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O relatório apresentado foi realizado no âmbito do Curso de Mestrado em Enfermagem, com Especialização em Enfermagem de Saúde Comunitária e de Saúde Pública (EESCSP), do Instituto de Ciências da Saúde, da Universidade Católica Portuguesa. Pretende-se descrever, analisar e refletir, por um lado, sobre as atividades desenvolvidas e as competências adquiridas no âmbito do estágio realizado numa unidade de saúde pública da região norte de Portugal, com foco na atuação sobre a adesão à segunda dose da vacinação contra a COVID-19 e, por outro, sobre o papel da enfermagem na promoção dessa adesão. Perante um quadro pandémico provocado pela doença COVID-19 e havendo disponível uma nova vacina capaz de minimizar as taxas de morbimortalidade e proteger a sustentabilidade do SNS, revelou-se de extrema importância promover a adesão à vacinação. A vacinação apresenta-se como uma das maiores conquistas da saúde pública, e Portugal apresentou desde sempre uma forte cultura vacinal. Como fator dificultador e com impacto negativo na adesão, encontra-se identificada a pouca informação junto dos utentes sobre uma nova vacina, criada e disponibilizada de uma forma nunca antes verificada. De acordo com a verificação de registos de saúde, na investigação-ação baseada no planeamento em saúde e através da estatística descritiva, procedeu-se à identificação de 503 utentes que não compareceram à segunda dose de vacinação. Com a intervenção prevista, realizou-se uma análise individual dos casos, percebendo as causas da não comparência e, deste modo, intervir de forma dirigida em cada uma das situações. Dos 428 utentes elegíveis 109 responderam ao questionário realizado via telefone. Desses: 15.6% mencionaram ter dúvidas quanto à importância da vacinação; 29% não aderiu por medo e 29.9% por contraindicação. Dos que não aderiram: 66.7% não aderiu por crenças, referindo não acreditar na doença e 55.6% da população não compareceu por acessibilidade comprometida. A observação dos diagnósticos de enfermagem referentes à adesão à vacinação, foi também realizada nesta população, sendo que dos 428 utentes com a segunda dose da vacina em atraso, 332 tinham o diagnóstico de adesão e 49 o de não adesão. A perceção de que as dificuldades estariam relacionadas com necessidades de promoção de literacia em saúde, permitiu a construção de uma árvore de apoio à decisão, de forma a orientar o enfermeiro na educação para a saúde de acordo com o foco comprometido. Foi possível criar um instrumento de sistematização de informação, com resultados dinâmicos, que podem nortear a atuação dos enfermeiros nas suas diversas intervenções. Os resultados foram analisados e comparados antes e depois da intervenção, de modo a perceber os ganhos em saúde. Pelo desgaste e foco na pandemia, a divulgação dos resultados do trabalho realizado durante a investigação foi repensada e melhorada. A partilha de conhecimento passou pela criação de uma newsletter digital, com pequenas formações realizadas em vídeo e difundidas pelas unidades funcionais do ACeS. No âmbito do desenvolvimento das várias competências dos EESCSP, foram também aprimoradas competências de mestre, procurando trazer novas formas de comunicação, interação e partilha, que possam alavancar a vontade por um melhor Saber
The present report was carried out as part of master’s Course in Nursing with Specialization in Community Health and Public Health Nursing (EESCSP), of the Institute of Health Sciences of the Universidade Católica Portuguesa. It is intended to describe, analyze, and reflect, on the one hand, on the activities developed and the competencies acquired in the context of the internship held in a public health unit in the northern region of Portugal, focusing on the action on the participation of the second dose of vaccination against COVID-19 and, on the other, on the role of nursing in promoting this support. Faced with a pandemic situation caused by COVID-19 and having a new vaccine capable of minimizing morbidity and mortality rates and protecting the sustainability of the health system, it was extremely important to encourage adherence to vaccination. Vaccination presents itself as one of the greatest achievements of Public Health, and Portugal has always presented a strong vaccination culture. As a complicating factor and with a negative impact on vaccination adherence, was identified the scarce level of information about a new vaccine, created and made available in a way never before verified. According to the verification of health records, in the action research based on health planning and through descriptive statistics, 503 users who did not attend the second vaccination dose were identified. The individual analysis of each of the cases made it possible to understand the causes of the no-show and in this way, it was possible to directly intervene. Of the 428 eligible users, 109 answered the questionnaire over the phone. Of these, 15.6% mentioned having doubts about the importance of