Mental health nursing consultations in Brazilian primary care: analysis of proposed competencies for advanced practice nurses

Abstract

Background: Primary Health Care (PHC) is described as a key strategy to identifying, managing and coordinating mental health cases. Considering that nurses stand out as an essential element to integrate mental health care in PHC, initiatives to broaden the discussion and incorporate the role of Advanced Practice Nurses (ANP) in this setting, can contribute to reduce disparities in mental health care. Thus, this study aimed to analyze mental health nursing consultations in PHC and investigate whether nurses have care management skills proposed for ANP. Methods: multicenter study, with a quantitative and qualitative approach, carried out in 17 Primary Care Health Units, distributed in three regions of Brazil, from May to July 2022. Data collection was carried out in two moments of the nurse's professional practice: nursing consultation (recorded using film, with direct and non-participatory observation) and nursing record. From a quantitative perspective and during the first research stage, consultations with ≥50% compliance with the nursing process were selected so that, in the second qualitative stage, through content analysis, the competencies proposed for ANP in PHC were identified. Results: a total of 49 mental health nursing consultations were performed by 21 nurses. Of these, seven were selected with a score greater than 50% of compliance with the Nursing Process, carried out by three nurses. The consultations presented few competencies in the care management dimension proposed for the ANP, nevertheless, NC presented 39.68% in the care focus, 38.78% in assessment and diagnosis and 47.62% in the provision of care. Conclusions: nurses who carry out mental health nursing consultations in PHC present, in a scarce and partial way, the competencies proposed for the ANP regarding the domain of care management.