Progress in research on health literate schools / 中国学校卫生

Abstract@#Health literate schools (HeLit-Schools) play a significant role in fostering students health literacy. The paper elucidates the background and conceptual connotations of HeLit-Schools, and analyzes how HeLit-Schools effectively integrate and enhance the health literacy of schools in three aspects: philosophy and core drivers, strategy and method implementation, as well as evaluation mechanisms and standard setting. Furthermore, the paper explores the implications of foreign HeLit-Schools research and practice for China under the context of "Healthy China" construction, as well as the key strategies for Chinese schools in the implementation of HeLit-Schools, aiming to provide a new perspective and theoretical support for Chinese schools to practice the "Healthy China initiative" and strengthen school construction from the perspective of health literacy.

Organização da atenção primária à saúde de municípios de São Paulo, Brasil: modelo de atenção e coerência com as diretrizes do Sistema Único de Saúde / Organización de la atención primaria de salud de municipios de São Paulo, Brasil: modelo de atención y coherencia con las directrices del Sistema Único de Salud / Primary health care organization in municipalities of São Paulo, Brazil: a model of care aligned with the Brazilian Unified National Health System's guidelines

Resumo: Este trabalho tem como objetivo analisar os principais padrões de organização das redes municipais de serviços de atenção primária à saúde (APS) e avaliá-los segundo os indicadores de interface entre gestão e gerenciamento local. Trata-se de pesquisa avaliativa que analisou 461 municípios de São Paulo, Brasil, que participaram do Inquérito de Avaliação da Qualidade de Serviços de Atenção Básica (QualiAB) em 2017/2018, classificados segundo a composição dos arranjos organizacionais de 2.472 serviços de APS. Para avaliar os padrões identificados, foram selecionados oito indicadores de gestão e gerenciamento local. Os resultados apontam dois grupos de municípios: homogêneos, com serviços de um mesmo arranjo (43,6%); e heterogêneos, com diferentes arranjos (56,4%). Os grupos foram subdivididos em sete padrões que variaram entre homogêneo-tradicional, homogêneo-Estratégia Saúde da Família, homogêneo-misto e diferentes combinações no grupo heterogêneo. Todos os indicadores apontaram diferenças significativas entre os grupos (p < 0,001), com destaque para o grupo homogêneo-tradicional, com padrão organizacional distante do modelo desejado para uma APS abrangente e resolutiva, enquanto aqueles com unidades de saúde da família (USF), e com unidades básicas com agentes comunitários de saúde e/ou equipes de saúde da família (UBS/USF) demonstraram um padrão mais aproximado desse modelo - com ações de planejamento e avaliação comprometidos com a realidade local e com a qualificação do trabalho. Discute-se a importância das políticas implementadas pela gestão federal e estadual e seu poder de indução na definição do modelo de atenção à saúde na APS dos municípios.

Resumen: El trabajo tiene el objetivo de analizar los principales patrones de organización de las redes municipales de servicios de atención primaria de salud (APS) y evaluarlos conforme los indicadores de interfaz entre la dirección y gestión local. Se trata de una investigación evaluativa que analizó 461 municipios de São Paulo, Brasil, que participaron de la Encuesta de Evaluación de la Calidad de los Servicios de Atención Primaria (QualiAB) en 2017/2018, clasificados según la composición de los arreglos organizativos de 2.472 servicios de APS. Para evaluar los patrones identificados, se seleccionaron ocho indicadores de dirección y gestión local. Los resultados indican dos grupos de municipios: homogéneos, con servicios de un mismo arreglo (43,6%) e heterogéneos, con arreglos diferentes (56,4%). Los grupos se subdividieron en siete patrones que iban desde homogéneo-tradicional, homogéneo-Estrategia de Salud de la Familia, homogéneo-mixto y diferentes combinaciones en el grupo heterogéneo. Todos los indicadores señalaron diferencias significativas entre los grupos (p < 0,001), con destaque para el grupo homogéneo-tradicional, con patrón organizativo alejado del modelo deseado para una APS completa y resolutiva, mientras aquellos con unidades de salud de la familia (USF), y con unidades básicas con agentes comunitarios de salud y/o equipos de salud de la familia (UBS/USF) demostraron un patrón más cercano a este modelo -con acciones de planificación y evaluación comprometidas con la realidad local y con la calificación del trabajo. Se discute la importancia de las políticas implementadas por la gestión federal y la gestión estatal y su poder de inducción para definir el modelo de atención a la salud en la APS de los municipios.

