RESUMO

ABSTRACT

Introduction: Sarcopenia is characterized by decreased strength and loss of muscle mass and is associated with frailty. Nutritional, physical and hormonal factors are interconnected in the development of sarcopenia and also diabetes. Diabetes is a syndrome characterized by chronic hyperglycemia and metabolic disorders that, when associated with sarcopenia, can lead the elderly to serious complications. Objective: To analyze the prevalence of sarcopenia in individuals with type 2 diabetes, users of primary care in the city of Divinópolis - Minas Gerais. Method: Cross-sectional study carried out with patients with DM2 registered in the Family Health Strategy. Questionnaires were administered containing information on physical, sociodemographic, clinical examination, physical activity and risk of falling. The questionnaire recommended by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) was used to diagnose sarcopenia, consisting of four stages. To associate the risk of falling with the risk of sarcopenia, binomial regression was used. All analyzes were performed using Stata 14.0 software. Results: 214 individuals were analyzed, with an average age of 63 years (10), the majority of whom were female (58%), with incomplete primary education (59%), sedentary (64%), and diagnosed with diabetes for a long time. less than 10 years (51%). Obesity was predominant among adults (61%) and the elderly (64%). The prevalence of sarcopenia risk was 15%, with 2% of confirmed cases and 1% of severe cases. Among adults, this prevalence was 4% (n=8) and among the elderly, 11% (n=25). The risk of sporadic and recurrent falls was 31% and 12%, respectively. Conclusion: The prevalence of sarcopenia and falls risk in the population, especially among the elderly, highlights the need for interventions. Early identification of these problems and application of preventive measures can significantly improve quality of life and reduce the negative effects of muscle mass loss.

A realização do estudo partiu da premissa de que durante a atenção à gestante de alto risco e, consequentemente, sua família, cuidados promotores de esperança podem contribuir com o preparo familiar para o manejo do neonato e seus cuidados. O objetivo do estudo foi compreender como se configura a esperança familiar, em situações envolvendo a chegada de um recém-nascido de risco. Optou-se por um estudo do tipo qualitativo por permitir capturar e revelar os processos de subjetivação relacionados à temática em análise. Esta pesquisa adotou como referencial teórico metodológico a Theoretical Model for understanding the complex nature of hope (Modelo Teórico de entendimento da natureza complexa da esperança), proposto por DUFAULT & MARTOCCHIO (1985). O cenário do estudo foi o domicílio das famílias de crianças acompanhadas pelo Programa de Intervenção Precoce Avançado (PIPA), e também o ambulatório multiprofissional de atenção ao neonato de risco, localizado na cidade de Divinópolis, Minas Gerais. Os participantes do presente estudo foram 28 familiares (incluindo mãe, pai, avó, tia e irmã), totalizando 14 famílias de neonatos de risco, cujas mães tiveram suas gestações avaliadas em situação de alto risco. Este estudo foi desenvolvido em três etapas. A primeira consistiu na realização de uma revisão de escopo (AROMATARIS; MUNN, 2020) para contribuir com a definição do referencial teórico-metodológico e elaboração dos instrumentos de coleta. Na segunda etapa foi realizada a construção do genograma e ecomapa da esperança de forma conjunta com os participantes seguindo as orientações de Charepe et al (2011). A terceira etapa consistiu na realização das entrevistas em história oral temática e construção das narrativas (MEIHY; HOLANDA, 2014). A estratégia adotada para definição do limite de participantes foi a análise do conteúdo das entrevistas de forma concomitante com a coleta, o que premitiu identificar resultados para cada um dos códigos correspondentes ao referencial teórico adotado (FONTANELLA et al, 2011; NASCIMENTO et al, 2018). Os dados foram submetidos ao processo de análise dedutiva temática (BRAUN, 2021). Os resultados foram apresentados em 3 capítulos, sendo o primeiro: uma revisão de escopo sobre “A esperança familiar nos cuidados de enfermagem direcionados à criança de risco: scoping review”; o segundo mostrou a “Apresentação das famílias participantes do estudo” e no terceiro capítulo apresentamos uma análise preliminar da “Experiência de Esperança familiar em situações envolvendo neonatos de risco: narrativas analisadas a partir do Modelo Teórico de Dufault & Martocchio”. 

