Health care for children and adolescents with HIV: longitudinality assessment

Paula, Cristiane Cardoso de; Padoin, Stela Maris de Mello; Silva, Clarissa Bohrer da; Kleinubing, Raquel Einloft; Ferreira, Tamiris

doi:10.1590/1982-0194201700022

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Original Article • Acta Paul Enferm. 30 (2) • Mar-Apr 2017 • https://doi.org/10.1590/1982-0194201700022 linkcopy

Health care for children and adolescents with HIV: longitudinality assessment

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective To evaluate the presence of Primary Health Care longitudinality from the perception of professionals from the municipalities of children and adolescents with HIV, who were treated in specialized services.

Methods Cross-sectional study, performed in 25 municipalities of Rio Grande do Sul, with 527 healthcare professionals. A characteristics questionnaire was used, and the Primary Care Assessment Tool - Brazil instrument, professional version. Pearson’s Chi-square test and Poisson regression were used.

Results The longitudinality was satisfactory (p=6.96). Professionals aged less than or equal to 30 years (p=0.01) and professional education (p = 0.03) were associated with high scores. In the Family Health Strategy, sufficient time to attend to clients (p 0.045) was associated with the high score.

Conclusion The assessment indicated the potential for Primary Health Care to care for children and adolescents with HIV, especially in providing a bond, which is a determinant for the continuity of care.

Nursing assessment; Primary care nursing; Child health; Adolescent health

Variables	Categories	High score (≥6.6)	Low score (<6.6)	p-value*
Variables	Categories	n(%)	n(%)	p-value*
Sociodemographic
Age	<30 years	269(51.04)	151(28.65)	0.01
Age	>30 years	54(10.25)	53(10.06)	0.01
Sex	Female	213(40.42)	126(23.91)	0.33
Sex	Male	110(20.87)	78(14.80)	0.33
Marital status (n=526)	Married	212(40.30)	130(24.71)	0.65
	Single	83(15.78)	52(9.89)
	Other	27(5.13)	22(4.18)
Education
Education	General Clinical	121(22.96)	53(10.06)	0.03
	Gynecologist	23(4.36)	15(2.85)
	Pediatrician	23(4.36)	10(1.90)
	Nurse	95(18.03)	72(13.66)
	Dentist	61(11.57)	54(10.25)
Years after graduation from undergraduate program (n=526)	<15 years	169(32.13)	105(19.96)	0.89
Years after graduation from undergraduate program (n=526)	>15 years	154(29.28)	98(18.63)	0.89
Graduation	None	83(15.75)	55(10.44)	0.81
	Residency	68(12.90)	36(6.83)
	Specialization	161(30.55)	105(19.92)
	Master’s degree	11(2.09)	8(1.52)
Graduation concluded (n=390)	<6 years	129(33.08)	76(19.49)	0.48
Graduation concluded (n=390)	>6 Years	110(28.21)	75(19.23)	0.48
Complementary education	Yes	276(52.37)	169(32.07)	0.42
Complementary education	No	47(8.92)	35(6.64)	0.42
Occupational
Employee contract type (n=526)	Private employee	93(17.68)	43(8.17)	0.06
	Civil servant	223(42.40)	153(29.09)
	Contracted	6(1.14)	8(1.52)
Years of service (n=526)	<3 years	154(29.28)	113(21.48)	0.09
Years of service (n=526)	>3 years	168(31.94)	91 (17.30)	0.09
Position (n=526)	Yes	52(9.89)	38 (7.22)	0.46
Position (n=526)	No	270(51.33)	166(31.56)	0.46
Type of position (n=87)	Director	13(14.77)	14(15.91)	0.17
	Coordinator	38(43.18)	19(21.59)
	PHC Responsible	1(1.14)	2(2.27)
Another job	Yes	168(31.88)	107(20.30)	0.92
Another job	No	155(29.41)	97(18.41)	0.92

