RESUMO
This work is a qualitative exploratory survey that aims to identify healthcare workers and skilled professionals' perceptions of the Food and Nutrition Surveillance System in the Zona da Mata Mineira region of Brazil. Data analysis was carried out through content analysis; testimonials were extracted from semi-structured interviews via the qualitative data processing software Interface de R pour lês Analyses Multidimensionnelles de Textes et de Questionnaires version 0.7 alpha 2. A total of 41 people were interviewed, including primary healthcare center coordinators, and technical consultants at the Food and Nutrition Surveillance System, as well as nutritionists and data entry clerks. The issues most mentioned during interviews were related to lack of anthropometric equipment, absence of transportation, and inadequate facilities. Regarding the work process, professionals identified scarce training and nonuse of the data collected for healthcare decision-making as factors that compromise desired system outcomes. System qualities were also recognized, especially the mapping of main nutritional issues in the region. The participants reported the need for greater efforts to raise awareness of the importance of Food and Nutrition Surveillance actions at all levels of the public healthcare system. They also highlighted the need for human resources training, higher quality data recording, and suitable facilities. Investments in the entire system are essential to strengthen the information-decision-making-action triad, which would result in the improvement of users' health indicators.
Assuntos
Atenção à Saúde , Pessoal de Saúde , Brasil/epidemiologia , Humanos , Percepção , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Arboviruses pose a serious and constant threat to public health, and have demanded surveillance efforts worldwide. The prevention of arbovirus transmission depends on effective measures to control vectors and promote health. The objective of this study was to examine the factors that enhance and impair the endemic disease control agents' field work, based on their own perspective. METHODOLOGY AND MAIN FINDINGS: In 2017, 65 ACE of seven municipalities participated in a series of seven focus groups in the Zona de Mata mesoregion (Minas Gerais, Brazil). The focus groups were organized aiming to broaden and deepen the discussion and analysis of ACE perception of their performance in relation to attributions, work processes, training, continuous education, and evaluation. All the workers, irrespective of municipality, recognize their role in disease prevention and health promotion, however they suffer from a reductionist stigma associated with their profession. Also, internal and external factors such as infrastructure, resources, administrative management, and the work process affect the quality of service delivered and job satisfaction. Practice challenges include incompatible demands such as refusal by residents and high sense of insecurity related to violence. The respondents reported that success of their activities depend on the population. CONCLUSIONS/SIGNIFICANCE: The recurrence of epidemics demands effective vector control policies. Therefore, the performance of these professionals as regards surveillance needs to be reassessed. Public awareness and acknowledgement of the role of ACE in the identification of risk and health protection factors are indispensable for the improvement of this workforce.
Assuntos
Aedes/virologia , Infecções por Arbovirus/epidemiologia , Infecções por Arbovirus/prevenção & controle , Doenças Endêmicas , Controle de Mosquitos , Adulto , Animais , Arbovírus , Brasil/epidemiologia , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Mosquitos Vetores/virologia , Saúde Pública , Adulto JovemRESUMO
The potential of the reflective collective portfolio as a method of teaching, learning and assessment needs to be emphasized. The objectives is to assess and validate the quality of the collective portfolio as a method of teaching, learning and assessment in the training of health professional. Portfolio quality was analyzed using an inventory of analysis that was adapted and tested for this study. In total, 70 portfolios were analyzed. The Kappa test was used to analyze reproducibility, confirming the level of agreement between the appraisers. Descriptive analysis and the t-test were performed to compare results from the years the portfolios were produced. The constructs (layout and organization, comprehensive, reflective, critical and creative thought) exhibited Cronbach alpha values above 0.7, confirming the high reliability of the tool. The weighted Kappa test revealed an elevated and significant agreement (+90%) between the appraisers. Notably, certain items and constructs exhibited significant differences over the years. All of the constructs were assessed better from 2011 onwards, when the assessment and self-assessment tool was implemented. The success of the portfolio depends on strategies that provide students with greater clarity and forms of developing the method.