Abstract: This study analyzes the main organization patterns used by primary health care (PHC) services in municipal networks and evaluates them according to indicators of local management-administration interface. Evaluative research analyzed 461 municipalities in São Paulo, Brazil, that participated in the Primary Care Services Quality Assessment Survey (QualiAB) in 2017/2018, classified according to the organizational arrangements composition of 2,472 PHC services. Eight indicators of local management and administration were selected to evaluate the identified patterns. Results indicate two groups of municipalities: homogeneous, with services presenting the same arrangement (43.6%); and heterogeneous, with different arrangements (56.4%). These were subdivided into seven patterns that ranged from homogeneous-traditional, homogeneous-Family Health Strategy, homogeneous-mixed, and different combinations in the heterogeneous group. All indicators showed significant differences between groups (p < 0.001), especially the homogeneous-traditional group, which presented an organizational pattern far from the desired model of a comprehensive and problem-solving PHC. Those integrated with family health units (FHU) and basic health units with community health workers and/or family health teams (BHU/FHU) showed a pattern closer to a comprehensive model - with planning and evaluation actions committed to the local reality and qualification of care. Implementation of federal and state policies are essential for defining the PHC health care model adopted by municipalities.

Estructura conceptual de la competencia gestión de desechos radiactivos para tecnólogos de Medicina Nuclear / Conceptual structure of the radioactive waste management competency for Nuclear Medicine technologists

Introducción: la Medicina Nuclear es una especialidad médica que trata o diagnostica diferentes afecciones mediante imágenes de tipo funcional-molecular, a partir del empleo de fuentes no selladas. Un aspecto importante en el desempeño profesional es la adecuada gestión de sustancias que puedan resultar nocivas. Objetivo: fundamentar la estructura conceptual de la competencia gestión de desechos radiactivos. Métodos: se realizó una revisión bibliográfica con un análisis crítico reflexivo, se consideraron documentos normativos de la actividad en Medicina Nuclear, tesis, artículos y libros, publicados a partir del 2018 en español e inglés. La búsqueda fue realizada en las bases de datos SciELO durante el periodo comprendido de enero a mayo del 2023. Las palabras clave utilizadas fueron: competencias, gestión y desechos radiactivos. Fueron revisados 73 textos y se seleccionaron 20 para conformar el texto final. Resultados: se delimitaron cuatro núcleos temáticos: pertinencia de formar competencias profesionales, base teórico-metodológica, base legal y riesgos e implicaciones. Resulta evidente el insuficiente tratamiento teórico-metodológico a la gestión de desechos como actividad de los tecnólogos de Medicina Nuclear. Se propone la definición de la competencia, los problemas contextuales que aborda, ejes procesuales, criterio de desempeño y evidencias requeridas. Conclusiones: el estudio de las competencias profesionales en los tecnólogos de la salud es un campo de notable vigencia encaminado a desarrollar su profesionalización. La evidente relación establecida entre la competencia gestión de desechos radiactivos y la reducción de riesgos y accidentes, conlleva la responsabilidad de formar profesionales preparados para desempeñarse con éxito en la Medicina Nuclear.

Introduction: Nuclear Medicine is a medical specialty that treats or diagnoses different conditions through functional-molecular images, using unsealed sources. An important aspect in professional performance is the proper management of substances that may be harmful. Objective: to support the conceptual structure of the radioactive waste management competence. Methods: a bibliographic review was carried out with a reflective critical analysis, normative documents of the activity in Nuclear Medicine, theses, articles, and books, published since 2018 in Spanish and English, were considered. The search was carried out in the SciELO databases from January to May 2023. The keywords used were competencies, management and radioactive waste. 73 texts were reviewed and 20 were selected to make up the final text. Results: four topic cores were defined: relevance of training professional competencies, theoretical-methodological base, legal base and risks and implications. The insufficient theoretical-methodological treatment of waste management as an activity of Nuclear Medicine technologists is evident. The definition of the competence, the contextual problems it addresses, procedural axes, performance criteria and required evidence are proposed. Conclusions: the study of professional competencies in health technologists is a field of notable validity aimed at developing their professionalization. The evident relationship established between radioactive waste management competence and the reduction of risks and accidents entails the responsibility of training professionals prepared to perform successfully in Nuclear Medicine.

