Primary Health Care For People Research Articles

Case management in primary healthcare for people with complex needs to improve integrated care: a large-scale implementation study protocol

IntroductionCase management (CM) is among the most studied effective models of integrated care for people with complex needs. The goal of this study is to scale up and assess CM...

Clinical-functional vulnerability index in older people of a family health strategy team in the central zone of Rio de Janeiro

AimTo evaluate the applicability of the Clinical-Functional Vulnerability Index (IVCF-20) in monitoring the health of older people in primary health care (PHC), estimate the prevalence of functional decline and identify associated factors. MethodsCross-sectional descriptive study, with individuals aged 60 or over, from a PHC unit in Rio de Janeiro. The instrument included sociodemographic, health and lifestyle variables and the IVCF-20. A descriptive analysis was carried out, prevalence ratios (PR) were calculated, and Poisson multiple analysis was performed. ResultsThe sample consisted of 120 individuals, mean age of 72.9 years (SD= 0.75), the majority were female. According to IVCF-20, 61 (50.8 %) of the individuals were robust, 41 (34.2 %) were in potential functional decline and 18 (15.0 %) were in established functional decline. In the bivariate analysis, not performing regular physical activity (RP 2.60 CI95 % 1.21–5.57), not believing that you live a healthy life (RP 4.39 CI95 % 1.92–10.06), not being satisfied with the way you live (RP 6.74 IC95 % 2.51–18.11) and reference to chronic illness (RP 4.57 IC95 % 1.22–17.14) showed an association with functional decline. In the Poisson model, the variables age (RP 1.37 95 % CI 1.07–1.75), not believing that you live a healthy life (RP 1.54 95 % CI 1.01–2.33) and lack of satisfaction with the way you live (RP 1.75 CI95 % 1.18–2.60) remained associated. ConclusionThe study made possible to draw a profile of the older adults accompanied by a team at PHC, contributing to discussions on care proposals for the older people with a focus on preventing functional decline.

VELOCIDADE DA MARCHA ASSOCIADA AOS FATORES CLÍNICOS EM IDOSOS NA ATENÇÃO PRIMÁRIA À SAÚDE: REVISÃO INTEGRATIVA

ABSTRACT Objective: to analyze national and international scientific production on gait speed associated with signs, symptoms, and clinical factors in elderly people in primary health care. Method: integrative literature review carried out in five data sources (Virtual Health Library, Embase, Web of Science, Cumulative Index To Nursing And Allied Health Literature (CINAHL), and PubMed) with publications from January 2017 to June 2023. Results: 13 publications met the eligibility criteria, with a predominance of studies in English. Studies indicated that reduced gait speed is associated with fractures (p<0.05), dementia (p<0.01), cardiovascular (p<0.001) and neuropsychiatric (p<0.01) diseases, falls (p<0.05) and polypharmacy (p<0.001). Conclusion: altered gait speed patterns in the older people are related to various clinical factors, reinforcing the need for further studies and the guiding role of the geriatric nursing team in the health of the older person.

Mental Health of Elderly Hypertensive Patients in Primary Health Care: An Integrative Review

Introduction: The global context highlights several challenges and manifestations stemming from population aging, among which mental health care for elderly people stands out. Primary health care (PHC), the largest gateway to Brazil’s health care network, is strategic in promoting health and care, and in preventing diseases such as systemic arterial hypertension (SAH). It is known that elderly people with SAH present various symptoms of psychological distress and mental disorders that can aggravate cardiac symptoms. This can lead to health, social, and financial impacts on the lives of elderly people and their families. Objective: To identify the evidence on mental health care for hypertensive elderly people in PHC. Materials and methods: This is an integrative literature review; data was collected in January 2023 from the following databases: PubMed, BVS/Bireme, Medline, Lilacs, Cinahl, Scopus, and APA PsycINFO. The studies included were those available in full, in Spanish, English, and Portuguese, and which answered the research question elaborated following the PICo strategy. The article’s search and selection processes were performed independently by two trained researchers through peer review. The Prisma guidelines were followed. Results: The studies found were published between 2008 and 2020 and showed two analysis categories: integrated care provided by the multi-professional team and measures that emphasize health-related quality of life. The studies highlighted integrated care management programs, qualification of the bond and territorialization, health measures that have an impact on psychological suffering, and group activities. Conclusions: Mental health care provided in an integrated and shared manner, combined with health activities and groups, is a powerful tool for elderly hypertensive patients in PHC. These strategies still have some challenges in certain contexts, but the review emphasizes the importance of consolidating this form of care, provided in PHC and has outcomes at all levels of care.

