Information Technology in the Dissemination of Results of the Primary Health Care Evaluation in Brazil: A Qualitative Study

Background: Considering advancements in information technology for disseminating results of evaluations, it is essential to demonstrate the functionalities and performance of these practices in order to achieve the objectives established by the evaluation proponents. This study aimed to evaluate the use of information technology for disseminating results obtained from the Primary Health Care evaluation in Brazil. Methods: A qualitative single-case study was performed with triangulation of techniques and key informants. Analyses of public documents and field research were conducted. Convenience sample of 54 participants (seven from the Department of Primary Care/Ministry of Health and 47 from teaching and research institutions) was selected from the external evaluation team. Content analysis was performed, and the Atlas ti.8.4.24 software organized, managed, and categorized textual data. Codification was performed by peers (three researchers) while experts validated codes (two researchers). Right after, codes were extracted and categorized.Results: Dissemination of results is complex due to multiple components. Incorporation also favored advances in data observation and implementation of data openness, becoming available for professionals, policymakers, and universities. Challenges regarding delivery time of reports, access restriction, lack of interest, and digital skills influenced reaching expected goals of the proponent.Conclusion: Information technology for disseminating results of evaluations may improve performance of health teams and managers and redefine priorities of work processes to strengthen Primary Health Care. Emphasis in planning, technological infrastructure, digital inclusion, and policy decision making is recommended to disseminate data effectively to the population.

Interdisciplinary Health Care Evaluation Instruments: A Review of Psychometric Evidence

Teamwork among health care professionals has been found to improve patient outcomes and reduce burnout. Surveys from individual team members are often used to measure the effectiveness of teamwork performance, as they provide an efficient way to capture various constructs of teamwork. This allows evaluators to better understand team functioning, areas of strength, and to identify potential areas for improvement. However, the majority of published surveys are yet to be validated. We conducted a review of psychometric evidence to identify instruments frequently used in practice and identified in the literature. The databases searched included MEDLINE, EMBASE, CINAHL, and PsycINFO. After excluding duplicates and irrelevant articles, 15 articles met the inclusion criteria for full assessment. Seven surveys were validated and most frequently identified in the literature. This review aims to facilitate the selection of instruments that are most appropriate for research and clinical practice. More research is required to develop surveys that better reflect the current reality of teamwork in our evolving health system, including a greater consideration for patient as team members. Additionally, more research is needed to encompass an increasing development of team assessment tools.

The Newcastle satisfaction with nursing scales in a Mexican Oncology Hospital

Objectives: The principal aim of this study was to identify whether the Newcastle Satisfaction with Nursing Scales (NSNS) could be used on cancer patients. Methods: This was a descriptive, cross-sectional study carried out on cancer patients (n = 298). Results: We found that a majority of cancer patients were around 50 years old (hospitalized patients [HP]: 49.5 ± 14.9; chemotherapy outpatients [COP]: 49.4 ± 12.7), were female (HP: 74%; COP: 63.5%), and had received education at least up to elementary level (HP: 70%; COP: 80%). Breast cancer was the principal type of cancer (>34%) in both groups (HP and COP). The groups were comparable in age, sex distribution, place of origin, educational qualification, and type of cancer. Among HP, the experience and satisfaction scales of the NSNS showed good internal consistency (n = 235, α >0.9, r > 0.7), while among COP, only the satisfaction scale showed good internal consistency (n = 62, α = 1.00). Most patients’ perceptions (level of satisfaction) of hospitalization and chemotherapy services were positive (98% and 97%, respectively). Conclusion: An NSNS instrument specifically designed for ambulatory care cancer patients is necessary for it to be useful in assessing cancer patients' perception of nursing care. This will help improve the quality of care in Mexico. The presence of cancer by itself could modify the patients’ satisfaction level. Further large-scale studies are required to inves- tigate the patients’ perceptions of nursing care using the NSNS on different cancer patient groups. Keywords: Spanish satisfaction tool; hospital; patient satisfaction; oncology nursing; health care evaluation mechanisms.

