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BACKGROUND: Sexually transmitted infections (STI) can have severe consequences. In Brazil, case management is recommended by the Clinical Protocol and Therapeutical Guidelines for Comprehensive Care for People with STIs (PCDT-IST). This study assessed the quality of PCDT-IST (2021) and reviewed the main recommendations for the management of STI that cause urethral discharge compared with the World Health Organization (WHO) STI Guidelines. METHODS: The PCDT-IST (2021) quality was independently assessed by 4 appraisers using the Appraisal of Guidelines Research and Evaluation instrument, version II (AGREE II). The PCDT-IST (2021) and the WHO Guidelines for the Management of Symptomatic STI (2021) were compared considering 14 different assessment domains. RESULTS: The PCDT-IST (2021) scores in the AGREE II domains were: Rigor of Development (58%), Applicability (35%), Editorial Independence (38%), Scope and Purpose (78%), Stakeholder Involvement (74%), and Clarity and Presentation (82%). The overall score was 67%, and all appraisers recommended the Brazilian guideline. Regarding the PCDT-IST (2021) and the WHO STI Guidelines (2021) comparation, 10 domains would be relevant for further reviewing the Brazilian recommendations: Diagnostic tests; Etiological approach; Treatment for recurrent urethral discharge; Treatment for urethritis without etiological agent identification; Treatment for gonococcal urethritis; Treatment for chlamydial urethritis; Retreatment for gonococcal infections; Treatment for Mycoplasma genitalium urethritis; Treatment for Trichomonas vaginalis urethritis; 10. Flowcharts. CONCLUSIONS: The PCDT-IST (2021) has a reasonable degree of quality. However, the domains of Applicability, Rigor of Development, and Editorial Independence must be better ensured. The guidelines comparison will help to select key topics that should be addressed with priority in the following national STI guidelines updates.
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Gonorrea , Enfermedades de Transmisión Sexual , Tricomoniasis , Trichomonas vaginalis , Uretritis , Humanos , Brasil/epidemiología , Gonorrea/diagnóstico , Gonorrea/complicaciones , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/terapia , Enfermedades de Transmisión Sexual/complicaciones , Uretritis/diagnóstico , Uretritis/etiologíaRESUMEN
BACKGROUND: Brazil has considerably reduced the number of cases of malaria in recent years and aims to eradicate the disease completely, however, vivax malaria continues to be a major challenge for the health system. In this context, the key to building a successful elimination programme may lie in the knowledge and the perceptions of the health agents, the patients affected by the disease and the personnel responsible for malaria diagnosis, treatment and control at the local level. METHODS: A qualitative study was undertaken in Manaus, capital of the state of Amazonas, Western Brazilian Amazon, using a sample of 33 patients who were being treated for malaria and 22 health agents who were working in malaria diagnosis, treatment and control at the local level. A semi-structured interview with a further thematic analysis was performed. RESULTS: There are still many myths regarding malaria transmission and treatment that may hinder the sensitization of the population of this region in relation to the use of current control tools and elimination strategies, such as mass drug administration (MDA). Most health professionals reported that the abandonment of treatment for malaria by the patient is related to poor social conditions, the high incidence of alcoholism and the low level of schooling of the affected population. One negative perception, observed in both groups with regard to the use of insecticide-treated nets, is that they may cause skin irritations and allergies. Most patients and health professionals have described malaria as an impossible disease to eliminate because it is intrinsically associated with forest landscapes, and according to them, elimination would only be possible if there were a vaccine against malaria. CONCLUSION: In the Amazon, cultural perceptions about the etiology of this disease can influence the behaviour and practices that social groups adopt in relation to the different forms of living in a malaria-endemic context. Negative perceptions about malaria elimination can act as a barrier when trying to reach proper coverage for control strategies such as mosquito nets and MDA.
