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ORIGINAL ARTICLE07-31-2023
Primary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
Abstract
ORIGINAL ARTICLEPrimary Health Care assessment in the COVID-19 pandemic from physicians’ and nurses’ perspective
Revista Brasileira de Enfermagem. 2023;76:e20220475
DOI 10.1590/0034-7167-2022-0475
Views0ABSTRACT
Objectives:
to assess the operationalization of Primary Health Care in the COVID-19 pandemic, according to Primary Care Assessment Tool: PCATool-Brasil attributes, from physicians’ and nurses’ perspective.
Methods:
a cross-sectional study, carried out with 99 physicians and nurses from Basic Health Units in a state in northeastern Brazil, with the aid of the adapted instrument PCATool-Brasil.
Results:
Essential Score was classified as high performance (6.6) and General Score as low performance (6.5). First Contact Access, Care Integration, and Community Guidance scores were <6.6. The best performances were attributed to the Longitudinality, Comprehensiveness and Family Guidance services (scores>6.6).
Conclusions:
the attributes of Primary Health Care, in general, showed values above or close to the cut-off point in the assessment. These data can support strategies for local and national managers to strengthen Primary Health Care in the COVID-19 pandemic and future public health emergencies.
Keywords:COVID-19Health Care Evaluation MechanismsHealth PersonnelHealth Services ResearchPrimary Health CareSee more -
ORIGINAL ARTICLE07-10-2023
Correlation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
Abstract
ORIGINAL ARTICLECorrelation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes
Revista Brasileira de Enfermagem. 2023;76(3):e20220741
DOI 10.1590/0034-7167-2022-0741
Views0See moreABSTRACT
Objectives:
to correlate depressive symptoms, attitude, and self-care of elderly people with type 2 diabetes.
Methods:
study developed with 144 elderly people with diabetes; carried out in Family Health Units. A semi-structured instrument was used to obtain data on the sociodemographic profile; the Geriatric Depression Scale (15 items), the Questionário de Atitudes Psicológicas do Diabetes [Psychological Attitudes of Diabetes Questionnaire], and the Diabetes Self-Care Activities Questionnaire (DSCA) were also used.
Results:
it was identified that 24.3% of the participants presented depressive symptoms, and 93.8% presented negative attitudes of coping. A greater adherence to self-care activities related to the practice of medication was observed. In the correlation between the scales, a negative and inversely proportional correspondence was noted between depressive symptomatology and physical activity (p=0.010) and foot care (p=0.006), likewise between attitude and foot care (p=0.009).
Conclusions:
self-care in elderly people with diabetes mellitus is influenced by depressive symptoms and negative coping attitudes.
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ORIGINAL ARTICLE07-10-2023
Metodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
ORIGINAL ARTICLEMetodologia Lean Seis Sigma para melhoria do processo de alta em uma unidade de terapia intensiva
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0RESUMEN
Objetivos:
describir el proceso de implementación de Lean Six Sigma para mejorar el proceso de alta en una unidad de cuidados intensivos brasileña.
Métodos:
estudio prospectivo siguiendo el método de desarrollo de proyectos denominado DMAIC (Define-Measure-Analyze-Improve-Control). Este método consta de cinco fases, a saber: definición del proyecto, medición del punto de partida y recolección de datos, análisis de resultados, mejora en los procesos y control estadístico.
Resultados:
la aplicación de la metodología Lean Six Sigma fue efectiva para mejorar el proceso de alta de la unidad de cuidados intensivos a la unidad de hospitalización. Esta mejora representó una reducción en el tiempo promedio de alta de 189 a 75 minutos, totalizando una mejora del 61%.
Conclusiones:
este artículo demuestra la efectividad de la aplicación de la metodología Lean Six Sigma para mejorar el flujo de descarga en una unidad crítica, lo que resulta en la reducción de tiempo y desperdicio.
Keywords:Administração em SaúdeFluxo de TrabalhoGestão da QualidadeMelhoria de QualidadeUnidades de Terapia IntensivaSee more -
REVIEW07-10-2023
Lean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
Abstract
REVIEWLean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit
Revista Brasileira de Enfermagem. 2023;76(3):e20220538
DOI 10.1590/0034-7167-2022-0538
Views0ABSTRACT
Objectives:
to describe the Lean Six Sigma implementation process to improve the discharge process in a Brazilian health institution’s ICU.
