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      Atributos da atenção primária nas internações de crianças: Acesso de primeiro contato e Longitudinalidade Translated title: Primary care features in child hospitalization: First-contact access and Longitudinality

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          Abstract

          Objetivo identificar os atributos da atenção primária à saúde Acesso de primeiro contato e Longitudinalidade em crianças hospitalizadas. Métodos estudo transversal, realizado em dois hospitais, com 120 crianças menores de cinco anos de idade internadas por condições sensíveis à atenção primária em saúde. Coleta de dados realizada utilizando o Primary Care Assessment Tool. Resultados o grau de afiliação obteve melhor escore (aproximadamente 8,0), sendo o único entre todos os componentes do instrumento avaliado de forma satisfatória (≥6,6). A Longitudinalidade (>4,0) apresentou menor escore em comparação ao Acesso de primeiro contato (5,6). Segundo os pais, o enfermeiro foi o profissional que mais realizou o acompanhamento na Puericultura. Conclusão os resultados apontam fragilidades nos serviços e insatisfação dos cuidadores, evidenciados pela baixa orientação aos princípios da Atenção Primária à Saúde.

          Translated abstract

          Objective to identify two features of primary health care, namely First-contact access and Longitudinality in hospitalized children. Methods cross-sectional study carried out in two hospitals with 120 children under five years of age hospitalized due to sensitive conditions of primary health care. Data collection performed using the Primary Care Assessment Tool. Results the degree of affiliation obtained a better score (approximately 8.0), being the only one among all components of the instrument satisfactorily evaluated (≥6.6). Longitudinality (>4.0) had a lower score than First-contact access (5.6). According to the parents, the nurse was the professional who had most performed the follow-up in childcare. Conclusion the results point to weaknesses in services and carergivers’ dissatisfaction, evidenced by the poor following to the Primary Health Care principles.

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          Most cited references15

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          Epidemiology and etiology of childhood pneumonia in 2010: estimates of incidence, severe morbidity, mortality, underlying risk factors and causative pathogens for 192 countries

          Background The recent series of reviews conducted within the Global Action Plan for Pneumonia and Diarrhoea (GAPPD) addressed epidemiology of the two deadly diseases at the global and regional level; it also estimated the effectiveness of interventions, barriers to achieving high coverage and the main implications for health policy. The aim of this paper is to provide the estimates of childhood pneumonia at the country level. This should allow national policy–makers and stakeholders to implement proposed policies in the World Health Organization (WHO) and UNICEF member countries. Methods We conducted a series of systematic reviews to update previous estimates of the global, regional and national burden of childhood pneumonia incidence, severe morbidity, mortality, risk factors and specific contributions of the most common pathogens: Streptococcus pneumoniae (SP), Haemophilus influenzae type B (Hib), respiratory syncytial virus (RSV) and influenza virus (flu). We distributed the global and regional–level estimates of the number of cases, severe cases and deaths from childhood pneumonia in 2010–2011 by specific countries using an epidemiological model. The model was based on the prevalence of the five main risk factors for childhood pneumonia within countries (malnutrition, low birth weight, non–exclusive breastfeeding in the first four months, solid fuel use and crowding) and risk effect sizes estimated using meta–analysis. Findings The incidence of community–acquired childhood pneumonia in low– and middle–income countries (LMIC) in the year 2010, using World Health Organization's definition, was about 0.22 (interquartile range (IQR) 0.11–0.51) episodes per child–year (e/cy), with 11.5% (IQR 8.0–33.0%) of cases progressing to severe episodes. This is a reduction of nearly 25% over the past decade, which is consistent with observed reductions in the prevalence of risk factors for pneumonia throughout LMIC. At the level of pneumonia incidence, RSV is the most common pathogen, present in about 29% of all episodes, followed by influenza (17%). The contribution of different pathogens varies by pneumonia severity strata, with viral etiologies becoming relatively less important and most deaths in 2010 caused by the main bacterial agents – SP (33%) and Hib (16%), accounting for vaccine use against these two pathogens. Conclusions In comparison to 2000, the primary epidemiological evidence contributing to the models of childhood pneumonia burden has improved only slightly; all estimates have wide uncertainty bounds. Still, there is evidence of a decreasing trend for all measures of the burden over the period 2000–2010. The estimates of pneumonia incidence, severe morbidity, mortality and etiology, although each derived from different and independent data, are internally consistent – lending credibility to the new set of estimates. Pneumonia continues to be the leading cause of both morbidity and mortality for young children beyond the neonatal period and requires ongoing strategies and progress to reduce the burden further.
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            Primary health care assessment tools: a literature review and metasynthesis

            This study comprises a systematic review and metasynthesis of qualitative literature on national and international databases to identify the main tools used to assess Primary Health Care (PHC). A total of 3,048 results were returned for literature written in Portuguese, Spanish and English published between 1979 and 2013. Thirty-three articles/studies were selected after thorough reading and analysis. Eight of these studies addressed the use of one or more of the following validated PHC assessment tools: the WHO Primary Care Assessment Tool (PCET); the ADHD Questionnaire for Primary Care Providers (AQ-PCP); the General Practice Assessment Questionnaire (GPAQ), PACOTAPS (primary health care software); and the PCAT (Primary Care Assessment Tool). The study showed that the majority of these tools were used internationally. The PCAT and EUROPEP were used in Brazil and the most commonly used tool in this country was the PCAT. The results show that the use of research tools to assess PHC may assist in the creation of new proposals to improve family healthcare and that PCAT is the most adequate tool for this purpose.
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              Internações por condições sensíveis à atenção primária à saúde em uma região de saúde paulista, 2008 a 2010

              OBJETIVO: descrever as internações por condições sensíveis à atenção primária (ICSAP) na região de saúde de São José do Rio Preto, no interior paulista. MÉTODOS: estudo descritivo cuja fonte de dados foi o Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS) no período 2008-2010. RESULTADOS: o coeficiente de ICSAP dessa região de saúde foi em torno de 13,0/1000 habitantes a cada ano; os cinco diagnósticos mais frequentes foram insuficiência cardíaca, angina, infecções do aparelho urinário, gastroenterites infecciosas e as doenças cerebrovasculares; doenças do aparelho circulatório foram o diagnóstico principal, registrado em 41,5% do total dessas internações; as ICSAP consumiram R$ 30.370.691,08, correspondendo a 17% do total de gastos com internações nessa região de saúde. CONCLUSÃO: a ocorrência de ICSAP, que são potencialmente evitáveis, aponta a necessidade de outras investigações sobre possíveis fatores que estejam interferindo na prestação e resolutividade da atenção primária na região estudada.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rene
                Revista da Rede de Enfermagem do Nordeste
                Rev. Rene
                Universidade Federal do Ceará (Fortaleza, CE, Brazil )
                1517-3852
                2175-6783
                October 2018
                : 19
                : 0
                : e3481
                Affiliations
                [1] Fortaleza Ceará orgnameUniversidade Federal do Ceará Brazil
                [2] Redenção orgnameUniversidade da Integração Internacional da Lusofonia Afro-Brasileira Brazil
                Article
                S1517-38522018000100335
                10.15253/2175-6783.2018193481
                9058457c-fd9f-4801-bc2b-1cdcd0eaf40a

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                : 19 April 2018
                : 24 July 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 0
                Product

                SciELO Revista de Enfermagem

                Categories
                Artigos Originais

                Child Care,Primary Health Care,Nursing,Cuidado da Criança,Atenção Primaria à Saúde,Enfermagem

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