Segurança do paciente na atenção primária à saúde: construção de um plano de ação colaborativo para a participação do paciente

• Ano de defesa: 2026
• Autor(a) principal: Falarz, Marina Mazzuco de Souza
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Santa Maria; Brasil; UFSM; Programa de Pós-Graduação em Enfermagem; Centro de Ciências da Saúde
• Palavras-chave em Português: Segurança do paciente; Atenção primária à saúde; Participação do paciente; Assistência centrada no paciente; Prática profissional; Patient safety; Primary health care; Patient participation; Patient-centered care; Professional practice; CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM
• Link de acesso: http://repositorio.ufsm.br/handle/1/38792

Patient safety is recognized as one of the pillars of quality healthcare and a priority challenge in contemporary health systems. Patient involvement as a partner in care emerges as a fundamental strategy for its strengthening, especially in Primary Health Care, a scenario characterized by longitudinality, care coordination, and person-centeredness. The objective of this thesis is to develop a collaborative action plan with the health team, based on patients' experiences and perceptions, in order to enhance their participation, strengthen safe practices, and contribute to improving the quality of care within the context of Primary Health Care. This is an Action Research study, with a quantitative-qualitative approach, conducted in a Basic Health Unit in the Paranoá Administrative Region, Federal District, Brasília. The participants were healthcare professionals and patients registered in the territory of the aforementioned Basic Health Unit. Data collection was carried out using a questionnaire administered to patients containing sociodemographic data, health conditions, and the compact Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) Brazil version, and four focus group sessions with the participation of healthcare professionals, in order to develop an action plan. Quantitative data were analyzed using PASW Statistics® 18.0 for Windows, through descriptive and inferential statistics. The testimonies were manually transcribed, individually reviewed, entered into NVivo 15® software for data coding and organization, and submitted to Discursive Textual Analysis. The results showed a generally positive perception of safety in primary healthcare, associated with trust in the healthcare team, especially physicians and nursing professionals. However, low patient participation was identified in reporting problems, asking questions, and suggesting improvements related to safety. In the qualitative phase, categories emerged that revealed patient safety as a relational, organizational, and territorial phenomenon, strongly influenced by communication, bonding, the organization of the work proces, and access to services. Discrepancies were identified between formal protocols and actual practice, weaknesses in the safety culture, and potential for the collective construction of educational and organizational strategies. The resulting collaborative action plan included interventions aimed at improving communication, health education, continuing education, and encouraging active patient participation, facilitated through six educational videos and a patient safety checklist. In the evaluation of the videos' attributes, the average score achieved was 1.91 for patients and 1.93 for healthcare professionals, classified as "adequate" according to the established cutoff points. The collective development of strategies based on the experience of patients and professionals presents itself as a promising path for strengthening the safety culture and co-participation in care.