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1.
Rev. latinoam. enferm. (Online) ; 31: e4049, Jan.-Dec. 2023. tab, graf
Article in Spanish | LILACS, BDENF | ID: biblio-1530185

ABSTRACT

Objetivo: evaluar las evidencias sobre estrategias de telesalud en la atención de personas con enfermedad renal crónica. Método: revisión integradora de la literatura. La búsqueda de estudios primarios se realizó en seis bases de datos: PubMed/MEDLINE, Web of Science, EMBASE, CINAHL, LILACS y Scopus. La muestra estuvo compuesta por 48 artículos publicados entre 2000 y 2021, la estrategia de telesalud fue aplicada mediante equipo multidisciplinario, médico, enfermero, farmacéutico, nutricionista y trabajador social. De los artículos se extrajo el tipo de estudio, país, estrategia aplicada, escenario, población y profesional. Los estudios fueron seleccionados mediante la lectura de título y resumen (fase 1) y, posteriormente, mediante la lectura completa (fase 2), se los categorizó por estrategia de telesalud. El resumen de resultados se presentó de forma descriptiva y los estudios se clasificaron según el nivel de evidencia. Resultados: el domicilio fue el más representativo en las terapias de diálisis y tratamiento conservador. Se identificaron seis categorías de estrategias de telesalud: dispositivos de monitoreo remoto, teleconsulta, plataforma digital, aplicaciones, estrategias multimodales y contacto telefónico. Conclusión: el uso de esas estrategias para la atención de personas con enfermedad renal crónica tiene diferentes formatos e implementaciones, las mismas son factibles para dicha población en cualquier etapa de la enfermedad y pueden ser aplicadas por diferentes profesionales de la salud especialmente en el ámbito domiciliario. La evidencia ha demostrado que la telesalud favorece la reducción de costos, la accesibilidad a ubicaciones remotas, un mejor seguimiento de la diálisis con resultados positivos sobre el control de los síntomas, la reducción de riesgos y capacitación del paciente.


Objective: to evaluate the evidence about telehealth strategies in caring for people with chronic kidney disease. Method: integrative literature review. The search for primary studies was carried out in six databases: PubMed/MEDLINE, Web of Science, EMBASE, CINAHL, LILACS, and Scopus. The sample consisted of 48 articles published between 2000 and 2021. The telehealth strategy was applied by a multidisciplinary team of doctors, nurses, pharmacists, nutritionis, and social workers. The type of study, country, strategy applied, setting, population, and professional were extracted from the articles. The studies were selected by reading the title and abstract (phase 1) and then reading them in full (phase 2), categorizing them by telehealth strategy. The results were summarized descriptively and the studies were classified according to their level of evidence. Results: the home was the most representative in dialysis and conservative treatment. Six categories of telehealth strategies were identified: remote monitoring devices, teleconsultation, digital platforms, apps, multimodality strategies, and telephone contact. Conclusion: using these strategies for the care of people with chronic kidney disease presents different forms and implementations, being feasible for the renal population at any stage of the disease and applicable by different health professionals with an emphasis on the home environment. The evidence shows that telehealth favors lower cost, accessibility to remote locations, and better monitoring of dialysis with positive resul in symptom control, risk reduction, and patient training.


Objetivo: analisar as evidências sobre as estratégias de telessaúde no atendimento às pessoas com doença renal crônica. Método: revisão integrativa da literatura. A busca pelos estudos primários foi realizada em seis bases de dados: PubMed/MEDLINE, Web of Science, EMBASE, CINAHL, LILACS e Scopus. A amostra foi composta por 48 artigos publicados entre 2000 e 2021, a estratégia de telessaúde foi aplicada por equipe multidisciplinar, médico, enfermeiro, farmacêutico, nutricionista e assistente social. Foram extraídos dos artigos o tipo de estudo, país, estratégia aplicada, cenário, população e profissional. Os estudos foram selecionados por leitura de título e resumo (fase 1) e, após, por leitura completa (fase 2), com sua categorização por estratégia de telessaúde. A síntese dos resultados foi apresentada de forma descritiva e os estudos classificados de acordo com o nível de evidência. Resultados: o domicílio foi o de maior representatividade nas terapias dialíticas e tratamento conservador. Foram identificadas seis categorias de estratégias de telessaúde: dispositivos de monitoramento remoto, teleconsulta, plataforma digital, aplicativos, estratégias multimodalidades e contato telefônico. Conclusão: a utilização dessas estratégias para o atendimento de pessoas com doença renal crônica apresenta diferentes formatos e implementações, sendo viável à população renal em quaisquer fases da doença e aplicável por diferentes profissionais de saúde com ênfase no ambiente domiciliar. As evidências apontaram que a telessaúde favorece a diminuição de custos, acessibilidade aos locais afastados, melhor monitoramento da diálise com resultados positivos no controle dos sintomas, redução dos riscos e treinamento do paciente.


Subject(s)
Humans , Renal Dialysis , Telemedicine , Remote Consultation , Renal Insufficiency, Chronic/therapy , Ambulatory Care Facilities
2.
Enferm. foco (Brasília) ; 14: 1-6, mar. 20, 2023. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1433773

ABSTRACT

Objetivo: Construir e validar instrumento para avaliar o grau de satisfação dos usuários idosos no modelo de atuação do enfermeiro navegador, clínico e de práticas avançadas em serviços de oncologia. Métodos: Estudo metodológico embasado no processo de construção e validação de instrumento que contemplou a estrutura conceitual; definição dos objetivos e população; construção dos itens e escala de resposta; seleção e organização dos itens; estruturação do instrumento; opinião de especialistas; pré-teste e validação de conteúdo. Resultados: Construiu-se instrumento com 13 itens, distribuídos em dois blocos temáticos: aspectos socioeconômicos, composto por oito itens, e cinco perguntas fechadas. Evidenciado por dois métodos estatísticos: correlação não paramétrica e coeficiente de concordância. Conclusão: Conclui-se que o instrumento de avaliação sobre o grau de satisfação de usuários idosos com um modelo de atuação do enfermeiro navegador, enfermeiro clínico e enfermeiro de práticas avançadas tem validade de conteúdo e aparência. (AU)


Objective: To construct and validate an instrument to evaluate the degree of satisfaction of elderly users in the nurse navigator, clinical and advanced practice models in oncology services. Methods: Methodological study based on the process of construction and validation of an instrument that included the conceptual structure; definition of objectives and population; construction of items and response scale; selection and organization of items; structuring of the instrument; expert opinion; pre-test and content validation. Results: An instrument with 13 items was constructed, distributed in two thematic blocks: socioeconomic aspects composed of eight items, and five closed questions. Evidenced by two statistical methods: non-parametric correlation and agreement coefficient. Conclusion: It is concluded that the assessment instrument on the degree of satisfaction of elderly users with a nurse navigator, nurse practitioner and advanced practice nurse performance model has content and appearance validity. (AU)


Objetivo: Construir y validar un instrumento para evaluar el grado de satisfacción de los usuarios mayores en los modelos de enfermera navegante, clínica y de práctica avanzada en los servicios de oncología. Métodos: Estudio metodológico basado en el proceso de construcción y validación de un instrumento que incluyó la estructura conceptual; la definición de los objetivos y la población; la construcción de los ítems y la escala de respuesta; la selección y organización de los ítems; la estructuración del instrumento; la opinión de expertos; el pre-test y la validación del contenido. Resultados: Instrumento construido con 13 ítems, distribuidos en dos bloques temáticos: aspectos socioeconómicos compuestos por ocho ítems, y cinco preguntas cerradas. Lo demuestran dos métodos estadísticos: la correlación no paramétrica y el coeficiente de acuerdo. Conclusión: Se concluye que el instrumento de aval sobre el grado de satisfacción de los usuarios idosos con un modelo de actuación del enfermero navegador, enfermero clínico y enfermero de prácticas avanzadas tiene validez de contenido y apariencia. (AU)


