Mayor uso de teleconsultas programadas y mensajería asincrónica del portal en atención primaria / Increased Use of Scheduled Teleconsultations and Asynchronous Portal Messaging in Primary Care

Introducción: durante la pandemia de COVID-19 hubo un auge sin precedentes de la telemedicina, probablemente por la forzada adopción de tecnología ante las medidas restrictivas. El presente estudio se propuso comparar la interacción y la comunicación entre médicos de cabecera (MC) y pacientes, antes y durante el período de pandemia, en términos de consultas ambulatorias programadas y mensajes del Portal de Salud. Materiales y métodos: corte transversal con muestreo consecutivo de turnos programados y mensajes, ocurridos entre las semanas epidemiológicas (SE) 10 y 23, de 2019 y 2020, respectivamente. Se incluyeron 147 médicos del Servicio de Medicina Familiar y Comunitaria, y una cápita de 73 427 pacientes afiliados al Plan de Salud del Hospital Italiano de Buenos Aires. Se realizó análisis cuantitativo y cualitativo. Resultados: hubo una reducción del 70% de las consultas presenciales (de 76 375 en 2019 a 23 200 en 2020) y un aumento concomitante de teleconsultas (de 255 en la SE13 a 1089 en la SE23). En simultáneo, los mensajes aumentaron sustancialmente (de 28 601 en 2019 a 84 916 en 2020), con un inicio abrupto al comienzo del confinamiento, y una tendencia decreciente a lo largo del tiempo. Antes de la pandemia, el contenido estuvo relacionado con órdenes electrónicas de estudios complementarios, control de resultados, recetas de medicación crónica y/o interconsultas a especialistas, mientras que los dominios más frecuentes durante la pandemia fueron necesidades informativas epidemiológicas, como medidas preventivas para COVID-19, vacuna antineumocócica, vacuna antigripal, casos o sospechas, resultados de hisopados, entre otras. Conclusión: el auge de las tecnologías de la comunicación e información durante la pandemia permitió dar continuidad a los procesos asistenciales en salud pese al distanciamiento físico. Hubo mayor utilización de mensajería por necesidades informativas de los pacientes, y la relación médico-paciente se ha modificado. (AU)

Introduction: during the COVID-19 pandemic, there was an unprecedented boom in telemedicine, probably due to the forced adoption of technology in the face of restrictive measures. This study aimed to compare the interaction and communication between general practitioners and patients before and during the pandemic based on scheduled outpatient consultations and Health Portal messages. Materials and methods: Cross-sectional study with a consecutive sampling of scheduled appointments and messages, occurring between epidemiological weeks (EW) 10 and 23 of 2019 and 2020, respectively. We included 147 physicians from the Family and Community Medicine Service and a capita of 73427 patients affiliated with the Hospital Italiano de Buenos Aires health plan. We conducted a quantitative and qualitative analysis. Results: there was a 70% reduction in face-to-face consultations (from 76375 in 2019 to 23200 in 2020) and a concomitant increase in teleconsultations (from 255 in EW13 to 1089 in EW23). Concurrently, messages increased substantially (from 28601 in 2019 to 84916 in 2020), with an abrupt onset at the beginning of confinement and a decreasing trend over time. Before the pandemic, the content involved electronic orders for complementary studies, outcome monitoring, chronic medication prescriptions, or expert consultations. The most frequent domains during the pandemic were epidemiological information needs, such as preventive measures for COVID-19, pneumococcal vaccine, influenza vaccine, cases or suspicions, and swab results, among others. Conclusion: the rise of communication and information technologies during the pandemic allowed the continuity of healthcare processes despite the physical distance. There was increased use of messaging for patients' information needs, and the doctor-patient relationship has changed. (AU)

Clima organizacional y calidad de atención del profesional de la salud de un Centro de Salud de Huánuco, Perú / Organizational Climate and Quality of Care according to Professionals from a Health Center in Huánuco, Peru

Introducción: La calidad constituye un desafío y una prioridad en las instituciones de servicios de salud y uno de los aspectos principales y más influyentes para el logro de este atributo es el clima organizacional. Objetivo: Identificar la relación entre el clima organizacional y la calidad de atención. Métodos: Estudio observacional, de corte transversal y de tipo correlacional realizado el año 2020 en profesionales de la salud del Centro de Salud "Aparicio Pomares" de Huánuco, Perú. Población conformada por 53 trabajadores. Se aplicó el cuestionario de clima organizacional y el cuestionario de calidad de atención. El análisis de los datos consistió en el contraste de correlaciones de Rho de Spearman. Resultados: En general, el clima organizacional promedio fue de 3,43 (de 1 a 5) y la calidad de atención promedia fue de 3,44 (de 1 a 5). Se encontró relación significativa entre el clima organizacional y la calidad de atención, con p ≤ 8804; 0,000. Y, se encontró relación significativa entre la calidad de atención y las dimensiones del clima organizacional como Credibilidad (p ≤ 8804; 0,000), Respeto (p ≤ 0,000), Imparcialidad (p ≤ 8804; 0,000), Orgullo (p ≤ 8804; 0,022) y Camaradería (p ≤ 0,000). Conclusiones: Se evidenció relación entre el clima organizacional y la calidad de atención de los profesionales de Atención Primaria de Salud de un Centro de Salud de Huánuco, Perú(AU)

Introduction: Quality is a challenge and a priority in healthcare institutions. One of the main and most influential aspects for the achievement of this aspect is the organizational climate. Objective: To identify the relationship between organizational climate and quality of care. Methods: An observational, cross-sectional and correlational study was conducted in 2020 with health professionals of Aparicio Pomares de Huánuco Health Center, in Peru. The study population consisted of 53 workers. The organizational climate and quality of care questionnaires were applied. Data analysis consisted in Spearman's rho correlation test. Results: Generally speaking, the average organizational climate was 3.43 and the average quality of care was 3.44, both within a 1-5 scale. A significant relationship was found between organizational climate and quality of care, accounting for P≤ 8804; 0.000. In addition, a significant relationship was found between quality of care and organizational climate dimensions such as credibility (P≤ 8804; 0.000), respect (P ≤ 8804; 0.000), impartiality (P≤ 8804; 0.000), pride (P≤ 8804; 0.022), and camaraderie (P≤ 8804; 0.000). Conclusions: A relationship was shown between the organizational climate and the quality of care in primary level professionals from a Health Center in Huánuco, Peru(AU)

