Ações dos agentes comunitários de saúde diante do usuário da estratégia saúde da família com estados depressivos no Município de Abaiara-CE-BR

Brazilian health public assistance is going through two Reforms, Sanitary and Psychiatric, and through these the assistance is guaranteed in the three levels: primary, secondary and tertiary. Thus, mental health assistance should be offered since preventive cares until the ones that demand larger technological apparatus. Programs like Health Community Agent's Program (HCAP) and Family Health Strategy (FHS), besides increasing the services coverage, have been making possible the system reorientation in the meaning of integrality, universalization and equity. Thus, united intervention of mental health team and FHS can offer several benefits to the population, providing assistance and follow-up to patients with mental disorder. It was aimed to assess health community agents facing the user of Family Health Strategy in depressive state. This quanti-qualitative study took place in the municipal district of Abaiara-CE. Semi-structured interview was applied with health community agents and Beck Depression Inventory with the users registered in Family Health Strategy. It was verified that among the 64 users interviewed, 12.5% didn't present symptoms of depression, 10.9% presented symptoms of light depression, 14.1% symptoms of moderate depression and 62.5% symptoms of serious depression. For the 22 health community agents interviewed, they all reported the existence of people with symptoms of depression in their personal micro-areas, being difficult to work with them, once the FHS team is not qualified to work with mental health problems. It was verified that the Municipal district doesn't have specialized professionals, making difficult the routing and treatment. Based on these results, it was concluded that in spite of the articulation of mental health with FHS is necessary and benefactor to the population, it still doesn't exist, worsening the situation, mainly in small Municipal districts, once they don't have mental health services. Thus, the population is exposed and without follow-up, which allows the identification of installed diseases and with gravity, like depression, because there are no prevention and control activities. It is recommended, due the extreme need, the elaboration and implantation of a mental health program in these municipal districts, articulated with FHS

Atenção à saúde mental na Estratégia Saúde da Família no Município de Parnamirim/RN: opinião dos profissionais, dos portadores de transtornos mentais e seus acompanhantes

This study aims to analyze and compare the opinion of professionals, managers and users about the mental health care in the Family Health Strategy (FHS). It is characterized as an Operations Research or Health System Research with a cross-sectional design and a descriptive quantitative nature. The study was developed from the application of the Opinion Measurement Scale allied to techniques of observation and structured interview in the city of Parnamirim / RN. The sample consists of 409 subjects, 209 professionals of the Family Health Strategy, 30 of the Oral Health Strategy, 19 of the Family Health Support Center, 24 directors of Basic Health Units, plus 68 users with mental disorders and 59 caregivers, respecting the ethical parameters of Resolution 196/96 of the National Health Council, trial registration number: CAAE 0003.0.051.000-11. Quantitative data were submitted to the Epi-info 3.5.2 for analysis. The network of mental health in Parnamirim involves the flow between the FHS, Psychosocial Care Centers, clinics and hospitals, having as main barriers the fragility of the referral and counter-referral system, of the municipal health conferences, of the FHS teams by the limitations in material and human resources as well as the population´s lack of acknowledge about the organization of the mental health network, issues that affect the integral attention. Even though the FHS professionals recognize the importance of their actions, they question their role in mental health care, experiencing difficulties in accessing psychiatric services (76.5%). Although most agree that the mentally ill is best treated in the family than in hospital (65.2%), the community health workers were the predominant category in the partial or total disagreement of this statement (40.8%), who is the professional in greater contact with the family. Nevertheless the caregivers miss the support of the FHS as the main focus of attention is on revenue control. The views of professionals, mental patients and caregivers converged in several statements, showing the main weaknesses to be focused by the mental health network of the city, as the perceptions that: (a) physical strength is needed to take care of mental patients for its tendency to aggression, requiring it to stay in the sanatorium for representing danger to society, (b) only a psychiatrist can help the person with emotional problems, (c) the user of alcohol and drugs does not necessarily develop mental illness, (d) the access barriers and doubts about the quality of psychiatric services, (e) caring of a mental health patient does not bring suffering to professionals. Therefore, the commitment to consensus building, monitoring and evaluation of the network are important mechanisms for an effective management system, reflecting in the importance of strengthening the health conferences and approximating different institutions. The results reinforce the importance of strengthening primary care through programs of continuing education focusing on the actions and functions of professionals in accordance with its competences and duties what contribute to the organization and response of mental health care, favoring user´s care and the promotion of family health

