Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose

Detalhes bibliográficos
Autor(a) principal: Garcia, Maria Concebida da Cunha
Data de Publicação: 2011
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Repositório Institucional da UFRN
Texto Completo: https://repositorio.ufrn.br/jspui/handle/123456789/14739
Resumo: Tuberculosis (TB) is one of the most important health problems being faced worldwide. In Brazil, the responsibility for the actions of to diagnosis and control of this disease was transferred to the municipalities within the Primary Health Care (PHC), aiming at improvement in epidemiological indicators, requiring reorientation of the practice of family health teams and requiring methodologies to analyze the extent to which components of the PHC are being achieved. Thus, this study aims to analyze the performance of primary care services in the city of Natal-RN for the diagnosis and control of TB, from the perspective of health professionals (doctors and nurses). The study is descriptive, cross-sectional and quantitative. Data collection was conducted from March to July 2011 and involved 121 health professionals working in 52 health units (family health unit, basic health unit and mixed units). The instrument is structured based on the Primary Care Assessment Tool (PCAT), validated and adapted to assess attention to TB in Brazil, and includes questions regarding the Structure and Process components of health services. For quantitative analysis, it was constructed indicators, whose response patterns are followed according to the Likert scale between one and five, which meant the degree of preference relation (or agreement) of the claims. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. With regard to inputs and equipment, the units had satisfactory condition for form (  = 4.26), consultation (  = 4.02) and basic basket (  = 4.24); regular condition to pot (  = 3.56) and unsatisfactory conditions for transportation tickets (  = 1.50) and sputum smear microscopy (  = 2.42) and X-rays (  = 1.07). In relation to actions, there was satisfactory development for those focused on the individual patient. Actions aimed at the collective level, as the search for respiratory symptoms (RS), monitoring of contacts and guidelines for the community ranged from regular to unsatisfactory (  = 3.16 -  = 1.34). With regard to training, 94,2% received training to identify RS. As regards the time for diagnosis, the median time elapsed between the identification of RS and the beginning of treatment it was 22 days. In relation to the difficulties faced by professionals in the diagnosis of TB, 56,2% reported that they are related only to health services, especially for the failure in the rearguard laboratory and in the specialized services reference, the lack of human and material resources and low performing an active search. The professionals perceive the performance of diagnosis and control of TB, permeated with limitations and barriers to organizational and operational character of various sizes, emerging the need for effective coordination of various sectors and key stakeholders of TB care, to adoption of a new intersectoral strategies that aim to increase the responsiveness of the PHC, providing the best performance in service delivery to the user, family and community, and ensuring effective action and resolving the needs of this population group.
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spelling Garcia, Maria Concebida da Cunhahttp://lattes.cnpq.br/3054573540987503http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4781295D6&dataRevisao=nullNogueira, Jordana de Almeidahttp://lattes.cnpq.br/8338527087554463Menezes, Rejane Maria Paiva dehttp://lattes.cnpq.br/5190926575194616Arcêncio, Ricardo Alexandrehttp://lattes.cnpq.br/9149546439669346Enders, Bertha Cruz2014-12-17T14:46:51Z2012-05-172014-12-17T14:46:51Z2011-12-08GARCIA, Maria Concebida da Cunha. Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose. 2011. 