Acessibilidade e utilização das redes de atenção primária e especializada por mulheres com HIV na perspectiva de usuárias e profissionais
Autor(a) principal: | |
---|---|
Data de Publicação: | 2018 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Manancial - Repositório Digital da UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/18528 |
Resumo: | The accessibility and utilization of Primary Health Care (PHC) optimize the diagnostic and early management of the infection by the Human Immunodeficiency Virus (HIV) and the shared management of care, positively affecting the health of the woman and child. The infected women access different health services during pregnancy, however, intersectoral communication is not established and there is discontinuity in puerperium, which negatively influences on the access of these women. The research objective was to collectively develop actions to promote the access of women with HIV to Specialized and PHC services of a city in the southern region of Brazil. It is a participatory research, which developed the knowledge creation cycle proposed by the Knowledge to Action Framework, in the period from September 2016 to October 2017. Three techniques for data production were developed, which were: interview with 14 women, 45 hours of records in field diary from participant observation in the services; and four focus group meetings with 11 professionals and managers. The content analysis structured the results in the subjects accessibility and utilization. The psychosocial accessibility indicated: positive communication, cultural and communicational barriers. Positive communication demonstrated that support, welcome, conversation and guidance promote the treatment follow-up by the women and reflect in the return to the health service. However, disrespectful assistance results in a conflicting relationship and impairs the access. The communication barriers indicated that unavailability, misunderstanding or divergence of information reflect negatively in the access, showing a necessity for training, co-responsibility and communication between services. The cultural barriers, such as confidentiality and prejudice, generate insecurity for the access. In temporal accessibility, the waiting time does not hinder the access, but causes dissatisfaction or preference for some services in the network. In geographical accessibility, the proximity of the PHC services to their homes and the transportation availability to the specialized service facilitate the access. Regarding the utilization, the first contact with the service was due to exposure to HIV, illness or pregnancy. The access to the PHC occurred through transfer between services, according to professional indication or by the user herself. The PHC takes responsibility for non-specific demands of the infection and shares the assistance with the specialized service in cases of immunizations, non-emergency assistance and examinations. The preference for the specialized service derives from the capacity to meet the users’ needs. There is continuity of utilization for follow-up of previous health problems, prevention and investigation of a new problem. The collective development of actions to promote accessibility and utilization resulted in the creation of a flowchart, as a tool for transformation of reality. This research allowed to broaden the view on the urgency for articulation in the network of attention to women living with HIV, in view of the need to promote improvement of the access, concerning the accessibility and utilization of services of the healthcare network. |
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2019-10-09T14:11:07Z2019-10-09T14:11:07Z2018-11-28http://repositorio.ufsm.br/handle/1/18528The accessibility and utilization of Primary Health Care (PHC) optimize the diagnostic and early management of the infection by the Human Immunodeficiency Virus (HIV) and the shared management of care, positively affecting the health of the woman and child. The infected women access different health services during pregnancy, however, intersectoral communication is not established and there is discontinuity in puerperium, which negatively influences on the access of these women. The research objective was to collectively develop actions to promote the access of women with HIV to Specialized and PHC services of a city in the southern region of Brazil. It is a participatory research, which developed the knowledge creation cycle proposed by the Knowledge to Action Framework, in the period from September 2016 to October 2017. Three techniques for data production were developed, which were: interview with 14 women, 45 hours of records in field diary from participant observation in the services; and four focus group meetings with 11 professionals and managers. The content analysis structured the results in the subjects accessibility and utilization. The psychosocial accessibility indicated: positive communication, cultural and communicational barriers. Positive communication demonstrated that support, welcome, conversation and guidance promote the treatment follow-up by the women and reflect in the