Introduction: the guarantee of access, attention and health care for people in homelessness is an emerging challenge in the field of public health, being essential to overcome vulnerabilities and identify the factors that corroborate for institutional exclusion, in order to strengthen and ensure the effectiveness of public policies aimed at homeless people. In this perspective, in order to provide access universal, integral and equitable, in 2011, the revision of the National Policy for Care Basic, which determined the creation and operation of the Street Consultancy Team, which works with strategic potential for articulating and providing comprehensive health care to these people. Thus, places that do not have such a team, these people need to be assisted by the Primary Health Care teams in the area where they are concentrated, with a view to guarantee universal access, an attentive look at their needs and unique care. Objective: understand access and equity in health care for homeless people in municipalities medium and large population in the center-west of Minas Gerais. Methods: for design of this study was used the qualitative approach conducted by the Theory Grounded in Data and Symbolic Interactionism. The scenario of this study is constituted by two municipalities in the center-west of the state of Minas Gerais, medium-sized Nova Serrana population and large population Divinópolis, which still do not have Street Office. The participants of the research were the professionals of Primary Care to Health/Family Health Strategy in both municipalities. The sources of evidence were individual interview and recording in memos. Data collection has already been completed in the municipality of Nova Serrana and started in the municipality of Divinópolis. So far, they have participated in the study 16 health professionals from Nova Serrana, who make up four teams of Primary Health Care/Family Health Strategy and three key informants who are professionals of the Specialized Service for Homeless People. Results: the results preliminaries check 31 codes in vivo. Completion of data collection and analysis is expected to October 2022. Preliminary results show that health care for people in a street situation in the municipality of Nova Serrana is carried out by reference teams of the Primary Health/Family Health Strategy, as well as intersectoral actions together with the Street Population Assistance Center (POP Center). There is mention of institutional exclusion and prejudice, determining factors for restricting access to homeless people to the health system; declare the difficulty of building strategies to care for these people, so most care actions are by spontaneous demand, although there is an intention to plan for improvements in care of these people. It is evident that it is necessary to discuss about equity in health. Considerations conclusions: Primary Health Care becomes indispensable in overcoming inequities in health, as it enables the attention and care of vulnerable groups such as people in street situation. It is noted that, even with sectoral and intersectoral policies, these people still face barriers in accessing health care and other fundamental rights.

