Digital technology and its effects on knowledge improvement for diabetes management: An integrative review.

AIM: To evaluate the effectiveness of educational digital technology in improving patients' and health professionals' knowledge about diabetes management. BACKGROUND: The use of digital technologies has been expanding in recent years in several areas of healthcare and education. DESIGN: Integrative literature review. DATA SOURCES: The following databases were searched: PubMed, Lilacs, BDENF, Web of Science and SciELO (1 January 2016 and 31 December 2020). REVIEW METHODS: Titles and abstracts were screened and selected by independent reviewers based on eligibility criteria. A consensus was drawn on which articles should be included. Data were extracted using an instrument created by the authors, and the synthesis of knowledge was made by compiling the results in a table and identifying thematic axes. RESULTS: Seventy-one articles were retrieved, and after the final analysis, a total of 11 were included. Most studies have pointed out benefits from the use of digital technologies in diabetes education, with two thematic categories emerging: 'Digital technologies in the education of patients with diabetes' and 'Digital technologies in continuing professional education in diabetes'. CONCLUSION: The use of digital technologies is beneficial and effective both for continuing professional education and educating patients about diabetes management.

E-MunDiabetes: A Mobile Application for Nursing Students on Diabetes Education During the COVID-19 Pandemic.

The COVID-19 pandemic caused tremendous disruption of health systems worldwide. Patients with diabetes are at a high risk of COVID-19 exposure because face-to-face consultations have been standard for diabetes management. This study describes the development and validation of a mobile application for nursing students on diabetes education during the COVID-19 pandemic. The application was developed by a certified diabetes educator nurse and by a freelance programmer and, in the next step, validated in terms of content and appearance by a group of expert nurses on diabetes (n = 29), nursing students (n = 40), and information technology experts (n = 11). Validity indexes of 0.99 for content and 0.92 for appearance were obtained, and usability values of 78.9 (±15.3) and 78.2 (±10.8) were obtained from nursing and information technology experts, respectively. The self-assessment and satisfaction items evaluated by nursing students had a total agreement of 96.3% and an intraclass correlation coefficient of 0.91. Both the content and the appearance of the application were considered adequate, and the usability scores indicate that the application is useful and easy to use.

Analyzing the concept of disruptive behavior in healthcare work: an integrative review.

OBJECTIVE: To analyze the concept of disruptive behavior in healthcare work. METHOD: An integrative review carried out in the theoretical phase of a qualitative research substantiated by the theoretical framework of the Hybrid Model of Concept Development. The search for articles was conducted in the CINAHL, LILACS, PsycINFO, PubMed and SciVerse Scopus databases in 2013. RESULTS: 70 scientific articles answered the guiding question and lead to attributes of disruptive behavior, being: incivility, psychological violence and physical/sexual violence; with their main antecedents (intrapersonal, interpersonal and organizational) being: personality characteristics, stress and work overload; and consequences of: workers' moral/mental distress, compromised patient safety, labor loss, and disruption of communication, collaboration and teamwork. CONCLUSION: Analysis of the disruptive behavior concept in healthcare work showed a construct in its theoretical stage that encompasses different disrespectful conduct adopted by health workers in the hospital context, which deserve the attention of leadership for better recognition and proper handling of cases and their consequences. OBJETIVO: Analisar o conceito comportamento destrutivo no trabalho em saúde. MÉTODO: Revisão integrativa realizada na fase teórica de pesquisa qualitativa fundamentada pelo referencial teórico-metodológico do Modelo Híbrido de Análise de Conceitos. A busca dos artigos foi realizada nas bases de dados CINAHL, LILACS, PsycINFO, PubMed e SciVerse Scopus, em 2013. RESULTADOS: 70 artigos científicos responderam à questão norteadora e atenderam aos critérios de inclusão, permitindo evidenciar os atributos do comportamento destrutivo: incivilidade, violência psicológica e violência física/sexual; seus principais antecedentes (intrapessoais, interpessoais e organizacionais): características de personalidade, estresse e sobrecarga de trabalho; e consequentes: sofrimento moral/psíquico dos trabalhadores, comprometimento da segurança do paciente, prejuízos laborais, rompimento da comunicação, da colaboração e do trabalho em equipe. CONCLUSÃO: A análise do conceito comportamento destrutivo no trabalho em saúde evidenciou, em sua fase teórica, um constructo que abrange diferentes condutas desrespeitosas adotadas por trabalhadores de saúde no contexto hospitalar, merecendo atenção de lideranças da área para maior reconhecimento e manejo adequado dos casos e suas consequências.