Gestão regional no enfrentamento à pandemia da Covid-19: estudo de casos em São Paulo / Regional management in the face of the COVID-19 pandemic: case study in São Paulo

RESUMO Ao final do ano de 2019 o mundo foi surpreendido pela Covid-19, que chegou ao Brasil no início de 2020, fazendo com que o Sistema Único de Saúde (SUS) adotasse estratégias imediatas para atender as necessidades de saúde da população, colocando em evidência todos os obstáculos que o sistema de saúde vinha enfrentando nos últimos anos. O estado de São Paulo não foi diferente do restante do País em relação ao enfrentamento. Este estudo objetivou identificar as principais estratégias adotadas em 5 regiões de saúde de São Paulo, com foco na gestão regional, analisando os processos e práticas adotados para o enfrentamento à pandemia da Covid-19. Tratou-se de um estudo qualitativo, realizado através de estudo de casos múltiplos, com abordagem exploratória, a partir de pesquisa de campo e realização de oficinas regionais. As regiões de saúde deste estudo puderam comprovar a importância da intersetorialidade nas ações de saúde como um todo. Notou-se o grande papel dos municípios nestas ações e a união destes, fortalecendo o papel da regionalização e ampliando a importância da governança em saúde. Ademais, as regiões de saúde saíram fortalecidas porque exerceram seu papel de liderança e organizaram ações junto aos municípios.

ABSTRACT At the end of 2019 the world was surprised by COVID-19, which arrived in Brazil at the beginning of 2020, causing the Unified Health System (SUS) to adopt immediate strategies to meet health needs, as well as putting in check all the obstacles that the health system has been facing in recent years. In the state of São Paulo it was not different from the rest of the country in relation to the confrontation. This study aimed to identify the main strategies adopted in 5 health regions of São Paulo, focusing on regional management, analyzing the processes and practices adopted to face the COVID-19 pandemic. It was a qualitative study, carried out through a multiple case study, with an exploratory approach, based on field research and regional workshops. In this study, the health regions were able to prove the importance of intersectoral actions in the health system. It was noted the great role of municipalities in these actions and their union, strengthening the role of regionalization and expanding the importance of governance in health. In addition, the health regions were strengthened because they exercised their leadership role and organized actions with the municipalities.

Modelo de gestión del cuidado de enfermería en servicios hospitalario / Nursing care management model in hospital services

RESUMEN Objetivo: Describir el modelo de gestión del cuidado de enfermería en servicios hospitalarios. Metodología: La metodología desarrollada en este estudio se basó en la perspectiva cuantitativa, utilizando tipologías documental-bibliográficas que ayudan a establecer el análisis del objeto de investigación. El material abordado se conformó por tesis de grado, investigaciones científicas, trabajos arbitrados y, con ello, descubrir características y relaciones entre los elementos. En conclusión: El rol de enfermería en el desarrollo de los modelos de gestión del cuidado en los servicios hospitalarios, es de gran importancia ya que establecen los mecanismos de comunicación para su implementación en conjunto con el resto del equipo de salud, que hace vida en los centros hospitalarios.

ABSTRACT Objective: To describe the nursing care management model in hospital services. Methodology: The methodology developed in this study is based on the quantitative perspective using documentary-bibliographic typologies that help to establish the analysis of the research object. The material approached consisted of degree theses, scientific research, refereed works and thus discovering characteristics and relationships between the elements. In conclusion: The role of nursing in the development of care management models in hospital services is of great importance since it is necessary to establish the communication mechanisms for its implementation together with the rest of the health team that works in the hospital centers.

Modelo de gestión del cuidado de enfermería en servicios hospitalario / Nursing care management model in hospital services

Describir el modelo de gestión del cuidado de enfermería en servicios hospitalario. Metodología: La metodología desarrollada en este estudio se basó en la perspectiva cuantitativa utilizando tipologías documental-bibliográficos que ayudan a establecer el análisis del objeto de investigación. El material abordado se conformó por tesis de grado, investigaciones científicas, trabajos arbitrados y con ello descubrir características y relaciones entre los elementos. En conclusión: El rol de enfermería en el desarrollo de los modelos de gestión del cuidado en los servicios hospitalarios, es de gran importancia ya que establecen los mecanismos de comunicación para su implementación en conjunto con el resto del equipo de salud, que hace vida en los centros hospitalarios.

