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SERGIA LANDARA BEZERRA SOARES
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AVALIAÇAO A EFETIVIDADE DAS PRÁTICAS COTIDIANAS DESENVOLVIDAS PELOS
CENTROS DE ATENÇÃO PSICOSSOCIAL NO MUNICÍPIO DE JOÃO PESSOA-PB A
PARTIR DA PERSPECTIVA DOS PROFISSIONAIS.
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Advisor : FILIPE FERREIRA DA COSTA
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Date: Dec 21, 2023
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Time: 16:00
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Show Summary
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No Brasil, diferentes modelos assistenciais em saúde mental são encontrados no
decorrer de sua história Com os desdobramentos da reforma psiquiátrica brasileira, e as
consequentes transformações das práticas do modelo de cuidado em saúde mental,
surgem os Centros de Atenção Psicossocial, que através da Portaria/GM no336, foram
reestruturados e organizados. Os CAPS são serviços que possuem atenção diária em
saúde mental, seguindo os princípios fundamentais da articulação entre saúde mental e
atenção básica: promoção da saúde; acolhimento, vínculo e responsabilização;
integralidade; intersetorialidade; multiprofissionalidade; organização da atenção à saúde
em rede; desinstitucionalização; reabilitação psicossocial; participação da comunidade;
promoção da cidadania dos usuários. Os CAPS trabalham com equipe multiprofissional
que promovem diversas atividades, tanto em grupo como individuais, como: oficinas
terapêuticas e de criação, atividades físicas, atividades lúdicas, arte-terapia; além da
medicação. Nestes serviços, a família é considerada como parte fundamental do
tratamento, tendo atendimento específico (grupal ou individual) e livre acesso ao serviço,
sempre que se fizer necessário. Há uma falta de pesquisas publicadas sobre avaliações e
caracterizações dos serviços de saúde mental, pois existem alguns obstáculos que
interferem nesse processo de avaliação dos serviços de saúde mental, que são: a falta de
concordância por parte da administração pública sobre a avaliação de programas e
projetos; a falta de consenso sobre um modelo avaliativo que defina e preconize a forma
de funcionamento dos serviços de saúde mental; e a falta de indicadores capazes de
quantificar e/ou qualificar os serviços de saúde mental. O processo avaliativo dentro
desses serviços torna-se um importante instrumento capaz potencializar a assistência,
minimizar ou solucionar problemas, verificar a capacidade de resolubilidade, e ainda,
aferir as perspectivas dos diferentes atores dos serviços (usuários, familiares,
profissionais etc.). Esse estudo objetiva avaliar a efetividade das práticas cotidianas
desenvolvidas pelos Centros de Atenção Psicossocial (CAPS) do Município de João
Pessoa, de acordo com a política de saúde mental vigente. Trata-se de um estudo de
avaliação de serviços de saúde, que se utiliza de abordagem quantitativa. A amostra foi
composta por profissionais vinculados aos Centros de Atenção Psicossocial do Município
de João Pessoa, Paraíba, quais sejam: CAPS AD Jovem Cidadão, CAPS III Gutemberg
Botelho, CAPS III Caminhar e CAPS AD III David Capristiano. Foi administrado o instrumento de coleta de dados Avalia CAPS, em sua versão para profissionais,
contando com 38 questões, que avaliam as dimensões da autonomia, integralidade e
intersetorialidade. Os dados serão avaliados por meio de estatística descritiva, com a
apresentação de médias e desvios-padrão para as variáveis numéricas, e frequências
absolutas e relativas para as variáveis categóricas. Com esse estudo, esperamos
contribuir para a melhor compreensão do funcionamento dos serviços de saúde mental,
possibilitando reflexões e melhorias no cuidado, nas políticas públicas e nos serviços
prestados pelos CAPS da cidade de João Pessoa.
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LIVIA MARIA TAVARES MIRANDA
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ANÁLISE DA PRODUÇÃO DE CUIDADO A PARTIR DE INDICADORES
DE AVALIAÇÃO E MONITORAMENTO EM UM CENTRO DE ATENÇÃO
PSICOSSOCIAL I DO SEMIÁRIDO PARAIBANO
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Advisor : FILIPE FERREIRA DA COSTA
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Date: Dec 21, 2023
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Time: 09:00
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Show Summary
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Os Centros de Atenção Psicossocial (CAPS) se destacam como
integrantes importantes da Rede de Atenção Psicossocial, sendo vistos como
organizadores da Rede de Atenção em Saúde Mental, tendo sua assistência
prestada integralmente para indivíduos em sofrimento psíquico grave e
persistente. Os processos avaliativos adquiriram função política por meio da
reformulação do modelo assistencial, servindo como instrumento de
potencialização das práticas substitutivas ao modelo hospitalocêntrico. Dessa
forma, a dissertação tem como objetivo geral analisar as práticas de cuidado
e processo de trabalho no CAPS do município de Queimadas-PB, por meio de
indicadores de avaliação e monitoramento. Trata-se de uma pesquisa avaliativa,
de abordagem quantitativa, no qual foram analisados o uso de 16 indicadores de
monitoramento, avaliação e gestão do CAPS, subdivididos em oito temas: Atenção
a Situação de Crise, Qualificação dos Atendimentos Grupais, Trabalho em Rede,
Gestão do CAPS, Educação Permanente, Singularização da Atenção, Uso da
Medicação, Atenção às Pessoas com Deficiência Intelectual, com recorte temporal
ano de 2022. Os dados foram analisados por meio da estatística descritiva,
através do programa excel, com medidas de tendência central e de dispersão. Os
resultados do estudo evidenciam o comprometimento contínuo da equipe em
qualificar suas práticas nos grupos terapêuticos, um expressivo percentual de 75% dos usuários está integrado à SRT, apresentando Deficiência Intelectual (DI).
Dentre as fragilidades identificadas, destacam-se o alto número de
encaminhamentos a emergência psiquiátrica de usuários durante situações de
crise, a participação limitada de familiares nos grupos destinados a eles, a
ausência de supervisão clínico-institucional, uma elevada carga de casos por
profissional de referência, a formulação e revisão de Projetos Terapêuticos
Singulares e o trabalho intersetorial ocorrendo de maneira insuficiente e limitada.
Conclui-se que a efetiva aplicação dos indicadores elaborados pode promover o
fortalecimento da cultura avaliativa, aprimorando tanto os CAPS quanto os
próprios instrumentos de avaliação. Mais do que permitir a comparação com
distintas realidades, essa cultura avaliativa pode contribuir diretamente para a
qualificação contínua dos serviços.
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ACAAHI CEJA DE PAULA DA COSTA
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ANÁLISE DA FISCALIZAÇÃO DA EXECUÇÃO DAS AÇÕES DE SAÚDE
PELOS CONSELHEIROS DOS MUNICÍPIOS DA PLANÍCIE LITORÂNEA DO
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Advisor : LUCIANO BEZERRA GOMES
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Date: Dec 20, 2023
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Time: 14:00
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Show Summary
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Os conselhos de saúde têm importância fundamental no processo participativo
nas elaborações das políticas públicas e fiscalizações das ações de saúde. Neste
sentido, este estudo intitulado Análise da Fiscalização da Execução das Ações de
Saúde pelos Conselheiros dos Municípios da Planície Litorânea do Piauí:
Registros e Percepções tem como pergunta norteadora como os membros dos
Conselhos de Saúde da Planície Litorânea (PI) exercem o papel de fiscalização da
efetivação das ações de saúde de seus respectivos municípios? Dessa forma, um
dos objetivos é analisar como os conselhos municipais de saúde da Planície
Litorânea (PI) exercem o papel de fiscalização na execução das ações de saúde
de seus respectivos municípios. Para atingi-lo, utilizou-se como percurso
metodológico uma pesquisa de campo cujo corpus foi composto por seis
entrevistas guiadas por um roteiro semiestruturado aplicado aos conselheiros de
saúde dos municípios da Planície Litorânea PI. Para a análise das entrevistas,
pautou-se na análise do discurso de Michel Pêcheux considerando as categorias de discurso, posição-sujeito, interdiscurso, condições de produção. Além disso,
além da pesquisa de campo, utilizou-se também a pesquisa documental para
acrescentar elementos para a análise das entrevistas. Dentre os resultados,
destacam-se casos de conselheiros representantes dos usuários, mas que são
indicados pela gestão; os conselheiros não percebem efetividade na atuação
enquanto fiscalizadores; os instrumentos de gestão como o Plano Municipal de
Saúde (PMS), Programação Anual de Saúde (PAS) e o Relatório Anual de Gestão
(RAG) não são de conhecimento dos conselheiros e o instrumento de fiscalização
usado é o livro balancete-contábil; todos os entrevistados solicitaram
"capacitações"; relataram que não sentem proximidade com o conselho estadual e
nacional de saúde.
