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巴西市政当局对儿童肥胖的综合护理。

Comprehensive care for childhood obesity in Brazilian municipalities.

机构信息

Universidade de Brasília. Faculdade de Ciências da Saúde. Programa de Pós-Graduação em Nutrição Humana. Brasília, DF, Brasil.

Universidade de Brasília. Faculdade de Ciências da Saúde. Programa de Iniciação Científica. Brasília, DF, Brasil.

出版信息

Rev Saude Publica. 2024 Aug 9;58:33. doi: 10.11606/s1518-8787.2024058005632. eCollection 2024.

Abstract

OBJECTIVE

To understand the potential and limits of care for childhood obesity from the perspective of comprehensiveness, in the context of Primary Health Care, in Brazilian municipalities.

METHODS

A qualitative approach was adopted, with an electronic form of a dissertative nature being applied in 11 municipalities in the five Brazilian regions, derived from the four axes of comprehensiveness defined by Ayres (needs, purposes, articulations, and interactions).

RESULTS

Among the strengths for comprehensive care, the following were observed: the provision of services at different levels of care; the relevance of intersectoral programs in the development of actions aimed at the multidimensionality of childhood obesity; the implementation of strategies for systematizing care and tools that encourage the expansion of dialogue and humanization; and intersectoral coordination to create appropriate responses to the expanded needs of children and their families. Limitations include: the centralization of actions in nutrition professionals and in the care sphere; the failure to prioritize childhood obesity in health agendas; and the lack of trained professionals to deal with the complexity of obesity.

CONCLUSIONS

The findings suggest that child obesity care practices, in order to be transformative, need to be understood in the context of comprehensiveness. And this includes (re)thinking public policies, professional practices, and the organization of work processes so that they are, in fact, more inclusive, participatory, dialogical, humanized, supportive, fair, and, therefore, effective.

摘要

目的

从初级卫生保健的角度,了解全面性视角下巴西各城市儿童肥胖护理的潜力和局限性。

方法

采用定性方法,通过电子形式的论文形式,在巴西五个地区的 11 个城市进行,源于 Ayres(需求、目的、关节和相互作用)定义的全面性的四个轴。

结果

在全面护理的优势方面,观察到以下几点:在不同护理水平提供服务;跨部门计划在制定针对儿童肥胖多维性的行动中的重要性;实施策略以规范护理和鼓励扩大对话和人性化的工具;以及跨部门协调,为儿童及其家庭扩大的需求创造适当的应对措施。局限性包括:行动集中在营养专业人员和护理领域;未能在卫生议程中优先考虑儿童肥胖问题;以及缺乏处理肥胖复杂性的训练有素的专业人员。

结论

研究结果表明,为了实现变革性,儿童肥胖护理实践需要在全面性的背景下加以理解。这包括(重新)思考公共政策、专业实践和工作流程的组织,以使它们实际上更加包容、参与性、对话性、人性化、支持性、公平性,因此更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de69/11319039/cbc335ce081b/1518-8787-rsp-58-33-gf01.jpg

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