Welcoming trans people in Primary Health Care

This study aims to discuss the reception of transgender individuals in primary health care in Brazil. Through the analysis of current health policies, we propose an intervention project focusing on training health professionals to improve the welcoming environment for transgender users. The methodology includes qualitative research and educational interventions. The expected results are an increase in awareness and improved access to health services for the trans population.

Quality of Life in the Face of Depression Among Older People: A Cross-Sectional Study in Brazil and Portugal.

This study aimed to analyze and compare the association of depression levels with quality of life among older people in primary health care in Brazil and Portugal. This was a cross-sectional study conducted with older people in primary health care. The Medical Outcomes Short-Form Health Quality of Life (SF-36) instrument was used to measure the quality of life, and the Beck Depression Inventory was used to evaluate depression. We grouped the depression level variables into "absent/mild" and "moderate/severe" and tested their association with the categorical variables of quality of life ("better quality of life" and "worse quality of life"). The total sample was 150 participants (Brazil n = 100 and Portugal n = 50). Each group results in the subcategory of absent/mild depression (n = 129) indicated better quality of life in Portugal in physical role functioning (P = .027/odds ratio = 2.768), physical functioning (P < .001/odds ratio = 5.864), and the physical health dimension (P = .002/odds ratio = 3.752). The binary logistic regression analysis highlighted the domains physical role functioning (odds ratio = 1.01/CI for 95% = 1.00-1.03), physical functioning (odds ratio = 1.02/CI for 95% = 1.01-1.03), and the physical health dimension (odds ratio = 1.09/CI for 95% = 1.04-1.13). There was an association between better assessments of the physical and functional aspects of quality of life and lower levels of depression, in which we could highlight those aspects related to physical health and functionality. Among the groups studied, Portugal had better quality of life evaluations than Brazil. However, none of the groups overlapped the other in levels of depression.

Predictors of frailty in older people users of Primary Health Care.

to identify the prevalence and predictors of frailty in older people in Primary Health Care. this is a descriptive and correlational study, carried out in a convenience sample of 136 older people in the community. Data were collected through a sociodemographic and clinical questionnaire and frailty phenotype. Student's t test or U-Mann-Whitney test, chi-square and binary logistic regression were used for data analysis. the prevalence of frailty was 26.5% (n=36). Frail individuals had older age (p=0.011), worse self-rated health (p=0.001) and lower physical capacity (p<0.001). In the multivariable regression, it was observed that frail individuals had older age (Odds Ratio=1.111; 95% confidence interval=1.026-1.203) and worse physical capacity (Odds Ratio=0.673; 95% confidence interval=0.508-0.893). the prevalence of frailty in older people in Primary Health Care was considerable. Advanced age and worse physical capacity were the most relevant predictors of frailty in the elderly.

A scoping review exploring reablement models of training and client assessment for older people in primary health care.

The aim of this scoping review is to explore the evidence by which community service providers have integrated reablement models of staff training and client assessment into practice. The concept of reablement, which has emerged during the last two decades globally, has recently been defined by health experts from 11 countries through a Delphi study. Reablement is seen as a way to support integrated frameworks that achieve person-centred, long-term care and assistance across community settings. International research indicates there is some evidence of developing models of reablement that include staff training and individual components of client assessment. However, evidence of integrating reablement into interdisciplinary practice continues to be sparse. The review adopted the preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) approach. Inclusion criteria for the review related to community care, primary care, long-term care, and residential care. Populations of interest included service providers, interdisciplinary staff, trainers, and assessors. A total of 11 papers were reviewed. The studies varied in their approach to reablement training and client assessment frameworks. Three studies included assessment of staff well-being. All included evidence-based, person-centred components that can be integrated across health care settings. Single disciplinary approaches were used in all studies and some included training evaluation. This review has identified that currently reablement models are not yet embedded as frameworks for practice by community service providers in primary health care settings. Different programmes of training and assessment are being designed based on single disciplinary approaches and the context in which they are delivered. Further developmental work is required to integrate the components of discipline-specific training programmes within interdisciplinary frameworks. This will achieve not only an integrated framework for delivery across settings but also further the success of 'ageing in place' policy.