Variables	Basic Health Unit (n=270)		p-value*	Family Health Strategy (n=257)		p-value*
	High score (≥6.6)	Low score (<6.6)		High score (≥6.6)	Low score (<6.6)
	n(%)	n(%)		n(%)	n(%)
Carie by the same physician / nurse
High score	52(19.26)	32(11.85)	0.447	108(42.02)	6(21.79)	0.463
Low score	16(39.26)	80(29.63)		57(22.18)	36(14.01)
Understanding the questions asked by your patients
High score	138(51.1)	94(34.81)	0.426	132(51.36)	72(28.02)	0.741
Low score	20(7.41)	18(6.67)		33(12.84)	20(7.78)
Patients’ understanding of what you ask for
High score	78(28.89)	48(17.78)	0.290	68(26.46)	40(15.56)	0.724
Low score	80(29.63)	64(23.70)		97(37.74)	52(20.23)
Patients can call and speak with a doctor or nurse who knows them better.
High score	118(43.70)	76(28.15)	0.219	70(27.24)	36(14.01)	0.607
Low score	40(14.81)	36(13.33)		95(36.96)	56(21.79)
Enough time with patients to discuss their problems or concerns
High score	119(44.07)	76(28.15)	0.177	122(47.47)	57(22.18)	0.045
Low score	39(14.44)	36(13.33)		43(16.73)	35(13.62)
Patients are comfortable telling you their concerns or problems
High score	91(33.70)	58(21.48)	0.344	70(27.24)	36(14.01)	0.607
Low score	67(24.81)	54(20.00)		95(36.96)	56(21.79)
Know “very well” the patients of your health service
High score	68(25.19)	47(17.41)	0.860	68(26.46)	44(17.12)	0.305
Low score	90(33.33)	65(24.07)		97(37.74)	48(18.68)
Know who lives with each of your patients
High score	11(4.07)	9(3.33)	0.740	22(8.56)	14(5.45)	0.676
Low score	147(54.44)	103(38.15)		143(55.64)	78(30.35)
Understand which problems are most important for the patients
High score	79(29.26)	51(18.89)	0.469	79(30.74)	39(15.18)	0,397
Low score	79(29.26)	61(22.59)		86(33.46)	53(20.62)
Know the complete medical history of each patient
High score	31(11.48)	30(11.11)	0.165	20(7.78)	12(4.67)	0,830
Low score	127(47.04)	82(30.37)		145(56.42)	80(31.13)
Know the job of each patient
High score	24(8.89)	13(4.81)	0.399	13(5.06)	9(3.50)	0,601
Low score	134(49.63)	99(36.67)		152(59.14)	83(32.30)
Would know about patients having difficulty getting or paying for medicines
High score	68(25.19)	44(16.30)	0.537	64(24.90)	26(10.12)	0,089
Low score	90(33.33)	68(25.19)		101(39.30)	66(25.68)
Know all the medications patients are taking
High score	49(18.15)	38(14.07)	0.613	44(17.12)	18(7.00)	0,202
Low score	109(40.37)	74(27.41)		121(47.08)	74(28.79)
Longitudinality score	158(58.52)	112(41.48)	0.005	165(64.20)	92(35.80)	<.0001

Variables	RPb*	CI95%†	p-value	RPa‡	CI95%†	p-value
Variables	RPb*	Min - Max	p-value	RPa‡	Min - Max	p-value
Age
<30 years	1.099	1.025 -1.177	0.008	1.084	1.008-1.167	0.030
>30 years	ref.			ref.
Education
General practitioner	1.138	1.003-1.291	0.045	1.106	0.972-1.258	0.127
Nurse	1.144	1.008-1.298	0.038	1.102	0.968-1.254	0.142
Dentist	1.148	1.008-1.307	0.038	1.113	0.976-1.269	0.110
Gynecologist	1.127	0.967-1.313	0.125	1.119	0.962-1.302	0.145
Pediatrician	ref.			ref.
Type of employee contract
Civil	1.124	0.935-1.352	0.212	1.114	0.921-1.348	0.265
Private	1.153	0.955-1.391	0.138	1.105	0.912-1.339	0.308
Contracted	ref.			ref.
Years of service
<3 years	1.048	0.996-1.104	0.072	1.030	0.973-1.091	0.309
>3 years	ref.			ref.
Position
Coordinator	1.237	0.823-1.858	0.306	-	-	-
Director	1.278	0.846-1.930	0.244	-	-	-
PHC responsible	ref.			ref.

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[TFN1001] * Pearson’s Chi-Square Test