ABSTRACT
Resumo O objetivo deste estudo foi avaliar a tendência temporal da qualidade da atenção à saúde da criança na consulta da primeira semana de vida no nível da Atenção Primária à Saúde, segundo características dos municípios, do processo de trabalho das equipes e das usuárias responsáveis pelas crianças. Foram realizadas análises transversais com dados dos três ciclos do Programa Nacional de Melhoria do Acesso e da Qualidade (PMAQ) (2012, 2014 e 2018). Usuárias adultas com filhos de até dois anos foram entrevistadas. O desfecho foi a "boa qualidade da atenção à saúde na primeira semana de vida". Foram realizadas análises descritivas e de tendência temporal por meio de regressão de mínimos quadrados ponderados por variância. A frequência de boa qualidade na consulta da primeira semana de vida foi 47,9% (IC95% 46,6-49,3) em 2012, 52,5% (IC95% 51,3-53,7) em 2014 e 53,3% (IC95% 52,2-54,4) em 2018, com um aumento anual de 0,73 ponto percentual (p<0,001). O aumento anual foi maior na região Nordeste (2,06 pp) e com IDH muito baixo/baixo (1,48 pp) e com 100% de cobertura de ESF (0,98 pp). Ao longo dos três ciclos do PMAQ-AB houve uma evolução favorável na frequência da boa qualidade na atenção à saúde na primeira semana de vida.
Abstract The aim of this study was to assess temporal trends in the quality of health care during the first-week child check-up in primary care services stratified by municipal, health team and maternal characteristics. We conducted a cross-sectional study using data from the three cycles of the National Program for the Improvement of Access and Quality (PMAQ) (2012, 2014 and 2018). Adult service users with children aged up to 2 were interviewed. The outcome was "good quality health care in the first week of life". Descriptive and time trend analyses were performed using variance-weighted least squares regression. The frequency of good quality care during the first-week check-up was 47.9% (95%CI 46.6-49.3) in 2012, 52.5% (95%CI 51.3-53.7) in 2014 and 53.3% (95%CI 52.2-54.4) in 2018, with an annual increase of 0.73 pp (p<0.001). The annual increase was greater in the Northeast (2.06 pp) and in municipalities with very low/low HDI (1.48 pp) and 100% family health strategy coverage (0.98 pp). Trends in the frequency of good quality health care during the first-week child check-up were favorable.
ABSTRACT
Abstract Objectives: to know the perception of parents of newborns regarding the support received from the nursing team during their child's hospitalization. Methods: prospective study. Sample of 127 mothers and fathers of newborns hospitalized for at least 72 hours in neonatal units of a hospital in the southern region of Brazil. Data collected from May to September 2018 through application of a proposed questionnaire and consultation of medical records. Descriptive and analytical statistics were used. Results: participants were aged 28.2 (SD = 6.8) years, mostly composed of mothers (76.4%), primiparous (51.2%). Full support was declared by 66.0% of participants in the appreciative domain and 65.5% in the instrumental, 51.7% in the informational and 46.2% in the emotional domains. Mothers declared they felt supported mainly in the instrumental (p=0.009) and informational (p=0.039) domains. There was a positive correlation between the emotional, appreciative and informational domains (p<0.001). Conclusion: for most participants, in the informational domain, there was a demand for knowledge provided by the team, inclusion in decisions and encouragement to ask questions; in the emotional, there was concern for wellbeing and attention to anguish. Greater support for parents in the informational and emotional domains must be reinforced with the use of training strategies for the nursing team.
Resumo Objetivos: conhecer a percepção dos pais de neonatos quanto ao apoio que recebem da equipe de Enfermagem durante a hospitalização do seu filho. Métodos: estudo prospectivo. Amostra de 127 mães e pais de neonatos internados por, no mínimo, 72 horas em unidades de neonatologia de um hospital da região Sul do Brasil. Dados coletados de maio a setembro de 2018, por meio da aplicação de questionário proposto e consulta a prontuários. Estatísticas descritiva e analítica foram utilizadas. Resultados: participantes com idade de 28,2 (DP=6,8) anos, maioria composta por mães (76,4%), primíparas (51,2%). Participantes declararam pleno apoio em 66,0% no domínio apreciativo, 65,5% no instrumental, 51,7% no informativo e 46,2% no emocional. Mães declararam-se apoiadas principalmente nos domínios instrumental (p=0,009) e informativo (p=0,039). Houve correlação positiva entre os domínios emocional, apreciativo e informativo (p<0,001). Conclusão: para a maioria dos participantes, no domínio informativo, houve demanda de conhecimento fornecido pela equipe, inclusão nas decisões e estímulo em realizar perguntas; no emocional, preocupação com bem-estar e atenção para angústias. Maior apoio aos pais nos domínios informativo e emocional deve ser reforçado com estratégias de capacitação para equipe de Enfermagem.
Subject(s)
Humans , Male , Female , Infant, Newborn , Parents , Perception , Professional-Family Relations , Quality of Health Care , Neonatal Nursing , Nursing, Team , Brazil , Intensive Care, Neonatal , Family Health , HospitalizationABSTRACT
BACKGROUND: Patients' perceptions of care tend to correlate with the quality of care provided. Different health care systems and service environments may show different associations between types of usual source of care (USC) and overall service quality assessment. We attempted to analyze this association as a benefit of having a USC. METHODS: This study used the 2012 Korea Health Panel data version 1.1 as representative national household survey data. The total number of subjects aged 18 years or more was 12,708. The number of subjects in the final analysis was 10,665. Multiple logistic regression analysis was used to assess the association between types of USC and overall health care service quality. The main outcome variable was users' ratings of the quality of health care service. RESULTS: People having a usual doctor (n=1,796) were more likely to positively assess the quality of health care they received than those not having a USC (n=7,920; odds ratio [OR], 1.39; 95% confidence interval [CI], 1.20–1.60) or with those having only a place as a USC without a usual doctor (n=949; OR, 1.29; 95% CI, 1.05–1.58) after adjustment for demographic characteristics and health-related variables. CONCLUSION: People having a usual doctor rated overall health care service quality as high, which might be due to benefits of primary care attributes related to usual doctors. Further studies are needed to elucidate the causal relationship. This finding implies that health policies encouraging people to have a usual doctor are needed in Korea.
Subject(s)
Delivery of Health Care , Family Characteristics , Health Policy , Korea , Logistic Models , Odds Ratio , Primary Health Care , Quality Assurance, Health Care , Quality of Health Care , Surveys and QuestionnairesABSTRACT
BACKGROUND: To prevent medically significant errors, hospital laboratories must perform thorough statistical quality control (QC) procedures. We surveyed the QC status of small laboratories and created new statistical QC software that they can easily use for improving QC. METHODS: A questionnaire on the status of external and internal QC was created and sent to clinics and hospitals with small-scale laboratories. We then created QC software that can be downloaded and installed for free. RESULTS: External quality assessments were performed in 32% of the clinics (22 of 66) and 52% of the hospitals (12 of 23). Seventy-three percent of all institutions (66 of 90) carried out an internal quality assessment based on their own guidelines, mostly using commercialized QC materials. However, only 52% of clinics and 23% of hospitals used their own acceptable range instead of the manufacturer's expected range. In addition, the proportion of manual QC management reached 52% in clinics and 82% in hospitals. The QC software we designed covers all the basic functions of statistical QC and aims to improve the quality of laboratories. CONCLUSIONS: We obtained basic data on the current status of external and internal QC in small-scale laboratories using this survey. Furthermore, we suggested that new QC software may actually help to improve QC of small laboratories.