Será traduzido após a defesa

A NÃO ADESÃO À ASSISTÊNCIA ODONTOLÓGICA POR ADOLESCENTES NA ATENÇÃO PRIMÁRIA À SAÚDE: A PERSPECTIVA DOS FAMILIARES

TECNOSSOCIALIDADE E PROMOÇÃO DA SAÚDE NO QUOTIDIANO DE USUÁRIOS DA ATENÇÃO PRIMÁRIA NA PANDEMIA DE COVID-19

ADOLESCENTES DE ESCOLAS PÚBLICAS: USO DE DROGAS, DETERMINANTES SOCIAIS DE SAÚDE E DISTRIBUIÇÃO ESPACIAL

Introduction: Cancer is the main public health problem in the world and is already among the four leading causes of premature death (before age 70) in most countries countries. The importance of the role of the dentist in the team multiprofessional health care is essential, from prevention to diagnosis of lesions of the oral cavity, to the follow-up of the patient during and after the treatment oncology (chemotherapy and radiotherapy). Therefore, the relevance of this study is to provide a mapping of the main measures for the safe dental care of patients undergoing radiotherapy and/or chemotherapy, as well as providing subsidies for the care practice in the services of oncology. Objective: to identify and synthesize the scientific evidence on safe dental care for patients undergoing anticancer treatment and/or radiotherapy. Method: Scoping review, according to Joanna Briggs Institute and PRISMA-ScR. A search was carried out in the National Library of Medicine and National Institutes databases. of Health, Cumulative Index to Nursing and Allied Health Literature, Web of Science, SCOPUS, Latin American and Caribbean Literature in Health Sciences, Embase and, Cochrane Library, in addition to four theses and dissertations catalogs, with no limit application temporal. Data collection took place from June 2021 to March 2022. The extracted data were analyzed and synthesized in a narrative way. Result: a total of 891 records and included 28 studies for the review. Most were produced on the mainland American (53.6%) and pointed to scientific evidence on dental care general to cancer patients, the types of mouthwashes/mouthwashes used in cancer patients, the use of oral cryotherapy in câncer patients, the management of mucositis oral care in cancer patients, the use of photobiomodulation and dental care to cancer patients in times of viral pandemic. Conclusion: there was an emphasis on both prevention as well as treatment, due to global efforts in the safety of care in health for all patients. Other highlights were the implementation of protocols based on evidence and on the primordial inclusion of the dentist in the team multiprofessional team in the oncology area, in order to provide greater safety and quality of services provided.

Introduction: As ostomy has become, nowadays, the focus of the main public health care policies, a fact that has attracted the attention of professionals and health authorities in the country. With the implementation of these policies, questions arise, therefore, in relation to network assistance for the health care of the person with an ostomy provided by health services, advances and difficulties in the operationalization of the implementation of these services. Objective: To assess the Degree of Implementation of Health Care Services for Persons with Ostomy in the Unified Health System in the State of Minas Gerais. Method: This is a descriptive and analytical cross-sectional study, which evaluated the Degree of Implementation of Health Care Services for People with Ostomy in the State of Minas Gerais, in the year 2021. Indicator criteria and criteria were related to the dimensions of structure (resources employed and their organization) and process (form of production of goods or services). The Degree of implementation was defined by evaluating the components of Service Management, Clinical Assistance and Educational Assistance, using a validated instrument, where services were classified in the scoring system as full implementation, satisfactory, incipient, not implemented. Results: The 53 SASPO from Minas Gerais are included. It was found that only 1 service had a greater number of services in compliance, and the incipient degree of compliance was obtained (50.9%). The development and process tools of professional support services and the need for training resources. Conclusion: It was concluded that, although active, most of the services proposed in relation to structural and process contexts do not comply with the requirements of the guidelines.

VILELA, R. B. N. Analysis of the acceptance of the e-SUS Territory application of the e-SUS APS strategy. 2022. 84p. Dissertation (Masters in Science) - Postgraduate Program in Nursing, Federal University of São João del-Rei, Divinópolis, 2022.

ABSTRACT

Introduction: The e-SUS Território is part of the Electronic Citizen's Medical System (PEC) and was developed to be used via mobile devices, computerizing the work process of the ACS. It is a pioneering initiative at the national level and, therefore, brings significant changes in their daily work. In this sense, it is important to analyze factors that enable the acceptance or rejection of this technological innovation by these professionals. Objective: To analyze the acceptance of the e-SUS Territory e-SUS APS application by the ACS. Method: This is a qualitative study with a case study design. The analytical body consisted of comments from users of the application registered in the Play Store platform and laws, ordinances and official documents of the Ministry of Health on the e-SUS Territory. Data analysis was performed through Thematic Analysis, systematized through the Open Logos program. The Technology Acceptance Model (TAM) was adopted as a theoretical model. Two analytical categories were previously defined: perceived ease of use and perceived utility. Results: The analyzed data allow us to infer that facilities and utilities were identified in the use of e-SUS Território. It is considered as a good app with great layout, easy handling, contributing to improve performance in everyday work. However, it has some difficulties in synchronization, in the update causing errors in registrations and duplication of citizens and losses of records of visits thus leading to a rework for the ACS. Other difficulties are pointed out as the disorganization of registrations and access to unifications only by nurses and mandatory of some fields. App is also considered a useful, practical and fast, because it speeds up the execution of activities, reduces the use of paper and is useful in places difficult to access the internet. Some suggestions are reported. Conclusion: The study identified by these professionals that the e-SUS Territory application has been characterized as a good application, being identified by the ACS that facilities and utilities directly contribute to the good intention of behavior of the use of the application in daily work. It is worth noting that adjustments are needed in it to correct problems.