To describe the nursing care management model in hospital services. Methodology: The methodology developed in this study is based on the quantitative perspective using documentary-bibliographic typologies that help to establish the analysis of the research object. The material approached consisted of degree theses, scientific research, refereed works and thus discovering characteristics and relationships between the elements. In conclusion: The role of nursing in the development of care management models in hospital services is of great importance since it is necessary to establish the communication mechanisms for its implementation together with the rest of the health team that works in the hospital centers.

Establishment of integrative medicine with patient first model in the clinical practice of hemodialysis access / 中华肾脏病杂志

Vascular accesses are the lifelines for hemodialysis patients. This paper proposes to establish an integrative medicine with patient first model in the clinical practice of vascular access based on characters of hemodialysis patients and combined with the domestic and global innovation of management of vascular access. This model emphasizes the integration of vascular access plan with the whole life plan of renal replacement therapy, the combination of characters of vessel and entire condition of the patient, as well as balanced with patient's psychosocial characters. To implement this model in clinical practice, a multidisciplinary team with different professional background should be built, suitable job position should be set up and workflows should be formulated and optimized.

Establishment and exploration of the mechanism of Co-morbidity，Shared Etiology，and Shared Prevention of major health problems of children and adolescents / 中国学校卫生

Abstract@#In recent years, child and adolescent health problems such as myopia, obesity, and mental health have attracted the attention of society as a whole and have become important public health issues. Considering high prevalence in each of the major health problems among children and adolescents in China, current high prevalence of co morbidities of these health problems needs further attention. Shared behavioral and environmental risk and protective factors make it possible to improve the co morbidities among children and adolescents through the same interventions. It is urgent to explore the Co morbidity，Shared Etiology，and Shared Prevention mechanism of common diseases of children and adolescents in China, and to explore standardized programs and processes for the implementation of comorbidity intervention for children and adolescents across varied scenarios including families, schools, communities and medical institutions, so as to improve the health level of children and adolescents.

Implementation of school mental health social service system in accordance with the contemporary characteristics of children and adolescents mental health problems / 中国学校卫生

Abstract@#In recent years, mental health problems of children and adolescents are increasingly recognised as one of the most significant public health concerns. The article briefly describes the contemporary characteristics of mental health problems in children and adolescents, and proposes the implementation of school mental health social service system, including the establishment of comprehensive school mental health social service policies, the improvement of the school mental health social service model, the construction of regional school mental health service centers, and the strengthening of school mental health service practices in order to address youth mental health needs.

Retrospective analysis of childcare center disinfection in some regions of Anhui Province during 2019-2022 / 中国学校卫生

Objective@#To understand the status of childcare center disinfection around the COVID-19 pandemic, the needs of professional technical support, so as to give advice for improvement measures.@*Methods@#Using multi stage stratified sampling method, one was selected from each area of northern and southern Anhui Province, with 3 counties/districts selected from each city. A total of 54, 58, 60 childcare institutions were selected. A questionnaire survey, as well as on site visits and data check were administered in these childcare centers in Anhui Province were implemented. Information regarding the three stage disinfection work from 2019 to 2022 and technical support needs were collected.@*Results@#A total of 54, 58, 60 childcare centers were investigated in 2019, 2020 and 2021-2022. Most of the childcare centers recorded disinfection work (96.3%, 96.6%, 98.3%), while few of them ( 26.4% , 26.3%, 58.3%) monitored disinfection factor intensity. The implementing rate of disinfection effect evaluation was 68.3% at the stage of normal prevention and control, the highest demand rate for professional technical support was guidance and training ( 95.0% ), and the highest demand rate for training content was disinfectant preparation method (81.7%). There were significant differences in the rate of disinfection tableware room allocation (A: 93.3%, B: 70.0%), and the rate of disinfection effect evaluation among different cities (A: 53.3%, B: 83.3%)( χ 2=6.24, 5.46, P <0.05).@*Conclusions@#From 2019 to 2022, childcare center disinfection has significantly improved, however, disinfection factor intensity monitoring and disinfection effect evaluation are neglected during the stage of normal prevention and control. The demand for professional technical institutions to provide disinfectant preparation method guidance and training is high.It is suggested to strengthen the monitoring and evaluation of disinfection and related technical guidance.

Current status of health standards and health management system in childcare institutions / 中国学校卫生

Abstract@#Children in childcare institutions are involved with a high degree of contact, poor personal hygiene habits, low resistance, high incidence of disease, infections diseases are easily spread without proper public health management. Compared with child care centers, the construction of national standards, industry standards and management systems for primary and secondary school health is relatively complete, while the applicability of the current hygiene standards and management systems for childcare centers is worth exploring. By reviewing the previous literature, the study sorted out the current status of hygiene standards and hygiene management system in childcare institutions, and assesse their applicability in childcare institutions, so as to provide references for the establishment of hygiene standards and hygiene management system in childcare institutions.

