Pathways by which case managers' match support influences youth mentoring outcomes: Testing the systemic model of youth mentoring.

Keller's systemic model of youth mentoring posits there are multiple pathways through which all stakeholders in the youth mentoring process, including the program staff who support the match (or case managers), influence youth outcomes. This study examines case managers' direct and indirect contributions to match outcomes and tests how transitive interactions facilitate a theorized sequence of mentoring interactions to effect greater closeness and length, specifically in nontargeted mentoring programs. A structural equations model of case manager contributions to match outcomes was tested using data from 758 mentor-mentee matches, supported by 73 case managers across seven mentoring agencies. Results reveal direct effects of mentor-reported match support quality on match length and indirect influences on match length through increasing youth-centeredness, goal-focused orientation, and closeness. The findings confirm the presence of multiple pathways of influence, including indirect effects on outcomes via transitive interactions in match support that scaffold youth-centeredness and goal-focused interactions in the match. Findings also suggest supervisors' evaluations of case managers may provide little information about how match support influences the nature of mentor-mentee interactions.

Quality Assessment of Cervical Cytology Practices in Estonia From 2007 to 2018.

BACKGROUND: Cervical cancer incidence and mortality in Estonia are among the highest in Europe, although the overall coverage with cervical cytology is high. This indicates potential issues with the quality of collection and/or laboratory evaluation of cervical cytology. OBJECTIVES: The aim of the retrospective observational study was to assess the quality of cervical cytology specimen collection, evaluation, and reporting using laboratory reports in Estonia. METHODS: The study included women with a cervical cancer diagnosis in 2017-2018. Cervical cytology and histology reports for these women in 2007-2018 were obtained from ten laboratories. We described the quality of cytology specimen collection and reporting of cytology results. Multivariate logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI) to identify factors associated with NILM as the last cervical cytology result within 5 or 2 years before the cervical cancer diagnosis. Also, we calculated cytology-histology correlation (CHC). RESULTS: We identified 503 cytology and 100 histology reports from 138 women. The laboratories differed greatly regarding human resources, work capacity and volume. Differences between local and regional laboratories were observed in reporting specimen adequacy (P < .001). We found that local laboratories had 3 times higher odds (OR = 2.95, 95% CI: 1.05-8.33) of reporting normal results 2 years before cancer diagnosis than regional laboratories. According to the CHC, 58.9% of pairs were in agreement. CONCLUSIONS: The study showed considerable heterogeneity and suboptimal performance of cervical cytology practices in Estonia, particularly at local laboratories. Efforts to improve laboratory quality assurance are crucial.

Evaluating the Practices and Challenges of Youth Volleyball Development in Amhara Regional State, Ethiopia by Using the CIPP Model.

Youth athletes' talent identification and development has become a serious concern around the globe. However, empirical evidence regarding youth sports policies and practices is limited. Emphasizing the talent development needs of youth volleyball players, in this study, the authors evaluated the practices and challenges of a youth volleyball development program in Amhara Regional State, Ethiopia. This study addressed this concern by drawing upon Stufflebeam's context, input, process, product (CIPP) model to explore a youth volleyball development program across the training sites located in Amhara Regional State, Ethiopia. With the help of this model, this study evaluated the prevailing contexts, allocated inputs, program implementation processes, and products. To this end, this study used multiple case studies involving ten youth project sites. The study participants included samples of participants (n = 179), consisting of youth volleyball players (n = 167), their coaches (n = 8), regional volleyball administrators, and regional educational office physical education coordinators (n = 4). The study participants identified some benefits from participating in the youth volleyball program, which included increased physical activity and health, enhanced positive interpersonal relationships, and knowledge of how to cope with challenges. However, they reported several challenges attributable to contextual constraints which included a lack of the necessary facilities and resources, lack of concern and convenient settings, poor implementation practices, and minimal outcomes. The findings suggest that the challenges of youth volleyball development in Ethiopia are complex and emanate from the context, input, process, and products. Accordingly, when addressing the issues of youth volleyball, it is necessary to develop systems, processes, methods, and tools that recognize all these concerns.

Quality of Educational Programs for Elementary School-Age Students With Autism.