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CICERA SUENIA SOARES MANGUEIRA
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O CUIDADO NA ATENÇÃO PRIMÁRIA À SAÚDE SOB O OLHAR DE UMA COMUNIDADE CIGANA CALON EM SOUSA-PB
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Advisor : MARIA DO SOCORRO TRINDADE MORAIS
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Date: Dec 19, 2023
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Time: 14:00
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Show Summary
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Os serviços de saúde devem garantir a equidade de acesso para que todos os povos e comunidades, independente de etnia, cultura e estrato socioeconômico, minimizando as iniquidades e vulnerabilidades. No Brasil, as políticas públicas para comunidades e povos tradicionais são ignoradas ou dadas como inexistentes quanto aos seus direitos de acesso as práticas de saúde. Entre esses grupos minoritários, os povos de etnias ciganas são marginalizados quantos aos seus direitos de assistência à saúde, sendo a Atenção Primária à Saúde o serviço de primeiro contato e de atenção cuidado a saúde desses povos. No Brasil, os ciganos se dividem em três etnias diferentes: os Rom, os Sinti e os Calons, em que estão distribuídos por todo território nacional. O município de Sousa, no sertão da Paraíba, se destaca por possuir a maior comunidade com residência fixa de povos cigano na América Latina. O presente estudo teve como objetivo compreender a percepção dos moradores da comunidade cigana Calon de Pedro Maia, sobre o cuidado na Atenção Primária à Saúde. Tratou-se de uma pesquisa exploratória, descritiva com
Resumo: Os serviços de saúde devem garantir a equidade de acesso para que todos os povos e comunidades, independente de etnia, cultura e estrato socioeconômico, minimizando as iniquidades e vulnerabilidades. No Brasil, as políticas públicas para comunidades e povos tradicionais são ignoradas ou dadas como inexistentes quanto aos seus direitos de acesso as práticas de saúde. Entre esses grupos minoritários, os povos de etnias ciganas são marginalizados quantos aos seus direitos de assistência à saúde, sendo a Atenção Primária à Saúde o serviço de primeiro contato e de atenção cuidado a saúde desses povos. No Brasil, os ciganos se dividem em três etnias diferentes: os Rom, os Sinti e os Calons, em que estão distribuídos por todo território nacional. O município de Sousa, no sertão da Paraíba, se destaca por possuir a maior comunidade com residência fixa de povos cigano na América Latina. O presente estudo teve como objetivo compreender a percepção dos moradores da comunidade cigana Calon de Pedro Maia, sobre o cuidado na Atenção Primária à Saúde. Tratou-se de uma pesquisa exploratória, descritiva com abordagem qualitativa, desenvolvida na comunidade cigana Calon de Pedro Maia localizada no município de Sousa-PB. A entrevista foi realizada de junho a julho de 2023, com a participação de 15 ciganos Calons. As entrevistas foram transcritas e analisadas pela Técnica de Análise de Conteúdo de Bardin.Os resultados foram trabalhados em seis categorias temáticas, cujo foco central foi o cuidar da saúde do população cigana no contexto da Atenção Primária à Saúde. Evidenciou-se que o cuidar no olhar da população cigana está relacionada ao cuidado coletivo do ser e sua relação com a natureza, garantida mediante tradição cultural repassada entre as famílias, sendo essa uma importante forma de preservação da identidade desse povo. A assistência à saúde aos povos ciganos ainda é frágil. Desrespeito a cultura e singularidades, discriminação e falta de execução de políticas públicas relacionadas as questões ambientais e estruturais, como saneamento básico, habitação, educação são a cerne do adoecimento entre essa população.A atenção à saúde oferecida pela Atenção Primária local ainda é fragilizada e precisa ser reorganizada para ofertar uma assistência integral, com equidade e respeito as singularidade
s da população cigana.
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NAYARA PEREIRA LIMÃO
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Structure, organization and access to oral health services offered in Primary Care in the state of Paraíba according to the population size of the municipalities: analysis based on the 3rd cycle of the PMAQ-AB.
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Date: Dec 19, 2023
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Time: 10:30
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Show Summary
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It is known that the process of evaluating and monitoring health actions and services is essential for the enrichment of Primary Care. Therefore, evaluation of services is structured as a tool that assists management, in terms of organization of services, contributing to decision-making in health. From the perspective of evaluating health services in Brazil, the Ministry of Health established the National Program for Improving Access and Quality of Primary Care (PMAQ-AB), with the aim of improving the quality of health care and increasing the supply of these services. The program started in 2011 and ended in 2019, where three cycles were carried out. The present study, of an observational, analytical and cross-sectional nature, with a secondary basis, aims to analyze whether the structure of the health unit and the organization of the oral health team influence access to dental care offered in Primary Care in Paraíba, considering the population size of municipalities, according to data from the 3rd cycle of external evaluation of PMAQ-AB. For this study, Module III was used - (Interview with the user in the Basic Health Unit), which aims to verify the users' perception regarding access and use of health services; Module V- (Observation in the basic health unit), in order to analyze variables related to the infrastructure conditions of the unit and Module VI (Interview with the professional from the Oral Health Team and verification of documents in the Basic Health Unit), to analyze variables related to the organization of oral health services. The outcome variable used was access to dental services (booking appointments with the dentist at the health unit). It was observed that the majority of users of primary care in Paraíba are able to schedule an appointment with the dentist, with the highest percentage found for users/residents in small municipalities I - 98.1%. Regarding the structural characteristics and ambiance of the UBS, it was found that the majority of dental offices have good ventilation or air conditioning, have good lighting (natural or artificial) and have environments in adequate conditions, from an acoustic point of view, for all population sizes. A logistic regression model will be carried out in order to determine the influence of the structure of the health unit and the organization of the oral health team influence access to dental care offered in Primary Care in Paraíba, considering the population size of the municipalities.
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ANTARES SILVEIRA SANTOS
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A Prática Interprofissional na Estratégia Saúde da Família: percepções e atitudes de profissionais em município de grande porte do interior nordestino.
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Date: Dec 15, 2023
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Time: 14:00
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Show Summary
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A Colaboração Interprofissional (CI) é considerada uma estratégia para
modificar as práticas dos serviços de saúde, sendo importante reconhecer como ela
está ocorrendo nesses espaços. O objetivo deste estudo é avaliar o processo de
Colaboração Interprofissional dos profissionais da saúde no contexto da Estratégia
Saúde da Família (ESF) no município de Campina Grande PB. Trata-se de um
estudo transversal, descritivo e analítico realizado com a Escala de Avaliação da
Colaboração Interprofissional em Equipe II (AITCS II). Esse instrumento é composto
por 23 itens distribuídos em 3 dimensões: Parceria, Cooperação e Coordenação. As
pontuações das dimensões foram calculadas a partir das médias das questões e o
escore médio da AITCS II a partir da média das 3 dimensões. As médias foram
classificadas em boa colaboração, avançando em direção à colaboração e
necessidade de foco no desenvolvimento de práticas colaborativas. Inicialmente, foi
realizado um estudo piloto para avaliar preliminarmente o cenário de pesquisa a
partir da distribuição das frequências de resposta e cálculo de medidas de tendência
central e de variabilidade segundo categorias profissionais e tempo de inserção do
profissional na equipe. Em seguida, foi realizada a coleta dos dados finais, os quais
foram analisados a partir dos testes Kruskal Wallis e Mann-Whitney para avaliar a
CI segundo sexo, faixa-etária, categorias profissionais, tempo de prática profissional
e tempo de inserção na equipe atual, com nível de significância fixado em 5%. As
análises foram realizadas através do software SPSS 20.0. No estudo piloto,
participaram 30 profissionais médicos, enfermeiros e agentes comunitários de
saúde (ACS). A partir dele, observou-se o escore médio da AITCS II avançando à
colaboração, com fragilidades principalmente nos quesitos relacionados à
coordenação. Também, houve diferenças nas distribuições de respostas entre as
categorias profissionais e entre tempos de inserção na equipe atual. No estudo final,
participaram 153 profissionais médicos, enfermeiros, ACS e cirurgiões-dentistas. A
partir dele, reforçou-se a dimensão coordenação percebida como estando
caminhando para a colaboração, porém sendo mais positiva entre aqueles com
maior faixa-etária (p = 0,017), menor titulação (p<0,001) e maior tempo de inserção
na equipe (p = 0,034), e com os cirurgiões-dentistas avaliando mais negativamente
essa dimensão (p=0,05). A dimensão Cooperação também foi percebida como
estando caminhando para a colaboração, sem associações significativas com as
variáveis, enquanto a Parceria foi avaliada com boa colaboração, tendo menor
pontuação entre aqueles com menor titulação (p=0,024). Assim, conclui-se que há diferenças quanto a percepção das atitudes colaborativas nos serviços de saúde
entre categorias profissionais, faixa-etária, titulação e tempo de inserção na equipe
atual, apontando necessidade de aprimoramento principalmente nos itens
relacionados à coordenação.
