Mestrado Profissional em Saúde Coletiva (PRPG)

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Absenteísmo-doença entre servidores públicos municipais de Goiânia
(Universidade Federal de Goiás, 2012-02-02) Leão, Ana Lucia de Melo; Rassi Neto, Elias; Turchi, Marília Dalva; http://lattes.cnpq.br/3769826743537934; Turchi, Marília Dalva; Corrêa Filho, Heleno Rodrigues; Souza, Marta Rovery de; Rosso, Claci Fátima Weirich; Bezerra, Ana Lúcia Queiroz
Background: Sickness absence (SA), known as work disability justified by sick leave, can be an indicator of workers health status. In municipal government, like the rest of the country, the prevalence of SA and its main causes are still poorly documented, and are restricted to the analysis of some occupational groups, especially those who engage in health care or in institutions education. Estimates of the magnitude of SA vary widely and socio-demographic aspects related to nature and working conditions are among the main factors associated with the frequency and duration. Aims: To study the prevalence and the factors related to SA workers from the public sector in the municipality of Goiânia. Methods: Cross-sectional population-based study assessing prevalence and factors associated with sick leave lasting longer than three days for the health treatment from 2005 to 2010, in civil servants. Outcomes: 40.578 sick leave were assessed among 14.484 absent workers which generated 944.722 absent days. The indicators of sickness absence in that period were: prevalence of sick leave of 39.0%, higher among education professionals (47.7%) and health (41.9%), the mean duration of SA was 40 days / year per worker away and the average duration of Licenses was 23 days per episode. Predominance of female sexual workers, aged between 41 and 50 years, married, white, with high educational background, earning up to three minimal salaries, with their own house, with from 3 to 10 years of public service, having a professional bond and basically in operational tasks registered in the Municipal Secretariat of Education and Health. The main cause of sickness was mental and behavioral disorder followed by musculoskeletal diseases. The Multivariate analysis showed an association between sickness absence and the female subjects (OR 1,54 IC95%1,41-1,68), being older (OR 1,86 IC95% 1,48-2,32), married (OR 1,51 IC95% 1,13-2,02), having elementary school degree (OR 12,35 IC95% 10,39-14,69), income of up to three minimal salaries (OR 1,37 IC95% 1,21-1,55), having more working experience concerning the time(OR 3,39 IC95% 2,50-4,59), being professional in the health and educational area (OR 2,96 IC95% 2,60-3,38 and OR 2,90 IC95% 2,51- 3,36), as well as being part of the staff in the Municipal Secretariat of Education and Health (OR 1,69 IC95% 1,30-2,21 e OR 1,60 IC95% 1,23-2,09 ). Conclusions: The indicators of SA express the magnitude of this phenomenon in public service and can assist in the planning of health worker prioritizing the most vulnerable occupational groups whose socio-demographic characteristics and work organization influence on absenteeism due to illness.
Acesso à saúde bucal na atenção primária no estado de Goiás
(Universidade Federal de Goiás, 2015-10-23) Vidigal, Frederico França; França, Mary Anne de Souza Alves; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4260160A0; Rosso, Claci Fátima Weirich; http://lattes.cnpq.br/1137218060736306; Rosso, Claci Fátima Weirich; Nunes, Maria de Fátima; Bezerra, Ana Lúcia Queiroz; Marcelo, Vânia Cristina; Souza, Marta Rovery de
Introduction: Access to dental services offered to the population, as well as their quality, is a major challenge for the Public Oral Health in Brazil . The primary care plays a key role in trying to universal access with equity within a comprehensive perspective of health, because it acts in various sizes, from actions of promotion and prevention following the treatment of the main oral diseases. Objective: Analyze the access to oral health services in primary health care in Goiás from the external evaluation of the program Improving Access and Quality. Methodology: Descriptive cross-sectional, which selected information were generated from the national basis of the database of the external evaluation of the program Improving Access and Quality of Primary Care (PMAQ-AB). The study sample consisted of the 712 Basic Health Units (UBS) of the 246 municipalities in the state of Goiás who joined the PMAQ-AB (a 1216 UBS universe) and the 677 professionals who answered the interviews of the module II. Data collection occurred between July and September 2012 through a structured instrument, standardized, previously validated. For analysis, the data was sent to a bank of the Ministry of Health, through the use tablets and via an internet network. After sending these data were stored and grouped into modules I, II and III. Statistical analysis was performed using the software Statistical Package of Social Sciences - SPSS version 19.0. The study met the ethical and legal aspects recommended by Resolution 466/2012.Results: It was found that most teams- schedule consultations in oral health any day and any time of the week, and in the cities of smaller population size this characteristic is more present. Welcoming the specific spontaneous demand for oral health is performed by 63% of pesquisa¬das teams, but almost half of them do not use any protocol. The security agenda for Oral Health Team for continuing user trata¬mento who started their treatment is reported by 72.3% of respondentspro¬fissionais. The assessment of risk and vulnerability in the first service is held by 70.6% of respondents, while 67.3% report that the supply of vacancies is defined according to the identified risk and 40.9% of the teams have protocol that defines flow to care for people with special needs. Carrying out surveillance activities in oral health related to campaigns for detection of oral lesions and referral of cancer suspected cases is done by 56.1% of respondents teams while 44.2% carry out the registration and monitoring of suspected / confirmed of oral cancer. Conclusions: This study showed that better planning should be done in primary care the state of Goiás , to ensure access to oral health care as an effective gateway to the SUS. It was also possible to see that there is an association between population size and access to oral health services , and in smaller municipalities there is less difficulty the population to enter the network care.