Implementing the special action plan to comprehensively strengthen and improve students mental health work / 中国学校卫生

Abstract@#In recent years, mental health issues have gradually expanded from adults and professional groups to the primary and secondary school students, and are showing a trend of younger age. The article analyzes the "Special Action Plan for Comprehensively Strengthening and Improving the Mental Health Work of Students in the New Era (2023-2025)" jointly issued by 17 departments including the Ministry of Education. It explores the current situation, overall concept, key tasks, and other aspects to further improve the "four in one" student mental health work system of health education, monitoring and warning, consulting services, intervention disposal, and improve students mental health literacy.

Public health emergency response capacity in primary and secondary schools / 中国学校卫生

Objective@#To understand the public health emergency response capacity in primary and secondary schools, and to explore the problems and challenges in the prevention and control of public health emergency in primary and secondary schools for specific strategies.@*Methods@#By using the stratified group sampling method, a questionnaire survey on general situation, knowledge, attitude and training, as well as public health emergencies response capacity among 2 988 teachers or leaders responsible for school emergency response in primary and secondary schools from Beijing, Chongqing and Yunnan.@*Results@#Participants varied on their positions, titles, educational background and knowledge accuracy. Higher knowledge accuracy was associated with higher educational background ( χ 2=50.73-203.36, P < 0.05 ). The implementation of regular public health emergency related programs was poorly conducted in high schools (50.0%). Urban schools (42.0%) had higher proportion of qualified health care professionals than rural schools (18.2%), and private schools (48.5%) was higher than public schools (24.7%). The primary challenges included the shortage of guidance from professionals and the lack of related testing equipment (84.91%, 74.03%).@*Conclusion@#Although the ability of emergency handling of public health emergencies in schools in the three regions is advancing with the times, there are still many deficiencies, some omissions in the mastery of knowledge. It is suggested to inerease pre service and special training of school health work CDC should strengthen technical guidance and work supervision of infectious disease management in schools.

A consensus on the management of allergy in kindergartens and primary schools / 中国学校卫生

Abstract@#Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.

Experience and associated factors of sexuality education among kindergarten and primary and secondary school teachers / 中国学校卫生

Objective@#To investigate the experience, attitude and practice of sexuality education for teachers, so as to provide evidence for promoting sexuality education training for teachers and teaching ability improvement.@*Methods@#From September to October 2021, 2 146 valid data of kindergarten and primary and secondary school teachers across the country were collected. Associateds factors of teachers sexuality education behavior were explored by Logistic regression analysis.@*Results@#Family and school based sexuality education experiences were insufficient among teachers (22.51%, 46.55%), and the proportions of female teachers who had received sexuality education (20.44%, 41.67%) were significantly higher than that of male teachers (2.05%, 4.90%). Currently, 47.53 % of the kindergartens and primary and secondary schools from participating teachers didn t carry out sex education, which mainly focused in the field of reproductive health and physical development. Kindergartens and primary and secondary schools often integrated sex education into other disciplines (64.48%, 47.83%). Teachers acceptance of family and school based sexuality education, students willingness to communicate on sexual topics with teachers, teachers confidence in answering sexual questions were positively correlated with teachers teaching activities of sexuality education ( OR=1.59, 1.37, 1.67, 1.67, P < 0.01 ).@*Conclusions@#Teachers teaching ability of sexuality education is insufficient, and school based sexuality education couldn t meet students developmental needs. Providing sexuality education training to teachers and enhancing their confidence in answering sexual questions are helpful to facilitate sexuality education teaching activities.

Nursing care management concepts: scoping review / Conceptos de gestión y administración de la atención de enfermería: revisión de ámbito / Conceitos de gestão e gerência do cuidado de enfermagem: revisão de escopo

ABSTRACT Objectives: to clarify the concepts of Nursing Care Management and Nursing Care Administration in the scientific literature, highlighting approximations and distances between the terms. Methods: scoping review as per Joanna Briggs Institute protocol and preferred reporting items for Systematic Reviews and Meta-analysis extension for Scoping Reviews (PRISMA-ScR). The searches were performed in LILACS, CINAHL, MEDLINE, and Scopus databases. Results: the qualitative analysis, through content analysis, counted 49 studies published between 2007 and 2020. Hospital care was the most evident level of care. It was identified that nursing care management aims at the macropolitical performance of nurses and mobilizes skills essentially strategic-cognitive, while Nursing Care Administration aims at the micropolitical performance of nurses, requiring essentially strategic-administrative skills. Final Considerations: the study allowed us to propose the conceptualization of the terms and identify the approximations and distances between them.