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MICHELLE GRACE FLORENTINO MAIA
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ANÁLISE DA PRODUÇÃO DO CUIDADO NOS CAPS DE JOÃO PESSOA A PARTIR DE INDICADORES DE ATENÇÃO PSICOSSOCIAL
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Date: Dec 15, 2023
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Time: 14:00
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Show Summary
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A Reforma Psiquiátrica no Brasil tem promovido uma mudança significativa na
assistência à saúde mental, priorizando a desospitalização e a atenção comunitária,
tornando os centros de atenção psicossocial (CAPS) fundamentais nesse novo
modelo de cuidado. Os CAPS são serviços abertos de base comunitária que atuam
sob a perspectiva do modelo de atenção psicossocial. Neste, o objeto de trabalho
não é a doença e sim o sujeito em sofrimento psíquico, considerando sua
constituição política, histórica e sociocultural, elegendo o território como espaço de
produção do cuidado, através de redes intersetoriais, sociais e de apoio. Tendo em
vista a importância dos CAPS no contexto da efetivação do modelo de atenção
psicossocial e considerando a avaliação de serviços como elemento fundamental do planejamento e gestão do SUS, este trabalho tem como objetivo analisar a
produção do cuidado nos CAPS III da cidade de João Pessoa-PB. Trata-se de
estudo descritivo de abordagem quantitativa baseado em análise documental.
Foram incluídos no estudo o CAPS Caminhar, CAPS Gutemberg Botelho e CAPS
AD Jovem Cidadão. A coleta de dados ocorreu entre dezembro de 2022 a abril de
2023 com recorte temporal de julho a dezembro de 2022. Foram analisados 2.664
prontuários, oito livros de plantão da enfermagem, sete livros de plantão de equipe
multiprofissional, dois livros de atividades coletivas, cinco livros de reunião de
equipe, um livro de encaminhamentos para outros serviços e um livro de admissão.
Foram selecionados 16 indicadores de saúde mental elaborados em pesquisa
participativa com trabalhadores e gestores de CAPS III da região Sudeste. Os
indicadores possuem metodologia de cálculo por razão, analisando oito dimensões
da atenção psicossocial com abrangência temporal mensal, trimestral, semestral ou
anual. A análise dos dados foi realizada pelo programa Excel, através de estatística
descritiva, apresentando-se os resultados sob a forma de frequência relativa
(medianas, mínima e máxima). Os resultados evidenciam a capacidade dos
serviços de responder localmente às situações de crise com baixo percentual de
encaminhamentos às urgências psiquiátricas (4,8%); o compromisso da equipe em
qualificar continuamente suas práticas grupais acontece de maneira relativamente
exitosa (40,1%). A formulação (20,9%), revisão de projetos terapêuticos singulares
(6,6%) e o trabalho intersetorial (5,5%) acontecem nos serviços, porém de maneira
insuficiente e limitada. Entre as fragilidades identificadas estão a inexistência de
supervisão clínico-institucional, baixa participação de familiares nos grupos de
família (0,9%) e ofertas terapêuticas insuficientes aos familiares de usuários durante
a situação de crise (6,3%). Os indicadores de adesão do usuário à medicação,
inserção do usuário com deficiência intelectual e participação dos gestores foram
inviáveis de serem analisados. Conclui-se que os CAPS atuam na perspectiva do
paradigma psicossocial apresentando algumas limitações, e que o conjunto de
indicadores de saúde mental estudados contribuem de maneira positiva para a
análise da produção do cuidado em saúde mental, podendo ser utilizados no cotidiano dos serviços como uma estratégia de avaliação do processo de trabalho
pelos próprios trabalhadores e gestores.
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FERNANDO SOARES DA SILVA NETO
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EFETIVIDADE DA AURICULOTERAPIA NA DOR E ANSIEDADE EM PARTURIENTES: ENSAIO CLÍNICO RANDOMIZADO
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Date: Dec 13, 2023
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Time: 10:00
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Show Summary
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Dentre os contextos mais recente de cuidado e humanização, as Práticas
Integrativas vêm ganhado espaço e se tornando uma forma de auxiliar a mulher dentro do
ciclo gravídico-puerperal. Práticas como aromaterapia, auriculoterapia, musicoterapia,
massagens, reflexologia e florais tem sido crescentemente utilizada e estudada no cuidado
a mulher na gestação, parto e puerpério em diversos desfechos. O uso das PICs é muito
relevante, pois detém uma forma alternativa de minimizar desconfortos, e promover a
melhorias das condições de saúde, numa visão holística e humanística. Esta dissertação
está estruturada em duas etapas: a primeira é uma investigação metodológica, que buscou
sumarizar os estudos científicos acerca do uso das práticas integrativas e complementares
(PICs) no manejo da dor em parturientes, para tal, realizou-se uma Revisão Sistemática.
Incluíram-se 17 estudos, que avaliaram 2.371 mulheres. O uso da massoterapia e
acupuntura se destacaram, frente ao manejo da dor durante o trabalho de parto. Não houve
homogeneidade entre os protocolos de aplicação terapêutica. Quatro estudos obtiveram
alto risco de víeis e 13 baixo risco de víeis. As PICs demonstram ser uma alternativa viável,
de fácil manejo e boa eficácia anverso a dor do parto, quando comparado a cuidados usuais
e/ou placebo. A segunda etapa, se deu por elaboração de um Ensaio Clinico, randomizado,
controlado, com dois braços, que propôs avaliar a efetividade do uso da auriculoterapia na
dor e ansiedade de mulheres em trabalho de parto. Foram recrutadas mulheres atendidas
no Instituto Cândida Vargas ICV, internas no Centro Obstétrico, em trabalho de parto
ativo. A coleta de dados realizou-se com a aplicação de questionários pré e pós-intervenção
e escalas associadas ao cenário de pesquisa. Elencou-se um nível de significância de 5% para todas as variáveis. A pesquisa segue os preceitos éticos com aprovação pelo CEP
Parecer: (5.722.961) e ReBEC obtendo número de aprovação RBR-6gpvcvr. A idade média
no grupo intervenção foi de 26,01 anos e no grupo controle de 25,51 anos. A maioria das
parturientes da intervenção (62-75,6%) e controle (71-79,8%) se declaram não brancas, ou
seja, parda, preta, indígena e/ou amarela. Observou-se um aumento progressivo da média
de dor no grupo controle em comparação à intervenção. Já em relação a ansiedade,
mantem um padrão de aumento discreto na escala de ansiedade no controle durante as 2
horas de observação, enquanto o grupo intervenção observa uma diminuição. A análise dos
dados mostrou que os escores de dor e ansiedade após 120 minutos são estatisticamente
significativos (p-valor <0,05) tanto para a intervenção como para o controle, entretanto, com
um aumento da média e mediana da dor e da ansiedade no grupo controle, e com a
diminuição da média e mediana no GI. O risco relativo para auriculoterapia é de 2,29, com
um número necessário para tratar de (n=03) e da ansiedade é de 79,3% na intervenção e
de 61,8% no controle, apresentando um risco relativo para a não piora de 1,62, e um número
necessário para tratar de (n=06). A análise de comparação da dor e da ansiedade após a
aplicação de auriculoterapia mostrou uma redução estatisticamente significativa de dor e
ansiedade no grupo intervenção quando comparado ao controle, tanto na comparação das
medianas como ao comparar a proporção de mulheres que obtiveram uma manutenção ou
melhora da dor e da ansiedade no durante o trabalho de parto nos dois grupos. A partir da
análise pode-se concluir que a auriculoterapia apresenta uma efetividade importante na
estabilização e melhora da dor e da ansiedade no trabalho de parto.
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NARA RAQUEL BARBOSA DA SILVA
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THE NASF HEALTH WORK PROCESS IN THE COVID-19 PANDEMIC: changes and repercussions.