Assuntos
Avaliação Educacional/métodos , Pessoal de Saúde/educação , Estudantes de Ciências da Saúde , Ensino , Humanos , Aprendizagem , Reprodutibilidade dos Testes , Autoavaliação (Psicologia)RESUMO
Abstract The potential of the reflective collective portfolio as a method of teaching, learning and assessment needs to be emphasized. The objectives is to assess and validate the quality of the collective portfolio as a method of teaching, learning and assessment in the training of health professional. Portfolio quality was analyzed using an inventory of analysis that was adapted and tested for this study. In total, 70 portfolios were analyzed. The Kappa test was used to analyze reproducibility, confirming the level of agreement between the appraisers. Descriptive analysis and the t-test were performed to compare results from the years the portfolios were produced. The constructs (layout and organization, comprehensive, reflective, critical and creative thought) exhibited Cronbach alpha values above 0.7, confirming the high reliability of the tool. The weighted Kappa test revealed an elevated and significant agreement (+90%) between the appraisers. Notably, certain items and constructs exhibited significant differences over the years. All of the constructs were assessed better from 2011 onwards, when the assessment and self-assessment tool was implemented. The success of the portfolio depends on strategies that provide students with greater clarity and forms of developing the method.
Resumo O potencial do portfólio coletivo reflexivo como método de ensino, aprendizagem e avaliação precisa ser enfatizado. Os objetivos consistem em avaliar e validar a qualidade do portfólio coletivo como um método de ensino, aprendizagem e avaliação na formação de profissionais de saúde. A qualidade do portfólio foi analisada utilizando um inventário de análise que foi adaptado e testado para este estudo. No total, foram analisados 70 portfólios. O teste Kappa foi utilizado para analisar a reprodutibilidade, confirmando o nível de concordância entre os avaliadores. Análise descritiva e teste t foram realizados para comparar a construção do portfólio nos diferentes anos. Os construtos (layout e organização, compreensão, reflexão, crítica e pensamento criativo) apresentaram valores de alfa de Cronbach acima de 0,7, confirmando a alta confiabilidade da ferramenta. O teste Kappa ponderado revelou uma concordância elevada e significativa (+ 90%) entre os avaliadores. Notavelmente, certos itens e construtos apresentaram diferenças significativas ao longo dos anos. Todas as construções foram avaliadas melhor a partir de 2011, quando a ferramenta de avaliação e autoavaliação foi implementada. O sucesso do portfólio depende de estratégias que proporcionem aos alunos maior clareza e formas de desenvolver o método.
Assuntos
Humanos , Estudantes de Ciências da Saúde , Ensino , Pessoal de Saúde/educação , Avaliação Educacional/métodos , Autoavaliação (Psicologia) , Reprodutibilidade dos Testes , AprendizagemRESUMO
Health Surveillance is of paramount importance when confronted with the current Brazilian epidemiological setting. This study aims to evaluate the level of Health Surveillance in the Zona da Mata Mineira region. This is an evaluative study, and data were collected in the first half of 2016. The research universe consisted of seven municipalities in the Zona da Mata Mineira complex. Municipalities were selected with reference to available operational epidemiological, environmental and sanitary surveillance. The subjects under analysis were the Surveillance coordinators (n = 21), Health Surveillance coordinators (n = 7) and Health secretaries (n = 7). We conducted interviews using a semi-structured and elaborated questionnaire based on the Donabedian triad: Structure, Process and Outcome. A score system was established in order to obtain the classification of performance, realm and sub-realms, in which a score was assigned for each criterion. We used incipient, intermediate or advanced cutoff points to classify the level of Health Surveillance of scores were below 5.99 points, between 6.0 and 7.99 points and between 8 and 10 points, respectively. The level of regional Health Surveillance performance level was classified as an intermediate.
