Navegando por Palavras-chave "Programa de saúde da família"
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- ItemAcesso aberto (Open Access)Aplicação de um modelo de gestão na atenção básica de Capela do Socorro, município de São Paulo(Universidade Federal de São Paulo (UNIFESP), 2009-11-25) Yashiro, Suely Miyuki [UNIFESP]; Ribeiro, Sandra Aparecida [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objectives: To verify if the model of PNGS can be understood and used to stimulate opportunities for performance improvement in Public Health Care units (PHCu) and to observe the differences in the management of traditional PHCU and Health Family Programs (HFP) evaluated with this model. Methods: This study was conducted in 10 from 14 PHCu of Capela do Socorro, in the city of São Paulo, from August 2006 to May 2007. After instruction, managers prepared the PHCu documents (presentation and profile) and the Management Report (MR) in ways of PNGS. As indicators of progress in management the number of patients registered in the HiperDia System was analyzed and two joint efforts with hypertensive patients enrolled in PHCU were made to verify the improvement in their control. Results: Regarding the analysis of the profile of PHCU in the item presentation, the average was 70.6% and 64.4% for the item profile. Health Family Programs obtained higher average in both presentation and profile compared with PHCu. In evaluating the MR on the criteria of PNGS for the template of 250 points, the total sum obtained by UBS ranged from 16 (6.4%) to 103 (41.2%) points. The units with HFP had a medium of 78 points (31.2%), while traditional PHCu had 51 points (20.4%). Most reports showed a good understanding of their formulation. There was an increase of 6,6% in the register of patients in HiperDia System and it was observed a significant decrease in the medium of Systolic Blood Pressure-SBP (167.0 to 156.6 mmHg) and Diastolic Blood Pressure-DBP (107.9 to 93.8 mmHg) in those patients considered non-controlled at the beginning of the project, between August 2006 and May 2007, respectively. Conclusion: The model of PNGS was understood and was helpful in assessing the management of PHCU. The presentation and profile of PHCu were satisfactory and HFP had best scores than the traditional ones. Although the MR was not prepared satisfactorily. There was an increase in registration of patients in HiperDia System and a significant decrease in measures of SBP and DBP of previously non-controlled patients, both in PHCu and HFP units.
- ItemAcesso aberto (Open Access)Desenvolvimento e análise avaliativa de uma capacitação em violência intrafamiliar contra crianças e adolescentes para profissionais do programa de Saúde da Família(Universidade Federal de São Paulo (UNIFESP), 2011-05-25) Machado, Andrea da Luz [UNIFESP]; Bordin, Isabel Altenfelder Santos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objectives: To develop and evaluate a training program on intrafamilial violence against children and adolescents for community health workers and nurses from the Family Health Program (FHP). Methods: The training program was applied to all FHP teams (n=7) from Embu city-São Paulo State and two FHP teams from Fortaleza city-Ceará State. Fifty-nine professionals (50 community health workers, eight nursing assistants and one nurse) were trained in Embu, and 37 professionals (30 community health workers and seven nurses) were trained in Fortaleza. Professionals were trained in groups (20 participants per group in average), being three groups from Embu and two from Fortaleza. The training program included 27 hours, divided in nine workshop sections (three-hour weekly meetings) conducted by a pair of trained instructors, based on the steps described in the training manual. The evaluation of knowledge acquisition and change in attitudes was based on case reports by participants obtained in three points in time (T0 - before training, T1 - one week after training, and T2 - three months after training). The evaluation followed three thematic axes: (1) case identification, (2) gathering of resources for notification, and (3) gathering of resources for the follow-up of families. Results: In total, 71 cases of intrafamilial violence against children and adolescents were reported by participants, but 22 of them did not report any cases. Resistance to report cases was observed among some professionals, and identification was restricted to severe cases. Regarding the ability of gathering resources for notification and follow-up of children/adolescents victims of intrafamilial violence, it was possible to identify three different professional profiles: (1) those who initially report cases with referral to the Tutorial Council, but were not intending to follow them up; (2) those who report cases without mentioning decisions taken and are inclined to notify, but do not seem inclined to follow the families up; (3) those who initially report cases without mentioning decisions taken and remain reluctant about the notification, but are inclined to follow-up cases they might identify in the future. Conclusion: Professionals that have better absorbed the content from the training program steps were those who spontaneously reported cases from their daily experience, revealing to be already sensitized and prepared to deal with the thematic of violence. Because each professional profile requires a different approach from the training program, it must be tailored to the needs of participants in order to be effective.