Methods:
prospective study following the Define-Measure-Analyse-Improve-Control project development method. This method consists of five phases, namely: project definition, measurement of the starting point and data collection, analysis of results, improvement in processes, and statistical control.
Results:
applying Lean Six Sigma methodology following the Define-Measure-Analyse-Improve-Control in the discharge process from the intensive care unit to the inpatient unit was effective in improving processes. This improvement represented a reduction in the mean patient transfer time to the inpatient unit from 189 minutes to 75 minutes, representing a 61% improvement in discharge time.
Conclusions:
this article demonstrates the effectiveness of applying Lean Six Sigma methodology to improve the discharge flow in a critical unit, resulting in time and waste reduction.
Keywords:Health Services AdministrationIntensive Care UnitsPatient DischargeTotal Quality ManagementWorkflowSee more -
ORIGINAL ARTICLE07-10-2023
Primary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
Abstract
ORIGINAL ARTICLEPrimary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases
Revista Brasileira de Enfermagem. 2023;76(3):e20220486
DOI 10.1590/0034-7167-2022-0486
Views0ABSTRACT
Objectives:
to identify whether implementing a supplementary Primary Health Care (PHC) system makes it possible to reduce care costs for older adults with heart diseases.
Methods:
a retrospective cohort of 223 patients with heart disease aged ≥ 60 years. Data were obtained from medical records and cost databases, assessed for a period of one year before and after PHC implementation. The results were expressed as mean absolute frequencies for number of hospitalizations and as average annual expenses expressed in dollars (US$) in relation to cost data.
Results:
there was a reduction in hospitalization expenses after implementing supplementary PHC (p=0.01) and a decrease in the frequency of hospitalizations for the entire sample (p=0.006). There was a reduction in the frequency of consultations at the Emergency Room among frail older adults (p=0.011).
Conclusions:
there was a reduction in hospitalization costs and frequency of visits to the Emergency Room after supplementary PHC.
Keywords:AgedCardiovascular DiseasesCosts and Cost AnalysisLearning Health SystemPrimary Health CareSee more -
ORIGINAL ARTICLE07-10-2023
Occurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
Abstract
ORIGINAL ARTICLEOccurrence and preventability of adverse events in hospitals: a retrospective study
Revista Brasileira de Enfermagem. 2023;76(3):e20220025
DOI 10.1590/0034-7167-2022-0025
Views0See moreABSTRACT
Objectives:
to analyze the incidence of preventable adverse events related to health care in adult patients admitted to public hospitals in Brazil.
Methods:
observational, analytical, retrospective study based on medical records review.
Results:
medical records from 370 patients were evaluated, 58 of whom had at least one adverse event. The incidence of adverse events corresponded to 15.7%. Adverse events were predominantly related to healthcare-related infection (47.1%) and procedures (24.5%). Regarding the adverse event severity, 13.7% were considered mild, 51.0% moderate, and 35.3% severe. 99% of adverse events were classified as preventable. Patients admitted to the emergency room had a 3.73 times higher risk for adverse events.
Conclusions:
this study’s results indicate a high incidence of avoidable adverse events and highlight the need for interventions in care practice.
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Factors associated with immunization against Hepatitis B among workers of the Family Health Strategy Program
Revista Brasileira de Enfermagem. 2015;68(1):84-92
Abstract
Factors associated with immunization against Hepatitis B among workers of the Family Health Strategy Program
Revista Brasileira de Enfermagem. 2015;68(1):84-92
DOI 10.1590/0034-7167.2015680112p
Views0See moreObjective:
to investigate the report of vaccination against Hepatitis B, verification of immunization and the factors associated with dosages of anti-HBs.
Method:
we collected blood samples from those reported that they had one or more doses of the vaccine. We evaluated the association of the dosage of anti- HBs with sociodemographic conditions, occupational and behavioral. The associations were verified by Mann Whitney and Kruskal Wallis and correlation Spermann by linear regression using SPSS® 17.0.
