Challenges in patient care among nursing professionals in the Family Health Strategy of Brazil
DOI:
https://doi.org/10.62331/2965-758X.v4.2026.81Keywords:
Coping, Nursing Professionals, Patient Care, Family Health Strategy, Primary Health CareAbstract
Aimed at health promotion, disease prevention, and comprehensive monitoring of individuals and families through multidisciplinary teams, the Family Health Strategy constitutes a primary policy of the Unified Health System (Sistema Único de Saúde - SUS). In this context, the nurse plays a central role, assuming responsibility for care, educational, and management activities. However, the daily routine of these professionals encounters obstacles that compromise healthcare effectiveness. This qualitative, exploratory, and descriptive study aimed to understand the main challenges faced by eight nursing professionals providing patient care within the Family Health Units of Santa Fé do Sul, São Paulo. Data were analyzed using thematic content analysis. The results revealed two main themes: treatment adherence within a culture of immediacy, and the care workload associated with staff shortages. The findings indicate that the demand for immediate results, combined with insufficient institutional support for nursing actions, undermines professional autonomy and community bonding. Furthermore, high demand and insufficient staffing levels contribute to excessive workloads, affecting both care quality and the physical and emotional well-being of the nursing team. In conclusion, strengthening institutional support, valuing the nursing role, and investing in continuing education are essential for promoting better working conditions and enhancing care quality.
References
Gomes TLCS. Fundamentos de atenção básica em saúde e Estratégia de Saúde da Família. São Paulo: Editora Senac São Paulo, 2024.
Fernandes AJNL, Ribeiro LC, Ferreira JBB. Possible connections between health equity and primary health care: a scoping review. BMC Public Health. 2025; 25:499. https://doi.org/10.1186/s12889-025-21526-9
Chaves LDP, Mininel VA, Silva JAM, Alves LR, Silva MF, Camelo SHH. Nursing supervision for care comprehensiveness. Rev Bras Enferm. 2017; 70(5):1106-11. https://doi.org/10.1590/0034-7167-2016-0491
Cavalheiro PMT, Scrignoli KEB, Duarte MC, Alves LLG, Genaro MC, Righetto RR. Assiduidade e qualidade do serviço na Atenção Básica: reflexões no contexto do Sistema Único de Saúde do Brasil. Biosciences and Health. 2024; 2:1-6. https://doi.org/10.62331/2965-758X.v2.2024.65
Mendes M, Trindade LL, Pires DEP, Biff D, Martins MMFPDS, Vendruscolo C. Workloads in the Family Health Strategy: interfaces with the exhaustion of nursing professionals. Rev Esc Enferm USP. 2020; 54:e03622. https://doi.org/10.1590/S1980-220X2019005003622
Dall'Ora C, Ball J, Reinius M, Griffiths P. Burnout in nursing: a theoretical review. Hum Resour Health. 2020; 18(1):41. https://doi.org/10.1186/s12960-020-00469-9
Batista TC, Nappi I, Xavier MVM, Fiuza IO, de Vasconcelos CBM, Enohi RT. Burnout in nursing: causal factors and impacts on health and professional performance - a systematic review. Rev Bras Med Trab. 2025; 23(3):e20251432. https://doi.org/10.47626/1679-4435-2025-1432
Silva LC, Souza CAL, Braz MR, Felicio FC, Ribeiro WA. Desafios de ser enfermeiro no Brasil: um estudo reflexivo. Revista Ibero-Americana de Humanidades, Ciências e Educação. 2024;10(11):8230-8240. https://doi.org/10.51891/rease.v10i11.17396
Lerch SP, Hänggi R, Bussmann Y, Lörwald A. A model of contributors to a trusting patient-physician relationship: a critical review using a systematic search strategy. BMC Prim Care. 2024; 25:194. https://doi.org/10.1186/s12875-024-02435-z
Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 9. ed. São Paulo: Hucitec; 2006.
Valle PRD, Ferreira JDL. Análise de conteúdo na perspectiva de bardin: contribuições e limitações para a pesquisa qualitativa em educação. Educ Rev. 2025;41:e49377. https://doi.org/10.1590/0102-469849377
Bardin L. Análise de Conteúdo. São Paulo: Edições 70, 2016.