Pharmaceutical Care in Primary Care: an Experience with Hypertensive Patients in the North of Brazil

Abstract Background: Uncontrolled blood pressure has been associated with poor adherence to drug treatment. Objectives: To assess blood pressure control in hypertensive patients attending primary health centers after implementation of a pharmaceutical follow-up program in a city of the north of Brazil. Methods: Observational, cross sectional, descriptive study with 163 hypertensive patients attending public primary health care centers - one located on the riverside and one in the urban area of the city of Santarem, western Pará, Brazil. Adherence to the anti-hypertensive treatment was assessed using the eight-item Morisky test. Pharmacotherapy follow-up (Dader method) of patients with uncontrolled hypertension and non-adherent to anti-hypertensive treatment was performed. Results of the normality test showed that the data did not follow a normal distribution. Continuous variables were then compared using the Wilcoxon signed-rank test, and categorical variables by the likelihood ratio and the McNemar tests. Statistical significance was set at 5%. Results: Of the total sample, 94.5% were not adherent to anti-hypertensive drug therapy and 77.2% had uncontrolled hypertension. Adherence rate was higher in men than women (p=0.006). Pharmacotherapy follow-up improved blood pressure levels, particularly systolic blood pressure (p<0.001). Conclusion: An individualized pharmacotherapeutic follow-up, considering regional and cultural specificities, can contribute to the treatment of hypertensin in the primary care.

Trastornos mentales comunes y calidad de vida relacionada con la salud mental en trabajadores de salud bucal / Common mental disorders and mental health-related quality of life among oral health providers

Introducción: Existen pocos estudios sobre los trastornos mentales comunes y calidad de vida relacionada con la salud mental en trabajadores de salud bucal. Objetivo: Describir los trastornos mentales comunes y la calidad de vida relacionada con la salud mental en trabajadores de equipos de salud bucal en atención primaria de salud del Sistema Único de Salud de la Región Metropolitana de Salvador de Bahía, Brasil. Métodos: Estudio transversal y descriptivo, que utilizó el Cuestionario de declaración de síntomas para evaluar trastornos mentales comunes, el Cuestionario de salud para calidad de vida relacionada con la salud y un cuestionario de caracterización sociodemográfica. Resultados: Conformaron la muestra 161 profesionales (59,6 por ciento odontólogos y 40,4 por ciento auxiliares de salud bucal). El promedio de la puntuación para Cuestionario de declaración de síntomas fue mayor para los odontólogos (p = 0,032). Los dominios de salud mental del Cuestionario de salud fueron menores y significativos en odontólogos. Tres factores del Cuestionario de declaración de síntomas presentaron alta correlación negativa con los dominios de salud mental del Cuestionario de salud. Conclusiones: Los odontólogos presentaron mayores síntomas de trastornos mentales comunes y deterioro de la calidad de vida relacionada con la salud mental que los auxiliares de salud bucal, siendo necesarias estrategias de promoción de la salud mental para trabajadores de los equipos de salud bucal(AU)

Introduction: Few studies are available about common mental disorders and mental health-related quality of life among dental healthcare providers. Objective: Describe the common mental disorders and the mental health-related quality of life of members of oral health teams from the primary health care section of the Unified Health System in the Metropolitan Region of Salvador de Bahia, Brazil. Methods: A descriptive cross-sectional study was conducted based on the Symptom reporting questionnaire for the evaluation of common mental disorders, the Health questionnaire about health-related quality of life, and a sociodemographic characterization questionnaire. Results: The study sample was composed of 161 professionals, of whom 59.6 percent were dentists and 40.4 percent were dental auxiliaries. Dentists obtained a higher average score in the Symptom reporting questionnaire (p = 0.032), whereas their scores in the mental health domains of the Health questionnaire were lower and significant. Three factors in the Symptom reporting questionnaire exhibited a high negative correlation with the mental health domains of the Health questionnaire. Conclusions: Dentists presented greater symptoms of common mental disorders and mental health-related quality of life deterioration than dental auxiliaries. It is therefore necessary to implement mental health promotion strategies aimed at members of oral health teams(AU)

Atherosclerosis Complications in the Brazilian Population: An Ecological Time Series Study

Abstract Background: Atherosclerosis is a serious health problem, and several factors contribute to its occurrence. Longitudinal and qualified monitoring of primary health care (PHC) may contribute to the management of atherosclerosis and reduction of avoidable hospital admissions. Objectives: To estimate the trend in hospitalizations for atherosclerosis and the impact of PHC coverage on its evolution from 2008 to 2018 in Brazil. Methods: An ecological time series analytical study based on the outcomes of hospital admissions for atherosclerosis in Brazil. Time in years, PHC coverage, and Family Health Strategy (FHS) services were considered independent variables. A Prais-Winsten model was used to estimate the outcome trend, and α < 0.05 was adopted. Results: We observed a mean increase of 1.81 hospitalizations for atherosclerosis per 100 000 inhabitants annually (p = 0.002) in Brazil. This growth was evidenced in the Northeast (p < 0.001), Southeast (p = 0.003), and South (p < 0.001) regions, being stable in the North (p = 0.057) and Midwest (p = 0.62) regions. Men presented twice the growth in hospitalizations from the fifth decade of life on (p < 0.01). An inversely proportional relationship was observed for PHC coverage (B = -0.71; p < 0.001) and the proportion of FHS services (B = -0.59; p < 0.001) with the rate of admissions due to atherosclerosis in Brazil. Conclusions: Although hospitalizations for atherosclerotic complications are increasing in Brazil, they present regional and individual gender and age discrepancies, as well as a mitigating effect exerted by PHC coverage.