Introduction: The Covid-19 pandemic has impacted the lives of all individuals, especially health workers. Primary Health Care (PHC) workers and professionals linked to Health Residency Programs are part of the risk group for dealing with directly with suspected or confirmed cases of Covid-19, in addition to being fundamental in facing the pandemic. Personal Protective Equipment (PPE) is the main security measure by creating a protective physical barrier. However, for protection offered is achieved, practitioners must be able to select and handle them properly. For this, it is recommended to carry out training activities aimed at stimulation of use, guidelines on the handling of devices and, thus, measures effective and safe preventive measures for professionals and patients.

Souza ED. Suicide, other deaths and hopelessness among adolescents [Dissertation]. Divinópolis: Programa de Pós-Graduação em Enfermagem da Universidade Federal de São João Del Rei; 2021.

ABSTRACT

Suicide is identified as a serious public health problem, resulting from the interaction of social, psychological and cultural factors. Representing the second leading cause of death among young people between 15 and 29 years old. This study aimed to understand the relationship between hopelessness levels and representations of suicide and other deaths of adolescent students from two public schools in Divinopolis - MG. This is an explanatory study, with a descriptive, cross-sectional design, with a qualitative approach. Adolescents between 15 and 19 years of age regularly enrolled in public schools participated in the research. Data collection took place through semi-structured interviews, with 40 adolescents who were subdivided into two groups: low and high hopelessness. For data analysis, Bardin Content Analysis was used. It was observed the idea of suicide that reverberates with a moral, simplistic and cause / effect judgment, and the idea of death as an enigma, something incognito and inexplicable and that is not thought out. In addition, death by suicide as unthinkable and death as a positive expectation was more found among adolescents with high hopelessness, whereas death by suicide as a negative idea, which reverberates availability of help, and death as an inevitable and life event, an ambiguous expectation was present among adolescents with low hopelessness. The participants' social representations and hopelessness can be related, as well as the life stage, personal and social experiences.

DIAS, C. M. Protocol for telephone follow-up of people with gastrointestinal
malignancies undergoing antineoplastic treatment. 2021. 123 p. Thesis (Master of
Science) – Postgraduate Program Master's Degree in Nursing, Universidade Federal
de São João del-Rei, São João del-Rei, Divinópolis, Minas Gerais, Brazil, 2018.
ABSTRACT
Introduction: In the oncological situation, there has been an increase in the use of
outpatient treatments, which represent a different context from hospitalization.
Compared to the hospital environment, outpatient antineoplastic chemotherapy (QT)
results in a better quality of life and lower treatment costs for patients. However,
administering outpatient QT is challenging due to high demand, time pressures and
low level of control. In addition, patients may need to receive essential drugs and side
effects usually occur at home. Treatment toxicities due to systemic QT are prevalent
and often little recognized, resulting in high rates of uncomfortable symptoms and,
consequently, avoidable visits to the emergency room, in addition to hospitalizations.
Patients undergoing QT have an average of eight different symptoms and side effects.
Objective: The general objective of this work was to: Build and validate construction
and content evaluation of protocols for telephone follow-up in reducing side effects
(inappetence, nausea and vomiting, diarrhea and constipation) associated with
outpatient antineoplastic chemotherapy for people with malignant neoplasia
gastrointestinal. Method: This is a methodological study, with a quantitative approach.
Held in the period from September to November 2020. They were developed according
to Pasquali's psychometric methodological framework. The methodological path of this
study was carried out in the following stages: Stage 1 - Scoping review, in search of
the level of scientific evidence; Step 2 - Construction of the protocols; Step 3 - Content
and appearance validation using the Delphi technique. For content evaluation, the
Delphi technique was used in two rounds (Delphi I [16 judges] and Delphi II [12 judges])
and those items with Content Validation Coefficient (CVC) greater than 0 were
considered valid, 80 and a consensus of more than 80.0% on the Delphi technique.
The data were analyzed using descriptive and inferential statistics (Binominal test).
The study was submitted to the Research Ethics Committee of the Federal University
of São João del-Rei and approved under Opinion No. 2,010,532. Results: All the
requirements of the protocols reached agreement between the judges above 80.0%,
as well as all items reached statistically significant levels of evaluation. At the end of
Delphi II, the four protocols were expressively valid (inappetence [CVC = 0.98]; nausea
and vomiting [CVC = 0.99]; diarrhea [CVC = 0.99]; and constipation [CVC = 0.98]).
Conclusion: The content of the protocols demonstrated high credibility and, its
adoption in health institutions, can contribute to follow-up by phone in reducing the side
effects (inappetence, nausea and vomiting, diarrhea and constipation) associated with
outpatient antineoplastic chemotherapy for people with gastrointestinal malignancy.