Ruksakulpiwat S, Pongsuwun K, Junphongsri P, Preeprem C, Nguantad S, Samart B. Nurse-led interventions to improve health, adherence, and functional outcomes in adults and older adults with multimorbidity: a systematic review of randomized and quasiexperimental studies. J Nurs Manag. 2025; 2025:6252049. https://doi.org/10.1155/jonm/6252049
Wiedermann CJ. Preserving continuity and trust in primary care: strategies for implementing team-based models in South Tyrol, Italy. Int J Environ Res Public Health. 2025; 22(4):477. https://doi.org/10.3390/ijerph22040477
Katende-Kyenda LN. Non-Adherence to Treatment Among Patients Attending a Public Primary Healthcare Setting in South Africa: Prevalence and Associated Factors. Int J Environ Res Public Health. 2025; 22(11):1665. https://doi.org/10.3390/ijerph22111665
Religioni U, Barrios-Rodríguez R, Requena P, Borowska M, Ostrowski J. Enhancing therapy adherence: impact on clinical outcomes, healthcare costs, and patient quality of life. Medicina. 2025; 61:153. https://doi.org/10.3390/medicina61010153
Coelho Ferreira E, Scherer Dornelles C, Laiany Lima Almeida R, Duarte Silva Magalhães O, Brasil da Silva G, Rodrigues Sousa G, et al. Fatores associados à má adesão ao tratamento de doenças crônicas na Atenção Primária à Saúde. Braz J Implantol Health Sci. 2024; 6(9):122-135. https://doi.org/10.36557/2674-8169.2024v6n9p122-135
Barratt J, Thomas N. Nurse practitioner consultations in primary health care: a case study-based survey of patients' pre-consultation expectations, and post-consultation satisfaction and enablement. Prim Health Care Res Dev. 2018; 20:e36. https://doi.org/10.1017/S1463423618000415
Wieczorek-Wójcik B, Milewska AJ, Kilańska D, Kulma-Pytlak A, Iltchev P, Gaworska-Krzemińska A, et al. Patient perspectives on coordinated care: preliminary results from the implementation stage using patient-reported experience measures (PREMs). Healthcare. 2025; 13(9):1026. https://doi.org/10.3390/healthcare13091026
Marcelo TG, Di João JG, Fernandez GCG. Superlotação das unidades de pronto atendimento: um desafio da atenção básica: uma revisão bibliográfica. Ensaios USF. 2022; 5:70-85. https://doi.org/10.24933/eusf.v5i1.167
Khatri R, Endalamaw A, Erku D, Wolka E, Nigatu F, Zewdie A, et al. Continuity and care coordination of primary health care: a scoping review. BMC Health Serv Res. 2023; 23:750. https://doi.org/10.1186/s12913-023-09718-8
Burch P, Walter A, Stewart S, Bower P. Patient reported measures of continuity of care and health outcomes: a systematic review. BMC Prim Care. 2024; 25:309. https://doi.org/10.1186/s12875-024-02545-8
Pavoni DS, Medeiros CRG. Processos de trabalho na equipe Estratégia de Saúde da Família. Rev Bras Enferm. 2009; 62(2):265-271. https://doi.org/10.1590/S0034-71672009000200015
Santos FPA, Acioli S, Rodrigues VP, Machado JC, Souza MS, Couto TA. Práticas de cuidado da enfermeira na Estratégia Saúde da Família. Rev Bras Enferm. 2016; 69(6):1124-1131. https://doi.org/10.1590/0034-7167-2016-0273
Ferreira DS, Ramos FRS, Teixeira E. Nurses' educational practices in Family Health Strategy. Rev Bras Enferm. 2021; 74(2):e20200045. https://doi.org/10.1590/0034-7167-2020-0045
Almeida PF, Santos AMD, Silvério RFL, Ribeiro AMVB, Silva DO, Vilasbôas ALQ. Continuity of care: trust-based relationship and availability of personalized information in user experience. Cad Saude Publica. 2025; 41(6):e00109524. https://doi.org/10.1590/0102-311XEN109524
Juvé-Udina ME, Adamuz J, González-Samartino M, Tapia-Pérez M, Jiménez-Martínez E, Berbis-Morello C, et al. Association between nurse staffing coverage and patient outcomes in a context of prepandemic structural understaffing: a patient-unit-level analysis. J Nurs Manag. 2025; 2025:8003569. https://doi.org/10.1155/jonm/8003569
Nunciaroni AT, Cunha CLF, Borges FA, Souza IL de, Koster I, Souza IS de, et al. Enfermagem na APS: contribuições, desafios e recomendações para o fortalecimento da Estratégia Saúde da Família. APS em Revista. 2022; 4:61-80. https://doi.org/10.14295/aps.v4i1.234
Endalamaw A, Khatri RB, Erku D, Zewdie A, Wolka E, Nigatu F, et al. Barriers and strategies for primary health care workforce development: synthesis of evidence. BMC Prim Care. 2024; 25:99. https://doi.org/10.1186/s12875-024-02336-1
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Maria Eduarda da Silva, Marcely da Silva Pacheco, Monise de Souza Vasconselos, Adriana Luiz Sartoreto Mafra, Marcia Cristina Nobukuni, Camila Maria Buso Weiller Viotto

This work is licensed under a Creative Commons Attribution 4.0 International License.





