The World Health Organization (WHO) (WHO, 2004:20) describes a community as a social group of any size, with its members residing in a specific locality, sharing government and a common cultural and historical heritage. In the context of health, a community can be considered as those who are affected by similar health issues, or it can simply be defined as stakeholders, such as health professionals or patients. Community participation is collaboration in which people voluntarily, or due to some incentive, collaborate with externally determined projects, either contributing their labour and/or resources for some expected benefit. Within the health system community participation can either be guided by law or regulations, for instance, the White Paper for Transformation of the Health System in South Africa and the South African patients' bill of rights charter, or it can be on a voluntary basis without any guidelines. The researcher believes that the focus should be on how the community can participate in the decisions that affect their health. The research was aimed at exploring and describing a rural community’s perceptions on community participation in Primary Health Care (PHC) services rendered to improve the quality of the current PHC services. The main question asked was: What does effective community participation in PHC services entails to improve the quality of health care according to the community members’ perspectives in a rural community? A qualitative research approach was used to conduct the research on the perceptions of community members on community participation in PHC services. The research took place in Dewetsdorp, a rural area situated in the Xhariep district of the Free State province in South Africa. Data was collected by means of focus groups, making use of a semi-structured interview schedule consisting of four questions in an endeavour to reach an answer on the research question. Three focus groups realised; one consisting of the community leaders as members of the community, another consisting of members from Non-Governmental Organisations (NGOs) and the last consisting of community members utilising the PHC services in Dewetsdorp. Digitally voice recorded focus groups were transcribed for data analysis. Data saturation occurred after three focus groups, with an average of seven participants per group. The themes that emerged from the focus groups are discussed with literature integration. The findings of the research suggest that the community members of Dewetsdorp have a strong sense that community participation should form part of the PHC services. They expressed the view that they play an important role that should be acknowledged and they want to be respected as partners who are willing to take ownership of the PHC services in their community through participation. From the research results and conclusions, the researcher compiled recommendations for nursing education, nursing research and primary health care nursing practice. / MCur, North-West University, Potchefstroom Campus, 2015

The World Health Organization (WHO) (WHO, 2004:20) describes a community as a social group of any size, with its members residing in a specific locality, sharing government and a common cultural and historical heritage. In the context of health, a community can be considered as those who are affected by similar health issues, or it can simply be defined as stakeholders, such as health professionals or patients. Community participation is collaboration in which people voluntarily, or due to some incentive, collaborate with externally determined projects, either contributing their labour and/or resources for some expected benefit. Within the health system community participation can either be guided by law or regulations, for instance, the White Paper for Transformation of the Health System in South Africa and the South African patients' bill of rights charter, or it can be on a voluntary basis without any guidelines. The researcher believes that the focus should be on how the community can participate in the decisions that affect their health. The research was aimed at exploring and describing a rural community’s perceptions on community participation in Primary Health Care (PHC) services rendered to improve the quality of the current PHC services. The main question asked was: What does effective community participation in PHC services entails to improve the quality of health care according to the community members’ perspectives in a rural community? A qualitative research approach was used to conduct the research on the perceptions of community members on community participation in PHC services. The research took place in Dewetsdorp, a rural area situated in the Xhariep district of the Free State province in South Africa. Data was collected by means of focus groups, making use of a semi-structured interview schedule consisting of four questions in an endeavour to reach an answer on the research question. Three focus groups realised; one consisting of the community leaders as members of the community, another consisting of members from Non-Governmental Organisations (NGOs) and the last consisting of community members utilising the PHC services in Dewetsdorp. Digitally voice recorded focus groups were transcribed for data analysis. Data saturation occurred after three focus groups, with an average of seven participants per group. The themes that emerged from the focus groups are discussed with literature integration. The findings of the research suggest that the community members of Dewetsdorp have a strong sense that community participation should form part of the PHC services. They expressed the view that they play an important role that should be acknowledged and they want to be respected as partners who are willing to take ownership of the PHC services in their community through participation. From the research results and conclusions, the researcher compiled recommendations for nursing education, nursing research and primary health care nursing practice. / MCur, North-West University, Potchefstroom Campus, 2015

Submitted by MARCIA ROVADOSCHI (marciar@unifra.br) on 2018-08-22T12:10:49Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_AmarilisPagelFlorianoDaSilva.pdf: 2844255 bytes, checksum: 56c5fe5c3d1f8bb5841725dd27806fcc (MD5) / Made available in DSpace on 2018-08-22T12:10:49Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_AmarilisPagelFlorianoDaSilva.pdf: 2844255 bytes, checksum: 56c5fe5c3d1f8bb5841725dd27806fcc (MD5) Previous issue date: 2018-04-30 / Introduction: patient safety represents an important concern in the quality of health care and has an analogy with the prevention of errors in care. Adverse events take place wherever health care is provided and, in many circumstances, could be prevented through preventive measures. Objective: to identify the actions of the professional practice of nurses that indicate patient safety in primary health care, with a view of qualifying health care. Specific Objectives: to identify, in the literature the area, the scientific publications related to patient safety actions related to the nurses' performance in primary health care and to understand the conceptions of nurses working in the Family Health Strategy on safety knowledge and practices of