Myocardial revascularization: factors intervening in the reference and counter-reference in Primary Health Care

Care Provided to Women Victims of Intimate Partner Violence From the Perspective of Health Professionals

Intimate Partner Violence (IPV) is a recurring phenomenon in society and can have important repercussions for the lives and health of women worldwide. Even in this alarming global scenario, many health workers still have difficulties approaching IPV with women and providing care for the victims of this type of violence. Given this context, this qualitative study aims at understanding how primary health care professionals provide care for women victims of violence by intimate partners. In view of the methodology design proposed in the Grounded Theory, data collection took place through theoretical sampling. Data collection was carried out in 22 institutions offering primary health care, with 31 female workers from different professional categories being interviewed individually and in depth, including physicians, nurses, dentists, psychologists, and social workers. The results show that, in order to overcome the difficulties encountered in caring for victims of IPV, primary health care workers have been developing strategies for the care of these women. These strategies include identification of such cases through questions about the woman’s intimate relationship, by establishing a bond with the victim so that she feels welcomed, and through articulation with other team professionals to propose expanded health care. The interventions carried out by these professionals include meeting the demands of women in the health institution where they work, referral to other services in the network, if necessary, and notification of IPV cases to epidemiological surveillance. Based on this understanding of the care offered by the professionals to women who are victims of IPV in primary health care, the research aims at contributing to the sensitization of professionals working in health institutions regarding the identification of signs that raise suspicion of IPV, as well as at addressing such cases in a way to fully meet these women’s needs.

Liaison nurse activities at hospital discharge: a strategy for continuity of care

Objective

to describe the activities developed by the liaison nurses for the continuity of care after hospital discharge.

Method

descriptive, qualitative study, based on the theoretical reference. Strength Based Care. The sample comprised 23 liaison nurses. The data was collected through a semi-structured questionnaire via Survey Monkey electronic platform and analyzed through the content analysis technique, with pre-defined categories.

Results

among the liaison nurses, nine (39.14%), between 35 and 44 years of age; 17 (73.91%) were female; 15 (65.22%) were working eleven years or more nurse and 11 (47.82%), were between six and ten years old as a liaison nurse. The professionals participate in the identification of the patients who need care after hospital discharge, coordinate the planning of the hospital discharge and transfer the patient’s information to an extra-hospital service.

Conclusion

the activities developed by the liaison nurses focus on the needs of the patient and the articulation with the extra-hospital services, and can be adapted to the Brazilian context as a strategy to minimize the discontinuity of care at the time of hospital discharge.

REVASCULARIZAÇÃO MIOCÁRDICA: REFERÊNCIA E CONTRARREFERÊNCIA DO PACIENTE EM UMA INSTITUIÇÃO HOSPITALAR

RESUMO Objetivo: compreender o processo de referência e contrarreferência vivenciado pelo paciente com coronariopatia submetido à cirurgia de revascularização do miocárdio. Métodos: pesquisa qualitativa, ancorada na Teoria Fundamentada nos Dados. O cenário da pesquisa foi uma instituição hospitalar pública, referência em atendimento cardiovascular no Estado de Santa Catarina (Brasil). A coleta de dados ocorreu entre março de 2013 a junho de 2014, por meio de entrevista semiestruturada envolvendo 21 participantes, distribuídos em três grupos amostrais (pacientes, profissionais de saúde e profissionais gestores). Resultados: o processo de referência e contrarreferência aponta o fenômeno “Emergindo a alta complexidade como referência para a pessoa submetida à revascularização miocárdica diante da fragilidade da Atenção Primária à Saúde no acompanhamento e articulação com os demais níveis de atenção no Sistema Único de Saúde”, sustentado por cinco categorias. Conclusão: para que a referência aconteça há necessidade de consolidar o vínculo do paciente com coronariopatia com a atenção primária à saúde, uma vez que este encontra dificuldades no acompanhamento da sua condição na rede pública. Na contrarreferência evidenciou-se a desarticulação entre os serviços de atenção à saúde, a qual afeta o cuidado à pessoa submetida à revascularização miocárdica na manutenção da sua qualidade de vida.

Referral and counter-referral: repercussions of coronary artery bypass graft in the perspective of Primary Care

OBJECTIVE

to understand how repercussions of the referral and counter-referral of patients with indication/submitted to Coronary Artery Bypass Graft Surgery in the context of Primary Health Care.

METHOD

qualitative research with a theoretical-methodological contribution anchored in the Grounded Theory. Theoretical sampling was performed with 41 participants, divided into three sample groups (patients, health professionals and managers) in the Metropolitan Region and Western Region of Santa Catarina State.

RESULTS

the need for improvement in the process of recording clinical data in the regulation system emerged to strengthen patient referral; and the absence of a formal process of counter-referral and adaptation of lifestyle with repercussion in the counter-referral.

FINAL CONSIDERATIONS

the repercussions of the referral and counter-referral of patients with indication/submitted to the CABGS in the context of Primary Care are experienced through professional guidance and, in particular, by family support.

Nurse liaison: a strategy for counter-referral

ABSTRACT Objective: to identify the profile of the counter-referred patients by the “nurse liaison” and to describe the experience of the professionals who participated in the project. Method: intervention research, with twelve nursing nurses from a hospital and an Emergency Care Unit, and 26 nurses from Primary Health Care. Data were obtained through questionnaires and counter-referral forms. Results: Out of 43 counter-referred individuals, 62.8% are over sixty years, 53.5% are men with multi-pathologies. Among the positive aspects, the nurses highlighted the dialogue between health care services, agility in the acquisition of inputs for the continuity of care in primary care, benefiting patients after hospital discharge. The greatest challenge was the lack of time and the deficit of nurses to perform the function. Final considerations: the presence of the “nurse liaison” has proved to be an important strategy to improve integration between services and to promote continuity of care.