OBJETIVOS: avaliar os atributos da atenção primária à saúde (APS), na assistência à saúde infantil ofertada pelas equipes da Estratégia Saúde da Família (ESF) em comparação a outros serviços de atenção à saúde da criança em Montes Claros (MG). MÉTODOS: pesquisa transversal, descritiva, de abordagem quantitativa. Para coleta de dados utilizou-se questionário validado no Brasil denominado de Instrumento de Avaliação da Atenção Primária na versão infantil (PCATool infantil). O instrumento foi aplicado aos cuidadores das crianças residentes e cadastradas nas áreas de abrangência das equipes de saúde da família. Foram atribuídos escores às oito dimensões da APS. RESULTADOS: apenas duas dimensões apresentaram valores satisfatórios para as crianças que utilizavam a ESF como fonte regular de atenção à saúde. Em geral os dados não apresentam diferenças significativas entre as crianças que utilizam a ESF para as que utilizam outros tipos de serviço, exceto para a integralidade (serviços complementares disponíveis), orientação familiar e comunitária. O escore geral da APS mostrou valor próximo ao ideal entre as crianças que utilizavam a ESF como fonte de atenção à saúde e superior ao escore atribuído pelos cuidadores que utilizavam outros serviços. CONCLUSÃO: fidelidade aos atributos da APS foram mais observadas nas equipes da ESF, no entanto, existem ainda alguns aspectos que precisam ser melhoradas.
ResumoObjetivo: traduzir e adaptar o PCATool versão usuários adultos ao contexto brasileiro e avaliar sua validade e fidedignidade. Métodos: Foi realizado um estudo transversal no qual foram entrevistados 2.404 usuários adultos residentes nas áreas adscritas da rede pública dos serviços de Atenção Primária à Saúde (APS) em Porto Alegre e usuários vinculados a um plano de autogestão. O processo de validação constituiu-se de tradução e tradução reversa, adaptação, validade de conteúdo, validade fatorial e fidedignidade. Resultados: Na análise fatorial, foram considerados 12 fatores que explicaram 50,83% da variação total. Assim, foram reconhecidos os seguintes atributos da APS: acesso -acessibilidade e utilização, longitudinalidade, coordenação -coordenação do cuidado e sistemas de informação, integralidade -serviços disponíveis e serviços prestados, enfoque familiar e orientação comunitária. Para a consistência interna, foi obtido alfa de Cronbach variando de 0,15 a 0,90. A estabilidade temporal não foi verificada para coordenação do cuidado (p<0,05), coordenação de sistema de informação (p<0,05) e integralidade de serviços prestados (p<0,05). Na razão êxito da escala, todos os componentes/atributos apresentaram valores próximos de 100%, à exceção do componente sistema de informação. Conclusões: os resultados indicaram que o PCATool-Brasil possui adequada validade e fidedignidade, podendo constituir-se em instrumento nacional de avaliação da APS para usuários adultos. AbstractObjective: to translate and adapt the PCATool version for adult users to the Brazilian context and assess its validity and reliability. Methods: We conducted a cross-sectional study of 2404 adult users living in areas covered from public services Primary Care in Porto Alegre, and users of a selfmanagement plan. We performed translation, reverse translation and adaptation of the instrument as well as its assessment in respect of content validity, factorial validity and reliability. Results: In the factor analysis were considered 12 factors that explained 50.83% of the total variation. In this way were recognized the attributes of Primary Care: access -accessibility and utilization; longitudinality; coordination -coordination of care and systems of information; comprehensiveness -services available and services provided; family orientation; and community orientation. In terms of internal consistency the values of Cronbach's alpha ranged from 0.15 to 0.90. The stability over time was not observed for coordination of care (p<0.05), coordination information of system (p<0.05) and comprehensiveness of services provided (p<0.05). The scaling success rate was close to 100% for all attributes, except to coordination of information system. Conclusions: the results indicated that the PCATool-Brazil has adequate validity and reliability, and it can act as a national instrument for the assessment of Primary Care from the perspective of adult users.
Objective: To estimate the prevalence of hypertension (H) and its association with other cardiovascular risk factors in a highly multiracial population. Methods:A cross-sectional study carried out in Salvador, Brazil, in a population sample of 1439 adults ≥ 20 years of age. All participants completed a questionnaire at home and had the following measurements taken: blood pressure, body weight, height, waist circumference (WC), and serum glucose and lipids. Hypertension was defined as mean SBP ≥140 and/or DBP ≥ 90 mmHg. Hypertension prevalence was estimated with a 95% confidence interval (CI). The associations were measured by the adjusted odds ratio (AOR), using regression analysis. Results:Overall prevalence of H was 29.9%: 27.4% CI (23.9-31.2) in men and 31.7%, CI (28.5-34.9) in women. Among black men, this prevalence was 31.6%, and among black women, 41.1%. Among white men it was 25.8%, and among white women, 21.1%. Arterial hypertension was significantly associated with age ≥ 40, overweight/obesity (AOR = 2.37[1.57-3.60]) for men and 1,62 (1.02 -2.58) for women. Among men, H was associated with a high level of education and among women, with dark brown and black skin, abdominal obesity, AOR = 2.05 CI (1.31-3.21), diabetes AOR = 2.16 CI (1.19-3.93), and menopause. Conclusion:Arterial hypertension predominated among black people of both genders, and in women. Those variables that remained independently associated with H differed in both genders, except overweight/obesity. Our results suggest the need for an in-depth study of H among black people and early, continuing educational interventions.
The validation process showed that the Brazilian OIDP has the necessary basic psychometric properties to be used in the 50-74 years age group in Brazil. 'Work' and 'vigorous physical activities' had low impact on oral health. The activity 'vigorous physical activities' was not maintained in the instrument because of its low impact, while 'work' was maintained due of the increase in the 50-59 years age group in the Brazilian population.
Background: Since 1994, Brazil has developed a primary care system based on multidisciplinary teams which include not only a physician and a nurse, but also 4-6 lay community health workers. This system now consists of 26,650 teams, covering 46% of the Brazilian population. Yet relatively few investigations have examined its effectiveness, especially in contrast with that of the traditional multi-specialty physician team approach it is replacing, or that of other existing family medicine approaches placing less emphasis on lay community health workers.
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