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Control de Enfermedades Transmisibles/métodos , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/psicología , Malaria Vivax/psicología , Adolescente , Adulto , Brasil , Niño , Femenino , Humanos , Malaria Falciparum/prevención & control , Malaria Falciparum/psicología , Malaria Vivax/prevención & control , Masculino , Persona de Mediana Edad , Plasmodium falciparum/fisiología , Plasmodium vivax/fisiología , Adulto JovenRESUMEN
OBJECTIVE: Characterize areas of interinstitutional cooperation and converging health agendas of the Pan American Health Organization/World Health Organization (PAHO/WHO), the Health Council of the Union of South American Nations (UNASUR), and the Amazon Cooperation Treaty Organization (ACTO) in South America based on social determinants of health. METHODS: A qualitative study based on official documentary sources from the three organizations, using a comparative analysis of the health agendas of these agencies and the Rio Political Declaration on Social Determinants of Health (2011). Information was systematized using an analytical matrix that identifies convergences in the respective agendas. RESULTS: Development of the health agendas of these agencies is influenced by various international forces such as Member States' foreign policy, international cooperation strategies and models, and the institutions' political and strategic guidelines. These agendas reveal efforts to strengthen blocs, cooperation mechanisms, and coordinated programmatic actions. CONCLUSIONS: The agendas of PAHO/WHO, the UNASUR Health Council, and ACTO point towards opportunities for convergence in various programmatic areas, emphasizing social determinants of health. Based on the overall agreements of the Rio Declaration as an analytical framework with recommendations in five decision-making spheres, structural cooperation actions can be carried out in the region's countries, jointly mediated by these agencies.
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Relaciones Interinstitucionales , Organización Panamericana de la Salud , Determinantes Sociales de la Salud , Humanos , Agencias Internacionales , Cooperación Internacional , Organizaciones , América del Sur , Naciones UnidasRESUMEN
BACKGROUND: Point-of-care (POC) screening for HIV and syphilis using rapid testing was implemented in indigenous communities in the triple-border area of the Brazilian Amazon. We describe the context of the early introduction of POC screening, explore hindering and enabling factors for POC implementation, and recommend strategies for feasible, viable, and sustainable syphilis and HIV screening interventions. METHODS: This was a qualitative study based on grounded theory methodology. Data were collected using in-depth interviews, semi-structured questionnaires, and field observations and were analysed using the framework approach. Qualitative information was complemented by quantitative data for descriptive purposes. RESULTS: An overall high score for vulnerability to acquiring HIV and syphilis was observed among the indigenous communities. Health professionals reported satisfactory rapid testing acceptance, although concerns were raised about the pain of the fingerprick. Counselling-related challenges included ensuring the accuracy of translations, collaborating with translators and communicating positive test results. Over 3 months, 86.7% of the syphilis-positive individuals began treatment, and all of them notified their partners. Accessibility, measured as travel time via the local transportation network, was a barrier to health care access. A lack of gasoline for boats and other transportation was also a hindering factor at all levels of implementation. CONCLUSIONS: The recommendations address the preparation phase at the coordination level as well as at the training level. Tools such as strengths, weaknesses, opportunities, and threats (SWOT) analyses; checklists; context-adapted protocols; and fact sheets are very simple methods to facilitate implementation. The findings of this study are important because they may inform the implementation of new health technologies in low-resource national disease control programmes in remote communities.