Atención de enfermería a mujeres en situación de violencia en Atención Primaria de Salud / Nursing Care for Women in a Situation of Violence in Primary Health Care

Introducción: La violencia contra la mujer es un problema de salud pública y consiste en cualquier acto que resulte en daño físico, sexual o psicológico. Objetivo: Analizar la evidencia científica nacional e internacional sobre cuidados de enfermería a mujeres en situación de violencia en Atención Primaria de Salud. Métodos: Revisión integradora de la literatura, realizado de mayo a octubre de 2018, en seis pasos, los cuales fueron: delimitación del tema y pregunta orientadora, búsqueda bibliográfica, definición de información, evaluación estudios, interpretación de resultados y síntesis de conocimientos, mediante la búsqueda de artículos en las bases de datos Lilacs, BDENF y Medline; y en biblioteca digital SciELO. Se encontraron 48 artículos, después de filtrar los criterios de inclusión, texto completo disponible, en idioma portugués, inglés o español, quedaron siete estudios. Los datos fueron procesados en el software IRAMUTEC y analizados por clasificación jerárquica descendente, basada en el dendograma. Fueron presentados en 5 clases, a saber: 1- Asistencia a mujeres víctimas de violencia intrafamiliar. 2- Dificultad de los profesionales para identificar e intervenir en casos de violencia contra la mujer. 3- Dispositivos utilizados para brindar atención integral a mujeres en situación de violencia. 4- El miedo como factor de perpetuación de la violencia contra la mujer. 5- Asistencia multiprofesional a víctimas de violencia intrafamiliar. Conclusión: Las enfermeras tienen un papel fundamental en la identificación e intervención en los casos de violencia contra la mujer, a través de una atención integral, humanizada y de calidad(AU)

Introdução: A violência contra a mulher é um problema de saúde pública e consiste em qualquer ato que resulte em dano físico, sexual ou psicológico. Objetivo: Analisar as evidências científicas nacionais e internacionais sobre a assistência de enfermagem à mulher em situação de violência na Atenção Básica à Saúde. Métodos: Revisão integrativa da literatura, realizada de maio a outubro de 2018, em seis etapas, quais sejam, delimitação do tema e questão norteadora, busca bibliográfica, definição das informações, avaliação dos estudos, interpretação dos resultados e síntese do conhecimento, por meio busca de artigos nas bases de dados Lilacs, BDENF e Medline; e na biblioteca digital SciELO. Foram encontrados 48 artigos, filtrados os critérios de inclusão, texto completo disponível, nos idiomas português, inglês ou espanhol, restando sete estudos. Os dados foram processados no software IRAMUTEC e analisado por meio de classificação hierárquica descendente, com base no dendrograma. Foram apresentados em 5 turmas, a saber: 1- Atendimento a mulheres vítimas de violência doméstica. 2- Dificuldade dos profissionais em identificar e intervir nos casos de Violência contra a Mulher. 3- Dispositivos para atendimento integral à mulher em situação de violência. 4- O medo como fator de perpetuação da violência contra a mulher. 5- Atendimento multiprofissional às vítimas de violência doméstica. Conclusão: O enfermeiro tem papel fundamental na identificação e intervenção nos casos de violência contra a mulher, por meio de uma assistência integral, humanizada e de qualidade(AU)

Introduction: Violence against women is a public health concern, manifested through any act resulting in physical, sexual or psychological harm. Objective: To analyze the national and international scientific evidence on nursing care for women in a situation of violence at the level of primary healthcare. Methods: An integrative literature review was carried out from May to October 2018, taking into account six steps: delimitation of topic and guiding question, literature search, definition of information, assessment of studies, interpretation of results, and synthesis of knowledge, by searching articles in the Lilacs, BDENF and Medline databases, as well as in the digital library of SciELO. Forty-eight articles were found; after filtering the inclusion criteria (full texts written in Portuguese, English or Spanish), seven studies remained. The data were processed in the IRAMUTEC software and analyzed by descending hierarchical classification, based on the dendogram. They were presented in five classes: support to women victims of family violence, professionals' difficulties to identify and intervene in cases of violence against women, devices used to provide comprehensive care to women in a situation of violence, fear as a factor in perpetuating violence against women, and multiprofessional assistance to victims of family violence. Conclusion: Nurses have a fundamental role for the identification and intervention in cases of violence against women through comprehensive, humanized and quality care(AU)

Validation of a permanent health education workshop on nutrition, physical activity and bodily practices / Validação de oficina de educação permanente em alimentação, atividade física e práticas corporais

This study aims to describe the development and validation of a permanent health education work-shop protocol for professional qualification in promoting adequate and healthy eating and physical activity and bodily practices for professionals working in Primary Health Care. The protocol de-velopment was based on the following theoretical references: Brazilian Dietary Guidelines, Brazil-ian Physical Activity Guidelines, Interprofessional Collaborative Practice, and Critical-Reflective Methodology (MCR); and it was proposed with 6 modules, totaling 30 hours of qualification. The protocol was evaluated in two panels of experts for content validation, which assessed aspects of clar-ity, relevance, and representativeness. The Content Validity Index (CVI), considering adequate the activities that scored CVI>0.8; and the proportion of theoretical representativeness in each activity were calculated. All 32 activities in the protocol have been validated for clarity and relevance, and the representativeness obtained results consistent with the objectives of each module. The represent-ativeness of MCR in the protocol as a whole was of 86.25%. The workshop activities protocol was evaluated as adequate for the proposed objective, considering its theoretical framework and its target audience. This is the first validated permanent education workshop to work in combination the Bra-zilian Dietary Guidelines and the Brazilian Physical Activity Guidelines, and it can be applied to the qualification of professionals in Primary Health Care throughout Brazil

O objetivo deste trabalho é descrever o desenvolvimento e validação de conteúdo de um protocolo de oficina de educação permanente em saúde para a qualificação profissional em promoção da alimentação adequada e saudável e da atividade física e práticas corporais voltado aos profissionais atuantes na Atenção Primária à Saúde. O desenvolvimento do protocolo utilizou como referenciais teóricos o Guia Alimentar para a Popu-lação Brasileira, o Guia de Atividade Física para a População Brasileira, a Prática Colaborativa Interpro-fissional e a Metodologia Crítico-Reflexiva (MCR); e foi definido com seis módulos presenciais, totalizando 30 horas de qualificação. O protocolo foi avaliado nos aspectos de clareza, pertinência e representatividade, em dois painéis de juízes para validação de conteúdo. Foram calculados o Índice de Validade de Conteúdo (IVC), considerando adequadas as atividades que pontuaram IVC>0,8; e o percentual de representatividade dos referenciais teóricos em cada atividade. Todas as 32 atividades do protocolo foram validadas para clareza e pertinência; e a representatividade obteve resultados condizentes com os objetivos de cada módulo. A repre-sentatividade da MCR no protocolo como um todo foi de 86,25%. As atividades da oficina foram avaliadas como adequadas ao objetivo proposto, considerando seu referencial teórico e seu público-alvo. Esta é a pri-meira oficina de educação permanente em saúde validada a trabalhar em formação combinada com o Guia Alimentar e o Guia de Atividade Física para a População Brasileira, e pode ser aplicada para a qualificação de profissionais da Atenção Primária à Saúde em todo Brasil