Subject(s)
Validation Study , Patient Satisfaction , Ambulatory Care Facilities , Nurses, Male , Nursing, Practical
3.
ABCS health sci ; 48: e023201, 14 fev. 2023. tab, ilus
Article in English | LILACS | ID: biblio-1414580

ABSTRACT

INTRODUCTION: The measurement of the adductor pollicis muscle thickness (APMT) has been investigated as an index for muscle mass and undernutrition. OBJECTIVE: However, there are few studies related to community-living older adults. METHODS: Cross-sectional study carried out with community-dwelling older adults, of both sexes. The APMT, the body mass index (BMI), arm circumference (AC), arm muscle circumference (AMC), and calf circumference (CC) were evaluated. For APMT classification, the 25th percentile value (P25 ≤9 mm) of the sample was considered to identify muscle mass deficit. Chi-square test, Pearson's correlation, and Poisson regression were performed, with a significance level of p<0.05. RESULTS: Among men, APMT showed a correlation with AC (r=0.350; p<0.01), and among women it was with BMI (r=0.337; p=0.01). There was an association between the BMI classification and the APMT percentile (p=0.020). Older adults with BMI<23 kg/m² were 1.28 times more likely to have APMT≤P25 (p=0.007) and older adults with adequate BMI were 1.23 times more likely (p=0.023). Older adults with reduced CC have a 1.18 times more chance of presenting APMT≤P25 (p=0.064). CONCLUSION: APMT has been associated with BMI in older adults, proving to be a good parameter for the assessment of malnutrition.


INTRODUÇÃO: A espessura do músculo adutor do polegar (EMAP) tem sido sugerido como um índice de massa muscular e desnutrição. OBJETIVO: Verificar a associação da EMAP com indicadores antropométricos convencionais em idosos da comunidade. MÉTODOS: Estudo transversal realizado com 159 idosos da comunidade, de ambos os sexos, com média de idade de 70,9±29,4 anos. Foram avaliados a EMAP, o índice de massa corporal (IMC), as circunferências do braço (CB), muscular do braço (CMB) e da panturrilha (CP). Para classificação da EMAP se considerou o valor do percentil 25 (P25≤9 mm) da amostra para identificar déficit de massa muscular. Teste Qui-quadrado, Correlação de Pearson e Regressão de Poisson foram realizados, sendo adotado um nível de significância de p<0,05. RESULTADOS: Entre os homens, a EMAP apresentou correlação com a CB (r=0,350; p<0,01) e entre as mulheres foi com o IMC (r=0,337; p=0,01). Houve associação entre a classificação do IMC e o percentil da EMAP (p=0,020). Os idosos com IMC<23 kg/m² tinham 1,28 vezes mais chances de possuir EMAP≤P25 (p=0,007) e idosos com IMC adequado tinham 1,23 vezes mais chance (p=0,023). Idosos com CP reduzido apresentaram 1,18 vezes mais chance de apresentar EMAP≤P25 (p=0,064). Conclusão: A EMAP apresentou associação com o IMC em idosos, demostrando ser um bom parâmetro para a avaliação da desnutrição.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Thumb , Residence Characteristics , Anthropometry , Health of the Elderly , Malnutrition , Muscles , Cross-Sectional Studies , Ambulatory Care Facilities
4.
Psicol. ciênc. prof ; 43: e249989, 2023.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1422420

ABSTRACT

O Serviço-Escola de Psicologia (SEP) da Unifesp foi constituído com o intuito de transcender o tradicional funcionamento das clínicas-escola, superando a atomização da Psicologia em áreas e oferecendo serviços integrados à rede. Isso possibilita uma formação interdisciplinar, pluralista, generalista, não tecnicista, crítica, permitindo a compreensão e atuação do psicólogo em diversos contextos socioculturais. O objetivo do artigo é descrever, avaliar e problematizar as ações do SEP da Unifesp, em relação à oferta de campos de estágio e ações desenvolvidas neles. É um estudo transversal, baseado em metodologia predominantemente quantitativa e descritiva. O levantamento de dados foi realizado por meio de dois questionários online respondidos por todos os supervisores. Os dados quantitativos foram submetidos à análise estatística descritiva. Os resultados evidenciaram maior incidência das ações no município de Santos e, em menor grau, em outros municípios da Baixada Santista e na cidade de São Paulo. A maioria das atividades de estágios não se limita ao espaço físico de atendimento clínico do Serviço-Escola, ocorrendo junto às instituições públicas ou às instituições ligadas ao terceiro setor na região, relacionadas, direta ou indiretamente, com a promoção de políticas públicas. A pluralidade de recursos utilizados (grupos, atendimento individual, acompanhamento terapêutico, oficinas, matriciamento, entre outros) revela uma ampliação do repertório de competências e habilidades. A variedade de oferta de projetos e campos de estágio, públicos-alvo atendidos, assim como a diversidade e flexibilidade de ações e estratégias desenvolvidas, apontam um movimento de congruência em relação às diretrizes curriculares nacionais e ao inovador Projeto Pedagógico do curso.(AU)


UNIFESP's Psychology Service-School (SEP) was founded with the objective of going beyond the traditional functioning of school-clinics, overcoming the atomization of Psychology in areas and offering services integrated to the network. This enables an interdisciplinary, pluralist, generalist, non-technicist, and critical training, allowing psychologists' understanding and action in different sociocultural contexts. This article aims to describe, evaluate, and discuss the actions of UNIFESP's SEP regarding the offer of internship fields and the actions developed in those fields. It is a cross-sectional study, based on a predominantly descriptive and quantitative methodology. The data was surveyed with two online questionnaires answered by all supervisors. Quantitative data were submitted to descriptive statistical analysis. The results showed a higher incidence of actions in the municipality of Santos and, to a lesser extent, in other municipalities of the Baixada Santista and in the city of São Paulo. Most internship activities are not limited to the physical space of the service-school's clinical care and take place alongside public institutions or institutions linked to the third sector in the area, directly or indirectly related to the promotion of public policies. The plurality of resources (groups, personal care, therapeutic monitoring, workshops, matrix support, among others) reveals an expansion of competences and skills repertoire. The variety of projects and internship fields offers, of target audiences served, as well as the diversity and flexibility of the developed actions and strategies point to a congruence movement relating to national curricular guidelines and to the innovative pedagogical project of the course.(AU)


El Serviço-Escola de Psicologia (SEP) de la Unifesp (Universidade Federal de São Paulo, Brasil) buscó trascender el funcionamiento tradicional de las clínicas universitarias, superar la atomización de la Psicología en áreas y ofrecer servicios integrados a la red. Esto permite una formación interdisciplinar, pluralista, generalista, sin tecnicismos, crítica, lo que posibilita a los/las psicólogos/as comprender y actuar en diferentes contextos socioculturales. Este artículo pretendió describir, evaluar y problematizar las acciones del SEP Unifesp respecto a la oferta de campos de prácticas profesionales y acciones desarrolladas. Es un estudio transversal, con metodología predominantemente cuantitativa y descriptiva. Los datos se recolectaron de dos cuestionarios en línea respondidos por los/las supervisores/as. Se les aplicaron un análisis estadístico descriptivo. Hubo más acciones en la ciudad de Santos (Brasil) que en otros municipios de la región metropolitana de la Baixada Santista y en la ciudad de São Paulo. La mayoría de las prácticas profesionales no se limita a la atención clínica del SEP, ocurriendo en instituciones públicas o vinculadas al tercer sector en la región, directa o indirectamente, relacionadas con la promoción de políticas públicas. La pluralidad de recursos (grupos, atención individual, acompañamiento terapéutico, talleres, soporte matricial, entre otros) revela un amplio repertorio de competencias y habilidades. La variada oferta de proyectos y campos para prácticas profesionales, los públicos destinatarios atendidos, así como la diversidad y flexibilidad de acciones y estrategias desarrolladas apuntan a una congruencia respecto a los lineamientos curriculares nacionales y al innovador proyecto pedagógico del curso.(AU)