The purpose of this study was to assess the quality of educational programs for school-aged children with autism in the United States. Investigators completed the Autism Program Environment Quality Rating Systems-Preschool/Elementary (APERS-PE) in 60 elementary schools enrolling children with autism. The mean total rating scores were near the midpoint rating, indicating schools were providing educational program environments classified as adequate but not of high quality. Domains of the APERS-PE reflecting structural quality tended to be significantly above average and domains reflecting process quality tended to be significantly below average. With a few exceptions, inclusive and special education program did not differ significantly in total program quality ratings and reflected the same pattern of domain quality ratings.

From Someone Who May Cause Trouble to Someone You Can Play With: Stakeholders' Perspectives on Preschool Program Quality for Autistic Children.

In Sweden, young autistic children typically attend community-based preschool programs, which may not be adapted to their needs. In the current study, stakeholders to autistic children receiving Early Intensive Behavioral Intervention were interviewed following a quasi-randomized study (#NCT03634761) aimed at improving the preschool program quality using the Swedish version of the Autism Program Environment Rating Scale (APERS). Stakeholders provided their perceptions and experiences concerning key factors for high quality preschool programs as well as well as their experiences of the abovementioned APERS study. Applying thematic analysis, stakeholder groups differed in what they emphasized, but all highlighted staff's competence, children's inclusion and participation, collaboration, and the learning environment as key program areas that had been positively influenced by the APERS-based intervention.

Program Quality and Developmental Outcomes Related to Youth Volleyball in Ethiopia: Assessing Relationships and Variations.

This study aims to assess program quality and developmental outcomes of a youth volleyball project in one of the regional states in Ethiopia, and further examine variations between groups across gender and project site zones. We applied a cross-sectional survey design, collecting quantitative data from youth volleyball players (n = 215) with a mean age of 16.18 years (SD = 0.69) through a self-reported questionnaire. The results indicated that young players' perceptions did not vary significantly across gender, except for the mean score of the perceived experience variable for girls (M = 2.68, SD = 0.318) was significantly higher than the mean score of boys (M = 2.58, SD = 0.258). One-way (project site zone) analyses of variance (ANOVAs) identified that youth volleyball projects in the central zone were consistently rated higher than those in the western zone, except for the current practice rating. Moreover, correlation analysis results indicated the presence of a significant relationship, both within and between program quality and developmental outcome variables. Furthermore, the results of regression analysis indicated that the program quality variables together predicted each of the developmental outcomes, accounting for 18.9% to 31.7% of the variances. It is concluded that the quality of the youth volleyball program in Ethiopia varies considerably across the project site zones and the program quality variables significantly relate to the developmental outcomes measured with differential effects. The data from this study reveals several practical applications for Ethiopia and beyond in terms of guiding youth volleyball projects. Moreover, the findings of the study showed that youth sport and the manner in which it is structured and delivered to youth players influences the attainment of positive developmental outcomes. These results suggest that contextual differences really do have an effect on the quality of youth sport program processes and developmental outcomes.

Developmental pathways linking the quality and intensity of organized afterschool activities in middle school to academic performance in high school.

INTRODUCTION: Adolescents' organized afterschool activities have been linked to their academic performance, but processes contributing to these relations are not well understood. This study tested two pathways linking activity intensity and activity quality in 6th grade to high school academic performance: adolescents' activities in 9th grade and adolescents' academic skills in 9th grade. METHODS: Data were from the Study of Early Child Care and Youth Development, a longitudinal study conducted at 10 sites in the United States. Data were collected from 918 participants (51% female) who were assessed in 6th grade (Age 12; middle school), 9th grade (Age 15; beginning of high school), and 12th grade (Age 18; end of high school). RESULTS & CONCLUSIONS: Findings from structural equation models indicated that adolescents who had higher activity intensity and activity quality in 6th grade participated in activities with higher intensity and quality in 9th grade. These 9th grade activities formed an indirect path linking 6th grade activities to high school academic performance, including grades and number of advanced classes. In addition, 6th grade activity quality promoted adolescents' work orientations in 9th grade, a key academic disposition that then predicted grades and number of advanced classes in high school. These findings suggest that organized afterschool activities in middle school may prepare adolescents for academic success in high school via their participation in activities in 9th grade as well a stronger work orientation in 9th grade.

The "Haves, Have Some, and Have Nots:" a Latent Profile Analysis of Capacity, Quality, and Implementation in Community-Based Afterschool Programs.