Evaluating the intervening factors in patient safety: focusing on hospital nursing staff.

OBJECTIVE: To evaluate intervening factors in patient safety, focusing on hospital nursing staff. METHOD: The study is descriptive, with qualitative approach, excerpt from a larger study with analytical nature. It was undertaken in a public hospital in Fortaleza, CE, Brazil, between January and June 2013, with semi-structured interviews to 70 nurses, using Thematic Content Analysis. RESULTS: The principal intervening factors in patient safety related to hospital nursing staff were staff dimensioning and workload, professional qualification and training, team work, being contracted to the institution, turnover and lack of job security, and bad practice/disruptive behaviors. These aspects severely interfere with the establishment of a safety culture in the hospital analyzed. CONCLUSION: It is necessary for managers to invest in nursing staff, so that these workers may be valued as fundamental in the promotion of patient safety, making it possible to develop competences for taking decisions with focus on the improvement of quality care.

The importance of logical thinking for clinical nursing care.

OBJECTIVE: To present a reflection on the importance of logical thinking for clinical nursing care. METHOD: Reflection paper. REFLECTION: The exercise of an effective clinical care brings with it the need for logical thinking and adequate reasoning for safe and effective nursing practices. Therefore, training based on philosophical principles that encourage the increase of logical and critical thinking is considered unquestionable, ensuring professionals the systematization of assistance with the application of the nursing process based on scientific understanding and strong arguments supported by the path of truthfulness, morality, ethics and critical self-reflection in order to value clinical practices. FINAL CONSIDERATIONS: The importance of logical thinking for nursing care is ratified here, supporting nursing care systematization and the nursing process stages. Thus, nurses can use clinical reasoning skills to deliver a humane, ethical, and effective professional performance.

[Theoretical-logical model and judgment matrix of the effectiveness of the Expanded Family Health and Basic Healthcare Centers]. / Construção de modelo teórico-lógico e matriz de julgamento para avaliação da efetividade do Núcleo Ampliado de Saúde da Família e Atenção Básica.

Primary health care requires work processes guided by collaborative inter-professional action to respond to health care needs. The Expanded Family Health and Basic Healthcare Center (NASF-AB) acts as an important device to expand the possibilities of care in this scenario. This study aims to describe the process of constructing a theoretical-logical model and judgment matrix to evaluate the effectiveness of the NASF-AB. Evaluative study, with a descriptive-qualitative approach using documentary research, in which 11 documents regulating the work process of NASF-AB were selected to support the theoretical-logical model. For the elaboration of the judgment matrix to evaluate the effectiveness of NASF-AB, we considered the fundamental concepts and expected competencies, with the definition of indicators and criteria for a staggered evaluation, which allows classifying the NASF-AB as effective, potentially effective, low effectiveness, and non-effective. Both the structuring of the model and the application of the matrix and its graphic expression are instruments that support the ideal functioning of the NASF-AB, being able to guide decision-making in the management and work process, in the care and pedagogical dimensions. The products of this investigation constitute theoretical and methodological devices to support the evaluation of the effectiveness of NASF-AB and to identify the weaknesses and potencies of its performance.

