The Evidence Gap: The
Imperative Need for a Contextualized Model
An
analysis of the available literature reveals a significant scarcity of research
and publications specifically addressing the design and validation of models
for dispensarization of individualized nursing care within the context of Cuban
PHC. While numerous studies exist on the nursing process (NP) in general, few
explicitly and methodologically integrate it within the workflow of
dispensarization[6]. This lack of contextualized scientific
evidence translates into insufficient ownership of the process by nursing
professionals. The problematic situation identified during supervision of
various primary health care institutions is clear: there is limited mastery of
dispensarization with a focus on individualized care, which restricts the
system's capacity to provide a quality, efficient, and personalized response to
the health needs of the population. This limitation does not stem from a
failure of the professional but is a consequence of the lack of a tool adapted
to their work reality.
Towards
a Solution: Proposal for a Model Based on Nola Pender's Theory
The
phases of dispensarization—registration, evaluation, intervention, and
follow-up—offer an ideal framework for tailoring care to the specific needs of
each patient. However, the lack of standardization and contextualized models
hinders its effective application. Faced with this challenge, we propose the
design of a model for the dispensarization of individualized nursing care,
contextualized for PHC in the province of Sancti Spíritus. The novelty of this
proposal lies in its theoretical foundation in Nola Pender's Health Promotion
Model [7].
The
choice of this theoretical framework is not arbitrary. Pender's model focuses
on the factors that motivate individuals to engage in behaviors that improve
their health, considering their individual characteristics and prior
experiences [7]. This aligns perfectly with the goal of dispensarization: to
actively influence health status through education and care management. By
integrating this model, the dispensarization process is endowed with a
theoretical-practical foundation that goes beyond the biomedical, incorporating
cognitive, perceptual, and psychosocial dimensions that are crucial for the
success of any health intervention. It is imperative that nursing research
focuses on developing practical tools to facilitate this process. The proposal
of a model for the dispensarization of individualized care, adapted to the
particularities of PHC in provinces like Sancti Spíritus, represents a
necessary advance to reduce variability in care and improve health outcomes.
Structuring
this model would contribute to:
- Reduce variability in practice:
By standardizing evidence-based processes.
- Promote
efficient care: By optimizing professional time and
resources.
- Improve
health outcomes: By ensuring continuous and coordinated
follow-up, personalized for each patient and family.
- Enrich
Cuban Nursing Science: By providing a concrete tool that links
theory with clinical practice.