SILVA, G. H. Bariatric surgery: perceptual accuracy, body satisfaction and quality of life. [Thesis]. Divinópolis: Nursing Graduate Program - Academic Master's Degree of the Universidade Federal de São João Del-Rei - 2020.
ABSTRACT
Introduction: Obesity has increased significantly worldwide, data showing that its prevalence has doubled since 1980, currently being 5% in children and 12% in adults (ZHANG et al, 2020).
Obesity is considered when the Body Mass Index (BMI) is above 30 kg / m². Its severity being classified as grade I (moderate excess weight), when the BMI is between 30 and 34.9 kg / m2, grade II (mild or moderate obesity) with a BMI between 35 and 39.9 kg / m2 and, finally, grade III obesity (morbid obesity) in which BMI exceeds 40 kg / m2 (FLEGAL et al, 2014; WHO, 2015).
Conventional treatment for grade III obesity (morbid obesity) has produced unsatisfactory results, with 95% of patients regaining their initial weight in up to two years. The indication for bariatric surgery has thus become more frequent in these cases, due to the low resolution of the conventional clinical approach.
This research thus proposes to evaluate the perceptual accuracy / inaccuracy, body satisfaction / dissatisfaction and the quality of life of patients who underwent bariatric surgery taking into account the postoperative time to elucidate possible behavioral and perceptual changes involved in this process.
Objective: To evaluate the perceptual accuracy, body satisfaction and quality of life of patients undergoing bariatric surgery.
Methods: cross-sectional study carried out with 305 patients from a medium-sized reference clinic in the execution of bariatric surgeries in the Midwest region of Minas Gerais. One scale was used to assess perceptual accuracy and body satisfaction and another to assess quality of life. Descriptive analysis of the data was performed.
Results: Statistically, the interquatile distance between patients (305) did not show any influence on the variables quality of life, body satisfaction and perceptual accuracy.
Conclusion: The time of bariatric surgery does not influence the quality of life considered good, the distortion of body image and the dissatisfaction that patients presented in the respective study over a period of 13 years after the procedure.

