Análise da situação de saúde de homens e o direcionamento da atenção primária: implicações para a Enfermagem

Abstract

To analyze the configuration of the men's health situation and the direction of government actions in Primary Health Care, in Brazil, and the implications of government actions aimed at men's health in the professional practice of Nursing in PHC. Descriptive study based on scientific literature using two strategies: scope review in bibliographic databases specialized in Nursing BDENF, COCHRANE, Scientific Electronic Library Online, LILACS, linked to the VHL, from nine published articles, from from 2000 to 2020, guided by the Joanna Briggs Institute methodology and documental analysis with data obtained in 31 government actions from 2009 to 2021, extracted from official databases hosted on the internet, from agencies related to the health sector and related areas from the federal government of Brazil: Ministry of Health website, legislation portal, Ministry of Health archives portal and others, obtaining laws, plans, technical notes, technical manuals, guidance and educational/instructional guides as primers, posters, flyers. The findings were discussed with the current scientific literature on the subject, in line with PNAISH principles and guidelines. The health situation of men in PHC is permeated by the concentration of barriers to access and demand for services, which are implied in this adherence: the clinical modalities; fear, family provision, invulnerability, self-medication and the feminization of health services. The main demands were related to pain, fever, musculoskeletal problems and the needs of oral, sexual and mental health and the prevention and control of neglected diseases and Chronic Non-Communicable Diseases. Social markers and the social construction of masculinities effectively influence the health situation and self-perception of health, which also contributes to the search for more specialized services. Men, despite the reduced frequency of consultations and adherence to therapies, participate in health education groups. As for the federal government actions related to the health situation of men, they express a focus of focus at each historical and political time, and are revealed by the deliberation of normative actions with a focus on the legislation of health care for men in the country, anchored in a political agenda to face the high morbidity and mortality of the male public and the expansion and strengthening of men's access to health services, with a focus on training, training and professional improvement of health teams, managers and technical supporters at the national level. Government actions are still not very expressive, as they do not cover all the PNAISH axes, such as the mental, spiritual, contexts of vulnerability such as the prison situation, sexual and gender diversity and ethnicity, culture and territories. It is necessary to insert the nurse, as a member of the multidisciplinary team working within the FHS, using tactics that provide the insertion of men in health services, pointing out the need for continuing education and training of these professionals to act in front of the PNAISH, in consolidating the construction knowledge about the relationship between gender and health.