Objective:To compare the health assistance models of Basic Traditional Units (UBS) with the Family Health Strategy (ESF) units for presence and extent of attributes of Primary Health Care (APS), specifically in the care of children. Method: A crosssectional study of a quantitative approach with families of children attended by the Public Health Service of Colombo, Paraná. The Primary Care Assessment Tool (PCA-Tool) was applied to parents of 482 children, 235 ESF units and 247 UBS units covering all primary care units of the municipality, between June and July 2012. The results were analyzed according to the PCA-Tool manual. Results: ESF units reached a borderline overall score for primary health care standards. However, they fared better in their attributes of Affiliation, Integration of care coordination, Comprehensiveness, Family Centeredness and Accessibility of use, while the attributes of Community Guidance/Orientation, Coordination of Information Systems, Longitudinality and Access attributes were rated as insufficient for APS. UBS units had low scores on all attributes. Conclusion: The ESF units are closer to the principles of APS (Primary Health Care), but there is need to review actions of child care aimed at the attributes of APS in both care models, corroborating similar studies from other regions of Brazil. DESCRIPTORS INTRODUCTIONAfter more than thirty years since the Alma Ata Conference, Primary Health Care (APS) has consolidated as one of the most equitable and efficient ways to organize a health system (1) by advocating equitable care with quality to the population, among other benefits. The Pan American Health Organization (PAHO) defines Primary Health Care as a "strategy for organizing health care systems in order to enable universal access to services and comprehensive and integrated care over time" (1)(2) .At the national level, the Ministry of Health adopted the Family Health Strategy (ESF) in 1994 to reorganize the Unified Health System (SUS) and expand the APS. According to the Ministry of Health in Brazil (3) , the number of family health teams deployed and funding for the expansion of the ESF have both increased, reaching/covering 52.1% of the Brazilian population.The scientific literature provides evidence of the association between greater APS orientation and increasing the effectiveness of health systems, promotion of fairness, user satisfaction and efficiency (4) . It is noteworthy that most of the studies are centered on the health systems of developed countries (4) . However, there is evidence of the positive impact of APS on the health systems of developing countries, primarily those which are located in Latin America.On the international scene, it has been observed (5-6) that increasing ESF coverage is linked to reducing infant mortality and promoting greater equity. Such evidence is present in the national results (7)(8) , studies which also indicate a higher quality of prenatal care, child care, offering use of health services, although in a low effectiveness context ...
Esta investigação objetivou apreender e analisar as representações de trabalhadoras de creches acerca do cuidado da criança. Os dados foram coletados em creches de uma universidade pública, no Município de São Paulo, Brasil, mediante entrevistas individuais e uma oficina pedagógica. Aqui é apresentado o tema O cuidado da criança na creche, parte dos resultados do estudo. O cuidado foi definido como atendimento às necessidades físicas e emocionais infantis, como etapa preliminar às atividades pedagógicas e como momento de aprendizado para as crianças. As trabalhadoras entendem o cuidado como fenômeno que prescinde de capacitação e habilitação específica e secundário em relação à educação. Atribui-se essa compreensão de senso comum à falta de reflexão sobre um referencial teórico-conceitual que sustente a ação cuidadora das trabalhadoras.
The “Be sweet to babies” video is a knowledge translation tool targeted at parents on the use of analgesic strategies during painful procedures performed in neonates. This study aimed to evaluate the effectiveness of the Portuguese version of this video on maternal involvement in neonatal pain management during the newborn screening blood test. Nonrandomized, pragmatic clinical trial. The study was conducted in a rooming‐in unit. All mothers received a pamphlet regarding neonatal pain management and were invited to participate in daily education sessions conducted by nurses, which included the video. The intervention group included mothers who voluntarily watched the video, while the control group was comprised of mothers who did not attend the education sessions or left the session before watching the video. Data were collected by interviews conducted by the research team. Descriptive and inferential analysis considered a confidence interval of 95%. A total of 73 mothers were included in the study. Analgesic strategies were used in 14 (40%) of the procedures in the intervention group and 9 (24%) in the control group, a clinically important difference of 16% points between groups, although no statistically significant difference was found (P = .13). Breastfeeding was the most commonly used strategy. Watching the video increased the chance of implementing analgesic strategies by 2.1 times (P = .19), while nurses suggesting the use of analgesia increased this chance by 5.5 times (P = .006). Although no statistical significance was found, the results suggest the clinical significance and feasibility of the “Be sweet to babies” video as a KT tool targeted at parents on neonatal pain management during nonurgent painful procedures. In addition, maternal involvement in pain care significantly increased when pain relief strategies were recommended by nurses, which suggests that nurses have a key role in facilitating parental participation.
Objectives: to perform concept analysis of the term child development (CD) and submit it to review by experts. Method: analysis of concept according to the hybrid model, in three phases: theoretical phase, with literature review; field phase of qualitative research with professionals who care for children; and analytical phase, of articulation of data from previous steps, based on the bioecological theory of development. The new definition was analyzed by experts in a focus group. Project approved by the Research Ethics Committee. Results: we reviewed 256 articles, from 12 databases and books, and interviewed 10 professionals, identifying that: The CD concept has as antecedents aspects of pregnancy, factors of the child, factors of context, highlighting the relationships and child care, and social aspects; its consequences can be positive or negative, impacting on society; its attributes are behaviors and abilities of the child; its definitions are based on maturation, contextual perspectives or both. The new definition elaborated in concept analysis was validated by nine experts in focus group. It expresses the magnitude of the phenomenon and factors not presented in other definitions. Conclusion: the research produced a new definition of CD that can improve nursing classifications for the comprehensive care of the child.