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Infecciones por VIH/diagnóstico , Servicios de Salud del Indígena , Pruebas en el Punto de Atención , Sífilis/diagnóstico , Brasil , Consejo , Femenino , Teoría Fundamentada , Infecciones por VIH/etnología , Personal de Salud , Accesibilidad a los Servicios de Salud , Humanos , Entrevistas como Asunto , Masculino , Tamizaje Masivo , Grupos de Población , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/etnología , Investigación Cualitativa , Parejas Sexuales , Encuestas y Cuestionarios , Sífilis/etnologíaRESUMEN
BACKGROUND: Social reintegration relies on the support given to prisoners not only during their reentry into society but also throughout their imprisonment. Our goal was to analyze the expectations reported by cisgender and transgender women returning to society and of the justice and social welfare professionals from the Brazilian prison system. METHODS: A qualitative analysis using saturation sampling was conducted. The participants were selected through a non-probabilistic sampling technique. Data was collected through semi-structured interviews with professionals involved in the management of the prison system and female former inmates. Interviews were transcribed and analyzed using an open and focused coding process. Textual data was stored, organized, and coded using Atlas software according to emerging themes. RESULTS: The study involved 15 professionals and 13 female former inmates, five of them identified as transgender women. Among the professionals, the age range went from 38 to 65 years old; they reported a work history in their respective fields, from 10 to 35 years, with an equal distribution across genders. As for the female former inmates, their ages ranged from 24 to 42 years old, and the most reported crime was drug trafficking. Their incarceration time varied from 1 to 8 years. Female inmates were vulnerable to abuse and violence, including physical, sexual, and emotional violence. Women in situations of prior vulnerability faced additional challenges during their sentences. Transgender women were even more neglected and discriminated against by the system. Despite the professionals being aware and concerned about vulnerabilities and the need to improve the reintegration process, in general, they were not sensitive to the gender perspective. There were no specific policies able to support social integration for this public. CONCLUSIONS: Data showed multifaceted challenges faced by female former inmates within the Brazilian prison system, highlighting the insufficient policies for both cisgender and transgender women. Additionally, the results revealed a lack of sensitivity among professionals regarding gender issues and their particularities in the prison system and social reintegration. These findings emphasize the need for a more comprehensive and intersectional approach that addresses the diverse socio-economic backgrounds of these individuals.
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OBJETIVE: To estimate the prevalence of psychological, physical, and sexual violence perpetrated against women by their intimate partner (IP) in Quilombola communities located in Espírito Santo State, Brazil. METHODS: The data is from a population-based cross-sectional study of Quilombola women conducted from 2017 to 2018. In-person interviews collected information on women's sociodemographic characteristics, behaviors, and their experience of violence perpetrated by their IP. The analysis used chi-square test and hierarchical logistic regression. RESULTS: 219 women (94.8% of the invited ones) agreed to participate in the study. 59.0% (95%CI: 5.25-65.5) reported psychological violence; 41% (95%CI: 34.5-47.5) physical violence; and 8.2% (95%CI: 4.6-11.8) sexual violence. Psychological violence was associated with having three or more sexual partners in life, when compared to those who had up to two partners (p = 0,009), and previous violence involving other people outside of family increased the chance of suffering psychological violence by an IP more than nine times (p ≤ 0.001). Regarding physical violence, the association with use of barrier contraception (p = 0.031) and having a partner with other sexual partners (p = 0.024) were protective factors for IP violence. Having 3 or more sexual partners in the last 12 months (p = 0.006), partner using illicit drugs (p = 0,006), and alcoholism in the family (p = 0,001), increased the chance of suffer physical violence by the partner. Sexual violence perpetrated by the IP was associated with miscarriage (p = 0.016), partner using drugs (p = 0.020), and gynecological symptoms (p = 0.045). CONCLUSIONS: These results showed the high frequency of intimate partner violence in Quilombola women and highlight the importance of reducing social and race inequities for interrupting the culture of violence against women.