AMARAL, R. A. C. Bundle for prevention and management of neutropenia-related complications in cancer patients: methodological study. Dissertation Defense (Master in Nursing) - Federal University of São João del-Rei, Divinópolis-MG, 2020.
ABSTRACT
One of the most widely used treatments for cancer is antineoplastic chemotherapy, which is effective, but it can cause numerous side effects. One of the most common is Febrile Neutropenia (NF). The objective was to build a bundle for the prevention and management of the complications of neutropenia in cancer patients. This is a methodological study, with a quantitative approach, for the construction, content validation and evaluation of a care bundle for the prevention and management of neutropenia in cancer patients. The methodological course of this study was carried out in the following steps: Step 1 - Scoping review, seeking the level of scientific evidence; Step 2 - Build the bundle; Step 3 - Validation of content and appearance (will determine the representativeness and suitability of bundle domains, items and guidelines) by the Delphi technique Step 4 - Bundle Evaluation - Pilot Test. For content evaluation, the Delphi technique was applied in two rounds (Delphi I [16 judges] and Delphi II [14 judges]) and those items with Content Validation Coefficient (CVC) greater than 0 were considered valid. 78 and consensus of more than 80.0%. Data were analyzed using descriptive and inferential statistics (binominal test). Results: The scoping review retrieved a total of 7,884 records and maintained 27 studies for the review. The main nursing care were related: risk factors for febrile neutropenia, prevention of infection and neutropenic sepsis, protocols for the use of colony stimulating factors and for the introduction of antibiotic therapy. The built bundle was divided into conducts regarding risk factors, prevention, management, pediatric specific management and the nursing staff. All bundle requirements reached agreement between judges greater than 80.0%, and all items achieved statistically significant assessment levels. At the end of Delphi I and Delphi II, the bundle was expressively valid with CVC = 0.92 and CVC = 0.93, respectively. It was concluded that the content of the bundle demonstrated high credibility and its adoption in health institutions can contribute to the quality of care and professional conduct regarding the prevention and management of complications of neutropenic cancer patients.

Introduction:

Pregnancy is an important moment in a woman's life and several biopsychosocial changes that prepare her for childbirth. Particularly the feelings bring reflections about the parturitive process related to the ability to manage, give birth and care. Given this, thinking about the psychological well-being of the pregnant woman in the last trimester of pregnancy, we ask ourselves what is the view of primiparous women about childbirth? Objective: to understand the experience of women primigravida about childbirth. Methodology: this is a descriptive, exploratory study of qualitative nature with Symbolic Interactionism as its theoretical framework. The data collection through participant observation, semi structured interview before and after delivery and application of bodymapping. All interviews in question were recorded and transcribed in full so that we could understand the experiences of pregnant women at the time of pregnancy, in addition to the expectations and desires of these interviewees in question about the theme Childbirth. The data were analyzed through content analysis proposed by Bardin. Results: 11 women in the pre-delivery and 05 in the group participated in the study. focal and postpartum. For the collection of data from the research in question, interviews were conducted semi-structured in pre-delivery, where women could express their feelings about the that they expected about their birth. Of the women who conducted the interviews, 90.9% they were married and 9.1% were single. Of the five women who answered the semi interviews structured, four had a normal delivery as planned and one underwent a cesarean depending on your baby's pelvic position. In view of the evaluation of data collected in interviews, four (4) discussion categories were identified: Expectations for childbirth / actual childbirth; Factors indicated by the pregnant woman that may help her in the parturition process; Factors indicated by pregnant women that may hinder her in the birth process; Vision about the future. Conclusion: It is evident that childbirth has transformative power with regard to the reframing of paradigms cultural and social aspects, especially with regard to changing the perspective on what really help and hinder. Social interaction with professionals and the social network has significant aspects that assist in coping with childbirth. However, there are other points, the significance of which brings difficulties.

CLEMENTINO, M. T. R. Bipolar affective disorder: family, professional, and social competence of patients. [Thesis]. Divinópolis: Nursing Graduate Program - Academic Master's Degree of the Universidade Federal de São João Del-Rei - 2020.