Subject(s)
Humans , Male , Female , Public Policy , Schools , Teaching , Thinking , Training Support , Contract Services , Hospitals, Teaching , Organization and Administration , Aptitude , Professional Practice , Psychology , Research , Science , Security Measures , Social Work , Women , Work , Health Policy, Planning and Management , Family , Child , Residence Characteristics , Medical Records , Organizations , Triage , Allied Health Occupations , Adolescent , Intersectoral Collaboration , Program Development , Negotiating , Health Care Quality, Access, and Evaluation , Interview , Competency-Based Education , Problem-Based Learning , Confidentiality , Consumer Behavior , Knowledge , Curriculum , Interdisciplinary Communication , Mandatory Programs , After-Hours Care , Health Care Economics and Organizations , Education, Continuing , Efficiency , User Embracement , Ethics, Professional , Professional Training , Project Reports , Evaluation Studies as Topic , Existentialism , Evidence-Based Practice , Feedback , Knowledge Management , Ambulatory Care Facilities , Social Skills , Psychological Distress , Right to Health , Psychosocial Intervention , Self-Testing , Social Vulnerability , Integrative Community Therapy , Health Occupations , Hospital Administration , Interprofessional Relations , Legislation as Topic , Mental Health Services , Morals
5.
Rev. saúde pública (Online) ; 57: 26, 2023. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1432160

ABSTRACT

ABSTRACT OBJECTIVE To estimate the public-private composition of HIV care in Brazil and the organizational profile of the extensive network of public healthcare facilities. METHODS Data from the Qualiaids-BR Cohort were used, which gathers data from national systems of clinical and laboratory information on people aged 15 years or older with the first dispensation of antiretroviral therapy between 2015-2018, and information from SUS healthcare facilities for clinical-laboratory follow-up of HIV, produced by the Qualiaids survey. The follow-up system was defined by the number of viral load tests requested by any SUS healthcare facility: follow-up in the private system - no record; follow-up at SUS - two or more records; undefined follow-up - one record. SUS healthcare facilities were characterized as outpatient clinics, primary care and prison system, according to the respondents' self-classification in the Qualiaids survey (72.9%); for non-respondents (27.1%) the classification was based on the terms present in the names of the healthcare facilities. RESULTS During the period, 238,599 people aged 15 years or older started antiretroviral therapy in Brazil, of which 69% were followed-up at SUS, 21.7% in the private system and 9.3% had an undefined system. Among those followed-up at SUS, 93.4% received care in outpatient clinics, 5% in primary care facilities and 1% in the prison system. CONCLUSION In Brazil, antiretroviral treatment is provided exclusively by SUS, which is also responsible for clinical and laboratory follow-up for most people in outpatient clinics. The study was only possible because SUS maintains records and public information about HIV care. There is no data available for the private system.


RESUMO OBJETIVO Estimar a composição público-privada da assistência em HIV no Brasil e o perfil organizacional da extensa rede de serviços públicos. MÉTODOS Foram utilizados dados da Coorte Qualiaids-BR, que reúne dados dos sistemas nacionais de informações clínicas e laboratoriais de pessoas com 15 anos ou mais com primeira dispensação de terapia antirretroviral, entre 2015-2018, e informações dos serviços do SUS de acompanhamento clínico-laboratorial do HIV, produzidas pelo inquérito Qualiaids. O sistema de acompanhamento foi definido pelo número de exames de carga viral solicitados por algum serviço do SUS: acompanhamento no sistema privado - nenhum registro; acompanhamento no SUS - dois ou mais registros; acompanhamento indefinido - um registro. Os serviços do SUS foram caracterizados como ambulatórios, atenção básica e sistema prisional, segundo autoclassificação dos respondentes ao inquérito Qualiaids (72,9%); para os não respondentes (27,1%) a classificação baseou-se nos termos presentes nos nomes dos serviços. RESULTADOS No período, 238.599 pessoas com 15 anos ou mais iniciaram a terapia antirretroviral no Brasil, das quais, 69% receberam acompanhamento no SUS, 21,7% no sistema privado e 9,3% tiveram o sistema indefinido. Entre os acompanhados no SUS, 93,4% foram atendidos em serviços do tipo ambulatório, 5% em serviços de atenção básica e 1% no sistema prisional. CONCLUSÃO No Brasil o tratamento antirretroviral é fornecido exclusivamente pelo SUS, que também é responsável pelo acompanhamento clínico-laboratorial da terapia da maior parte das pessoas em serviços ambulatoriais. O estudo só foi possível porque o SUS mantêm registros e informações públicas acerca do acompanhamento em HIV. Não há nenhum dado disponível para o sistema privado.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Unified Health System , Health Care Quality, Access, and Evaluation , Anti-HIV Agents/supply & distribution , Supplemental Health , Ambulatory Care Facilities
6.
S. Afr. med. j. (Online) ; 113(1): 24-30, 2023. figures, tables
Article in English | AIM | ID: biblio-1412845

ABSTRACT

Background. Many patients have their healthcare needs met at primary healthcare (PHC) clinics in KwaZulu-Natal (KZN), without having to travel to a hospital. Doctors form part of the teams at many PHC clinics throughout KZN, offering a decentralised medical service in a PHC clinic. Objectives. To assess the benefit of having a medical doctor managing patients with more complex clinical conditions at PHC clinic level in uMgungundlovu District, KZN. Two key questions were researched: (i) were the patients whom the clinic doctors managed of sufficient clinical complexity that they warranted a doctor managing them, rather than a PHC nurse clinician? and (ii) what was the spectrum of medical conditions that the clinic doctors managed? Methods. Doctors collected data at all medical consultations in PHC clinics in uMgungundlovu during February 2020. A single-page standardised data tool was used to collect data at every consultation. Results. Thirty-five doctors were working in 45 PHC clinics in February 2020. Twenty-six of the clinic doctors were National Health Insurance (NHI)-employed. The 35 doctors conducted 7 424 patient consultations in February. Staff in the PHC clinics conducted 143 421 consultations that month, mostly by PHC nurse clinicians. The doctors concluded that 6 947 (93.6%) of the 7 424 doctor consultations were of sufficient complexity as to warrant management by a doctor. The spectrum of medical conditions was as follows: (i) consultations for maternal and child health; n=761 (10.2%); (ii) consultations involving non-communicable diseases (NCDs), n=4 372 (58.9%) ­ the six most common NCDs were, in order: hypertension, diabetes, arthritis, epilepsy, mental illness and renal disease; (iii) consultations involving communicable diseases constituted 1 745 (23.5%) of cases; and (iv) consultations involving laboratory result interpretation 1 180 (15.9%).Conclusion. This research showed that at a PHC clinic the more complex patient consultations did indeed require the skills and knowledge of a medical doctor managing these patients. These data support the benefit of a doctor working at every PHC clinic: the doctor is a 'must-have' member of the PHC clinic team, offering a regular, reliable and predictable medical service.