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Violencia de Pareja , Población Rural , Humanos , Femenino , Brasil/epidemiología , Estudios Transversales , Factores de Riesgo , Violencia de Pareja/psicología , Parejas Sexuales , PrevalenciaRESUMEN
Introducción: La atención primaria de salud en Brasil se considera una prioridad. En el año 2013 se creó el Programa Mais Médicos, de formación en servicio y de ampliación de la cantidad de médicos en el país. La cooperación cubana, gestionada por la Organización Panamericana de la Salud fue quien envió la mayor cantidad de profesionales. Objetivo: Analizar las representaciones sociales de los consejeros de salud sobre el Programa Mais Médicos, en municipios en los que prestaron atención a su población médicos provenientes de Cuba. Métodos: Estudio de caso descriptivo de corte transversal abordado con metodología cualitativa. La muestra fue intencional. Se trabajó con 58 entrevistas semiestructuradas y el análisis fue realizado mediante el software gratuito Iramuteq con la técnica de análisis lexical. Resultados: Se pudo distinguir cuatro grupos de representaciones, sobre el funcionamiento de los consejos municipales de salud, sobre las representaciones del Programa Mais Médicos, sobre las redes de atención y sobre los médicos brasileños y cubanos. El estudio aporta evidencias de la aplicación de un nuevo modelo de atención para los consejeros que objetivaron y anclaron en el concepto de nacionalidad. El modelo cubano incorpora características de humanismo, atributos que no estaban contenidos en las representaciones sobre los médicos locales. Conclusiones: Las representaciones sociales sobre el Programa Mais Médicos aluden a una acción que mejora la calidad de los servicios, no obstante, la literatura sobre atención básica aún deja ver algunos problemas de acceso y tránsito por la red del sistema único de salud(AU)
Introduction: Primary health care in Brazil is considered a priority. In 2013, Mais Médicos Program was created, providing in-service training and expanding the number of doctors in the country. Cuban cooperation, managed by the Pan American Health Organization, sent the largest number of professionals. Objective: Analyze the social representations of health counselors on Mais Médicos Program, in municipalities in which doctors from Cuba cared to their population. Methods: Descriptive cross-sectional case study approached with qualitative methodology. The sample was intentional. It was conducted a work with 58 semi-structured interviews and the analysis was carried out using the free software Iramuteq with the lexical analysis technique. Results: Four groups of representations could be distinguished: on the functioning of the municipal health councils, on the representations of Mais Médicos Program, on the care networks and on Brazilian and Cuban doctors. The study brings evidence of the application of a new model of care for counselors who objectified and anchored in the concept of nationality. The Cuban model incorporates characteristics of humanism, attributes that were not contained in the representations about local doctors. Conclusions: The social representations on Mais Médicos Program allude to an action that improves the quality of services, however, the literature on basic care still shows some problems of access and transit through the network of the health system(AU)
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Humanos , Masculino , Femenino , Calidad de la Atención de Salud , Accesibilidad a los Servicios de Salud , Cooperación Internacional , Programas Nacionales de Salud , Brasil , Epidemiología Descriptiva , Estudios TransversalesRESUMEN
ABSTRACT OBJETIVE To estimate the prevalence of psychological, physical, and sexual violence perpetrated against women by their intimate partner (IP) in Quilombola communities located in Espírito Santo State, Brazil. METHODS The data is from a population-based cross-sectional study of Quilombola women conducted from 2017 to 2018. In-person interviews collected information on women's sociodemographic characteristics, behaviors, and their experience of violence perpetrated by their IP. The analysis used chi-square test and hierarchical logistic regression. RESULTS 219 women (94.8% of the invited ones) agreed to participate in the study. 59.0% (95%CI: 5.25-65.5) reported psychological violence; 41% (95%CI: 34.5-47.5) physical violence; and 8.2% (95%CI: 4.6-11.8) sexual violence. Psychological violence was associated with having three or more sexual partners in life, when compared to those who had up to two partners (p = 0,009), and previous violence involving other people outside of family increased the chance of suffering psychological violence by an IP more than nine times (p ≤ 0.001). Regarding physical violence, the association with use of barrier contraception (p = 0.031) and having a partner with other sexual partners (p = 0.024) were protective factors for IP violence. Having 3 or more sexual partners in the last 12 months (p = 0.006), partner using illicit drugs (p = 0,006), and alcoholism in the family (p = 0,001), increased the chance of suffer physical violence by the partner. Sexual violence perpetrated by the IP was associated with miscarriage (p = 0.016), partner using drugs (p = 0.020), and gynecological symptoms (p = 0.045). CONCLUSIONS These results showed the high frequency of intimate partner violence in Quilombola women and highlight the importance of reducing social and race inequities for interrupting the culture of violence against women.
