PREVIEW NOTES

Healthcare focused on children and adolescents living with HIV: a descriptive study

Daniela Dal Forno Kinalski¹, Cristiane Cardoso de Paula²

^1,2 Federal University of Santa Maria

ABSTRACT
Aim: To discuss the constitution of the healthcare network focused on children and adolescents living with HIV.
Method: This is a descriptive exploratory study that uses a qualitative approach. The study population will be comprised of healthcare professionals providing primary healthcare services and specialized services for HIV patients. Inclusion criteria: being a professional acting in one of the study settings; exclusion criteria: not belonging to the permanent staff of the municipality. The focus group technique involving up to 15 participants representing the professional and service categories involved will be used. The resulting data will be used to develop a qualitative analysis. A thematic content analysis will be developed.
Expected results: To contribute to the quality of healthcare of this population based on a discussion of the actions taken in each service. The care flow built with the help of professionals will assist in the first contact in terms of Primary Health Care (PHC), in transferring users between services and, consequently, in the extent and comprehensiveness of care.
Descriptors: Nursing; Child Health; Adolescent Health; HIV; Health Services.

PROBLEM SITUATION AND ITS SIGNIFICANCE

Children and adolescents living with the Human Immunodeficiency Virus (HIV) feature a healthcare dependence beyond the usual due to the specificities of their HIV status. They need ongoing health monitoring, including the demand for drug technology.

From 1980 to June 2014, 37,959 cases of Acquired Immune Deficiency Syndrome (AIDS) were reported in the 0 to 19 year age group in Brazil. Of these cases, 20,461 were between 0 and 9 years of age (children) and 17,498 between 10 and 19 (adolescents). In the year 2014, a total of 209 children and 427 teenagers were reported, which indicates the importance of investment both in the prevention of new cases, and in the support for existing cases in order to reduce mortality and morbidity due to infection⁽¹⁾.

However, this population faces barriers in accessing Primary Health Care (PHC) services, and this results in their being directed to specialized services. It is recommended that these specialized services are able to rely on the PHC services, in an attempt to ensure quality of healthcare, preferably under the coordination of the PHC. In this sense, the creation of a Healthcare Network (HCN) could be used to achieve integration between the services in accordance with public national health policy⁽²⁾.

Therefore, it is necessary to structure municipal policy in such a way as to implement a transfer system, define the responsibilities and activities of each service, and ensure the continuing education of professionals. They need to know the children and adolescents living with HIV in their area and develop actions for the reception and strengthening of bonds.

GUIDING QUESTION

How has the healthcare flow aimed at supporting children and adolescents living with HIV been constituted?

OBJECTIVE

To discuss the constitution of the HCN aimed at supporting children and adolescents living with HIV in the municipality of Santa Maria, Rio Grande do Sul (RS), Brazil (BR).

METHOD

This is a descriptive research using a qualitative approach. Data collection will take place through the use of the focus group technique, between the months of March and June 2015. We have scheduled three meetings to make use of the following guiding questions:

1) What is the healthcare situation with regard to children and adolescents living with HIV in Santa Maria/RS/BR?
2) What is the responsibility of each healthcare service in terms of the attention provided with regard to children and adolescents living with HIV?
3) How is the healthcare service flow aimed at supporting children and adolescents living with HIV constituted in Santa Maria?

The scenarios will be the primary care services in the municipality of Santa Maria, and specialized services such as the pediatric infectious diseases outpatient clinic at the University Hospital of Santa Maria (HUSM) and the Casa Treze de Maio Healthcare unit. Inclusion criteria: being a professional employed in one of the study settings. Exclusion criteria: hired professionals who do not belong to the permanent staff of the municipality, or those who have a health certificate or were absent from work in the data collection period.

The groups will be made up of up to 15 professionals, according to the technique selected for collection. The population will aim for the representation of each professional category (nurse, general practitioner, pediatrician, gynecologist and infectious disease specialist), of each health service. The invitation to participate in the survey will be delivered to the services, as a result of which practitioners will indicate interest and availability to participate by contacting the researcher.

Each group will also include observers and a moderator. A field diary will be used, and the data will be audio recorded and subsequently transcribed.

Data analysis will be performed according to the operative proposal of Thematic Content Analysis⁽³⁾. This project was approved by the Ethics Committee of the Federal University of Santa Maria and will comply with the ethical aspects of research on human beings, following Resolution 466/12 of the National Health Council.

EXPECTED RESULTS

We point out the importance of the development of this research for the epidemiological scenario and in terms of the clinical and social demands for healthcare with regard to children and adolescents living with HIV. We expect to contribute to the quality of healthcare through the improvement of access, an emphasis on comprehensive and longitudinal care, and family and community participation. The identification of the initiatives in terms of the responsibilities of each service, and the proposition of the service flow will promote integration between services and the HCN organization, under the coordination of the PHC organization.

REFERENCES

1. Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de DST, AIDS e Hepatites Virais. Boletim Epidemiológico – AIDS e DST. Brasília: Ministério da Saúde; 2014. [ cited 2015 Jan 21 ] Available from:http://www.aids.gov.br/sites/default/files/anexos/publicacao/2014/56677/boletim_2014_1_pdf_60254.pdf

2.Mendes, E.V. As redes de atenção à saúde. Brasília: Organização Pan-Americana da Saúde; 2011. Available from: http://www.conass.org.br/pdf/Redes_de_Atencao.pdf Acesso em: 21 de Janeiro de 2015.

3. Minayo, MCS. O Desafio do Conhecimento: pesquisa qualitativa em saúde. 13. ed. São Paulo; 2013.

All authors participated in the phases of this publication in one or more of the following steps, in According to the recommendations of the International Committee of Medical Journal Editors (ICMJE, 2013): (a) substantial involvement in the planning or preparation of the manuscript or in the collection, analysis or interpretation of data; (b) preparation of the manuscript or conducting critical revision of intellectual content; (c) approval of the versión submitted of this manuscript. All authors declare for the appropriate purposes that the responsibilities related to all aspects of the manuscript submitted to OBJN are yours. They ensure that issues related to the accuracy or integrity of any part of the article were properly investigated and resolved. Therefore, they exempt the OBJN of any participation whatsoever in any imbroglios concerning the content under consideration. All authors declare that they have no conflict of interest of financial or personal nature concerning this manuscript which may influence the writing and/or interpretation of the findings. This statement has been digitally signed by all authors as recommended by the ICMJE, whose model is available in http://www.objnursing.uff.br/normas/DUDE_eng_13-06-2013.pdf

Received: 03/20/2015
Revised:06/23/2015
Approved: 06/23/2015