ginecológica. CONCLUSÃO: a consulta ginecológica faz parte das ações integrantes do processo de trabalho das enfermeiras nas Unidades Básicas de Saúde da Família, contudo, as profissionais não visualizam o seu protagonismo neste atendimento e apresentam práticas limitadas, mostrando uma visão reducionista da assistência. Sobrecarga de trabalho, fragilidade na educação permanente e inadequações estruturais prejudicam o processo de trabalho desses profissionais e a atenção à saúde da mulher.

Autoclassificação da saúde e autovaliação da assistência para seu cuidado segundo moradores de assentamentos rurais

Residents of rural settlements face difficulties in accessing health services. This is determined by the socioeconomic conditions of these populations. It is possible that these people rate their own health and the quality of public services they have access to as unsatisfactory. This study aimed to analyze the self-evaluation of health among residents of rural settlements and their assessment of the health services they use. This was a cross-sectional study, which interviewed, through a semi-structured instrument, residents of two rural settlements located in Uberlândia, Minas Gerais, Brazil. The instrument sought to analyze the epidemiological profile, the self-evaluation of the health of these residents, using an evaluative scale. Moreover, their assessment of the quality of the health services they access was evaluated. Twenty-four residents of two settlements were interviewed. 54.2% of them (n=13) had chronic diseases. The most reported were Systemic Arterial Hypertension and Diabetes Mellitus. Among residents, 45.8% (n=11) evaluated their own health as poor or fair and 45.8% as good. The analysis of the speeches indicated dissatisfaction with the quality of the health services used. The chronic disease rates found among residents of rural settlements may be due to the low coverage of Primary Health Care close to their homes. Improving the quality of the service provided by the Basic Family Health Units closest to rural settlements can reduce future cardiovascular disease rates among this population.

Parceria ensino-serviço na formação em odontologia

Resumo: A parceria ensino-serviço é fundamental na formação de futuros profissionais, assim como na educação permanente dos profissionais que já atuam nos serviços de saúde. O objetivo deste estudo foi sistematizar e compreender problemas diagnosticados nas unidades básicas de saúde da família (ESF), por estudantes da graduação em Odontologia da Universidade Federal de Goiás (FO/UFG). Foi utilizada a pesquisa documental para levantamento dos dados em projetos acadêmicos elaborados no período de 2006 a 2013, por alunos de graduação do sétimo período no Estágio em Odontologia Coletiva I. Os problemas relatados nos projetos acadêmicos aconteceram em 16 unidades de ESF do Município de Goiânia-Go e foram diagnosticados pelo método da estimativa rápida. Os 80 projetos elaborados pelos acadêmicos foram examinados e apresentou um total de 950 problemas diagnosticados. Os problemas elencados variaram de acordo com o território onde o estágio aconteceu. Após a coleta realizada pelos acadêmicos os problemas foram hierarquizados em função da viabilidade de intervenção. Os problemas priorizados foram aqueles que tiveram soluções a nível local. Após a coleta dos dados, foi realizada a categorização e emergiram sete categorias e 15 subcategorias. Dentre as categorias, as mais citadas foram ‘gestão’ e ‘problema social’ e, das subcategorias foram ‘gestão pública’, ‘gestão dos serviços de saúde’ e ‘organização dos processos de trabalho’. As categorias menos citadas foram ‘trabalho em equipe’ e ‘controle social’. Concluiu-se que as categorias se interligam umas às outras, demonstrando que os problemas de saúde muitas vezes têm diversas causas e necessitam de soluções compartilhadas. Vários destes problemas não têm solução a nível local, relacionam-se aos determinantes sociais de saúde e merecem atenção especial da gestão dos serviços. A categorização dos problemas demonstrou a amplitude das dificuldades vivenciadas pelas equipes de saúde da família, e a necessidade de inserção dos acadêmicos de odontologia precocemente nos serviços de saúde, para vivenciarem a realidade prática, na busca de uma formação que aproxime o futuro profissional de odontologia das reais necessidades da população. Palavras chaves: Ensino na saúde. Ensino-serviço. Odontologia.