Results:
among the 761 respondents, 504 (66.1%) were vaccinated, 52.5 % received three doses, 30.4 % verified immunization. Of the 397 evaluated for the determination of anti-Hbs, 16.4% were immune.
Conclusion:
it was found that longer duration of work was associated with higher levels of anti-HBs, while levels of smoking were inversely associated with anti-HBs. These workers need for vaccination campaigns.
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The decreasing number of cigarettes during psychiatric hospitalization: intervention or punishment?
Revista Brasileira de Enfermagem. 2015;68(1):76-83
Abstract
The decreasing number of cigarettes during psychiatric hospitalization: intervention or punishment?
Revista Brasileira de Enfermagem. 2015;68(1):76-83
DOI 10.1590/0034-7167.2015680111p
Views0See moreObjective:
To identify the mental disorders carriers’ perception, the smokers ones, about the decreasing number of cigarettes during psychiatric hospitalization.
Method:
Exploratory study with 96 hospitalized carriers of mental disorders who are smokers: G1 (34 subjects hospitalized when was allowed one cigarette by hour) and G2 (62 subjects hospitalized when it was reduced to eight cigarette by day). Semi-structured questionnaire. Thematic content analysis.
Results:
The G1 admitted satisfaction with the restriction – smoking during hospitalization as entitlement. The G2 resists the restriction change occurred without dialogue or support. In spite of the difficulties, some attitude changes about the cigarette were noticed such as increase of the responsibility, discovery of the ability to reduce smoking and the meaning of its role.
Conclusion:
Some subjects understand the smoking health policy change as punishment, while others as opportunity to think about the role of cigarette in their life.
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Family functionality in oldest old household residents
Revista Brasileira de Enfermagem. 2015;68(1):68-75
Abstract
Family functionality in oldest old household residents
Revista Brasileira de Enfermagem. 2015;68(1):68-75
DOI 10.1590/0034-7167.2015680110p
Views0See moreObjective:
the aim of this study was to identify factors associated with family functionality of non-institutionalized long-lived subjects, who were residents in Goiânia (GO), Brazil.
Method:
this was a population-based epidemiological study with cross-sectional outline. Evaluation scales of the functional and cognitive capacities were used. Family dynamics was measured using the Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) instrument by making home interviews with 131 long-lived individuals.
Results:
there was prevalence of the female gender, average of age of 83.87 years old, widowhood condition, and residence in a big family, primary schooling, and self-perception of regular health. A great amount showed independence for self-care and partial dependence for daily life instrumental activities. Family functionality prevailed with score average of 9.06 points.
Conclusion:
in conclusion, family functionality in long-lived subjects is associated with self-perception of poor/bad health, osteoporosis, and fall. Results allowed characterizing long-lived subjects’ family functionality with the aim of valuing and prioritizing family as a caregiver.
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Prevalence of non-adherence to antihypertensive pharmacotherapy and associated factors
Revista Brasileira de Enfermagem. 2015;68(1):60-67
Abstract
Prevalence of non-adherence to antihypertensive pharmacotherapy and associated factors
Revista Brasileira de Enfermagem. 2015;68(1):60-67
DOI 10.1590/0034-7167.2015680109i
Views0See moreObjective:
the aim of the study was to determine the prevalence of non-adherence to antihypertensive drug treatment and its association with factors bio-socio-economic and welfare.
Method:
it was a descriptive, cross-sectional study, performed with 422 hypertensive individuals. Data were collected through home interviews, conducted between December 2011 and March 2012.
Results:
the results showed that the respondents were mostly female, married, elderly, low income and little time of diagnosis. Were considered non adherent to medication 42.65% of participants. Non-Caucasian hypertensive patients, with fewer than eight years of schooling, who did not regularly attend doctor’s appointments, took more than two anti-hypertensive medications and did not have private health insurance, showed higher likelihood of not complying with the drug treatment.
Conclusion:
these findings suggest that hypertensive patients with unfavorable socioeconomic characteristics and difficulty of access to the service require different interventions in order to encourage them to adhere to medication treatment.