Implementation of evidence-based practices is a critical factor in whether afterschool programs are successful in having a positive impact upon risk reduction and positive youth development. However, important prevention research reveals that contextual and organizational factors can affect implementation (Bradshaw & Pas in School Psychology Review, 40, 530-548, 2011) (Flaspohler et al., in American Journal of Community Psychology, 50(3-4), 271-281, 2012) (Gottfredson et al., Prevention Science, 3, 43-56, 2002) (McIntosh et al., Journal of Positive Behavior Interventions, 18(4), 209-218, 2016) (Payne in Prevention Science, 10, 151-167, 2009). Using a latent profile approach (LPA), this paper examines multiple organizational and neighborhood contextual factors that might affect the degree to which afterschool programs effectively implement evidence-based practices in the context of a cluster-randomized trial of the Paxis Good Behavior Game (PaxGBG). The Interactive Systems Framework (ISF) explores dimensions of capacity that might matter for prevention efforts. As expected, we found that well-resourced and high-quality programs performed well in terms of implementation (the Haves) and, in neighborhood contexts rich in racial-ethnic diversity. Yet, we found that some programs with less physical and material capacity (the Have Nots), demonstrated greater program quality (i.e., supportive adult and peer relationships, engagement, a sense of belonging) and implementation, relative to programs with better capacity (e.g., space, material resources, staffing, and leadership, the Have Somes). While capacity matters, intentional prevention initiatives that seek to promote evidence-based practices are helpful to sites in supporting organizations that might otherwise fail to provide quality programming for youth. This paper addresses a conundrum in prevention science, namely, how to make programming accessible to those who need it with a focus on organizational processes, program quality, and implementation of evidence-based practices.

Quality is Critical for Meaningful Synthesis of Afterschool Program Effects: A Systematic Review and Meta-analysis.

Afterschool programs are designed to promote academic achievement and youth development as well as mitigate risk for students who attend. Systematic reviews have reported that afterschool programs are associated with increased academic proficiency, school bonding, prosocial behavior, and decreased problem behavior. However, the majority of meta-analyses that report on these outcomes limit their samples to only rigorously conducted studies, which is not representative of the larger literature base. This systematic review and meta-analysis is designed to extend the literature by meta-analyzing a comprehensive sample of studies and examine the impact of study quality on meta-analytical results. A comprehensive literature and effect size extraction process search yielded 130 effect sizes from 30 studies that examined the effects of afterschool programs on secondary students' academic achievement and social / behavioral development. The majority of studies were unpublished reports, and study quality in the sample represented a high risk of bias. The results confirm the hypothesis that the inclusion of lower quality studies significantly impacts overall outcomes in comparison to prior meta-analyses that have limited samples. As such, it is imperative that researchers and practitioners increase the rigor of study design across individual program evaluations so that fewer reports will be excluded. This will improve future meta-analytic outcomes by ensuring a more representative sample of the literature base. Only through improved rigor of study design will a more clear understanding of program impacts on secondary students be possible.

Enhancing Program Quality in a National Sample of After-school Settings: The Role of Youth-Staff Interactions and Staff/Organizational Functioning.

Using multilevel data from the national evaluation of Boys and Girls Clubs of America (BGCA), this study examined associations among programmatic structures, workplace and workforce characteristics, and relational practices of program staff as they relate to young people's ratings of their experience attending local clubs. The sample included 57,710 members and 5,231 staff members at 740 BGCA sites throughout the United States. Staff relational practices-including establishing caring relationships, setting high expectations, positive behavior management, encouraging youth input and agency, and cultural sensitivity-explained associations between staffing and organizational functioning and youths' perceptions of the quality of their clubs. Findings suggest a central role of staff relational practices in establishing conditions that youth experience positively, and that staffing and organizational processes, including community engagement and teamwork and efficiency can be viewed as foundations for establishing a culture of positive adult-youth interaction, which in turn can contribute to the promotion of positive youth development. Further, identification with the experiences of youth had a direct association with youths' perceptions of club quality. These results underscore the importance of staff workforce development initiatives as key to improving youth experiences in after-school programs.

PERFORMANCE MEASUREMENT IN TRIBAL HOME VISITING: CHALLENGES AND OPPORTUNITIES.