134 f. Dissertação (Mestrado em Assistência à Saúde) - Universidade Federal do Rio Grande do Norte, Natal, 2011.https://repositorio.ufrn.br/jspui/handle/123456789/14739Tuberculosis (TB) is one of the most important health problems being faced worldwide. In Brazil, the responsibility for the actions of to diagnosis and control of this disease was transferred to the municipalities within the Primary Health Care (PHC), aiming at improvement in epidemiological indicators, requiring reorientation of the practice of family health teams and requiring methodologies to analyze the extent to which components of the PHC are being achieved. Thus, this study aims to analyze the performance of primary care services in the city of Natal-RN for the diagnosis and control of TB, from the perspective of health professionals (doctors and nurses). The study is descriptive, cross-sectional and quantitative. Data collection was conducted from March to July 2011 and involved 121 health professionals working in 52 health units (family health unit, basic health unit and mixed units). The instrument is structured based on the Primary Care Assessment Tool (PCAT), validated and adapted to assess attention to TB in Brazil, and includes questions regarding the Structure and Process components of health services. For quantitative analysis, it was constructed indicators, whose response patterns are followed according to the Likert scale between one and five, which meant the degree of preference relation (or agreement) of the claims. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. With regard to inputs and equipment, the units had satisfactory condition for form (  = 4.26), consultation (  = 4.02) and basic basket (  = 4.24); regular condition to pot (  = 3.56) and unsatisfactory conditions for transportation tickets (  = 1.50) and sputum smear microscopy (  = 2.42) and X-rays (  = 1.07). In relation to actions, there was satisfactory development for those focused on the individual patient. Actions aimed at the collective level, as the search for respiratory symptoms (RS), monitoring of contacts and guidelines for the community ranged from regular to unsatisfactory (  = 3.16 -  = 1.34). With regard to training, 94,2% received training to identify RS. As regards the time for diagnosis, the median time elapsed between the identification of RS and the beginning of treatment it was 22 days. In relation to the difficulties faced by professionals in the diagnosis of TB, 56,2% reported that they are related only to health services, especially for the failure in the rearguard laboratory and in the specialized services reference, the lack of human and material resources and low performing an active search. The professionals perceive the performance of diagnosis and control of TB, permeated with limitations and barriers to organizational and operational character of various sizes, emerging the need for effective coordination of various sectors and key stakeholders of TB care, to adoption of a new intersectoral strategies that aim to increase the responsiveness of the PHC, providing the best performance in service delivery to the user, family and community, and ensuring effective action and resolving the needs of this population group.A tuberculose (TB) é um dos principais agravos à saúde a ser enfrentado em âmbito global. No Brasil, a responsabilidade pelas ações de diagnóstico e controle dessa doença foi transferida aos municípios, no âmbito da Atenção Primária à Saúde (APS), visando melhorias nos indicadores epidemiológicos, impondo reorientação da prática das equipes de saúde da família e requerendo metodologias que analisem em que medida os componentes da APS estão sendo alcançados. Destarte, este estudo tem o objetivo de analisar o desempenho dos serviços de APS do Município de Natal/RN para o diagnóstico e controle da TB, sob a perspectiva dos profissionais de saúde (médicos e enfermeiros). O estudo é descritivo, de corte transversal e quantitativo. A coleta de dados foi realizada de março a julho de 2011, e envolveu 121 profissionais de saúde, que atuam em 52 unidades de saúde (USF, UBS e Unidades Mistas). O instrumento de coleta é estruturado, baseado no Primary Care Assessment Tool (PCAT), validado e adaptado para avaliar a atenção à TB no Brasil, e inclui questões referentes aos componentes Estrutura e Processo dos serviços de saúde. Para análise quantitativa, construíram-se indicadores, cujos padrões de respostas são seguidos de acordo com a escala de Likert, entre 1 e 5, que significou o grau de relação de preferência (ou concordância) das afirmações. Os valores entre 1 e 3 foram considerados insatisfatórios para o indicador; entre 3 e menores que 4, regulares; e, entre 4 e 5, satisfatórios. No tocante aos insumos e equipamentos, as unidades apresentaram condições satisfatórias, para formulário (=4,26), consulta médica (  =4,02) e cesta básica (  =4,24); condição regular para pote (  =3,56); e condições insatisfatórias para vale-transporte (  =1,50), e realização da baciloscopia (  =2,42) e raioX (  =1,07). Em relação às ações, observou-se desenvolvimento satisfatório para aquelas centradas no indivíduo doente. As ações voltadas para o âmbito coletivo, como