Perceptions and Expectations of Advanced Geriatric Nursing Role Development in Primary Health Care: A Qualitative Study Exploring Staff's Perspectives.

PurposeThis qualitative study aimed to explore multidisciplinary members’ perceptions and expectations of advanced geriatric nursing role development in primary health care.Patients and MethodsA multi-center, cross-sectional study based on semi-structured individual interviews was conducted with registered nurses, general physicians, and managers involved in the care of older people in primary health care between September 2020 and January 2021. Recruitment was purposive and the framework method was used to inductively analyze the data. The Consolidated Criteria for Reporting Qualitative research (COREQ) served to structure our manuscript.ResultsIn total, 29 registered nurses, 6 general physicians, and 10 managers from 8 health centers were interviewed. The relevant themes interpreted from the interview data were as follows: (1) the current roles of registered nurses in the care of older people; (2) the factors affect the advanced geriatric nursing role development; (3) expectations of the advanced geriatric nursing roles.ConclusionThere is a need for appropriate educational programs, well-established laws, and regulations to support the sustainable development of advanced geriatric nursing roles. To build the expected role model, the nursing education program in the future should integrate gerontological nursing, public health nursing, and nursing management to maximize the role of gerontological nurse practitioners in primary health care.

Implementing a weight-specific quality-of-life tool for young people in primary health care: a qualitative study.

BackgroundObesity is thought to be one of the most serious global public health challenges of the 21st century. The primary care setting is important in terms of the diagnosis, education, and management of obesity in children and young people. This study explored the views of primary care clinicians on the implementation of a quality-of-life (QoL) tool to help young people and their families identify the impact of weight on QoL.AimTo assess the acceptability and feasibility of implementing the Weight-specific Adolescent Instrument for Economic-evaluation (WAItE) QoL tool for young people aged 11–18 years in primary care.Design & settingQualitative study in Northern England, UKMethodOne-to-one, semi-structured interviews were conducted with a purposive sample of primary healthcare clinicians working in practices located in areas of varying deprivation in Northern England, UK. Interview transcripts were coded and analysed using framework analysis in NVivo (version 10).ResultsParticipants (n = 16 GPs; n = 4 practice nurses) found the WAItE tool acceptable for them and their patients, and believed it was feasible for use in routine clinical practice. It was important to primary care clinicians that the tool would provide an overall QoL score that would be easy for GPs and nurses to interpret, to help them identify patients most in need of specialist help.ConclusionThis study has developed a platform for further research around QoL in young people who are overweight and obese. A future feasibility study will focus on implementing the tool in a small number of primary healthcare practices.

"Not Alone in Loneliness": A Qualitative Evaluation of a Program Promoting Social Capital among Lonely Older People in Primary Health Care.

The weekly group-based program “Paths: from loneliness to participation” was conducted face-to-face over 15 sessions by nurses, social workers and volunteers in primary care in Catalonia (Spain) to alleviate loneliness among older people by promoting peer support and participation in community assets. We aimed at exploring participants’ experiences of loneliness and participation prior to the program and its perceived benefits. The qualitative design was descriptive-interpretative. Data were collected through three focus groups and 41 interviews applying a semistructured topic guide involving 26 older participants, six professionals and nine volunteers. Participant-observation of all sessions involved the 38 older people who started the program. A thematic content analysis was applied. Older persons with diverse profiles of loneliness and participation explained different degrees of decrease in loneliness, an increase in participation in local community assets, companionship, peer support and friendship, and an empowerment process. Successful cases reported improvements in mental wellbeing and recovering the sense that life was worth living. Loneliness persisted among some widowed participants and vulnerabilities hampered some benefits. Participants, professionals and volunteers reported different degrees of success in older people to alleviate loneliness by enhancing social relationships and activities through complex processes interrelated with health and socioeconomic factors.