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Advisor : LUCIANA FIGUEIREDO DE OLIVEIRA
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Date: Nov 30, 2023
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Time: 09:00
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Show Summary
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This study approached health professionals from the Expanded Family Health and Primary Care Center (NASF, in Portuguese). The inclusion of NASF in the Unified Health System (SUS, in Portuguese) with these teams interprofessional cooperation expanded the health interventions provided in PHC. This study approached the workflow at NASF in Recife, Brazil, during the COVID-19 pandemic and the consequences of this context, observing workflow components (objectives or goals; means and conditions; object; agent or subject). This study aimed to investigate the changes and consequences in the workflow at NASF-Recife during the COVID-19 pandemic. It is a qualitative, exploratory, descriptive research with a convenience sample, using Bardins content analysis as the theoretical epistemological framework. The analysis indicated the following three main categories related to the NASF-Recife professionals workflow: a) the care provided to users, b) the COVID-19 pandemic and the workflow at NASF-Recife; and c) the consequences of the pandemic on the NASF-Recife workers and future perspectives. The results point to precautions taken to ensure biosafety, with consequences to the operationalization of care, the use of NASF to fight COVID-19, further precarious infrastructure, changes in how care is understood and managed, some canceled activities, while other ones were included, the Internet used as a tool to operationalize healthcare, and consequences to the health workflow and its components. This research found that fighting COVID-19 caused fatigue in a wide range of aspects of the workflow, as addressed and discussed in this dissertation. In conclusion, the experience of the professionals in this research during the pandemic revealed greater gaps in health infrastructure, organization, and management, which were already present before the pandemic. Such gaps must be revisited and changed concerning the extant workflow means and conditions and the expectations of these workers, given the new adversities and characteristics of a generation of professionals and the population who survived COVID-19.professionals and finally, discuss how the current Primary Care Policy reflects on the health work process of NASF workers. The results observed in the integrative review point to the inversion of the care logic, with the focus on hospital spaces; Lack of studies aimed at PHC work in combating COVID-19; Mental illness of PHC health professionals, due to social isolation, long working hours, fear of contamination of themselves and their families; management weaknesses, regarding adequate support of inputs and training. The results of the second stage, an exploratory-descriptive study, present the following results: It was observed that the work process at NASF-Recife underwent changes resulting from the current PNAB, with the report of charging for productivity, change in the care focus, with emphasis on outpatient profile; the new PNAB also brought a scenario of insecurity regarding the NASF's permanence in the municipality, seen as the devaluation of work, ultimately understood as detrimental to the work carried out by the NASF since its implementation in 2010. Regarding the implications of COVID-19, it was found that the NASF's work process was changed, with the implementation of remote activities and suspension of groups; allocation to other performance spaces; as a vaccination campaign. It was observed that professionals faced difficulties, regarding their emotional state, these deal with the psychological suffering experienced during the pandemic, with reports of fear of contamination; suffering from the loss of co-workers; social isolation. It was observed that the NASF professional was already in psychological distress, due to the scarcity of resources arising from municipal management, with PNAB there was a significant worsening of these problems, with COVID-19 this suffering was intensified, to the point of some professionals require medical leave and psychological support.
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EMILY MÍRIAM ARAUJO TAURINO
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Assessment of the Impact of Covid-19 on Indigenous Health.
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Date: Nov 30, 2023
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Time: 08:00
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Show Summary
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Covid-19 caused significant impacts on populations, including indigenous people, who suffer a historic milestone in the fight against genocide, their ancestry, culture, territory, search for their rights, given their vulnerable situation. Evidence indicates that pandemics behave severely in indigenous peoples, the social factor, the diversity of forms of organization, the process of physical and cultural changes are determining factors in the presentation of greater biological vulnerability. Indigenous health still follows a dynamic and complex scenario that changes over the years, however, requiring more attention, monitoring this process in these populations represents a major challenge in carrying out notifications, the lack of data disaggregation and possible failures in the inclusion of systems, they contribute to ruptures in the detailed dimension caused by indigenous people, where it is possible, through epidemiological data, to play a supporting role in the construction and execution of public policies. This research seeks to analyze the impact and coping with COVID-19 in the context of indigenous peoples in the Special Indigenous Health Districts of Brazil, as well as systematically review scientific articles that measure the topic of indigenous health in the context of COVID-19. This research addresses two aspects, chapter 1 refers to a systematic review verifying the impact of covid-19 on the indigenous population in the scientific literature, and chapter 2 is a longitudinal, descriptive study with a quantitative and qualitative approach, which will be developed based on epidemiological data collection, as well as the use of theoretical references on Human Infection by the new Coronavirus (COVID-19) in Indigenous Peoples. The data were extracted from the Indigenous Health Care Information System (SIASI) database, which were organized and tabulated using MicrosoftExcel®, and processed using the Statistical Package of the Social Sciences 20.0 software program. (SPSS). The systematic review resulted in 189 records identified in the databases, 71 duplicates excluded, 123 studies to be read in full, 43 eligible for evaluation, 20 studies included in synthesis, resulting in 15 studies selected for preparation of the review. For data analysis, descriptive analyzes were carried out and incidence rates of Flu Syndrome, Acute Respiratory Flu Syndrome and COVID-19 (coronavirus-19) were obtained, in addition to the mortality rate; temporal trend estimated by the Prais-Winsten Regression model; spatial autocorrelation analysis using the Moran Global and Local Index (IGM/ILM); the cartographic demonstration was carried out using the LISA map (LISA map - Local Indicators of Spatial Association); and spatial scanning technique using the Kulldorff Scan method. The analyzed data may contribute to determining epidemiological patterns by providing necessary subsidies to measure the real impact of Covid-19 on indigenous peoples, such as effective health barrier measures.
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CADI DABO
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PATIENT SAFETY MANAGEMENT: PERCEPTION OF NURSES IN THE MATERNITY OF A HOSPITAL IN GUINEA-BISSAU
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Date: Nov 23, 2023
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Time: 14:00
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Show Summary
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Patient safety management plays a fundamental role in reducing risks and damages. This study aims to evaluate the perception of nursing professionals regarding patient safety management in the maternity ward of a hospital in Guinea-Bissau. This was a study with a qualitative approach that took place in the maternity ward of the Nacional Simão Mendes hospital. Nurses and midwives were interviewed, totaling 13 interviewees. The collection was carried out between September and November 2022, using a semi-structured interview. The empirical material was organized and based on Bardin's Content Analysis. The project was approved under CAAE: N° 049/CNES/INASA/2022 (National Health Research Ethics Committee of Guinea-Bissau). The results were presented in six thematic categories: Knowledge about patient safety; Occurrence of adverse events; Understanding of patient safety protocols; Training and continuing education; Strategies for reducing errors in care; and Precarious working conditions and the impact on assistance. It is expected that the results can serve as a guiding element to support the implementation and improvement of public health policies aimed at patient safety and strengthening the culture of safety in care, considering the specificities and singularities of the Guinean health system.
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GABRIELLA DANTAS DOS SANTOS
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Citizen's Electronic Health Record: Perception of the Health Care Team
Primary Health Care Nursing in Olinda-PE
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Advisor : MARIA DO SOCORRO TRINDADE MORAIS
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Date: Sep 5, 2023
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Time: 14:00
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Show Summary
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The implementation of the Electronic Citizen Record (PEC) in the context of Primary Care
à Saúde has promoted significant advances in the management of care in Olinda-PE. However,
it is noticed that the perception of nursing professionals, the quality of connectivity and the
digital competence can influence the effectiveness of this tool. Thus, the present study
aimed to evaluate the perception of these professionals regarding the implementation and use of the
SPEC. For this, a descriptive exploratory cross-sectional study was carried out, with
quantitative and qualitative approach, involving nursing professionals who use the PEC in
health units in Health Region 2 of Olinda (PE). Data collection was carried out by
through semi-structured interviews and document analysis. The collected data were
tabulated and submitted to descriptive and inferential statistical analysis in the Statistical software
Package for the Social Sciences (SPSS), version 21. The perceptions of 32
professionals, revealing a generally positive evaluation of the PEC, with emphasis on its
functionality and meeting work needs. However, challenges were identified,
mostly related to IT infrastructure and connectivity, in addition to a persistent
preference for physical records among some professionals. Through Factor Analysis
Exploratory, it was possible to regroup the study variables into four main factors, which
explained 62.19% of the total variance. The results demonstrated that the success of the PEC does not
is restricted to its intrinsic characteristics, but is also linked to the perception and use by professionals, as well as the available infrastructure. It is concluded, therefore, that the
PEC's effectiveness is multifactorial and depends on both technological and human aspects.
This study emphasizes the need to deepen investigations in this regard, aiming at
optimizing the implementation and use of the PEC, and the consequent improvement in customer service
Primary Health Care.
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ANA PAULA MAIA ESPÍNDOLA RODRIGUES
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FOOD AND NUTRITION EDUCATION PRACTICES IN PRIMARY HEALTH CARE: MEMORIES AND STORIES OF EXPERIENCES IN POPULAR EDUCATION
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Advisor : PEDRO JOSÉ SANTOS CARNEIRO CRUZ
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Date: Aug 31, 2023
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Time: 08:00
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Show Summary
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The main objective of this research is to reveal the practices of Food and Nutrition Education (EAN) in Primary Health Care (PHC) carried out from the perspective of Popular Education (PE) in Paraíba, in order to understand the contributions of PE in these practices. The investigative path was built through an investigation with a qualitative approach, of a descriptive nature, which was carried out from the realization of an Integrative Literature Review and semi-structured interviews carried out in a narrative perspective with subjects with experience in PE practices that had an interface with the dimension of the EAN in the PHC, identified using the snowball technique. As a result of these data collection strategies, it was possible to develop 2 scientific articles, one of which was carried out based on the integrative review, in which it was possible to seek the approaches currently mentioned in the PE and EAN literature in the PHC context; and a second article on the mapping of experiences identified from the semi-structured interviews carried out and analyzed from the dialectic hermeneutics. The results of the literature review were systematized and presented based on three themes which brought dimensions of the potentialities emerging from the approximation of EP and EAN in PHC, namely: 1) The shared construction of knowledge; 2) Diving into social reality and the political intention of EAN's actions; 3) Methodologies and dynamics to enable a process
critical and liberating education. From the interviews, it was possible to identify that among the activities mentioned by the interviewees, the use of strategies that value culture and ancestry to carry out the actions stands out. In addition, the activities presented brought popular knowledge, desires and needs of the territory as the center and basis of the discussions. The conversation wheel appears in the speech of all interviewees as one of the necessary methodologies for carrying out their experiences and among the numerous approaches mentioned, it is possible to verify the artistic character of the actions mentioned, such as paintings, music, cordel, soirée, theater, etc. Dialogicality was the PE principle most mentioned in the interviews, as a major influence on EAN practices. Therefore, this research pointed out that the PE methodology contributed and was mentioned in the EAN practices in PHC and provided a critical and reflective educational process, seeking to break with technical, biological and knowledge transmitting models, without criticism and reflection. In addition, the pedagogical practices immersed in PE build an interdisciplinary and interprofessional dialogical process, with activities that value art and culture, with the aim of creating connections, discussions and proposals with a view to the emancipation of subjects for social transformation.