Over the last several decades, performance measurement has become an increasingly prevalent requirement among human services agencies for demonstrating program progress and achieving outcomes. In the Tribal Maternal, Infant, and Early Childhood Home Visiting Program (Tribal MIECHV), performance measurement was one of the central components of the Administration for Children and Families' cooperative agreements to tribes, urban Indian organizations, and tribal organizations. Since the inception of the Tribal MIECHV Program in 2010, the benchmark requirement was intended to be a mechanism to systematically monitor program progress and performance toward improving the quality of home-visiting programs that serve vulnerable American Indian or Alaska Native families. In this article, we examine performance measurement in the context of Tribal MIECHV, providing an overview of performance measurement, the Tribal MIECHV requirement, and how grantees experienced the requirement; we describe the existing literature on performance measurement challenges and benefits, and the specific challenges and advantages experienced by tribal grantees; and provide recommendations for performance measurement in tribal home-visiting contexts based on grantees' own experiences. This article contributes to the literature by examining performance measurement challenges and opportunities in the context of tribal communities, and provides recommendations that may inform future policy on performance measurement design and implementation in tribal communities.

Do Programs for Runaway and Homeless Youth Work? A Qualitative Exploration From the Perspectives of Youth Clients in Diverse Settings.

Runaway and homeless youth (RHY) comprise a large population of young people who reside outside the control and protection of parents and guardians and who experience numerous traumas and risk factors, but few buffering resources. Specialized settings have developed to serve RHY, but little is known about their effects. The present cross-sectional qualitative descriptive study, grounded in the positive youth development approach and the Youth Program Quality Assessment model, addressed this gap in the literature. From a larger sample of 29 RHY-specific settings across New York State, RHY ages 16-21 from 11 settings were purposively sampled for semi-structured in-depth interviews on their transitions into homelessness, experiences with settings, and unmet needs (N = 37 RHY). Data were analyzed with a theory-driven and inductive systematic content analysis approach. Half of participants (54%) were female; almost half (49%) identified as non-heterosexual; and 42% were African American/Black, 31% were Latino/Hispanic, and 28% were White/other. Results indicated that because RHY are a uniquely challenged population, distrustful of service settings and professional adults and skilled at surviving independently, the population-tailored approaches found in RHY-specific settings are vital to settings' abilities to effectively engage and serve RHY. We found the following four major themes regarding the positive effects of settings: (1) engaging with an RHY setting was emotionally challenging and frightening, and thus the experiences of safety and services tailored to RHY needs were critical; (2) instrumental support from staff was vital and most effective when received in a context of emotional support; (3) RHY were skilled at survival on the streets, but benefited from socialization into more traditional systems to foster future independent living; and (4) follow-through and aftercare were needed as RHY transitioned out of services. With respect to gaps in settings, RHY highlighted the following: (1) a desire for better management of tension between youths' needs for structure and wishes for autonomy and (2) lack of RHY input into program governance. This study advances our understanding of RHY, their service needs, and the ways settings meet these needs, as well as remaining gaps. It underscores the vital, life-changing, and even life-saving role these settings play for RHY.

Chemotherapy Extravasation: Establishing a National Benchmark for Incidence Among Cancer Centers.

BACKGROUND: Given the high-risk nature and nurse sensitivity of chemotherapy infusion and extravasation prevention, as well as the absence of an industry benchmark, a group of nurses studied oncology-specific nursing-sensitive indicators. 
. OBJECTIVES: The purpose was to establish a benchmark for the incidence of chemotherapy extravasation with vesicants, irritants, and irritants with vesicant potential.
. METHODS: Infusions with actual or suspected extravasations of vesicant and irritant chemotherapies were evaluated. Extravasation events were reviewed by type of agent, occurrence by drug category, route of administration, level of harm, follow-up, and patient referrals to surgical consultation.
. FINDINGS: A total of 739,812 infusions were evaluated, with 673 extravasation events identified. Incidence for all extravasation events was 0.09%.

Mystery behind the match: an undergraduate medical education-graduate medical education collaborative approach to understanding match goals and outcomes.