Perspectivados cirurgiões-dentistas sobre a inserção da fisioterapia na atenção básica de saúde

This work aims at investigating the surgeons-dentists acceptability in the field of public health in the city of Natal, State of Rio Grande do Norte, about the possibility of medicinal plants insertion in basic attencion of health. Moreover, it searchs to know if during their professinal formation it had some theoretician-pratical basement on this subject, as well as investigating their confidence on the medicinal plants. The basic motivation for developing this study is the possibility of contributing to the insertion of a tradicional health pratical at public assistance scope, endorsed by popular use, but now scientifically proven. For in a such way, the medicinal plants use is emphasized as a way to be followed to increase basic pharmaceutical assistance, improving the acess to the medicine and diminish expenses. Following this logic, family health program constitutes the way through which this pratical will be available to the users of health services. The research was done over thirty surgeonsdentists, all ofthem pertaining to public service ofNatal, state ofRio Grande do Norte. It was used, as research instrument, semi-estructured interview associated with methodological analysis user s speeches. On this form, this work is inserted in a trend observed nowadays not only in Brazil, where the use of the medicinal plants has been stimulated and defended to be inserted at programs ofprimary attenction of health

Avaliação do programa de atenção à saúde do trabalhador: uma abordagem da atenção primária

The accelerated industrialization, coming with the Industrial Revolution, caused profound changes in the working world. These changes led to the households risks from work environment. Trying to assist comprehensively the health of workers, Brazil has a program of Health Care Workers in the Primary Care, and the Family Health Strategy is the main entrance for this system. The study sought to determine if the actions of the health care worker have been developed in primary care through the Family Health Strategy. This is a quantitative study with a methodological evaluation, focusing on normative assessment. The sample was formed by professionals from Team Family Health Strategy, in the municipalities of Pau dos Ferros, Caicó and Natal in Rio Grande do Norte state. The sample consists of 202 professionals (Doctors, Nurses, Assistant / Technician Nursing and Community Health Workers) in 52 Health Family Units from the 3 municipalities cited. The instrument used consists of a checklist, from Manual of Primary Care 5 - Family Health - Occupational Health, Ministry of Health. The data were analyzed describing the variables by its frequency and doing a classification of cities from the scores obtained by each. It was observed that the Family Health professionals know the program of health care worker, however do not know the Manual of Primary Care 5, which is a guidance tool. As a result of non-appropriation of the FHT professionals with worker health, these activities are not performed, mainly surveillance in occupational health and health education labor

Prevalência das infecções do trato genital em gestantes de baixo risco da Estratégia Saúde da Família da Atenção Primária em Saúde

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Abordagem em grupo na atenção primária: o caso do Grupo do colesterol de Centro de saúde Escola de Botucatu

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Saúde na roça: expressões da qualidade das práticas de atenção primária

Esta obra tem como meta diagnosticar o funcionamento do Programa Saúde na Família, descortinando suas qualidades e seus problemas em um contexto de baixa urbanização e dificuldades estruturais. A escolha do objeto de estudo decorreu da adoção em ampla escala do programa, que hoje se constitui na principal estratégia para a expansão do atendimento à população por meio do Sistema Único de Saúde e está presente em praticamente todos os municípios do Brasil. Foi selecionada para a pesquisa uma pequena cidade do interior de São Paulo, com menos de quatro mil habitantes, distante de centros urbanos desenvolvidos e com baixo índice de riqueza. Com inspiração no trabalho etnográfico, a autora acompanhou de perto, durante uma semana, as atividades de equipes de unidades municipais de saúde e entrevistou seus integrantes. Os dados coletados diretamente no campo de estudo permitiram à autora analisar a realidade do Programa Saúde na Família, por meio dos conceitos de universalidade, integralidade e equidade, que norteiam a construção de serviços públicos de qualidade.