Comparison of smoking reduction with improvement of social conditions in early life: simulation in a British cohort

Background Health care evaluation models can be useful to assign different levels of priority to interventions or policies targeting different age groups or different determinants of health. We aimed to assess early mortality in counterfactual scenarios implying reduced adverse childhood experience (ACE) and/or improved educational attainment (childhood and early life characteristics), compared with a counterfactual scenario implying reduced smoking in adulthood. Methods We used data from the 1958 National Child Development Study British birth cohort, which initially included 18 558 subjects. Applying a potential outcome approach, scenarios were simulated to estimate the expected mortality between ages 16 and 55 under a counterfactual decrease by half of the observed level of exposure to (i) ACE, (ii) low educational attainment (at age 22), (iii) ACE and low educational attainment (a combined exposure) and (iv) smoking at age 33. Estimations were obtained using g-computation, separately for men and women. Analyses were further stratified according to the parental level of education, to assess social inequalities. Results The study population included 12 164 members. The estimated decrease in mortality in the counterfactual scenarios with reduced ACE and improved educational attainment was close to the decreased mortality in the counterfactual scenario with reduced smoking, showing a relative difference in mortality of respectively −7.2% [95% CI (confidence interval) = (−12.2% to 1.2%)] versus −7.0% (−13.1% to +1.2%) for women, and −9.9% (−15.6% to −6.2%) versus −12.3% (−17.0% to −5.9%) for men. Conclusions Our results highlight the potential value of targeting early social characteristics such as ACE and education, compared with well-recognized interventions on smoking.

Retrato da judicialização da saúde no munícípio de São Paulo entre 2017 e setembro de 2018 e os principais resultados obtidos pelas ações adotadas

A Constituição Federal de 1988, que trouxe a saúde como direito social de todos os brasileiros, dependente de políticas públicas de Estado (art. 196), criou o Sistema Único de Saúde (SUS) para garantia das ações e serviços assistenciais universais, igualitários e integrais (art. 198), acabando por propiciar, em pouco tempo, o aumento progressivo da judicialização da saúde no Brasil, em grandes dimensões, especialmente em razão da geração de significativo impacto orçamentário. Diante desta perspectiva, no Município de São Paulo, nos anos de 2017 e 2018, teve início o reforço da estrutura administrativa da Secretaria Municipal de Saúde no sentido do enfrentamento desta realidade, em especial, com a implementação e incremento do setor técnico e jurídico especializado nesta temática, o que trouxe mais subsídios para a defesa da Prefeitura de São Paulo em Juízo, desempenhada pela Procuradoria Geral do Município (PGM), sendo que as referidas ações adotadas, no presente estudo, guardaram relação com a redução dos gastos de recursos públicos em ações individuais nas situações amostrais analisadas, bem como na redução de gastos totais em compras judiciais para que os mesmos fossem aplicados nos programas de saúde pública do SUS paulistano. Este estudo é um retrato do panorama da Judicialização da Saúde no Município de São Paulo e os principais resultados obtidos por este trabalho.Palavras-chave: Poder judiciário. Saúde pública. Judicialização da Saúde. Mecanismos de avaliação da assistência à saúde. ABSTRACTThe Federal Constitution of 1988, which brought health as a social right for all Brazilians, dependent on state public policies (article 196), created the Unified Health System (SUS) to guarantee universal, egalitarian and (article 198), which in a short time led to the progressive increase of the judicialization of health in Brazil, in large dimensions, especially due to the generation of a significant budgetary impact. In view of this perspective, in the Municipality of São Paulo, in 2017 and 2018, the administrative structure of the Municipal Health Department began to be strengthened in order to address this reality, especially with the implementation and increase of the specialized technical and legal sector in this subject, which brought more subsidies for the defense of the Municipality of São Paulo in Judgment, performed by the Attorney General of the Municipality (PGM), and the actions adopted in this study were related to the reduction of public resources expenditures in individual actions in the analyzed sample situations, as well as in the reduction of total expenditures on judicial purchases so that they could be applied in the public health programs of the São Paulo SUS.This study is a portrait of the panorama of the Judicialization of Health in the Municipality of São Paulo and the main results obtained by this work.Keywords: Judiciary. Public health. Judiacialization of Health. Health care evaluation mechanisms.