BACKGROUND: There is a paucity of information regarding institutional targets for the number of undergraduate medical education (UME) graduates being matched to graduate medical education (GME) programs at their home institutions. At our institution, the Duke University, the number of UME graduates matched to GME programs declined dramatically in 2011. To better understand why this decline may have happened, we sought to identify perceived quality metrics for UME and GME learners, evaluate trends in match outcomes and educational program characteristics, and explore whether there is an ideal retention rate for UME graduates in their home institutions' GME programs. METHODS: We analyzed the number of Duke University UME graduates remaining at Duke for GME training over the past 5 years. We collected data to assess for changing characteristics of UME and GME, and performed descriptive analysis of trends over time to investigate the potential impact on match outcomes. RESULTS: A one-sample t-test analysis showed no statistically significant difference in the number of Duke UME graduates who stayed for GME training. For both UME and GME, no significant changes in the characteristics of either program were found. DISCUSSION: We created a process for monitoring data related to the characteristics or perceived quality of UME and GME programs and developed a shared understanding of what may impact match lists for both UME graduates and GME programs, leaving the Match somewhat less mysterious. While we understand the trend of graduates remaining at their home institutions for GME training, we are uncertain whether setting a goal for retention is reasonable, and so some mystery remains. We believe there is an invaluable opportunity for collaboration between UME and GME stakeholders to facilitate discussion about setting shared institutional goals.

Physical Exercise and Cancer-Related Fatigue in Hospitalized Patients: Role of the Clinical Nurse Leader in Implementation of Interventions.

BACKGROUND: Guidelines suggest that aerobic endurance training and moderate resistance training lessen the effects of cancer-related fatigue (CRF). However, specifics regarding frequency, intensity, and type of physical activity required to alleviate fatigue are less specific. In addition, outcomes of these interventions during the initial stages of active treatment are not well documented. OBJECTIVES: The purpose of this article is to review the current evidence-based literature regarding the effects of physical exercise on CRF and the role that the clinical nurse leader (CNL) can play in implementing interventions to address CRF and promote physical exercise to improve patient outcomes. METHODS: A literature review of the effect of physical exercise on CRF was conducted using the CINAHL®, PubMed, and Google Scholar databases. FINDINGS: As leaders in health care, CNLs have the knowledge and skill to take an active role in managing CRF and to develop evidence-based interventions to address fatigue in this patient population. Interventions may include creating and evaluating individualized exercise plans for inpatients with cancer and/or developing educational programs for the inpatient setting that may be continued after discharge and during outpatient treatment.

Ranking Surgical Residency Programs: Reputation Survey or Outcomes Measures?

OBJECTIVE: The release of general surgery residency program rankings by Doximity and U.S. News & World Report accentuates the need to define and establish measurable standards of program quality. This study evaluated the extent to which program rankings based solely on peer nominations correlated with familiar program outcomes measures. DESIGN: Publicly available data were collected for all 254 general surgery residency programs. To generate a rudimentary outcomes-based program ranking, surgery programs were rank-ordered according to an average percentile rank that was calculated using board pass rates and the prevalence of alumni publications. A Kendall τ-b rank correlation computed the linear association between program rankings based on reputation alone and those derived from outcomes measures to validate whether reputation was a reasonable surrogate for globally judging program quality. RESULTS: For the 218 programs with complete data eligible for analysis, the mean board pass rate was 72% with a standard deviation of 14%. A total of 60 programs were placed in the 75th percentile or above for the number of publications authored by program alumni. The correlational analysis reported a significant correlation of 0.428, indicating only a moderate association between programs ranked by outcomes measures and those ranked according to reputation. Seventeen programs that were ranked in the top 30 according to reputation were also ranked in the top 30 based on outcomes measures. CONCLUSIONS: This study suggests that reputation alone does not fully capture a representative snapshot of a program's quality. Rather, the use of multiple quantifiable indicators and attributes unique to programs ought to be given more consideration when assigning ranks to denote program quality. It is advised that the interpretation and subsequent use of program rankings be met with caution until further studies can rigorously demonstrate best practices for awarding program standings.

Improving cancer-related fatigue outcomes. Walking patients through treatment and beyond.

Participation in the ONS Foundation-supported Breast Cancer Care Quality Measures Set pilot study defined areas of need for compliance with proposed standards. Key outcomes were the revision of nursing assessment and documentation tools. Subsequent to those efforts, a walking track was made available for patients within the clinical cancer center. The track serves as an exercise resource for patients and family members to use while waiting for and after appointments. The planning involved multiple disciplines, and criteria established by the multidisciplinary team defined what group of patients should be advised of or encouraged to use the walking track without provider consultation. The scheduled nurse-patient education appointment prior to start of chemotherapy provides the venue for the discussion. The goal is to assist patients in staying active during and after treatment.