Survey on medicinal plants used by traditional healer for skin diseases at Pirganj, Rangpur, Bangladesh

Background: Skin diseases are common and often have an impact on an individual’s health-related quality of life. Skin diseases have been of major concern recently due to their association ruler area. It is known that the lay people in this area depend on medicinal plants for their primary health care. Find out scientific validation of those plants used by traditional healer. The investigated which medicinal plants use in skin diseases.The objective for this study was to perform on easement of skin disease prevalence in our country and assess to the associated impact of any skin disease. The study area was visited several times the study period.Methods: The information collected from traditional healer they use treating skin diseases. After obtaining their consent, information regarding their knowledge of medicinal plants is recorded with the help of questionnaire-based interview and the data collection by traditional healer. The Survey purposely selected and participant traditional healers.This study has identified medicinal plants used for skin disease treatment by traditional healer in Pirganj, Rangpur, Bangladesh. Generally fresh part of the plant used to preparation of medicine. When fresh plant part are not available dried parts also used in primary health care of people. During the survey it was that there must need to protect this knowledge forever. This might not reflect the actual scenario of the whole country.Result: This medicinal plants use: Azadirachta indica, Curcuma longa, Aloe Vera/Aloe inlica, Allium sativum, Allium cepa, Pterocarpus santalinus, Solanum lycopersicum, Curcuma aromatica Salisb, Vitex negundo, Cassia angustifolia, Terminalia Chebula, Celosta argentea, Mentha spicata/Arvensis, Solanum ingrum, Rosa damascena, Androgrphis paniculata, Lawsonia inermis, Nigella sativa, Nymphaea nouchali, Mimosa pudica, Pericaria hydro piper, Terminalia bellarica, Ficus carica, Citrus, Centella asiatica.Common treatment of skin diseases in traditional healers include rashes, eczema, leprosy and skin disease, fever, purification of blood, leaves is anti-septic, boils, ringworm, scabies, ulcers, eczema, antiviral, anti-fungal, ringworm, itching, wound, scabies, swelling, viral infections, bacterial infections, fungal infections, parasitic infections, pigmentation disorder.

Standard drug consumption: a study with elderly people in Primary Health Care.

To identify the pattern of medication consumption among the elderly assisted in Primary Health Care. Descriptive, quantitative, cross-sectional study, with a sample of 315 elderly people, in a city in rural Rio Grande do Norte. The average age was 72.41 years, with an average consumption of 3.15 medications per day, ranging from 1 to 16 medications daily. There was a prevalence of antihypertensives, antidiabetics, hypolipidemic and psychotropic drugs. 238 different drugs were mentioned, 15 of which were "potentially inappropriate drugs" for the elderly. Most of these patients follow treatment according to medical prescription, with low self-medication. Most elderly people buy their drugs, although many are available for free. The most consumed drugs are consistent with the most reported diseases (hypertension and diabetes). The daily use of inappropriate medications for the elderly is worrying, especially psychotropics, given the risks of dependence or health complications of these users.

Evaluating the integration of chronic care elements in primary health care for people with mental illness: a longitudinal study in Nepal conducted among primary health care workers

BackgroundDespite many important developments in the global mental health arena in the past decade, many people with mental health problems still do not have access to good quality mental health care. The aim of this study was to evaluate the perceived impact of a mental health care package (MHCP) in integrating chronic care elements in primary health care for people with mental illness.MethodsA controlled pre-post study design was used in 20 primary health care facilities in Chitwan, Nepal. We compared 10 health facilities that had implemented a MHCP (intervention group), with 10 health facilities that had not implemented the MHCP (comparative control group) but provided regular physical health services. We administered the Assessment of Chronic Illness Care (ACIC) tool on a group basis within all 20 health facilities among 37 health workers. Data was collected at three time points; at baseline, midline (at 13 months from baseline) and end line (at 25 months from baseline).ResultsFrom baseline to end line, we see a notable shift in the level of support reported by the intervention health facilities compared to those in the comparative control group. While at baseline 10% of the intervention health facilities had basic support for the implementation of chronic illness care, at the end line, 90% of the intervention group reported having reasonable support with the remaining 10% of the intervention facilities reporting that they had full support. In contrast, 20% of the health facilities in the comparative control group at end line still reported having limited support for the implementation of chronic illness care, with the remaining 80% only managing to shift to the next level which is basic support.ConclusionsThese findings suggest that training and supervision of primary health care workers in the implementation of MHCP interventions can lead to strengthening of the system to better address the needs of patients with chronic mental health problems. However, substantial financial and coordination inputs are needed to implement the MHCP. The comparative control group also demonstrated improvements, possibly due to the administration of the ACIC tool and components of counselling services for family planning and HIV/AIDS services.

