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REVIEW • Rev. Bras. Enferm. 76 (Suppl 2) • 2023 • https://doi.org/10.1590/0034-7167-2021-0805 copiar

Ausentismo en los servicios de salud infantil: una revisión sistemática

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivos:

analizar datos de estudios cualitativos relacionados con el fenómeno del abandono del seguimiento de la salud de los recién nacidos, lactantes y preescolares en los servicios de salud del niño.

Métodos:

revisión sistemática, realizada en 19 bases de datos. Se incluyeron estudios que retratan las razones del abandono del seguimiento de la salud de los niños hasta los cinco años. Se utilizó la metodología JBI para revisiones sistemáticas de evidencia cualitativa.

Resultados:

se identificaron 20.199 estudios. Después de aplicar los criterios de elegibilidad, se seleccionaron 81. Siete fueron excluidos por duplicidad, resultando en 74 artículos que fueron leídos en su totalidad. Después de esta fase, se seleccionaron tres artículos para la muestra final y, posteriormente, después de la lectura de sus referencias, se incluyó uno más, totalizando cuatro artículos para análisis crítico.

Conclusiones:

los hallazgos sintetizados destacan que el abandono del seguimiento de la salud se basa en los conocimientos y creencias personales, la dinámica de la rutina familiar y el acceso a los servicios.

Descriptores:
Absentismo; Servicios de Salud del Niño; Revisión Sistemática; Cuidado del Niño; Barreras de Acceso a los Servicios de Salud.

Question	Dias	Madeira	Ximenes-Neto et al	Rechel et al
1. Is there congruence between the philosophical perspective and the methodology?	Yes	Yes	Yes	Yes
2. Is there congruence between the methodology and the question/objectives?	Yes	Unclear	Yes	Yes
3. Is there congruence between the methodology and data collection?	Yes	Yes	Yes	Yes
4. Is there congruence between method and data representation/analysis?	Yes	Yes	Yes	Yes
5. Is there congruence between method and interpretation of results?	Yes	Yes	Yes	Yes
6. Is there a statement theoretically locating the researcher?	No	No	No	No
7. Is the influence of the researcher in the research indicated?	Unclear	Unclear	Unclear	Unclear
8. Are participants and their voices well represented?	Yes	Yes	Yes	Yes
9. Is the research ethical according to current criteria, and is there evidence of ethical approval by an appropriate body?	Yes	Unclear	Yes	Yes
10. Do the conclusions reflect data analysis and interpretation?	Yes	Yes	Yes	Yes

Population: relatives of newborns, infants and preschoolers (children from zero to five years).
Phenomenon of interest: the reasons attributed to non-attendance and dropout of follow-up of child growth and development.
Context: child health services, regardless of the level of care.
Synthesized findings	Study design	Dependability	Credibility	ConQual score	Comments
Family members’ belief that healthy children do not need follow-up of growth and development.	Phenomenological Exploratory Descriptive	High	Moderate	High	Credibility was affected due to the lack of statement locating researchers culturally and their influence on the study.
Daily chores, forgetfulness, lack of prior notice and unforeseen family events to the detriment of child care follow-up.	Phenomenological Exploratory Descriptive	High	Moderate	High	Credibility was affected due to the lack of statement locating researchers culturally and their influence on the study.
Geographical distance and lack of resources as causes of child care drop-out.	Phenomenological Exploratory Descriptive Grounded Theory	High	Moderate	High	Credibility was affected due to the lack of statement locating researchers culturally and their influence on the study.
Population: relatives of newborns, infants and preschoolers (children from zero to five years).
Phenomenon of interest: the reasons attributed to non-attendance and dropout of follow-up of child growth and development.
Context: child health services, regardless of the level of care.
Synthesized findings	Study design	Dependability	Credibility	ConQual score	Comments
The long wait for consultation in the child health service can lead family members to give up children’s follow-up.	Phenomenological Exploratory Descriptive	High	Moderate	High	Credibility was affected due to the lack of statement locating researchers culturally and their influence on the study.

Title/reference	Year/ country	Design/ number of participants	Interventions	Outcomes	ConQual score quality indicator
A consulta de puericultura na perspectiva de mães e profissionais de unidades básicas de saúde de Belo Horizonte (¹⁸18 Dias PRM. A consulta de puericultura na perspectiva de mães e profissionais de unidades básicas de saúde de Belo Horizonte[Dissertação]. Universidade Federal de Minas Gerais; 2017.)	2017 Brazil	Descriptive, exploratory, qualitative n = 14	Conducting in-depth interviews with structural analysis of narration.	The main justifications for the absences admitted by mothers were distance, forgetfulness, lack of financial resources, error in consultation date (date had already passed), delay and delay in the consultations, in addition to the lack of attention of the professionals.	High
O abandono da consulta de enfermagem: uma análise compreensiva do fenômeno (¹⁹19 Madeira AMF. O abandono da consulta de enfermagem: uma análise compreensiva do fenômeno. Rev Esc Enferm USP. 1996;30(1):82-92. https://doi.org/10.1590/S0080-62341996000100008 https://doi.org/10.1590/S0080-6234199600... )	1996 Brazil	Descriptive, exploratory, qualitative n = 12	Conducting open interviews analyzed in light of the Maurice Merleau-Ponty phenomenological framework.	Absences and dropout were justified by the mothers’ belief that healthy children do not need follow-up. In addition to claiming physical tiredness, long geographic distance to the service. The lack of money to pay for transport, long waiting times for consultations and frequent strikes by the health service were also mentioned as barriers.	High
Why I don’t take my child for a childcare consultation(²⁰20 Ximenes Neto FRG, Queiroz CA, Rocha J, Cunha ICKO. Why I don’t take my child for a childcare consultation. Rev Soc Bras Enferm Ped. 2010;10(2):51-9. https://doi.org/10.31508/1676-3793201000007 https://doi.org/10.31508/1676-3793201000... )	2010 Brazil	Descriptive, exploratory, qualitative n = 16	Conducting semistructured interviews and analyzed based on Minayo’s framework.	The reasons given by the mothers for absences/dropout were forgetfulness, not being informed of consultation day, lack of time, inconvenient consultation times, they see no importance in the consultation, in addition to unforeseen family circumstances.	High
Access to health care for Roma children in central and eastern Europe: findings from a qualitative study in Bulgaria(²¹21 Rechel B, Blackburn CM, Spencer NJ, Rechel B. Access to health care for Roma children in central and eastern Europe: findings from a qualitative study in Bulgaria. Int J Equity Health. 2009;8:24. https://doi.org/10.1186/1475-9276-8-24 https://doi.org/10.1186/1475-9276-8-24... )	2009 Bulgaria	Descriptive, exploratory, qualitative n = 12	Conducting interviews which were analyzed following the assumptions of theory based on Strauss’ data.	In the reports about non-attendance to health services, poverty, administrative and geographic obstacles were found, in addition to the lack of adaptation to cultural, linguistic and religious specificities.	High

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