Master's Program in Collective Health, Multidisciplinary Health Institute, Federal University of Bahia, Vitória da Conquista, Bahia, Brazil.
Epidemiology and Collective Health Nucleus, Multidisciplinary Health Institute, Federal University of Bahia, Hormindo Barros Street, 58 - Candeias, Vitória da Conquista, Bahia, 45029-094, Brazil.
BMC Health Serv Res. 2022 May 19;22(1):673. doi: 10.1186/s12913-022-08078-z.
Primary health care-oriented systems provide better healthcare, especially for chronic diseases. This study analyzed the perspectives of physicians and nurses performing care for patients with chronic diseases in Primary Health Care in a Brazilian city.
A qualitative study was conducted in Vitória da Conquista, Bahia, Brazil, using semi-structured interviews with five physicians and 18 nurses. The interview included questions from an analytical matrix based on three dimensions of healthcare practices: organizational, technical care, and biopsychosocial, following a deductive approach. The interviews were fully transcribed and analyzed using a thematic categorical approach.
The results indicated that the provision of chronic care occurs in a comprehensive way. Potentialities were identified in the diversification of access, offer of care actions and technologies, integration of teamwork, and bringing together social networks to foster autonomy and self-care. Weaknesses were mostly related to the high number of people in the teams, follow-up of several cases, high turnover of support teams, low integration of Primary Health Care with other levels, difficulties in intersectoral articulation and family participation in care.
The multidimensional assessment of health care practices aimed at individuals with chronic noncommunicable diseases was useful to portray the strengths and weaknesses of the services. It also ratifies the need to consider the importance of and investment in primary health care by offering the necessary technical, political, logistical and financial support to the units, to ensure the sustainability of the actions by nurses, doctors and entire team.
以初级保健为导向的系统提供了更好的医疗保健，特别是对于慢性病。本研究分析了巴西某城市初级保健中从事慢性病患者护理的医生和护士的观点。
在巴西巴伊亚州的维多利亚达孔基斯塔市进行了一项定性研究，对 5 名医生和 18 名护士进行了半结构化访谈。访谈包括基于医疗实践三个维度（组织、技术护理和生物心理社会）的分析矩阵的问题，采用演绎法。对访谈进行了完整的转录，并使用主题分类方法进行了分析。
研究结果表明，慢性病护理是全面提供的。在扩大就诊途径、提供护理行动和技术、团队整合以及汇集社会网络以促进自主和自我护理方面，发现了一些潜力。弱点主要与团队人数多、跟进多个病例、支持团队人员流动率高、初级保健与其他层次整合程度低、部门间协调和家庭参与护理困难有关。
对患有慢性非传染性疾病的个体进行多维医疗保健实践评估有助于描绘服务的优势和劣势。它还证实了需要考虑初级保健的重要性和投资，为单位提供必要的技术、政治、后勤和财政支持，以确保护士、医生和整个团队的行动可持续性。