A atenção básica requer processos de trabalho orientados pelo agir interprofissional colaborativo para responder às necessidades de saúde. O Núcleo Ampliado de Saúde da Família e Atenção Básica (NASF-AB) atua como importante dispositivo para ampliar as possibilidades de cuidado nesse cenário. Objetiva-se descrever o processo de construção de um modelo teórico-lógico e matriz de julgamento para avaliação da efetividade do NASF-AB. Foi realizado um estudo avaliativo, de abordagem descritivo-qualitativa com uso de pesquisa documental, em que foram selecionados 11 documentos regulamentadores do processo de trabalho do NASF-AB para subsidiar o modelo teórico-lógico. Na elaboração da matriz de julgamento para avaliação da efetividade do NASF-AB, consideraram-se os conceitos fundamentais e as competências esperadas, com a definição de indicadores e critérios para uma avaliação escalonar, a qual permite classificar o NASF-AB em efetivo, potencialmente efetivo, com baixa efetividade e não efetivo. Tanto a estruturação do modelo quanto a aplicação da matriz e sua expressão gráfica são instrumentos que subsidiam o funcionamento ideal do NASF-AB, sendo capazes de orientar a tomada de decisão na gestão e no processo de trabalho, nas dimensões assistencial e pedagógica. Os produtos desta investigação se constituem em dispositivos teórico-metodológicos para subsidiar a avaliação da efetividade do NASF-AB e permitir identificar insuficiências e potências de sua atuação.

La atención primaria requiere procesos de trabajo guiados por la acción colaborativa interprofesional para satisfacer las necesidades de salud. El Núcleo Ampliado de Salud Familiar y Atención Básica (NASF-AB) actúa como un importante dispositivo para ampliar las posibilidades de atención en este escenario. El objetivo es describir el proceso de construcción de un modelo teórico-lógico y una matriz de evaluación de la eficacia del NASF-AB. Estudio evaluativo de abordaje descriptivo-cualitativo con uso de investigación documental, en el que se seleccionaron 11 documentos reguladores del proceso de trabajo del NASF-AB para subsidiar el modelo teórico-lógico. Para la elaboración de la matriz de evaluación para la evaluación de la eficacia del NASF-AB, se consideraron los conceptos fundamentales y las competencias esperadas, con la definición de indicadores y criterios para una evaluación escalonada que permite clasificar el NASF-AB en eficaz, potencialmente eficaz, poco eficaz y no eficaz. Tanto la estructuración del modelo como la aplicación de la matriz y su expresión gráfica son instrumentos que subsidian el funcionamiento ideal del NASF-AB, pudiendo orientar la toma de decisiones en la gestión y en el proceso de trabajo, en las dimensiones asistencial y pedagógica. Los resultados de esta investigación se constituyen en dispositivos teórico-metodológicos para subsidiar la evaluación de la eficacia del NASF-AB y permitir la identificación de insuficiencias y potencialidades de su actuación.

Digital technologies in the care of people with diabetes during the COVID-19 pandemic: a scoping review.

OBJECTIVE: To map evidence on the use of digital technologies in the care of people with diabetes during the COVID-19 pandemic. METHOD: This is a scoping review, based on the JBI manual, which included scientific articles and gray literature from nine primary and seven secondary databases. Articles were independently assessed by two reviewers. Rayyan® was used to select the studies. The description of study characterization is presented in a table and tables, ending in a narrative synthesis. RESULTS: A total of 1,964 studies were identified and, after selection, 23 publications remained for analysis. It turned out that telemedicine was used in all studies and remote consultation support technologies included continuous glucose monitoring devices, glucose data analysis software, insulin delivery systems, applications, audio and/or voice communication devices, which facilitated remote diabetes mellitus monitoring and management. CONCLUSION: Telehealth, monitoring technologies, insulin delivery systems and communication devices were tools used to monitor patients with diabetes during the pandemic.

Competences in health promotion in the environmental education practices of community health agents.