RESUMOEstudo teórico que teve como objetivo elaborar uma matriz conceitual para analisar a vulnerabilidade da criança diante de situações adversas para seu desenvolvimento. Propõe-se que vulnerabilidade da criança seja analisada por meio dos aspectos das dimensões individual, relativa a relações sustentadoras contínuas e proteção física e segurança; social, concernente à inserção social da família e ao acesso a direitos à proteção e promoção social, e programática, cenário político-programático, de diretrizes e implementação político-programáticas. A aplicação prática desta matriz permite a captação do processo saúde-doença para além da dimensão individual, possibilitando a articulação das políticas públicas e das ações dos profissionais, a fim de obter eficácia no atendimento às necessidades das crianças. O uso desse instrumento conceitual pode propiciar às equipes de saúde a apreensão, de forma específica, das situações adversas ao desenvolvimento infantil, bem como subsidiar a construção de planos de intervenção a partir das dimensões analíticas da vulnerabilidade. DESCRITORES Análise de vulnerabilidade Desenvolvimento infantil Saúde da criança ABSTRACTThis theoretical study presents a conceptual matrix built to analyze the vulnerability of children in adverse situations to their development. It proposes that the vulnerability of children is analyzed by means of the following dimensions: individual, which is related to ongoing nurturing relationships, physical protection and security; social, which concerns the social insertion of family and access to rights of social protection and promotion; and programmatic, which involves the political-programmatic scenario and the guidelines and political-programmatic implementation. The practical application of this matrix allows apprehending the health-disease process beyond the individual dimension, enabling the articulation of public policies and actions of professionals to achieve effectiveness in meeting the needs of children. The use of this conceptual matrix can provide to health teams a specific understanding of the adverse situations to child development as well as subsidizing intervention plans based on the analytical dimensions of vulnerability. DESCRIPTORS Vulnerability analysis Child development Child health RESUMENEste estudio teórico tuvo como objetivo elaborar una matriz conceptual para analizar la vulnerabilidad del niño delante de situaciones adversas para su desarrollo. Se propone que la vulnerabilidad del niño sea analizada a través de los aspectos de las dimensiones: Individual-relaciones sostenedoras continuas, y protección física y seguridad; Social-inserción social de la familia y acceso a los derechos, a la protección y la promoción social; y Programático-escenario político-programático y directrices y realización político-programáticas. La aplicación práctica de esta matriz permite la captación del proceso salud-enfermedad más allá de la dimensión individual, posibilitando la articulación de las políticas públicas y de las acciones de los profe...
O atual currículo do curso de graduação em Enfermagem da Escola de Enfermagem da USP está sendo reformulado e sua implantação está prevista para 2009. Este artigo tem por objetivo apresentar, em linhas gerais, o novo currículo do curso de graduação em Enfermagem da EEUSP. A estrutura proposta está dividida em três ciclos: Básico (1.500 horas), Intermediário (1.500 horas) e Complementar (1.000 horas), com carga horária total de 4.000 horas, ministrada em oito semestres letivos. A mudança visa a aumentar a integração entre as disciplinas e os departamentos, a autonomia do estudante e adotar a formação para o Sistema Único de Saúde como orientação geral do currículo. O novo currículo está voltado à formação da enfermeira generalista, com competência técnica, científica e ético-política para prestar cuidados de enfermagem a indivíduos, famílias e grupos sociais.
Portuguese / English: www.scielo.br/reeusp RESUMO A literatura de saúde tem abordado os aspectos éticos da investigação com seres humanos há décadas, mas ainda há desafios a serem reconhecidos e superados, tais como os referentes à pesquisa com crianças. Este artigo apresenta e discute aspectos éticos da pesquisa com crianças. Descreve estratégias de abordagem conformes às necessidades infantis, segundo seu processo de desenvolvimento e característi-cas individuais, para garantir a participação voluntária da criança na pesquisa. DESCRITORES RESUMENLa literatura de salud ha tratado de los aspectos éticos de la investigación con seres humanos hace décadas, pero aun hay retos que deben ser reconocidos y superados, tales como los referentes a la investigación con la población infantil. Este artículo presenta y discute aspectos éticos de la investigación con niños y niñas. Describe estrategias de abordaje adecuadas a las necesidades infantiles, según su proceso de desarrollo y características individuales, para garantizar la participación voluntaria de niños y niñas en investigaciones. DESCRIPTORESÉtica en investigación. Niño. Salud del niño. Defensa del niño. Autonomía personal.
Este artigo de reflexão discute as bases teórico-metodológicas da Promoção da Saúde e seu potencial na construção de tecnologias de caráter emancipatório, bem como a complexidade de pesquisas de avaliação de ações nesse campo. Para tanto, descreve e analisa um projeto de promoção de desenvolvimento infantil, construído segundo as bases da Promoção da Saúde na vertente crítica e implementado por equipes de saúde da família em regiões prioritárias no município de São Paulo, e pesquisas de avaliação de suas tecnologias e estratégias de implantação. Conclui que o referencial da Promoção da Saúde contribuiu para reorientação das ações dos profissionais para a atenção integral e fortalecimento dos potenciais de saúde das crianças e famílias e que as pesquisas de avaliação de ações no campo da Promoção demandam instrumentos e abordagens múltiplos, que possibilitem abranger a complexidade de processos e resultados das ações.
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