Access to Primary Health Care by older adults from rural areas in Southern Brazil.

ABSTRACTOBJECTIVE To characterize the access and use of health services considered reference among the older rural population from a municipality in southern Brazil, whose rural area has full coverage of the Family Health Strategy (FHS), investigating factors associated with the choice of the Basic Family Health Unit (BFHU) as reference.METHODS This is a cross-sectional study conducted in 2017 with systematic sampling of rural households in the municipality of Rio Grande (RS) using a standardized in-house questionnaire. We performed descriptive analyses of sociodemographic profile, type of reference service chosen, and reasons for choosing/using the prime-choice service and the nearest BFHU. Poisson regression was used to investigate factors associated with the type of reference service chosen.RESULTS Among the 1,030 older adults who participated in the study, 61.4% considered the BFHU a prime choice/reference service mostly due to its proximity (82.6%); the others sought other places due to a greater ease (34.6%) and resoluteness (52.6%). Almost ⅔ of the respondents sought care at the BFHU during the last year, and the reasons differed among those who considered the unit as reference (chronic disease) and those who sought another place (procedures). We also found that the lower the age, income, education, and household-unit distance, the greater the likelihood of the older adult considering the nearest BFHU as reference service.CONCLUSIONS The FHS has reached the vulnerable older rural population, approaching an equitable public health system. However, further evaluations are necessary to verify the quality and adequacy of care, given that social structure, enabling factors (such as economic condition), and possible beliefs regarding health still establish the standards for choosing a service.

Ações de Enfermagem no cuidado à criança na atenção primária durante a pandemia de COVID-19

Resumo Objetivo Verificar a atuação do enfermeiro de atenção primária, em unidades básicas de saúde tradicionais e unidades de saúde da família, nas ações de cuidado de rotina à saúde da criança, durante o período de pandemia da COVID-19. Métodos Pesquisa qualiquantitativa realizada em junho e julho de 2020; aplicou-se formulário online para 80 enfermeiros de três municípios brasileiros. Análise descritiva e análise de conteúdo. Resultados Identificou-se três categorias analíticas: O antigo e o atual: desafios para o cuidado da [...]

O principio da hereditariedade de estrias: influência genética e fatores associados

Introdução: A estria consiste em uma atrofia tegumentar adquirida, de caráter linear, a qual pode se apresentar em maior número ou não, trata-se de uma afecção que acomete bastante as gestantes e que produz significativo impacto emocional. Objetivo: Caracterizar a etiopatologia das estrias e comparar a teoria mecânica e hormonal com a influência genética. Metodologia: Trata-se de um estudo de caráter descritivo e de abordagem quantitativa. A coleta de dados foi realizada em Unidades Básicas de Saúde da Família localizada na cidade de Lagoa Seca. A amostra foi composta por pacientes puérperas que estavam em acompanhamento da enfermagem na unidade. Resultados e Discussão: A respeito dos heredogramas gerados é possível observar a prevalência de indivíduos acometidos por estrias em maioria dos casos na primeira e segunda geração. Outro achado interessante é que a característica apareceu em dado momento com frequência em determinado grupo, em outro apareceu com escassez. 80% das pacientes entrevistadas ressaltaram que as suas estrias tem assimilação com o de algum familiar e apenas 20% relataram localização diferente. Considerações finais: É possível inferir que o desenvolvimento da estria pode ser associado decorrente de características única do genótipo ou não, foi possível reconhecer o papel da hereditariedade como fator etiológico na presente amostragem.