the patient in primary health care. Methodology: This dissertation was developed in two stages, one consisting of a integrative review of literature in which scientific articles were found with the objective of the review. The second stage consisted of a descriptive-exploratory study with a qualitative approach, developed in Family Health Strategies located in the western region of Santa Maria - RS. The data were analyzed according to the thematic content analysis of Minayo. This research is approved by the Research Ethics Committee of the Franciscan University, and is registered under opinion nº 1.876.855. Results: The publications found in the review totaled 10 scientific articles presented in a synthesis table, in order to characterize the publications according to author / year, objectives, type of study, approach, results and conclusions. In field research, the analysis process resulted in the organization of three thematic categories: Patient safety meanings for the nurses of the Family Health Strategy; Barriers to safe care in the context of Primary Health Care and Strategies for safe care in the work of nurses of the Family Health Strategy. Discussion: the findings of the integrative literature review did not allow a more in-depth analysis of the topic, since the studies about nurses' work in primary care related to the subject are scarce and incipient, indicating the existence of spaces for new research to be carried out. Many articles, because they are international, have brought a primary health care organization that is very similar to the Family Health Strategy model and traditional Basic Health Units, which are characteristic models of Primary Care in Brazil. In the field research, it was noticed that the conception of the majority of the nurses regarding the safety of the patient are related to the safe care that avoids damages. Some participants highlighted the concern about infection prevention as one of the criteria for avoiding risk and harm. Some difficulties were also signaled both in the speeches and in the professional performance, through the observations. Although many difficulties have been mentioned and observed in nurses' work, it is important to highlight that they have been developing some strategies to promote safe care, even in adverse working conditions. Final Considerations: the integrative review made it possible to identify and ponder existing studies on nurses' performance in primary care pertinent to patient safety. The data allowed to address nurses' understanding of the patient's knowledge and safety practices in primary health care, as well as the main barriers and strategies for the development of safe care. It is necessary to explore in depth questions related to patient safety in the work of nurses, since this topic presents a strategic role in the planning and implementation of health team actions and in the direct supervision of the work of Community Health Agents. attributions are heavily included actions of health promotion and care management, which impacts on a role of articulation and leadership towards the team. / Introdução: a segurança do paciente representa uma importante preocupação na qualidade do cuidado de saúde e tem analogia com a prevenção de erros no atendimento e ao cuidado. Eventos adversos acontecem em qualquer lugar onde se proporcionam cuidados de saúde e, em muitas circunstâncias, poderiam ser evitados por meio de medidas preventivas. Objetivo: identificar as ações da prática profissional do enfermeiro que indiquem a segurança do paciente na atenção primária em saúde, com vistas à qualificação do cuidado em saúde. Objetivos Específicos: identificar, na literatura da área, as publicações científicas referentes às ações de segurança do paciente relacionadas à atuação do enfermeiro na atenção primária em saúde e compreender as concepções de enfermeiros atuantes na Estratégia de Saúde da Família acerca dos saberes e práticas de segurança do paciente na atenção primária em saúde. Metodologia: esta dissertação foi desenvolvida em duas etapas, uma constituída de uma revisão integrativa de literatura na qual foram encontrados artigos científicos que atenderam ao objetivo da revisão. A segunda etapa constou de um estudo descritivo-exploratório com abordagem qualitativa, desenvolvido em Estratégias de Saúde da Família localizadas na região oeste de Santa Maria – RS. Os dados foram analisados segundo análise de conteúdo temática de Minayo. A pesquisa possui aprovação do Comitê de Ética em Pesquisa da Universidade Franciscana, estando registrada sob o parecer nº1.876.855. Resultados: As publicações encontradas na revisão totalizaram 10 artigos científicos apresentados em um quadro síntese, a fim de caracterizar as publicações segundo autor/ano, objetivos, tipo de estudo, abordagem, resultados e conclusões. Na pesquisa de campo, o processo de análise resultou na organização de três categorias temáticas: Significados de segurança do paciente para as enfermeiras da Estratégia de Saúde da Família; Barreiras para o cuidado seguro no contexto da Atenção Primária em Saúde e Estratégias para o cuidado seguro na atuação das enfermeiras da Estratégia de Saúde da Família. Discussão: os achados da revisão integrativa de literatura não permitiram uma análise mais aprofundada sobre o tema, pois os estudos acerca do trabalho do enfermeiro na atenção primária relacionados à temática são escassos e incipientes, o que indica a existência de espaços para que novas pesquisas sejam realizadas. Muitos artigos, por serem internacionais, trouxeram uma organização de atenção primária em saúde que pouco se assemelha com o modelo de Estratégia de Saúde da Família e Unidades Básicas de Saúde tradicionais, que são modelos característicos da Atenção Primária do Brasil. Na pesquisa de campo, percebeu-se que a concepção da maioria das enfermeiras quanto à segurança do paciente está relacionada com o cuidado seguro que evita danos. Algumas participantes elencaram a preocupação com a prevenção de infecções como um dos critérios para se evitar o risco e o dano. Algumas dificuldades também foram sinalizadas tanto nas falas como na atuação profissional, por meio das observações. Embora muitas dificuldades tenham sido referidas e observadas na atuação das enfermeiras, destaca-se que estas vêm desenvolvendo algumas estratégias para potencializar um cuidado seguro, mesmo que em condições de trabalho adversas. Considerações Finais: a revisão integrativa possibilitou identificar e ponderar sobre os estudos já existentes sobre a atuação do enfermeiro na atenção primária pertinentes à segurança do paciente. Os dados permitiram abordar a compreensão das enfermeiras sobre os saberes e práticas de segurança do paciente na atenção primária em saúde, assim como as principais barreiras e estratégias para o desenvolvimento do cuidado seguro. É necessário explorar em profundidade questões pertinentes à segurança do paciente no trabalho do enfermeiro, uma vez que este tema apresenta papel estratégico no planejamento e implementação das ações de equipe de saúde e na supervisão direta do trabalho dos Agentes Comunitários de Saúde. Ainda, dentre suas atribuições estão fortemente incluídas as ações de promoção da saúde e de gestão do cuidado, o que repercute em um papel de articulação e liderança perante a equipe.