People with disabilities have greater need for healthcare on average, but often face barriers when accessing these services. The Brazilian government launched the National Health Policy for People with Disabilities (PNSPD) in 2002 to address this inequality. PNSPD has six areas of focus: quality of life, impairment prevention, comprehensive health care, organization and functioning of health services, information mechanisms, and training of human resources. The aim of this article was to undertake a scoping review to assess the evidence on the experience of people with disabilities in Brazil with respect to the six themes of the PNSPD. The scoping review included articles published between 2002 and 2019, from four electronic databases: PUBMED/MEDLINE, LILACS, Science Direct, and Scielo. In total, 8076 articles were identified, and after review of titles, abstracts, and full texts by two independent reviewers, 98 were deemed eligible for inclusion. The evidence was relatively limited in availability and scope. However, it consistently showed large gaps in delivery of healthcare to people with disabilities across the six dimensions considered. There was lack of actions aimed at promoting quality of life; insufficient professional training about disability; little evidence on the health profile of people with disabilities; large gaps in the availability of care due to widespread physical, informational, and attitudinal barriers; and poor distribution of the supply and integration of services. In conclusion, the policy framework in Brazil is supportive of the inclusion of people with disabilities in health services; however, large inequalities remain due to poor implementation of the policy into practice.
The purpose of this article is to analyse the circumstances in which the National Health Policy for Persons with Disabilities (PNSPCD) came into place in 2002, and factors supporting or impeding its implementation from 2002 to 2018. The analysis was based on the Comprehensive Policy Analysis Model proposed by Walt and Gilson, and focussed on understanding the Context, Process, Content and Actors involved in the formulation and implementation of the Policy. Data was obtained from two sources: Document analysis of the key relevant documents and seven key informant interviews. Content analysis was undertaken using the Condensation of Meanings technique. The research demonstrates that the development and implementation of PNSPCD is marked by advances and retreats, determined, above all, by national and international macro political decisions. The policy was formulated during Fernando Henrique’s governments, under pressure from social movements and the international agenda and constituted a breakthrough for the rights of persons with disabilities. However, progress on implementation only took place under subsequent center-left governments with the establishment of a care network for people with disabilities and a defined specific budget. These developments resulted from the mobilization of social movements, the ratification of the United Nations Convention on the rights of people with disabilities and the adherence of these governments to the human rights agenda. The coming to power of ultra-right governments triggered fiscal austerity, a setback in the implementation of the care network, and weakening in the content of various social policies related to the care of people with disabilities. During this era, the political approach changed, with the attempt to evade the role of the State, and the perspective of guaranteeing social rights. Undoubtedly, the neoliberal offensive on social policies, especially the Unified Health System, is the main obstacle to the effective implementation of the PNPCD in Brazil.
Objetivo: Identificar, a partir da compreensão de gestores e profissionais de saúde, as dificuldades e desafios, potencialidades e facilidades encontradas na Atenção à Saúde Integral de Lésbicas, Gays, Bissexuais, Travestis e Transexuais, no município do Recife. Métodos: É uma pesquisa de natureza exploratória, com metodologia qualitativa, realizada com entrevistas semiestruturadas, colhidas de gestores e profissionais de quatro estabelecimentos de saúde que direcionam ações voltadas para população LGBT, tanto a nível de gestão, quanto assistencial. As entrevistas foram realizadas de maneira individual, gravadas, e posteriormente transcritas. A análise dos dados coletados foi feita através da Análise de Discurso, da qual emergiu duas categorias temáticas: conhecimento sobre a Política de Saúde Integral a População LGBT e o entendimento sobre a Atenção à Saúde Integral a população LGBT. Resultados: A análise dos dados coletados foi feita através da Análise de Discurso, da qual emergiu duas categorias temáticas: conhecimento sobre a Política de Saúde Integral a População LGBT e o entendimento sobre a Atenção à Saúde Integral a população LGBT. Conclusão: Foi possível conhecer a percepção dos entrevistados, tornando visível as necessidades de direcionar ações mais amplas a população LGBT, preenchendo algumas lacunas na construção da Atenção Integral à Saúde, desde acolhimento, acesso aos serviços de saúde, a qualidade do atendimento oferecida, tornando o estudo com profissionais de saúde e gestores praticamente pioneiro na produção cientifica brasileira.
Objetivo: Analisar as condições de acessibilidade aos serviços de saúde, vivenciadas por pessoas com deficiência, predominantemente nas unidades básicas de saúde no estado de Pernambuco. Métodos: Trata-se de uma pesquisa de natureza exploratória e de abordagem qualitativa. A população estudada foi formada por pessoas com algum tipo de deficiência sensorial (visual/auditiva) ou física, residentes de área coberta, usuárias ou não dos serviços de saúde. As entrevistas foram realizadas sob a anuência do entrevistado e, posteriormente, transcritos para análise. Foram entrevistados doze usuários com deficiência: o primeiro participante foi escolhido por um profissional de uma das unidades de saúde, e os demais foram definidos a partir da técnica de amostragem snowball. Resultados: A análise dos dados foi feita através da análise de discurso, cujas ideias centrais originaram duas grandes categorias: Acessibilidade aos serviços de saúde e a Rede de Cuidados a Pessoa com Deficiência. Conclusão: As limitações de acessibilidade aos serviços de saúde foram relatadas pelos entrevistados, englobando barreiras tanto físicas quanto atitudinais. Foi identificada a relevância da escuta das pessoas com deficiência para a discussão e elaboração de ações para a prática do cuidado integral à saúde de tal parcela da população.
Objective: Describe the effects related to sleep disorders in nursing professionals with nocturnal labor activity. Method:A descriptive transversal study with a quantitative approach. There were 184 participants in this research, including 46 nurses, 133 nursing technicians and 05 of them were excluded as losses. We used the chi-square test and Fisher's exact test for the intersection of responses between the categories.Results: 53.1% of them presented diseases as consequences of the nocturnal labor activity, which were: sleep disorders (26.8%), hypertension (17.3%), spinal problems (16.2%), gastritis (11.7%) and vascular problems (10.1%). Conclusion:The changes in the circadian cycle, developed by the nocturnal labor activity have a negative impact on health and life of nursing professionals.
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