Treatment of patients with neuropathic pain and provision of drug information by clinical pharmacists

Abstract Patient's satisfaction with healthcare services has an influence on pain management, which can be improved by patient education. Therefore, this study was aimed at identifying primary care health service opportunities in the treatment of neuropathic pain and assessing patients' satisfaction with the provision of drug information by clinical pharmacists. This was a cross- sectional, prospective study conducted at a pain unit during March-May 2017. Patients aged >18 years; diagnosed with neuropathic pain; and who used amitriptyline, gabapentin, pregabalin, or duloxetine were included. They were verbally informed about drug treatment by a clinical pharmacist, and their satisfaction was evaluated after 1 month. In all, 90 patients were included. The median duration for which the patients experienced pain until hospital admission was 3.6 years; furthermore, this duration was longer among women (p < 0.05). However, the median time to seeking advice from doctors was 3 months. The patients (15.6%) were less likely to admit pain unit initially and 46.7% had visited different units before being admitted to a pain unit. More than 95% of the patients indicated that they had received information from a pharmacist at a clinic and were satisfied with the provision of information (median duration, 8.5 min). Thus, the involvement of pharmacists in multidisciplinary pain management may help improve health- related outcomes at hospitals and/or in community care settings

Situação vacinal de crianças cadastradas em equipes de saúde da família / Vaccine situation of children registered in family health teams / Situación de vacunas de niños matriculados en los equipos de salud familiar

Objetivo: analisar a situação vacinal de crianças menores de três anos, cadastradas em Equipes de Saúde da Família. Método: estudo transversal, realizado em Unidades de Saúde da Família de João Pessoa, Paraíba, Brasil, com 424 cadernetas de crianças menores de três anos. Os dados foram coletados entre maio e novembro de 2019, com o auxílio de um instrumento elaborado conforme Caderneta da Criança, e analisados por estatística descritiva e inferencial. Resultados: 295 (69,6%) cadernetas estavam atualizadas conforme idade da criança, com maior porcentagem de atraso 58 (40%) nas cadernetas de crianças entre 12 e 23 meses. As vacinas mais registradas foram BCG e Hepatite B. Crianças do sexo masculino e entre 12 e 23 meses apresentaram associação significante com atualização vacinal. Conclusão: a cobertura vacinal está abaixo do recomendado, sendo necessárias campanhas de orientação a população para melhor adesão as vacinas e busca ativa de crianças com atraso vacinal.

Objective: to analyze the vaccination status of children under three years old, registered in Family Health Teams. Method: cross-sectional study carried out in Family Health Units in João Pessoa, Paraíba, Brazil, with 424 booklets for children under three years of age. Data were collected between May and November 2019, with the help of an instrument prepared according to the Child Handbook, and analyzed using descriptive and inferential statistics. Results: 295 (69,6%) booklets were updated according to the child's age, with a higher percentage of delay 58 (40%) in the booklets of children between 12 and 23 months. The most registered vaccines were BCG and Hepatitis B. Male children aged between 12 and 23 months showed a significant association with vaccination update. Conclusion: vaccination coverage is below what is recommended, and campaigns are needed to guide the population for better adherence to vaccines and an active search for children with delayed vaccinations.

Objetivo: analizar el estado de vacunación de los niños menores de tres años, registrados en los Equipos de Salud de la Familia. Método: estudio transversal realizado en Unidades de Salud de la Familia en João Pessoa, Paraíba, Brasil, con 424 folletos para niños menores de tres años. Los datos fueron recolectados entre mayo y noviembre de 2019, con la ayuda de un instrumento elaborado según el Manual del Niño, y analizados mediante estadística descriptiva e inferencial. Resultados: 295 (69,6%) cuadernillos se actualizaron según la edad del niño, con mayor porcentaje de atraso 58 (40%) en los cuadernillos de niños entre 12 y 23 meses. Las vacunas más registradas fueron BCG y Hepatitis B. Los niños varones de entre 12 y 23 meses mostraron una asociación significativa con la actualización de la vacunación. Conclusión: la cobertura de vacunación está por debajo de lo recomendado, y se necesitan campañas que orienten a la población para una mejor adherencia a las vacunas y una búsqueda activa de niños con vacunación tardía.

Cost-utility analysis of traditional drug therapy with and without exercise program for hypertensive patients in real-life data primary health care

Abstract Aim: The study aimed to conduct a cost-utility analysis of traditional drug therapy (TDT) provided for hypertensive patients at primary care in comparison to the protocol based on combination with an exercise program (TDT+E) in real-life conditions, adopting a health system perspective. Methods: Longitudinal study based on enrollment of 49 hypertensive adults distributed into two groups, for 12 months. Quality-adjusted life years were estimated using health-related quality of life. Direct health care costs were calculated including inputs and human resources in primary care from medical records. Sensitivity analysis was performed based on multivariate and probabilistic scenarios. Results: Incremental cost-effectiveness ratios of TDT+E in comparison to TDT were +79.69. Sensitivity analysis showed that TDT+E presented advantages considering uncertainties. Conclusion: Our findings show that exercise programs may improve quality of life and life expectancy among hypertensive patients.

Limites e possibilidades de agentes comunitários de saúde na identificação de sintomas depressivos / Límites y posibilidades de los agentes comunitarios de salud en la identificación de síntomas depresivos / Limitations and possibilities of community health workers in identifying depressive symptoms

RESUMO Objetivo: avaliar o conhecimento de agentes comunitários de saúde sobre identificação de sintomas depressivos na comunidade. Método: trata-se de pesquisa qualitativa, realizada em Unidade Básica de Saúde, em Teresina, Piauí, Brasil, com 15 agentes comunitários de saúde. Utilizou-se o método da Pesquisa-Ação. A produção dos dados aconteceu em janeiro e fevereiro de 2019, por meio de dois seminários temáticos, pautados no Método Criativo Sensível. Os discursos foram submetidos à análise temática. Resultados: agentes comunitários de saúde reconhecem os sintomas depressivos por tristeza, choro, isolamento, anedonia e solidão, manifestados pelos indivíduos. Os limites para essa identificação, relatados pelos profissionais, foram dificuldade de acesso aos usuários e às famílias e estigma e preconceito com a depressão. Quanto às possibilidades, destacaram-se acesso à informação sobre a temática pela mídia, diálogo/conversa estabelecido entre usuário e profissional e acesso à rede de apoio. Considerações finais: conclui-se que o reconhecimento, as limitações e as possibilidades de identificação de sintomas depressivos por esses profissionais refletem no diagnóstico, planejamento e implementação de ações no cuidado em saúde mental de forma precoce e segura.

