Nóbrega Vanessa Medeiros da, Souza Maria Helena do Nascimento, Santos Mariana Matias, Silva Maria Elizabete de Amorim, Collet Neusa
Programa de Pós-Graduação em Enfermagem, Universidade Federal da Paraíba. Campus Universitário I. 58059-900 João Pessoa PB Brasil.
Escola de Enfermagem Anna Nery, Universidade Federal do Rio de Janeiro. Rio de Janeiro RJ Brasil.
Cien Saude Colet. 2018 Oct;23(10):3257-3265. doi: 10.1590/1413-812320182310.13942018.
The objective of this qualitative study was to analyze the structural characteristics of the governance system and support offered by the secondary social network in health care for children and adolescents with chronic diseases. The study was carried out at Family Health Strategy (FHS) units, a specialized outpatient clinic, and a public pediatric hospital in João Pessoa, Paraiba, Brazil, from February to October 2013, using semi-structured interviews and focus groups. The participants included six managers, 14 health professionals, and 12 family caregivers of children or adolescents with chronic diseases. The data were analyzed according to the principles of thematic content analysis. The governance system found in health care for children and adolescents with chronic diseases was collaborative. Additionally, the limitations of managerial public governance were clear, weakening the secondary social network with repercussions regarding the support offered to the family and cooperation between services. This reality can have a negative impact on the quality and effectiveness of the care provided to children and adolescents with chronic conditions, as it does not meet the real needs of this population.
这项定性研究的目的是分析二级社会网络在为患有慢性病的儿童和青少年提供医疗保健方面所提供的治理体系结构特征及支持。该研究于2013年2月至10月在巴西帕拉伊巴州若昂佩索阿市的家庭健康战略（FHS）单位、一家专科门诊和一家公立儿童医院开展，采用半结构化访谈和焦点小组的方式。参与者包括六名管理人员、14名卫生专业人员以及12名患有慢性病的儿童或青少年的家庭照顾者。数据依据主题内容分析原则进行分析。在为患有慢性病的儿童和青少年提供医疗保健中发现的治理体系具有协作性。此外，公共管理治理的局限性很明显，削弱了二级社会网络，对向家庭提供的支持以及服务之间的合作产生了影响。这种现实情况可能会对为患有慢性病的儿童和青少年提供的护理质量和效果产生负面影响，因为它无法满足这一人群的实际需求。