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Adherence and knowledge about the use of personal protective equipment among manicurists
Revista Brasileira de Enfermagem. 2015;68(1):52-59
Abstract
Adherence and knowledge about the use of personal protective equipment among manicurists
Revista Brasileira de Enfermagem. 2015;68(1):52-59
DOI 10.1590/0034-7167.2015680108i
Views0See moreObjective:
this study aimed to assess adherence and knowledge of manicures/pedicures on the use of Personal Protective Equipment (PPE).
Methods:
it was a survey with 235 manicures/pedicures in salons, Belo Horizonte/Brazil. Data were analyzed with the software Statistical package for the social sciences (17.0), using descriptive statistics, chi-square and logistic regression.
Results:
the adherence and the knowledge of the professional were evaluated using the median of the results, obtaining 52% and 63% respectively. The professionals younger than 31 were more likely (2.54 times) to adhere to PPE and those who claimed to have done biosafety course and to use uniform during work, had better chance of understanding (2.86 and 3.12 times, respectively). The majority (83.4 %) stated that the use of PPE should occur for all procedures, meanwhile 71.5 % cited not use them.
Conclusions:
the results indicate the poor adherence to PPE, strengthen occupational biological risk and need for training of these professionals.
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Predictive value of the Manchester Triage System: evaluation of patients’ clinical outcomes
Revista Brasileira de Enfermagem. 2015;68(1):45-51
Abstract
Predictive value of the Manchester Triage System: evaluation of patients’ clinical outcomes
Revista Brasileira de Enfermagem. 2015;68(1):45-51
DOI 10.1590/0034-7167.2015680107i
Views0See moreObjective:
to analyze the predictive value of the Manchester Triage System in relation to clinical outcome of patients.
Methods:
prospective observational study of 577 patients admitted to the ER and subjected to risk classification. The Therapeutic Intervention Scoring System-28 (TISS-28) was used to measure the severity of patients (primary outcome) and secondary outcomes: high / transfer, death, and length of hospital stay. Descriptive and univariate analyzes were conducted.
Results:
patients classified as red are 10.7 times more likely to have scores above 14 in TISS-28 in relation to others. Patients classified as red have 5.9 times more chance of progression to death compared to others. Patients of high priority service are 1.5 times more likely to be hospitalized over five days than low priority.
Conclusions:
STM proved a good predictor of clinical outcomes.
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Entrepreneurship in Nursing: overview of companies in the State of São Paulo
Revista Brasileira de Enfermagem. 2015;68(1):40-44
Abstract
Entrepreneurship in Nursing: overview of companies in the State of São Paulo
Revista Brasileira de Enfermagem. 2015;68(1):40-44
DOI 10.1590/0034-7167.2015680106i
Views0See moreObjective:
the present study aimed to identify and characterize nursing companies managed by entrepreneur nurses registered at the Commercial Registry of São Paulo by 2011.
Method:
it’s a descriptive, exploratory study, whose data collection, made throughout January 2012, was carried out on the Commercial Registry of Sao Paulo website. This non-governmental body has the function of registering the opening of companies and supervising their trade situation.
Results and conclusion:
this study allowed us to identify that the entrepreneur nurse is a growing reality through the identification of 196 companies opened by these professionals. Afterwards, it was analyzed their time of functioning, the main economic activity of the company, capital value, percentage of nurse partners and the distribution of companies by region of Sao Paulo State.
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Knowing blood donation surroundings: Implications for nurse service in hemotherapy
Revista Brasileira de Enfermagem. 2015;68(1):32-39
Abstract
Knowing blood donation surroundings: Implications for nurse service in hemotherapy
Revista Brasileira de Enfermagem. 2015;68(1):32-39
DOI 10.1590/0034-7167.2015680105i
Views0See moreObjective:
the study aims at discussing the significations apprehended by the non-blood donators, considering the context and the consequences of the acting of the nurse in hemotherapy.
Method:
it is a qualitative approach, with theoretical frame of Symbolic Interactionism and Grounded Theory method. The data production was carried out by intensive interview with subjects of three sample groups of a University Hospital of Rio de Janeiro City.
Results:
the phenomenon originated two analysis categories: “Perceiving the blood matter” and “Reflecting about the blood donation campaigns”. It was observed that the environment of the donor is not composed by contact with the other and the information that it can achieve, including the media.