RESUMEN Objetivo: evaluar el conocimiento de agentes comunitarios de salud sobre identificación de síntomas depresivos en la comunidad. Método: se trata de investigación cualitativa, realizada en Unidad Básica de Salud, en Teresina, Piauí, Brasil, con 15 agentes comunitarios de salud. Se utilizó el método de Investigación-acción. La producción de los datos tuvo lugar en enero y febrero de 2019, a través de dos seminarios temáticos, de acuerdo con el Método Creativo-sensible. Los discursos fueron sometidos al análisis temático. Resultados: Los agentes comunitarios de salud reconocen los síntomas depresivos por tristeza, llanto, aislamiento, anhedonia y soledad, manifestados por los individuos. Los límites para esa identificación, relatados por los profesionales, fueron dificultad de acceso a los usuarios y a las familias y estigma y prejuicio con la depresión. En cuanto a las posibilidades, se destacaron acceso a la información sobre la temática por los medios, diálogo/conversación establecido entre usuario y profesional y acceso a la red de apoyo. Consideraciones finales: se concluye que el reconocimiento, las limitaciones y las posibilidades de identificación de síntomas depresivos por parte de estos profesionales reflejan en el diagnóstico, la planificación e implementación de acciones en el cuidado en salud mental de forma precoz y segura.

ABSTRACT Objective: to evaluate the knowledge of community health workers about the identification of depressive symptoms in the community. Method: this is a qualitative research, conducted in a Primary Health Care Unit in Teresina, Piauí, Brazil, with 15 community health workers. We used the Action-Research method. Data production took place in January and February 2019, through two thematic seminars, guided by the Creative Sensitive Method.The speeches were submitted to thematic analysis. Results: community health workers recognize the depressive symptoms by means of sadness, crying, isolation, anhedonia and loneliness, manifested by individuals. The limitations to this identification, reported by professionals, were difficulty of access to users and families, as well as stigma and prejudice against depression. As for the possibilities, access to information about the theme through the media, dialogue/conversation established between users and professionals, besides access to a support network, were highlighted. Final considerations: we conclude that the recognition, limitations and possibilities of identification of depressive symptoms by these professionals are reflected in the diagnosis, planning and implementation of actions in mental health care in an early and safe way.

Educação permanente em saúde como prática possível: uma experiência na atenção primária / Educación permanente en salud como práctica posible: experiencia en atención primaria / Permanent health education as a possible practice: an experience in primary care

RESUMO Objetivo: descrever o processo de análise de necessidades, execução e avaliação de um programa educativo na Atenção Primária à Saúde, na lógica da Educação Permanente em Saúde (EPS). Método: pesquisa-ação com abordagem mista, desenvolvida entre 2014 e 2016, com trabalhadores da saúde. A coleta de dados ocorreu nos encontros de grupo focal, oficinas do programa educativo e aplicação de questionários. Os dados qualitativos foram submetidos à análise de discurso do sujeito coletivo, e os dados quantitativos, à análise estatística descritiva. Resultados: a necessidade priorizada foi a comunicação prejudicada no ambiente de trabalho; e, durante a execução do programa educativo, os participantes pactuaram acordos para superação dos problemas identificados, a exemplo da criação de espaços de diálogo e fluxos definidos de comunicação. Sentiram-se satisfeitos em participar, e percebeu-se que o programa educativo causou impacto positivo no trabalho. Considerações finais: o objetivo de descrever todo processo da EPS foi alcançado. Houve maior estímulo para um movimento de transformação no processo de trabalho, em referência ao aprimoramento da comunicação na dimensão profissional da gestão do cuidado, a partir de um paradigma dialógico e crítico, capaz de ressignificar o processo de ensino-aprendizagem no trabalho. Como produto, tem-se um modo mais efetivo de operar a EPS.

RESUMEN Objetivo: describir el proceso de análisis de necesidades, ejecución y evaluación de un programa educativo en la Atención Primaria de Salud, en la lógica de la Educación Permanente en Salud (EPS). Método: investigación-acción con enfoque mixto, desarrollada entre 2014 y 2016, con trabajadores de la salud. La recolección de datos tuvo lugar en los encuentros de grupo focal, talleres del programa educativo y aplicación de cuestionarios. Los datos cualitativos fueron sometidos al análisis de discurso del sujeto colectivo, y los datos cuantitativos, al análisis estadístico descriptivo. Resultados: la necesidad priorizada fue la comunicación perjudicada en el ambiente de trabajo; y, durante la ejecución del programa educativo, los participantes pactaron acuerdos para superar los problemas identificados, a ejemplo de la creación de espacios de diálogo y flujos definidos de comunicación. Se sintieron satisfechos de participar, y se percibió que el programa educativo causó impacto positivo en el trabajo. Consideraciones finales: el objetivo de describir todo el proceso de EPS fue alcanzado. Hubo mayor estímulo para un movimiento de transformación en el proceso de trabajo, en referencia al perfeccionamiento de la comunicación en la dimensión profesional de la gestión del cuidado, a partir de un paradigma dialógico y crítico, capaz de resignificar el proceso de enseñanza-aprendizaje en el trabajo. Como producto, se tiene un modo más efectivo de operar la EPS.

ABSTRACT Objective: to describe the process of needs analysis, execution and evaluation of an educational program in Primary Health Care, in the logic of Permanent Health Education (PHE). Method: action research with mixed approach, developed between 2014 and 2016, with health workers. Data collection occurred in focus group meetings, educational program workshops and questionnaire application. The qualitative data were submitted to discourse analysis of the collective subject, and quantitative data were submitted to descriptive statistical analysis. Results: the prioritized need was impaired communication in the work environment; and, during the implementation of the educational programme, participants agreed agreements to overcome the identified problems, such as the creation of dialogue spaces and defined communication flows. They were satisfied to participate, and it was noticed that the educational program had a positive impact on the work. Final considerations: the objective of describing the entire Process of PHE was achieved. There was a greater stimulus for a movement of transformation in the work process, in reference to the improvement of communication in the professional dimension of care management, from a dialogical and critical paradigm, capable of resignifying the teaching-learning process at work. As a product, there is a more effective way to operate PHE.