Acesso e acolhimento inseridos no processo de trabalho da atenção básica à saúde
(Universidade Federal de Goiás, 2017-09-15) Castro, Lorena Peres; Almeida, Nilza Alves Marques; http://lattes.cnpq.br/2486258562480055; Souza, Marta Rovery de; http://lattes.cnpq.br/115504257912315; Souza, Marta Rovery de; Barros, Patrícia de Sá; Veronezi, Rafaela Júlia Batista
Introduction: Access to and acceptance of spontaneous demand in basic health units (UBS) are fundamental strategies of the work process in health, quality assurance and strengthening of Basic Health Care (ABS). Objective: To characterize the work process of the health teams related to the access and reception of the users in the UBS of the State of Goiás, through a national survey of evaluation of Primary Care carried out by the Ministry of Health (MS). Methodology: This is a descriptive, quantitative approach whose results were generated from secondary data extracted from the Bank of the External Evaluation component of the second cycle of the National Program for Improving Access and Quality of Basic Care (PMAQAB). The data were collected between December 2013 and March 2014 and represent a sample composed of 975 basic health units and 1180 family health teams from 242 municipalities that joined the PMAQ-AB in the State of Goiás. It was possible to characterize and discuss the health work process related to the access and reception, under two axes of analysis: characterization of the access to health services of the basic health units and systematization of the reception to the spontaneous demand of users attended by family health teams. Results: With regard to access to UBS in Goiás, only 9.8% work on Saturdays and 2.7% open during the night; 99.6% of the family health teams make a face-to-face appointment, and 43.5% refer to appointments on a first-come, first-served basis. With regard to the reception, 97.6% of the family health teams host the spontaneous demand, but the majority (57.4%) in the waiting room; 89.7% report risk and vulnerability assessment, but 25.7% were not qualified for such assessment; 4.5% do not provide urgent and emergency care and 43.6% of the teams said they did not have protocols to meet spontaneous demand. Final considerations: The analysis of the results allows to conclude that in relation to access to basic health units, there are weaknesses that should be reassessed by health unic system (SUS) management instances, such as: limited appointment marking system, pre-scheduled appointments, hours of operation of the predominantly commercial units, reservation of vacancies in the health professional's appointment book for continued care and absence of professionals in the health teams. Regarding the reception, in spite of the fact that most health teams affirm it, the results indicate that its systematization is under construction in the State of Goiás, constituting obstacles and advances that qualify the reception.
Administração segura de medicamentos: proposta de protocolo de orientações para equipe de enfermagem
(Universidade Federal de Goiás, 2016-07-15) Fortes, Alba Valéria Sales; Junqueira, Ana Luiza Neto; http://lattes.cnpq.br/5630152521626068; Junqueira, Ana Luiza Neto; http://lattes.cnpq.br/5630152521626068; Bezerra, Ana Lúcia Queiroz; Ribeiro, Luana Cássia Miranda
This paper aims to draw up a protocol on safe administration of medication intramuscularly to be made available to nursing staff. Methodology: descriptive study focused on the development of protocol for safe medication administration intramuscularly which were formulated based on the standards set by the scientific community, following pre-existing technical guidance grounded in clinical evidence, which were collected through a integrative literature review the following topics emerged: theoretical concepts related to anatomical issues for each drug administration region intramuscularly, as well as their graphic representations; factors that interfere directly and / or indirectly in making the decision as the best region of choice for the administration of injection; advantages and disadvantages of each region for drug administration and drug application techniques in the recommended intramuscular regions, with illustrations of them. Results: Prepared protocol with guidance on safe practices for administering medication intramuscularly, which includes the detailed description of the technique, images of anatomic regions, as well as key recommendations to this procedure, such as the correct choice of the site to be accessed, following recommended safety order, age, size of the needle, maximum volume to be injected. Conclusions: The activity of care, as well as complex, requires reliability to the assistance provided through insurance procedures and in this light, the construction of the protocol is notorious for carrying out the activities in which nursing is involved, since it is configured as a guiding instrument of care, promoting the work process of the nursing team regarding the safe administration of medications. The use of this instrument can help the practitioner to maximize therapeutic effects of administered medication, minimizing or eliminating injury to the patient and discomfort associated with intramuscular injections.
Análise da gestão nos distritos sanitários em Goiânia - uma proposta de descentralização
(Universidade Federal de Goiás, 2012-10-03) Souza, Maria Cláudia Honorato da Silva; Rosso, Claci Fátima Weirich; http://lattes.cnpq.br/1137218060736306; Rosso, Claci Fátima Weirich; Rocha, Dais Gonçalves; Rovery, Marta
The Sanitary Districts are the extension of the central level of the Municipal Health Department in the Health Units which are part of the process of decentralization of the municipal management. To develop assistance continuously in a solvable way it is necessary that the manager and the teams in the units and Sanitary Districts know about the flows, that partnerships are established and agreed upon. In this study we aimed to diagnose elements of the work developed in the management of the Sanitary District in the Municipal Health Department in Goiânia, Goiás. We used a descriptive exploratory research methodology with professionals working in the health field who carried out duties of directors and supervisors in the seven Sanitary Districts of the Municipal Health Department in 2011. A well-structured interview was used to collect data. Thus it was organized in a way that allowed its analysis in the SPSS 15.0 program. Data were coded to proceed with the descriptive analysis based on the theoretical frame of reference. This study was assessed and approved by the Ethics Committee for Human and Animal Research of the Clinical Hospital of the Federal University of Goiás, under Protocol number 031/2009. Twenty managers of various professional categories who represent 95% of the district directors, took part in the research at the time of the study. The results show that most managers are female between 31-50 years old, and are graduated from private universities for more than 10 years. 80% of them have active employment whereas 90% exert their management under exclusive dedication. The political appointment is the aspect which influenced 55% of the management positions. 80% of the managers participated in specific training in management. Amongst the management activities considered important, the team management was cited by many, whereas the planning was devalued. From this study we intend to consolidate proposals of ongoing training, reinforcing the aspects appointed as weak and those which are essential to good management.