Conclusion:
these were the main basis for the knowledge of blood donation according to their beliefs, culture and values. Therefore, all these aspects must be considered by the nurse acting on donors capture.
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RESEARCH06-01-2015
Perceptions of adolescent students about drugs
Revista Brasileira de Enfermagem. 2015;68(3):517-523
Abstract
RESEARCHPerceptions of adolescent students about drugs
Revista Brasileira de Enfermagem. 2015;68(3):517-523
DOI 10.1590/0034-7167.2015680320i
Views0See moreABSTRACT
Objective:
To analyze the perceptions of adolescent public school students about drugs.
Method:
Qualitative approach of focus groups with 16 adolescent students. The data collected were analyzed by means of content analysis, leading to the following categories: meaning of drugs; living with drug use; opinions, beliefs and attitudes toward drug use; and preventing drug abuse in adolescence.
Results:
The adolescent students know about some drugs, and associate their use with delinquent and criminal behavior. The students identifi ed factors that lead to drug abuse, such as easy access, use by family and friends, idleness, dropping out of school and the characteristic vulnerability of adolescence.
Conclusion:
the results point to the need for educational activities in the context of where the adolescents live, including school, community and family environments, to support and to minimize their vulnerability.
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RESEARCH06-01-2015
Cognitive stimulation for older people with Alzheimer’s disease performed by the caregiver
Revista Brasileira de Enfermagem. 2015;68(3):510-516
Abstract
RESEARCHCognitive stimulation for older people with Alzheimer’s disease performed by the caregiver
Revista Brasileira de Enfermagem. 2015;68(3):510-516
DOI 10.1590/0034-7167.2015680319i
Views0See moreABSTRACT
Objective:
to learn the infl uence of cognitive therapy at home, conducted by the caregivers of older people with Alzheimer’s Disease.
Method:
a case study was developed with fi ve older people with Alzheimer’s Disease and their caregivers. The stages of research development were: orientation with the caregivers; selection of older people and caregivers; approach of the study subjects at home; weekly meetings and reapplication of tests to follow up the cognitive function of the participants.
Results:
in three months it was possible to identify improved cognition, verifi ed by the result of the Mini-Mental State Examination (MMSE). The scores of the other tests (KATZ, LAWTON, CLOCK TEST and VFT) remained the same.
Conclusion:
this strategy can be considered a light technology of nursing care for older people with dementia. When providing this care with the support of a nurse, caregivers re feel less anxious and understand the disease better.
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RESEARCH06-01-2015
Anxiety and spirituality in university students: a cross-sectional study
Revista Brasileira de Enfermagem. 2015;68(3):504-509
Abstract
RESEARCHAnxiety and spirituality in university students: a cross-sectional study
Revista Brasileira de Enfermagem. 2015;68(3):504-509
DOI 10.1590/0034-7167.2015680318i
Views0See moreABSTRACT
Objective:
to study anxiety and spirituality and the relationship between them in university students.
Method:
the State-Trait-Anxiety Inventory (STAI) and Pinto and Pais-Ribeiro Spirituality Scales were used for data collection.
Results:
six hundred and sixty-nine students participated in the study, of whom 91.5% had moderate and high levels of trait anxiety and 92.9% of state anxiety; 93.8% had high spirituality scores. The multiple linear regression test showed a signifi cant relationship between anxiety and the presence of physical discomfort, unusual body movements, and the need for treatment. Furthermore, higher levels of anxiety were associated with the female gender, the lack of leisure activities, and low levels of optimism in the spirituality scale.
Conclusion:
it is important to develop strategies for coping with anxiety, which in turn can be oriented toward protective factors such as spirituality.
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RESEARCH06-01-2015
Nursing guidance on bed baths to reduce anxiety
Revista Brasileira de Enfermagem. 2015;68(3):497-503
Abstract
RESEARCHNursing guidance on bed baths to reduce anxiety
Revista Brasileira de Enfermagem. 2015;68(3):497-503
DOI 10.1590/0034-7167.2015680317i
Views0See moreABSTRACT
Objective:
to evaluate the effectiveness of a nursing guidance protocol to reduce the anxiety of patients with acute coronary syndrome undergoing bed bath, and the correlation of vital signs with state-anxiety.