a busca de sintomáticos respiratórios (SR), controle de comunicantes e orientações para comunidade, variaram de regular a insatisfatórias (  =3,16 -  =1,34). Quanto à capacitação, 94,2% receberam treinamentos para identificar SR. No que se refere ao tempo para o diagnóstico, a mediana do tempo decorrido entre a identificação do SR e o início do tratamento foi de 22 dias. Em relação às dificuldades enfrentadas pelos profissionais para o diagnóstico da TB, 56,2% referiram que estas estão relacionadas somente aos serviços de saúde, com destaque para deficiência na retaguarda laboratorial e na referência para os serviços especializados, o déficit de recursos humanos e materiais e a baixa realização de busca ativa. Os profissionais percebem o desempenho das ações de diagnóstico e controle da TB permeados por limitações e entraves de caráter organizacional e operacional de diversas dimensões, emergindo a necessidade de articulação efetiva dos diversos setores e atores-chave da atenção à TB, para adoção de novas estratégias intersetoriais que visem à ampliação da capacidade de resposta da APS, promovendo o melhor desempenho na prestação dos serviços ao usuário, família e comunidade, e assegurando ações efetivas e resolutivas às necessidades deste grupo populacional.Conselho Nacional de Desenvolvimento Científico e Tecnológicoapplication/pdfporUniversidade Federal do Rio Grande do NortePrograma de Pós-Graduação em EnfermagemUFRNBRAssistência à SaúdeEnfermagemTuberculoseAtenção primária à saúdeDesempenho.NursingTuberculosisPrimary health carePerformance.CNPQ::CIENCIAS DA SAUDE::ENFERMAGEMDesempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculoseinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRNinstname:Universidade Federal do Rio Grande do Norte (UFRN)instacron:UFRNORIGINALMariaCCG_DISSERT.pdfapplication/pdf2302501https://repositorio.ufrn.br/bitstream/123456789/14739/1/MariaCCG_DISSERT.pdf97cbbe5d4b5a91a6182b0e5e8c2d02fcMD51TEXTMariaCCG_DISSERT.pdf.txtMariaCCG_DISSERT.pdf.txtExtracted texttext/plain269280https://repositorio.ufrn.br/bitstream/123456789/14739/6/MariaCCG_DISSERT.pdf.txtde00cd3f000f00c7468abb68d5808d68MD56THUMBNAILMariaCCG_DISSERT.pdf.jpgMariaCCG_DISSERT.pdf.jpgIM Thumbnailimage/jpeg2878https://repositorio.ufrn.br/bitstream/123456789/14739/7/MariaCCG_DISSERT.pdf.jpgd9aae7db704225f51e795b076655219fMD57123456789/147392017-11-01 01:50:14.866oai:https://repositorio.ufrn.br:123456789/14739Repositório de PublicaçõesPUBhttp://repositorio.ufrn.br/oai/opendoar:2017-11-01T04:50:14Repositório Institucional da UFRN - Universidade Federal do Rio Grande do Norte (UFRN)false
dc.title.por.fl_str_mv Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose
title Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose
spellingShingle Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose
Garcia, Maria Concebida da Cunha
Enfermagem
Tuberculose
Atenção primária à saúde
Desempenho.
Nursing
Tuberculosis
Primary health care
Performance.
CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM
title_short Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose
title_full Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose
title_fullStr Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose
title_full_unstemmed Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose
title_sort Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose
author Garcia, Maria Concebida da Cunha
author_facet Garcia, Maria Concebida da Cunha
author_role author
dc.contributor.authorID.por.fl_str_mv
dc.contributor.authorLattes.por.fl_str_mv http://lattes.cnpq.br/3054573540987503
dc.contributor.advisorID.por.fl_str_mv
dc.contributor.advisorLattes.por.fl_str_mv http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4781295D6&dataRevisao=null
dc.contributor.referees1.pt_BR.fl_str_mv Nogueira, Jordana de Almeida
dc.contributor.referees1ID.por.fl_str_mv
dc.contributor.referees1Lattes.por.fl_str_mv http://lattes.cnpq.br/8338527087554463
dc.contributor.referees2.pt_BR.fl_str_mv Menezes, Rejane Maria Paiva de
dc.contributor.referees2ID.por.fl_str_mv
dc.contributor.referees2Lattes.por.fl_str_mv http://lattes.cnpq.br/5190926575194616
dc.contributor.referees3.pt_BR.fl_str_mv Arcêncio, Ricardo Alexandre
dc.contributor.referees3ID.por.fl_str_mv
dc.contributor.referees3Lattes.por.fl_str_mv http://lattes.cnpq.br/9149546439669346
dc.contributor.author.fl_str_mv Garcia, Maria Concebida da Cunha
dc.contributor.advisor1.fl_str_mv Enders, Bertha Cruz
contributor_str_mv Enders, Bertha Cruz
dc.subject.por.fl_str_mv Enfermagem
Tuberculose
Atenção primária à saúde
Desempenho.