ABSTRACT

Introduction: Bipolar Affective Disorder (BAD) is a severe and chronic mental illness of late diagnostic, characterized by marked mood swings with episodes of depression alternating with those of euphoria (mania). In general, this mood disorder manifests in both men and women between the ages of 15 and 25 but can also affect children and the elderly. Global data indicate an increase from 32.7 million to 48.8 million (49.1%) in the number of prevalent cases between 1990 and 2013. In Brazil, bipolar disorder has a similar epidemiological profile, with a prevalence of approximately 1 to 4% of the population. This disorder is associated with a risk of suicide 23 times higher than that observed in people without the disease. Bipolar Affective Disorder negatively affects the quality of life and social competence of patients in various areas, especially the economic situation, leisure, and interpersonal relationships. The severity of the disease is also associated with a greater workload for the caregiver, whether family or health care professional. Objective: To evaluate family and professional overload, as well as the social competence of patients with Bipolar Affective Disorder. Methods: A cross-sectional and non-probabilistic study performed with 71 participants from a Psychosocial Care Center III. The sociodemographic data were collected from the patients using three scales: one to assess family overload (Family Burden Interview Schedule FBIS-BR), another to assess professional overload (IMPACTO-BR Scale), and one to evaluate the patients’ overload social competence (A Social Behaviour Schedule - SBS-BR). The descriptive analysis was performed by measures of absolute and relative frequency distribution and central tendency. Results: The sociodemographic characterization showed a predominance of female patients (67.7%) between 41 and 50 years of age (32.3%), who were single (41.9%), with incomplete primary education (54.8%), and with no work (87.1%). The objective overload had a global score of 3.44 ± 0.25. Subscale A, which evaluates the patient assistance by the family in daily life, presented the highest average objective overload score (3.69 ± 0.80). The overall score of the subjective scale was 3.69 ± 0.42. Subscale E, which considers the concern of family members concern with the patient, obtained the highest mean subjective overload score (4.18 ± 0.63). The highest rate of professional overload was related to the emotional repercussions of work (1.93 ± 0.41) and the global score was 1.59 ± 0.36. The study patients had greater difficulties that could compromise their social competence in the areas of social interaction: proportion of social contacts that are by nature hostile (96.8%), social interaction: flashy behavior (96.8%), and laughing and speaking alone (90.3%). Conclusion: We demonstrated the importance of assessing family and professional overload, as well as the social competence of patients to produce knowledge that can provide greater effectiveness of Mental Health Services, minimizing the suffering of patients and family members and maximizing the practices of professionals working in the service, as well as their working conditions. 

ABSTRACT
SANTANA, R.C.S. Evaluation of the Electronic Health Record of the Citizen of the e-SUS Primary Care strategy. 2019. 126 p. Dissertation (Master of Science) - Federal University of São João del-Rei, Divinópolis, 2019.
Introduction: The Ministry of Health (MS) has been implementing since 2013 a new Health Information System for Primary Care called SISAB. The implementation of SISAB takes place through the strategy of the Department of Primary Care of the Ministry of Health (DAB / MS), called e-SUS Primary Care (e-SUS AB). Among the various activities involved in the e-SUS AB strategy, we highlight the implementation of two software systems that instrumentalize data collection to be inserted in SISAB, namely: a) Simplified Data Collection (CDS) and b) Electronic Health Record Citizen (PEC). PEC has been adopted as the main software for feeding SISAB. This new set of software systems has the central objective of supporting the computerization process of Basic Health Units, allowing interoperability with other Primary Care systems. Given that the PEC is in the implementation phase and its importance for the AB computerization process in the national territory, it is necessary to develop evaluative processes for this system. However, it is necessary initially to develop an evaluation study of this system to verify the feasibility of carrying out systematic evaluations of it. Objective: To carry out an Evaluation Study (EA) of the Electronic Health Record of the e-SUS Basic Care strategy (PEC e-SUS AB). Method: This is an exploratory study with a qualitative approach, based on the system of the seven elements proposed by Thurston and Ramaliu. Results: From documents and scientific productions, it was possible to better understand the operationalization and functionalities of the PEC. The theoretical / logical model configured the organization of the PEC visually and systematically with details of the inputs, activities, products and expected effects. Evaluation questions were established to evaluate the software, which were systematized in the elaboration of the measurement matrix. Conclusions: It is concluded that the PEC is evaluable and presented a favorable scenario for its development. The realization of this study proved to be an important strategy for planning subsequent evaluations.