RESUMEN Objetivos: aclarar conceptos de Gestión de Atención de Enfermería y Administración de Atención de Enfermería en la literatura científica, destacando aproximaciones y alejamientos entre los términos. Métodos: revisión de ámbito conforme protocolo del Joanna Briggs Institute e Items de Informes Preferenciales para Revisiones Sistemáticas y extensión de Meta-Análisis para Revisiones de Ámbito (PRISMA-ScR). Las búsquedas ocurrieron en las bases LILACS, CINAHL, MEDLINE y Scopus. Resultados: el análisis cualitativo, mediante el análisis de contenido, cuenta con 49 estudios, publicados entre 2007 y 2020. La Atención Hospitalaria fue el nivel de atención más evidenciado. Identificado que la Gestión de la Atención de Enfermería objetiva la actuación macropolítica del enfermem y moviliza competencias esencialmente estratégico-cognitivas, mientras la Administración de la Atención de Enfermería objetiva a la actuación micropolítica del enfermera, demandando competencias esencialmente estratégico-administrativas. Consideraciones Finales: el estudio posibilitó proponer la conceptuación de los términos e identificar las aproximaciones y alejamientos entre esos.

RESUMO Objetivos: esclarecer os conceitos de Gestão do Cuidado de Enfermagem e Gerência do Cuidado de Enfermagem na literatura científica, destacando aproximações e distanciamentos entre os termos. Métodos: revisão de escopo conforme protocolo do Joanna Briggs Institute e Itens de Relatórios Preferenciais para Revisões Sistemáticas e extensão de Meta-Análises para Revisões de Escopo (PRISMA-ScR). As buscas ocorreram nas bases LILACS, CINAHL, MEDLINE e Scopus. Resultados: a análise qualitativa, mediante a análise de conteúdo, contou com 49 estudos, publicados entre 2007 e 2020. A Atenção Hospitalar foi o nível de atenção mais evidenciado. Identificou-se que a Gestão do Cuidado de Enfermagem objetiva a atuação macropolítica do enfermeiro e mobiliza competências essencialmente estratégico-cognitivas, enquanto a Gerência do Cuidado de Enfermagem visa à atuação micropolítica do enfermeiro, requisitando competências essencialmente estratégico-administrativas. Considerações Finais: o estudo possibilitou propor a conceituação dos termos e identificar as aproximações e distanciamentos entre eles.

Adaptation and validation of an adult patient classification instrument with emphasis on the family dimension / Adaptación y validación de instrumento de clasificación de paciente adulto con énfasis en la dimensión familiar / Adaptação e validação de instrumento de classificação de paciente adulto com ênfase na dimensão familiar

ABSTRACT Objectives: to adapt and validate an instrument for classifying adult patients that emphasizes the family support network in the demand for nursing care. Methods: methodological study, carried out in three phases: adaptation of an instrument considering the reality of adult patients; content validation with seven experts and assessment of measurement properties (construct validity and internal consistency) with 781 hospitalized patients. Results: in content validation, the indicators reached the values established for the Content Validity Index (0.85-1.00). In the confirmatory factor analysis, the 11 indicators were distributed in three domains and presented average variance extracted and factor loading greater than 0.5. Composite reliability was greater than 0.7. Conclusions: the present study adapted and made available, with evidence of validity and reliability, an instrument for classifying adult patients that considers the family support network in the demand for nursing care.

RESUMEN Objetivos: adaptar y validar un instrumento para clasificación de pacientes adultos que enfatiza la red de apoyo familiar en la demanda de cuidados de enfermería. Métodos: estudio metodológico, realizado en tres fases: adaptación de un instrumento considerando la realidad de pacientes adultos; validez de contenido con siete especialistas y evaluación de las propiedades de medida (validez de constructo y consistencia interna) con 781 pacientes internados. Resultados: en la validez de contenido, los indicadores alcanzaron los valores establecidos para el Índice de Validez de Contenido (0,85-1,00). En el análisis factorial confirmatorio, los 11 indicadores fueron distribuidos en tres dominios y presentaron desviación mediana extraída y carga factorial superiores a 0,5. La confiabilidad compuesta fue superior a 0,7. Conclusiones: el presente estudio adaptó y proveyó, con evidencias de validez y confiabilidad, un instrumento para clasificación de pacientes adultos que considera la red de apoyo familiar en la demanda de cuidados de enfermería.