A análise da organização dos processos de trabalho das equipes de saúde da família de Goiânia segundo Programa de Melhoria do Acesso e Qualidade (PMAQ-AB) – 2012
(Universidade Federal de Goiás, 2015-02-25) Parreira, Patrícia Belém; Souza, Marta Rovery de; http://lattes.cnpq.br/1155042579123151; Souza, Marta Rovery de; http://lattes.cnpq.br/1155042579123151; Freitas, Revalino Antônio de; Pereira, Edsaura
The Primary Health Care acquires a central role in the Public Health System in Brazil for being the main entry of the user in the system. It has become the focus of assessment by the Ministry of Health Care in order to guide the public policies, as well as to strengthen the working processes of teamwork, ensuring the access of the population, the completeness and the coordination of care. The Program for the Improvement of the Access to and Quality of Primary Care (PMAQ-AB) appears in Brazilian scenario with this order. As one of the stages of this program, the external assessment focuses on three main approaches: structure, processes and user satisfaction. This paper aims to perform an analysis of the data from the first cycle of the PMAQ-AB, collected from July to September 2012, in the city of Goiania in relation to processes of work "light-dependent technologies ". Therefore, we performed a cross-sectional study of descriptive approach, developed from this basis of secondary data and a restriction on the variables: team planning and actions of the management for organization of the work process; institutional support; matrix support; team meetings; reception to the spontaneous demand and organization of the agenda. The study revealed the need for improvements in the care of users, especially in the assessment of risk and vulnerability and strengthening of institutional support so that teams can optimize their organization.
Análise da percepção do paciente com a segurança no atendimento em unidade de urgência e emergência
(Universidade Federal de Goiás, 2016-12-19) Arruda, Nara Lília Oliveira; Bezerra, Ana Lúcia Queiroz; http://lattes.cnpq.br/0088227879433410; Bezerra, Ana Lúcia Queiroz; Silva, Ana Elisa Bauer de Camargo; Prado, Marinésia Aparecida; Paranaguá, Thatianny Tanferri de Brito; Rosso, Claci Fátima Weirich
This study aimed at analyzing users' perception due to safeness of health care offered by professionals in an emergency and urgency unit of a university hospital in Midwest of Brazil. The population was composed of 100 patients who met pre – established criteria for research. This is a cross-sectional, descriptive, quanti-qualitative study. The data were collected from May 31 to August 30, 2015 through interviews, guided by a semi-structured adapted and tested tool. The quantitative data were entered in the Statistical Package for The Social Science (SPSS) version 20.0 and analyzed, descriptively, by means of simple and absolute frequencies. For qualitative analysis, Bardin content analysis was used. The results showed that 53.0% of the patients were females from 19 to 84 years, an average of 50.6 years. Regarding the care, 100% were of urgency for clinical treatment. 99% of the patients were satisfied with the care received, and 99% felt safe with professionals care; 96% had no problems during the period they remained in the emergency and urgency unit. As a safe conduit, they pointed out that 99% of the professionals confirmed the name before any procedure and 89% clearly explained the procedures; 86% were advised on possible complications; 93% reported that professionals showed skill in performing procedures; 69% that professionals always consulted the prescription before the procedure. Regarding the occurrence of errors, 97% would like to be informed about the occurrence of errors during the treatment, even if, it did not cause damage; 80% relied on the team and judged they were unable to anticipate the possible error in care. Patients' satisfaction with the care and rehabilitation of the emergency and urgency services was considered an important indicator of assistance quality in emergency and urgency units in the hospital. It is expected that this study contributes to the formulation and enhancement of educational actions as a strategic way to reach and / or strengthen patient satisfaction with care security, as well as, for the policies elaboration that subsidize the formation of a culture decreasing the risks of hospitalization and ensuring improvements in care quality in emergency and urgency units in local and national context.
Análise da tendência da cárie e influência de fatores individuais e contextuais em escolares de 12 anos em Goiânia-GO, no período de 1988 a 2010
(Universidade Federal de Goiás, 2013-08-29) Oliveira , Lorena Batista de; Bahia, Sandra Cristina Guimarães; Freire , Maria do Carmo Matias; http://lattes.cnpq.br/6056344372250078; Freire, Maria do Carmo Matias; Mohn Neto, Carlos Rodolfo; Queiroz, Maria Goretti; Nunes, Maria de Fátima; Lemos, Cristiane Lopes Simão
The monitoring of oral health and its determinants are of utmost importance for the planning and evaluation of health programs at the local level and to expand knowledge about this issue in Brazil. The aim of this study was to analyze the trend of dental caries and its association with individual and contextual factors in 12 years-old in the city of Goiânia. We conducted a cross-sectional study using data from epidemiological surveys of oral health conducted in the county from 1988 to 2010 and data from local information systems on contextual factors related to schools. For trend analysis of caries from 1988 to 2010 the Spearman correlation coefficient was used. Comparisons among Health Districts (HD) were made for the years 1994 and 2010. To analyze the association of the disease with individual and contextual factors in 2010 a multilevel analysis and log-linear regression negative binomial ratio averages were conducted, considering the complex sampling design. The dependent variable was the DMFT index and the independent variables were individual (sex, race and maternal education) and contextual related to schools (type of school, health district and the presence of oral health programs). The mean DMFT decreased 78.5% in the period, from 8.26 in 1988 to 1.78 in 2010 (r = -1.0, p ≤ 0.01) and there was a decrease of 86.8% in the decayed component, 73.3% in the missing due to caries and 41.7% in the filled teeth. There was an increase of 86.8% in the number of caries-free schoolchildren from 1994 to 2010 (r = 1.0, p ≤ .01). Children attending schools located in the HD with the worst socioeconomic indicators showed higher caries prevalence and lower percentage reductions compared with those with better indicators. In the multilevel model, female students and those whose mothers had less education, attending public schools located in districts with the worst socioeconomic indicators, and covered by the Family Heath Strategy had a higher DMFT in 2010. We concluded that there was a decrease in the prevalence of caries in Goiania from 1988 to 2010 and inequalities in the disease distribution in relation to sociodemographic factors related to individuals and school environment, which indicate the need for more effective actions seeking to reduce the inequalities, with emphasis on the school population less economically favored.