OBJECTIVE: To recognize the domains of competencies in promoting health in the environmental education practices performed by community health agents. METHOD: A mixed study, which adopted the Developing Competencies and Professional Standards for Health Promotion Capacity Building in Europe (CompHP) as a theoretical framework, conducted in Crato, Ceará, with 16 community health agents, based on semi-structured interviews and data organization through the ALCESTE software. RESULTS: The following domains of competencies in health promotion were evidenced: partnership, possibility of changes, and diagnosis. We recognize evidence signaling other domains, although with less statistical significance, such as: communication, planning and implementation, with a view to developing environmental education activities. FINAL CONSIDERATIONS: There is a mobilization of a limited number of health promotion competences in the environmental education practices developed by community health agents, which requires the wholeness of these elements to implement health promotion practices and, thus, positive transformations on the environment and health.

[Analysis of managerial work of the nurse in basic health units]. / Análise da atuação do enfermeiro na gerência de unidades básicas de saúde.

The purpose was to analyse the managerial work of the nurse, to know nurses' actions, to verify the importance towards the planning and to identify some factors that interfere in the management. A descriptive research was accomplished in 10 basic health units in Fortaleza, CE, Brazil, with 10 nurses. Data collection was carried aout in january 2008, by means of a structured interview. Most of the nurses were female between 37 and 57 years-old. For seven nurses the management of people and the planning are the most important aspects. Some difficulties about the incomplete composition of the teams, lack of professional ability and low financial resource were reported. This research gathers information for knowledge and analisys of the management actions of the nurses in the basic atention.

Professional skills for health promotion in caring for tuberculosis patients.

OBJECTIVES: to understand the health promotion skills found in the speeches of health practitioners in care for TB patients. METHODS: qualitative study, developed with seven practitioners involved in care for TB patients, identified from a sociocentric approach, whose speeches were submitted to analysis based on the health promotion skills model in the Galway Consensus. RESULTS: there were four domains: Catalyzing change; Leadership; Planning; and Partnerships. These domains resulted from health education actions, contribution of management nursing practitioners, seeking to meet patients' needs and articulation of professional sectors. FINAL CONSIDERATIONS: there were some skill domains in the speeches of health practitioners, with the nurse being quoted in the development of essential skills for health promotion activities, such as catalyzing change and leading care for TB patients.

Temporal trend of leprosy in a region of high endemicity in the Brazilian Northeast.

OBJECTIVE: to analyze the temporal trend and epidemiological patterns of leprosy indicators in Sobral, a municipality countryside of the state of Ceará, from 2001 to 2016. METHOD: a time series study based on data from the Department of Informatics of the Unified Health System. The time trend analysis was performed using the join point regression model. RESULTS: There were 2,220 new cases of leprosy in Sobral from 2001 to 2016. Of these, 158 (7.2%) in children younger than 15 years of age, the proportion of new male cases was 52.8% (1,162), cases with grade 2 were 7.0% (156), and proportion of cases diagnosed by contact examination 5.7% (126). FINAL CONSIDERATIONS: leprosy remains hyperendemic in adults and children, demonstrating the character of neglected disease. Analysis of the temporal trend allowed to verify that the instability in the detection coefficients, reflect operational problems in the organization of the services.

[International research in nursing: thematic and methodological tendencies]. / Pesquisa internacional em enfermagem: tendências temáticas e metodológicas.

It was aimed to analyze the research tendency developed by nursing in international scope. Obtained data of two nursing journals were analyzed from the total of 104 articles, being 58 of the Nursing and Health Sciences and 48 of the Journal of Research in Nursing published in the period of 2005 the 2006. The most investigated thematic areas are: professional formation (19.2%), adult health (11%), collective health (11%) and Care and Autonomy (9.6%). A major tendency of data collection carried outin hospital area (42.3%), teaching (34.7%), and public health (23%). We consider that the articles under analysis reveal tendency for qualitative approach, however, the study reveals the need to expand some areas such as the management.