RESUMO Objetivos: adaptar e validar um instrumento para classificação de pacientes adultos que enfatiza a rede de suporte familiar na demanda de cuidados de enfermagem. Métodos: estudo metodológico, realizado em três fases: adaptação de um instrumento considerando a realidade de pacientes adultos; validação de conteúdo com sete especialistas e avaliação das propriedades de medida (validade de construto e consistência interna) com 781 pacientes internados. Resultados: na validação de conteúdo, os indicadores alcançaram os valores estabelecidos para o Índice de Validade de Conteúdo (0,85-1,00). Na análise fatorial confirmatória, os 11 indicadores foram distribuídos em três domínios e apresentaram variância média extraída e carga fatorial superiores a 0,5. A confiabilidade composta foi superior a 0,7. Conclusões: o presente estudo adaptou e disponibilizou, com evidências de validade e confiabilidade, um instrumento para classificação de pacientes adultos que considera a rede de suporte familiar na demanda de cuidados de enfermagem.

Adaptation and validation of an adult patient classification instrument with emphasis on the family dimension / Adaptación y validación de instrumento de clasificación de paciente adulto con énfasis en la dimensión familiar / Adaptação e validação de instrumento de classificação de paciente adulto com ênfase na dimensão familiar

ABSTRACT Objectives: to adapt and validate an instrument for classifying adult patients that emphasizes the family support network in the demand for nursing care. Methods: methodological study, carried out in three phases: adaptation of an instrument considering the reality of adult patients; content validation with seven experts and assessment of measurement properties (construct validity and internal consistency) with 781 hospitalized patients. Results: in content validation, the indicators reached the values established for the Content Validity Index (0.85-1.00). In the confirmatory factor analysis, the 11 indicators were distributed in three domains and presented average variance extracted and factor loading greater than 0.5. Composite reliability was greater than 0.7. Conclusions: the present study adapted and made available, with evidence of validity and reliability, an instrument for classifying adult patients that considers the family support network in the demand for nursing care.

RESUMEN Objetivos: adaptar y validar un instrumento para clasificación de pacientes adultos que enfatiza la red de apoyo familiar en la demanda de cuidados de enfermería. Métodos: estudio metodológico, realizado en tres fases: adaptación de un instrumento considerando la realidad de pacientes adultos; validez de contenido con siete especialistas y evaluación de las propiedades de medida (validez de constructo y consistencia interna) con 781 pacientes internados. Resultados: en la validez de contenido, los indicadores alcanzaron los valores establecidos para el Índice de Validez de Contenido (0,85-1,00). En el análisis factorial confirmatorio, los 11 indicadores fueron distribuidos en tres dominios y presentaron desviación mediana extraída y carga factorial superiores a 0,5. La confiabilidad compuesta fue superior a 0,7. Conclusiones: el presente estudio adaptó y proveyó, con evidencias de validez y confiabilidad, un instrumento para clasificación de pacientes adultos que considera la red de apoyo familiar en la demanda de cuidados de enfermería.

RESUMO Objetivos: adaptar e validar um instrumento para classificação de pacientes adultos que enfatiza a rede de suporte familiar na demanda de cuidados de enfermagem. Métodos: estudo metodológico, realizado em três fases: adaptação de um instrumento considerando a realidade de pacientes adultos; validação de conteúdo com sete especialistas e avaliação das propriedades de medida (validade de construto e consistência interna) com 781 pacientes internados. Resultados: na validação de conteúdo, os indicadores alcançaram os valores estabelecidos para o Índice de Validade de Conteúdo (0,85-1,00). Na análise fatorial confirmatória, os 11 indicadores foram distribuídos em três domínios e apresentaram variância média extraída e carga fatorial superiores a 0,5. A confiabilidade composta foi superior a 0,7. Conclusões: o presente estudo adaptou e disponibilizou, com evidências de validade e confiabilidade, um instrumento para classificação de pacientes adultos que considera a rede de suporte familiar na demanda de cuidados de enfermagem.