Análise da utilização de bundle de prevenção de infecção primária de corrente sanguínea relacionada a cateter venoso central, em unidades de terapia intensiva de um hospital público de Goiás
(Universidade Federal de Goiás, 2016-04-15) Yoshida, Thais; Silva, Ana Elisa Bauer de Camargo; http://lattes.cnpq.br/8388407861788466; Turchi, Marília Dalva; Souza, Sandra Maria Brunini de
INTRODUCTION: Primary bloodstream infections related to central venous access(CVA) are among the most frequent infections related to the health assistance and are associated to a longer hospitalization time, high mortality risk and higher costs to health services. Preventive measurements as bundles can reduce the recurring cases of hospitalization and other complications. OBJECTIVES: To analyze the use of a prevention bundle on primary laboratory bloodstream infection related to central venous access on Intensive Care Units in a public hospital in Goiás, from 2012 to 2015. METHODOLOGY: Retrospective study performed on adult and kids intensive care units(ICU) through the analyses of secondary data of the physical and electronic data archives from the Medical Infection Control Service. The following tests were used: Shapiro-Wilk test to check the normal quantitative variables; test of U-Mann-Whitney and Fisher to compare the median differences and proportions of the ICU’s. Two models were used to achieve the objectives. To evaluate the effect of the bundle implementation two periods were compared, these periods were determined as pre intervention period ( prior to bundle implementation) and post intervention. In the adult ICU the pre intervention period corresponds from January 2012 until October 2014 and at the kids ICU, from January 2012 to August 2014. The post intervention phase corresponded of data between November 2014 to December 2015 on the adult’s ICU and from September 2014 to December 2015 on the kids ICU. To evaluate the bundle process indicators, two periods were taken in comparison (2014 and 2015), 2014 being the year that the bundle was implemented. Indicators and variables found on the pre and post intervention period were compared using the regression models of Poisson. <0,05 p rates were considered statistically significant. Confidence intervals of 95% were calculated to the indicators. The analyses were performed on the STATA software, 12.0 version and the graphics were built on the Graph Pad Prism software, 6.07 version. The project was approved by the Ethic Committee, 011/2012 protocol number. RESULTS: A non significant reduction on the IPCSL/CVC in adults ICU’s (RR:0,75; IC 95%: 0,15-3,60; p = 0,723), even though there was high bundle use on the post intervention period. On the other hand, there was a non significant increase on the kids ICU’s(RR: 1,17; IC 95%: 0,26-5,27; p = 0,834). Low bundle total conformity on the kids ICU’’s . Insertion and removal of the catheter were the two least adhered methods adopted on both ICU’s. CONCLUSION: This study did not find significant reduction on the IPCSL/CVC density after bundle implementation, which suggests the need of reviewing the use process, just as the need of continuous professional training to apply bundle and ways to measure the use of the processes with the assistance team.
Análise das contribuições de uma regional de saúde do estado de Goiás na governança interfederativa da região
(Universidade Federal de Goiás, 2018-12-14) Mendes, Patrícia Freitas; Silva, Marilúcia Batista Antônio; http://lattes.cnpq.br/9435306631014870; Pereira, Edsaura Maria; http://lattes.cnpq.br/8820722314388248; Pereira, Edsaura Maria; Souza, Marta Rovery de; Freitas, Revalino Antônio de; Silva, Marilúcia Batista Antônio
Introduction: The Health Department of Goiás has 18 Health Regions acting as administrative support to articulate, refine and plan the health services offer, identifying priorities for intervention in order to allow greater access of citizens to services. The Pireneus Health Region, located within the central-north macroregion, is responsible for supporting a region that includes 10 municipalities, with a population of 500,652 people. Understanding the potential of Regional Health as a participant in guidelines for collective health actions in the region may favor the cooperation of each of the parts that make up the health region. Objective: To analyze the performance of the Regional of Pireneus Health of the State of Goiás before the process of regionalization of SUS. Methodology: Mixed, descriptive and qualitative study, using questionnaire applied to the servers of the Regional Health of the Pyrenees; documentary research and focal group interview with representatives of the workers of the Unified Health System and collegiate bodies of interfederative articulation (CIB, CIR and COSEMS). The analysis and comprehension of the data collected was based on the categorization of information, through spreadsheets and figures formulated in Microsoft Office (Excel) and by the use of MAXQDA 2018 software. Results: It was possible to correlate the demographic profile and the workforce of the Pireneus Health Region, to relate the actions performed and the level of satisfaction of the employees, and to discuss the political-administrative relations of the Pireneus Health Region. Regarding the Regional Health contributions to the region it was observed, it was observed that the team has sufficient technical capacity to support the municipalities and region and perform the administrative and support function for the region. As for the weaknesses pointed out, there is little integration among the regional sectors, difficulty in monitoring the actions and services carried out by the region, and absence of the situational diagnosis of the region with the implementation of the actions according to the demand due to insufficient human resources. Considerations: This research contributed to identify strengths and fragilities of the Pyrenean Health Region in order to subsidize the delimitation of its responsibilities and attributions. It is considered important to expand the technical capacity of professionals working in the region studied, institutionalize planning processes in all sectors using the monitoring and evaluation of actions performed, strengthening and encouraging the greater commitment of the institution's employees. This action can contribute to the technical needs of the municipalities, boosting the organization of health services in a regional manner defined by the municipalities and state, in the implementation, consolidation and management of health care networks according to the needs of the region.
