Barreiras e facilitadores na implementação de um programa para a Doença de Parkinsonaplicação do quadro conceitual consolidado para pesquisa de implementação em um serviço na Amazônia

Resumo

Most health services provided by health systems still attend to people with chronic diseases in an episodic way, with fragmented responses to the demands of the population. This model is ineffective in dealing with problems such as Parkinson's disease, a neurodegenerative condition whose complexity requires the offer of integral and continuous care. This study sought to explore such challenge. From a case study approach with participant observation, the qualitative methodology based on exercise-conceptual references of implementation science was utilized, along with the CFIR analysis model. The aim was to describe and analyze the stages of formulation and implementation of the Multidisciplinary and Multidimensional Program (PMP) developed for patients with Parkinson’s disease in a health service in the Brazilian Amazon region. It was sought to identify barriers and facilitators of implementation and alternative solutions for the expansion and sustainability in the organization under study. The results present an analysis of the implementation of the PMP, in the abovementioned institution, following the constructs of the CFIR model and organized by domains in the following order: intervention characteristics, external environment, internal scenario, and processes. Altogether, 34 constructs were analyzed, with six very evident barrier constructs, four lowly evident barrier constructs, seven neutral constructs, eight lowly evident facilitating constructs and nine very evident facilitating constructs. In the end, the constructs were allocated in a matrix by domains categorized by the degree of proof of the barriers and the facilitators present during implementation. The analysis carried out revealed a predominance of very evident constructs linked to the domain “intervention characteristics” as the main determining factors for implementation. On the other hand, the use of the CFIR analysis model made it possible to identify some important barriers to implementation related to the “processes” domain, this domain being considered fundamental for an effective implementation. From the analysis of facilitators and barriers to implementation, proposals are presented that seek to provide greater sustainability to the program in the institution. The use of the CFIR model to analyze the experience was useful to describe in detail the implementation process and understand contextual factors that interfere in the maintenance of the assistance program, which is extensive and complex

Ficha do documento

Tipo

Dissertação

Ano

2022

Instituição

Fundação Getulio Vargas

Fonte

Repositório da FGV

Idioma

Português

Acesso

Acesso aberto

Identificador

oai:repositorio.fgv.br:10438/32801

Temas

SaúdeMeio Ambiente

Palavras-chave

Implementation scienceParkinson diseaseHealthcare modelsCiência da implementaçãoDoença de ParkinsonModelos de assistência à saúdeAdministração de empresasServiços de saúde - PesquisaAssistência médica - PlanejamentoAdministração dos serviços de saúde - AmazôniaParkinson, Doença de