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Introduction: The use of Information and Communication Technologies in the field of health is increasing across the world, demarcating the field of digital health. The goal of this study is to formulate and validate a matrix of indicators, design assessment scripts and indicate data collection techniques for assessing the quality of digital health care in Brazilian Primary Health Care (PHC). Methodology: This is a validation study divided into three phases: preparation of the instrument, analysis of validity and pilot study. The instrument was prepared based on the PHC assessment model from a literature review; the analysis of validity used the Delphi technique associated with the nominal group and the evidence from the literature reference. In the pilot study, audio-recorded interviews were conducted with strategic primary care actors. Results: The matrix of indicators "QualiAPS Digital-Brazil" introduces a set of 37 indicators, distributed into three distinct components and their respective dimensions. The component "Structure" includes the dimension "Resources"; the component "Processes" includes the dimensions "Technical," "Organizational" and "Relational"; and the component "Results" includes the dimensions "Short-Term Results" and "Medium-Term Results." The general values obtained for CVI and IRR were 0.89 and 1.00; respectively. Therefore, it was possible to design assessment scripts and indicate qualitative data collection techniques for assessing digital health in Brazilian PHC. Conclusion: The instrument presented was validated regarding its relevance, content and theoretical support to evaluate the quality of digital health care, supporting decision-making by managers and health professionals in the search for improving remote primary care provided to the population.

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BACKGROUND: Population aging is forcing the transformation of health care. Long-term care in the home is complex and involves complex communication with primary care services. In this scenario, the expansion of digital health has the potential to improve access to home-based primary care; however, the use of technologies can increase inequalities in access to health for an important part of the population. The aim of this study was to identify and map the uses and types of digital health interventions and their impacts on the quality of home-based primary care for older adults. METHODS: This is a broad and systematized scoping review with rigorous synthesis of knowledge directed by the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The quantitative data were analyzed through descriptive statistics, and the qualitative data were analyzed through basic qualitative content analysis, considering the organizational, relational, interpersonal and technical dimensions of care. The preliminary results were subjected to consultation with stakeholders to identify strengths and limitations, as well as potential forms of socialization. RESULTS: The mapping showed the distribution of publications in 18 countries and in the Sub-Saharan Africa region. Older adults have benefited from the use of different digital health strategies; however, this review also addresses limitations and challenges, such as the need for digital literacy and technological infrastructure. In addition to the impacts of technologies on the quality of health care. CONCLUSIONS: The review gathered priority themes for the equitable implementation of digital health, such as access to home caregivers and digital tools, importance of digital literacy and involvement of patients and their caregivers in health decisions and design of technologies, which must be prioritized to overcome limitations and challenges, focusing on improving quality of life, shorter hospitalization time and autonomy of older adults.

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OBJECTIVE: To analyze nurses' practice in child health nursing consultations and the presence of care management competencies proposed for Advanced Practice Nurses (APN). METHOD: Multicenter, exploratory sequential mixed methods research, carried out in 17 Basic Health Units in four Brazilian cities. Collection was carried out from May to July 2022 through filming of consultation and analysis of medical records. Consultations with compliance with the Nursing Process ≥50% were analyzed to identify the competencies proposed for APN. RESULTS: 24 child consultations carried out by 12 nurses were filmed. In the quantitative analysis, 11 nursing consultations, carried out by seven nurses, achieved ≥50% Nursing Process compliance. In the qualitative analysis of these consultations, some APN competencies in care management were identified, but incomplete. CONCLUSION: child health nursing consultations present weaknesses in carrying out the Nursing Process, and nurses demonstrated a partial and superficial application of the care management competencies proposed for APN.

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OBJETIVO: Sumarizar as evidências existentes acerca das ações de Prática Avançada em Enfermagem no âmbito da Atenção Primária à Saúde à nível mundial através de uma revisão sistemática. MÉTODO: Trata-se de um protocolo desenvolvido com base nas diretrizes do Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P). O protocolo foi registrado no International Prospective Register of Systematic Reviews (PROSPERO) sob o ID: CRD42022301785. Para condução da revisão, a busca sistemática será realizada nas bases de dados ScienceDirect, Scopus, Medical Literature Analyses and Retrieval System Online (MEDLINE/PubMed), Web of Science, Excerpta Medica Database (Embase) e Cumulated Index in Nursing and Allied Health Literature (CINAHL), sendo utilizada a seguinte expressão de busca: (("Advanced Practice Nursing" OR Nursing OR "Nursing specialities") AND "Primary Health Care" AND "Public Health"). Os critérios de inclusão incluem todos os estudos transversais publicados em inglês até outubro de 2022 que respondam à questão de pesquisa. Destes, serão excluídos: (i) estudos em animais; (ii) cartas, editoriais, revisões de literatura, revisões sistemáticas e metanálises.