Análise de tendência da mortalidade prematura por doenças crônicas não transmissíveis nas unidades federadas - Brasil 2000 a 2011
(Universidade Federal de Goiás, 2014-05-14) Alves, Carla Guimarães; Morais Neto, Otaliba Libânio de; http://lattes.cnpq.br/4030124246791320; Morais Neto, Otaliba Libânio de; Malta, Deborah Carvalho; Oliveira, Ellen Synthia Fernandes de; Siqueira Junior, João Bosco; Minamisava, Ruth
Chronic non-communicable diseases (NCDs) have the highest mortality rate worldwide, with an increase in middle-income and low-income countries. The main groups are circulatory diseases (CAD), chronic respiratory diseases (CRD), cancer and diabetes. In Brazil, the first two groups are showing a decrease trend in the last decade and the others remain stable. The strategic action plan for dealing with chronic non-communicable diseases in Brazil, from 2011-2022, sets a target to reduce premature mortality by 2% per year until 2022. Therefore the purpose of this article is to identify the trend in mortality rates and the scenarios of meeting the goals for reducing premature mortality rates by 2% per year by the states. It was performed a time series analysis of the standardized mortality rates for NCDs, corrected for underreporting deaths and ill defined causes of death in each of the four causes groups in the period from 2000 to 2011 in males and females. The autoregressive linear regression of the Prais-Winsten was the model of choice. There were estimated the average annual increment rates of mortality and the confidence intervals in 95%. The states was defined with favorable and unfavorable scenarios for achieving the goal of the plan from the states that showed significant average annual of increment rate of reduction (p <0.05) and upper limit of 95% CI <= -2.0%. For the CAD group, both genders, the states have showed that a favorable scenario were: Distrito Federal, Santa Catarina, Mato Grosso, Rio Grande do Sul, Minas Gerais, Bahia, Espírito Santo, and Paraná. For the DRC group the states were Amazonas, Distrito Federal, e Paraná. For groups of cancer and Diabetes Mellitus all the states had unfavorable scenarios upper limit of 95% of the annual average increment rate greater than two. The conclusion was that the states, with the support of the Ministry of Health in conjunction with other Federal Agencies, together with state and municipal governments should strengthen interventions focused on modifiable risk factors for NCDs and ensure comprehensive integrated care to diagnosed users to reduce premature mortality in the four groups of causes.
Análise de uma comissão intergestores regional do estado de Goiás na estruturação das redes de atenção à saúde
(Universidade Federal de Goiás, 2018-08-28) Campos, Cláudio Silva; Alves, Carla Guimarães; http://lattes.cnpq.br/4751410153566264; Pereira, Edsaura Maria; http://lattes.cnpq.br/8820722314388248; Pereira, Edsaura Maria; Souza, Marta Rovery de; Barbosa, Nelson Bezerra
INTRODUCTION: The decentralization process has brought the Unified Health System (UHS) closer to the needs of the population, giving managers the challenge of organizing health service networks and services. The strategy used to consolidate regionalization is the structuring of health care networks (HCN), by overcoming fragmented care models. One component employed in the construction of this model of attention is governance through inter- managers relations, mainly at the regional level, in the case of the Regional Inter-managers Commission (RIC). OBJECTIVES: To describe and analyze the nature of the deliberations of the RIC of the state of Goiás and to investigate its process of governance and structuring of HCN; to relate the composition of health services in this region; identify the profile of managers; to describe the organization of the RIC under study and to analyze the perception of the municipal health secretaries on RIC governance and the consolidation of HCN’s. METHOD: Descriptive study with a qualitative approach, using content analysis of data collected from interviews guided by a semi-structured script, with the managers that make up the CIR, associated with the analysis of documents produced by RIC, such as meeting minutes, resolutions and guidelines. RESULTS: The study showed that the RIC in question has a consolidated institutional structure, adequate organizational and technical structuring, with a collaborative and consensual governance process with no state representation in the decisions, and in relation to the HCN, there was a recognition of the importance of RIC as a key actor in governance, but the mechanisms for implementing this process have not been clearly defined. FINAL CONSIDERATIONS: This study pointed out the need to broaden the participation of other actors in the regional governance process, such as health regional, health councils and other, improving managers in relation to HCN’s, institutional and normative planning, institute processes for monitoring and evaluation of HCN’s and redefining the role and relationship of primary health care in HCN’s and their thematic networks.