Barriers and facilitators to primary health care for people with intellectual disabilities and/or autism: an integrative review.

BackgroundGlobally, people with intellectual disabilities and/or autism experience health inequalities. Death occurs at a younger age and the prevalence of long-term morbidities is higher than in the general population. Despite this, their primary healthcare access rates are lower than the general population, their health needs are often unmet, and their views and experiences are frequently overlooked in research, policy, and practice.AimTo investigate the barriers and facilitators reported by individuals with intellectual disabilities, autism, or both, and/or their carers, to accessing and utilising primary health care for their physical and mental health needs.Design & settingAn integrative review was undertaken, which used systematic review methodology.MethodElectronic databases MEDLINE, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Cochrane were searched for relevant studies (all languages) using a search strategy. Two researchers independently screened the results and assessed the quality of the studies.ResultsSixty-three international studies were identified. Six main themes relating to barriers and facilitators emerged from an analysis of these studies. The main themes were: training; knowledge and awareness; communication; fear and embarrassment; involvement in healthcare decision-making; and time. All the themes were underpinned by the need for greater care, dignity, respect, collaborative relationships, and reasonable adjustments. Opposing barriers and facilitators were identified within each of the main themes.ConclusionAdolescents and adults with intellectual disabilities and/or autism experience several barriers to accessing and utilising primary health care. The findings highlight the reasonable adjustments and facilitators that can be implemented to ensure that these individuals are not excluded from primary health care.

Prevalence and correlates of generalized anxiety disorder among elderly people in primary health care

ABSTRACT Objective To examine the prevalence of generalized anxiety disorder (GAD) and its associations with sociodemographic and health factors. Methods A cross-sectional study with a population-based sample of 578 individuals aged 60 years or older from the Family Health Strategy (FHS) program of Porto Alegre, RS, Brazil. Home visit screening and general data collection were made by trained Community Health Workers (CHWs). Diagnoses of psychiatric disorders were made by board-certified psychiatrists using the Mini International Neuropsychiatric Interview plus (MINIplus) in the Hospital São Lucas of the Pontifical University of Rio Grande do Sul (PUCRS). Results GAD was found in 9% of the sample (n = 52; CI 95% = 6.9-11.6). The main results of the multivariate analysis show associations between GAD and retirement (PR: 0.43, CI: 0.25-0.76), history of falls (PR: 2.52, CI: 1.42-4.49), cohabitation with four or more people (PR: 1.80, CI: 1.04-3.13), having more than one hospitalization in the last year (PR: 2.53, CI: 1.17-5.48) and self-perception of health as regular (PR: 2.75, CI: 1.02-7.47). Retirement in the elderly shows 2.32x less risk of GAD, although confounding factors may have overestimated this finding and underestimated the association with female gender (PR: 1.61, CI: 0.83-3.10). Conclusions We estimate a high prevalence of GAD in this population. Associations were found between GAD and health self-perceived as regular, cohabitation with four or more people, history of falls and more than one hospitalization in the last year. These epidemiological data from the Family Health Strategy are important to develop further strategies for this age group that could improve the health care practice.

&lt;p&gt;Structured follow-up of frail home-dwelling older people in primary health care: is there a special need, and could a checklist be of any benefit? A qualitative study of experiences from registered nurses and their leaders&lt;/p&gt;

AimTo identify experiences and opinions about the need for a structured follow-up and to identify potential benefits and barriers to the use of a checklist (Sub Acute Functional decline in the Older people [SAFE]) when caring for frail home-dwelling older people.BackgroundThe complexity of older peoples’ health situation requires more coordinated health care across health care levels and a better structured follow-up than is currently being offered, especially in the transitional phase between hospital discharge and primary care, but also in more stable phases at home.DesignThis was a qualitative study using focus group interviews.MethodsData were collected during six focus group interviews in three districts in a municipality. Nineteen registered nurses (RNs) and seventeen leaders responsible for the follow-up of frail home-dwelling older people participated. Participants were representatives of the RNs in homecare and their leaders.ResultsOur results highlight that although most RNs and their leaders saw a number of significant benefits to conducting a structured assessment and follow-up of frail older people home care recipients, a number of barriers made this difficult to realize on a daily basis.ConclusionThere is no common perception that a structured follow-up of frail home-dwelling older people in primary health care is an important and contributing factor to better quality of health care. Despite this, most RNs and leaders found that the use of a structured checklist such as SAFE was a benefit to achieving a structured follow-up of the frail older people. We identified several factors of importance to whether a structured follow-up with a checklist is conducted in home care.