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Humanos , Femenino , Violencia Doméstica , Mujeres Maltratadas , Violencia contra la Mujer , Violencia de Pareja , QuilombolaRESUMEN
A spectrum of diverse prevention methods that offer high protection against HIV has posed the following challenge: how can national AIDS policies with high coverage for prevention and treatment make the best use of new methods so as to reverse the current high, and even rising, incidence rates among specific social groups? We conducted a narrative review of the literature to examine the prevention methods and the structural interventions that can have a higher impact on incidence rates in the context of socially and geographically concentrated epidemics. Evidence on the protective effect of the methods against sexual exposure to HIV, as well as their limits and potential, is discussed. The availability and effectiveness of prevention methods have been hindered by structural and psychosocial barriers such as obstacles to adherence, inconsistent use over time, or only when individuals perceive themselves at higher risk. The most affected individuals and social groups have presented limited or absence of use of methods as this is moderated by values, prevention needs, and life circumstances. As a result, a substantial impact on the epidemic cannot be achieved by one method alone. Programs based on the complementarity of methods, the psychosocial aspects affecting their use and the mitigation of structural barriers may have the highest impact on incidence rates, especially if participation and community mobilization are part of their planning and implementation.
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Infecciones por VIH/prevención & control , Conducta Sexual , Condones Femeninos , Humanos , Factores de RiesgoRESUMEN
Objetivo. Mostrar las narrativas de miembros brasileños de los equipos de salud de la familia acerca del humanismo percibido en la práctica de los cooperantes cubanos del programa Mais Médicos. Métodos. Estudio de caso descriptivo de corte transversal. Se aplicó una entrevista semiestructurada a miembros brasileños de los equipos de salud de la familia que trabajaran desde el inicio del programa con médicos cubanos en municipios seleccionados inscritos en el programa Mais Médicos, con 20% o más de su población en extrema pobreza, y menos de cinco médicos o una tasa de 0,5 médicos por 1 000 habitantes antes del programa. Se procesaron los datos mediante la técnica de análisis de contenido. Resultados. Se entrevistaron 30 licenciados y 28 técnicos en enfermería, 1 técnico administrativo y 19 agentes sanitarios. Los entrevistados valoraron positivamente el trabajo de los médicos cooperantes cubanos y resaltaron su responsabilidad, ética y humanismo, así como la elevada calidad de las consultas médicas y sus buenas relaciones con los pares de la atención básica. Conclusiones. Se constataron diferencias en los patrones de atención de los médicos cooperantes cubanos del programa Mais Médicos con respecto a los médicos que ejercieron en las comunidades estudiadas antes de la implantación de ese programa. Entre los rasgos diferenciales de los médicos cubanos resaltados más frecuentemente figuran el compromiso con la población tanto en la consulta médica como en la solución de sus problemas, la empatía, el respeto y, en general, el humanismo con el que tratan a los pacientes.(AU)
Objective. To present the narratives of Brazilian members of family health teams with regard to the humanism perceived in the practice of Cuban physician cooperating in the Mais Médicos program. Methods. Cross-sectional descriptive case study. A semi-structured interview was applied to Brazilian members of family health teams who had worked from the beginning of the program with Cuban physicians in selected municipalities included in the Mais Médicos program (20% or more of the population in extreme poverty and less than five physicians or a rate of 0.5 physicians per 1, 000 population prior to the program). The data were processed using the content analysis technique. Results. Interviews were held with 30 senior nurses, 28 nursing assistants, one administrative technician, and 19 health agents. The interviewees offered a positive assessment of the work of the Cuban cooperating physicians, emphasizing theirresponsibility, ethics, and humanism, as well as the high quality of their medical consultations and their good relations with their peers in basic health care teams. Conclusions. There were confirmed differences between the patterns of care of the Cuban cooperating physicians in the Mais Médicos program and the physicians who were working before in the studied communities prior to implementation of that program. The differential features of the Cuban physicians most frequently mentioned include their commitment to the population (both in medical consultations and in solving people's problems), their empathy, their respect, and in general, the human values with which they treat patients.(AU)