Análise do processo de implementação do plano estadual de saúde 2012-2015: o caso Goiás
(Universidade Federal de Goiás, 2015-12-16) Paiva, Cláudia de Menezes Vidal; Barbosa, Nelson Bezerra; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4755831U7; Pereira, Edsaura Maria; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4757072H9; Pereira, Edsaura Maria; Villela, Edlaine Faria de Moura; Teixeira, Ricardo Antônio Gonçalves; Marques, Nilza Alves; Carnelosso, Maria Lucia
For the Brazilian Health System (SUS) to be effective and able to meet all doctrinal and organizational principles for which it was designed, it needs to be well structured. In this sense, we realize that the efforts made by the Health Ministry in order to strengthen and institutionalize planning, through the elaboration and implementation of their planning instruments, considered as of great importance taking into account that it is a relevant management mechanism which aims at giving directionality to the consolidation process of SUS. This study aimed at analyzing the implementation process of the State Health Plan of Goiás for the four-year period of 2012-2015, as well as answering the following questions: how is the implementation process of the State Health Plan 2012-2015 being developed? (b) which methodology is used to design the plan? c) How structured is the monitoring and evaluation process of the Annual Schedules of health? d) What advantages and difficulties were identified in the implementation process of the Health Plan? This is a case study, exploratory qualitative research in which the author used as a secondary data source: The Annual Health Schedules and Annual Management Reports. Data was collected through two sources which allowed monitoring implementation of the goals, identifying the following aspects: the guideline, the goal, the percentage of implementation of goals, the area and the factors which are responsible for facilitating and inhibiting execution. The theoretical framework used was based on concepts and approaches on Carlos Matus’s situational strategic planning, Mario Testa’s Assumption of consistency and Habermas’s communicative action. We also analyzed theoretical course on public policies and their constituting elements. Another relevant point discussed was the concept of strategic management, resultoriented management, directly related to the implementability of government policies and programs, in an environment marked by increasing limitations to development funding from fiscal resources. We also presented the legal framework of the Government and the SUS. The results show that the process of institutionalization of planning, through implementation of the State Health Plan and other planning instruments of SUS, has not been effective yet in SES-GO. It is mentioned the various initiatives and strategies developed by managing instances of SUS in the search of incorporation of such instruments. We emphasize the need to improve working practices of management of SUS in Goiás, through the expansion of room for dialogue and negotiation, enabling the technical areas and promoting partnerships with educational institutions.
Análise situacional dos Núcleos de Apoio à Saúde da Família no estado de Goiás
(Universidade Federal de Goiás, 2017-11-30) Souza, Ana Lúcia Ferreira de; Souza, Marta Rovery de; http://lattes.cnpq.br/1155042579123151; Almeida, Nilza Alves Marques de; Veronezi, Rafaela Júlia
Introduction: The Family Health Support Center is an innovative strategy that aims to support, expand and improve health practices and management through a range of professionals from different areas of knowledge who will work side by side along with the Family Health Teams, in view of the significance of this level of attention within the system and the lack of professionals in the daily lives of the teams. Objective: To characterize and describe the work developed by the Family Health Support Centers in the State of Goiás through the National Program for Improving Access and Quality of Primary Care, cycle II. Methodology: a cross-sectional descriptive study, which evaluated the results of National Program for Improving Access and Quality of Primary Care in Goiás. Secondary data were extracted from external evaluation database between November 2013 and February 2014. Participation in the study was 60 Family Health Support Center of the state of Goiás and 550 Family Health Teams that are supported by them. Results: the most mentioned professionals in the composition were physical educator, physiotherapist, veterinarian and nutritionist. Only 45% of the have clinics for exclusive use in health units. As for the work process, the planning and programming of the actions are carried out monthly by the majority (86.2%). The activities that stood out most were Health Education, Community Activities, Home Care and Therapeutic Groups. The frequency of meetings and activities between Family Health Support Center and Family Health Teams is quite variable and a small part does not work with defined periodicity. The average time for support to be taken care of was 7 days for 78% of ESF. Conclusion: the work done by the Family Health Support Center in the state of Goiás strengthens the Primary Health Care since the referrals to the specialized demand have been reduced and the health indicators have improved. However, there is still a lot to do to refine the work, and for that, one of the key factors is to increase the proximity and synchronism of the Family Health Support Center with the Family Health Teams, establishing partnership and really working together.
As potencialidades e fragilidades do processo de acreditação hospitalar na perspectiva dos enfermeiros
(Universidade Federal de Goiás, 2018-07-04) Barbosa, Valquíria Vicente da Cunha; Silva, Ana Elisa Bauer de Camargo; http://lattes.cnpq.br/8388407861788466; Pereira, Edsaura Maria; http://lattes.cnpq.br/8820722314388248; Pereira, Edsaura Maria; Souza, Marta Rovery de; Alves, Sergiane Bisnoto
Health facilities have sought to achieve improvements in their services through quality management, aiming at safer patient care. In this context, the accreditation process emerges as a method to evaluate the resources of these establishments, aiming to guarantee the quality of the assistance through pre- established standards. The objective of this research was to analyze nurses' perceptions about the accreditation process in public hospitals of a state in the Midwest region of the country, to verify the meaning of this process for nurses and to identify the potentialities and fragilities arising from this process from the perspective of the nurses. A descriptive, exploratory qualitative approach was carried out. Data were collected through focal groups in March 2018, with nurses from two public hospitals accredited by the National Accreditation Organization (levels I and III). The Bardin content analysis method was used, considering the following steps: pre-analysis, material exploration and treatment and interpretation of results. The following categories were apprehended, with their respective subcategories: meaning of the accreditation process - premises, organization and tools of this process; potentialities of the accreditation process - advantages of the process for the professional, institution and patient; weaknesses of the accreditation process - negative impact on the professional, for institution and deficient knowledge about this process. It was identified that the nurses had knowledge about the accreditation process; that the most outstanding potentialities were professional development, continuous improvement and safety for the patient and professional; and that the most mentioned weaknesses were an increase in the workload, a lack of professionals' insertion in the process, an increase in bureaucracy and a decrease in the quality of patient care due to this process itself. Another important finding was that, although the participants affirmed, on several occasions, that the accreditation process aims to offer patients more safety, more advantages were scored for the professionals and institution than for the patients themselves. It is concluded that the potentialities seized were more prominent than fragilities, evidencing that the accreditation process offers more benefits to the health sector, than harm.
