Diabetes mellitus e Atenção Primária à Saúde: avaliação da qualidade da estratégia Saúde da família na perspectiva do usuário

Abstract

Introduction: Brazil stands out as the largest country in Latin America and the fifth largest country in the world for having the highest number of people with diabetes mellitus (DM). The North and Northeast regions of the country showed higher rates of DM cases. These high rates are associated with socioeconomic inequalities. Thus, in Ceará, between 2013 and 2022, 22,708 deaths from DM were recorded. Objectives: This study evaluates the quality of the Family Health Strategy (FHS) in controlling diabetes mellitus in a city in the interior of Ceará, in addition to analyzing the essential and derived attributes of Primary Health Care from the perspective of individuals with diabetes mellitus using the PCATool-Brazil. Methodology: The study is divided into two chapters. The first is an observational, cross-sectional, quantitative study conducted in the city of Sobral/Ceará, with a sample size of 408 individuals. Eight Family Health Centers were selected to cover the largest number of registered individuals with diabetes. The PCATool was used as a data collection tool, allowing the evaluation of the attributes of Primary Health Care from the perspective of users. In addition, an integrative literature review was conducted, focusing on the evaluation of primary health care from the perspective of users with chronic diseases in Brazil, with the aim of supporting and contextualizing the study findings. Results: Primary Health Care was better evaluated among women and the elderly, in addition to people with a per capita income of one to three minimum wages. In addition, the research shows that long-term monitoring of patients with DM is flawed, given the scarce request for the glycated hemoglobin test for monitoring these patients. The importance of more effective health care, a specialized team and greater promotion of self-care and assiduity of the population is highlighted, as well as the relevance of carrying out qualified listening to the demands for improvements reported by the community. Final considerations: The assessment of the care offered to these users is based on the agreement between managers and users, as well as on continuous and comprehensive monitoring of patients with diabetes mellitus, which involves regular laboratory tests, continuous monitoring of blood glucose levels, strengthening the bond between health professionals and patients, in addition to the promotion of personalized educational actions for self-care and prevention of complications.