Objectives: The objective of this study is to define medical eligibility criteria for Home Care within the scope of Primary Health Care. Brief description of the experience: through a modified Delphi study, a consensus was reached among 30 participating physicians regarding the eligibility criteria for Home Care in Primary Health Care. Strong consensus (> 75%) was obtained for: bedridden, dependence for basic activities of daily living, palliative care, impaired mobility, advanced underlying disease, and untrained caregiver; and weak consensus (50% to 75%) for: use of ostomies/oxygen, dependence for instrumental activities of daily living, post-hospitalization, physical disability, and impaired cognitive function or communication. Conclusion: The eligibility criteria for Home Care in Primary Health Care, according to the participants' consensus, focus on functional impairment, as well as the absence of a trained caregiver who could address difficulties in performing daily activities and mobility. The proposed criteria can help physicians in the Family Health Strategy to organize access to Home Care within their teams.

Este trabalho apresenta a experiência dos Encontros da Atenção Primária, como uma estratégia de Educação Permanente em Saúde voltada à formação contínua e crítica de profissionais da Atenção Primária à Saúde. Relata como essa iniciativa contribui para o fortalecimento do Sistema Único de Saúde e para o alinhamento da capacitação profissional às necessidades reais do cotidiano de trabalho, a partir de levantamento das demandas dos profissionais participantes. Os Encontros da Atenção Primária, iniciados em 2021, ocorrem em formato online e presencial, com horários protegidos durante o expediente para a participação dos trabalhadores da saúde. As temáticas são escolhidas com base em questionários preenchidos pelos próprios trabalhadores e a metodologia inclui levantamento prévio de dúvidas, participação de especialistas, gravação das sessões e estímulo à participação ativa dos profissionais. A experiência demonstrou boa adesão dos profissionais e avaliação positiva da iniciativa. Os participantes relataram melhorias na qualidade do cuidado prestado, maior segurança do paciente e fortalecimento do trabalho em equipe. Os Encontros da Atenção Primária mostraram-se como uma estratégia viável de Educação Permanente em Saúde, contribuindo para a valorização dos trabalhadores e para a qualificação do cuidado na Atenção Primária à Saúde, reforçando a Educação Permanente como ferramenta fundamental para o fortalecimento do Sistema Único de Saúde.

Objectives: To analyze the influence of Social Determinants of Health on the diagnosis, treatment, and care of patients with colorectal cancer, and to discuss the implications of these influences for the formulation of public health policies. Data sources: This is an Integrative Literature Review conducted in six systematic steps, based on the PICo strategy and guided by the methodological recommendations of PRISMA (2020), adapted to the integrative approach. Study selection was performed using Rayyan software, which facilitated blind and automated screening of titles and abstracts. Searches were carried out in the LILACS, CINAHL, Web of Science, and PubMed databases, using previously defined inclusion and exclusion criteria, and a time frame from 2008 to 2024. Data extraction was conducted using the Joanna Briggs Institute Mixed Methods Appraisal Tool (JBI-MMAT), and the analysis of findings was based on the theoretical models of Social Determinants of Health proposed by Dahlgren and Whitehead (1991), and Diderichsen, Evans, and Whitehead (2001). Results: A total of 21 articles were included, of which 14 (66.7%) had level IV evidence, and 11 (52.4%) achieved the highest score on the Heterogeneous Methodologies Assessment Scale (6 points). Two main approaches were identified: "ecosocial" and "multilevel" models, dynamically integrating individual, social, and biological dimensions. A significant process of racialization of the disease was evident, highlighting the importance of intersectoral actions and effective governance to mitigate inequalities. Conclusions: The Integrative Review reaffirms the relevance of Social Determinants of Health as key elements in public health, with direct implications for the control and care of colorectal cancer.

Introduction: Medical Psychology is an essential component of contemporary medical education. Objective: To document, through an experience report, the pedagogical practice of the Medical Psychology discipline in the Medical School at the Federal University of Pelotas (1968–2023), using an integrative literature review and the teaching plans of the Medical Psychology courses at UFPel. Method: Qualitative research, primarily based on an experience report. However, to complement and substantiate the institutional evidence from UFPel, an integrative review was conducted. Twelve articles were selected from the VHL database (following PRISMA criteria), along with books, national guidelines, and institutional documents. Results: A unique pedagogical model was identified, structured into four sequential courses, integrating psychoanalytic foundations, communicative competencies, and a longitudinal biopsychosocial approach. Conclusions: This experience demonstrates the feasibility of a sustained curriculum in medical humanities, whose structure may serve as a reference for comparable institutions.

Physical activity (PA) during pregnancy provides several benefits. This study aimed to analyze whether, and how, PA is addressed in prenatal care within primary health care (PHC). A qualitative study was conducted with interviews of 16 physicians and 16 nurses from PHC, randomly selected from the four health districts of Florianópolis, SC, Brazil. Group activities with pregnant women were in decline at the local PHC, but when they occurred, they included PA guidance and practices. In consultations, most participants did not regularly provide such guidance, although they acknowledged its importance, knew how to deliver it, and expressed willingness to standardize this practice. Knowledge about PA in pregnancy stemmed more from exchanges with PHC colleagues than from academic training, and those who felt less knowledgeable were willing to improve. Reported barriers to practicing PA were mainly related to socioeconomic determinants and inequities. Considering the high technical qualifications of the participants, the national situation is likely to be even less favorable. It is necessary to strengthen professional training and, above all, to encourage the provision of such guidance in prenatal care, in order to improve the quality of care within the Brazilian Unified Health System (SUS).