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IRIS DE SOUZA ABILIO
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POULAR HEALTH EDUCATION IN BRAZIL: REFLECTIONS BASED ON THE NARRATIVES OF ITS PROTAGONISTS
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Advisor : PEDRO JOSÉ SANTOS CARNEIRO CRUZ
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Date: Aug 30, 2023
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Time: 14:00
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Show Summary
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This study aims to address, historically, in the format of an annotated timeline, the landmarks of Popular Education in Health (PEH) from the narratives of some of its protagonists and to build syntheses of ideas and reflections of the interviewees regarding the main challenges popular education today. This study was constituted in an articulated way and inserted in a broader research project, conducted by the Thematic Group of Popular Education in Health of the Brazilian Association of Collective Health (GT EPS/ABRASCO). This is a research with a qualitative approach, as founded by Maria Cecília de Souza Minayo, from the perspective of systematizing experiences, in the terms proposed by Oscar Jara Holliday. It was developed through two stages: the first was the bibliographical survey of the four interviews previously carried out and published by the GT EPS/ABRASCO with Educadores Populares do Brasil, and the second, the performance of new individual interviews (all the interviews used in the studies follow the perspective of narratives along the lines of oral history). The method of analysis chosen was the dialectic, in the theoretical perspective of Jara Holliday. The results allowed us to travel through the historical landmarks of EPS, dialoguing with the interviewees' experience and their socio-political contexts. The journey of the EPS began in the 1950s/1960s, still closely linked to the education of young people and adults, and went through several milestones: it overcomes the context of the military dictatorship; approaches the initiatives of community medicine, popular health and the Movement for Brazilian Sanitary Reform; achieves its institutionalization of the Unified Health System (SUS), through democratic and participatory government agendas, in force in the country between 2003 and 2016, especially with regard to the achievement of the National Policy of Popular Education in Health within the scope of the Unified Health System (PNEPS-SUS); transits through the democratic rupture imposed by the impeachment of President Dilma Rousseff in 2016, from which a series of dismantling of participatory public policies and civilizing setbacks poses several challenges to the EPS; resists with difficulty, creativity and resilience, in its movements and practices, governments of an ultraneoliberal, ultraconservative and anti-democratic nature, in the period 2016-2022, aggravated by the crisis of the covid-19 pandemic; and arrives at its current context of reunion with a national public agenda committed to democracy and the expansion of social participation. In this process, the initiatives and actions that led to these achievements stood out, among them we can highlight the Pastoral Land Commission (CPT), Popular Health Movement (MOPS), Popular Health Education Network (REDPOP), Multiprofessional Advisory Center ( CAMP), National Articulation of Popular Extension (Anepop), National Articulation of Movements and Practices of Popular Education in Health (ANEPS), among others, reflecting the power of popular participation in the implementation of public policies and the scope of EPS in health care . The research also promoted reflections on current challenges, where the setbacks resulting from anti-democratic governments that were in power and are contrary to the principles of EPS were pointed out; the distancing of some EPS actors and collectives from grassroots work, an action front that was so important for the emergence and diffusion of the field; low investment in permanent political training in EPS spaces; weaknesses in the mobilization of social movements in struggles and social resistance; and the difficulty of renewing the cadre of popular educators in the social and political role in the area, since some of the interviewees perceive themselves in the aging process and feel the need to mobilize new members to continue this mission. Thus, this study allowed a look to the past and to its historical construction, providing reflections on the present challenges, in an attempt to instigate new and unpublished viable actions for the continuity of this reference.
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ADRIANA MARIA MACEDO DE ALMEIDA
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PERMANENT HEALTH EDUCATION POLICY IN PARAÍBA: TRAJECTORY, ADVANCES AND CHALLENGES OF ITS IMPLEMENTATION
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Advisor : FRANKLIN DELANO SOARES FORTE
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Date: Aug 29, 2023
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Time: 14:00
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Show Summary
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Permanent Health Education (EPS) in Paraíba began its movement in 2003, but was only implemented as a policy in 2009. This study aims to analyse how the processes of implementation and strengthening of PHE in Paraíba have been taking place, focusing on the description and analysis of the actions and events carried out, seeking to deepen these PHE processes that have stagnated over the years, identifying potentialities and weaknesses experienced. This is a single case study through interviews, which were recorded, transcribed and analysed. Impressions of data collection were also recorded by the researcher's field diary. Thematic analysis of the interviews and documentary analysis were adopted. The single case study had as its unit of analysis the state of Paraíba and was developed in partnership with the Paraíba State Health Secretariat, through the School of Public Health (ESP) and the Regional Health Managements (GRS). The identification of the participants for this phase of the research was carried out according to the snowball technique, in which the "seeds", which refer to the first participants contacted from each segment, were: 1) Manager linked to ESP, with longer experience in conducting the EPS policy; 2) Regional Managers linked to the GRS located in the municipalities belonging to one of the three Health Macroregions of Paraíba. In addition, documentary research was carried out through official homepages and requests at the entities, including reports, plans, management instruments, ordinances and documents, as well as scientific publications in academic journals. Among the potentialities, we highlight the creation of the School of Public Health of Paraíba; the strengthening of the Teaching-Service Integration Commission (CIES) by the action of its actors/guidelines; the creation of the Strategic Coordination as a specific sector to support the actions and discussion of the EPS guidelines; the consolidation of the Institutional Support function; a closer relationship between state management and municipalities during the pandemic and, among the most significant weaknesses, we have the delay in the beginning of the policy in the state, in contrast to what occurred on the national scene; the CIES as an advisory body; insufficient number of professionals in the Strategic Coordination; the non-use of most resources to fulfil the Macroregional EPS Plan; the lack of support from some partners in monitoring the plans and use of resources and the incipient participation of managers in the CIES were observed as weaknesses. The involvement and dialogue of several individual and institutional agents with the Permanent Health Education Policy in Paraíba was observed. Important actions to strengthen the EPS, in the spaces already established and also to promote new scenarios of follow-up and permanent monitoring, development of research and actions of sustainability of the Policy with articulation and institutional partnerships of the service, management, teaching and community.
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JOSÉ IURY FERREIRA PIRES
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HEALTH EDUCATION USING DIGITAL MEDIA FOR THE EMOTIONAL WELL-BEING OF THE ELDERLY: ACTION-RESEARCH.
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Date: Aug 28, 2023
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Time: 17:30
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Show Summary
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This work aims to evaluate the impact of the use of digital media on the health education process and on the emotional well-being of older adults from a Family Health Strategy and the Reference Center for the Elderly in the city of João Pessoa, Northeast Brazil. Method: this is an action research with a quantitative-qualitative approach while considering both human subjectivity and the use of validated psychometric instruments for the screening of anxiety, using the Beck Anxiety Inventory (BAI), depression with the Patient Health Inventory (PHQ-9) and quality of life with the SF-36. The research was conducted through virtual rooms by WhatsApp, where weekly meetings took place with themes chosen by the elderly, bringing information and health education to the participants. Eighteen elderly women aged 60 to 80 years participated in this research. The selection was non-probabilistic for convenience. The health education process was carried out with aspects of the theme analyzed, occurring in eight meetings. Data were collected through interviews and questionnaires based on two semi-structured scripts, before and after the educational period, in order to perform a comparative analysis of the two moments, where descriptive and inferential statistics were used, as well as Bardin's thematic analysis for qualitative evaluation. Results: Although the elderly do not belong to the generation of digital natives, they have a certain understanding of what Digital Social Networks (DSN) are and their majority are active in social interaction applications such as WhatsApp, presenting 44.4% of exclusive use on this platform because it has greater ease of handling and accessibility. It was observed in the interventions that the lack of knowledge reduces mental health care. After the intervention, a statistically significant improvement in mental health was evidenced, obtaining a reduction in signs and symptoms of anxiety, obtaining differences from the medians of 7.5 in the first application to 4.0 in the second application, being p < 0.001, in the same way there was a decrease in signs and symptoms of depression, obtaining in the first application a median of 3.5 to 1.5 in the second application, being p < 0.001, improving mental health care and healthy practices, resulting in the improvement of 5 of 8 domains investigated by the quality of life instrument, namely: limitation by physical aspects, general health status, vitality, social aspects and mental health, where p < 0.001. The process of health education through the use of digital tools with the aid of social networks in educational interventions has the potential to improve knowledge and stimulate emotional well-being in the elderly population, highlighting the importance of using resources such as this in health education actions.
