Evaluation of Implantation of Ostomy Patient Health Care Program

Abstract

RESUMOObjetivo: avaliar a implantação dos Serviços de Atenção à Saúde das Pessoas Ostomizadas em Minas Gerais. Método: estudo seccional realizado em 28 unidades de saúde do estado de Minas Gerais. Os dados foram coletados a partir de questionários que compõem a base do Sistema Integrado de Gerenciamento da Assistência Farmacêutica da Secretaria de Estado de Saúde. O grau de implantação foi definido por meio de uma matriz de análise e julgamento validada para o estudo com escores diferenciados para cada indicador avaliado. Resultados: foram analisados dados sobre estrutura e processo dos serviços de saúde. Observou-se que 11% atingiram o grau de implantação plena; 42% apresentaram implantação satisfatória; 36% incipientes e 11% foram classificados como não implantados. Na organização do programa, a estrutura foi mais bem avaliada que o processo. Destaca-se ausência de orientação e capacitação de profissionais, atendimento em grupo, organização da demanda de atendimento e escassez de enfermeiro qualificado. Conclusão: os serviços estão focados no fornecimento de equipamentos coletores em detrimento de serviços norteados para uma assistência integral, ampliada e em rede. Palavras-chave: Estomia; Atenção à Saúde; Políticas Públicas de Saúde; Avaliação de Programas e Projetos de Saúde. ABSTR ACT

Assessment of health care services for people with stoma: a multicase study

“…Deficiencies in the structure of the Care Ser-vices to People with Stomata were also observed in a study carried out in Minas Gerais, Brazil (2) , which identified that both structure and process were not in accordance with that recommended in the established legal guidelines (1) . The regional services must be restructured in accordance with the norms established and agreed by the State Health Department (1) , which establish adequate physical structures and an interdisciplinary team capable of carrying out actions aimed at self-care, prevention of complications in the stomata and rehabilitation of patients with stoma.…”

“…Although the services are in operation, we observed the non-fulfillment of some purposes established in the guidelines for health care of people with stoma (1) , namely the organization and promotion of actions related to primary health care, the establishment of reference and counter-reference flows and mechanisms, and the promotion of permanent education of professionals for providing adequate care to the person with stoma and their family members. Thus, there has been the maintenance of an organization centered on the traditional model, based on the distribution and storage of devices to the detriment of comprehensive care, characterized by interdisciplinary care, focused on the individual and the family, aimed at early rehabilitation and improvement of the quality of life (1)(2) .…”

“…From the degree of implementation of each component, the categories for the classification of the Health Care Services of People with Type I Stomata were defined, adopting the scores (2) : complete (80.0%│--│100.0%); satisfactory (60.0%│--│79.9%); poor (40.0%│--│59.9%); and not implemented (<40.0%).…”

“…The organization of health care to people with stoma in Brazil has been restructured from a model of care network, regionalized and hierarchical, in order to guarantee a comprehensive care to people with disabilities (1) . This new model is based on interdisciplinary, preventive, individualized and systematized care, aiming at early rehabilitation and improvement of the quality of life of people with stoma (1)(2) .…”

“…Therefore, it is hoped to reach the organization of services within the health territories, the qualified attention to the individual and his/her family, the stimulation of self-care, besides the prescription and the provision of suitable collecting equipment and auxiliary protection and safety mechanisms (2) . The decentralization of these services subsidizes the planning and monitoring of care (3) .…”