Efeito da atividade física no uso de serviços de saúde na atenção primária no município de Rio Claro, SP

Introduction: Physical inactivity is identified as the fourth greatest risk factor of mortality worldwide. Little is known about how physical inactivity alters the demand for use of primary health care services, and it is a subject which demands further investigation. Objective: This study aims to determine the influence that physical activity has on the demand for use of primary health care services. Methods: This is a retrospective and cross-sectional study. The Rio Claro Active Health Program (SARC), studied in this research, is a partnership between the Municipal Health Foundation and Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), represented by the Nucleus of Physical Activity, Sport and Health (NAFES) department of Physical Education and coordinated by Prof. Dr. Eduardo Kokubun. The study was carried out on residents of Rio Claro of both sexes seen at SARC. To assess the influence that physical activity had on the demand of the use of health services a questionnaire was given to participants who had attended the program since 2009. This questionnaire contains questions concerning the level of physical activity, health service use, number of both blood pressure and glucose measurement takings, number of spontaneous and scheduled medical visits, number of medications taken, number of illnesses and hospitalizations, comparing the data found in the previous year and the year after the program began. An informed term of consent was used for research participants. Descriptive analysis was carried out, using frequency, mean, maximum and minimum standard deviation. Results: Active participation in The Rio Claro Active Health program has positively influenced the following variables: perception of health, uncontrolled blood pressure, did not modify the number of diseases, number of medications in general, ...(Complete abstract click electronic access below)

Prática de atividades físicas, doenças crônicas não transmissíveis e mortalidade entre adultos usuários da atenção primária do sistema público de saúde de Bauru, São Paulo: estudo longitudinal

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Interdependência entre os níveis de atenção do Sistema Único de Saúde (SUS): significado de integralidade apresentado por trabalhadores da Atenção Primária

Integrality constitutes an important principle of the SUS, achieved through the struggles of the Brazilian health movement. It represents an expansion of the concepts of health and illness, to include the social determinants of healthcare needs. Intending to investigate the meanings of integrality reported by primary care workers, a study was developed in a medium-sized municipality in the state of São Paulo, concerning distinct technological work organization models in primary healthcare units. Among the results, the dimension of system integrality appeared with greatest frequency, according to analysis on focus groups. The workers pointed out difficulties in integration and communication between the healthcare levels, determined by selective social policies and medium/high-technology services delegated to the private market. The theoretical-philosophical framework of this study was based on cultural-historical psychology, taking into consideration the categories of work/activity, consciousness, mediation and totality.

Abandono do tratamento da tuberculose e integralidade da atenção na estratégia saúde da família

Estudo qualitativo que objetivou analisar os motivos que levam o doente de tuberculose a abandonar o tratamento, em municípios da região metropolitana de João Pessoa-PB. Como referencial teórico utilizou-se a integralidade do cuidado. Os dados foram coletados no período de outubro a novembro de 2008, mediante entrevista semiestruturada. Participaram nove usuários que abandonaram o tratamento da tuberculose. Na identificação das unidades de significação, utilizou-se a técnica de análise de conteúdo. Os resultados mostram inconsistências relacionadas ao cuidado integral do doente, no que tange à diretriz doutrinária do Sistema Único da Saúde, à consideração do contexto sócio-cultural do usuário com tuberculose e às debilidades na continuidade da atenção, mediante inadequado acompanhamento do mesmo na rede de atenção à saúde. Esses aspectos, ao dificultarem a construção de uma rede de cuidado e apoio ao doente de tuberculose e sua família, contribuem para o abandono do tratamento da tuberculose.

