Prática avançada de Enfermagem: reflexões para subsidiar a implementação na atenção primária a saúde brasileira
In view of the growing global dimension on the strengthening of Primary Health Care through the expansion and training of human resources, especially in nursing, it is essential to present the role of Advanced Practice Nursing and its potential for transformation in Primary Health Care in Brazil....
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| Formato: | doctoralThesis |
| Idioma: | pt_BR |
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Universidade Federal do Rio Grande do Norte
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| Endereço do item: | https://repositorio.ufrn.br/handle/123456789/32770 |
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| Resumo: | In view of the growing global dimension on the strengthening of Primary Health Care through
the expansion and training of human resources, especially in nursing, it is essential to present
the role of Advanced Practice Nursing and its potential for transformation in Primary Health
Care in Brazil. The objective of this study is to analyze Advanced Practice Nursing, focusing
on the role of Family Nurse Practitioners, in order to support reflections for the implementation
in Brazilian Primary Health Care. This is a multi-method study with three stages, with a
conceptual focus on the PEPPA framework, described below: Literature review on the impact
of the management of Advanced Practice Nurses on NonCommunicable Diseases in Primary
Health Care; Case study with Family Nurse Practitioners in the USA; Theoretical-Philosophical
Essay in light of Max Horkheimer's Critical Theory where the following reflections guided the
study: What is the contribution of Critical Theory to the discipline of Nursing? How to relate
the main concepts of Max Horkheimer's Critical Theory with nursing praxis? Can advancedpractice nursing be an instrument on the path to social transformation by increasing universal
access to health? In step 1, it was possible to verify the positive impact that advanced nursing
practice has on the four most frequent categories of Noncommunicable Diseases, namely:
Diabetes, Cardiovascular Diseases, Chronic Respiratory Diseases and Cancer. In step 2, from
the analysis of the interviews conducted with the Family Nurse Practitioner in the USA, three
partitions emerged based on the content of the participants' statements: 1) Being an advanced
practice nurse; 2) Educational routes and possibilities of action and 3) Being political: a path
for transformation, where it was possible to describe competences and skills considered to be
outstanding points in relation to other professional categories, points of improvement in their
educational background and the importance of political representation and being active in
performing the role. In the last stage of the research, the emergence of a change in the scenario
of primary health care in Brazil was highlighted, placing nurses as a primary tool in the struggle
for social transformation and the search for autonomy as citizens and professionals in the light
of Critical Theory and its concepts. The complexity of the nurse's work dialogues with the
concepts of Critical Theory and stimulates critical behavior towards praxis in knowledge /
action, strengthening its function. At the present time, it is biased to expand the practice of
nurses through the implementation of Advanced Nursing Practice as one of the possible
solutions for the reduction of social inequalities caused by the lack of equal access to health. It
is expected through this study, to subsidize the implementation of Advanced Nursing Practice
in the context of Primary Health Care, along the lines of the PEPPA framework, by
understanding what Advanced Nursing Practice is in the scope of family health, reflecting about
the path taken so far and the next steps to be taken, always in the constant search for recognition,
autonomy and transformation. |
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