Práticas do cuidado ao adolescente com obesidade na atenção primária à saúde

Abstract

The objective was to analyze care practices for adolescents with obesity within the scope of Primary Health Care in the municipality of Iguatu-Ceará. This is a single, integrated and qualitative case study, carried out with municipal and state health managers, nutritionists associated with the school lunch sector and professional nurses, doctors and nutritionists linked to Primary Health Care. Data collection was carried out from march to june 2022 and occurred in two stages: Analysis of official documents and legislation implemented in the municipality and aimed at combating obesity; Semi-structured interview with five municipal and state managers and 19 health professionals, totaling 24 participants. The analytical procedure adopted for the first stage was based on the proposal of document analysis, and the data from the interviews were processed through the software Interface de R pour les Analyzes Multidimensionnelles de Textes et de Questionnaires and appreciated from the perspective of Bardin's content analysis, which culminated in the elaboration of five thematic categories. This study was based on Resolution No. 466/12 of the National Health Council and was approved by the Research Ethics Committee of the Universitary Hospital Onofre Lopes of the Federal University of Rio Grande do Norte through Opinion No. 5.272.685 . With the realization of the first stage of the study, 11 documents were found that were suitable for the profile sought by the researcher, that is, documents guiding actions aimed at combating obesity, this material consists essentially of legal documents and authored by the federal government, published between the years 1994 to 2021. The second stage revealed aspects about the care for adolescents with obesity, where fragile care practices were identified, carried out as the professional deems to be important, without clear directions and with few opportunities for access to health care permanent education on the subject. Therefore, it was observed that the health of adolescents and obesity are not priorities in the scope of health in the municipality and that actions aimed at the public take place, almost exclusively, through the Health at School Program, although the program is centralized in the health sector and has little articulation with education. As for the performance of managers, it was incipient, always based on the need for federal or state incentive to carry out actions on obesity. Respondents pointed out difficulties, mostly associated with the actions of adolescents and potentialities, primarily related to the practices of the multidisciplinary health team. It is concluded that the study presented an overview of care practices and made it possible to see the main weaknesses and challenges for consolidating care for adolescents with obesity. Managers are recommended to guide obesity as a priority theme in the municipality and professionals are suggested to act based on the principle of integrality and co-responsibility of care. The need to align the actions of the Health at School Program is highlighted, so that they are articulated from an intersectoral perspective. As a limitation, the fact that the study was carried out in only one municipality stands out.