Fatigue levels among Family Health Strategy professionals in the Brazilian countryside

Introduction: This research addresses fatigue within the team of nursing professionals of the Family Health Strategy (FHS). Objectives: To describe the fatigue levels of FHS nursing professionals. Identify the presence of fatigue among nursing professionals. Method: The research has a descriptive-analytical, quantitative character. Questionnaires were applied to a sample of 112 professionals at basic family health units in the city of Uberlândia, Brasil. Simple and applied statistics were used in order to collect the data. Results: The study showed that the sample had a greater predominance of females, aged between 30 and 49 years, with a greater number of nurses and who have only one job. It was identified with the DUFS questionnaire that 20, 8% say that they always need extra energy to handle their daily tasks and that 36.9% of professionals have had the need to rest more. Thus, this research shows the presence of fatigue in 70.8% of professionals. Conclusion: Evaluating the projections of fatigue on the body, this research shows self-reported signs that are already present signs, which can be recognized as symptoms and that translate signs of compromise, at some level, of the well-being of the workers in question, certainly reflecting on daily life, which may also compromise the health of these workers and their performance.

A percepção de agentes comunitárias de saúde sobre o planejamento reprodutivo com adolescentes

Objetivo: conhecer a percepção de agentes comunitárias de saúde sobre o planejamento reprodutivo realizado com os adolescentes. Método: estudo qualitativo com dez agentes de uma unidade básica de saúde da família. Para a coleta de dados foi utilizado Grupo Focal. Utilizou-se a Análise de Conteúdo. Resultados: as agentes acreditavam na importância do planejamento reprodutivo com adolescentes, considerando o pouco diálogo intrafamiliar e a dificuldade em abordar o assunto nas visitas domiciliares. Reconheciam a necessidade de abordar o planejamento de modo ampliado, ao encontro do autoconhecimento, do respeito com o próximo e da prevenção das violências. Conclusão: a percepção das agentes pode ser favorecida ou prejudicada pela relação de proximidade com os profissionais de saúde. A temática deve ser discutida com os adolescentes, pois muitos não possuem comunicação com os pais, representando um tabu em muitos lares, seja por questões culturais ou por acreditarem ser um incentivo à prática sexual.

Estado vacinal de adolescentes de uma unidade básica de saúde

Objetivo: O presente artigo objetivou identificar o estado vacinal dos adolescentes da área adscrita de uma Unidade Básica de Saúde da Família de uma cidade no Estado do Piauí. Métodos: Trata-se de um estudo seccional com abordagem quantitativa, desenvolvido por meio de inquérito domiciliar, no período de abril a julho de 2017. A amostra foi constituída por 361 adolescentes e a análise foi realizada por meio de estatística descritiva. Resultados: Verificou-se que, a cobertura vacinal contra rubéola, sarampo e caxumba atingiu 42,7% dos adolescentes, difteria e tétano (31,9%), hepatite-B observou-se 42,1% de cobertura, enquanto que, 43,2% dos adolescentes foram vacinados contra febre amarela e 21,1% contra HPV. Destaca-se que, aproximadamente 50% dos entrevistados desconhecem a existência de um cartão de vacina do adolescente e que 58,8% dos adolescentes não sabiam informar contra quais doenças estavam imunizados. Conclusão: Conclui-se que o conhecimento dos adolescentes é incipiente em relação à imunização, destacando-se assim, a necessidade da realização de ações educativas pelos profissionais da saúde em parceria com as escolas.

Perception on facilitators and benefits of participation in body practice groups

Abstract The practice of physical activity has been considered as an important factor in the area of public health, as it helps in the prevention and treatment of various diseases. Thus, understanding the facilitators for participation and benefits from healthy lifestyle can contribute to population awareness. The aim of this study was to analyze facilitators for body practice and benefits perceived by participants of body practice groups of two basic family health units of Santa Rosa/RS. This qualitative research included 25 participants. Data were obtained by the focal group technique. Motivation/incentive, mainly linked to family support, the pedagogical practice of the Physical Education professional, good health status and social life were aspects considered facilitators for adherence to body practice groups. Physical and psychological gains, prevention and control of diseases, lifestyle changes, cognitive improvement and decreased use of medications were pointed as benefits. Motivating participants to participate in body practice programs is an important factor for adherence and participation in these activities can provide biopsychosocial benefits that can contribute to health promotion and quality of life of users of basic family health units.