Pain Perception Before Endodontic Treatment: from Primary Care to Specialized Care

Abstract Objective: To analyze patients' pain perception requiring endodontic treatment referred to a Dental Specialties Center. Material and Methods: Data was collected through a self-administered questionnaire for patients about their experience of pain and another for endodontists about the treatment performed. The results were analyzed descriptively using Pearson's Chi-square test and Fisher's Exact test, with Bonferroni correction (p≤0.05). Results: The median age of the patients was 39 years, and 71.1% were female. The median waiting time for treatment was five months. Pain was reported by 75.2% of patients, occurred more than one month earlier (63.6%), with moderate/severe intensity (66.9%), and most patients sought emergency treatment more than once (79.1%). In addition, pain was associated with sex (female; p=0.008); moderate/severe intensity (p<0.001); the number of times that patient had to go to the dentist because of the tooth treatment (twice or more; p=0.002); and type of tooth treated (posterior tooth; p=0.002). Conclusion: Severe pain episodes resulted in a repeated search for emergency services, which may overload the primary care service, especially if the waiting time for endodontic treatment is long.

Level of Satisfaction and Quality of Life of Caregivers of People with Disabilities in Secondary Dental Care

Abstract Objective: To assess the level of satisfaction and quality of life (QOL) of caregivers of Patients with Special Needs seen at the Dental Specialties Center in Aracaju, Brazil. Material and Methods: The Program for Primary Care Access and Quality Improvement (PMAQ - DSC) and the World Health Organization's Quality of Life - Brief (WHOQOL-BREF) questionnaires were applied to PSN and caregivers. Results: The PMAQ questionnaire was applied to 31 patients or caregivers; 97% had no paid work and 61% used public transportation to reach the Dental Specialties Center. The WHOQOL-BREF questionnaire was applied to 20 caregivers; 60% considered their life to be good; however, 60% had practically no leisure time. Correlation tests (Pearson's coefficient) showed a statistically significant correlation between the physical and psychological domain (p=0.02; r=0.64), the psychological and social domain (p=0.033; r=0.48), and the psychological and environment domain (p<0.001; r=0.80). Conclusion: The caregivers and patients with special needs felt satisfied with the specialized oral health service offered by the municipality. Concerning the quality of life of caregivers, the majority stated they had a good quality of life, despite not having the opportunity to participate in leisure-oriented activities and often having negative feelings.

Avaliação da terceira etapa do método canguru na atenção primária a saúde / Evaluation of the third stage of the kangaroo method in primary health care / Evaluación de la tercera etapa del método canguro en atención primaria de salud

Objetivo: avaliar a assistência prestada às crianças pela Atenção Primária à Saúde na terceira etapa do método canguru. Métodos: estudo transversal com 156 crianças pré-termo no período de janeiro a junho de 2020. Utilizou-se questionário contendo variáveis sócio-demográficas, clínicas e relacionadas à assistência prestada. Resultados: Dentre as crianças: 54,5% tinham idade acima de seis meses; 51,9% eram do interior ou de outras localidades; 94,9% eram de baixa renda; 39,1% tiveram peso menor que 1500g; 62,2% e 12,2% nasceram com idade gestacional entre 28 a 33 semanas e inferior a 28 semanas, respectivamente. Quanto à assistência prestada: 74,4% das crianças não realizaram consultas na atenção primária e dentre as atendidas, 78,2% classificaram como ruim/regular; 59,6% não receberam visita domiciliar. Conclusão: a avaliação da terceira etapa do método canguru na atenção primária, sob o olhar de mães, apontou fragilidades na qualificação, integralidade da assistência, redesenho/discussão da rede, na referência e contra-referência.

Objective: to evaluate the assistance provided to children by Primary Health Care in the third stage of the kangaroo method. Methods: cross-sectional study with 156 preterm children from January to June 2020. A questionnaire was used containing socio-demographic, clinical and care-related variables. Results: Among the children: 54.5% were over six months old; 51.9% were from the countryside or other locations; 94.9% were low-income; 39.1% weighed less than 1500g; 62.2% and 12.2% were born with gestational age between 28 and 33 weeks and less than 28 weeks, respectively. As for the assistance provided: 74.4% of the children did not undergo consultations in primary care and among those attended, 78.2% classified it as poor/fair; 59.6% did not receive a home visit. Conclusion: the evaluation of the third stage of the kangaroo method in primary care, from the perspective of mothers, pointed out weaknesses in qualification, comprehensiveness of care, network redesign/discussion, in reference and counter-reference.

Objetivo: evaluar la asistencia brindada a los niños por la Atención Primaria de Salud en la tercera etapa del método canguro. Métodos: estudio transversal con 156 niños prematuros de enero a junio de 2020. Se utilizó un cuestionario con variables sociodemográficas, clínicas y asistenciales. Resultados: Entre los niños: 54,5% tenían más de seis meses; El 51,9% eran del campo u otras localidades; 94,9% eran de bajos ingresos; El 39,1% pesaba menos de 1500 g; El 62,2% y el 12,2% nacieron con edades gestacionales entre 28 y 33 semanas y menos de 28 semanas, respectivamente. En cuanto a la asistencia brindada: el 74,4% de los niños no acudió a consultas en atención primaria y entre los atendidos, el 78,2% la clasificó como mala / regular; El 59,6% no recibió visita domiciliaria. Conclusión: la evaluación de la tercera etapa del método canguro en atención primaria, desde la perspectiva de las madres, señaló debilidades en la calificación, integralidad de la atención, rediseño / discusión de la red, en referencia y contrarreferencia.

Validade do prisma-7 na identificação da síndrome de fragilidade em idosos na atenção primária à saúde / La validez del prisma-7 en la identificación del síndrome defragilidad en personas mayores en atención primaria / Validity of the prisma-7 in the identification of the frailty syndrome in older adults in primary health care

Objetivo: validar o Prisma-7 de forma concorrente com o Fenótipo de Fragilidade e o Indicador de Fragilidade de Groningen. Método: estudo de validade concorrente realizado na atenção primária à saúde com amostra de conveniência de 136 idosos. Instrumento incluiu variáveis sociodemográficas, familiares, clínicas, Prisma-7, Fenótipo de Fragilidade e Indicador de Fragilidade de Groningen. Na análise, utilizou-se a validade (sensibilidade, especificidade) e a confiabilidade (kappa e porcentagem de concordância PC), em relação ao Fenótipo de Fragilidade e Indicador de Fragilidade de Groningen. Resultados: Prisma-7 apresentou especificidade /sensibilidade de 97%/19,4% e 94%/11,1%, quando comparado ao Fenótipo de Fragilidade e ao Indicador de Fragilidade de Groningen, respetivamente. Este é parcialmente concordante com o Fenótipo de Fragilidade (kappa=0,233, p<0,01; percentagem de concordância=76,5%). Prisma-7 e Indicador de Fragilidade de Groningen apresentaram concordância baixa (kappa=0,061, p>0,05, Percentagem de Concordância=77,2%). Conclusão: o Prisma-7, no contexto da atenção primária à saúde, apresentou baixa sensibilidade, devendo ser utilizado com prudência.