Subject(s)
Primary Health Care , Delivery of Health Care , Ambulatory Care Facilities , National Health Programs , Personnel, Hospital
7.
West Afr. j. med ; 40(2): 143-147, 2023. figures, tables
Article in English | AIM | ID: biblio-1428562

ABSTRACT

INTRODUCTION: Cervicofacial infections (CFI) are life-threatening and constitute some of the common emergencies seen by the oral and maxillofacial surgeon on a regular basis. The COVID-19 pandemic resulted in reduced human activities for most of 2020 including the first worldwide lockdown. At the height of the pandemic, it was expected that the number of patients presenting with cervicofacial infections would drop as with most health conditions. The purpose of this study was to determine the impact of COVID-19 on the management and outcome of cervicofacial infections in a tertiary maxillofacial institution. PATIENTS AND METHODS: A retrospective analysis of patients who presented at the Maxillofacial clinic with cervicofacial infections and were subsequently admitted into the ward during the lockdown (2020) was compared with those of the previous year (2019) and the year after (2021).RESULTS: The total number of patients seen and admitted with cervicofacial infections in 2020 was 39(31.2%) which was lower than that seen the preceding year 48(38.4%) but higher than 38(30.4%) of the year after. 116 patients were treated while nine patients left hospital without treatment. All patients presented with extensive cervicofacial infections, involving more than three fascial spaces and were treated using parenteral antibiotics with surgical incision and drainage under local anesthesia. There were more deaths in 2020 (n=10) than in the preceding year (n=8) and the year after (n=7).CONCLUSION: A high percentage of CFI was admitted duringCOVID-19 period compared to the previous and following years. Involvement of multiple fascial spaces was also noted


INTRODUCTION: Les infections cervico-faciales (ICF) mettent la vie en danger et constituent certaines des urgences les plus courantes que rencontre régulièrement le chirurgien buccal et maxillo-facial. La pandémie de COVID-19 a entraîné une réduction des activités humaines pendant la majeure partie de l'année 2020, y compris le premier verrouillage mondial. Au plus fort de la pandémie, on s'attendait à ce que le nombre de patients présentant des infections cervico-faciales diminue comme pour la plupart des problèmes de santé. Le but de cette étude était de déterminer l'impact de COVID19 sur la gestion et le résultat des infections cervicofaciales dans une institution tertiaire maxillo-faciale. PATIENTS ET MÉTHODES: Une analyse rétrospective des patients qui se sont présentés à la clinique maxillo-faciale avec des infections cervico-faciales et ont ensuite été admis dans le service pendant le lockdown (2020) a été comparée à celles de l'année précédente (2019) et de l'année suivante (2021). RÉSULTATS: Le nombre total de patients vus et admis pour des infections cervico-faciales en 2020 était de 39 (31,2 %), ce qui était inférieur à celui de l'année précédente (48 (38,4 %)) mais supérieur à celui de l'année suivante (38 (30,4 %)). 116 ont été traités tandis que neuf patients ont quitté l'hôpital sans traitement. Tous les patients présentaient des infections cervico-faciales étendues, impliquant plus de trois espaces fasciaux et ont été traités à l'aide d'antibiotiques parentéraux, avec incision chirurgicale et drainage sous anesthésie locale. Il y a eu plus de décès en 2020 (n=10) que l'année précédente (n=8) et l'année suivante (n=7). CONCLUSION: Bien qu'un pourcentage élevé de FCI ait été admis pendant la période COVI-19 par rapport aux années précédentes et suivantes, l'implication de multiples espaces fasciaux a également été constatée


Subject(s)
Humans , Male , Female , Communicable Disease Control , Disease Management , Ambulatory Care Facilities , COVID-19
8.
Acta sci., Health sci ; 44: e56262, Jan. 14, 2022.
Article in English | LILACS | ID: biblio-1367442

ABSTRACT

The aim of this study is to evaluate the direct diagnostic costs for disease groups and other variables (such as gender, age, seasons) that are related to the direct diagnostic costs based on a 3-year data. The population of the study consisted of 31,401 patients who applied to family medicine outpatient clinic in Turkey between January 1st, 2016 and December 31st, 2018. With this study, we determined in which disease groups of the family medicine outpatient clinic weremost frequently admitted. Then, total and average diagnostic costs for these disease groups were calculated. Three-year data gave us the opportunity to examine the trend in diagnostic costs. Based on this, we demonstratedwhich diseases' total and average diagnostic costs increased or decreased during 3 years. Moreover, we examined how diagnostic costs showed a trend in both Turkish liras and USA dollars' rate for 3 years. Finally, we analysedwhether the diagnostic costs differed according to variables such as age, gender and season. There has been relatively little analysis on the diagnostic costs in the previous literature. Therefore, we expect to contribute to both theoristsand healthcare managers for diagnostic costs with this study.


Subject(s)
Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Costs and Cost Analysis/economics , Costs and Cost Analysis/statistics & numerical data , Family Practice/instrumentation , Family Practice/statistics & numerical data , Ambulatory Care Facilities/supply & distribution , Outpatients/statistics & numerical data , International Classification of Diseases/economics , Disease , Delivery of Health Care/statistics & numerical data , Ambulatory Care/statistics & numerical data
9.
Braz. J. Pharm. Sci. (Online) ; 58: e21266, 2022. tab, graf
Article in English | LILACS | ID: biblio-1420436

ABSTRACT

Abstract The prevalence of epidemiological diseases, including diabetes, has continued to increase because of the adaption of Western culture and the lack of self-care activities among patients with diabetes. Therefore, in this cross-sectional study, we aimed to assess self-care plans and determinants among diabetes outpatients in Warangal. We conducted a prospective observational study among diabetes outpatient clinic in Warangal, India over 6 months from October 2019 to March 2020. We used the expanded Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. A P value of less than < 0.05 was considered statistically significant. Respondents (mean age, 52.3 (standard deviation (SD), 11.01) years) had an overall SDSCA score of 49.18 ± 3.57 (SD). Mean scores for the diet, physical activity, foot care, medication adherence, and blood sugar testing scales were 12.79 (SD, 1.61), 10.24 (SD, 1.77), 15.67 (SD, 1.5), 5.66 (SD, 1.17), and 4.80 (SD, 0.68), respectively. Patients' age, education, disease duration and hemoglobin A1C (HbA1C) levels of <7.5% (P < 0.001)) had significantly higher mean scores for blood sugar testing, diet, physical activity, and adherence (P < 0.001). The employment status is associated with all the domains of Summary of Diabetes Self-Care Activities (P < 0.001). Taken together, our results revealed that patients with diabetes in Warangal had poor self-care planning, highlighting the need for strengthening initiatives that generate awareness regarding diabetes and improving related self-care practices


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Outpatients/classification , Self Care/ethics , Diabetes Mellitus/pathology , Awareness/classification , Cross-Sectional Studies/methods , Surveys and Questionnaires/statistics & numerical data , Diet/adverse effects , Medication Adherence , Ambulatory Care Facilities/classification
10.
Niger. j. clin. pract. (Online) ; 25(1): 49-54, 2022. Tableaux
Article in English | AIM | ID: biblio-1357859

