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Previous issue date: 2013 / Funda??o de Amparo ? Pesquisa do estado de Minas Gerais (FAPEMIG) / Funda??o Diamantinense de Apoio ao Ensino, Pesquisa e Extens?o (Fundaep) / O Programa de Educa??o Permanente para M?dicos da Estrat?gia de Sa?de da Fam?lia foi implantado na Regi?o Ampliada de Sa?de Jequitinhonha em outubro de 2010, com a finalidade de melhorar o n?vel de resolubilidade da Aten??o Prim?ria ? Sa?de, tomando como ponto de partida a aprendizagem significativa e integrada das diversas compet?ncias cl?nicas necess?rias aos m?dicos das equipes de sa?de da fam?lia. O objetivo deste trabalho foi avaliar as a??es de planejamento, execu??o e resultados do PEP na Regi?o Ampliada de Sa?de Jequitinhonha de Minas Gerais em interface com os objetivos propostos pelo Programa. O estudo foi desenvolvido em 14 munic?pios desta Regi?o, que possu?am m?dicos da Estrat?gia de Sa?de da Fam?lia com frequ?ncia de participa??o no PEP igual ou superior a 60,0%. Participaram da pesquisa 14 gestores municipais de sa?de, 31 m?dicos e 383 usu?rios. Tratou-se de uma pesquisa de triangula??o descritiva, quantitativa e qualitativa. Utilizou-se como instrumentos de coleta de dados: 1) Question?rios estruturados dirigidos aos usu?rios, m?dicos e gestores de sa?de; 2) Relat?rios de supervisores dos GAPs para o levantamento dos temas estudados nos encontros e 3) Atestos de gestores municipais de sa?de para calcular a rotatividade profissional dos m?dicos. As entrevistas das consultas m?dicas foram filmadas e analisadas. Utilizou-se a an?lise descritiva dos dados, o teste do qui-quadrado e teste de Fisher (p = 0,05). A m?dia de idade dos m?dicos entrevistados foi de 39,5 anos, 67,7% eram do sexo masculino e 48,2% solteiros. Em rela??o ? titula??o, 45,2% dos m?dicos possu?am apenas gradua??o em medicina, sendo que 35,5% possu?am no m?ximo quatro anos de forma??o. A rela??o m?dicos inscritos/presentes nos encontros do PEP foi de 41,5% em 2011 e 38,4% em 2012. Os temas mais estudados nos encontros de GAP foram a metodologia do PEP (24,3%) e as doen?as cr?nicas n?o transmiss?veis (10,5%). Para os m?dicos participantes, o supervisor do GAP segue a metodologia proposta e os materiais atendem ?s necessidades dos grupos (100,0%). Os m?dicos (93,5% e 96,8%, respectivamente) relatam que ap?s a participa??o no PEP houve redu??o de encaminhamentos e de pedidos de exames desnecess?rios. Os m?dicos participantes (93,5%) afirmam ainda que suas consultas foram reestruturadas ap?s a participa??o no Programa. Segundo o ponto de vista de 35,7% dos gestores municipais de sa?de, os m?dicos vinculados a seus munic?pios participam do PEP apenas como forma de cumprir o Contrato do Programa Sa?de em Casa, mas para a maioria (62,5%) este n?o ? o motivo da participa??o, enquanto 50% dos Secret?rios Municipais de Sa?de afirmam que os m?dicos que s?o liberados para o PEP, n?o comparecem nos encontros. A maioria dos usu?rios (76,1%) relatou ter percebido melhora no atendimento ap?s a participa??o do m?dico no Programa. O ?ndice de rotatividade para os m?dicos que participam do PEP com frequ?ncia igual ou superior a 60,0% foi de 35,5%, enquanto para aqueles que n?o participam efetivamente do Programa o valor foi de 60,9%. Conclui-se, assim, que a Educa??o Permanente nos moldes do PEP pode melhorar o desempenho cl?nico dos m?dicos e envolver mais o usu?rio em seu tratamento, al?m de contribuir para a fixa??o de profissional na regi?o. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2013. / ABSTRACT
The Permanent Education Program for Physicians in the Family Health Strategy was implemented in the Jequitinhonha Extended Health Region in October 2010 for the purpose of improving the level of resolution capability in Primary Health Care. It took as the starting point the significant and integrated learning of the various clinical skills that the physicians in the family health teams need. The objective of this paper was to assess the planning and execution actions, as well as the results of the PEP in the Jequitinhonha Extended Health Region, in Minas Gerais state, in interface with the objectives proposed by the Program. The study was developed in 14 municipalities in this Region, which had physicians from the Family Health Strategy whose participation rate in the PEP was equal to or greater than 60 percent. 