- ItemAcesso aberto (Open Access)Envelhecimento bem sucedido em idosas do Programa Saúde da Família de Maceió: o papel da aptidão funcional(Universidade Federal de São Paulo (UNIFESP), 2011-03-30) Santos, Marlete Bezerra dos [UNIFESP]; Ribeiro, Sandra Aparecida [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: The successful aging is considered the new gerontology paradigm. The functional fitness is imperative to the successful aging. Objective: investigate the socioeconomic and health conditions and the relation between the functional fitness by American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD) and successful aging in elderly female registered in the Family Health Program of Maceio, from 2008 to 2009. Method: The study took place in Primary Care Settings with Family Health Program, from July, 2008 to February, 2009. The population was a random sample of women from 60 until 79 years-old, registered in the Family Health Program of Maceio. The variables studied were: socioeconomic and health perception conditions, flexibility, agility and balance, coordination (AAHPERD), self-referred morbidities, nutritional status (body mass index and waist circumference); depression (geriatric depression scale-30); international physical activity questionnaire (IPAQ) and functional capacity (Lawton scale). The data were analyzed by descriptive statistics, qui-Square test, Fisher fs exact test, non-pared t-test, correlation coefficient of Pearson, being considered of significant level the values of p<0.05. Results: 268 elderly women were analyzed with a mean of 66.68 years (DP+/-5.77). There were a higher proportion of women from 60 to 69 years (70.5%). Hypertension was more prevalent (84%), followed by arthritis/rheumatism/artrosis (56.7%) and diabetes (31.3%). Of the women, 41% have mild to moderate depression (Geriatric Depression Scale.11), 12.7% were classified with functional dependency and 50.7% were considered as sedentary or insufficiently actives. In the AAHPERD tests, 76.1% had good/very good evaluation related to flexibility, 34.7% for agility and dynamic balance and 6% for coordination. Of the sample, 30.6% were shown with good/very good functional fitness. This functional fitness was correlated to age, years of education, functional capacity and physical activity. 16.4% of the sample was considered for the successful aging model. The association among successful aging and lack of hypertension, diabetes, heart diseases and arthritis/rheumatism/artrosis were significant. Conclusion: The evaluated elderly female had low educational level, low income and had a regular to bad perception of health. There was a high level of self-referred morbidities, being the hypertension, arthritis/rheumatism/artrosis and diabetes as more frequent. The functional fitness measured by AAHPERD were related to age, educational level, functional capacity and level of physical activity and may work as a evaluation parameter and follow-up for successful aging.
- ItemAcesso aberto (Open Access)Fatores associados ao histórico de quedas de idosos assistidos pelo Programa de Saúde da Família(Faculdade de Saúde Pública, Universidade de São Paulo.Associação Paulista de Saúde Pública., 2010-12-01) Ricci, Natalia Aquaroni [UNIFESP]; Gonçalves, Daniele de Faria Figueiredo; Coimbra, Ibsen Bellini; Coimbra, Arlete Maria Valente; Universidade Federal de São Paulo (UNIFESP); Universidade Paulista; Universidade Estadual de Campinas (UNICAMP)This study aims at identifying the sociodemographic, clinical-functional and psycho-cognitive factors associated with the history of falls of community-dwelling elderly individuals assisted by Programa Saúde da Família (PSF - Family Health Program). The sample comprised 96 elderly subjects equally divided into three groups according to the report of falls that occurred during the past year, as follows: without falls, one fall or recurrent falls. There were no significant differences between groups in relation to sociodemographic data. The non-faller group presented less complaints about pain (p=0.012) and dizziness (p=0.003), and less near-falls reports (p=0.003) when compared to the faller groups. Besides, it presented better mobility (p<0.001) and functional capacity (p<0.001) in comparison with the same groups. In the psycho-cognitive assessment, recurrent fallers showed higher depressed mood score (p=0.009) and higher cognitive impairment score (p=0.040) compared to non-fallers. The occurrence of falls must be considered a significant agent that negatively affects elders' life. This is why its causative as well as impeditive factors must be accurately identified, so that professionals can effectively prevent falls or their debilitating consequences.