return to the health service. However, disrespectful assistance results in a conflicting relationship and impairs the access. The communication barriers indicated that unavailability, misunderstanding or divergence of information reflect negatively in the access, showing a necessity for training, co-responsibility and communication between services. The cultural barriers, such as confidentiality and prejudice, generate insecurity for the access. In temporal accessibility, the waiting time does not hinder the access, but causes dissatisfaction or preference for some services in the network. In geographical accessibility, the proximity of the PHC services to their homes and the transportation availability to the specialized service facilitate the access. Regarding the utilization, the first contact with the service was due to exposure to HIV, illness or pregnancy. The access to the PHC occurred through transfer between services, according to professional indication or by the user herself. The PHC takes responsibility for non-specific demands of the infection and shares the assistance with the specialized service in cases of immunizations, non-emergency assistance and examinations. The preference for the specialized service derives from the capacity to meet the users’ needs. There is continuity of utilization for follow-up of previous health problems, prevention and investigation of a new problem. The collective development of actions to promote accessibility and utilization resulted in the creation of a flowchart, as a tool for transformation of reality. This research allowed to broaden the view on the urgency for articulation in the network of attention to women living with HIV, in view of the need to promote improvement of the access, concerning the accessibility and utilization of services of the healthcare network.Tem-se que a acessibilidade e a utilização da Atenção Primária à Saúde (APS) potencializam o diagnóstico e o manejo precoce da infecção pelo Vírus da Imunodeficiência Humana (HIV) e a gestão compartilhada da atenção, repercutindo positivamente na saúde da mulher e da criança. As mulheres infectadas acessam diferentes serviços de saúde durante a gestação, entretanto não se estabelece a comunicação intersetorial e há descontinuidade no puerpério, o que implica negativamente no acesso dessas mulheres. O objetivo da pesquisa foi desenvolver coletivamente ações para promoção do acesso de mulheres com HIV aos serviços de APS e Especializado de município da região Sul do Brasil. Pesquisa participante que desenvolveu o ciclo de criação do conhecimento proposto pelo modelo conceitual de Tradução do Conhecimento em Ação, desenvolvida no período de setembro de 2016 e outubro de 2017. Foram desenvolvidas três técnicas para produção dos dados, sendo entrevista com 14 mulheres, 45 horas de registros em diário de campo de observação participante nos serviços; e quatro encontros de grupo focal com 11 profissionais e gestores. A análise de conteúdo estruturou os resultados nos temas acessibilidade e utilização. A acessibilidade psicossocial apontou: comunicação positiva, barreiras culturais e de comunicação. A comunicação positiva mostrou que apoio, acolhimento, conversa e orientações promovem o seguimento do tratamento pelas mulheres e repercutem no retorno ao serviço de saúde. Entretanto, o atendimento desrespeitoso gera relação conflituosa e inviabiliza o acesso. As barreiras de comunicação indicaram que indisponibilidade, equívoco ou divergência de informações repercutem negativamente no acesso, revelando a necessidade de capacitação, corresponsabilização e comunicação entre serviços. As barreiras culturais, como sigilo e preconceito, geram insegurança para o acesso. Na acessibilidade temporal, o tempo de espera não impede o acesso, mas provoca insatisfação ou preferência por alguns serviços na rede. Na acessibilidade geográfica, a proximidade dos serviços de APS de suas residências e a disponibilidade de transporte para o serviço especializado facilitam o acesso. Quanto à utilização, o primeiro contato com o serviço se deu pela exposição ao HIV, adoecimento ou gestação. O acesso à APS ocorreu via transferência entre os serviços; conforme indicação profissional ou pela própria usuária. A APS responsabiliza-se por demandas não específicas da infecção e compartilha o atendimento com o serviço especializado em casos de imunizações, atendimento sem urgência e exames. A preferência pelo serviço especializado origina-se da capacidade de suprir as necessidades das usuárias. Há continuidade da utilização para acompanhamento de problema de saúde antigo, prevenção e investigação de novo problema. A construção coletiva de ações para promoção da acessibilidade e da utilização culminou na criação de um fluxograma, como ferramenta de transformação da realidade. Esta pesquisa possibilitou ampliar o olhar acerca da urgência da articulação na rede de atenção às mulheres vivendo com HIV, tendo em vista a necessidade de promover a melhoria do acesso, no que tange a acessibilidade e utilização dos serviços da rede de atenção à saúde.