Method:
randomized clinical trial study. The sample consisted of 120 patients. The intervention group received a nursing guidance protocol about bed bath and the control group received the unit’s routine information. The STAI-State scale was used to assess anxiety, and data were collected at three times: immediately after informing the patients about the bed bath; immediately after interventions; and immediately after the bath.
Results:
the intervention group presented signifi cantly lower state-anxiety compared to the control group (p<0.001) after the intervention.
Conclusion:
the nursing orientation was effective to reduce anxiety in patients with acute coronary syndrome undergoing bed bath.
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RESEARCH06-01-2015
Body language in health care: a contribution to nursing communication
Revista Brasileira de Enfermagem. 2015;68(3):490-496
Abstract
RESEARCHBody language in health care: a contribution to nursing communication
Revista Brasileira de Enfermagem. 2015;68(3):490-496
DOI 10.1590/0034-7167.2015680316i
Views0See moreABSTRACT
Objective:
to classify body language used in nursing care, and propose “Body language in nursing care” as an analytical category for nursing communication.
Method:
quantitative research with the systematic observation of 21:43 care situations, with 21 members representing the nursing teams of two hospitals. Empirical categories: sound, facial, eye and body expressions.
Results:
sound expressions emphasized laughter. Facial expressions communicated satisfaction and happiness. Eye contact with members stood out in visual expressions. The most frequent body expressions were head movements and indistinct touches.
Conclusion:
nursing care team members use body language to establish rapport with patients, clarify their needs and plan care. The study classifi ed body language characteristics of humanized care, which involves, in addition to technical, non-technical issues arising from nursing communication.
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RESEARCH06-01-2015
Health promotion in supplementary health care: outsourcing, microregulation and implications for care
Revista Brasileira de Enfermagem. 2015;68(3):482-489
Abstract
RESEARCHHealth promotion in supplementary health care: outsourcing, microregulation and implications for care
Revista Brasileira de Enfermagem. 2015;68(3):482-489
DOI 10.1590/0034-7167.2015680315i
Views0See moreABSTRACT
Objective:
to analyze health promotion programs in the supplementary health care.
Methods:
This was a multiple case study with a qualitative approach whose data were obtained from interviews with coordinators of providers contracted by the corporations of health insurance plans in Belo Horizonte, Minas Gerais. The data were submitted to Critical Discourse Analysis.
Results:
Home care has been described as the main action in the fi eld of health promotion transferred to the providers, followed by management of patients and cases, and the health education.groups. The existence of health promotion principles is questionable in all programs. Outsourcing is marked by a process with a division between cost and care management. Implications of this process occur within admission and interventions on the needs of the benefi ciaries.
Conclusions:
Statements revealed rationalization of cost, restructuring of work, and reproduction of the dominant logic of capital accumulation by the health insurance companies.
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RESEARCH06-01-2015
Gateway to the diagnosis of tuberculosis among elders in Brazilian municipalities
Revista Brasileira de Enfermagem. 2015;68(3):467-473
Abstract
RESEARCHGateway to the diagnosis of tuberculosis among elders in Brazilian municipalities
Revista Brasileira de Enfermagem. 2015;68(3):467-473
DOI 10.1590/0034-7167.2015680313i
Views0See moreABSTRACT
Objective:
to analyze the factors associated with the gateway of the health systems of Brazilian municipalities for the diagnosis of tuberculosis in older people.
Method:
survey study type, with a sample of 91 elders, in a population with 706 cases of tuberculosis. Data were collected by means of an instrument based on the Primary Care Assessment Tool (PCAT) adapted for tuberculosis care, emphasizing the gateway variable. Variables were categorized and compared between primary health care (PHC) and specialized care (SC) services. Bivariate analysis and the Chi-square association test were used.
Results:
a statistically signifi cant association (p = 0.0001) was found between the fi rst health service sought and the unit that diagnosed tuberculosis, showing better performance of specialized care services in the diagnosis.
Conclusion:
it is necessary to improve primary health care services to tackle delayed diagnosis of tuberculosis in older people.
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