Navegando por Palavras-chave "Assistência hospitalar"
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- ItemAcesso aberto (Open Access)Avaliação das medidas de profilaxia da transmissão vertical do vírus HIV e da sífilis(Universidade Federal de São Paulo (UNIFESP), 2018-12-20) Holzmann, Ana Paula Ferreira [UNIFESP]; Barbosa, Dulce Aparecida [UNIFESP]; Silva, Carla Silvana de Oliveira e; http://lattes.cnpq.br/5393988286775602; http://lattes.cnpq.br/1924137485244907; http://lattes.cnpq.br/2393906738746122; Universidade Federal de São Paulo (UNIFESP)Objective: To describe and evaluate actions aimed at preventing vertical transmission of HIV and morbidity and mortality of congenital syphilis. Methods: Retrospective cohort study performed at two maternity hospitals in the city of Montes Claros, MG. The population was composed by women diagnosed with syphilis and HIV infection during pregnancy, childbirth or puerperium, who received care at the maternity wards from 2014 to 2017 and their respective newborns. The variables of interest were mainly collected from clinical records and typed in a database created with Epidata version 3.0 program and later transferred to SPSS version 19.0, where a descriptive analysis of the data was performed. Results: A total of 250 parturients/ postpartum women diagnosed with syphilis and 46 with diagnosis of HIV were enrolled in the study, in addition to 233 live births exposed to syphilis and 46 exposed to HIV infection. The coefficient of HIV and syphilis detection in pregnant women during the period was 1.9 cases / 1000 and 10.4 / 1000 live births, respectively. The incidence rate of congenital syphilis was 11.9 / 1000 live births. The maternity hospitals care evaluation revealed that the management of syphilis was inadequate in 54% of the cases in parturients and 74,2% in newborns. The main reasons for inadequate management of puerperal women were the lack of referral for ambulatorial treatment continuity (65,2%), while for newborns, the reasons were lack of disease notification. Significant association with maternal management was found in the variables: case of syphilis reported during pregnancy (p = 0.036), parturient / puerperal VDRL titration (p <0.001), number of previous abortions (p = 0.006), treatment of partner prescribed at maternity (p <0.001) and duration of labor (p <0.001). Concerning the management of the newborn, the following independent variables were associated with the outcome: long bone RX realization (p = 0.001), Congenital Syphilis definition criterion (p = 0.006), case report (p <0.001), and length of birth (p <0.001). In regard to prevention of vertical HIV transmission, management was considered inadequate in 30 parturients / puerperae cases (65.2%) and in 14 newborns (30.4%). The main reasons for management inadequacy in women were nonachievement of lactation inhibition (53.3%) and the lack of counseling and consent for the HIV test (56,6%). On the other hand, neonate management failure was mainly due to late use of zidovudine oral solution (50.0%) and nonprescription of nevirapine, when there was such indication (28.6%). Conclusion: These results indicate that hospital health care professionals do not follow all Health Ministry recommendations. They also demonstrate the need for investments aimed at training and raising awareness among health professionals involved in care.
