Internments suitable for Primary Healthcare constitute a new indicator used in some countries to indirectly measure the resolution capability of Primary Healthcare. The scope of this study is to present the panorama of the internments suitable for primary healthcare in Sao Paulo State. An ecological descriptive study was carried out for the period from 2000 to 2007. The data were generated by patient's county of residence and grouped by Regional Health Departments. The Information Systems of the Health Ministry and the population estimates of the Brazilian Institute of Geography and Statistics (IBGE) were used to obtain the data of all patients. The internments suitable for primary healthcare in the state follow a tendency toward reduction suggesting a connection with the adoption of the Family Health Program. A reduction in internments for diabetes was detected and attention was drawn to the increase of internment for illnesses related to prenatal care and childbirth. In light of the recent publication of the Brazilian Diagnostics List, studies that analyze the statistics from it can be very useful for managers involved with primary care, and can serve as benchmarks for quality and contribute to assessment for the implementation of health policies in Brazil.

O presente estudo aborda o tema da Assistência Domiciliar (AD), identificando-a com uma modalidade de atenção que vem sendo adotada no âmbito dos sistemas de saúde, aliando motivações racionalizadoras e humanitárias. Por meio de uma breve contextualização histórico-conceitual, reconhece-se o predomínio desta abordagem no contexto hospitalar, problematizando, entretanto, a necessidade de seu fortalecimento no contexto da atenção básica. Neste sentido, desenvolve-se uma análise comparada entre uma proposta de assistência domiciliar no âmbito da Atenção Básica no Brasil, formulada pelo Ministério da Saúde, com o modelo adotado pelo Canadá. A despeito das diferenças socioeconômicas e sanitárias entre os dois países, a análise empreendida forneceu elementos que podem subsidiar a proposta brasileira, seja nos aspectos normativos e operacionais, seja no tocante à sua viabilidade político-institucional.

Objective: To evaluate the frailty syndrome in the elderly nursing diagnosis in elderly with chronic diseases of a health district of the Federal District. Method: A quantitative, descriptive, cross-sectional study was conducted with elderly patients served at the Basic Health Units, who presented arterial hypertension and/or diabetes mellitus. The following were used: a sociodemographic questionnaire, the Mini-Mental State Examination, anthropometric data, evaluation of sarcopenia (measured by body composition), muscle strength and functional capacity, and the identification of NANDA-I nursing diagnosis. A statistical software was used for data analysis. Results: Participation of 78 elderly people, of which 93.6% of had Impaired memory, 93.6% had Impaired physical mobility, 82.1% had Fatigue, 76.9% had Impaired ambulation, 53.8% had Dressing self-care deficit, 43.6% had Activity Intolerance, 35.9% had Social Isolation, 30.8% had Hopelessness, 29.5% had Feeding self-care deficit, 29.5% had Bathing self-care deficit, 12.8% had Toileting self-care deficit, and 10.3% had Decreased cardiac output. Conclusion: The nursing diagnosis Frailty Syndrome in the Elderly allows a multidimensional view of the elderly. Since one factor can cause health problems in several health fields, nurses must intervene early, plan and implement actions in the short and long term.

Ambulatory Care Sensitive Conditions List was adopted in Brazil, to evaluate access and care effectiveness. This study aimed to present panoramic view of these hospitalizations in a General Hospital of São Paulo Municipality, Brazil. The methodology used was type ecological and exploratory. The data source was the Hospital Information System of Brazilian Unified Health System collected and a sample of hospitalizations. The results showed that there is a reduction tendency of this kind of hospitalizations and the most important cause during three years was bacterial pneumonia. There was predominance of women and patients older than 65 years old. In conclusion, the List is an important tool to evaluate access and effectiveness of Primary Care Services, but also it is relevant to know and evaluate the health network organization due to assure continuity of care to reach the principle of integrality of health care. DESCRIPTORS:Hospitalization. Primary health care. Evaluation. INTERNAÇÕES POR CONDIÇÕES SENSÍVEIS À ATENÇÃO INTERNAMIENTOS POR CONDICIONES SENSIBLES DE ATENCIÓN PRIMARIA EN SALUD: ESTUDIO EN HOSPITAL GENERAL DE LA CIUDAD DE SÃO PAULO, BRASILRESUMEN: El indicador Internamientos por Condiciones Sensibles a la Atención Primaria fue adoptada en Brasil para evaluación de los servicios de este nivel. Se objetivó presentar el panorama de estos internamientos en un Hospital de la ciudad de São Paulo, Brasil. Se realizó un estudio ecológico, exploratorio, cuya fuente fue el Sistema de Información Hospitalarios del Sistema Único de Salud y una muestra de expedientes de pacientes internados en este Hospital. Se utilizó la estadística descriptiva. Los internamientos por Condiciones Sensibles siguen la tendencia de reducción: siendo las neumonías bacterianas las mayores causas de internamiento; la frecuencia fue más alta para los mayores de 65 años de edad y para el sexo femenino. Las internaciones por condiciones sensibles, per sé, no son suficientes para evaluar la atención primaria pero permite evaluar la organización de la red de salud, para asegurar la continuidad del cuidado integral a los pacientes. DESCRIPTORES:Hospitalización. Atención primaria de salud. Evaluación.

Resumo A doença renal crônica (DRC) acarreta ao indivíduo uma sobrecarga de cuidados indispensáveis ao alcance das metas terapêuticas e qualidade de vida. O controle nutricional, o regime medicamentoso e as terapias de substituição renal são exemplos que requerem participação ativa. Assim, foi realizada revisão integrativa de artigos científicos para identificar os que versam sobre envolvimento e participação do paciente em seus cuidados na DRC. Os descritores “Chronic kidney disease”; “Self-Care” and “Patient Participation” foram aplicados nas bases CINHAL, Bireme e Medline. Selecionamos 21 publicações entre 2012 e 2016. A entrevista semiestruturada destacou-se como método de coleta de dados, com a aplicação da análise temática fenomenológica. Conforme a predominância do assunto tratado, os manuscritos foram alocados em quatro eixos temáticos: Manejo da doença renal e seu tratamento; Envolvimento na tomada de decisão; Plano avançado de cuidados; e, Diálise peritoneal domiciliar. Verificamos que abordagens envolvendo pessoas transplantadas ou nos primeiros estágios da doença são pouco explorados com a aplicação do método qualitativo e, ainda, consideramos que pessoas com DRC devem ser instigadas no envolvimento ativo de seus próprios cuidados, necessitando de conhecimento, motivação e suporte dos profissionais de saúde.