Atenção ao câncer do colo de útero e de mama no estado de Goiás
(Universidade Federal de Goiás, 2015-02-26) Silva, Wycilene Bernardes da; Almeida, Nilza Alves Marques; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4701664Z7; Souza, Marta Rovery de; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4783833P0; Souza, Marta Rovery de; Rosso, Claci Fátima Weirich; Freitas Júnior, Ruffo de
Introduction: Cervix and breast cancers are a public health problem that affects women around the world. In Brazil, Primary Care plays a fundamental role in controlling these cancers because it acts in several scopes, from promotion and prevention to the follow-up of treated women. This study aimed to analyze the actions and Primary Care services (PC) in cervical and breast cancers prevention in the state of Goiás. Methodology: This is a descriptive cross-sectional study, which selected information were from the national base of the database of external evaluation of the Improvement Access and Quality of Primary Care Program (IAQP-PC) in Goiás held from July to September 2012. The sample of this study is 1.216 basic Health Units (BHU) of 246 municipalities in the state of Goiás, which joined the IAQP-PC and responded to module I, by 677 professionals who answered the module II interviews and 1,936 users who were at the BHU and responded to the module III. Results: It was found that most units (98.1%) perform the collection of cervical cancer screening, but not all permanently have the necessary supplies and materials for the exam. The amount of mammography devices is sufficient to meet women, but they are not well distributed by health districts. PC users think the distance from the health units to their houses is reasonable or near, opening hours meet their needs, consultations are booked according to arrival order (91.4%) and when they are with some gynecological problem, 17.4% cannot be meet on time. Some women (13.5%) never performed the screening test, among these 44.6% were mean aged according to Ministry of Health. Only 8.5% received an indication of colposcopy after some abnormal test result and 78.1% have never been sent for a gynecological consultation. Conclusions: This study showed that not only Primary Care in Goiás is not well managed enough to be the originator center of the Health Care Networks as well as that there is some weakness regarding the line of cancer care, making it difficult to access to services and comprehensive care to women. Keywords: Breast Neoplasms; Neoplasms of the cervix; Health Services for Women
Atenção básica ao pré-natal e puerpério no estado de Goiás
(Universidade Federal de Goiás, 2015-02-27) Sodré, Rúbia Lícia Rodrigues; Almeida, Nilza Alves Marques; http://lattes.cnpq.br/2486258562480055; Souza, Marta Rovery de; http://lattes.cnpq.br/1155042579123151; Almeida, Nilza Alves Marques; Martins, Cleusa Alves; Souza, Márcia Maria de
The Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica- National Programm of Improvement to Acess and Quality of Basic Attention- (PMAQAB), proposed as an evaluation tool of organizational performance by the Ministry of Health (MOH), is nowadays, an evaluation strategy of accessment and usage of these services by the user. The objective of this study is to analyze the actions of Primary Care services to prenatal and postpartum Health in Goiás State. This is a descriptive cross-sectional study, recut of MS´ national research what made the evaluation to Basic Attention to Health in the country, linked to the first cycle of PMAQ-AB/2012 evaluation.The data collection in the national bank of research, referring to Goiás State, was held in 2014, from the selection of plenty prenatal care and postpartum treatment, answered by health professionals and users of these services. The survey covered 1.216 Primary Care services, from the 246 cities in Goiás State, who answered to the Census PMAQ-AB /2012. From these services, 712 has participated in the survey with 677 health teams who went through the external evaluation process. Thus, 677 professionals and 368 users of these services had participated in the analysis of this research. The most part of these services are Health Centers/Basic Health Units (517; 72,7 %) and those offer prenatal and postpartum (562; 83%). The 368 service users had presented the average age of 25,6 years, age group between 18 and 49 years; 98,4 % said to know reading and writing ; 49,7% said be a mixage of race ; 84,5% live with a partner; 53,3% have family income between one to two minimum salaries. In relation to accessment and organization of the services, 87% of users considered satisfactory the opening hours for the service; 90,2% reported that the appointments occurred in order of arrival; 61,2% rated the service as good host; 20,7% managed to immediate care by gynecological problem; 360 (97,8%) women had prenatal care in their last pregnancy, with the majority held in the unit where he was interviewed (234; 63,6%), between six and nine consultations (226; 61,4%) with medical professionals (214; 91,5%) and nurses (151; 64,5%); Most urine tests performed (229; 97,9%), HIV/AIDS (228; 97,4%) Syphilis (221; 94,4%), glucose (195; 83,3%) and ultrasound (218; 93,2%), with a waiting time to seven days (55 to 63%); 147 (62,8%) did not participate in educational activities; 198 (53,8%) underwent outpatient consultation labor review, most (78,8%) with the doctor and small portion in the household (5%) of community-agent business (32,3%). The services of Basic attention to prenatal and postbirth in Goiás State, has presented an adequated infrastructure related to information management resources, drugs, biopharmaceuticals and laboratory support. However, the organizations of the work process raises challenges for health professionals and assume efforts to managers of services to better accommodate the spontaneous demand of scheduling appointments, eliminate institutional barriers to access, promote more inclusive and comprehensive care to pregnant women and puerperty women to guarantee qualified and humanized obstetric care.