[Reflections about the use of counseling in HIV/AIDS under the perspective of Freire]. / Reflexões sobre o aconselhamento em HIV/AIDS em uma perspectiva freireana.

This reflection intended to analyze the counselling starting from the vision of the Freire's pedagogy visualizing it in a wider way, as an education activity, an intervention act for the subject's autonomy. The counselling is an activity developed by a Health professional, properly, and it is destined to who has indication of accomplishing the anti-HIV. In the ambit of the epidemic of HIV/AIDS, the counselling contains three components: the emotional support to the customer; educational support; and evaluation of risks, that propitiates the reflection on values, attitudes and conducts. In that way, they will avoid to be he turned into a no obligation 'chat' and led according to the counselor's will.

Identity of primary health care nurses: perception of "doing everything".

OBJECTIVE: To analyze, in the speeches of nurses, the habitus that conforms their professional identity in the primary health care area. METHOD: Qualitative study, carried out from March to October 2015, with nurses of primary healthcare units in the cities of Cajazeiras, in the state of Paraíba, and Maracanaú, in the state of Ceará. Data were collected by means of semi-structured interviews, and analyzed through discourse analysis. RESULTS: Nurses, in their practice and perception, perceive that professional identity is linked to the meaning that involves the word "everything". This situation constitutes a habitus that directs the range of daily actions, often distant from the profession's core of knowledge. FINAL CONSIDERATIONS: Trying to be and do everything in primary health care involves negative repercussions in the professional identity of nurses. Strategic guidance is necessary in order to achieve and embrace elements that reflect the essence of this category.

Brazilian Unified Health System and democracy: nursing in the context of crisis.

OBJECTIVE: to discuss, taking for reference the crisis in Brazil and its impact on public health policies, the insertion of Brazilian nursing in that context and its ways of practicing the profession, based on the study about the politicality of care. METHOD: the reflection is divided into two topics, the first is about public policies, the Brazilian Unified Health System and the deconstruction of the right to health with neoliberal offensive; and the second is about the nursing political action in the fight for the right to health and for democracy. FINAL CONSIDERATIONS: we emphasize that nursing must assume its sociopolitical role to contribute to the construction of a better and fairer Brazil, saying no to neoliberal reforms, as well as fighting for rights already acquired and for the resumption of the democratic stability in the country.

Análise dos indicadores de gestão do serviço de atendimento móvel de urgências do ceará / Analysis of the management indicators of the mobile emergency care service of ceará / Análisis de los indicadores de gestión del servicio móvil de atención de urgencias de ceará

RESUMO Objetivo: analisar os indicadores de gestão em saúde relacionados ao serviço de atendimento móvel de urgências do Ceará. Método: trata-se de um estudo documental, retrospectivo, de abordagem quantitativa, realizado no sítio eletrônico IntegraSUS do governo do estado do Ceará - Brasil, no período de julho de 2021, para análise dos indicadores "total de chamadas" e "tempo médio de resposta". Resultados: verificou-se um perfil de chamadas prevalentes para homens (52,66%), com idade avançada >70 anos (22,06%), ocorrências de atendimento Covid-19 para a Central Juazeiro (7,62%) e acidentes por motocicleta para a Central Eusébio (7,94%). O serviço obteve chamados para 177 municípios cearenses (96,19%) com tempo médio de resposta maior para Covid-19. Conclusão: a análise sinaliza a necessidade de ajuste das estratégias para melhorar o desempenho do tempo-resposta do serviço, com revisão do sistema organizacional, inclusive, da publicização dos dados pela plataforma digital.

ABSTRACT Objective: To analyze the health management indicators related to the mobile emergency care service in Ceará. Method: This is a documentary, retrospective, quantitative study, carried out on the IntegraSUS website of the Ceará state government - Brazil, during the period July 2021, to analyze the indicators "total calls" and "average response time". Results: It was verified a profile of prevalent calls for men (52.66%), with advanced age >70 years (22.06%), Covid-19 service occurrences for the Juazeiro central station (7.62%) and motorcycle accidents for the Eusébio central station (7.94%). The service got calls for 177 cities in Ceará (96.19%) with a longer average response time for Covid-19. Conclusion: The analysis signals the need to adjust strategies to improve the performance of the service response time, with a review of the organizational system, including the publication of data by the digital platform.