Análise do perfil de encaminhamento da atenção primária para pré-natal de alto risco: desafios para o ensino de competências em saúde materno-infantil

OBJECTIVE: to identify a profile of the main causes of inappropriate referrals from primary care to specialized services, as strategy for the curriculum development of core competencies related to maternal health. METHODS: a cross-sectional study was performed using document analysis of all referrals of pregnant women from primary care to the high-risk pregnancy service, state of Rio Grande do Norte, Brazil. All pregnant women referred from June to December 2014 (n = 771) were included. According to their causes the referrals were categorized as adequate, inadequate or inconclusive. RESULTS: a total of 188 referrals were classified as inadequate (24.4%) and 93 inconclusive (12.1%) totalizing 36.5% of inappropriate referrals. The main causes identified in these inappropriate referrals were: low-risk pregnancy (12.8%), unconfirmed hypertension (12.1%), risk of abortion (8.9%), teenage pregnancy (7.1%) , toxoplasmosis (5.3%), Rh incompatibility (4.6%) and urinary tract infection (4.3%). These data contributed to the formulation of the following products: 1) a continuing education program for health professionals working in primary care, undergraduate students and residents; and 2) development of a virtual platform to support professionals who need to refer patients to high-risk pregnancy service. CONCLUSION: the results of this study are relevant in the current context of education of health professionals, with potential for positively impact not only in the development of skills related to maternal health in undergraduate and graduate education, as well as contributing for improvement of the health care of the population.

Rede Assistencial em Saúde Mental na Atenção Básica

Vídeo da Unidade 01 do Módulo 02 do Curso de Especialização em Saúde Mental, da UNA-SUS/UFMA, que aborda questões referentes às ações da Saúde Mental que devem estar inseridas na Atenção Primária. O objetivo é implementar ações de promoção, prevenção e reabilitação, de forma contínua, abrindo possibilidades de atendimento, por meio de planos terapêuticos individuais, respeitando os direitos de cada usuário.

Cuidado à Saúde Bucal da Gestante na Atenção Básica

A atenção à saúde bucal da gestante é de extrema importância para a promoção da saúde materna e puerperal. O trabalho do cirurgião-dentista junto à equipe de saúde da família enriquece o acompanhamento do pré-natal e auxilia na prevenção de problemas bucais que podem causar transtornos para a mulher e o bebê. Ações educativas, preventivas e curativas para gestantes podem e devem ser realizadas na Atenção Básica, desde que sigam alguns critérios clínicos específicos. Esta webpalestra tem por objetivo refletir sobre questões clínicas e de processo de trabalho da Equipe de Saúde Bucal na atenção à gestante.

EDUCAÇÃO EM SAÚDE NA SALA DE ESPERA DA UNIDADE BÁSICA DE SAÚDE 2 DE ABRIL EM JI-PARANÁ/RO

O presente trabalho aborda o contexto da Sala de Espera e o tempo ocioso entre a chegada do paciente e seu acolhimento, até o momento de seu efetivo atendimento, quer seja para sua consulta médica, quer seja outra ação para a qual o paciente buscou a Unidade de Saúde. A aplicação de um programa de Educação em Saúde na Sala de Espera foi a ferramenta utilizada para a conversão do tempo ocioso despedido entre sua chegada e a satisfação de suas expectativas, transformando a Sala de Espera em ambiente propício para a construção de momentos de vivências construtivas. O Projeto foi desenvolvido entre os meses de julho a setembro de 2014, na Unidade Básica de Saúde 2 Abril, Ji-Paraná, Município do interior do Estado de RO, dentro da concepção do aproveitamento do tempo ocioso do usuário da Unidade Básica de Saúde, sendo conformado em apresentação de atividades educativas, concebidas de maneira a trabalhar informações sobre o próprio processo de trabalho da Unidade de Saúde, do Sistema Único de Saúde, contemplando seus princípios e doutrinas, bem como as questões ligadas ao exercício da cidadania, cuidados individuais e coletivos. Mostra a experiência bem sucedida da implantação do programa de atividades educativas, que foram ministradas pelos integrantes das Equipes de Saúde da Família apoiadas pela Unidade, como pilar de conversão do usuário, que via de regra, adota uma postura passiva, para uma postura protagonista. Qualifica-se ainda por ampliar a proposta com aspectos de educação e cidadania. A estratégia tanto contemplou o aproveitamento do tempo ocioso, quanto acabou por fomentar a aproximação do usuário ao seu centro de referência quando o assunto é problema de saúde. Esta aproximação serviu também para conotar a Unidade Básica de Saúde como referência de ensinamentos em saúde com reforço do pensamento preventivo e promocional de saúde.