A visão de gerentes de atenção básica à saúde sobre suas atribuições / The perspective of primary health care managers about their attributions

Resumo O artigo objetivou compreender o desenvolvimento das atribuições do gerente de atenção básica a partir da perspectiva desses mesmos profissionais, na capital Maceió, Alagoas, Brasil. Trata-se de pesquisa qualitativa, que entrevistou a oito gerentes de Unidades Básicas de Saúde e tratado por meio da análise de conteúdo. Os resultados identificaram que os gerentes, como rotina, administram o fluxo assistencial e o registro de frequência dos membros da equipe, mas apresentam limitações para gerir o trabalho em equipe e a estrutura física. Em nível institucional, mediam a relação dos profissionais da equipe com a sede administrativa, porém demostram escassa participação no estabelecimento de ações intersetoriais. Valorizam a relação com a comunidade, no entanto, relatam haver pouca participação social no âmbito das Unidades. Demonstram, ainda, pouco conhecimento sobre as políticas e sistemas de informação em saúde. Considera-se que, para um impacto positivo no acesso e na qualidade à saúde da população, é necessária: a garantida da governabilidade dos gerentes sobre os recursos materiais e da gestão de pessoal; o monitoramento das metas de saúde com a participação colaborativa da comunidade; apropriação e fomento das redes de trabalho em saúde; e um programa de formação em serviço que auxilie a gestão local.

Abstract The article aimed to understand the development of the attributions of the primary care manager from the perspective of these same professionals, in the capital Maceió, Alagoas, Brazil. It is a qualitative research, which interviewed eight managers of Basic Health Units and treated by means of content analysis. The results identified that the managers as routine manage the flow of care and the attendance record of the team members, but present limitations to manage the teamwork and the physical structure. At the institutional level, they mediate the relationship of the team's professionals with the administrative headquarters, but show little participation in the establishment of intersectoral actions. They value the relationship with the community, however, they report little social participation at the Unit level. They show little knowledge about health policies and information systems. It is considered that, for a positive impact on access and quality to the health of the population, it is necessary: to guarantee the governability of managers over material resources and personnel management; the monitoring of health goals with the collaborative participation of the community; the appropriation and promotion of health work networks; and an in-service training program that helps local management.

Programa de Gestão e Desempenho: ponte para uberização no serviço público federal brasileiro / Management and Performance Program: bridge to uberization in the Brazilian federal public service

Resumo Objetivo: analisar a introdução do Programa de Gestão e Desempenho (PGD) na Universidade Federal Fluminense (UFF). Métodos: o PGD começou a ser implementado na UFF a partir de maio de 2022, este ensaio apresenta as mudanças estabelecidas e discute suas relações com o processo de uberização. Resultados: as diretrizes estabelecidas pelo PGD, bem como a experiência inicial de sua implementação na UFF, apontam uma forte influência do ideário que orienta o fenômeno da uberização do trabalho. Ao produzir mudanças profundas na forma de organização e controle das atividades laborais, o PGD traz também potenciais impactos na saúde do trabalhador, destacadamente a maior dificuldade no mapeamento e controle dos riscos nos ambientes de trabalho, que se tornam mais pulverizados; e os efeitos nocivos à saúde mental, provocados por um modelo de gestão baseado no controle rigoroso de processos e cumprimento de metas. Conclusões: o programa instituído na UFF guarda muitas relações com o modelo de gestão do trabalho uberizado, que vem se impondo como tendência do capitalismo contemporâneo, impactando, de forma desigual, os trabalhadores. A mudança no modelo de gestão das atividades laborais, imposta pelo programa, aponta para potenciais efeitos sobre a saúde física e mental do trabalhador.

Abstract Objective: to analyze the introduction of the Performance and Management Program (PMP) at the Federal Fluminense University (UFF). Methods: the PMP began to be implemented at the UFF in May 2022. This essay presents the established changes and discusses their relationship with the process of "uberization". Results: the guidelines established by the PMP, as well as the initial experience of its implementation at UFF, indicate a strong influence of the ideas guiding the phenomenon of "uberization" of work. By bringing about profound changes in the organization and control of work activities, the PMP also has the potential to impact the workers' health, notably increasing the difficulty in mapping and controlling risks in work environments, which become more decentralized. It can also have detrimental effects on mental health, caused by a management model based on strict process control and goal fulfillment. Conclusions: the program instituted at UFF shares many similarities with the model of "uberized" work management, which has been emerging as a trend in contemporary capitalism, affecting workers unevenly. The change in the management model of work activities imposed by the program suggests potential effects on the workers' physical and mental health..