Estimación de calidad del cuidado de enfermería en pacientes sometidos a hemodiálisis

Objetivo: Evaluar la calidad del cuidado de enfermería en una población de pacientes con tratamiento de hemodiálisis en la ciudad de Bogotá. Materiales y Métodos: Se realizó un estudio descriptivo de corte transversal, mediante la aplicación de la adaptación colombiana del instrumento Care-Q que relaciona actitudes y actividades de cuidado que realiza el enfermero(a) y que fueron evaluadas por el paciente a través de una escala Likert. El universo estuvo conformado por la totalidad de los pacientes en hemodiálisis que pertenecen a un grupo de apoyo de pacientes crónicos, se llegó a un tope de 100 pacientes convocados a los cuales se les aplicó el instrumento. Resultados: Se determinó que entre el 60% y 85% de la población evaluaba de manera positiva los cuidados proporcionados por el personal de enfermería. Conclusiones: Se encontró un porcentaje considerable de satisfacción dentro de la población participante, lo cual se contrasta con lo evidenciado en la literatura donde se plantea que el enfermero (a) es el profesional más indicado para el cuidado de este tipo de pacientes, también se hizo evidente la necesidad de generar investigaciones dirigidas a la evaluación continua de la atención de enfermería, debido a que ello facilita la creación de acciones de mejoramiento en la gestión del cuidado y permite trabajar por el cumplimiento de la calidad en la atención en salud.Palabras clave: Satisfacción del Paciente; Mecanismos de Evaluación de la Atención de Salud; Fallo Renal CrónicoEstimation of quality of nursing care in patients subjected to hemodialysisAbstractObjective: To evaluate the quality of nursing care in a population of patients with hemodialysis treatment in the city of Bogotá. Materials and Methods: A cross-sectional descriptive study was carried out, through the application of the Colombian adaptation of the Care-Q instrument that relates attitudes and nursing care activities that were evaluated by the patient through a Likert scale. The universe consisted of all the patients on hemodialysis who belong to a support group of chronic patients, reaching a limit of 100 patients summoned to whom the instrument was applied. Results: It was determined that between 60% and 85% of the population evaluated in a positive way the care provided by the nursing staff. Conclusions: A considerable percentage of satisfaction was found within the participating population, which is contrasted with what is evidenced in the literature where it is stated that the nurse is the most suitable professional for the care of this type of patients. It made evident the need to generate research aimed at the continuous evaluation of nursing care, because it facilitates the creation of actions for improvement in the management of care and allows working for the fulfillment of quality in health care.Key words: Patient Satisfaction; Health Care Evaluation Mechanisms; Kidney Failure, Chronic Estimativa da qualidade do cuidado de enfermagem em pacientes submetidos ahemodiáliseResumoObjetivo: Avaliar a qualidade do atendimento de enfermagem em uma população de pacientes com tratamento de hemodiálise na cidade de Bogotá. Materiais e Métodos: Foi realizado um estudo descritivo transversal, através da aplicação da adaptação colombiana do instrumento Care-Q que relaciona atitudes e atividades de cuidados de enfermagem que foram avaliadas pelo paciente através de uma Escala Likert. O universo consistiu de todos os pacientes em hemodiálise que pertencem a um grupo de apoio de pacientes crônicos, atingindo um limite de 100 pacientes convocados para quem o instrumento foi aplicado. Resultados: Determinou-se que entre 60% e 85% da população avaliam de forma positiva os cuidados prestados pela equipe de enfermagem. Conclusões: Uma percentagem considerável de satisfação foi encontrada na população participante, o que é contrastado com o que é evidenciado na literatura onde se afirma que a enfermeira é o profissional mais adequado para o cuidado desse tipo de pacientes. Indicou a necessidade de gerar pesquisa voltada para a avaliação contínua dos cuidados de enfermagem, pois facilita a criação de ações de melhoria na gestão dos cuidados e permite trabalhar para o atendimento da qualidade nos cuidados de saúde.Palavras chave: Satisfação do Paciente; Mecanismos de Avaliação da Assistência à Saúde; Falência Renal Crônica