Estrutura e processo de trabalho na prevenção do câncer de colo de útero na Atenção Básica à Saúde no Brasil: Programa de Melhoria do Acesso e da Qualidade – PMAQ

Tomasi, Elaine; Oliveira, Talita Fischer; Fernandes, Pedro Agner Aguiar; Thumé, Elaine; Silveira, Denise Silva da; Siqueira, Fernando Vinholes; Duro, Suele Manjourany Silva; Saes, Mirelle de Oliveira; Nunes, Bruno Pereira; Fassa, Anaclaudia Gastal; Facchini, Luiz Augusto

doi:10.1590/s1519-38292015000200003

Cited by 80 publications

(75 citation statements)

References 14 publications

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“…The finding regarding the better screening quality in the South and Southeast regions when compared to the other areas is coherent with several studies 4 , 5 , 24 . The apparent surprise comes from the worst screening situation in the Midwest, even when compared to the North and Northeast regions.…”

Section: Discussionsupporting

confidence: 87%

Quality of cervical cancer screening in Brazil: external assessment of the PMAQ

et al. 2017

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OBJECTIVE To examine whether demographic and socioeconomic variables and the variables of the organization of services are associated with the quality of cervical cancer screening.METHODS This is a survey carried out in the health services of the five Brazilian regions in 2012. The sample consisted of users of basic health units participating in the Program for Improving Access and Quality of the Primary Care. The independent variables analyzed were: socioeconomic characteristics (municipal context), demographic characteristics (user profile), and two domains related to the organization of basic services (work structure and process). The low quality of the screening was assessed from the lack of access, late examination, and lack of guidance. Crude and adjusted analyses by Poisson regression assessed the association between outcomes and independent variables.RESULTS The values of lack of access, late examination, and lack of guidance were 6.7%, 11.2%, and 19.2%, respectively. Problems of quality were lower according to the increase in Municipal Human Development Index and per capita household income, increasing with population size and municipal coverage of the Family Health Strategy. The Midwest region of the country presented the highest occurrences of low quality outcomes. Indigenous and yellow women had the highest prevalence of outcomes. Women with partner, who received the Bolsa Família Program, and who had paid work had less chances of having lack of access, late examination, and lack of guidance. The appropriate work process in health services decreased the likelihood of low quality in all indicators.CONCLUSIONS Investments in the work process of health teams, social cash transfer programs, and social conditions of the population are essential to improve the quality of the program of cervical cancer screening in Brazil.

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Section: Discussionsupporting

confidence: 87%

Quality of cervical cancer screening in Brazil: external assessment of the PMAQ

et al. 2017

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“…In line with some studies, (7,17) the professionals understood the PMAQ as a guide for the work processes, which indicates the achievement of the Program objectives in terms of improving the processes and the use of information in line with the local reality. (2) On the other hand, they appointed that the PMAQ entailed more work for the teams, demanding a more detailed analysis to understand the reasons for this finding.…”

Section: Discussionmentioning

confidence: 52%

Implementação do Programa de Melhoria do Acesso e Qualidade segundo gestores da Atenção Básica de São Paulo

et al. 2017

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Objective: To analyze the implementation of the National Improved Access and Quality Program according to Primary Health Care managers. Methods: The thematic oral history was used, through semistructured interviews with five managers from Primary Health Care Services who participated actively in the two cycles of the Program in an administrative district of São Paulo City. The subjects answered the question "How do you assess the implementation process of the National Improved Access and Quality Program at this Primary Health Care Service?", among others. The analysis of the testimonies revealed the categories "The managers' perception of the implementation of the National Improved Access and Quality Program" and "Changes in the work processes since the implementation of the National Improved Access and Quality Program". Results: The managers acknowledged the Program as a well-structured proposal, which permits a broader management view on the health services. The interviewees evidenced the use of the quality indicators, which was hardly addressed and understood in the managers and teams' daily reality though. The interviewees demonstrated that they do not understand the concepts of continuing education and institutional support. The external evaluation phase was considered subjective and without standardization, producing data that did not contribute to the assessment of the changes the teams made. Conclusion: The systematic incorporation process of the assessment culture to support the continuing quality improvement in Primary Health Care is incipient. Despite the continuing distance between the proposals of Primary Health Care and the practice at the Primary Health Care services studied, the Program favored the organization of the work processes and contributed to the managers' focus on the teams' practice and their own activities. ResumoObjetivo: Analisar a implementação do Programa Nacional de Melhoria do Acesso e da Qualidade segundo gerentes de Unidades Básicas de Saúde. Métodos: Utilizou-se a história oral temática, por meio de entrevistas semiestruturadas com cinco gerentes de Unidades Básicas de Saúde que participaram ativamente dos dois ciclos do Programa em um distrito administrativo do município de São Paulo. Os sujeitos responderam, dentre outras, à questão "Como você avalia o processo de implementação do Programa Nacional de Melhoria do Acesso e da Qualidade nesta Unidade Básica de Saúde?" e da análise dos depoimentos emergiram as categorias "Percepção dos gestores quanto à implementação do Programa Nacional de Melhoria do Acesso e da Qualidade" e "Mudanças nos processos de trabalho a partir da implementação do Programa Nacional de Melhoria do Acesso e da Qualidade". Resultados: Os gerentes reconheceram o Programa como uma proposta bem estruturada, que permite ampliar a visão gerencial nos serviços de saúde. O uso dos indicadores de qualidade foi evidenciado pelos entrevistados, mas pouco trabalhado e compreendido no cotidiano dos gestores e equipes. Os entrevistados demonstraram não compr...

