Resolutividade da assistência a saúde de pessoas com úlceras vasculares atendidas na atenção básica
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Data
2014-06-26
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Universidade Federal de Goiás
Resumo
INTRODUCTION: Vascular ulcers are a major public health problem, affecting
around 1% of the general population, with a higher prevalence among the aged.
Treatment is time consuming and costly, they can cause physical, social, economic
and emotional problems. They are considered complex and difficult to heal, have a
high number of relapses, and most of them are critically colonized or infected.
Service to people with vascular ulcers is challenging to both health professionals and
the public administration by virtue of its complexity, including the absence of public
policies for this population, structuring services, access to care, professional
qualification, and appropriate resources. GENERAL OBJECTIVE: To analyze the
outcomes of healthcare for people with vascular ulcers treated in the examination
rooms of the primary care system from the perspective of the evolution of healing
over a period of six months. METHODOLOGY: Analytic longitudinal study with
nested cross-sectional studies, in the examination rooms of the public health service
of the city of Aparecida de Goiania, Goias, Brazil, from August 2012 to October 2013.
Population consists of users receiving treatment by nurses, and professionals who
provided nursing care in the study setting. Data collection occurred through
structured nonparticipant observation, interview, physical examination, and use of
Pressure Ulcer Scale for Healing (PUSH), planigraphy of ulcers, and photographic
record. Absolute frequencies and percentages were used for data collection. The
study complies with guidelines for research ethics, being approved under protocol
085/2012. RESULTS: The three rooms designed to care for people with vascular
ulcers in the studied scenario showed non-washable walls, windows not screened,
without adequate hand hygiene resources, without proper procedures for cleaning
and disinfection of the environment, and lack of essential resources and inconsistent
supply thereof. As for users, there was gender parity, prevalence among 60 years or
older, and social and economic conditions in the lower middle class and below. The
majority had lesions for more than one year, which were usually painful.
Microbiological examination showed predominantly Gram-negative rods, including
Pseudomonas aeruginosa. Among professionals, most were females, aged between
18 and 36 years and "reasonable experience" in treating people with vascular ulcers.
CONCLUSION: Conditions were inadequate for serving people with vascular ulcers
and contribute to care not compliant with current recommendations, which creates a
discontinuity of care and diminished capacity to resolve these issues. Therefore, it is
necessary to structure the service with respect to people with chronic ulcers, and
maintain supplies and appropriate resources for care.
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Citação
SANTOS, Q. R. Resolutividade da assistência a saúde de pessoas com úlceras vasculares atendidas na atenção básica. 2014. 197 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2014.