Acupuncture is an ancient practice widely spread in the Western Word to provide quality of life and well-being. This study aimed to describe the insertion of systemic acupuncture in the treatment of depression according to the national and international literature. An integrative literature review study, elaborated through the IOP strategy, based on the guiding question: how has acupuncture contributed (or not) to the treatment of depression? The search expression consisted of indexed descriptors and their respective synonyms, combined by Boolean operators, which were inserted in Bases de Dados de Enfermagem (BDENF), Latin American and Caribbean Literature in Health Sciences (Lilacs), Medical Literature Analysis and Retrieval System Online (Medline), Scopus, Web of Science, Cochrane Library and PsycArticles. Randomized clinical trials and full articles published in Portuguese, English, and Spanish were considered as inclusion criteria. In turn, as exclusion criteria were duplicate articles, studies involving animals, reviews, gray literature, articles that addressed only microsystems (auriculopuncture/auriculotherapy/craniopuncture), electroacupuncture and any other point stimulation other than systemic acupuncture. A total of 21 articles were found, which were read in full, where the positive and negative contributions of acupuncture to the treatment of depression were identified. It was found that acupuncture, as a complementary technique to the conventional treatment of depression, can redeem or reduce symptoms, bringing well-being and quality of life. However, it generates controversy in the literature regarding its effectiveness and safety.

This study aimed to describe the hospital discharge process concerning the physiotherapeutic follow-up of patients diagnosed with stroke in a hospital, as well as to identify potential barriers to physiotherapy treatment after discharge. Post-stroke patients and physiotherapists from hospital wards were evaluated. To assess the patients, an evaluation form, the Modified Rankin Scale, and the Mini-Mental State Examination were used. One week after discharge, patients or their caregivers were interviewed by phone to discuss aspects related to the discharge process. Thirty days after discharge, a new interview was conducted to identify barriers to physiotherapy follow-up, along with the reapplication of the Modified Rankin Scale. The physiotherapists answered a questionnaire regarding the patients' discharge process. The responses were analyzed using the Collective Subject Discourse technique. The study included 14 patients and 7 physiotherapists. The analysis revealed key ideas such as the guidance received at hospital discharge and the positive and negative experiences reported by patients. The physiotherapists, in turn, provided suggestions to improve the discharge process. It was observed that after 30 days, 50% of the patients had no access to physiotherapy. Given this, the importance of physiotherapeutic follow-up from the hospitalization period is highlighted, with a discharge plan that considers the comprehensiveness and individuality of each patient. Moreover, strengthening access to healthcare services in the post-discharge period is essential to ensure continuity of care and rehabilitation.

O objetivo deste trabalho é apresentar o jogo da atenção contínua como ferramenta educacional para qualificar o cuidado em saúde desenvolvido por equipes multiprofissionais da Atenção Secundária Ambulatorial. A experiência ocorreu em 2023, em um ambulatório na linha de cuidado da pessoa com hipertensão arterial e diabetes mellitus localizado no Centro-Oeste do Brasil. Participaram das atividades de educação permanente quatorze profissionais de saúde do ambulatório e três representantes da gestão regional e central. O jogo consistiu em um caso clínico fictício, com 12 momentos que finalizavam na construção do plano de cuidados integrado em equipe. A experiência possibilitou ampliar o olhar da equipe sobre o trabalho colaborativo interprofissional e interdisciplinar, desenvolver habilidades de gestão do cuidado e qualificar as oportunidades de melhoria que foram identificadas no ciclo de atenção contínua praticado pela equipe no ambulatório.

Introdução: o câncer de colo uterino é considerado um problema de saúde pública, e o agente comunitário de saúde ao estar no território é um importante aliado na sua prevenção. Objetivo: analisar os saberes de agentes comunitários de sau?de sobre prevenção do câncer de colo uterino. Métodos: trata-se de uma pesquisa qualitativa com abordagem da pesquisa-ação, realizada em novembro de 2019, em uma Unidade Básica de Saúde da região sul do Rio Grande do Sul. Participaram da pesquisa dez agentes comunitários de saúde. Para a produção de dados utilizou-se um questionário para caracterização dos participantes e oficinas com participação ativa dos agentes comunitários. Para a análise de dados utilizou-se a análise de conteúdo temática. Resultados: a pesquisa indicou que os profissionais possuem saberes sobre o câncer de colo uterino, porém alguns apresentam insegurança para abordar o tema e orientar as mulheres para prevenção. Constatou-se que há fragilidades quanto à formação e educação continuada na atenção primária à saúde. Conclusão: há necessidade de promover espaços educativos para a reflexão crítica das práticas dos agentes comunitários a fim de fortalecer a prevenção do câncer de colo uterino.