ABSTRACT

Background: As the SARS-CoV-2 pandemic continues to ravage the world, its impact on the health systems and survival of people with chronic diseases especially People living with HIV [PLWH] could be undermined. It becomes relevant to assess the challenges PLWH face during this period to institute measures towards combating the negative effects of the pandemic. Aims: This study aims to investigate the challenges faced by PLWH in accessing care during the lockdown period in Lagos, Nigeria. The study was a cross-sectional one involving PLWH aged 18 years and above who presented for care. An interviewer-administered questionnaire was used to obtain information on demographic characteristics, their knowledge about COVID-19 disease, and challenges experienced in accessing care during the COVID-19-induced lockdown. Ethical approval was obtained from the Institution Research Ethics Board (IRB) of NIMR. Patients and Methods: Data generated from the survey was exported to Excel and analyzed using SPSS version 23.0. Results: The mean age of PLWH who participated in the study was 42.2 (±12.2) years. The majority were female (74.3%), married (66.3%), employed (58.9%), and on less than $100 monthly income (80.5%). The commonest challenges experienced were psychological (78.5%), financial (68%) and food (40.7%). There were significant association among the income status, lack of food (OR: 2.5, CI: 1.4-4.5, P = 0.002), financial challenges (OR: 1.7, CI: 1.0­3.0, P = 0.048) and psychological challenges (OR; 1.8, CI: 1.0-3.5, P = 0.05). Ninety­five percent of participants believed SARS-COV-2 infection is a viral infection. Conclusions: PLWH faces a myriad of challenges that would have a significant impact on their overall well-being and the gains of HIV care.


Subject(s)
Humans , Male , Female , Middle Aged , HIV Infections , Ambulatory Care Facilities , SARS-CoV-2 , COVID-19 , Antiretroviral Therapy, Highly Active
11.
Research Journal of Heath Sciences ; 10(2): 80-89, 2022. figures, tables
Article in English | AIM | ID: biblio-1370930

ABSTRACT

Introduction: In sub ­ Saharan Africa, oral health services are greatly hampered by low availability and poor accessibility to health care and these are various interrelated factors responsible. This study determined the factors that influence oral health seeking behavior among patients attending outpatients' clinic. Methodology: A total of 460patients were selected into the study from the outpatients' clinic using systematic random sampling. Data was collected and was analyzed using SPSS 17. The significant level was set at 0.05 Results: Of the 97.3% of the respondents with awareness of oral health facility, 90.9% of them had oral health facility within 5km distance. The commonest complaint was toothache. Majority of the respondents (88.2%) accessed orthodox oral health services mostly for teeth extraction (61.3%). There was statistically significant difference between the awareness of Oral health facility and closeness to residence. Conclusion: Age, awareness and attitude have positive effect on health seeking behavior of patients.


Subject(s)
Awareness , Health Behavior , Oral Health , Ambulatory Care Facilities , Health Services Research
12.
African Health Sciences ; 22(1): 28-40, March 2022. Figures, Tables
Article in English | AIM | ID: biblio-1400307

ABSTRACT

Objective: This paper establishes levels and patterns of ability and willingness to pay (AWTP) for contraceptives, and associated factors. Study design: A three-stage cluster and stratified sampling was applied in selection of enumeration areas, households and individuals in a baseline survey for a 5-year Family planning programme. Multivariable linear and modified Poisson regressions are used to establish factors associated with AWTP. Results: Ability to pay was higher among men (84%) than women (52%). A high proportion of women (96%) and men (82%) were able to pay at least Ug Shs 1000 ($0.27) for FP services while 93% of women and 83% of men who had never used FP services will in future be able to pay for FP services costed at least Shs 2000 ($0.55). The factors independently associated with AWTP were lower age group (<25 years), residence in urban areas, attainment of higher education level, and higher wealth quintiles. Conclusion: AWTP for FP services varied by different measures. Setting the cost of FP services at Shs 1000 ($0.27) will attract almost all women (96%) and most of men (82%). Key determinants of low AWTP include residence in poor regions, being from rural areas and lack of/low education. Implications statement: Private providers should institute price discrimination for FP services by region, gender and socio-economic levels. More economic empowerment for disadvantaged populations is needed if the country is to realise higher contraceptive uptake. More support for total market approach for FP services needed


Subject(s)
Aptitude , Cleavage Stage, Ovum , Contraceptive Agents , Ambulatory Care Facilities , Uganda , Women , Men
13.
West Afr. j. med ; 39(11): 1180-1187, 2022. tales, figures
Article in English | AIM | ID: biblio-1410940

ABSTRACT

Contraceptive use has numerous benefits for thefamily and the nation that can be maximized with its consistent use.However, many women have preferences for certain contraceptiveswith implications for continued use.OBJECTIVE: To determine the contraceptive preferences of women,their utilization pattern and factors affecting utilization of the preferredcontraceptive choices.METHODS: This cross-sectional study was conducted among 426women of reproductive age selected from 32 primary health facilitiesusing multistage sampling technique. Data was collected using a semi-structured interviewer-administered questionnaire. Descriptive andinferential analysis of data collected was carried out using IBM SPSSversion 22 software. P-value was set at 0.05.RESULTS: Close to half of the respondents 211 (49.5%) preferredinjectable contraceptives, 79 (18.6%) selected implants and 27 (6.3%)chose condoms. The majority 212 (49.8%) of respondents usedinjectable contraceptives, followed by implants 66 (15.5%), condoms33 (7.7%), IUCD 54 (12.7%) and OCP 61 (14.3%). Age (p<0.001),number of children (p<0.001), clients' employment status (p<0.001),husband support (p<0.021) and desire for more children (p<0.001)were all statistically associated with the utilization of preferredcontraceptives.CONCLUSION: Even though respondents preferred the injectablecontraceptives, implants and IUCD in that order, their utilizationpattern followed the order of Injectable, implants and OCP. Severalfactors were identified to be statistically associated with the utilizationof preferred contraceptives. Health education on contraceptive useamong women, spousal support and health workers training tohighlight those factors influencing women's contraceptive preferencesand utilization are recommended


Subject(s)
Humans , Contraceptive Agents, Female , Territorialization in Primary Health Care , Patient Acceptance of Health Care , Consumer Behavior , Ambulatory Care Facilities
14.
Chinese Journal of Preventive Medicine ; (12): 351-354, 2022.
Article in Chinese | WPRIM | ID: wpr-935292

ABSTRACT

From 2011 to 2020, there were 111 213 cases of rabies exposed people recruited from the rabies immunization clinic of a hospital in Beijing. The monthly distribution of patients in each year was not statistically significant (P>0.05). The distribution of patients showed remarkable seasonality, with the exposure peak from May to October. The ratio of male to female was 1∶1.3. The majority of patients were aged 20-29 years old (39.1%) and in-service personnel (56.5%). Level-Ⅱ wounds (84.2%) were more common than level-Ⅲ wounds (14.9%). The number of visits to level-Ⅲwounds increased rapidly since 2017. The most common injured body part was hand (60.7%). Dogs were the most common animal for injuries (60.6%), followed by cats (32.3%), of which most were host animals (75.5%). The vaccination rate from 2016 to 2020 [49.8% (24 276/48 703)] was significantly higher than that from 2011 to 2015[18.6% (6 559/35 272)](χ²=8597.18, P<0.001).


