Issue The fragile reading habit is a common feature in Brazil, having wide negative impacts in Health and Education areas. Itapoã-DF presents important social vulnerabilities with challenges about the reading habit. Stimulating individual reading from early childhood to elderly, associated with positive reinforcement during doctor appointments, is a way to provide health education. Description of the problem In October of 2016, the “Prescreva um Livro” (prescribe a book) project began from childcare doctor appointments, by encouraging children with books and the borrowing of material, in addition to positive reinforcement in consultations. In 2019, book references for adults were incorporated into the chapters of the School of Patients DF - especially for prenatal care and chronic conditions such as hypertension. It highlights the potencial of primary care as point of encouragement for reading and community support, reading coordinator. Results The Reading stimulus brought, since 2016, a change in the relationship of young people with the service, making it a space of curiosity and fun instead of “fear of needles”. The importance of primary care in constructive stimuli to reading is reinforced even more considering the difficulties of education in Brazil. Lessons Initially focused on children and adolescents, the practice was incorporated into the health education strategy of the School of Patients, grouping prevalent comorbidities and printed guidelines delivered at each consultation. The participating children reported the stories they had read at subsequent visits. This feedback reinforces the influence that the primary care environment can have in several areas of the user's life, including reading Key messages Waiting rooms and home visits are opportunities to exchange information also of a literary nature. The stimulus to reading is vital for the full exercise of citizenship, and health services can be a reference for reading.
Background The region of practice of the School of Patients DF is vulnerable at health literacy and income. Audiovisual information is strategic in primary care for its great power of reach and information retention. Objectives Since 2016 videos of health education have been produced, initially technical on the Planification for hypertension and diabetes. After the focus switched to popular health education, aiming at improving communication between health professionals and patients on chronic diseases and health promotion, including testimonials. The is potential for video exhibition in qualified waiting rooms and forwarding in social network. Results There are videos from diabetes, hypertension, obesity to dengue, pre-natal care and other APS themes, which follow printed orientation with pertinent links. There are graduate and post-graduate studies in course for optimizing audio-visual content for support and capacitation of the family caregivers, especially regarding the facilitated visual model of prescription (“Illustrated Prescription”). Data until 2020-January: YOUTUBE 3146 views, 118,6 hours of exhibition, 50 videos. FACEBOOK page with a reach of 369.248 views. INSTAGRAM 10.119 followers, 193 posts, 37.800 likes and 1003 commentaries. Conclusions Modifications in lifestyle and adherence to medication are fundamental for treatment, and videos are promising for health promotion and selfcare capacitation. There is potential for reducing the hierarchy barriers (testimonials). The shared construction of knowledge and its dissemination makes the patient active part in community diffusion of information. Key messages Health professionals have a vital role as educators, including for social online networks. Patients have a protagonist role in their treatment, as well as multipliers of knowledge at their community.
Background In scenarios of vulnerability that include triple charge of diseases, permanent education in Primary Care and university is fundamental to allow greater access, efficiency and safety for users and health teams. Objectives The School of Patients DF was created as a tool for popular and technical health education, including case simulations for practice. It consists of standard technical content (Chapters), categorized by conditions and diseases, shared by Google Drive and used primarily in selected primary care units of Brazil's capital city. Results Technical simulations are performed in pairs, 1 participant acts as “patient” with script in hand (topics of the training) while the other acts as “health professional” as if in a regular visit. Simulations are timed for 10 minutes for consultation and 5 for feedback, boosting learning. Contents are based on guidelines and protocols from the Ministry of Health, Secretary of Health and Brazilian Community and Family Medicine Society. Since 2016 there have been realized over 1400 simulations, including weekly classes for last term medical students at the capital city federal university. Conclusions Simulations optimize the time necessary for permanent education (15 minutes blocks), avoiding limiting access for triage and consults, allowing smaller groups to train with greater focus and independent of computers or projectors. Key messages Standardizing training and practice bring benefit to patient care and safety. Simulations with structured physical examination are important both for professional as well as students.
Issue Chronic diseases such as hypertension and diabetes have great global impact on morbidity, mortality and costs. Incorrect use of medicines is especially worrisome for vulnerable populations with low health literacy, and visual models of prescription can bring benefit. The objective of this study was to validate the visual model of prescription Illustrated Prescription to obtain an adapted prescription with greater clarity, correction and cost-efficiency especially for risk users in a vulnerable peripheral region of the capital of Brazil served free of charge by the Unified Health System. Description of the Problem We conducted a content validation by primary health care nurses, pharmacists and physicians (PHC) by Delphi technique, applied in two phases from November to December 2018, through a questionnaire that evaluated clarity, relevance and feasibility of performing Illustrated Prescription, with field for comments. We used a 4-point Likert scale, Cronbach Alpha for reliability and Content Validation Index (CVI) with agreement above 0.8 indicating validation. Project approved by the Ethics Committee - FEPECS. Results Round-1: 29 out of 32 items were validated, with Cronbach's alpha .9812. Round-2: Included 4 new items, guidelines for indicating whole tablet, adjustment of the font size and color column size of elastic alloys, all items being validated and Cronbach's alpha of 0.9876. Lessons Validation ensures clarity and correction of the Illustrated Prescription, being extremely important for dissemination of the visual model for prescribing. It allows future evaluation of increased drug adherence and risk reduction related to incorrect use of medications especially for illiterate or visually impaired users. Key messages Illustrated Prescription is a validated tool that opens up the possibility of greater safety and efficient use of chronic medications, especially for vulnerable users with chronic diseases. Validation ensures clarity and correction of the Illustrated Prescription, being extremely important for dissemination of the visual model for prescribing.
Issue There are challenges in PHC associated with low functional literacy in health. The Illustrated Prescription was developed aiming to reduce drug error and increase access to self-care, allowing better understanding and adherence to treatment; facilitate the safe use of medications; strengthen the support network. Description of the Problem In April 2016, systematization and preparation of pictorial prescriptions began in the service of origin, one of the researches with the highest participation of multiprofessional residents of pharmacy and medical interns. Optimization and complement of recipe was performed. Several models were systematized in the orientation of users in face-to-face care of prescription reviews. The proposed model has (1) written component, schedule of medicines and strategy organizing medicines according to time of administration and (2) strategy for organizing primary packaging of medicinal products using coloured elastic bands. Results The evolution of Illustrated Prescription components resulted in the progressive organization and understanding in the indication of schedules and drugs. There was development, improvement and validation of it as a self-care tool, especially for patients with CNDs. There was a social impact with media dissemination (6 TV stations and 2 radio stations) and national and international congresses; totaling 5 show-forums and 4 congress with participation of the service. Cash prizes were invested in the infrastructure of the FHS workplaces. Lessons The evolution of Illustrated Prescription allowed progressive gain of organization and clarity for patients with difficulty reading, which directed efforts to avoid drug errors, especially prescription. Key messages Illustrated Prescription allowed us to invest more time guiding the patient in accessible and understandable language. Illustrated Prescription is useful for empowering and training it in self-care, promoting, mainly, autonomy and citizenship.
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