Introduction:The Family Health Strategy (FHS) should be first-contact care in the Brazilian Health System. However, Primary Health Care (PHC) still encompasses two models: the FHS and the traditional health care facilities. The expansion of the FHS has been slow and heterogeneous in many cities, rendering a comparative evaluation of key quality-related elements of PHC models crucial. Objective: To compare the performance of PHC models as perceived by health professionals. Methods: A cross-sectional study involving managers and health professionals from PHC of a medium-size city in South-eastern Brazil. Data were collected by applying the Primary Care Assessment Tool. The performance was estimated through primary health care indexes (general and partial PHCI by attributes). Univariate polytomous logistic regression was performed to compare care model performances according to their attributes. Strength of association was estimated by odds ratio with 95% confidence interval. Results: Three managers and 81 health professionals participated in the study. The FHS had a better index rating than the traditional care model for general PHCI and for the attributes longitudinality, comprehensiveness, family focus and professional level. Conclusion: Although the FHS attained higher scores compared to the traditional model, it has not yet achieved the performance expected. This scenario points to the need for increased FHS cover and quality improvements at the existing units.
RESUMO Trata-se de pesquisa qualitativa que tem por objetivo analisar as relações de poder estabelecidas no trabalho da Estratégia Saúde da Família. Foram realizadas entrevistas semiestruturadas com dezenove profissionais integrantes de três equipes e utilizados registros efetuados a partir de observação participante. Os dados foram analisados segundo Bardin e categorizados em duas unidades analíticas. O estudo demonstrou que alguns paradigmas são difíceis de modificar, especialmente quando são vistos de forma natural pelos envolvidos. No entanto, avanços foram verificados a partir do posicionamento daqueles muitas vezes vistos como inferiores nas relações de poder desse serviço.ABSTRACT It is a qualitative study that aims to analyze the power relations established in the work of the Family Health Strategy. Semi-structured interviews with nineteen professional members of three teams were conducted and records obtained from participant observation were used. Data were analyzed according to Bardin and organized into two analytical categories. The study showed that some paradigms are difficult to modify, especially when they are seen as natural by the involved people. However, advances have been verified from the positioning of those often seen as inferiors on power relations in this service.
Background: The laboratory tests most used by blood banks to diagnose anemia are the hemoglobin (Hb) and microhematocrit (Hct) tests, measured from capillary samples. Objective: To analyze the two capillary screening methods for pre-donation anemia by comparing their agreement in diagnosing anemia. Method: A cross-sectional study in a population of 15,521 blood donation candidates for whom information was available on Hb and Hct, performed from capillary blood samples. Hb was determined using the HemoCue® test and Hct by the centrifugation method. The Kappa coefficient was calculated to assess the agreement between the methods. Pearson’s correlation tests and gender-adjusted linear regression were used to assess the change in the response variable (Hb) as a function of the explanatory variable (Hct). Results: The majority of the study population were men (70.4%), aged between 18 and 44 years (72.1%), who declared themselves white or mixed skin color (85.6%), and had undergone at least 11 years of complete education (72.4%). The Kappa coefficient found was 92.7 and 99.2 for women and men, respectively. Pearson’s correlation showed a correlation coefficient of 0.98 and the linear regression graph showed an adequate relationship between the tests with R2 = 0.97. Conclusions: Comparing the Hb and Hct capillary tests, it was found that Hct can be safely used to screen for anemia in pre-blood donation.
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