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CAIO CÉSAR FERREIRA ALVERGA
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DEVELOPMENT AND VALIDATION OF A QUESTIONNAIRE TO ASSESS THE CLINICAL ASPECTS OF LONG COVID IN PRIMARY HEALTH CARE
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Advisor : FLAVIA EMILIA LEITE DE LIMA FERREIRA
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Date: Jul 31, 2023
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Time: 09:30
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Show Summary
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Covid-19 is a respiratory infection caused by SARS-Cov-2 that can result in persistent symptoms for weeks or months after the acute period. The lack of standardization makes it difficult to manage long-term Covid in primary care. The objective of the study is to develop and validate a research instrument to characterize the long covid in João Pessoa -PB. Content validity was obtained through questionnaires applied to 9 health professionals, while reproducibility was assessed through the test-retest method in 37 individuals. The content validity index was calculated for each instrument item, and Cohen's Kappa coefficient was used to estimate the agreement between test and retest responses. The content validity index of the symptoms was considered high, with 58.4% of the items evaluated as excellent or good. The studied population consisted of 23 women and 14 men, most of whom were classified as brown or black. All participants tested positive for COVID-19, and 97.3% had received at least one dose of the vaccine. The internal consistency of the questionnaire used to assess symptoms was excellent, with a Cronbach's alpha value of 0.873. Test-retest concordance ranged from fair to excellent, with high percentages of concordance observed. In conclusion, the study provides valuable information about the symptoms of COVID-19, its validity and the reproducibility of its evaluation.
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MARTHA MARIA DE ALBUQUERQUE BELO
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Assessment of risk factors associated with the post-COVID-19 condition in residents of João Pessoa-PB, 2020-2022
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Advisor : GABRIEL RODRIGUES MARTINS DE FREITAS
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Date: Jun 30, 2023
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Time: 10:00
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Show Summary
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With the advance of COVID-19, the arrival of new potentially more transmissible SARS-CoV-2 variants and the appearance of individuals with persistent multisystemic consequences after the acute phase of the disease emerged as new concerns, afflicting public managers and health professionals. Knowledge of the profile of individuals infected with variants of concern (VOC) and the post-COVID-19 manifestations linked to the cases, allowing the understanding of the chain of events associated with each variant of the virus, enabling better initial clinical management and avoidability of negative outcomes futures. A retrospective cohort study was carried out based on secondary data from notifications of COVID-19 cases and the self-completion of an online questionnaire in a virtual environment. A total of 131 sequenced cases diagnosed with VOC were identified and who agreed to participate in the research. The main manifestations identified for the post-COVID-19 condition were respiratory, neurological and psychosocial, with 41.2%, 29.0% and 20.6%, respectively. In all, 35.9% of the analyzed sample fits as individuals who had or have a post-COVID-19 condition. The multivariate analysis identified that the risk factors associated with the post-COVID-19 condition in residents of João Pessoa-PB were: the presence of dyspnea/desaturation in the acute phase of the disease (p-value<0.001/OR 8.13/CI95 % 3.12-22.84), comorbidities prior to the event (p-value 0.023/OR 4.50/95%CI 1.29-18.57) and VOC Gamma infection (p-value 0.047/OR 3, 14/95%CI 1.14-8.96). The post-COVID-19 condition is yet to increase in the world. Therefore, it is important to maintain, even during the low period of COVID-19 cases, the monitoring of SARS-CoV-2 strains in circulation, especially for the identification of genetic variations of the virus that may result in mutations or recombinations that lead to to increased transmissibility, disease severity, and decreased neutralization by antibodies or vaccines.
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MÔNICA DA COSTA BATISTA
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ANALYSIS OF THE PROFILE OF JUDICIALIZATION IN HEALTH REGARDING SURGICAL PROCEDURES IN THE STATE OF PARAÍBA
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Advisor : LUCIANO BEZERRA GOMES
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Date: May 31, 2023
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Time: 17:00
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Show Summary
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Judicialization is a tool for citizens to access health care, given that the decisions appealed by judges are intended to ensure the social right, guaranteed in the constitution and other normatives. The increase in judicialization as a form of access to health services led the National Council of Justice to develop several measures to enable the construction of decisions, based on technical subsidies provided by the Nucleus of Technical Support to the Judiciary, in order to reduce the likelihood of conflicting court decisions on issues concerning health care. The study aims to analyze the profile of judicialization in health concerning the access to surgical procedures in the state of Paraíba. This is a quantitative, descriptive and documental study, carried out on the website of the Court of Justice of Paraíba, in the Jurisprudence section, under "Registry of Agreements and Decisions". A search was conducted for decisions in the second instance, of lawsuits filed against the denial of surgical procedures, within a timeframe of January 1, 2017 to December 31, 2021. After the extraction of the data and was carried out the categorization of the data, given that these are relevant premises in the judicialization of health. Resultados: The results show that the judicialization presents itself as a tool for access to health services, due to the inefficiency of the State. The difficulty in accessing the judiciary is corroborated by the scenario in Paraíba of a reduction in the number of districts, being reinforced by the inexistence of guidelines in the State Health Plan that aim to reduce judicialization concerning the access to surgical procedures, reinforcing the inequity of access to social rights and consequently to health services.
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BRUNO WESLEY RAMALHO CIRILO FERREIRA
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Integrative and Complementary Practices in Primary Health Care in João Pessoa-PB
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Date: May 29, 2023
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Time: 10:00
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Show Summary
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The study aimed to understand and evaluate the offer, work, and continuing education around Integrative and Complementary Practices (IPC) from the perspective of health professionals in Primary Health Care (PHC) of a capital city in the northeast of Brazil. In the quantitative stage a cross-sectional study was developed, with analysis of modules I and II of the 3rd Cycle of the National Program for Improving Access and Quality of Primary Care; and in the qualitative stage interviews were conducted with PHC professionals. In the quantitative stage 186 health professionals were interviewed considering the five health districts of a northeastern capital. Of these, 88.7% offered some practice, being nurses the ones who offered the most (96.2%). Auriculotherapy (83.3%), the use of medicinal plants and herbal medicines (77.9%) and community therapy (48.9%) were the most offered practices. 86.5% of the interviewees reported receiving managerial support, however, a shortage of inputs was observed, in which seeds or crystals for auriculotherapy (56.7%), vegetable drug (15.2%), manipulated herbal medicine (12.5%) or industrialized (4.1%) were not made available in sufficient quantities. 82.2% of the interviewees participated in moments of continuing education related to the practices offered by the municipal management (93%), in the health unit itself (90.8%). In the qualitative study, twelve professionals who worked in family health teams participated. Data collection was carried out from semi-structured interviews. For understanding and systematization of data, it was adopted the thematic content analysis. Among the interviewees, most were female nurses (4), followed by dental surgeons (3), social workers (2), physiotherapists, psychologists, and physical educators (1). From the thematic analysis, four units of analysis and eight thematic categories emerged: perception of PHC in health care, work process and change in the production of care, conflict between models of health care: service centered goals x PHC, visibility of PHC: record in users' records, management support, management of inputs for the development of PHC in PHC, continuing health education focused on PHC: supply involving various PHC actors and the supply of PHC in PHC and the pandemic period. On the one hand, the offer of IPC in the municipality was observed, however, improvements in the management of the work process, inputs, managerial support, continuing education in health were needed, aiming at the qualification and expansion of the offer of different PIC in PHC.