Person-Centered Interactive Self-Management Support in Primary Health Care for People with Type 2 Diabetes: Protocol for a Randomized Controlled Trial.

BackgroundType 2 diabetes (T2D) is increasing as the population ages. The development of new medical treatments is promising and important, but the basic treatment remains self-management, even if adherence to lifestyle advice is low. Electronic health (eHealth) or mHealth interventions can increase empowerment among people living with T2D and may compensate for the lack of professional resources and geographical distances. The interactive self-management support (iSMS) project aims at including digital tools to support people living with T2D in their self-management and facilitating their interaction with diabetes specialist nurses (DSNs). This protocol outlines a study with the purpose of developing and evaluating an intervention where people living with T2D can increase self-efficacy and empowerment through digital self-monitoring and interaction with DSNs.ObjectiveTo develop and evaluate a person-centered iSMS intervention in primary health care for people with T2D in addition to their usual diabetes care.MethodsThis study is a 12-month, 3-armed, nonblinded randomized controlled trial (RCT), which will be conducted in 6 primary health care centers (HCCs) in northern Sweden. Eligible participants will be randomized to either an intervention group (n=46), a control group (n=46), or an external group (n=46) for comparison. The intervention group will receive the mobile app, and the control group will receive a minimal intervention (diabetes brochure) and the usual standard of care. Changes in glycated hemoglobin (HbA1c) will be the primary outcome measure.ResultsThis trial is currently open for recruitment. The first results are expected to be submitted for publication in Autumn 2019.ConclusionsThis study, with its focus on iSMS, will provide insights regarding suitable ways to promote and develop a person-centered intervention. If successful, the intervention has the potential to become a model for the provision of self-management support to people with T2D.International Registered Report Identifier (IRRID)DERR1-10.2196/10250

Relationship between the practice of physical activity and the functionality of older people from primary care health: Mediation by sedentary behavior

IntroductionThis study aimed to analyze the relationship between the practice of physical activity and the functionality of older people in primary health care, mediated by sedentary behavior. Material and methodsA cross-sectional study carried out with 654 older people from primary health care in Maringá, Brazil. The International Physical Activity Questionnaire and the World Health Organization Disability Assessment Schedule 2.0 were used. Data analysis was conducted through Structural Equation Modeling (p<.05). ResultsThe direct effect of sedentary behavior on functionality was weak and significant (β=.10; p<.05). Vigorous activity had a significant (p<.05) and weak (β=−.11) direct effect on sedentary behavior. When mediated by sedentary behavior, the relationship between vigorous activity and functionality showed a weak reduction in the total effect (−.10 to −.09), with an indirect effect of β=.01. ConclusionsSedentary behavior acts to reduce, weakly, the effect of vigorous activity on the functionality of older people.

Avaliação da atenção integral à saúde do idoso na percepção de profissionais

Objetivo: Avaliar a atenção integral à saúde do idoso segundo a percepção de profissionais em Unidades de Saúde da Família (USF). Métodos: Estudo de abordagem qualitativa, do tipo descritivo-exploratório, realizado no segundo semestre de 2016 em dez Unidades de Saúde da Família (USF) de um município localizado no sudoeste do estado de Mato Grosso, do qual participaram as equipes multiprofissionais das USF. Coletaram-se dados através da técnica de grupo focal. Para análise e interpretação, construíram-se narrativas e submeteu-se à análise de conteúdo do tipo temática. Resultados: O estudo evidenciou que a atenção integral à saúde do idoso na Atenção Primária à Saúde (APS), no município estudado, ocorre de maneira fragmentada e reforça a cultura biomédica. A integralidade, tida como um dos princípios doutrinários do Sistema Único de Saúde (SUS), se encontra fragilizada e pouco valorizada pelos profissionais desse nível de atenção à saúde. Conclusão: Concluiu-se que, no contexto deste estudo, a atenção integral à população idosa ocorre de forma fragmentada e desarticulada. Os profissionais de saúde investigados consideram que o cuidado realizado é puramente clínico e focado em ações curativas ou preventivas.