14 health managers, 31 physicians, and 383 users participated in the research. The research used a descriptive, quantitative, and qualitative triangulation approach. The following data collection tools were used: 1) Structured questionnaires addressed to users, physicians, and health managers; 2) Reports by supervisors from the Professional Development Groups (PDGs) for an overview of the topics studied in the meetings, and 3) Statements by municipal health managers to calculate the professional turnover rate of medical doctors. The interviews during medical appointments were filmed and analyzed. Descriptive data analysis, the?chi-square test? and the Fisher Test (p = 0.05), and the Pearson Correlation Test (p = 0.0.5%) were used. The average age of the interviewed physicians was 39.5 years; 67.7% were males, and 48% were single. As far as academic degree was concerned, 45.2% of the physicians only had a degree in Medicine, and 35.5% of them had graduated no more than four years prior to these interviews. The percentages of physicians who signed up for / participated in the meetings of the PEP were 41.5% in 2011 and 38.4% in 2012. The most widely studied topics in the Professional Development Group meetings were the methodology of the Permanent Education Program (24.3%) and chronic non-communicable diseases (10.5%). For the participating physicians, the supervisor of the Professional Development Group follows the proposed methodology, and the materials meet the needs of the groups (100%). The physicians (93.5% and 96.8%, respectively) reported that, after participating in the Permanent Education Program, there was a reduction in the number of unnecessary referrals and requests for medical examinations. The participating physicians (93.5%) also stated that their medical consultations were restructured after they participated in the Program. From the point of view of 35.7% of the municipal health managers, the physicians working in their municipalities attend the Permanent Education Program only to comply with the Home Health Care Program Agreement. However, for most of the municipal health care managers (62.5%), this is not the reason why physicians attend the PEP, while 50% of the Municipal Health Secretaries stated that physicians who are released to attend the PEP do not show up for the meetings. Most of the users (76.1%) reported that they noticed an improvement in the health care services after their doctor participated in the Program. The turnover rate was 35.5% for physicians whose participation in the PEP was equal to or greater than 60.0% , whereas for those who do not participate effectively in the Program the turnover rate was 60.9%. It is therefore concluded that permanent education, along the lines of the Permanent Education Program, can improve the clinical performance of the physicians and make users more involved in their treatment. Furthermore, it contributes to retaining professionals in the region.
| Identifer | oai:union.ndltd.org:IBICT/oai:acervo.ufvjm.edu.br/jspui:1/371 |
| Date | January 2013 |
| Creators | Cruz, Cleya da Silva Santana |
| Contributors | Oliveira, Leida Caleg?rio de, Pires, Herton Helder Rocha, Silv?rio, Jo?o Batista, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Oliveira, Leida Caleg?rio de |
| Publisher | UFVJM |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Repositório Institucional da UFVJM, instname:Universidade Federal dos Vales do Jequitinhonha e Mucuri, instacron:UFVJM |
| Rights | A concess?o da licen?a deste item refere-se ao ? termo de autoriza??o impresso assinado pelo autor, assim como na licen?a Creative Commons, com as seguintes condi??es: Na qualidade de titular dos direitos de autor da publica??o, autorizo a Universidade Federal dos Vales do Jequitinhonha e Mucuri e o IBICT a disponibilizar por meio de seus reposit?rios, sem ressarcimento dos direitos autorais, de acordo com a Lei n? 9610/98, o texto integral da obra disponibilizada, conforme permiss?es assinaladas, para fins de leitura, impress?o e/ou download, a t?tulo de divulga??o da produ??o cient?fica brasileira, e preserva??o, a partir desta data., info:eu-repo/semantics/openAccess |
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