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESporUniversidade Federal de Santa MariaCentro de Ciências da SaúdePrograma de Pós-Graduação em EnfermagemUFSMBrasilEnfermagemAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessAtenção primária à saúdeAcesso aos serviços de saúdeGravidezPeríodo pós-partoHIVPrimary health careAccess to health servicesPregnancyPostpartum periodCNPQ::CIENCIAS DA SAUDE::ENFERMAGEMAcessibilidade e utilização das redes de atenção primária e especializada por mulheres com HIV na perspectiva de usuárias e profissionaisAccessibility and utilization of the primary and specialized care networks by women with HIV in the perspective of users and professionalsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisPaula, Cristiane Cardoso dehttp://lattes.cnpq.br/8247264269439154Langendorf, Tassiane Ferreirahttp://lattes.cnpq.br/4042225711702331Porto, Adrize Rutzhttp://lattes.cnpq.br/9425000336640831Silva, Ethel Bastos dahttp://lattes.cnpq.br/8503234995266686Cabral, Ivone Evangelistahttp://lattes.cnpq.br/7561708512534413Padoin, Stela Maris de Mellohttp://lattes.cnpq.br/6899455553008245http://lattes.cnpq.br/5886303551824178Kleinubing, Raquel Einloft400400000000600955f52bc-fa26-4000-9f63-fe6b25fb65c75766caa1-2b9c-4f41-b76f-8802479e55149c4b15f2-fd20-4df0-a10d-def7c549cb1a079a27c6-e59a-4106-8595-ae8bf5048ac1334a2cb4-f3c2-46d6-a26f-8b736fa0c51b2370de5b-971e-4e43-930a-b13b4fb94223e62147fb-7b9b-4c7c-9d5d-23704eeb96ccreponame:Manancial - Repositório Digital da UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMORIGINALTES_PPGENFERMAGEM_2018_KLEINUBING_RAQUEL.pdfTES_PPGENFERMAGEM_2018_KLEINUBING_RAQUEL.pdfTese de Doutoradoapplication/pdf2314980http://repositorio.ufsm.br/bitstream/1/18528/1/TES_PPGENFERMAGEM_2018_KLEINUBING_RAQUEL.pdfbf8d8ffcd222efa812479d2e4b166a3eMD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8805http://repositorio.ufsm.br/bitstream/1/18528/2/license_rdf4460e5956bc1d1639be9ae6146a50347MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-816http://repositorio.ufsm.br/bitstream/1/18528/3/license.txtf8fcb28efb1c8cf0dc096bec902bf4c4MD53TEXTTES_PPGENFERMAGEM_2018_KLEINUBING_RAQUEL.pdf.txtTES_PPGENFERMAGEM_2018_KLEINUBING_RAQUEL.pdf.txtExtracted texttext/plain351862http://repositorio.ufsm.br/bitstream/1/18528/4/TES_PPGENFERMAGEM_2018_KLEINUBING_RAQUEL.pdf.txtbe15f59554adaa3a316e284280f2160cMD54THUMBNAILTES_PPGENFERMAGEM_2018_KLEINUBING_RAQUEL.pdf.jpgTES_PPGENFERMAGEM_2018_KLEINUBING_RAQUEL.pdf.jpgIM Thumbnailimage/jpeg4365http://repositorio.ufsm.br/bitstream/1/18528/5/TES_PPGENFERMAGEM_2018_KLEINUBING_RAQUEL.pdf.jpg6b073a2140b3f3f3c7d3978ba1a36a1eMD551/185282022-04-12 09:20:17.021oai:repositorio.ufsm.br:1/18528Q3JlYXRpdmUgQ29tbW9ucw==Repositório Institucionalhttp://repositorio.ufsm.br/PUBhttp://repositorio.ufsm.br/oai/requestopendoar:39132022-04-12T12:20:17Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.por.fl_str_mv |
Acessibilidade e utilização das redes de atenção primária e especializada por mulheres com HIV na perspectiva de usuárias e profissionais |
dc.title.alternative.eng.fl_str_mv |
Accessibility and utilization of the primary and specialized care networks by women with HIV in the perspective of users and professionals |
title |
Acessibilidade e utilização das redes de atenção primária e especializada por mulheres com HIV na perspectiva de usuárias e profissionais |
spellingShingle |
Acessibilidade e utilização das redes de atenção primária e especializada por mulheres com HIV na perspectiva de usuárias e profissionais Kleinubing, Raquel Einloft Atenção primária à saúde Acesso aos serviços de saúde Gravidez Período pós-parto HIV Primary health care Access to health services Pregnancy Postpartum period CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM |
title_short |
Acessibilidade e utilização das redes de atenção primária e especializada por mulheres com HIV na perspectiva de usuárias e profissionais |
title_full |
Acessibilidade e utilização das redes de atenção primária e especializada por mulheres com HIV na perspectiva de usuárias e profissionais |
title_fullStr |
Acessibilidade e utilização das redes de atenção primária e especializada por mulheres com HIV na perspectiva de usuárias e profissionais |
title_full_unstemmed |
Acessibilidade e utilização das redes de atenção primária e especializada por mulheres com HIV na perspectiva de usuárias e profissionais |
title_sort |
Acessibilidade e utilização das redes de atenção primária e especializada por mulheres com HIV na perspectiva de usuárias e profissionais |
author |
Kleinubing, Raquel Einloft |
author_facet |
Kleinubing, Raquel Einloft |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Paula, Cristiane Cardoso de |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/8247264269439154 |
dc.contributor.advisor-co1.fl_str_mv |
Langendorf, Tassiane Ferreira |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/4042225711702331 |
dc.contributor.referee1.fl_str_mv |
Porto, Adrize Rutz |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/9425000336640831 |
dc.contributor.referee2.fl_str_mv |
Silva, Ethel Bastos da |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/8503234995266686 |
dc.contributor.referee3.fl_str_mv |