- ItemAcesso aberto (Open Access)Matriciamento na atenção básica: estudo de equipes ESF e NASF atuando na região da Capela do Socorro-SP(Universidade Federal de São Paulo (UNIFESP), 2015-11-30) Santos, Rosimeire Aparecida Bezerra de Gois dos [UNIFESP]; Lima, Laura Camara [UNIFESP]; Uchôa-Figueiredo, Lúcia da Rocha [UNIFESP]; http://lattes.cnpq.br/3179063226554474; http://lattes.cnpq.br/6277780648747957; http://lattes.cnpq.br/1414454195907488; Universidade Federal de São Paulo (UNIFESP)In early 1970, the Brazilian Government reformed the basic attention to health (ABS). The outpatient model, centered in the medical professional, it moved to a strategy or the family health program (PSF), with new principles as: health promotion, health responsibility for a territory. In January 2008, the core of support for family health (NASF) was created for the expansion, increased resolution and completeness in health care. The NASF was thought of as a specialized rear toward the clinical and educational action in support of teams, using technologies such as: Matrix Support, Expanded Clinic, Unique Therapeutic Project (PTS), Health project in the territory (PST) and continuing education (EP). The research presented here aims to investigate the General theoretical knowledge and practices that the ESF professionals and the NASF associated with the Matrix-based. The specific objectives are: to investigate how the Matrix-based into the daily routine of the professionals and shared construction; besides enabling scientific return for public authorities and contribute to effective public policy. It is descriptive and exploratory study, quantitative approach, with qualitative refinement. Were invited to join the PSF doctors and nurses and all the professionals of the NASF linked the five basic health units (UBS) of the region of Capela do Socorro of Sao Paulo. Data collection took place by questionnaire; It took five dates of 30 minutes each, in five UBS, to perform it. 78:44 professionals participated in the PSF and 34 of the NASF. Descriptive statistics and inferenciais were carried out. The results reveal that 80 of surveyed have graduate degrees, but only 35 are post-graduates in family health, indicating lack of theoretical training. The answers regarding the everyday actions of Matrix-based, indicate the existence of differences between PSF teams and NASF, in particular three concepts: intersectoral approach (32.6 of the PSF against 76.5 of the NASF), Permanent Education (51 of the PSF against 85 of the NASF) and Expanded Clinic (48.8 of the PSF and 79 of the NASF). The differences are smaller with regard to the practice of PTS and discussion of Case, respectively: 76.7 of the PSF and 100 of NASF and 85 of the PSF and 100 of the NASF. There is more consensus when it comes to work. The analysis of qualitative issues have enabled a refinement, giving access to freely meanings assigned to the Matrix-based by groups of subjects and the set of parsed data indicates that the PSF teams tend to organize from a model of ambulatory assistance doctor-centric, while the teams of the NASF are more open to other sectors, knowledge and trading spaces. It was noticed that the Matrix-based can be a good strategy, but still need to make adjustments to make it more compatible with the work of the two teams, for example making the ESF professional agendas, as well as raise the awareness of managers and trainers of universities of the need to expand the vision that they have of the possibilities of sharing knowledge and experiences.
- ItemSomente MetadadadosSaúde mental na atenção básica no município do Guarujá/SP: a percepção de enfermeiros e agentes comunitários de saúde acerca de suas práticas na estratégia de saúde da família(Universidade Federal de São Paulo (UNIFESP), 2013-02-27) Gazignato, Elaine Cristina da Silva [UNIFESP]; Castro-Silva, Carlos Roberto de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The Family Health Strategy is the main gateway in primary health system even as the demands for mental health. However, these guidelines from the Ministry of Health are recent and require changes in the functioning of the health system, highlighting a closer look to the professional team of family health as their preparation and ability to cope with this demand that used to be directed to specialized services. In this sense, the objective of this study is to investigate the perceptions of nurses and community health workers of the Family Health Units in the city of Guaruja-SP as the demands of mental health. This is an exploratory and descriptive qualitative approach, data were collected in semistructured interviews and subjected to content analysis. We interviewed 05 community health workers and 05 nurses of all five Family Health Units the municipality. The results were organized into four thematic main: conceptions of mental health, work acting, inter-relationship and networking. Regarding conceptions in mental health can be observed that are related to changing patient behavior, living conditions that may contribute to the onset of disease and the person considered difficult to handle. In general, the referral to the specialist was cited as the most practiced, however, guidance, listening, encouragement and care practices also emerged as recurring. The links with staff, patients and families trigger feelings related to fear, discomfort, insecurity and powerlessness against the demand for mental health. Moreover, the close and constant interaction with the community and knowledge of this fact favors the bonds and shares of professionals. The relationship with family shows up it’s extremely important in the evolution of treatment, but often it is little strengthened, and the staff does not always show itself capable of accepting and sharing the doubts and anxieties, especially community health workers in relation to these patients. In this sense, there is need to strengthen the networking that despite some important initiatives is still incipient, and the importance of continuing education to prepare professionals to deal with this demand. The work of the Specialist Orientation mental health, defined as a technical support in specific areas to the responsible teams for the development of basic health, was cited as a suitable alternative strategy to deal with the issue of ignorance and inexperience of the healthcare family team, and may strengthen the practice of co-responsibility of patients needing such care. We consider data from that work articulated networking, continuing education and matricial are strategies that can generate positive results contributing to a service based on the principles and guidelines of the SUS and the Psychiatric Reform.