Highly reliable health care in the context of oncology nursing: Part II.

The principles of reliability science are used in various high-risk and high-tech industries to improve quality and safety. In part one of this two-part series, three of the five principles (the principles of anticipation) were discussed as they pertain to delivering oncology care in challenging and variable circumstances. This article will address the final two principles (the principles of containment) and examine how a healthcare organization responds when an error in treatment has occurred.

Qualidade dos serviços oferecidos em uma unidade de saúde da família: avaliando a conformidade com os padrões do programa avaliação para melhoria da qualidade / Calidad de los servicios que se oferecenen una unidad de salud dela familia: evaluar el cumplimiento com los estándares de la evaluacióndel programa de mejoramiento de la calidad / Quality of services in a family health unit: evaluating adequay according to standards of the quality improvement evaluation program (amq)

A avaliação da qualidade em saúde parte de parâmetros que vão direcionar as ações ofertadas aos usuários, além de subsidiar a construção de novos instrumentos avaliativos. O objetivo deste estudo foi verificar o estágio de desenvolvimento de uma Unidade de Saúde da Família (USF) da cidade do Recife, Pernambuco, segundo os padrões de qualidade preconizados pelo Ministério da Saúde. A metodologia utilizada foi um estudo descritivo de corte transversal com abordagem quantitativa. Foram aplicados 27 questionários semi-estruturados aos profissionais, residentes e alunos de graduação da USF. As respostas foram confrontadas com os Padrões de Qualidade da Avaliação para Melhoria da Qualidade. Os resultados demonstraram que a USF apresenta-se 100% adequada ao nível ?elementar? e 12,5% ao nível ?consolidado? para Infraestrutura e Equipamentos; para Insumos, Imunobiológicos e Medicamentos apresenta variação de 50 a 100% de adequação. Para Organização do Trabalho, 76% adequado ao ?elementar? e ?avançado?. O acolhimento, a utilização do cronograma e a participação dos agentes comunitários no planejamento das ações foram os aspectos positivos apontados. Conclui-se que uma avaliação participativa com enfoque na qualidade, refletindo sobre o estágio de desenvolvimento dos serviços oferecidos pela Estratégia Saúde da Família e envolvendo os estudantes contribui para o aprimoramento dos serviços.

The assessment of health care quality is based on parameters that will not only guide the attitudes towards the users, but also support the framing of new assessment tools. The objective of this study was to determine the development stage of a Family Health Unit in Recife, Pernambuco, Brasil, according to the quality standards established by the Brazilian Ministry of Health. The methodology consisted of a cross-sectional study with a quantitative approach. We applied 27 semi-structured questionnaires to professionals, residents and graduate students at USF. The responses were compared with the Quality Standards - AMQ (Evaluation for Quality Improvement). The results showed that the USF presents 100% suited to ?elementary? level and 12.5% a ?consolidated? level for Infrastructure and Equipment; for Inputs, Immunobiologicals and Medicine presents variation of 50% to 100% of adequacy. For Organization of Work, 76% suited to ?elementary? and ? advanced? level. The reception, the use of timeline and the participation of Community Health Agents in planning actions were mentioned as positives aspects. In conclusion, a participatory evaluation focusing on quality, reflecting the development stage of the services offered by the Family Health Strategy and involving students contributes to the improvement of services.