Cabral, Ivone Evangelista |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/7561708512534413 |
dc.contributor.referee4.fl_str_mv |
Padoin, Stela Maris de Mello |
dc.contributor.referee4Lattes.fl_str_mv |
http://lattes.cnpq.br/6899455553008245 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/5886303551824178 |
dc.contributor.author.fl_str_mv |
Kleinubing, Raquel Einloft |
contributor_str_mv |
Paula, Cristiane Cardoso de Langendorf, Tassiane Ferreira Porto, Adrize Rutz Silva, Ethel Bastos da Cabral, Ivone Evangelista Padoin, Stela Maris de Mello |
dc.subject.por.fl_str_mv |
Atenção primária à saúde Acesso aos serviços de saúde Gravidez Período pós-parto HIV |
topic |
Atenção primária à saúde Acesso aos serviços de saúde Gravidez Período pós-parto HIV Primary health care Access to health services Pregnancy Postpartum period CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM |
dc.subject.eng.fl_str_mv |
Primary health care Access to health services Pregnancy Postpartum period |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM |
description |
The accessibility and utilization of Primary Health Care (PHC) optimize the diagnostic and early management of the infection by the Human Immunodeficiency Virus (HIV) and the shared management of care, positively affecting the health of the woman and child. The infected women access different health services during pregnancy, however, intersectoral communication is not established and there is discontinuity in puerperium, which negatively influences on the access of these women. The research objective was to collectively develop actions to promote the access of women with HIV to Specialized and PHC services of a city in the southern region of Brazil. It is a participatory research, which developed the knowledge creation cycle proposed by the Knowledge to Action Framework, in the period from September 2016 to October 2017. Three techniques for data production were developed, which were: interview with 14 women, 45 hours of records in field diary from participant observation in the services; and four focus group meetings with 11 professionals and managers. The content analysis structured the results in the subjects accessibility and utilization. The psychosocial accessibility indicated: positive communication, cultural and communicational barriers. Positive communication demonstrated that support, welcome, conversation and guidance promote the treatment follow-up by the women and reflect in the return to the health service. However, disrespectful assistance results in a conflicting relationship and impairs the access. The communication barriers indicated that unavailability, misunderstanding or divergence of information reflect negatively in the access, showing a necessity for training, co-responsibility and communication between services. The cultural barriers, such as confidentiality and prejudice, generate insecurity for the access. In temporal accessibility, the waiting time does not hinder the access, but causes dissatisfaction or preference for some services in the network. In geographical accessibility, the proximity of the PHC services to their homes and the transportation availability to the specialized service facilitate the access. Regarding the utilization, the first contact with the service was due to exposure to HIV, illness or pregnancy. The access to the PHC occurred through transfer between services, according to professional indication or by the user herself. The PHC takes responsibility for non-specific demands of the infection and shares the assistance with the specialized service in cases of immunizations, non-emergency assistance and examinations. The preference for the specialized service derives from the capacity to meet the users’ needs. There is continuity of utilization for follow-up of previous health problems, prevention and investigation of a new problem. The collective development of actions to promote accessibility and utilization resulted in the creation of a flowchart, as a tool for transformation of reality. This research allowed to broaden the view on the urgency for articulation in the network of attention to women living with HIV, in view of the need to promote improvement of the access, concerning the accessibility and utilization of services of the healthcare network. |
publishDate |
2018 |
dc.date.issued.fl_str_mv |
2018-11-28 |
dc.date.accessioned.fl_str_mv |
2019-10-09T14:11:07Z |
dc.date.available.fl_str_mv |
2019-10-09T14:11:07Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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http://repositorio.ufsm.br/handle/1/18528 |
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Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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Programa de Pós-Graduação em Enfermagem |
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UFSM |
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Brasil |
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Enfermagem |
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Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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