RESUMO
Introdução: Nas últimas décadas, o Brasil apresentou avanços importantes para a qualidade de vida da saúde das mulheres e crianças. No entanto, ainda persistem inúmeros desafios para se garantir condições seguras de nascimento e eliminar a mortalidade materna e neonatal evitáveis no país. Neste cenário, em 2011, o Ministério da Saúde cria a Rede Cegonha (RC), uma rede de cuidados que assume o compromisso de garantir à mulher e à criança o direito à atenção humanizada ao pré-natal, parto e puerpério e o crescimento e desenvolvimento saudável de seus filhos seguindo os princípios do Sistema Único de Saúde e de práticas baseadas em evidências científicas recomendadas pela Organização Mundial da Saúde (OMS). Objetivo: Avaliar o grau de adequação das Boas Práticas na Atenção ao Parto e Nascimento em maternidades da Rede Cegonha no estado de Minas Gerais. Método: Estudo transversal, que avaliou 44 maternidades pertencentes às cinco macrorregiões de saúde prioritárias de Minas Gerais, escolhidas inicialmente para compor o processo de adesão à Rede Cegonha: Centro, Norte, Leste, Nordeste e Jequitinhonha. A coleta de dados se deu por meio de análise de documentos, observação direta e questionários estruturados. Participaram da pesquisa gestores, trabalhadores e puérperas. Para a estimativa do grau de adequação, foi utilizada uma matriz de análise e julgamento, com três componentes e vinte e cinco critérios referentes à diretriz “Boas Práticas na Atenção ao Parto e Nascimento” da RC. O grau de adequação foi definido, por meio de um sistema de escores, com pesos diferenciados para cada critério, arbitrados por especialistas. Resultados: o grau de adequação das boas práticas foi classificado como não adequado em 61,4% das maternidades e parcialmente adequado em 38,6%. O componente direito ao acompanhante de livre escolha foi responsável pelo maior grau de adequação entre as maternidades, seguido pelo componente boas práticas na atenção à mulher e redução de intervenções desnecessárias. O componente pior avaliado foi o de boas práticas na atenção ao recém-nascido. Conclusão: os resultados mostram baixa adequação das boas práticas na atenção ao parto e nascimento e a avaliação em saúde pode ser um instrumento de orientação no monitoramento da assistência nas maternidades.

Macedo, A. S. The network of human and non-human actors in the implementation of an electronic health record. 2019. 115p. Dissertation (Master of Nursing) - Federal University of São João del-Rei, Divinópolis, 2019.

ABSTRACT

A description of the network of human and non-human actors involved in the implementation of an electronic health record in Primary Health Care is the objective of this research, a qualitative approach study. The Actor-Network Theory (ANT) was used as the theoretical framework, and the Cartography of Controversies was used as the methodological framework of this investigation. Data collection consisted of the conducting of audio-recorded interviews and participant observation, based on semi-structured scripts on the daily work of professionals involved with the implementation of an Electronic Health Record in a city in the western region of the State of Minas Gerais. At first, the initial spokespersons were identified and accompanied, and the network was mapped from their interactions with other actors. Both the track of other actors emerging on the network and their established associations were followed. Besides, the registration devices that made it possible to embody the network were cataloged. The research proceeded with field diary records and observation notes from September 2018 to May 2019. The description was made from the narrative of facts and events, following the propositions defined by the theoretical and methodological framework. It was verified that the patient´s electronic health record is a tool which contributes to the care management process; it is a tool of great help in decision-making and the real-time knowledge of the patient's health history, also being a facilitator of information exchange between the health facilities of the different complexities that are present in the network, aiding in the planning, care supervision and the continuity of care provided. Difficulties were also observed, such as the lack of access to medical records by mid-level professionals, records which may not be currently available for viewing, which often hinders the assistance provided by these professionals. The conclusion was that the continuity of the implementation of the Electronic Health Record should include the participation of the team, the supervision and the management control in both the training and the qualification of professionals, daily inserting them in this network of human and non-human actors that meet the actual needs of both professionals and patients, favoring, thus, the empowerment of those ones who work directly with this tool.