1. Difficulty in establishing the limits of the professional-user relationship. |
1. Difficulty in establishing the limits of the professional-user relationship. |
2. Prejudgment of service users by the teams. |
2. Oral health professionals or UBS workers pre-judge and disrespect users and family members based on prejudice and stigmas. |
2. Disrespect for users or family members by ESB professionals or UBS workers, based on prejudice and stigmas. |
3. The professional disrespects the user. |
4. Inadequate clinical indications. |
4. Inadequate clinical indications. |
4. Inadequate clinical indications of treatments or procedures by oral health professionals. |
5. Prescription of a medicine that the user cannot afford. |
5. The professionals prescribe specialized treatments or procedures that the user cannot afford, when these treatments/procedures are not offered by SUS. |
5. Prescription of treatment or indication of procedure that the user cannot afford. |
7. The user asks the doctor and nurse for the procedures they want. |
7. The user asks the dentist for the procedures they want. |
7. User ask the dentist for the procedures they want, following a coercive consumption pattern or traditional invasive cure. |
8. How to convince the user to continue the treatment. |
8. Oral health professionals feel powerless to convince the user to continue the treatment, especially without the educational and promotional work strengthened by the team, more specifically the TSB. |
8. How to convince or motivate the user to continue the treatment, especially without the TSB's health promotion clinical work. |
8. Difficulty in convincing or motivating the user to continue the treatment, especially without the TSB's clinical-educational work. |
14. Lack of commitment and involvement of some professionals who work in the PSF. |
14. Lack of commitment and involvement of some professionals who work in oral health and EqSF. |
14. Lack of commitment and involvement of some ESB professionals related to their duties. |
15. EqSF do not collaborate with each other. |
15. ESB and EqSF do not collaborate with each other, have low strategic planning level and few joint actions. |
15. EqSF and ESB do not collaborate with each other, resulting in few inter-professional actions. |
16. Lack of respect among team members. |
16. There is a lack of respect among the ESB members, especially with regard to valuing the auxiliary service and teamwork. |
16. Lack of respect among the ESB members, especially with regard to valuing the auxiliary service and teamwork. |
18. It is difficult to limit the role and responsibilities of each professional. |
17. Lack of preparation of professionals to work in the PSF. |
17. Lack of preparation/training (profile) of professionals to work in the PSF. |
17. Inadequate training of oral health professionals to perform their duties in PHC. |
19. Omission by professionals when the prescription is inadequate or wrong. |
19. Omission by professionals when an improper or wrong clinical procedure is performed. |
19. Omission by oral health professionals in face of inadequate clinical procedures or prescriptions. |
21. Difficult in preserving privacy due to problems in the physical structure and routine of the USF. |
21. Difficult in preserving privacy due to problems in the physical structure and routine of the USF. |
21. Difficult in preserving user's privacy due to problems in the physical structure and routine of the ESB and UBS. |
22. Lack of support with intersectoral actions to discuss and resolve ethical problems. |
22. Oral health and EqSF professionals lack support from intersectoral actions, which depend on the system organization and management, to discuss and resolve ethical problems they encounter in their practice. |
22. Lack of institutional support with intersectoral actions to discuss and resolve ethical problems. |
23. Lack of transparency of the UBS management in solving problems with the professionals. |
23. Lack of transparency of the UBS management in solving problems with the professionals. |
23. Lack of transparency of the UBS coordination in solving problems involving professionals. |
24. Excess of families assigned to each team. |
24. Excess of families assigned to each team of the ESF and ESB. |
24. Excess of families assigned to each ESB. |
26. Devaluation of referrals made by PSF doctors. |
26. Devaluation of referrals made by public service dentists. |
26. Devaluation of the quality of care provided by public service dentists by other professionals, especially from the private sector. |
27. Difficulties and lack of reference to carry out complementary examinations. |
27. There is difficulty related to the referral and counter-referral system for radiographic examinations, in addition to lack of service agility and efficiency. |
27. Difficulty in the reference system to carry out complementary examinations, especially radiographic ones. |
32. Users who refuse to follow medical instructions or undergo examinations. |
32. Users who refuse to follow the indications of preventive oral care actions, without changing their individual health management. |
32. Users who do not follow professional guidelines in caring for their own health. |
35. USF workers question the medical prescription. |
35. ESB professionals question the dentists’ conduct. |
35. Difficulty in preserve user's privacy due to problems in the physical structure and routine of the ESB and UBS. |
38. Lack of structure at the USF to carry out home visits. |
38. Home visits are hampered by issues related to commuting, especially the Odontomóvel, reducing the dentist's clinical practice power. |
38. Lack of conditions for ESB professionals to carry out home visits. |
39. Lack of conditions at the USF for emergency care. |
39. UBS does not handle all dental emergency care, besides operational problems. |
39. Lack of conditions or installed capacity for the ESB to meet all urgent needs. |