Atenção básica em saúde bucal em Goiás
(Universidade Federal de Goiás, 2016-05-31) Nascimento, Renata do; Souza, Marta Rovery de; Souza, Marta Rovery de; Pereira, Edsaura Maria; Mohn Neto, Carlos Rodolfo
Introduction: from the creation and implementation of the National Oral Health Policy in 2004, there has been a noticeable increase in access to public dental care. However, there are still major challenges to improving access and quality to dental services. Objective: To describe the organization of basic dental care in Goiás in 2012. Methodology: this is a descriptive study that analyzed the secondary data extracted from external evaluation component of the bank's National Program for Improving Access and Primary Care Quality (PMAQ-AB), first cycle, between September and October 2012. The sample consisted of 540 oral health teams (eSB) that responded to the questionnaire PMAQ-AB, located in 174 municipalities and distributed in 17 health regions (RS). Results: among the eSB, 42% conducted the scheduling of the population on any given day and time; over 80% conducted all dental procedures; 96.6% said that there is reception to spontaneous demands; 54% reported that there is a Dental Speciality Center of reference for the routing of the population in need of such care. The highest percentages of eSB which claimed to have a reference CEO were in the RS Environs South (96.6%), Serra da Mesa (92.3%) and Southwest II (81%). No team of RS Northeast I and II Northeast had CEO to reference. In the RS Red River, 90.9% of eSB affirmed not have a CEO for reference, the same occurred in the RS Railway in which 85.2% of the teams have nowhere to refer patients in need of care in dental specialties. Final Considerations: The Oral Health Care Network of the state of Goiás is still incipient. The future challenge is the consolidation of a regionalized Oral Health Care Network, where primary care is the major focus of attention.
Atendimento educacional hospitalar e domiciliar: uma pesquisa-ação
(Universidade Federal de Goiás, 2016-06-23) Barros, Rodrigo Carvalho do Rego; Teixeira, Ricardo Antonio Gonçalves; http://lattes.cnpq.br/0272312162765846; Teixeira, Ricardo Antonio Gonçalves; Mendonça, Alzino Furtado de; Oliveira, Ellen Synthia Fernandes de
Hospital classes and home educational services are an area of education, linked to special education, established to provide educational services to students who are unable to attend school for health reasons. The teachers of hospital class and home educational services are in the intersection of health and education and therefore are the ones who become ill due to work. This research aims to promote the health of the teachers and coordinating team of NAEH confronting the problems of the hospital and home educational services. Therefore, was accomplished a mapping of the legal bases and of the main public policies of inclusion oriented to hospital and home educational services and a study on the health of teachers who work in this type of education. It was adopted as methodology the predominantly existential action research, since it is situations that cause suffering to the people involved, justifying actions to reframe and transform the reality experienced. As a theoretical framework was adopted the prospect of Dejours (2007), which uses as a health parameter the presence of pleasure and suffering at work. Although there was no verified illness between the research participants, from a psychopathological reference, a situation of suffering was found among the people involved because of difficulties encountered in educational visits involving cases of mental disorder. The search for solution was conducted by the collective researcher, following the very démarche of action research. The results were considered positive by the changes noted in the reports of the coordinator team of NAEH. Germana Da Silva Leal
Atuação do agente comunitário de saúde durante a visita domiciliar na perspectiva do usuário
(Universidade Federal de Goiás, 2017-11-07) Araújo, Kárita Silva; Queiroz, Maria Goretti; http://lattes.cnpq.br/7079676967280121; Queiroz, Maria Goretti; Souza, Marta Rovery de; Rocha, Barbara Souza
The action of the Community Health Agent (ACS) with the population attached is an essential condition for the organization of public health services. However, it is necessary to know how this work is developed and the users' satisfaction with these activities. Within this perspective, this study aimed to understand the performance of the ACS during home visits from the perspective of the population served by the Family Health Strategy (ESF) in a medium-sized municipality in Goiás. This study was carried out in a municipality located in the state of Goiás, with medium size, with a sample composed of 400 families attended by the ACS of the municipality. The data collection instrument was composed of a structured questionnaire, whose questions sought to collect data that allowed to understand the work of the ACS in the community served. It was tried to verify if the scope of work defined by the National Basic Attention Policy (BANP) for the ACS is being fulfilled, in addition to the establishment of a link, in the user's perception, since these assignments should be performed by the ACS during the visit household (VD). The questionnaire was submitted to the Cronbach Alpha Test, whose value was 0.83. Data were submitted to associations test, Student's t-test and chi-square test. Regarding the work of the ACS during the VD, it was observed that the population understands that the RV is important, that the ACS are prepared to perform them and that the number of visits made to the family and the time dedicated to each of these visits are satisfactory. The satisfaction with the RV for families with people with disabilities obtained lower indexes. Regarding the relationship between the ACS and the population, it was identified that the families consider the work of the ACS and the VD to be important, in addition to declaring that they trust this professional. However, this confidence does not turn into a demand for ACS in case of illness in the family. Women up to 59 years of age do not seek ACS in case of illness in the family. Regarding the fulfillment of the assignments provided for in the PNAB, it was observed that approximately half of the participants are satisfied with the followup of the ACS in case of illness. Regarding the guidelines for healthy food and eating disorders, less than half of the participants expressed satisfaction with the ACS 'performance, as well as with the demand for adolescents involved in drugs and sex and with the conference on the criteria of the Bolsa Família program. The need to improve the performance of ACS was identified, but it was not possible to indicate which aspects should be improved. The services available at the Basic Health Unit (UBS) had a higher rate of user satisfaction (72.1%). These results demonstrate that the population knows the ACS and recognizes the importance of their work and the RV, but these feelings are not turning into action, such as the search for ACS in case of illness in the families. The population surveyed does not understand that the ACS is performing all its duties, as provided in the PNAB. Thus, it is observed that there is a wide field of actions, which can be developed by the ACS, aiming to contribute to the fulfillment of its actions, as foreseen in the PNAB.

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