Objetivo. Apresentar as narrativas dos integrantes brasileiros das equipes de saúde da família sobre o humanismo percebido na prática dos colaboradores cubanos do Programa Mais Médicos. Métodos. Trata-se de um estudo de caso descritivo transversal. Foi realizada uma entrevista semiestruturada com os integrantes brasileiros das equipes de saúde da família que trabalhavam desde o início do programa com médicos cubanos em municípios selecionados cadastrados no Programa Mais Médicos. Estas localidades têm 20% ou mais da população vivendo em situação de extrema pobreza, contando com menos de cinco médicos (taxa de 0,5 médico por 1.000 habitantes) antes do programa. Os dados foram analisados com o uso da técnica de análise de conteúdo. Resultados. Foram entrevistados 30 enfermeiros diplomados, 28 técnicos em enfermagem, 1 técnico administrativo e 19 agentes comunitários de saúde. Os participantes avaliaram de forma positiva o trabalho dos médicos colaboradores cubanos destacando características como responsabilidade, postura ética e humanismo bem como a alta qualidade das consultas médicas e o bom relacionamento com os pares da atenção básica. Conclusões. Foram constatadas diferenças no padrão de atenção dos médicos colaboradores cubanos do Programa Mais Médicos em relação aos médicos brasileiros que atuavam nas comunidades estudadas antes da implantação do programa. Entre as características distintivas dos médicos cubanos destacadas estão o compromisso com os pacientes, tanto na consulta médica quanto na solução de problemas, a empatia, o respeito e o humanismo em geral com que eles tratam os pacientes.(AU)
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Humanos , Educación Médica/ética , Médicos Graduados Extranjeros , Programas Nacionales de Salud , Relaciones Médico-Paciente , Atención Primaria de Salud , Brasil , CubaRESUMEN
ABSTRACT A spectrum of diverse prevention methods that offer high protection against HIV has posed the following challenge: how can national AIDS policies with high coverage for prevention and treatment make the best use of new methods so as to reverse the current high, and even rising, incidence rates among specific social groups? We conducted a narrative review of the literature to examine the prevention methods and the structural interventions that can have a higher impact on incidence rates in the context of socially and geographically concentrated epidemics. Evidence on the protective effect of the methods against sexual exposure to HIV, as well as their limits and potential, is discussed. The availability and effectiveness of prevention methods have been hindered by structural and psychosocial barriers such as obstacles to adherence, inconsistent use over time, or only when individuals perceive themselves at higher risk. The most affected individuals and social groups have presented limited or absence of use of methods as this is moderated by values, prevention needs, and life circumstances. As a result, a substantial impact on the epidemic cannot be achieved by one method alone. Programs based on the complementarity of methods, the psychosocial aspects affecting their use and the mitigation of structural barriers may have the highest impact on incidence rates, especially if participation and community mobilization are part of their planning and implementation.
RESUMO A existência de diferentes métodos preventivos que oferecem elevado grau de proteção contra o HIV tem trazido à luz um desafio: como países que proporcionaram ampla cobertura de prevenção e tratamento poderão utilizar novos métodos preventivos para reverter taxas de incidência que permanecem elevadas, até mesmo crescentes, em grupos sociais específicos? Realizamos uma revisão narrativa da literatura com a finalidade de examinar os métodos preventivos e as intervenções estruturais que, no contexto de epidemias concentradas populacional e geograficamente, podem ter maior impacto nas taxas de incidência. Com isso, analisamos o conhecimento acerca do grau de proteção dos diferentes métodos, seus limites e suas potencialidades. O alcance e a efetividade dos métodos têm sido minimizados, notadamente, por barreiras estruturais e psicossociais, como falhas de adesão, uso inconsistente ao longo do tempo ou apenas em situações em que as pessoas se percebem em maior risco. Indivíduos e grupos sociais mais atingidos pela epidemia têm limitado o uso e o não uso de métodos de acordo com seus valores, necessidades identificadas de prevenção e condições de vida. Isso impede que um método isoladamente venha a promover um forte impacto de redução na epidemia. Políticas baseadas na oferta conjunta e na complementaridade entre os métodos, na atenção aos aspectos psicossociais que interferem no seu uso e na redução das barreiras estruturais de acesso poderão ter maior impacto na incidência, especialmente se forem planejadas e implantadas com participação e mobilização social.