Objetivo: validar el Prisma-7 de forma concordante con el Fenótipo de Fragilidad y el Indicador de Fragilidad de Groningen. Método: estudio de validez concordante realizado en la atención primaria a la salud con la amostra de conveniencia de 136 idosos. El instrumento incluía variables sociodemográficas, familiares, clínicas, Prisma-7, Fenótipo de Fragilidad e Indicador de Fragilidad de Groningen. En el análisis, se utilizó la validez (sensibilidad, especificidad) y la fiabilidad (kappa y porcentaje de concordancia PC) en relación con el Fenotipo de Fragilidad de Groningen y el Indicador de Fragilidad. Resultados: Prisma-7 mostró una especificidad/sensibilidad del 97%/19,4% y del 94%/11,1%, en comparación con el Fenotipo de Fragilidad y el Indicador de Fragilidad de Groningen, respectivamente. Esto es parcialmente concordante con el Fenotipo de Fragilidad (kappa=0,233, p<0,01; porcentaje de concordancia=76,5%). El Prisma-7 y el Indicador de Fragilidad de Groningen mostraron una baja concordancia (kappa=0,061, p>0,05, porcentaje de concordancia=77,2%). Conclusión: el Prisma-7, en el contexto de la atención primaria a la salud, presentó una baja sensibilidad, por lo que debe ser utilizado con prudencia.

Objective: to validate the Prisma-7 concurrently with the Frailty Phenotype and the Groningen Frailty Indicator. Method: concurrent validity study conducted in primary health care with a convenience sample of 136 older adults. Instrument included sociodemographic, family, clinical, Prisma-7, Frailty Phenotype and Groningen Frailty Indicator variables. In the analysis, we used validity (sensitivity, specificity) and reliability (kappa and percentage of agreement) in relation to the Frailty Phenotype and Groningen Frailty Indicator. Results: Prisma-7 showed specificity/sensitivity of 97%/19.4% and 94%/11.1%, when compared to the Frailty Phenotype and the Groningen Frailty Indicator, respectively. This is partially concordant with the Fragility Phenotype (kappa=0.233, p<0.01; Percentage of agreement=76.5%). Prisma-7 and Groningen Frailty Indicator showed low agreement (kappa=0.061, p>0.05, Percentage of agreement=77.2%). Conclusion: the Prisma-7, in the context of primary health care, showed low sensitivity and should be used with caution.

Cuidados de enfermagem às pessoas com doença de Parkinson na Atenção primária à Saúde: protocolo de scoping review / Nursing care for people with Parkinson's disease in Primary Health Care: a scoping review protocol

Resumo Objetivo: Identificar na literatura os principais temas investigados sobre cuidados de enfermagem à pessoa com doença de Parkinson na atenção primária à saúde. Metodologia: Trata-se de um protocolo de revisão de escopo, realizado de acordo com a metodologia do Joanna Briggs Institute e checklist do Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), seguindo as seguintes etapas: protocolo; critérios de elegibilidade; fontes de informação; estratégia de pesquisa; seleção de fontes de evidência; extração dos dados; análise de dados e apresentação dos resultados. Tem como pergunta de revisão: Quais os cuidados de enfermagem à pessoa com doença de Parkinson em nível de atenção primária à saúde, descritas na literatura? Para identificar documentos relevantes, as seguintes bases de dados bibliográficas serão pesquisadas: Public Medline, Cumulative Index to Nursing & Allied Health Literature, Web of Science, SciVerse Scopus, Base de Dados de Enfermagem, Literatura Latino-Americano e do Caribe em Ciências da Saúde, e Scientific Electronic Library Online. O resultado do fluxo de seleção, desta etapa metodológica, será apresentado em forma de figura, conforme o Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Resultados: Os resultados deste estudo possibilitarão o conhecimento das principais áreas de cuidados e intervenções de enfermagem voltadas a pessoas com doença de Parkinson, na atenção primária à saúde. Conclusão: Este estudo constitui o primeiro passo em uma agenda de pesquisa que visa aprofundar a análise e sistematização dos cuidados de enfermagem às pessoas que vivem com doença de Parkinson.

Resumen Objetivo: Identificar en la literatura los principales temas investigados sobre el cuidado de enfermería para personas con enfermedad de Parkinson en atención primaria de salud. Método: Es un protocolo de revisión de alcance, llevado a cabo de acuerdo con la metodología del Instituto Joanna Briggs y la lista de verificación de los elementos de informes preferidos para revisiones sistemáticas y extensión de metaanálisis para revisiones de alcance(PRISMA-ScR), siguiendo los siguientes pasos: protocolo, criterio de elegibilidad, fuentes de información, estrategia de investigación, selección de fuentes de evidencia, extracción de datos, análisis de datos y presentación de resultados. Tiene como pregunta de revisión la siguiente: ¿cuáles son los cuidados de enfermería brindados a las personas con enfermedad de Parkinson en el nivel de atención primaria de salud, descritos en la literatura? Para identificar documentos relevantes, se buscó en las siguientes bases de datos bibliográficas: Medline pública, Índice acumulativo de literatura de enfermería y salud aliada, Web of Science, SciVerse Scopus, Base de datos de enfermería, Literatura latinoamericana y caribeña en ciencias de la salud y Scientific Electronic Library en línea. El resultado del flujo de selección, de este paso metodológico, se presentará en forma de figura, de acuerdo con los elementos de informes preferidos para revisiones sistemáticas y metaanálisis. Resultados: Los resultados de este estudio permitirán conocer las principales áreas de atención e intervenciones de enfermería dirigidas a personas con enfermedad de Parkinson, en la atención primaria de salud. Conclusión: Este estudio es el primer paso de una agenda de investigación que tiene como objetivo profundizar en el análisis y sistematización de la atención de enfermería a las personas que viven con la enfermedad de Parkinson.