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RAYSSA NAFTALY MUNIZ PINTO
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FACTORS ASSOCIATED WITH TIME BETWEEN DIAGNOSIS AND START OF TREATMENT OF CENTRAL NERVOUS SYSTEM TUMORS IN CHILDREN AND ADOLESCENTS IN REFERENCE HOSPITALS IN PARAÍBA
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Date: May 24, 2023
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Time: 16:00
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Show Summary
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Central Nervous System (CNS) tumors are one of the most frequent neoplasms in pediatric patients. Faced with the challenges of coping with cancer, in 2012 Law 12,732 was created, which establishes that, in the Unified Health System (SUS), the first treatment of patients with proven malignant neoplasm must be instituted within 60 days after diagnosis. Thus, the present study aims to analyze the factors associated with the time between diagnosis and initiation of treatment of children and adolescents with CNS tumors in reference centers in Paraíba, from 2010 to 2019, using data available in Hospital Records of Cancer (CHR). This is a historical, analytical study with a quantitative approach, the sample consisted of 115 records. The selected variables were classified into demographic, clinical and treatment. The outcome of interest corresponded to the time to start treatment, being categorized into intervals ≤ 60 days and > 60 days. Data were analyzed using descriptive and inferential statistics, using the technique of survival analysis, the Kaplan-Meier method and Cox regression. The mean age of the children and adolescents was 9 years (±5.22), the majority being female 53.0% (n=61), with brown skin color 65.4% (n=70), of the first health macro-region 46.1% (n=53) and attended at Hospital Napoleão Laureano 58.3% (n=67). The brain (85.1%; n=98) was most affected, with the brain being the most affected detailed region (33.9%; n=39). Most referrals occurred through the SUS (83.2%; n=89), pediatric oncology (44.3%; n=51) and the most important basis for diagnosis was tumor histology (86.8%; n=99). The first hospital treatment was radiotherapy (28.7%; n=33), the number of hospital treatments was 1 (60.9%; n=70), the pathological state at the end of the first hospital treatment was stability of the disease in 56.6% (n=13). The time interval between the diagnosis and the start of treatment occurred within the period established by law in 59.3% (n=67) of the cases. In the survival analysis, 37 cases exceeded the time period of the law, with the probability of the patient arriving up to 61 days to have the diagnosis of 97.3%, in the Cox regression, the primary location for the cerebellum was significant (p=0.008); histology/tumor markers (p=0.012) and imaging tests (p=0.005) were the most important basis for diagnosis. It was found that the time between diagnosis and initiation of treatment was adequate for most cases, but a significant number of patients exceed this time. Thus, it is suggested that there are weaknesses in compliance with the law and access to the state's reference centers, requiring a better organization of the flow in the RAS and public health mobilizations.
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KARLLA DANNIELLE DA SILVA GUEDES
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MUNICIPAL HEALTH MANAGER IN BRAZIL UNDER A
REGIONAL PERSPECTIVE: profile, challenges and possibilities in the management of
strategic themes for the SUS
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Date: May 24, 2023
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Time: 11:00
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Show Summary
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Public management practices in the SUS have different expressions and have been
conducted by health managers of the three federal entities. Among these, the secretaries
municipalities are strategic political actors in the definition and conformation of policy directions
health in the country. The responsibilities of these entities were significantly expanded by
throughout the process of decentralization of social policies established by the Constitution of
1988, which is an important strategy for social inclusion and democratization of society
Brazilian. In this sense, the present study proposed to analyze the profile and perception of
municipal health managers and presidents of COSEMS in the northeast region, on the
strategic challenges linked to SUS management in the region. This is a cross-sectional study,
descriptive and exploratory with a mixed approach, with 141 study participants
municipal health secretaries and 5 presidents of COSEMS in the northeast region. the collection of
information occurred through an electronic questionnaire, available via the web for the
municipal managers and through a semi-structured interview directed to the
COSEMS representatives. The results show that the municipal health secretary of the
Northeast region is mostly represented by women, brown and black, aged
between 30 and 50 years old, with no previous management experience. Furthermore, the findings point to the
existence of challenges related to financial resources for the development of actions
directed to primary care and regionalization and the need for greater MS participation
in local management practices to strengthen health planning.
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SUELEN FARIAS COSTA DOS SANTOS
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THE PERFORMANCE OF THE DENTAL SURGEON IN PRIMARY CARE DURING THE COVID-19 PANDEMIC
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Advisor : ANDRE LUIS BONIFACIO DE CARVALHO
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Date: May 22, 2023
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Time: 11:00
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Show Summary
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The COVID-19 disease, whose etiological agent is the SARS-CoV-2 virus, has become an emerging topic and a public health problem, which affects the lives of the population and the professionals who work in it. In view of this context, in Brazil, Primary Health Care (PHC) has taken the necessary adjustments to face COVID-19, which have reformulated some professional practices, among the professional activities in this scenario, dentistry stands out as a protagonist in the fight to COVID-19. In this sense, the objective of the study is to evaluate the performance of the Dental Surgeon in primary care during the COVID-19 pandemic, where a quantitative study will be carried out, with an exploratory cross-sectional characteristic, of a descriptive and analytical nature, with a survey of secondary data that have as a source the results obtained through the parent questionnaire of the online survey Work Process of the Family Health Strategy in the COVID-19 pandemic in light of the essential attributes of primary health care, which analyzed the work of Primary Health Care professionals, during the COVID-19 pandemic, where a systematic sample of participants will then be carried out, representative of the universe of dentists who participated in the research and of questions pertinent to the objective of the present study. Data collection will be carried out and then analyzed by the SPSS v.20.0 program where we will formulate graphs and tables for a better understanding of the reader. The work will provide a better understanding of the subject that still has little research in the area, allowing to collaborate not only with the academic environment, but with society in general.
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KAIQUE BRUNO FERREIRA BEZERRA
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VACCINATION COVERAGE IN CHILDREN UNDER TWO YEARS OLD: A look from the Family Health Strategy
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Advisor : MARIA DO SOCORRO TRINDADE MORAIS
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Date: May 12, 2023
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Time: 10:00
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Show Summary
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The National Immunization Program (PNI), over the years, has become an important strategy for preventing injuries and promoting health in Primary Health Care, with positive impacts on reducing child morbidity and mortality. The emergence of the Covid-19 pandemic brought changes in habits and routines that negatively impacted vaccine rates in children under two years of age. This study aimed to understand the perception of the Family Health team about the challenges to achieve vaccination coverage in children under two years of age, in the period of the Covid-19 pandemic. This is an exploratory, descriptive research with a qualitative approach, carried out in three Basic Family Health Units in the municipality of Goiana, Pernambuco. The study included 12 professionals included in the Family Health Strategy, namely: doctors, nurses, community health agents and nursing technicians, who worked in the period between 2020 and 2021. Data were collected from June to July 2022 , through the application of an interview script, and its content analyzed using the Thematic Content Analysis technique proposed by Bardin. The results were presented in two categories: 1) Challenges and limits to maintain vaccination coverage; 2) Strategies adopted to deal with absences in the vaccination sector. These categories were divided into subcategories and based on the relevant literature. It was evidenced, among the challenges, that the Covid-19 pandemic allowed a wave of fear and insecurity in the population due to the spread of the virus, which implied the discontinuity of preventive services offered by Primary Health Care, causing a significant drop in coverage vaccination, especially in children under two years of age. Weaknesses related to the physical structure of the units, insufficient workers and reduction of inputs that negatively impacted the supply of vaccines for children were also observed. The study showed that, in order to deal with these challenges, the teams had to adapt their communication, using digital means such as WhatsApp to exchange information; readjustment of the physical space to better accommodate children and mothers, preventing the spread of the virus; active search for children with overdue vaccines. The research findings provoked reflections on the importance of the work of professionals, especially Community Health Agents, in identifying and actively searching for those who are absent. We understand that childhood vaccination is an extremely effective and inexpensive strategy to control epidemics of vaccine-preventable diseases, especially during pandemic periods.
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ISAAC LINHARES DE OLIVEIRA
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BETWEEN BLOWS AND HITS: THE INSERTION OF MEDICINE IN
FAMILY AND COMMUNITY IN SUPPLEMENTARY HEALTH
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Advisor : JULIANA SAMPAIO
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Date: Apr 27, 2023
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Time: 10:00
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Show Summary
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This master's thesis analyzes the training profile and the performance,
of Family and Community Doctors inserted in the context of a clinic of
Primary Health Care that provides services to a health plan operator,
in the city of Natal, Rio Grande do Norte. It started from a cartographic study that
took place between June/2021 and January/2022. The production of the data was done by a
closed electronic questionnaire, in-depth interviews and cartographic diaries.
