Práticas avançadas na atenção primária à saúde da mulher: um olhar sobre a atuação dos enfermeiros da região sul

Abstract

The present study comes from a matrix project, entitled “Nursing Practices in the context of Primary Health Care: national mixed methods study”. As part of this research, the object of analysis were the practices developed by nurses in Primary Health Care (PHC) in the Southern region of Brazil. The objective is to analyze nurses' practices in women's health care in the context of PHC in the southern region of Brazil and its interfaces with the EPA. This is an exploratory and descriptive study with a mixed approach, using primary data. Quantitative data collection took place from November 2019 to August 2021 using an electronic questionnaire, with closed questions and a structured script, with 1,323 nurses from the southern region of Brazil participating. Qualitative data were collected from October 2020 to February 2021 through online interviews with 174 nurses, using a semi-structured script divided into 3 blocks: social data, professional training and work in the health service. The analysis of quantitative data occurred through descriptive and inferential statistics and qualitative data was analyzed using the Collective Subject Discourse (DSC). Of the participants, 92.4% were female. In the professionals' perception, the area of women's health allows for more autonomous action, with great mastery when it comes to nursing consultations, with 63.3% of nurses carrying out daily activities, in addition to activities such as cytopathology collection and breast examination. As for medication prescription to verify an infectious process or referral to another professional or another level of care in the service network, it is mainly linked to the use of protocols. Participants highlight their work in sexual and reproductive health, with the perception of it being sufficient (57.37%), highlighting the insertion of an Intrauterine Device, and insufficient (22.4%). In relation to pregnant women, low-risk prenatal care in interspersed consultations stands out, with requests for exams in the first trimester, however, there is still the perception of (12.4%) who claim that it is a non-resolutive service or insufficient. It is concluded that care for women demonstrates great proximity to advanced practice, demonstrating mastery and autonomy in nursing in PHC due to the implementation of policies and protocols that regulate professional performance. The great potential for implementation in the EPA in Brazil is highlighted, indicating positive impacts on improving access, promoting greater equity and resolution.