RESUMEN Objetivo: analizar los indicadores de gestión de salud relacionados con el servicio móvil de atención de urgencias en el Estado de Ceará. Método: se trata de un estudio documental, retrospectivo, de abordaje cuantitativo, realizado en el sitio IntegraSUS del gobierno del estado de Ceará - Brasil, en el período de julio de 2021, para el análisis de los indicadores "total de llamadas" y "tiempo medio de respuesta". Resultados: se verificó un perfil de prevalencia de llamadas para hombres (52,66%), con edad avanzada >70 años (22,06%), ocurrencias de asistencia del Covid-19 para la Central Juazeiro (7,62%) y accidentes de motocicleta para la Central Eusébio (7,94%). El servicio obtuvo llamadas para 177 municipios de Ceará (96,19%) con un tiempo medio de respuesta mayor para Covid-19. Conclusión: el análisis señala la necesidad de ajustar las estrategias para mejorar el rendimiento del tiempo de respuesta del servicio, con una revisión del sistema organizativo, incluida la publicación de datos por la plataforma digital.

Melhorando a autogestão do diabetes durante a pandemia de COVID-19: uma revisão de escopo / Improving diabetes self-management during the COVID-19 pandemic: a scoping review

OBJETIVO: Sintetizar evidências disponíveis sobre ações de enfermagem para melhorar a autogestão do diabetes durante a pandemia de COVID-19. MÉTODO: Revisão de escopo usando a metodologia Joanna Briggs Institute (JBI) e o Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Identificaram-se estudos acadêmicos e literatura cinzenta de sete bases de dados primárias e seis secundárias. Dois revisores avaliaram os estudos e os dados foram analisados ​​descritivamente. RESULTADOS: Foram identificados 1.322 títulos, dos quais 31 estudos foram incluídos. Os estudos foram publicados em 2020, principalmente em inglês. A teleconsulta foi uma estratégia relevante para ajudar os pacientes a controlar o diabetes e sua saúde. CONCLUSÃO: A revisão indica que ações de enfermagem realizadas durante a pandemia para melhorar a autogestão do diabetes não foram diferentes do que está consolidado, mas algumas adaptações foram realizadas. A necessidade de autocuidado, apoio social e uma abordagem centrada no paciente é reforçada.

OBJECTIVE: To synthesize the available evidence on nursing-based actions to improve diabetes self-management during the COVID-19 pandemic. METHOD: Scoping review using the Joanna Briggs Institute methodology (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The research covered academic studies and gray literature from seven primary and six secondary databases. Two independent reviewers assessed the studies, and the data were analyzed descriptively. RESULTS: A total of 1,322 titles were identified, of which 31 studies were included. All studies were published in 2020, mainly in English. Teleconsultation was a relevant strategy to help patients manage diabetes and their general health. CONCLUSION: The review indicates that the nursing-based actions carried out during the COVID-19 pandemic to improve diabetes self-management are not different from what has been consolidated, but some adaptations have been undertaken. The need for self-care, social support, and a collaborative and patient-centered approach is reinforced.