- ItemAcesso aberto (Open Access)Compreendendo a inserção do trabalho voluntário no ambiente hospitalar : contribuições para a humanização do cuidado(Universidade Federal de São Paulo (UNIFESP), 2015) Batista, Maria Beatriz de Souza [UNIFESP]; Carmagnani, Maria Isabel Sampaio [UNIFESP]; Ribeiro, Circéa Amália [UNIFESP]; http://lattes.cnpq.br/2300731487624854; http://lattes.cnpq.br/9000331959925216; http://lattes.cnpq.br/0408255954683641; Universidade Federal de São Paulo (UNIFESP)Este estudo teve como tema o trabalho voluntário em um hospital de ensino e sua relação com a humanização hospitalar. Objetivo: compreender a inserção do trabalho voluntário e suas interações no ambiente hospitalar. Metodologia: estudo descritivo com abordagem qualitativa, cujo referencial teórico foi o Interacionismo Simbólico, a estratégia para o tratamento dos dados foi a Análise Qualitativa de Conteúdo. Foi realizada entrevista semiestruturada com cinco coordenadores de projetos de humanização do Hospital São Paulo Hospital Universitário da Universidade Federal de São Paulo, e a observação participante das atividades dos respectivos voluntários onde se buscou conhecer a experiência do voluntário, o significado e sua percepção sobre as interações com os pacientes e profissionais do hospital, suas dificuldades e percepções sobre seu trabalho no contexto da Política Nacional de Humanização. Resultados: os voluntários sentem-se motivados pela oportunidade de ajudar outras pessoas, que buscam recursos e capacitação para desenvolver o trabalho voluntário, de forma contínua e com qualidade. A interação com os profissionais evolui com o passar do tempo; acham que a relação dos gestores com os voluntários influencia positivamente os profissionais. Eles se percebem contribuindo com a humanização e transformando o ambiente hospitalar por meio das diversas formas de interação com os pacientes e profissionais, utilizando Terapia Assistida por Animais, meditação e várias modalidades de arte terapia. Os entrevistados percebem o trabalho voluntário, como uma ferramenta de transformação social e sentem-se gratificados por estarem realizando um trabalho importante e prazeroso, em que podem interagir com o paciente e o profissional ao mesmo tempo. Recebem carinho e gratidão dos pacientes e profissionais do hospital e percebem um benefício pessoal inestimável que se reflete em sua humanização. Considerações Finais: este estudo trouxe algumas considerações sobre o processo de humanização no Hospital São Paulo ? Hospital Universitário/Universidade Federal de São Paulo e a importância do trabalho voluntário nesse processo. A análise dos depoimentos e da observação participante mostrou que o voluntariado é uma experiência mágica, traz benefícios a todos os envolvidos e contribui para a humanização do hospital.
- ItemAcesso aberto (Open Access)O hospital-escola de São Carlos: análise do funcionamento por meio da satisfação dos usuários(ABRASCO - Associação Brasileira de Saúde Coletiva, 2011-01-01) Ricci, Natalia Aquaroni [UNIFESP]; Wanderley, Fábio da Silva [UNIFESP]; Oliveira, Marilda Siriani de; Rebelatto, José Rubens [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Secretaria Municipal da Saúde de São CarlosThis research assessed the satisfaction of the users of São Carlos Hospital School in its first six months of functioning. A sample of 137 users was grouped according to the service used: hospital admittance, home care, emergency medical assistance, spontaneous emergency and shelter. Inferential statistics were realized by Chi-Square and Fischer Exact tests. The majority of users were women and aged 18 to 45 years-old. The users were very satisfied (46.2%) with attendance agility and with the team (52.6%). A number of 59.2% of the users were very satisfied with the hospital and 68.8% considered the service better than expected. Less clarity concerning health was reported for shelter regarding hospital admittance and home care (p<0.05). Users under hospital admittance presented greater satisfaction and better expectation compared to acceptance and emergency medical assistance (p<0.05). User profile characteristics as skin color and health plan presented statistical differences regarding general satisfaction. The study showed that the adoption of a humanized model of assistance in healthcare as the proposal of this Hospital resulted in user satisfaction.