Resumo A Vigilância em Saúde é de suma importância ao se defrontar com o atual cenário epidemiológico do Brasil. Objetiva-se avaliar o grau de atuação da Vigilância em Saúde da Zona da Mata Mineira. Trata-se de um estudo avaliativo. A coleta de dados ocorreu no primeiro semestre de 2016. O universo da pesquisa foi composto por sete municípios polo da Zona da Mata Mineira. Os municípios foram selecionados tendo como referência a presença e a atuação das vigilâncias: epidemiológica, ambiental e sanitária. Os sujeitos em análise foram os coordenadores das vigilâncias (n = 21), coordenadores de Vigilância em Saúde (n = 7) e secretários de saúde (n = 7). Foram realizadas entrevistas utilizando-se um questionário semiestruturado e elaborado baseado na tríade de Donabedian: Estrutura, Processo e Resultado. A fim de obter a classificação da atuação, da dimensão e subdimensões foi criado um sistema de escores, no qual se atribuiu pontuação para cada critério. Para classificação do grau de atuação da Vigilância em Saúde, os pontos de corte utilizados foram: incipiente, intermediário ou avançado, se obtiver até 5,99 pontos; entre 6,0 e 7,99 pontos e entre 8 e 10 pontos, respectivamente. O grau de atuação da Vigilância em Saúde em âmbito regional foi classificado como intermediário.
Assuntos
Métodos Epidemiológicos , Monitoramento Epidemiológico , Vigilância da População/métodos , Brasil/epidemiologia , Cidades , Humanos , Entrevistas como Assunto , Projetos Piloto , Inquéritos e QuestionáriosRESUMO
Resumo A Vigilância em Saúde é de suma importância ao se defrontar com o atual cenário epidemiológico do Brasil. Objetiva-se avaliar o grau de atuação da Vigilância em Saúde da Zona da Mata Mineira. Trata-se de um estudo avaliativo. A coleta de dados ocorreu no primeiro semestre de 2016. O universo da pesquisa foi composto por sete municípios polo da Zona da Mata Mineira. Os municípios foram selecionados tendo como referência a presença e a atuação das vigilâncias: epidemiológica, ambiental e sanitária. Os sujeitos em análise foram os coordenadores das vigilâncias (n = 21), coordenadores de Vigilância em Saúde (n = 7) e secretários de saúde (n = 7). Foram realizadas entrevistas utilizando-se um questionário semiestruturado e elaborado baseado na tríade de Donabedian: Estrutura, Processo e Resultado. A fim de obter a classificação da atuação, da dimensão e subdimensões foi criado um sistema de escores, no qual se atribuiu pontuação para cada critério. Para classificação do grau de atuação da Vigilância em Saúde, os pontos de corte utilizados foram: incipiente, intermediário ou avançado, se obtiver até 5,99 pontos; entre 6,0 e 7,99 pontos e entre 8 e 10 pontos, respectivamente. O grau de atuação da Vigilância em Saúde em âmbito regional foi classificado como intermediário.
Abstract Health Surveillance is of paramount importance when confronted with the current Brazilian epidemiological setting. This study aims to evaluate the level of Health Surveillance in the Zona da Mata Mineira region. This is an evaluative study, and data were collected in the first half of 2016. The research universe consisted of seven municipalities in the Zona da Mata Mineira complex. Municipalities were selected with reference to available operational epidemiological, environmental and sanitary surveillance. The subjects under analysis were the Surveillance coordinators (n = 21), Health Surveillance coordinators (n = 7) and Health secretaries (n = 7). We conducted interviews using a semi-structured and elaborated questionnaire based on the Donabedian triad: Structure, Process and Outcome. A score system was established in order to obtain the classification of performance, realm and sub-realms, in which a score was assigned for each criterion. We used incipient, intermediate or advanced cutoff points to classify the level of Health Surveillance of scores were below 5.99 points, between 6.0 and 7.99 points and between 8 and 10 points, respectively. The level of regional Health Surveillance performance level was classified as an intermediate.