Efeito da consulta de enfermagem na promoção de práticas seguras em insulinoterapia: estudo retrospectivo / The effect of nursing consultation on the promotion of safe practices in insulin therapy: a retrospective study

OBJETIVO: Analisar a correlação entre a consulta de enfermagem e o cumprimento de ações de autocuidado e práticas seguras em insulinoterapia por pessoas com diabetes. MÉTODO: Estudo observacional, retrospectivo e analítico. Analisaram-se características sociodemográficas e clínicas e acertos em questionário com 16 itens sobre práticas seguras em insulinoterapia, aplicado na primeira e segunda consulta de enfermagem. RESULTADOS: Constatou-se aumento significativo de acertos no questionário nos aspectos relacionados à insulinoterapia na segunda consulta (14,22±1,59), em comparação com a primeira (9,24±3,13) (p<0,001), sugerindo melhoria do autocuidado e da adesão às práticas seguras em insulinoterapia. CONCLUSÃO: Houve melhora do cumprimento de ações de autocuidado e práticas seguras em insulinoterapia, após as consultas de enfermagem, mostrando que essa intervenção é eficaz para promoção do tratamento insulínico adequado.

OBJECTIVE: To analyze the correlation between nursing consultation and the execution of self-care actions and safe practices in insulin therapy by people with diabetes. METHOD: Observational, retrospective, and analytical study. Sociodemographic and clinical characteristics and correct answers in a questionnaire with 16 items on safe practices in insulin therapy, applied in the first and second nursing consultations, were analyzed. RESULTS: There was a significant increase in the number of correct answers in the questionnaire regarding aspects related to insulin therapy in the second consultation (14.22±1.59) compared to the first (9.24±3.13) (p<0.001), suggesting improvement in self-care and adherence to safe practices in insulin therapy. CONCLUSION: There was an improvement in the execution of self-care actions and safe practices in insulin therapy after the nursing consultations, showing that this intervention effectively promotes adequate insulin treatment.

[The National Health Promotion Policy: an evaluability assessment in a health region in Brazil]. / Política Nacional de Promoção da Saúde: um estudo de avaliabilidade em uma região de saúde no Brasil.

The National Health Promotion Policy (PNPS) is based on the broadened concept of health and presents the promotion of health as a set of strategies and ways of promoting health, both individually and collectively with responsibilities for the three federated entities. The scope of this study was to develop an evaluability assessment of the PNPS. It is a qualitative-based evaluability assessment conducted in a health region in the Brazilian Northeast in the year 2013. Participants in the study were 18 key informants directly involved in PNPS implementation, of which eight are municipal health secretaries, six are coordinators of primary health care, two are coordinators of epidemiological surveillance, a general regional coordinator and a regional primary care coordinator. The semi-structured interview and the legal documents of the policy were used for gathering information from 2006 to 2012. The construction of the logical model made it possible to reflect on the possible influences of the context on the PNPS implementation. The results showed that PNPS is not yet sufficiently established in the health region and pointed to the need to incorporate specific monitoring and evaluation instruments for this policy.

A Política Nacional de Promoção da Saúde (PNPS) baseia-se no conceito ampliado de saúde e apresenta sua promoção como um conjunto de estratégias e formas de produzir saúde, no âmbito individual e coletivo com responsabilidades para os três entes federados. Trata-se de estudo de avaliabilidade com abordagem qualitativa, realizada em uma região de saúde no nordeste brasileiro no ano de 2013. Participaram do estudo 18 informantes-chave envolvidos diretamente com a execução da PNPS, sendo que oito são secretários municipais de saúde, seis são coordenadores da atenção básica, dois coordenadores da vigilância epidemiológica, um coordenador regional geral e um coordenador regional da atenção básica. Foram utilizadas para a coleta de informações a entrevista semiestrutrurada e os documentos legais da política no período de 2006 a 2012. A construção do modelo lógico permitiu refletir sobre as possíveis influências do contexto sobre a implementação da PNPS. Os resultados demonstraram que a PNPS ainda não está suficientemente implantada na região de saúde e sinalizaram para a necessidade de incorporação de instrumentos de monitoramento e avaliação específicos para esta política.