OBECTIVE: To synthesize the existing evidence on advanced practice nursing interventions in primary health care settings worldwide through a systematic review. METHOD: A protocol was developed based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P) guidelines. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under ID: CRD42022301785. To conduct the review, a systematic search will be performed in the databases ScienceDirect, Scopus, Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Web of Science, Excerpta Medica Database (Embase), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) using the following search terms: (("Advanced Practice Nursing" OR Nursing OR "Nursing specialties") AND "Primary Health Care" AND "Public Health"). Inclusion criteria include all cross-sectional studies published in English through October 2022 that address the research question. The following will be excluded: (i) animal studies; (ii) letters, editorials, literature reviews, systematic reviews, and meta-analyses.

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ABSTRACT Objective: To analyze nurses' practice in child health nursing consultations and the presence of care management competencies proposed for Advanced Practice Nurses (APN). Method: Multicenter, exploratory sequential mixed methods research, carried out in 17 Basic Health Units in four Brazilian cities. Collection was carried out from May to July 2022 through filming of consultation and analysis of medical records. Consultations with compliance with the Nursing Process ≥50% were analyzed to identify the competencies proposed for APN. Results: 24 child consultations carried out by 12 nurses were filmed. In the quantitative analysis, 11 nursing consultations, carried out by seven nurses, achieved ≥50% Nursing Process compliance. In the qualitative analysis of these consultations, some APN competencies in care management were identified, but incomplete. Conclusion: child health nursing consultations present weaknesses in carrying out the Nursing Process, and nurses demonstrated a partial and superficial application of the care management competencies proposed for APN.

RESUMEN Objetivo: Analizar la práctica del enfermero en consultas de enfermería en salud infantil y la presencia de habilidades de gestión del cuidado propuestas para el Enfermero de Práctica Avanzada (EPA). Método: Estudio multicéntrico, método mixto secuencial exploratorio, realizado en 17 Unidades Básicas de Salud de cuatro ciudades brasileñas. La recolección se realizó de mayo a julio de 2022 mediante filmación de la consulta y análisis de historias clínicas. Se analizaron las consultas con cumplimiento ≥50% del Proceso de Enfermería para identificar las competencias propuestas para EPA. Resultados: Se filmaron 24 consultas infantiles realizadas por 12 enfermeras. En el análisis cuantitativo, 11 consultas de enfermería, realizadas por siete enfermeros, alcanzaron ≥50% de cumplimiento del Proceso de Enfermería. En el análisis cualitativo de estas consultas se identificaron algunas competencias del EPA en la gestión del cuidado, pero incompletas. Conclusión: Las consultas de enfermería en salud infantil presentan debilidades en la realización del Proceso de Enfermería, y los enfermeros demostraron una aplicación parcial y superficial de las habilidades de gestión del cuidado propuestas para el EPA.

RESUMO Objetivo: Analisar a prática de enfermeiros nas consultas de enfermagem em saúde da criança e a presença das competências de gestão do cuidado propostas para o Enfermeiro de Prática Avançada (EPA). Método: Estudo multicêntrico, método misto sequencial exploratório, realizado em 17 Unidades Básicas de Saúde em quatro cidades brasileiras. A coleta foi realizada de maio a julho de 2022 através de filmagem da consulta e análise dos registros em prontuário. As consultas com cumprimento do Processo de Enfermagem ≥50% foram analisadas para identificar as competências propostas para EPA. Resultados: Foram filmadas 24 consultas de crianças realizadas por 12 enfermeiros. Na análise quantitativa, 11 consultas de enfermagem, realizadas por sete enfermeiros, alcançaram cumprimento ≥50% Processo de Enfermagem. Na análise qualitativa dessas consultas, algumas competências do EPA em gestão do cuidado foram identificadas, porém incompletas. Conclusão: As consultas de enfermagem em saúde da criança apresentam fragilidades na realização do Processo de Enfermagem, e os enfermeiros demonstraram uma aplicação parcial e superficial das competências de gestão do cuidado propostas para o EPA.

