Sistematização de instrumento de estratificação de risco familiar: a Escala de Risco Familiar de Coelho-Savassi

Abstract

ResumoA Escala de Risco Familiar de Coelho-Savassi, instrumento de estratificação de risco familiar, é aplicada às famílias adscritas a uma equipe de saúde da família, para determinar seu risco social e de saúde, refletindo o potencial de adoecimento de cada núcleo familiar. Utiliza dados presentes na ficha A do Sistema de Informações da Atenção Básica (SIAB) e outros identificáveis na rotina das equipes de saúde da família. Nas equipes em que foi aplicada, a escala mostrou-se útil na reorganização da demanda e promoveu um percepção mais apurada, objetiva e qualificada do risco das famílias avaliadas, impactando de maneira positiva o trabalho em equipe. A Escala é ainda uma ferramenta útil para o planejamento de ações na equipe, para a percepção da interrelação entre os fatores de risco, e como instrumento de apoio a intervenções no território. Além disso, ela corroborou, em nível local e microrregional, os dados do Índice de Vulnerabilidade à Saúde. Estas observações apontam para um amplo potencial de aplicação da Escala de Risco Familiar de Coelho e Savassi, e para a necessidade de sua sistematização e padronização, para ampliação de seu uso. Neste artigo, as sentinelas de risco foram avaliadas e discutidas pelos autores, resultando em uma definição clara e precisa dos termos, bem como a justificativa para a inserção de cada evento como um indicador a ser pontuado pela Escala. Foram definidos os critérios de pontuação para as famílias e sugeridas formas de aplicação prática da Escala nas equipes. Ao final, foram feitas recomendações sobre a aplicação em situações peculiares. AbstractThe Coelho-Savassi Family Risk Scale, a risk stratification family instrument, is applied to families ascribed to a family health team, to determine their social and health risk, reflecting the illness potential of each family. It uses data presented in the Primary Care Information System (SIAB) A form and other data identifiable in the routine of family health teams. In teams where it was applied, the scale proved itself as useful to reorganize the demand and promote a more accurate, objective and qualified perception of the families risks impacting positively the teamwork. The scale is still a useful tool for action planning in the team, to the perception of the interrelationship between risk factors, and as a tool to support interventions in the territory. Moreover, it corroborated in local and micro-regional levels, the data from the Health Vulnerability Index These observations point to a broad range of potential application of Coelho-Savassi Family Risk Scale, and the need for systematization and standardization, to broaden its application. In this article, the sentinels of risk were evaluated and discussed by the authors, resulting in a clear and precise definition of the terms, as well as the rationale for inclusion of each event as an indicator to be scored in the Scale. There were defined scoring criteria for families and suggested ways of practical implementation of Scale in teams. Finally, recommendations were made on th...

Social Risk for The Family of Drug Users Hospitalized Due to Physical Injury / Risco Social de Familias de Usuários de Drogas Internados por Trauma Físico

“…7,9 The data collection instruments were a script for a semi-structured interview, with questions for socio-demographic and economic characterization of the interviewee and his/her family, and the Family Risk Scale. 14 The Escala de Risco Familiar de Coelho e Savassi (ERF/ CS) [Coelho-Savassi's Family Risk Scale] is an instrument with sentinel information to assess the situations of risk to which families may be exposed in daily life and social vulnerability, which is used by Primary Health Care teams in Brazil. It is a tool for evaluating and monitoring the social and economic reality in the context of the life of each family, recognizing the real health needs and, thus, offers subsidies to carry out prevention, promotion and health planning, according to the risks presented.…”

“…It is a tool for evaluating and monitoring the social and economic reality in the context of the life of each family, recognizing the real health needs and, thus, offers subsidies to carry out prevention, promotion and health planning, according to the risks presented. 14 The use of ERF/CS risk sentinels is justified by the characteristics present in the family and is classified according to the risk criteria identified. They are related to the epidemiological relevance -less than six months, more than 70 years old, systemic arterial hypertension, diabetes mellitus, to sanitary relevance -low sanitation conditions, and the impact on family dynamics -bedridden, physical and mental deficiencies, severe malnutrition, drug addiction, unemployment, illiteracy, and the resident.…”

“…They are related to the epidemiological relevance -less than six months, more than 70 years old, systemic arterial hypertension, diabetes mellitus, to sanitary relevance -low sanitation conditions, and the impact on family dynamics -bedridden, physical and mental deficiencies, severe malnutrition, drug addiction, unemployment, illiteracy, and the resident. 14 Among the risk situations, those that receive the highest score are families with people who are bedridden or physically disabled, low sanitation conditions, cases of severe malnutrition or who present a tenant/room ratio larger than one. Situations of risk with a score equal to two are cases of drug addiction, unemployment and tenant/room ratio equal to one.…”

“…Likewise, families with lower social risk should also be assisted less often than those of average and higher social risk than families without social risk. [14][15] Concerning the scoring presented in the family risk scale, the contexts found relate the situations experienced in the family to unfavorable social indicators and among the most striking findings to determine social vulnerability are unemployment, low sanitation conditions and illiteracy, and the presence of individuals with some type of chronic pathology, in addition to alcoholism, such as hypertension, diabetes mellitus, and mental deficiency of more than one member. However, there seems to be a combination of the social determinants of health representative of the economic and epidemiological transition -chronic noncommunicable conditions and aspects of living conditions with potential high-risk for infectious parasitic diseases.…”

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“…Para avaliação da família em estudo foi utilizada a Escala de Risco Familiar de Coelho-Savassi (ERF-CS) que é um instrumento para estratificação de risco aplicado às famílias adscritas a uma equipe de saúde, utilizando, para tanto, informações presentes na "Ficha A" do Sistema de Informação da Atenção Básica (SIAB) definidas como "sentinelas de risco", cuja soma dos escores de risco de cada família, as classificam em risco menor a máximo (Savassi, Lage & Coelho, 2012), conforme Quadro 1 a seguir:…”