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Humanos , Infecciones por VIH/prevención & control , Conducta Sexual , Condones Femeninos , Factores de RiesgoRESUMEN
A partir de uma perspectiva antropológica e do desenvolvimento de um registro etnográfico entre grupos de mútua ajuda de pessoas vivendo com aids do Distrito Federal, o estudo busca compreender o funcionamento e os potenciais benefícios dessas tecnologias para a vivência com o vírus, em particular para adesão à medicação antirretroviral. A abordagem metodológica envolveu um processo de observação participante em um dos grupos e entrevistas com frequentadores e facilitadores. Como resultados do estudo, pode-se melhor compreender os mecanismos de interação dentro dos grupos, além de concluir pelo seu potencial para a melhoria dos níveis de adesão à terapia antirretroviral a partir do encontro entre pares...
Anthropological study carried out by ethnographic method within the members of two HIV support groups for people living with HIV/AIDS, in the city of Brasilia. The research aims to understand the potential benefits of these forms of social organization for facing the daily life with the virus and the contribution to antiretroviral adherence. The methodological approach focused on the development of ethnographic work which included techniques such as participant observation and interviews with members and group coaches. Results led to the identification of interacting mechanisms within health staff and people living with HIV/AIDS, the adoption of attitudes to deal with the drug prescription, and input provided by the group to improve adherence to ARV by highlighting the role of networking and peer support...
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Humanos , Masculino , Femenino , VIH , Cumplimiento de la Medicación , Conducta de Ayuda , Síndrome de Inmunodeficiencia Adquirida , Síndrome de Inmunodeficiencia Adquirida/terapia , Terapia Antirretroviral Altamente Activa , Antropología Cultural , Sistema Único de SaludRESUMEN
Identifica os conceitos e valores sobre o Sistema Único de Saúde (SUS), que vigoram entre profissionais de saúde de nível superior de um hospital secundário do Distrito Federal. O estudo busca explorar as dificuldades de implementação do SUS, considerando as distorções entre a esfera cognitiva e as diversas valorações acerca do SUS nesse contexto. Estudo descritivo exploratório baseado numa amostra definida por critérios de conveniência, tendo sido incorporados 28 sujeitos de pesquisa. O instrumento de coleta de dados foi um questionário estruturado com perguntas abertas e de múltipla escolha aplicado a vinte e oito trabalhadores de saúde de nível superior, lotados no Hospital Regional de Sobradinho, Secretaria de Estado de Saúde - Distrito Federal. Dentre os participantes do estudo, 97,9 por cento trabalham há mais de dez anos na instituição. Evidenciou-se o contraste entre os aspectos cognitivos e de valoração sobre o Sistema Único de Saúde. Ainda que os conhecimentos sobre a estrutura e o funcionamento do sistema de saúde tenham-se revelado apropriados, para a maioria dos profissionais, a imagem do Sistema Único de Saúde e a valoração de sua dinâmica de funcionamento mostram uma distorção entre conhecimentos e aspectos valorativos sobre o SUS no âmbito dos profissionais de saúde. Observou-se que entre os princípios do SUS o mais citadoem todas as categorias profissionais foi o princípio da universalidade. Quando perguntados se os serviços do SUS são prestados sem qualquer preconceito ou privilégio 53,6 por cento dos participantes responderam positivamente. Para a assertiva de que o SUS informa a população sobre os serviços e como utilizá-los, 67,9 por cento dos profissionais participantes discordaram. E finalmente sabe ser o SUS um sistema no qual se pode confiar, que dá segurança ao cidadão, 67,8 por cento discordaram. Embora o estudo apresente limitações da amostra em termos de sua representatividade, os resultados obtidos podem ser indicativos important...