Avaliação da qualidade da Estratégia Saúde da Família na atenção ao usuário com diabetes mellitus durante a pandemia de Covid-19
Diabetes mellitus is a chronic metabolic syndrome, which has a high worldwide prevalence and is related to high rates of morbidity and mortality, being a threat to public health. Health services, especially Primary Health Care, must be prepared for quality monitoring of people with this condition...
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| Formato: | Dissertação |
| 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/123456789/51225 |
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| Resumo: | Diabetes mellitus is a chronic metabolic syndrome, which has a high worldwide
prevalence and is related to high rates of morbidity and mortality, being a threat to
public health. Health services, especially Primary Health Care, must be prepared for
quality monitoring of people with this condition. In the context of the COVID-19
Pandemic, the essential attributes and derivatives of Primary Health Care become
even more necessary to be achieved and evaluation in the emerging context is
essential. Thus, we sought to evaluate the quality of the Family Health Strategy in the
interior of Rio Grande do Norte in the care of individuals with Diabetes mellitus in the
context of the COVID-19 pandemic, identifying the factors associated between
quality and glycemic control. For this, a cross-sectional observational study with a
quantitative approach was carried out in which 120 subjects were evaluated through
the application of the general structured questionnaire and the instrument for
evaluating the quality of Primary Care (PCATool-Brasil), in addition to the
retrospective analysis of the records made in medical records of users diagnosed
with Diabetes mellitus. The Poisson model, with robust variation, was used for
multivariate analysis. The result of the general score of the PCATool-Brasil indicated
that 70% of the sample evaluated the quality of the Family Health Strategy as
satisfactory, with a score ≥ 6.6. However, it showed an unsatisfactory assessment of
the attributes available services, services provided and community guidance.
Inadequate glycemic control was present in 64.2% of the subjects. However, having
a service with a high degree of orientation towards Primary Care did not show a
significant difference in relation to services with a low degree of orientation regarding
glycemic control. After the adjusted multivariate analysis of the managements, the
request for the lipid profile maintained a statistical difference (PR=0.762; 95%CI
0.630-0.921); guidance on the correct use of medication (PR=0.693; 95%CI 0.502-
0.956); encouraging the practice of physical activity (PR=0.862; 95%CI 0.781-0.951);
referral to an ophthalmologist (PR=1.169; 95%CI 1.016-1.344); consultation with an
ophthalmologist (PR=1.209; 95%CI 1.063-1.376) and follow-up with a nutritionist
(PR=0.864; 95%CI 0.768-0.972). The results found showed a strong orientation to
Primary Health Care from the perspective of diabetic users, although it is necessary
to invest in promotion and prevention actions, and in the recognition of the family
context and the encouragement of community participation. While the practice of guidance in Primary Health Care on the topics correct use of medications and practice of physical activity, in addition to nutritional monitoring with a specialized professional, were highlighted as a protective factor for glycemic control. |
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