Avaliação da qualidade da estratégia de saúde da família pelos enfermeiros de um município mineiro

Abstract

Quality from the perspective of professionals means observing whether the service meets the needs defined within the norms of the health system and whether the necessary techniques and procedures are carried out in an appropriate and resolutive manner. At the level of primary care, the nurse is a professional of fundamental importance, as it incorporates the evaluation in the administrative cycle of its routine work process, therefore it is configured as a key informant in evaluative research. The objective of this study is to evaluate the quality of the Family Health Strategy from the perspective of nurses. An evaluative, quantitative and cross sectional research was carried out with 27 nurses from a municipality in the southern region of the State of Minas Gerais, Brazil. Data collection took place in November 2018 through interviews, using the professional characterization questionnaire instruments, the Primary Health Assessment Tool (PCA Tool) health professional version and some sub dimensions of the Self Assessment Tool for Improving Access and of Primary Care Quality (AMAQ), using the tool in Google Forms. The analysis was performed based on the guidelines of the instruments themselves, data from Google Forms were imported into an electronic spreadsheet, from which the descriptive analytical approach of the responses was carried out using the Statistical Package for the Sciences SPSS software (version 20.0). For comparisons between instruments, Pearson, Shapiro Wilk, ANOVA, Kruskal Wallis, Fisher and Tukey tests were used. It was found that the majority of nurses were female, with an average age of 36.26 years, a workload of 40 hours per week in the health unit to which they were linked by competition, not having another job or paid activity, and with specialization in family health. The averages of time were: 11.56 years since graduation, 7.67 years of work time in family health strategy and 2.35 years of time in the current unit. On the assessment of the presence and extent of the essential and derived attributes of primary care, satisfactory results were obtained. Positive performance was found for the attributes longitudinality, coordination information system, integrality and family orientation. Accessibility, coordination integration of care and community guidance did not reach the satisfactory score. In the sub dimensions of quality assessed by AMAQ, the majority had a higher percentage in the satisfactory and very satisfactory classifications, with the exception of the sub dimension permanent education and qualification. In the analysis of the association of variables, the employers' employment relationship positively interfered in the evaluation of the coordination attribute information systems. Conclusion: The evaluation of the quality of the FHS from the perspective of nurses at this level of care was considered satisfactory, both in the evaluation of the PCA Tool and in the sub dimensions of the AMAQ. The weaknesses found were the attributes accessibility, coordination integration of care and community guidance and in the sub dimension permanent education and qualification, supporting the development of strategies aimed at improving the quality of care.