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Este estudo tem como objetivo analisar os sentidos atribuídos pelos enfermeiros ao seu trabalho na Atenção Primária à Saúde em áreas rurais. A relevância desta pesquisa está no fato de existirem lacunas em relação ao trabalho dos profissionais da Atenção Primária à Saúde rural, tendo em vista que o Brasil ainda não tem uma política de Atenção Primária à Saúde específica para áreas rurais que direcione o trabalho dos profissionais. Pesquisa qualitativa, descritiva-exploratória, com enfermeiros de equipes da Estratégia de Saúde da Família rurais do município de Campina Grande, Paraíba. Utilizaram-se entrevistas semiestruturadas, com análise a partir da técnica de Análise de Conteúdo. Constatou-se que o sentido do trabalho dos enfermeiros está na satisfação pessoal, contribuição social, na identificação com o trabalho em áreas rurais e na existência de vínculo com a população rural e equipe; e como perda de sentido para o trabalho, as condições de trabalho precárias, além da ordenação dos serviços, e a distância do ponto de vista físico e relacional entre a gestão municipal e os profissionais de áreas rurais, que não oferece suporte para o desenvolvimento eficaz das ações. A partir desta pesquisa, pôde-se constatar a influência dessas dimensões na atribuição de sentido ao trabalho exercido pelos enfermeiros de Atenção Primária à Saúde de áreas rurais. Este estudo pode contribuir na orientação de pesquisas de enfermagem em sistemas e serviços de saúde, em se tratando de áreas mais vulneráveis, como as rurais e remotas.

This study aims to analyze the meanings attributed by nurses to their work in Primary Health Care in rural areas. The relevance of this research lies in the fact that there are gaps in relation to the work of rural Primary Health Care professionals, given that Brazil still does not have a specific Primary Health Care policy for rural areas that directs the work of professionals. Qualitative, descriptive-exploratory research, with nurses from rural Family Health Strategy teams in the city of Campina Grande, Paraiba. Semi-structured interviews were used, with analysis based on the Content Analysis technique. It was found that the meaning of nurses' work lies in personal satisfaction, social contribution, identification with work in rural areas and the existence of a bond with the rural population and the team; and as a loss of meaning for work, precarious working conditions, in addition to the ordering of services, and the distance from the physical and relational point of view between municipal management and professionals in rural areas, which does not offer support for effective development of the actions. From this research, it was possible to verify the influence of these dimensions in the attribution of meaning to the work carried out by primary health care nurses in rural areas. This study can contribute to guiding research on nursing in health systems and services, when it comes to more vulnerable areas, such as rural and remote areas.

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Resumo O estudo objetivou compreender os significados atribuídos à saúde do trabalhador (ST) pelos profissionais de saúde do Núcleo Ampliado de Saúde da Família e Atenção Básica (Nasf-AB), bem como seus desdobramentos na produção de cuidados na Atenção Primária à Saúde. Entrevistas feitas com 13 profissionais de diferentes áreas, que foram exploradas com base na Análise do Discurso. Emergiram sentidos do trabalho como gerador de agravos e aqueles relacionados com os Determinantes Sociais de Saúde (DSS). Por intermédio das ações do Nasf-AB sobre o trabalho/trabalhador, foi possível visualizar o quanto essa equipe funciona como filtro das tensões produzidas por usuários, equipes de saúde da família e gestão. O discurso do trabalho como produtor de agravos ainda é predominante; contudo, a percepção do trabalho como DSS produz aberturas para que esses profissionais possam agir na clínica ampliada como técnicos de referência em ST.(AU)

Resumen El objetivo del estudio fue comprender los significados atribuidos a la Salud del Trabajador (ST) por parte de los profesionales de la salud del Núcleo Ampliado de Salud de la Familia y Atención Básica (Nasf-AB), así como sus desdoblamientos en la producción de cuidados en la Atención Primaria de la Salud. Se analizaron entrevistas realizadas con 13 profesionales de diferentes áreas, con base en el Análisis del Discurso. Surgieron sentidos del trabajo como generador de agravios y aquellos relacionados con los Determinantes Sociales de Salud (DSS). Por medio de las acciones del Nasf-AB sobre el trabajo/trabajador, fue posible ver hasta qué punto ese equipo funciona como filtro de las tensiones producidas por usuarios, equipos de salud de la familia y gestión. El discurso del trabajo como productor de agravio todavía es predominante; no obstante, la percepción del trabajo como DSS produce aperturas para que esos profesionales puedan actuar en la clínica ampliada como técnicos de referencia en ST.(AU)