topic Enfermagem
Tuberculose
Atenção primária à saúde
Desempenho.
Nursing
Tuberculosis
Primary health care
Performance.
CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM
dc.subject.eng.fl_str_mv Nursing
Tuberculosis
Primary health care
Performance.
dc.subject.cnpq.fl_str_mv CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM
description Tuberculosis (TB) is one of the most important health problems being faced worldwide. In Brazil, the responsibility for the actions of to diagnosis and control of this disease was transferred to the municipalities within the Primary Health Care (PHC), aiming at improvement in epidemiological indicators, requiring reorientation of the practice of family health teams and requiring methodologies to analyze the extent to which components of the PHC are being achieved. Thus, this study aims to analyze the performance of primary care services in the city of Natal-RN for the diagnosis and control of TB, from the perspective of health professionals (doctors and nurses). The study is descriptive, cross-sectional and quantitative. Data collection was conducted from March to July 2011 and involved 121 health professionals working in 52 health units (family health unit, basic health unit and mixed units). The instrument is structured based on the Primary Care Assessment Tool (PCAT), validated and adapted to assess attention to TB in Brazil, and includes questions regarding the Structure and Process components of health services. For quantitative analysis, it was constructed indicators, whose response patterns are followed according to the Likert scale between one and five, which meant the degree of preference relation (or agreement) of the claims. Values between 1 and 3 were considered unsatisfactory for the indicator, between 3 and less than 4, regular, and between 4 and 5, satisfactory. With regard to inputs and equipment, the units had satisfactory condition for form (  = 4.26), consultation (  = 4.02) and basic basket (  = 4.24); regular condition to pot (  = 3.56) and unsatisfactory conditions for transportation tickets (  = 1.50) and sputum smear microscopy (  = 2.42) and X-rays (  = 1.07). In relation to actions, there was satisfactory development for those focused on the individual patient. Actions aimed at the collective level, as the search for respiratory symptoms (RS), monitoring of contacts and guidelines for the community ranged from regular to unsatisfactory (  = 3.16 -  = 1.34). With regard to training, 94,2% received training to identify RS. As regards the time for diagnosis, the median time elapsed between the identification of RS and the beginning of treatment it was 22 days. In relation to the difficulties faced by professionals in the diagnosis of TB, 56,2% reported that they are related only to health services, especially for the failure in the rearguard laboratory and in the specialized services reference, the lack of human and material resources and low performing an active search. The professionals perceive the performance of diagnosis and control of TB, permeated with limitations and barriers to organizational and operational character of various sizes, emerging the need for effective coordination of various sectors and key stakeholders of TB care, to adoption of a new intersectoral strategies that aim to increase the responsiveness of the PHC, providing the best performance in service delivery to the user, family and community, and ensuring effective action and resolving the needs of this population group.
publishDate 2011
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dc.identifier.citation.fl_str_mv GARCIA, Maria Concebida da Cunha. Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose. 2011. 134 f. Dissertação (Mestrado em Assistência à Saúde) - Universidade Federal do Rio Grande do Norte, Natal, 2011.
dc.identifier.uri.fl_str_mv https://repositorio.ufrn.br/jspui/handle/123456789/14739
identifier_str_mv GARCIA, Maria Concebida da Cunha. Desempenho dos serviços de atenção primária do município de Natal/RN para o diagnóstico e controle da tuberculose. 2011. 134 f. Dissertação (Mestrado em Assistência à Saúde) - Universidade Federal do Rio Grande do Norte, Natal, 2011.
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