Subject(s)
Animals , Dogs , Female , Humans , Male , Ambulatory Care Facilities , Bites and Stings/epidemiology , Hospitals , Rabies/prevention & control , Rabies Vaccines/therapeutic use , Vaccination
15.
Rev. Esc. Enferm. USP ; 56: e20220127, 2022. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1406777

ABSTRACT

ABSTRACT Objective: To analyze management styles in outpatient clinics of university hospitals and their impacts on the nursing workers' health. Method: Quantitative, cross-sectional study with 388 nursing professionals working in 11 outpatient clinics linked to public universities in Rio de Janeiro. The Management Styles Scale, the Pathogenic Suffering at Work Scale, and the Work-Related Physical and Psychosocial Harms Scale were used. Results: The managerial and collective management styles showed a moderate presence for the outpatient clinics nursing staff. The characteristics of the predominantly managerial management style, evidenced by the lack of participation in decision-making, the strongly hierarchical work, focused on norms and control, acted as predictors of the experiences of suffering and of the physical, psychological, and social damages presented by the professionals working in this context. Conclusion: The analysis of management styles allowed elucidating characteristics that have the potential to negatively impact the workers' health, highlighting the need to review the management models currently adopted for the outpatient nursing team.


RESUMEN Objetivo: Analizar los estilos de gestión en ambulatorios de hospitales universitarios y sus impactos en la salud de los trabajadores de enfermería. Método: Estudio cuantitativo, transversal, participaron 388 profesionales de enfermería actuantes en 11 ambulatorios vinculados a las universidades públicas en Rio de Janeiro. Se utilizó la Escala de Estilos de Gestión, la Escala de Sufrimiento Patogénico en el Trabajo y la Escala de Daños Físicos y Psicosociales relacionados al Trabajo. Resultados: Los estilos de gestión gerencial y colectiva presentaron presencia moderada en el equipo de enfermería de los ambulatorios. Las características del estilo de gestión predominantemente gerencial, evidenciadas por la falta de participación en la toma de decisión, el trabajo fuertemente jerarquizado, enfocado en las normas actuaron como predictores de las vivencias de sufrimiento y de los daños físicos, psíquicos y sociales presentados por los profesionales actuantes en ese contexto. Conclusión: El análisis de los estilos de gestión permitió elucidar características que tienen potencial para impactar negativamente la salud de los trabajadores destacándose la necesidad de revisar los modelos de gestión actualmente adoptados para el equipo de enfermería ambulatorial.


RESUMO Objetivo: Analisar os estilos de gestão em ambulatórios de hospitais universitários e seus impactos na saúde dos trabalhadores de enfermagem. Método: Estudo quantitativo, transversal, participaram 388 profissionais de enfermagem atuantes em 11 ambulatórios vinculados a universidades públicas no Rio de Janeiro. Utilizamos a Escala de Estilos de Gestão, a Escala de Sofrimento Patogênico no Trabalho e a Escala de Danos Físicos e Psicossociais relacionados ao Trabalho. Resultados: Os estilos de gestão gerencialista e coletivo apresentaram presença moderada para a equipe de enfermagem dos ambulatórios. As características do estilo de gestão predominantemente gerencialista, evidenciadas pela falta de participação na tomada de decisão, o trabalho fortemente hierarquizado, focado nas normas e controle, atuaram como preditores das vivências de sofrimento e dos danos físicos, psíquicos e sociais apresentados pelos profissionais atuantes nesse contexto. Conclusão A análise dos estilos de gestão permitiu elucidar características que têm potencial para impactar negativamente a saúde dos trabalhadores destacando-se a necessidade de rever os modelos de gestão atualmente adotados para a equipe de enfermagem ambulatorial.


Subject(s)
Personnel Management , Occupational Health , Nursing, Team , Health Management , Ambulatory Care Facilities
16.
Rev. latinoam. enferm. (Online) ; 30(spe): e3846, 2022. graf
Article in English | LILACS, BDENF | ID: biblio-1409638

ABSTRACT

Abstract Objective: to understand the transition from disease to survival of adolescents who had experienced cancer. Method: qualitative study, developed with the theoretical framework of symbolic interactionism, conducted with 14 adolescent cancer survivors treated at an outpatient clinic after cancer therapy, in the city of São Paulo. Individual in-depth interviews were performed and recorded, and the data were analyzed and interpreted using the methodological framework of the thematic analysis. Results: four themes were identified: going back to school, being able to live like other adolescents, living in the present moment, and seeking a purpose in life. Conclusion: the transition from disease to cancer survival was full of insecurities, difficulties, and challenges. After the disease, survivors acquire new values and new priorities in life, a reconstruction of the self. They also feel thankful to God and the people who were part of their treatment journey.


Resumo Objetivo: conhecer a transição da doença para a sobrevivência de adolescentes que vivenciaram o câncer. Método: estudo de abordagem qualitativa, desenvolvido por meio do referencial teórico Interacionismo Simbólico, realizado com 14 adolescentes sobreviventes de câncer atendidos em um ambulatório de pacientes fora de terapia na cidade de São Paulo (SP). Foram realizadas e gravadas entrevistas individuais e em profundidade e os dados foram analisados e interpretados pelo referencial metodológico da análise temática. Resultados: quatro temas foram identificados: voltando para a escola; podendo viver como outros adolescentes; vivendo o agora e buscando um propósito na vida. Conclusão: a transição da doença para a sobrevivência do câncer se revelou cheia de inseguranças, dificuldades e desafios. Após a doença, os sobreviventes adquirem novos valores e novas prioridades de vida; uma reconstrução do self; além do sentimento de gratidão a Deus e às pessoas que participaram da trajetória percorrida durante o tratamento.


Resumen Objetivo: conocer la transición entre la enfermedad y la supervivencia de adolescentes que han sufrido cáncer. Método: estudio con enfoque cualitativo, desarrollado a través del referencial teórico del Interaccionismo Simbólico, realizado con 14 adolescentes supervivientes de cáncer atendidos en un ambulatorio, sin terapia, de la ciudad de São Paulo (SP). Se realizaron y grabaron entrevistas en profundidad individuales y los datos fueron analizados e interpretados utilizando el marco metodológico de análisis temático. Resultados: se identificaron cuatro temas: regreso al colegio; poder vivir como otros adolescentes; viviendo el presente y buscando un propósito en la vida. Conclusión: la transición entre la enfermedad y la supervivencia del cáncer se mostró llena de inseguridades, dificultades y desafíos. Después que termina la fase de la enfermedad, los supervivientes adquieren nuevos valores y prioridades en la vida; una reconstrucción del Self; además del sentimiento de gratitud hacia Dios y las personas que participaron del camino recorrido durante el tratamiento.


Subject(s)
Humans , Adolescent , Emotions , Ambulatory Care Facilities , Cancer Survivors , Neoplasms/therapy
17.
Psicol. ciênc. prof ; 42: e232410, 2022.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1356591

ABSTRACT

Este artigo tem por objetivo apresentar os fundamentos teóricos da implantação de uma clínica de atendimento psicanalítico a crianças autistas em uma Universidade Federal. Aqui, apresentamos como se fundamenta essa clínica, como ela se iniciou, seu funcionamento, sua práxis na instituição e como se dá o tratamento da criança autista no Serviço de Psicologia Aplicada de uma Universidade Federal. O método implica uma discussão sobre o "estado da arte" nesse campo a fim de discutir as bases teóricas e a implementação recente (em 2019) de um serviço de psicanálise pela Universidade Federal de São João del-Rei para crianças autistas, realizado por meio da prática entre vários, método que agrega todas as intervenções realizadas por todos que trabalham com as crianças autistas na instituição. Ressaltamos neste artigo a importância da fundamentação teórica de todo e qualquer trabalho clínico, uma vez que é a partir dela que poderemos orientar os tratamentos disponibilizados para a população em geral, principalmente em tempos em que a saúde pública tem sido precarizada. Concluímos reiterando a necessidade dessa especialidade de trabalho realizado pela psicanálise, em especial a clínica psicanalítica dos autismos, em tempos de massificação do tratamento, que pretende retirar a psicanálise do campo de práticas possíveis de atendimento em políticas públicas de saúde mental.(AU)