Situational diagnosis of older adults with diabetes mellitus in a city in the state of Ceará, Brazil

Abstract Objective: To describe the situational diagnosis of older adults with diabetes mellitus (DM) registered at a Basic Family Health Unit, using sociodemographic profile, health conditions and lifestyle. Method: A descriptive, cross-sectional study was carried out with 70 older adults in the city of Jijoca de Jericoacoara, Ceará, Brazil. Data were gathered from questionnaires on sociodemographic conditions, health and individual lifestyle profile, and were submitted to descriptive statistics techniques, and the results presented in tables. Results: The predominance of women was three times greater than men (52=74%); the mean age was 71.19 years (±7.12); the number of married people was higher than the other categories (44=62.8%); the vast majority of the sample received a pension equivalent to the minimum wage as a rural worker (64=91%); and just over half declared themselves to be literate (36=51.4%). In terms of health conditions, the majority (56=80%) had had DM for more than 10 years, although they considered their health status to be satisfactory (40=57.14%). Among the main complications were hypertension (n=53; 75.71%), muscle and joint pain (n=43; 61.43%) and hearing loss (48=68.57%). Conclusion: The present study provided indicators for the planning and execution of educational actions, based on interprofessional collaboration aimed at the promotion of health.

Suporte básico de vida: conhecimento de enfermeiras (os) que atuam na estratégia de saúde da família

Objective: To analyze the knowledge of FHS nurses from a municipality of Recôncavo de Bahía against SBV. Method: This is a descriptive epidemiological research, conducted with 14 nurses from Basic Health Units and Family Health Units in a municipality of Bahia, using a questionnaire on sociodemographic, occupational and educational characteristics and about general and specific SBV education. Data were analyzed through descriptive analysis of variables, calculating absolute and relative frequencies and measures of central tendency and dispersion. Results: most had knowledge of how to check the victim's pulse on cardiac arrest (92.9%), the frequency of chest compressions if ventilation could not be guaranteed (57.1%), and the minimum depth of chest compressions ( 71.4%). 92.9% did not know the proper place for hand placement and chest compressions; 50% were aware of the situations in which AED could be used; 57.1% knew the PCR rates and 57.1% were shockable PCR rates. Conclusion: We found that nurses have satisfactory knowledge about the performance of SBV in relation to CRP. Descriptors: Urgency and emergency; Life Basic Support; Primary Care.

Functioning and disability of premenopausal women with urinary incontinence: An assessment by using the World Health Organization Disability Assessment Schedule-WHODAS 2.0.

To analyze the association between urinary incontinence and disability status in premenopausal women. The study included 120 premenopausal women recruited from six Basic Family Health Units to participate in this study. We assessed sociodemographic, gynecological, and obstetric data by using specific questions. The International Continence Society's definitions were applied to determine the presence and type of urinary incontinence, and the disability was assessed by using the 36-item version of the World Health Organization Disability Assessment Schedule (WHODAS) 2.0. The WHODAS scores showed that women with urinary incontinence had a worse disability in cognition (P = .023) and mobility (P = .020) domains, in addition to the total score (P = .23). Women with mixed urinary incontinence had a worse disability in mobility domain (P = .039) than those with stress or urgency incontinence. Qualitative analyses of disability showed a significant difference between women with and without urinary incontinence (P = .033), with higher percentages of incontinent women with moderate and severe disability. Women who reported urinary incontinence had 7.69 more points on the final score of WHODAS than those who did not report this outcome. Urinary incontinence in women of reproductive age is associated with disability and worse scores of WHODAS when we compare them to women without urine leakage. The results presented can be useful for designing and adapting strategies for comprehensive care of women with urinary incontinence and disability, and developing rehabilitation programs based on functioning.