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“…This test is considered an effective diagnostic tool for prevention and health promotion; it is highly specific, and reduces the chances of unnecessary treatments and interventions (Tomasi et al, 2015). Primary health care professionals are responsible for instructing the population about the importance of the screening as an important tool for preventing and detecting CC at early stages (Cunha, 2015).…”

Section: Discussionmentioning

confidence: 99%

<b>Conceptions of women on cervical cancer screening

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Sousa

Monteiro³

et al. 2018

Acta Sci. Health Sci.

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ABSTRACT. Despite the high prevalence and incidence of cervical cancer, this disease can be avoided and has great healing potential when detected at early stages. Cervical cancer screening is used in monitoring programs for early diagnosis and is considered safe and effective. This study aimed to analyze the conceptions of women on cervical cancer screening. A qualitative study was carried out with 30 women assisted in primary care, in Teresina, Piauí, Brazil. The Discourse of the Collective Subject was obtained from interviews carried out from August to October 2016. The speeches expressed the notions that women have about the significance of the screening test, the importance of undergoing the test, and prevention of cervical cancer. The conceptions of the interviewed women revealed that the test prevents diseases, including cervical cancer. However, the discourses left clear the lack of knowledge on HPV, its forms of prevention and cervical cancer. The analysis revealed that women have superficial or insufficient knowledge about the significance of the screening test and cervical cancer.Keywords: women's health, papanicolaou test, uterine cervical neoplasms, family health strategy.Concepções de mulheres sobre o exame preventivo do câncer do colo do útero RESUMO. Embora o câncer do colo uterino apresente-se com alta prevalência e incidência, pode ser evitado e tem grande potencial de cura quando detectado precocemente. O exame preventivo do câncer do colo do útero é utilizado em programas de monitoramento para o diagnóstico precoce, sendo considerado seguro e eficaz. Este estudo objetivou analisar as concepções de mulheres sobre o exame preventivo do câncer do colo do útero. Realizou-se um estudo qualitativo, com 30 mulheres atendidas na atenção básica, em Teresina, Piauí, Brasil. Os dados foram coletados de agosto a outubro de 2016 por meio de entrevistas e analisados pelo Discurso do Sujeito Coletivo. Os discursos expressaram as concepções das mulheres sobre o significado do exame de prevenção, a importância da realização do exame de prevenção e o conhecimento e prevenção do câncer do colo do útero. As concepções das mulheres entrevistadas revelaram que o exame previne doenças, dentre elas, o câncer do colo uterino. No entanto, os discursos explicitaram o desconhecimento entre a associação do HPV, suas formas de prevenção e o câncer cervical. A análise revelou que as mulheres apresentam pouca profundidade ou conhecimento insuficiente sobre o significado do exame preventivo e o câncer do colo do útero.Palavras-chave: saúde da mulher, teste de papanicolaou neoplasias do colo do útero, estratégia saúde da família.

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Estrutura e processo de trabalho na prevenção do câncer de colo de útero na Atenção Básica à Saúde no Brasil: Programa de Melhoria do Acesso e da Qualidade – PMAQ

Abstract: Objectives: to outline and examine the adequacy of the structure and processes used by Access and Quality Improvement Program (PMAQ-AB)

Cited by 80 publications

References 14 publications

Quality of cervical cancer screening in Brazil: external assessment of the PMAQ

Quality of cervical cancer screening in Brazil: external assessment of the PMAQ

Implementação do Programa de Melhoria do Acesso e Qualidade segundo gestores da Atenção Básica de São Paulo

<b>Conceptions of women on cervical cancer screening

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