Formação e atuação dos agentes comunitários de saúde em Sobral-CE para a identificação e acompanhamento das pessoas com diagnóstico de transtorno do espectro autista (TEA) frente ao decreto nº 8.368/2014

Abstract

Studies that seek to understand the needs of patients diagnosed with Autism Spectrum Disorder (ASD) may contribute to better provision of care / attention for these individuals. Decree #8,368/2014 recognized that people with ASD have the Rights of Persons with Disabilities. The Community Health Worker (CHW) is a unique character in the early identification of cases of ASD in primary care, gateway to the Unified Health System (SUS) and reference for comprehensive care. The aim of this study was to analyze the implementation of continuous education actions and the technical qualification of 406 CHWs, in Sobral-CE, regarding the care of people diagnosed with ASD, after the commencement of Decree #8,368/2014. Data collection was conducted by means of a semi-structured and selfmanaged questionnaire administered to 251 CHWs in the municipality of Sobral-CE (sample equal to 61.8% of the population). The participants signed the Informed Consent Form (Resolution #196/96). The results showed that: 90.8% of the sample was represented by female CHWs; a concentration above 60% of the sample was aged between 25-44 years old; only 1.6% of the sample had not completed elementary school, while 64.5% of CHWs had completed High School, and more than 25% of the sample were attending or had completed higher education. Regarding the knowledge of the CHWs on ASD, it was observed that: 65.7% of the CHWs know what autism is. When asked if they consider autism a deficiency there was a similarity in the percentage of those who consider autism a disability (41%) and those who do not (54.6%). 74.9% of CHWs affirmed that there were patients diagnosed with ASD in their attendance area. When asked about participation at any point in Continuing Education where the theme of Autism was discussed, 88.4% of CHWs responded that they had not participated in this type of training. Analyzing the question: how do you consider your knowledge in this area, 82.1% of the CHWs consider their knowledge as regular-bad. This observation is more evident when the CHWs were questioned whether they felt prepared to identify these patients, and 82.9% of CHWs responded that they did not feel prepared. Moreover, when questioned whether they had an interest in improving their knowledge in this area, 97.2% of the CHWs affirmed their interest. In addition, 98.4% of the sample considers it important for the CHWs to identify patients with ASD. When asked about how the practice of CHWs could contribute in the identification and monitoring of people with ASD, the following was reported: the need for training on the theme; and that they could contribute through the good reception of people with ASD and their families. Still, their speech shows the expanded view on the need for multi-professional work in the care of people with ASD, through the work of the CHWs, the minimum staff of a Family Heath Team (FHS) and a Support Center for Family Health (SCFH). Another aspect mentioned corresponds to the desire of professionals to promote the social inclusion of people with ASD. To sum up, there is a demand for ASD in Sobral-CE. No training activities for ASD were identified for these professionals that have demonstrated a clear interest in the subject. Therefore, there is urgency for the involvement of CHWs in Continuous Education processes with emphasis on ASD to achieve efficient and transforming professional practice, by means of constant learning, qualifying health care and its resoluteness, overcoming one of the biggest challenges of ASD, which is the late diagnosis.