Fatores associados à presença de feridas em usuários acompanhados na Atenção Primária à Saúde

Abstract

This study aimed to analyze the factors associated with the presence of wounds in users treated in Primary Health Care in a municipality in Minas Gerais. This is an observational, crosssectional, and quantitative study, based on secondary analysis of an institutional database containing 1,399 records collected between July 2023 and July 2024. Data analysis involved descriptive statistics and association tests (chi-square), with a significance level of p≤0.05. The results revealed an epidemiological profile in line with the literature, with a predominance of men (50.6%) in the age group of 61 to 80 years (47.3%). The most prevalent etiologies were venous ulcer (34.5%) and pressure injury (22.1%), with arterial hypertension (57.1%) and diabetes mellitus (34.9%) as the main comorbidities. A central finding was the high chronicity, with 53.7% of the injuries existing for more than three months, a challenge for Primary Health Care. The inferential analysis demonstrated that social determinants, such as housing conditions (p=0.035) and location in regions with greater health vulnerability (p=0.011), are significantly associated with the duration of the wounds. This study quantifies the fragmentation of care, where the high prevalence of procedures performed by caregivers or nursing technicians without systematic evaluation by the nurse is directly associated with a longer treatment time (p<0.001) and the existence of the injury (p=0.015). The lack of treatment with special dressings was also significantly associated with greater chronicity (p=0.030), reinforcing that inadequate therapeutic choice, often resulting from a lack of in-depth technical knowledge, contributes to worse outcomes. It is concluded that the chronicity of wounds in Primary Health Care is a complex phenomenon, linked not only to clinical factors, but also to the organization of the work process and professional qualification. The research shows that a care model focused on the execution of tasks and the absence of continuous clinical reasoning by nurses is insufficient to deal with the complexity of this care. The findings point to the need to restructure care flows, invest in continuing education, strengthen the autonomy of nurses and integrate the expertise of specialists in enterostomal therapy to ensure assertive, comprehensive and evidence-based management, aiming not only at wound healing, but also at improving the quality of life of the population