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Publication
Gestão das Unidades de Saúde Familiar: A Perspetiva Dos Enfermeiros, Assistentes Técnicos e Médicos
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| 1.7 MB | Adobe PDF |
Advisor(s)
Abstract(s)
As Unidades de Saúde Familiar (USF) foram um marco na reforma dos cuidados de saúde primários, ao contratualizarem objetivos, garantindo, aos utentes, acessibilidade, efetividade, eficiência e qualidade. São geridas/coordenadas apenas pelo médico coordenador – cargo que acumula com a medicina familiar –, que delega funções de gestão nos outros profissionais (enfermeiros, assistentes técnicos e médicos) no âmbito da gestão descentralizada das USF. Ao coordenador requer-se apenas que seja médico da equipa da USF, sem necessidade de formação em gestão. Considerou-se pertinente conhecer a perspetiva das equipas quanto à gestão/coordenação das USF e aos critérios de seleção para coordenador.
O estudo pretende contribuir para melhorar a gestão das USF, com os seguintes objetivos: conhecer a perceção dos seus profissionais sobre os modelos de gestão; como organizam as respetivas atividades de gestão; compreender a sua perceção sobre as características/habilitações relevantes para o desempenho destas atividades; compreender o papel dos enfermeiros na gestão das USF; e conhecer as atividades de gestão nestas unidades.
Em termos metodológicos, optou-se por um estudo qualitativo, descritivo, exploratório. A colheita de dados foi efetuada através de entrevistas semiestruturadas a 15 participantes: enfermeiros, assistentes técnicos e médicos de um Agrupamento de Centros de Saúde (ACeS) do Norte de Portugal, a exercer funções em USF modelo B há mais de três anos. O software ATLAS-Ti serviu de ferramenta de apoio à análise de conteúdo, segundo os pressupostos de Bardin.
Da análise dos dados, emergiram três domínios, que agregam as respetivas categorias e subcategorias: “Perceção sobre a gestão em uso na USF”, “Identificação do coordenador”; “Ambiente organizacional”. Constatou-se a necessidade de melhorar a gestão e liderança nas equipas, promovendo: comunicação interdisciplinar, relacionamento interpessoal, motivação, envolvimento dos profissionais. O estudo ressalva a importância de se reverem os termos de elegibilidade e mandato da coordenação, valorizando a formação em gestão e perfis adequados. Realça, ainda, a necessidade de investir na formação dos profissionais das USF, não só a nível científico, mas também em termos de desenvolvimento profissional e pessoal
The Family Health Units (USF) were a milestone in the reform of primary health care, as they contractualised objectives, guaranteeing users accessibility, effectiveness, efficiency, and quality. The USFs are managed/coordinated solely by the coordinating doctor – who also keeps his role as family doctor – who delegates management duties to other professionals (nurses, technical assistants and doctors) as part of the decentralised management of the USFs. The coordinator is only required to be a doctor on the USF team, with no need for management training. It was considered pertinent to find out the teams’ perspective on the management/coordination of the USFs and the selection criteria for coordinator. The study aims to contribute to improving the management of USFs with the following objectives: to understand the perception of its professionals regarding management models; how they organize their respective management activities; comprehend their perception of the relevant characteristics/qualifications for performing these activities; understand the role of nurses in the management of USFs; and to become acquainted with the management activities in these units. Methodologically, we opted for a qualitative, descriptive, and exploratory study. Data was collected through semi-structured interviews with 15 participants: nurses, technical assistants, and doctors from a Health Centre Grouping (ACeS) in the north of Portugal, who had been working in a model B USF for more than three years. The ATLAS-Ti software served as a tool to support data analysis according to Bardin. From the data analysis, three domains emerged, aggregating the respective categories and subcategories: “Perception of the management in use at the USF”, “Identification of the coordinator”; “Organisational environment”. It was identified a need to improve management and leadership in teams, by promoting interdisciplinary communication, interpersonal relationships, motivation, and the involvement of professionals. The study emphasises the importance of reviewing the terms of eligibility and mandate of coordination, valuing management training and appropriate profiles. It also highlights the need to invest in training for USF professionals, not only at a scientific level, but also in terms of professional and personal development.
The Family Health Units (USF) were a milestone in the reform of primary health care, as they contractualised objectives, guaranteeing users accessibility, effectiveness, efficiency, and quality. The USFs are managed/coordinated solely by the coordinating doctor – who also keeps his role as family doctor – who delegates management duties to other professionals (nurses, technical assistants and doctors) as part of the decentralised management of the USFs. The coordinator is only required to be a doctor on the USF team, with no need for management training. It was considered pertinent to find out the teams’ perspective on the management/coordination of the USFs and the selection criteria for coordinator. The study aims to contribute to improving the management of USFs with the following objectives: to understand the perception of its professionals regarding management models; how they organize their respective management activities; comprehend their perception of the relevant characteristics/qualifications for performing these activities; understand the role of nurses in the management of USFs; and to become acquainted with the management activities in these units. Methodologically, we opted for a qualitative, descriptive, and exploratory study. Data was collected through semi-structured interviews with 15 participants: nurses, technical assistants, and doctors from a Health Centre Grouping (ACeS) in the north of Portugal, who had been working in a model B USF for more than three years. The ATLAS-Ti software served as a tool to support data analysis according to Bardin. From the data analysis, three domains emerged, aggregating the respective categories and subcategories: “Perception of the management in use at the USF”, “Identification of the coordinator”; “Organisational environment”. It was identified a need to improve management and leadership in teams, by promoting interdisciplinary communication, interpersonal relationships, motivation, and the involvement of professionals. The study emphasises the importance of reviewing the terms of eligibility and mandate of coordination, valuing management training and appropriate profiles. It also highlights the need to invest in training for USF professionals, not only at a scientific level, but also in terms of professional and personal development.
Description
Keywords
Gestão Enfermagem Unidade de Saúde Familiar Profissionais da Saúde