vaccination; 29% did not adhere due to fear and 29.9% by contraindication. Of those who did not join: 66.7% did not adhere due to beliefs, stating that they did not believe in the disease and 55.6% of the population did not attend due to compromised accessibility. The observation of nursing diagnoses regarding adherence to vaccination was also carried out in this population, and of the 428 users with the second dose of the vaccine overdue, 332 had the diagnosis of adherence raised and only 49 had the diagnosis of non-adherence. The perception that the difficulties were mainly related to the low health literacy allowed the construction of a decision support tree, to guide the Nurse in health education according to the committed focus. It was possible to create an instrument for the systematization of information, with dynamic results, which can guide the performance of nurses in their various interventions. The results were analyzed and compared before and after the intervention aiming to understand the health gains. Due to weariness and focus on the pandemic, the dissemination of the results of the work carried out during the investigation was rethought and improved. The sharing of knowledge was done through the creation of a digital newsletter, training courses in form of online videos and disseminated by the functional units of ACeS. As part of the development of the various skills of the EESCSP, Master's competences were also improved, seeking to bring new forms of communication, interaction and sharing, which can leverage the desire for a better Knowledge
The present report was carried out as part of master’s Course in Nursing with Specialization in Community Health and Public Health Nursing (EESCSP), of the Institute of Health Sciences of the Universidade Católica Portuguesa. It is intended to describe, analyze, and reflect, on the one hand, on the activities developed and the competencies acquired in the context of the internship held in a public health unit in the northern region of Portugal, focusing on the action on the participation of the second dose of vaccination against COVID-19 and, on the other, on the role of nursing in promoting this support. Faced with a pandemic situation caused by COVID-19 and having a new vaccine capable of minimizing morbidity and mortality rates and protecting the sustainability of the health system, it was extremely important to encourage adherence to vaccination. Vaccination presents itself as one of the greatest achievements of Public Health, and Portugal has always presented a strong vaccination culture. As a complicating factor and with a negative impact on vaccination adherence, was identified the scarce level of information about a new vaccine, created and made available in a way never before verified. According to the verification of health records, in the action research based on health planning and through descriptive statistics, 503 users who did not attend the second vaccination dose were identified. The individual analysis of each of the cases made it possible to understand the causes of the no-show and in this way, it was possible to directly intervene. Of the 428 eligible users, 109 answered the questionnaire over the phone. Of these, 15.6% mentioned having doubts about the importance of vaccination; 29% did not adhere due to fear and 29.9% by contraindication. Of those who did not join: 66.7% did not adhere due to beliefs, stating that they did not believe in the disease and 55.6% of the population did not attend due to compromised accessibility. The observation of nursing diagnoses regarding adherence to vaccination was also carried out in this population, and of the 428 users with the second dose of the vaccine overdue, 332 had the diagnosis of adherence raised and only 49 had the diagnosis of non-adherence. The perception that the difficulties were mainly related to the low health literacy allowed the construction of a decision support tree, to guide the Nurse in health education according to the committed focus. It was possible to create an instrument for the systematization of information, with dynamic results, which can guide the performance of nurses in their various interventions. The results were analyzed and compared before and after the intervention aiming to understand the health gains. Due to weariness and focus on the pandemic, the dissemination of the results of the work carried out during the investigation was rethought and improved. The sharing of knowledge was done through the creation of a digital newsletter, training courses in form of online videos and disseminated by the functional units of ACeS. As part of the development of the various skills of the EESCSP, Master's competences were also improved, seeking to bring new forms of communication, interaction and sharing, which can leverage the desire for a better Knowledge
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Keywords
Vacinação COVID-19 Enfermagem Adesão Saúde pública Vaccination Nursing Adherence Health planning