Abstract The study aimed to understand the meanings attributed to Worker's Health (WH) by health professionals of the Expanded Core for Family Health and Primary Care (Nasf-AB in the Portuguese acronym), as well as its consequences in the production of care in PHC. Interviews with 13 professionals from different areas were analyzed based on Discourse Analysis. Meanings of work as a generator of diseases and those related to the Social Determinants of Health (SDH) emerged. Through the actions of Nasf-AB on work/worker, it was possible to see how this team works as a filter of the tensions produced by users, family health teams and management. The discourse of work as a producer of diseases is still predominant; however, the perception of work as SDH produces openings for these professionals to act in the expanded clinic as reference technicians in WH.(AU)

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BACKGROUND: The application of cell phones, similar portable devices (ie, tablets), apps, the internet, and GPS in evaluation have established new ways of collecting, storing, retrieving, transmitting, and processing data or information. However, evidence is incipient as to which technological resources remain at the center of assessment practice and the factors that promote their use by the assessment community. OBJECTIVE: This study aimed to analyze the relationship between the use of the National Program for Improving Primary Healthcare Access and Quality's (PMAQ-AB; Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica) mobile app and management system and the external evaluation quality of Brazil's PMAQ-AB. METHODS: We conducted a qualitative case study during the external evaluation of Brazil's PMAQ-AB. Data collection consisted of interviews, focus groups, and document analysis. A total of 7 members from the Department of Primary Care of the Ministry of Health and 47 researchers from various higher education and research institutions across the country participated in the study. Data were categorized using the ATLAS.ti software program, according to the quality standards of the Joint Committee on Standards for Educational Evaluation, following the content analysis approach by Bardin. RESULTS: The results related to feasibility, thematic scope, field activity management, standardized data collection, data consistency, and transparency. They demonstrated improvements and opportunities for advancements in evaluation mediated by the use of information technology (IT), favored the emergence of new practices and remodeling of existing ones, and took into account the multiple components required by the complex assessment of access and quality in primary health care. Difficulties in technology operation, inoperative systems, and lack of investment in equipment and human resources posed challenges to increasing the effectiveness of IT in evaluation. CONCLUSIONS: The use of technology-based tools-the app and the management system-during the external evaluation offered evaluators a greater opportunity for stakeholder engagement. This also allowed the insertion of different organizational, operational, and methodological components that are capable of triggering influences and confluences. In addition, this allowed connections in collaborative and synergistic networks to increase the quality and allow the development of a more consistent and efficient evaluation process with greater possibility of incorporating the results into public health policies.

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BACKGROUND: The COVID-19 pandemic brought social, economic, and health impacts, requiring fast adaptation of health systems. Although information and communication technologies were essential for achieving this objective, the extent to which health systems incorporated this technology is unknown. OBJECTIVE: The aim of this study was to map the use of digital health strategies in primary health care worldwide and their impact on quality of care during the COVID-19 pandemic. METHODS: We performed a scoping review based on the Joanna Briggs Institute manual and guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Extension for Scoping Reviews. A systematic and comprehensive three-step search was performed in June and July 2021 in multidisciplinary health science databases and the gray literature. Data extraction and eligibility were performed by two authors independently and interpreted using thematic analysis. RESULTS: A total of 44 studies were included and six thematic groups were identified: characterization and geographic distribution of studies; nomenclatures of digital strategies adopted; types of information and communication technologies; characteristics of digital strategies in primary health care; impacts on quality of care; and benefits, limitations, and challenges of digital strategies in primary health care. The impacts on organization of quality of care were investigated by the majority of studies, demonstrating the strengthening of (1) continuity of care; (2) economic, social, geographical, time, and cultural accessibility; (3) coordination of care; (4) access; (5) integrality of care; (6) optimization of appointment time; (7) and efficiency. Negative impacts were also observed in the same dimensions, such as reduced access to services and increased inequity and unequal use of services offered, digital exclusion of part of the population, lack of planning for defining the role of professionals, disarticulation of actions with real needs of the population, fragile articulation between remote and face-to-face modalities, and unpreparedness of professionals to meet demands using digital technologies. CONCLUSIONS: The results showed the positive and negative impacts of remote strategies on quality of care in primary care and the inability to take advantage of the potential of technologies. This may demonstrate differences in the organization of fast and urgent implementation of digital strategies in primary health care worldwide. Primary health care must strengthen its response capacity, expand the use of information and communication technologies, and manage challenges using scientific evidence since digital health is important and must be integrated into public service.