MARIANA ARANTES NASSER
Projetos de Pesquisa
Unidades Organizacionais
CLIMED-05, Faculdade de Medicina
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
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- Caminhos da integralidade: adolescentes e jovens na Atenção Primária à Saúde(2012) AYRES, José Ricardo de Carvalho Mesquita; CARVALHO, Yara Maria de; NASSER, Mariana Arantes; SALTÃO, Rodrigo Marcinkevicius; MENDES, Valéria MonteiroAdolescents and young adults constitute an important challenge in constructing comprehensiveness within primary healthcare. This is because of the complexity of understanding and responding to their set of healthcare needs, consequent to the growth and development process that is characteristic of this phase, and especially to the related sociocultural factors. The present study sought to recognize the reach and limits of how the comprehensiveness principle has been operated at a primary healthcare unit. Although it was possible to identify effective perception of the specific healthcare needs of this group, it was also possible to observe important limitations relating to construction of care projects capable of integrating the various aims of the day-to-day work, insufficiency of professional and sectorial interactions, and weaknesses in communications among professionals and between professionals and users.
- Assessment in the primary care of the State of Sao Paulo, Brazil: incipient actions in sexual and reproductive health(2017) NASSER, Mariana Arantes; NEMES, Maria Ines Battistella; ANDRADE, Marta Campagnoni; PRADO, Rogerio Ruscitto do; CASTANHEIRA, Elen Rose LodeiroOBJECTIVE: The objective of this study is to assess performance in sexual and reproductive health of primary health care services of the Brazilian Unified Health System, in the State of Sao Paulo, Brazil. METHODS: An evaluative framework was built for sexual and reproductive health with the categorization of 99 indicators in three domains: sexual and reproductive health promotion (25), sexually transmitted infections/AIDS prevention and care (43), and reproductive health care (31). This framework was applied to assess the services responses to the questionnaire of Quality Evaluation of Primary Health Care in the Municipalities of Sao Paulo State (QualiAB), in 2010. Percentages were calculated for positive responses to indicators and performance in the sexual and reproductive health dimension, according to domains, and their contribution to the overall score in sexual and reproductive health (Friedman), relative participation (Dunn), and correlation (Spearman) was verified. RESULTS: Overall, 2,735 services participated in the study. They were located in 586 municipalities (distributed throughout the 17 regional health departments of Sao Paulo), of which 70.6% had fewer than 100,000 inhabitants. The overall average performance of these services for sexual and reproductive health is 56.8%. The actions are characterized by: prenatal with adequate beginning and exams, better organization for immediate rather than for late postnatal care, and selective reproductive planning for some contraceptives; prevention based on specific protection, limitations in the prevention of congenital syphilis, in the treatment of sexually transmitted infections, and in the screening of cervical and breast cancer; specific educational activities, with a restricted vulnerability approach, focus on sexuality over reproduction. The domain of reproductive health has greater participation in the overall score, followed by prevention/care and promotion. The three domains are correlated; the domain of prevention/care has the highest correlation with the other ones. CONCLUSIONS: The implementation of sexual and reproductive health in primary health care in the services studied is incipient. The revision of the purpose of the work, the dissemination of technologies, and the investing in permanent education are needed. The evaluative framework built can be used by the sexual and reproductive health program services and management in primary health care, thereby contributing to their actions.
- The Samuel B. Pessoa Health Center-School (Butanta, Sao Paulo, Brazil) turns 40 years(2017) NASSER, Mariana Arantes; DALMASO, Ana Silvia Whitaker; AYRES, Jose Ricardo de Carvalho Mesquita; LOPES JUNIOR, Ademir; FIGUEIRO, Miriam de Toledo Leitao; TEIXEIRA, Ricardo Rodrigues; KON, Rubens; PEREIRA, Maria Goreti Barros Salgueiro; SILVAO, Norma Sueli Colucci da; CORREA, Yessame Maria Gregorio; PEREIRA, Lygia Maria de Franca
- Delphi Technique in the validation process of the national application of the Questionnaire for Primary Care Assessment (QualiAB)(2021) ZARILI, Thais Fernanda Tortorelli; CASTANHEIRA, Elen Rose Lodeiro; NUNES, Luceime Olivia; SANINE, Patricia Rodrigues; CARRAPATO, Josiane Fernandes Lozigia; MACHADO, Dinair Ferreira; RAMOS, Nadia Placideli; MENDONCA, Carolina Siqueira; NASSER, Mariana Arantes; ANDRADE, Marta Campagnoni; NEMES, Maria Ines BattistellaThis article aims to describe the use of the Delphi Technique in a process of updating and validating the content of the Primary Care Services Quality Assessment Questionnaire (QualiAB) for national application. In this study, 19 experts with experience in research in health evaluation, care and management in primary Health Care (PHC) agreed to participate. A revised version of the QualiAB instrument with 105 indicators was submitted for evaluation as to its relevance, national applicability and acceptability. The modified Delphi Technique was performed in two rounds. The response rate of experts in the first round was 73.6%, 40 indicators were accepted and 65 did not reach consensus. of which 54 obtained suggestions to change the question and/or indicator. In the second, the response rate was 92.8%, and 65 indicators were resent with incorporation of changes, of which six were accepted Of the remaining 59, 51 obtained suggestions for change The modified Delphi technique contributed to the Improvement of the QualiAB instrument as an intermediate step in an iterative validation process. However, the performance in two rounds proved to be insufficient to validate the organizational quality indicators in view of the scope and diversity of the actions performed by the PHC services.
article 11 Citação(ões) na Scopus QualiAB: desenvolvimento e validação de uma metodologia de avaliação de serviços de atenção básica(2011) CASTANHEIRA, Elen Rose Lodeiro; NEMES, Maria Ines Battistella; ALMEIDA, Margareth Aparecida Santini de; PUTTINI, Rodolfo Franco; SOARES, Ivete Dalben; PATRICIO, Karina Pavao; NASSER, Mariana Arantes; CALDAS JUNIOR, Antonio Luis; MACHADO, Dinair Ferreira; VASCONCELOS, Roseli d'Avilla; PISSATO, Stella Brasil; CARRAPATO, Josiane Fernandes Lozigia; BIZELLI, Sabrina Sinabucro KanesiroThis paper presents the development, validation and utilization of a methodology for assessing the quality of the primary health care services of Sistema Unico de Sa de (SUS - Brazil's National Health System), the Questionnaire for the Assessment of the Quality of Primary Health Care Services - QualiAB. It is addressed to all primary health care services, organized according to different care models, including Family Health. It contains 50 indicators about availability and organization of the care and programmatic work, and 15 about local management, in the form of multiple choice questions self-responded through the Web by the local service team. It attributes to every answer the values zero, one or two; the general average attributes a 'quality degree' to the service, expressed by the distance to the best standard corresponding to the average two. It was built by an interactive consensual process, which included qualitative methodologies, pilot-testing, application to 127 services, construct validation and reliability. It was answered in 2007 by 598 (92%) services of 115 municipalities of the State of Sao Paulo, showing good sensitivity to differentiate quality levels. It was adopted in 2010 as part of a supporting program to the Primary Health Care of Sao Paulo's State Health Department, being answered by 95% (2735) of the services of 586 cities (90,8% of the State). The results were sent to the municipalities. QualiAB provides a valid and simple assessment, with immediate feedback to managers and professionals. It has shown feasibility, acceptability, power to differentiate quality levels and utility to help the management of the primary health care network of SUS in Sao Paulo. This experience might be extended to Brazil as a whole.