Qualidade da formação em enfermagem: análise a partir de dados do sistema nacional de avaliação / Quality of nursing graduation: analysis from data from a national assessment system / Calidad de la educación en enfermería: análisis basado en datos de un sistema nacional de evaluación

Objetivo: Analisar a qualidade da formação em Enfermagem no Ceará, Brasil. Métodos: Estudo descritivo, retrospectivo, de abordagem quantitativa, a partir dos resultados do Exame Nacional de Desempenho dos Estudantes e do Conceito Preliminar de Cursos. Foram incluídas todas as Instituições de Ensino Superior que dispunham de cursos de Enfermagem e que obtiveram nota no Exame Nacional de Desempenho até 2017. Resultados: No Ceará, existem 65 cursos de Enfermagem, sendo seis públicos (9,2%) e 59 privados (90,8%). As instituições públicas apresentam melhores resultados no Exame Nacional de Desempenho, no entanto, as privadas apresentam melhores notas nos quesitos estrutura e oportunidades de ampliação da formação. Entre os 21 cursos, apenas 10 possuem conceito 4 e 5 no Exame Nacional de Desempenho e, também, no Conceito Preliminar de Cursos. Apenas 3 obtiveram conceito menor que 3 no Exame Nacional de Desempenho e todos obtiveram conceito igual ou maior que 3 no Conceito Preliminar de Cursos. Conclusão: A partir dos critérios estabelecidos pelo Ministério da Educação, os cursos de Enfermagem do Ceará podem ser considerados de qualidade, no entanto há que se refletir até que ponto os profissionais oriundos de instituições com notas 3 estão preparados para atender as demandas de saúde da população. (AU)

Objective: To analyze the quality of nursing education in Ceara, Brazil. Methods: Descriptive, retrospective study with a quantitative approach, based on the results of the National Student Performance Examination and the Preliminary Concept of Courses. All Higher Education Institutions that had Nursing courses and that obtained a grade in the National Performance Examination until 2017 were included. Results: In Ceará, there are 65 Nursing courses, six of which are public (9.2%) and 59 private (90.8%). Public institutions present better results in the National Performance Examination, however, private ones' present better marks in terms of structure and opportunities for training expansion. Among the 21 courses, only 10 have grade 4 and 5 in the National Performance Exam and also in the Preliminary Concept of Courses. Only 3 obtained a grade lower than 3 in the National Performance Examination and all obtained grade equal to or higher than 3 in the Preliminary Concept of Courses. Conclusion: Based on the criteria established by the Ministry of Education, nursing courses in the State of Ceará can be considered of quality, however, it is necessary to reflect to what extent professionals from institutions with grades 3 are prepared to meet the health demands of population. (AU)

Objetivo: Analizar la calidad de la educación en enfermería en Ceará, Brasil. Métodos: Estudio descriptivo, retrospectivo con enfoque cuantitativo, basado en los resultados del Examen Nacional de Desempeño del Estudiante y el Concepto Preliminar de Cursos. Se incluyeron todas las Instituciones de Educación Superior que contaban con cursos de Enfermería y que obtuvieron calificación en el Examen Nacional de Desempeño hasta 2017. Resultados: En Ceará, hay 65 cursos de Enfermería, seis de los cuales son públicos (9,2%) y 59 privados (90,8%). Las instituciones públicas presentan mejores resultados en el Examen Nacional de Desempeño, sin embargo, las instituciones privadas presentan mejores calificaciones en términos de estructura y oportunidades para ampliar la formación. De los 21 cursos, solo 10 tienen 4º y 5º grado en el Examen Nacional de Desempeño y también en el Concepto Preliminar de Cursos. Solo 3 obtuvieron una calificación inferior a 3 en el Examen Nacional de Desempeño y todos obtuvieron una calificación igual o superior a 3 en el Concepto Preliminar de Cursos. Conclusión: Con base en los criterios establecidos por el Ministerio de Educación, los cursos de enfermería en el Estado de Ceará pueden ser considerados de calidad, sin embargo es necesario reflexionar en qué medida los profesionales de instituciones con grado 3 están preparados para atender las demandas de salud de la población. (AU)