This article presents the theoretical foundations of the implementation of a psychoanalytic clinic for autistic children inside a Federal University. We will present what this clinic is based on, how it started, its operation, its praxis in the institution and how the treatment of the autistic child is performed at the Applied Psychology Service at a Federal University. The method involves a discussion of the "state of art" in this field with the aim of discussing the theoretical bases and the recent implementation (2019) of a psychoanalysis service by the Federal University of São João del-Rei for autistic children by means of the practice among several, as the method that aggregates all the interventions performed by all the people who work with autistic children at the institution. We emphasize in this article the importance of the theoretical basis of any clinical work since it guides the treatments available to the general population, especially in times when public health has been precarious. We conclude by reiterating the necessity of this specialty of work done by psychoanalysis, especially the psychoanalytic clinic of autism in times of mass treatment, which aims to remove psychoanalysis from the field of possible practices of care in public mental health policies.(AU)


Este artículo tiene el propósito de presentar los fundamentos teóricos de la implementación de una clínica de asistencia psicoanalítica para niños autistas en el interior de una Universidad Federal. Seguiremos con el objetivo de presentar como se fundamenta esa clínica, como se ha dado su inicio, su operación, su praxis en la institución y, de esa manera, como se da el tratamiento del niño autista en el Servicio de Psicología Aplicada en una Universidad Federal. El método implica una discusión acerca del «estado del arte¼ en este campo con el objetivo de discutir las bases teóricas y la implementación reciente (2019) de un servicio de psicoanálisis de la Universidad Federal de São João del-Rei para niños autistas a través de la «práctica entre varios¼, como «método que agrega todas las intervenciones realizadas por todas las personas¼ que trabajan en la institución para niños autistas. Subrayamos en este artículo la importancia de la fundamentación teórica de todo y cualquier trabajo clínico desde lo cual podremos orientar los tratamientos ofrecidos a la población general, principalmente en tiempos en que la salud pública ha sido precarizada. Concluimos reiterando esa especialidad de trabajo realizado por el psicoanálisis, en especial la clínica psicoanalítica de los autismos en tiempos de masificación del tratamiento, que pretende quitar el psicoanálisis del campo de prácticas posibles de asistencia en políticas públicas de salud mental.(AU)


Subject(s)
Humans , Male , Child, Preschool , Child , Psychoanalysis , Autistic Disorder , Universities , Ambulatory Care Facilities , Psychology , Specialization , Therapeutics , Mental Health , Clinical Laboratory Techniques , Health Policy
18.
Psicol. ciênc. prof ; 42: e233089, 2022.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1356594

ABSTRACT

Este estudo buscou compreender as práticas discursivas de psicólogas(os) sobre a atuação psicológica na abordagem às IST/HIV-Aids em serviços especializados em uma cidade da Bahia. Para tanto, foram realizadas nove entrevistas semiestruturadas com profissionais ligadas(os) a serviços da rede pública de saúde. A perspectiva teórico-metodológica da psicologia social construcionista inspirou o processo de produção e análise das informações. Os resultados apontaram para importantes rupturas e ressignificações dos repertórios linguísticos gestados no cotidiano das práticas em saúde (tempo vivido e tempo curto), em atenção às necessidades dos contextos de atuação, ainda que elementos da formação clássica da psicologia também sejam utilizados para caracterizar a atuação nesses espaços. Nos serviços pesquisados, as(os) psicólogas(os) têm conseguido enxergar e reconhecer demandas de ordens biológica e social, que indicam aspectos objetivos da vivência dos(as) usuários(as) (menos afeitos ao ideário individualista), apontando para uma contextualização da clínica psicológica no campo da saúde pública, embora nem todas(os) admitam que essas demandas devam ser cuidadas também pela(o) profissional de psicologia. Do ponto de vista teórico, partimos de reflexões sobre as noções de clínica ampliada e de atuação psicológica coletiva até alcançarmos a noção de clínica psicológica ampliada, situada em relação às especificidades da atuação psicológica no campo do HIV-Aids. Nessa direção, a clínica psicológica ampliada apresenta-se em potencial construção, situando-se entre aproximações e recuos do que seria uma prática desenvolvida de modo contextualizado e comprometido com os processos subjetivos de pessoas vivendo com HIV-Aids ou tentando se proteger em situações concretas de vulnerabilidade, que geram sofrimento psicossocial.(AU)


This study aimed to understand the discursive practice of psychologists regarding the psychological practice in the approach to STI/HIV-AIDS in specialized services in a city of Bahia. To do so, we conducted nine semi-structured interviews with professionals related to health public services. The theoretical-methodological perspective of social constructionist psychology inspired the process of information production and analysis. The results pointed towards important ruptures and resignifications of the linguistic repertoires created in the everyday health practices (lived time and short time), attentive to the needs of the contexts of practice, although elements of traditional psychology training are also used to characterize the work in these contexts. In the surveyed services, the psychologists have been noticing and recognizing biological and social demands, which indicate objective aspects of the users' experience (less adept to individualistic values). This fact points towards a contextualization in the psychological work in the public health field, although not all interviewed psychologists admit that this type of demand should also be addressed by psychology professionals. From a theoretical point of view, we started from reflections on the notions of amplified clinic and the collective psychological practice resulting in the concept of amplified psychological clinic that relates to specificities of the psychological work in the field of HIV-AIDS. In this respect, the amplified psychological clinic is in potential construction, approaching and retreating from what would be a developed practice contextualized and committed to the subjective processes of people living with HIV-AIDS or trying to protect themselves in concrete vulnerable situations, which produces psychosocial suffering.(AU)


Este estudio pretende comprender las prácticas discursivas de psicólogas/os sobre la acción psicológica para abordar las infecciones de transmisión sexual y el sida (ITS/VIH-sida) en servicios asistenciales especializados en una ciudad de Bahía (Brasil). Con este fin, se realizaron nueve entrevistas semiestructuradas con profesionales vinculados a los servicios de salud pública. La perspectiva teórico-metodológica de la psicología social construccionista inspiró el proceso de producción y análisis de datos. Los resultados apuntaron a importantes rupturas y resignificaciones de los repertorios lingüísticos producidos en la práctica diaria de la salud (tiempo vivido y tiempo corto), atentos a las necesidades de los contextos de acción, aunque también se utilizan elementos de la formación clásica de la psicología para caracterizar la práctica en esos espacios. En los servicios investigados, las/los psicólogas/os han podido ver y reconocer las demandas y sus dimensiones biológicas y sociales, que indican aspectos objetivos de la experiencia de los/as usuarios/as (poco afectados por los ideales individualistas), apuntando a una contextualización de la clínica psicológica en el contexto de la salud pública, aunque no todos admiten que estas demandas también deban ser atendidas por el profesional de la psicología. Del punto de vista teórico, partimos de reflexiones sobre las nociones de clínica ampliada y acción psicológica colectiva hacia llegar a la noción de clínica psicológica ampliada, situada en la relación con las especificidades de la acción psicológica en el campo del VIH/sida. En ese sentido, la clínica psicológica ampliada es una potencial construcción, que tiene lugar entre aproximaciones y retrocesos de lo que sería una práctica desarrollada de manera contextualizada y comprometida con los procesos subjetivos de las personas que viven con VIH/sida o que intentan protegerse en situaciones concretas de vulnerabilidad, que generan sufrimiento psicosocial.(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Psychology, Social , Acting Out , Sexually Transmitted Diseases , HIV , Address , Ambulatory Care Facilities , Practice, Psychological , Psychiatry , Psychology , Unified Health System , Health Knowledge, Attitudes, Practice , Public Health , Acquired Immunodeficiency Syndrome , Condoms
19.
Rev. bras. ginecol. obstet ; 43(11): 853-861, Nov. 2021. tab, graf
Article in English | LILACS | ID: biblio-1357073