With this, five analyzers were defined: the encounter with the differences
social services", "from SUS training to the enchantment with supplementary health", "the
disenchantment and precariousness in supplementary health", "the size of the territory"
and implication and over-implication in supplementary health research. it was observed
as soon as these physicians choose to act in Supplementary Health,
in the context of the precariousness of the Unified Health System, and by bringing the
their socio-demographic profile with the users of the clinic, in addition to the best
availability of light-hard and hard technologies that help in the practice
professional. On the other hand, this choice makes their work precarious, pushing them away
the guarantee of basic labor rights and entails a loss of the dimension
territorial with a weakening of the family and community approach. It is also observed
the presence of micropolitical disputes of ethical-political projects
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JOÃO PAULO LOPES DA SILVA
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DAILY WORKING LIFE OF RURAL PRIMARY HEALTH CARE PROFESSIONALS IN THE BRAZILIAN NORTHEAST
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Date: Mar 16, 2023
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Time: 14:00
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Show Summary
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The rural setting has historically been marked by popular clashes, social disparities, and inequities in health. The rural population has long lacked the attention of public policies, especially the Unified Health System, due to unfavorable health conditions and the organization of Primary Health Care services. In the rural area, despite the expansion of the Family Health Strategy units, the dispersion of the population and the vast territorial area and poorly qualified management have been aggravating factors for the coverage of the strategy, insufficient for a resolutive Primary Health Care. This study aimed to analyze the conceptions of the professionals of the Family Health Strategy about the daily work in rural territories of municipalities in the Northeast of Brazil. This is a qualitative study that took place in four municipalities located in the interior of the State of Paraíba: Juru, Manaíra, Princesa Isabel and Tavares. A team from the Family Health Strategy from the rural area of each municipality participated in the research, totaling twenty-three interviewees. The semi-structured interviews were conducted between May and July 2022 and the empirical material was organized in the Atlas.ti22® software and based on Content Analysis. The results are presented in three thematic axes: constructions and organization of the work in the Family Health team in rural areas; professional view on the specificities in caring for the rural population; challenges and potentialities in the work in the rural Family Health Strategy. For each axis, categories emerged that gave rise to subcategories that emerged from the speeches. The meanings produced by the narratives showed that the rural territory studied is permeated with barriers and socio-spatial singularities that influence the organization of the work process and the schedule in the Family Health Strategy. There is a fragmentation in the work planning process of some teams, especially in oral health. The performance of decentralized actions such as home visits and care at the anchor posts was signaled as a way to overcome the sociogeographic barriers. The study also revealed that difficulties such as sociogeographic access, related to transportation and displacement, problems in the infrastructure of the anchor units, the lack of resources and professional turnover are common difficulties found in Brazilian territories that compromise the longitudinality of care. As for the potentialities, the professional bond, the importance of teamwork, and the provision and retention of medical professionals through the Doctors for Brazil program were highlighted. Despite the challenges imposed on the work in rural territories and taking into account the specificities linked to this territory and the working conditions, the professionals find satisfaction in developing their work. It is expected that the results can guide the improvement of public health policies for the rural population, reducing the inequities existing in the work in rural areas, as well as the strengthening of Primary Health Care, based on the specificities and singularities of this population considered vulnerable.
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TEODORA TCHUTCHO TAVARES
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Factors Associated with the Evaluation of Teamwork in the Extended Family Health and Primary Care Centers
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Date: Mar 14, 2023
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Time: 07:00
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Show Summary
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Introduction. Teamwork is understood as the union of several people who join efforts to solve a certain problem they have in common. On the other hand, when two or more people work together to perform a task, this dynamic allows the sharing of knowledge from several professional categories, and thus collaboration facilitates the production of efficient care. In this context, the joint work between NASF-AB teams and the Family Health Teams (FHT) allows the development of strategies such as permanent education for professionals and users, identification of health problems, and development of expanded therapeutic approaches. In order to consolidate and support the insertion of the Family Health Strategy in the health service network and increase coverage, resolution, regionalization, and territorialization, as well as to expand the actions of the Family Health Care Units (FHU), the Ministry of Health created the Family Health Support Centers (NASF) in 2008, under Ordinance GM No. 154 of 24/01/2008. In 2017, the NASFs were renamed with the reformulation of the National Primary Care Policy (PNAB) and were renamed Expanded Family Health and Primary Care Centers - NASF-AB. Objective. To analyze the factors associated with the evaluation of teamwork among NASF-AB professionals from two capital cities of Brazil. Materials and Method. This is a quantitative cross-sectional study with 182 NASF-AB professionals. Two capital cities of Brazil were defined as case-units: João Pessoa, capital of Paraíba (PB), and Campo Grande, capital of Mato Grosso do Sul (MS). The collection process was carried out from February to March 2020. To collect the data, a structured questionnaire was applied to a random sample of upper-level workers that make up the NASF-AB teams. To verify the homogeneity of the sample between the municipalities, the chi-square test (χ2) was performed to compare the frequency of each independent and dependent variable in the municipalities of João Pessoa and Campo Grande. To verify the individual association between the dependent and independent variables the outcomes were adjusted in the Binary Logistic Regression models and entered in the Multiple Logistic Regression model. Associations were expressed as Odds Ratio (OR) values and 95% confidence interval (95%CI). The research was approved by the HSE of the two cities, and by the Health Sciences Research Ethics Committees of UFPB opinion no. 3.281.041 and of UFMS opinion no.3.584.953. Results. It was verified, the predominance of the female gender (n=151; 83%), between 25 to 45 years of age (n= 153; 84%), the majority had more than five years of graduation (n=137; 75.2%). Workers satisfied with communication between their team partners (OR= 4.83; 95% CI 1.52 - 16.49). Workers with more time in NASF-AB (OR= 5.82; 95%CI 1.39 - 40.77) and who felt fulfilled with their work in NASF-AB (OR= 2.85; 95%CI 1.31 - 6.40) were more likely to evaluate positively the interprofessional work between NASF-AB and FHS. Final Considerations. It can be stated that this study was able to achieve its objectives. The instrument used to assess personal factors and satisfaction with the interprofessional work, the relationship between NASF-AB members and a positive evaluation of the work made it possible to identify the profiles and interpersonal relationships among NASF-AB workers with NASF-AB and NASF-AB with ESF.
Translated with www.DeepL.com/Translator (free version)
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BRUNA DE OLIVEIRA ABREU
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The interprofessional education and collaborative work in the family health residences in the municipality of João Pessoa PB
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Advisor : TALITHA RODRIGUES RIBEIRO FERNANDES PESSOA
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Date: Feb 16, 2023
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Time: 14:00
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Show Summary
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Introduction: The reorganization of training processes, both in graduate and postgraduate programs, has awakened the most diverse reflections regarding the importance of teamwork, collaborative practices, and interprofessional education. Objective: To understand the perception of residents and graduates about the role of interprofessional education and the elements of collaborative work within the two Residency Programs in Family Health in the Municipality of João Pessoa - Paraíba. Method: This is exploratory and descriptive research with a qualitative approach. The Consolidated Criteria for Reporting Qualitative Research and a protocol were adopted and a semi-structured instrument was developed. Graduates who had completed their residency in March 2022 and were chosen for accessibility and convenience participated in the survey. Data collection was carried out remotely with screen recording (image and audio) with the permission of the participants. The interviews from May to June 2022. Using the saturation criterion, the records were analyzed from the perspective of Bardin's content analysis, in the thematic categorization modality. Results and discussion: The analysis resulted in four categories: collaborative interprofessional work, collaborative interprofessional practice, effects of residency on interprofessional work, and interprofessionality in the pandemic period. An understanding of the importance of interprofessionality for training in residency programs was observed, through the understanding of how graduates perceive it and, because of this, put it into practice, even immersed in a pandemic context, triggering changes in interpersonal practices stimulated by the program. Final considerations: The graduates presented mastery of the concept of interprofessionality in their speeches and understood the role of interprofessional education in professional practices and health care. In the light of the graduates' perspective, it was found that the residency programs in family health, despite perceived weaknesses, are excellent fields of action for the development of interprofessionality, favoring an expanded clinical view and comprehensive care in assistance.
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ERIKA MAYRA DE ALMEIDA BARRETO
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ULTRA-PROCESSED FOODS CONSUMPTION AND SLEEP DURATION IN ADOLESCENTS: LONGITUDINAL STUDY
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Date: Jan 31, 2023
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Time: 09:00
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Show Summary
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Objective: To analyze longitudinally the relationship between sleep duration and consumption of ultra-processed foods in school adolescents. Methods: Longitudinal study, conducted between 2014 and 2017, with adolescents aged 10 to 14 years. Data collection was conducted through face-to-face interview, with application of questionnaire, on an individual basis. the variables selected were sociodemographic factors, school shift, sleep duration, sedentary behavior, weight, height, BMI/age, food consumption, level of physical activity. To test the longitudinal association between sleep duration, BMI, and consumption of ultra-processed foods the bank was evaluated in panel, with unbalanced data, and the criterion for the individual to remain in the analysis was to have at least 2 measures of the main dependent and independent variables in the study. Sleep duration was considered the independent variable in which it was divided into quartiles, quartile 25 being used as the reference, and the percentage of consumption of ultraprocessed foods (in relation to the total calories consumed by the individual) was considered the dependent variable. Results: A higher mean weight was observed among boys in all years of the study. BMI/age values changed little between the sexes, girls showed a higher percentage of overweight and obesity in the last two years (2016 30.7% and 2017 27.5%) and reduced physical activity practice. Sedentary behavior for both genders decreased over the years and the consumption of ultra-processed food seems higher among girls, especially in the last two years of the study, 37.1 % and 39.8% respectively. When looking at the consumption of ultra-processed foods by gender, girls had the highest mean consumption of ultra-processed foods in all variables (age, education, sleep, physical activity, sedentary behavior). The mean consumption of ultraprocessed food was higher among adolescents who slept less than 9 hours a day. Conclusion: According to this study, sleep influenced the consumption of ultraprocessed foods in adolescents, showing that as sleep time increases the consumption of foods classified as ultraprocessed decreases, an important factor to warn about the importance of adequate sleep time and healthy lifestyle.
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