Abstract Aim: To identify in the literature the main topics investigated about nursing care for people with Parkinson's disease in primary health care. Method: This is a scope review protocol carried out according to the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic reviews checklist and the Meta-Analyzes extension for Scoping Reviews(PRISMA-ScR). This investigation will follow these steps: protocol, eligibility criteria, information sources, research strategy, selection of sources, data extraction, data analysis, and presentation of results. Its review question is "What are the nursing cares provided to people with Parkinson's disease in primary health care as described in the literature?". To identify the relevant documents, the following bibliographic databases will be used: Public Medline, Cumulative Index to Nursing & Allied Health Literature, Web of Science, SciVerse Scopus, Nursing Database, Latin American and Caribbean Literature in Health Sciences, and Scientific Electronic Library Online. The results of this selections flow will be presented using figures as outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. Results: The results of this study will shed light on the main researched areas of care and nursing interventions aimed at people with Parkinson's disease in primary healthcare. Conclusion: This study is the first step in a research agenda that aims to deepen the analysis and systematization of nursing care for people living with Parkinson's disease.

Relación entre la calidad de los cuidados primarios y la caries dental en preescolares / Relationship between primary health care quality and dental caries in preschoolers

Introducción: La atención primaria de salud aporta la resolución de la mayoría de los problemas de salud de la población, proporciona el acceso primario al servicio, la continuidad e integralidad de la atención y la coordinación de los cuidados. Objetivo: Evaluar la relación entre la calidad de los cuidados primarios y la caries dental en preescolares. Métodos: Se realizó un estudio descriptivo de corte transversal en una muestra de 515 preescolares. La selección de las escuelas tuvo lugar a partir de un muestreo aleatorio estratificado, seguido por muestreo aleatorio simple para la selección de los participantes. Se realizó un examen bucal para evaluar caries dental y se aplicó a los padres/responsables un cuestionario de calidad de los servicios primarios utilizados por los niños. Se emplearon chi cuadrado, Wilcoxon y el coeficiente de Spearman (95 por ciento de confianza) para el cálculo de los datos. Resultados: La calidad de la atención primaria tuvo relación con el índice ceod de preescolares (p = -0,19; p < 0,05). Se observó diferencias significativas entre la prevalencia de caries dental cuando comparados servicios de calidad (ceod = 0,50) con el grupo baja calidad (ceod = 1,13). También, la calidad fue asociada con la modalidad del servicio (p < 0,001), obteniéndose en los servicios privado y la estrategia de salud de la familia puntajes mayores (55,31 por ciento y 69,48 por ciento de calidad, respectivamente). Conclusiones: La calidad de la atención primaria está estrechamente relacionada con salud bucal, de esta forma, cuando la calidad de los servicios de atención primaria no es buena, repercute en un mayor índice de caries dental en los preescolares.

ABSTRACT Introduction: Primary health care solves most of the health problems of the population, provides primary access to the service, ensures the continuity and comprehensiveness of health care, and coordinates its different forms. Objective: Evaluate the relationship between primary health care quality and dental caries in preschoolers. Methods: A cross-sectional descriptive study was conducted of a sample of 515 preschoolers. Participant schools were selected by stratified random sampling, followed by simple random sampling for the selection of participant children. Oral examination was performed to evaluate dental caries, and parents / guardians were given a questionnaire about the quality of the primary services attended by their children. Data were estimated with the chi-squared test, the Wilcoxon test and Spearman's coefficient (95 percent confidence). Results: A relationship was found between primary health care quality and the ceod index of preschoolers (p = -0.19; p < 0.05). Significant differences were observed in the prevalence of dental caries when quality services (ceod = 0.50) were compared with the low quality group (ceod = 1.13). Quality was also associated to the service mode (p < 0.001). Private services and the family health strategy obtained higher quality scores (55.31 percent and 69.48 percent, respectively). Conclusions: Primary health care quality is closely related to oral health, in such a way that when the quality of primary health care services is not good, a higher dental caries rate is observed among preschoolers(AU)

Desafíos para los médicos de familia ante la pandemia de COVID-19 / Challenges for family doctors in the face of the COVID-19 pandemic

RESUMEN La atención primaria de salud es el área de actuación fundamental de la medicina familiar y una herramienta clave para su desarrollo. Al ser declarada como pandemia por la Organización Mundial de la Salud, la COVID-19 ha hecho que los sistemas de salud consideren los sólidos servicios de atención primaria como base de la respuesta ante esta emergencia. El objetivo del presente trabajo fue describir los desafíos a los que se enfrentan los médicos de familia en la atención a pacientes sospechosos o confirmados por la COVID-19. Es necesario que el personal de salud y toda la población conozcan las características del nuevo coronavirus. En Cuba, existe un Protocolo Nacional contra la COVID-19, en constante actualización, donde se definen los criterios de casos, las principales medidas preventivas y el tratamiento para combatir la enfermedad. El médico familiar debe establecer consultas de clasificación para atender los pacientes con enfermedades respiratorias agudas; de esta manera se evita el contacto con los demás pacientes que acuden con otros problemas de salud. Asimismo, debe insistir en las medidas preventivas y tratar los casos sospechosos y confirmados, mantenerse actualizado, realizar pesquisa activa de los casos, garantizar la atención de las personas que se encuentran en los centros de aislamiento, e investigar cada una de las características de la enfermedad. A modo de conclusión, se plantea que la medicina familiar es necesaria para prevenir la enfermedad por coronavirus 2019. Son varios los retos y desafíos que deben enfrentar los médicos de familia ante la pandemia (AU).

ABSTRACT Primary health care is the main area of action of family medicine and a key tool for its development. Being declared a pandemic by the World Health Organization, COVID-19 has made health systems consider solid primary care services as the basis of the response to this emergency. The aim of this paper was to describe the challenges faced by family physicians in taking care of COVID-19 suspected or confirmed patients. The health care staff and the entire population need to know the characteristics of the novel coronavirus. There is a National Protocol against COVID-19 in Cuba that is regularly updated; it defines the cases criteria, the main preventive measures and the treatment to fight the disease. The family doctor should establish classification consultations to take care of patients with acute respiratory diseases; this avoids contact with the rest of patients who come with other health problems. They should also insist on preventive measures and take care of suspicious and confirmed cases; keep themselves updated; carry out an active investigation of cases; ensure the care of persons in isolation centers, and study each of the characteristics of the disease. As a conclusion, it is indicated that family medicine is necessary to prevent coronavirus disease 2019. There are several challenges and defies that family doctors must face in the face of the pandemic (AU).