La evaluación de la calidad en salud parte de parámetros que orientarán las acciones ofrecidas a los usuarios, además de subsidiar la construcción de nuevos instrumentos evaluativos. El objetivo de este estudio fue verificar el nivel de desarrollo de una Unidad de Salud de la Familia (USF) de la ciudad de Recife, Pernambuco, según los estándares de calidad preconizados por el Ministerio da Salud. La metodología utilizada fue un estudio descriptivo de corte transversal con abordaje cuantitativo. Fueron aplicados 27 cuestionarios semiestructurados a los profesionales, residentes y alumnos de graduación de la USF. Las respuestas fueron confrontadas con los Estándares de Calidad da Evaluación para Mejora de la Calidad. Los resultados demostraron que la USF se presenta 100% adecuada al nivel ?elemental? y 12,5% al nivel ?consolidado? para Infraestructura y Equipamientos; para Insumos, Inmunobiológicos y Medicamentos presenta variación de 50 a 100% de adecuación. Para Organización del Trabajo, 76% adecuado al ?elemental? y ?avanzado?. El acogimiento, la utilización del cronograma y la participación de los agentes comunitarios en el planeamiento de las acciones fueron los aspectos positivos apuntados. Se concluye que una evaluación participativa con enfoque en la calidad, reflejando sobre el nivel de desarrollo de los servicios ofrecidos por la Estrategia Salud de la Familia y envolviendo los estudiantes contribuye al mejoramiento de los servicios.

Qualidade de vida dos agentes comunitários de saúde de um município do interior do Paraná / Quality of life of community health agents from a city in the interior of Paraná State

Este é um estudo descritivo, de corte transversal e com abordagem quantitativa, tendo como objetivo avaliar a qualidade de vida de agentes comunitários de saúde de um município do interior do Paraná, Brasil. Foi utilizado um instrumento genérico para avaliar qualidade de vida, elaborado por pesquisadores da Organização Mundial da Saúde, denominado WHOQOL-bref, na sua versão para o português. Este instrumento é composto de duas partes. A primeira refere-se à ficha de informações sobre o respondente. A segunda consta de 26 questões, sendo que as duas primeiras avaliam a qualidade de vida de modo geral e a satisfação com a própria saúde (Qualidade de Vida Geral), as outras 24 questões estão divididas em quatro domínios: Físico, Psicológico, Relações Sociais e Meio Ambiente. A coleta de dados foi realizada durante reuniões, de forma auto-administrada. Do total de 196 agentes comunitários de saúde, o grupo de estudo ficou composto por 169 agentes (86,2% do total existente). Os dados foram analisados utilizando-se medidas descritivas e o programa estatístico SPSS. O nível de significância adotado foi de 5%. A confiabilidade do WHOQOLbref mostrou-se satisfatória, com coeficiente Alfa de Cronbach de 0,87 para as 26 facetas e para os domínios variou de 0,50 (domínio Relações Sociais) a 0,72 (domínio Físico). A maioria dos agentes era do sexo feminino (89,3%); idade entre 19 e 30 anos (47,9%) e idade média de 31,1 anos (DP=8,8); 61,5% com segundo grau completo e com predomínio de casados (42,6%). Quanto à qualidade de vida, numa escala de 0 a 100, onde maiores escores médios indicam melhor avaliação da qualidade de vida, a Qualidade de Vida Geral obteve um escore médio de 69,6 (DP=14,5). O domínio Relações Sociais obteve o melhor escore médio, 75,8 (DP=14,2). O domínio Físico obteve escore médio de 74,2 (DP=13,2) e o domínio Psicológico, 74,0 (DP=11,4). O domínio Meio Ambiente obteve o menor escore médio, de 54,1 (DP=12,0). As facetas que obtiveram os maiores escores médios em cada domínio foram: relações pessoais (domínio Relações Sociais); mobilidade e capacidade de trabalho (domínio Físico); espiritualidade, religião e crenças pessoais e auto-estima (domínio Psicológico) e ambiente no lar e segurança física e proteção (domínio Meio Ambiente). As facetas que obtiveram os menores escores médios em cada domínio foram: suporte ou apoio social (domínio Relações Sociais); energia e fadiga (domínio Físico); pensar, aprender, capacidade de memória e concentração (domínio Psicológico), e recursos financeiros e oportunidades de recreação/lazer (domínio Meio Ambiente). Pela correlação entre cada questão que compõe o domínio e o escore médio do domínio, observou-se que todas as facetas foram estatisticamente significativas, em maior ou menor proporção, em cada um dos respectivos domínios. Os resultados obtidos sugerem uma avaliação positiva para a Qualidade de Vida Geral e para os domínios Relações Sociais (maior escore médio entre os domínios), Físico e Psicológico, e uma avaliação intermediária para o domínio Meio Ambiente (menor escore médio entre os domínios). Este estudo possibilitou uma avaliação sobre qualidade de vida geral de um grupo de agentes comunitários de saúde e melhor entendimento sobre o tema.