- ItemEmbargoMedical Outcomes Study 36-Item Short Form Health Survey e Center for Epidemiological Studies-Depression em idosos com úlcera por pressão(Universidade Federal de São Paulo (UNIFESP), 2010-08-25) Souza, Diba Maria Sebba Tosta de [UNIFESP]; Santos, Ivan Dunshee de Abranches Oliveira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Little is known about how pressure ulcers (PU) may affect the quality of life of the elderly living in different types of housing. Objective: To evaluate health-related quality of life (HRQoL) and depression in elderly patients with PU living in a hospital, long-term care facility (LTCF) or at home. Methods: A cross-sectional study was conducted with 110 elderly patients aged 60 and older, without cognitive impairment, with (n = 36) and without PU (n = 74). The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) was used to assess HRQoL and the Center for Epidemiological Studies Depression Scale (CES-D) was used to assess depression. Results: Forty-eihgt ulcers were found in 36 patients. Patients with PU had significantly lower (worse) scores than patients without PU on physical functioning (hospital p<0,001, LTCF p<0,001, at home p<0,001) and role physical (hospital p=0,013, LTCF p=0,034, at home domicílio p=0,024) in the three types of housing. In the LTCF, patients with PU had significantly lower scores on the social functioning (p = 0.045) and role emotional (p = 0.036) subscales than patients without PU. The hospitalized elderly with PU had significantly higher scores on general health (p = 0.046) and vitality (p = 0.009) than those without PU. Among the elderly without PU, hospitalized patients had significantly lower scores on the bodily pain subscale than the other participants (p = 0.007). The patients with PU who were hospitalized or living in a LTCF reported significantly lower CES-D scores than those without PU (p = 0.007 and p = 0.003, respectively). Conclusion: The elderly with PU living in a LTCF reported lower scores on the physical functioning, role physical, social functioning, and role emotional subscales, reflecting a lower HRQoL. The elderly with PU who were hospitalized or living in a LTCF reported higher levels of depression.
- ItemAcesso aberto (Open Access)Percepções de profissionais de enfermagem sobre intervenções de Terapia Ocupacional em Saúde Mental em hospital universitário(Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2011-01-01) Tedesco, Solange [UNIFESP]; Citero, Vanessa de Albuquerque [UNIFESP]; Nogueira-Martins, Maria Cezira Fantini; Nogueira-Martins, Luiz Antonio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To identify the perceptions of professional nurses on group interventions by occupational therapists in mental health with patients admitted to a university hospital. METHODS: A qualitative study of the type described. The notes of the coordinators of occupational therapy groups were analyzed in relation to the interviews held with a professional and technical nursing staff that participated in the occupational therapy intervention group for a period of two years. The results were analyzed using the collective subject discourse (DSC) method. RESULTS: We identified four central ideas of the DSC: occupational therapy as favoring integrated care, valuing the subject and his experience, the occupational therapy process to help and care for their own team, the occupational therapy group as a space of resonance and facilitation of the management with the patient because of the perception of relational aspects. CONCLUSION: The strategies were perceived, either as promoters of the reorganization of the life situation experienced by the patient on admission, or as learning opportunities and support for nursing staff.
- ItemAcesso aberto (Open Access)Trabalho em equipe e integralidade num cenário hospitalar(Universidade Federal de São Paulo (UNIFESP), 2015-04-30) Sanches, Sarita Barbosa [UNIFESP]; Capozzolo, Angela Aparecida [UNIFESP]; http://lattes.cnpq.br/7660336218859464; http://lattes.cnpq.br/2055985295714686; Universidade Federal de São Paulo (UNIFESP)The present research aims to understand and analyze how a team of a hospital unit works on the prospect of a full attendance. The option was for an exploratory and qualitative case study, whose production data was collected by means of observations recorded in field journal and meetings with professionals with semi structured interviews and conversation, as well as informal conversations with patients and documentary analysis. In the meetings, were discussed issues related to the organization of work, the mode of operation of the team, the problems involved for the production of integral care and continuity of care. Our study showed that the team working in this hospital scenario presents many difficulties and is still a challenge. The organization of the work process, vertical and fragmented, does not contribute to joint performances of professionals. The professional area has an organization of its own and, in general, performs their work in a isolated manner from other areas. There are very few spaces for exchange of information, to discussions of cases and planning joint interventions. The care of patients is more focused on performing procedures than listen and dialogue with their living conditions. The issues that emerged from the investigation indicate the need for changes in the organization of the work process in the hospital, with the deployment of strategies that contribute to better coordination between the different professionals who work there, among them we highlight the deployment of team meetings and moments of permanent education. Also indicate the importance of the participation of management in these transformations for producing integral care.