Family Health Support Center: An Intersection Between Primary and Secondary Health Care

Abstract

Objective: to identify the space in which the Family Health Support Center is structured in the services and how it works within the scope of the Unified Health System. Method: a conceptual study based on partial results of a multicenter, descriptive-exploratory study with a qualitative approach, carried out in 2017, in the State of Santa Catarina, with managers and professionals from the Family Health Support Center. Content thematic analysis was used with the data from semi-structured interviews with professionals and individual interviews with managers, totalling 18 participants. Results: the professionals of the Family Health Support Center are identified as specialists who work in or close interaction with Primary Health Care, in the context of matrix support, in order to assist in the planning of the Health Care Network, which strengthens the general practice in Family Health. In addition to primary health care, they can act in intercessory spaces and perform secondary health care; set forth possibilities for intervention and enhance inter-sectoriality and co-responsibility. Conclusion: the Family Health Support Center was recognized as an important articulator of interdisciplinarity in health work, cabable of promoting comprehensive and intersectoral care, in addition to its initial proposal of supporting the Family Health Strategy, which could help in the coordination and fulfillment of secondary health care in the Brazilian Unified Health Care System, thus being an intersecting space between primary and secondary health care.

Implication of the training ad continuing education process for the interprofessional performance

“…On the other hand, the field of knowledge refers to a space of uncertain limits, in which each discipline and profession is supported by the others and common actions are shared between them for fulfilling their theoretical and practical attributions (6) . With such outlines, the work of Nasf-AB professionals has been oriented towards workers' performance in their own nucleus of knowledge and practice and close to the nucleus of the Family Health team, which embraces a common field of collective health care (14) .…”

<b>Ações de promoção da saúde dos núcleos ampliados de saúde da família e atenção básica/Health promotion actions in the extended family health and basic healthcare centers

“…O trabalho interprofissional incita discussões de casos clínicos, atendimento compartilhado entre profissionais e favorece a construção de projetos terapêuticos (14) . Contudo, chama a atenção no depoimento que a atuação institucional dos profissionais do Nasf-AB ainda está vinculada ao núcleo de especialidades, o que potencializa sua competência específica, porém negligencia a atuação interprofissional e a necessária articulação entre serviços para fomentar a coordenação do cuidado pela APS/AB por meio da ESF (10) .…”

“…As ações desenvolvidas pelas equipes, "ditas" promotoras da saúde, por vezes, situam-se no campo da prevenção de doenças. Assim, o trabalho do Nasf-AB, no âmbito da PS, via de regra, converge para a ampliação da qualidade do cuidado, na direção da prevenção, podendo impactar na acessibilidade e na resolutividade (10) .…”

“…Com base em estudos (2,4,(8)(9)(10)(11) que evidenciam desafios para atuar na PS no âmbito da APS, considera-se relevante analisar as ações desenvolvidas pelos Nasf-AB, em Santa Catarina (SC),na perspectiva da Promoção da Saúde, objetivo deste artigo. Considera-se a atuação dos profissionais dessas equipes substancial para a resolutividade da APS e, por conseguinte, para a PS.…”

Ações do enfermeiro na interface com os núcleos ampliados de Saúde da Família e Atenção Básica

“…It is assumed that this team is adequate to attend the attributes of integrality, longitudinality, in addition to contributing to the resolution of PHC. This can be enhanced by the general training of professionals, who develop actions, such as diagnosis of the territory, to plan interventions aimed at disease prevention, health promotion and clinical care (4) .…”