ABSTRACT

Abstract Objective To evaluate the knowledge, attitudes, and behaviors regarding complementary and alternative medicine methods of patients who were admitted to gynecology outpatient clinics. Methods In the present survey, a questionnaire on complementary and alternative medicine practices was applied on 1,000 women (ages between 18 and 83 years old) who were admitted to the gynecology outpatient clinic of a tertiarymaternity hospital. Demographic features and knowledge, attitudes, and behaviors about these methods were inquired in face-to-face interviews. Results While 80.7% of the total participants thought that complementary and alternative medicine was beneficial, only 37.5% of them had used these methods previously. The rate of prior knowledge on this subject was of 59.7% and the source of information was physicians for 8.5% of the patients. However, 72.4% of all participants wanted to obtain information on these methods and 93.7% wanted to be informed by physicians. In the decision tree model, having knowledge about complementary and alternative medicine was the most effective factor determining its use (p<0.001). Phytotherapy was found to be the most used method, with 91.4%. The most preferred plant was onion (18.9%), and the most common reasons for herbal use were stress (15.4%) and fatigue (15.2%). Conclusion More than one-third of the patients who applied to the gynecology outpatient clinics used one of the complementary and alternativemedicine methods at least once. As gynecologists and obstetricians, we need to be more knowledgeable about these methods to provide correct guidance to our patients for accessing accurate and effective information.


Resumo Objetivo Avaliar o conhecimento, as atitudes e os comportamentos em relação aos métodos de medicina complementar e alternativa de pacientes internadas em ambulatórios de ginecologia. Métodos Na presente pesquisa, um questionário sobre práticas de medicina complementar e alternativa foi aplicado a 1.000 mulheres (idades entre 18 e 83 anos) que foram admitidas nos ambulatórios de ginecologia de uma maternidade terciária. Características demográficas e conhecimento, atitudes e comportamentos sobre esses métodos foram investigados em entrevistas pessoais. Resultados Enquanto 80,7% do total de participantes achavam que a medicina complementar e alternativa era benéfica, apenas 37,5% deles haviam usado esses métodos anteriormente. A taxa de conhecimento prévio sobre o assunto foi de 59,7% e a fonte de informação foi médica para 8,5% dos pacientes. No entanto, 72,4% de todos os participantes queriam obter informações sobre esses métodos e 93,7% queriam ser informados por médicos. No modelo de árvore de decisão, ter conhecimento sobre medicina complementar e alternativa foi o fator mais eficaz para determinar seu uso (p<0,001). A fitoterapia foi o método mais utilizado, com 91,4%. A planta preferida foi a cebola (18,9%), e osmotivos mais comuns para o uso de ervas foram estresse (15,4%) e fadiga (15,2%). Conclusão Mais de um terço das pacientes que se inscreveram no ambulatório de ginecologia utilizaram um dos métodos de medicina complementar e alternativa pelo menos uma vez. Como ginecologistas e obstetras, precisamos ter mais conhecimento sobre estes métodos a fimde fornecer orientações corretas aos nossos pacientes para o acesso a informações precisas e eficazes.


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Complementary Therapies , Gynecology , Attitude , Health Knowledge, Attitudes, Practice , Surveys and Questionnaires , Ambulatory Care Facilities , Phytotherapy , Middle Aged
20.
Rev. baiana saúde pública ; 45(2, n.esp): 201-216, 10 out. 20211.
Article in Portuguese | LILACS | ID: biblio-1342845

ABSTRACT

Este trabalho buscou relatar a experiência da rede de humanização atuante no Sistema Único de Saúde da Bahia (SUS-BA) durante o enfrentamento da pandemia de Covid-19. Essa rede realizou diversas estratégias para colocar em prática os dispositivos e as diretrizes das Políticas Nacional e Estadual de Humanização da Atenção e da Gestão do SUS. O objetivo é descrever o processo de implementação da humanização nas unidades de saúde no estado da Bahia, durante a pandemia da Covid-19. A partir de análise documental, foi desenvolvido um estudo descritivo de metodologia qualitativa, que utilizou as técnicas de observação participante e coleta de dados secundários, registrados em um formulário desenvolvido na plataforma virtual Microsoft Form. O formulário foi respondido por trabalhadoras(es) e gestoras(es) das unidades da rede assistencial, gestão direta e indireta da Secretaria de Saúde do Estado da Bahia (Sesab) e outras unidades importantes para a rede de humanização do SUS-BA. A partir das experiências, foi possível perceber a forte atuação da rede no enfrentamento à pandemia, que fortaleceu as ações de cuidado aos trabalhadores e usuários nas unidades da Sesab. Considera-se necessária a continuidade dessas práticas e a concretização da rede para além do momento de pandemia, sendo fundamental a inerência de tais práticas humanizadas para a potencialização do SUS.


This study sought to report the experience of the humanization network active in the Unified Health System of the state of Bahia (SUS-BA) during the confrontation of the pandemic of COVID-19. This network conducted several strategies to put into practice the provisions and guidelines of the National and State Policies for the Humanization of SUS Care and Management (PNH and PEH). The objective is to describe the process of implementing Humanization in health units in the state of Bahia during the COVID-19 pandemic. Based on documentary analysis, a descriptive study of qualitative methodology was developed, using participant observation techniques and collection of secondary data recorded on a form developed on the Microsoft form virtual platform, which was answered by workers and managers of the units of the the assistance network, direct and indirect management of SESAB and other important units for the SUS-BA humanization network. From the experiences, a strong performance of the network in the fight against the pandemic was observed, which strengthened the care actions for workers and users in the Health Department units. It is considered necessary to continue these practices and establish the network beyond the time of the pandemic, being essential the inherence of these humanized practices for the enhancement of SUS.


Este trabajo pretende reportar la experiencia de la red de humanización activa en el Sistema Único de Salud de Bahía (SUS-BA) durante el enfrentamiento a la pandemia del covid-19. Esta red llevó a cabo diversas estrategias para poner en práctica las disposiciones y lineamientos de las Políticas Nacionales y Estadual para la Humanización de la Atención y Gestión del SUS. El objetivo del trabajo es describir el proceso de implementación de la humanización en las unidades de salud del estado de Bahía durante la pandemia del covid-19. Con base en el análisis documental, se desarrolló un estudio descriptivo de metodología cualitativa utilizando las técnicas de observación participante y recolección de datos secundarios registrados en un formulario desarrollado en la plataforma virtual de Microsoft form, el cual fue respondido por trabajadores y gerentes de las unidades de la red asistencial, gestión directa e indirecta de la Sesab y otras unidades importantes de la red de humanización del SUS-BA. A partir de las experiencias se pudo percibir el fuerte desempeño de la red en el combate a la pandemia, lo que fortaleció las acciones de atención a los trabajadores y usuarios en las unidades de la Sesab. Se considera necesario continuar con estas prácticas y establecer la red más allá del momento de la pandemia, siendo fundamental la inherencia de estas prácticas humanizadas para el fortalecimiento del SUS.


Subject(s)
Coronavirus , Humanization of Assistance , User Embracement , Pandemics , Ambulatory Care Facilities , COVID-19
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