Navegando por Palavras-chave "Equipe De Assistência Ao Paciente"

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    Avaliação da percepção da atitude interprofissional de estudantes de graduação em fisioterapia após exposição à educação e prática interprofissional
    (Universidade Federal de São Paulo (UNIFESP), 2021) Estevam, Jhony de Almeida [UNIFESP]; Silva, Maria Stella Peccin da [UNIFESP]; http://lattes.cnpq.br/0428199048138850; Universidade Federal de São Paulo
    Introduction: Due to the complexity of the entire health/disease process, the Organization World Health Organization (WHO) advocates the interprofessional work model as a strategy to ensure comprehensive and resolute assistance to users of health services. Objectives: to evaluate the perception of the interprofessional attitude of students in the last year of degree in physiotherapy, after exposure to interprofessional practice. Methods: It was A longitudinal, prospective and analytical study was carried out with students in the last year of degree in physical therapy at a public university. The participants underwent evaluation through two questionnaires in electronic format, namely: the Readiness for Interprofessional Learning Scale – RIPLS and the Interdisciplinary Education Perception Scale – IEPS, at the beginning and after completion of mandatory curricular internships. The students were inserted in a health service where they were encouraged to practice collaborative interprofessional team, through experiments with an interprofessional team that composes the multiprofessional residency program in the health area. The data collected were analyzed using the Wilcoxon statistical test, considered significant when p<0.05. RESULTS: All invited students agreed to participate in the study, totaling 21 individuals, of both sexes, with a mean age of 21.3 years. CONCLUSION: after exposure to collaborative practice and education interprofessional, there was an increase in the scores of the evaluative instruments, demonstrating greater perception of the importance of the interprofessional attitude in the strategies of health care.
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    Não adesão ao tratamento no transplante de fígado
    (Universidade Federal de São Paulo (UNIFESP), 2019-04-25) Oliveira, Priscilla Caroliny De [UNIFESP]; Roza, Bartira De Aguiar [UNIFESP]; Schirmer, Janine [UNIFESP]; http://lattes.cnpq.br/3721636964139813; http://lattes.cnpq.br/9255434835123749; http://lattes.cnpq.br/3558901850783019; Universidade Federal de São Paulo (UNIFESP)
    Objectives: To evaluate the interventions of the multiprofessional team that provide improved adherence to treatment after liver transplantation; to assess levels of non-adherence to immunosuppressive therapy in a sample of liver transplant recipients using the Basel Assessment of Adherence with immunosuppressive medication Scalee to correlate sociodemographic characteristics and clinical factors to non-adherence to medication; to develop a model of evaluation of nonadherence to the treatment in the context of liver transplantation capable of covering several dimensions of the phenomenon, correlating the levels of non adherence to the different methods of measurement applied in liver transplant patients; to reflect on the theoretical and practical aspects related to non-adherence to treatment in the context of liver transplantation and to correlate with the concepts of normality established by Michael Foucault and The Power as Knowing Participation in Change Theory. Methods: This study adopted a mixed method design, in which elements of qualitative and quantitative research were combined. The work was divided into four subprojects: 1- adherence to treatment in liver transplantation: an integrative review; 2- evaluation of adherence to treatment in patients submitted to liver transplantation; 3 - New perspectives of analysis in nonadherence research in liver transplantation by means of data association: pilot study. 4 - subjectivity, adherence in transplantation and biopolitics - possible reflections of power as normative practice in health. The study was and approved by the Ethics and Research Committee under the opinion 623.082 and Certificate of Presentation for Ethical Appreciation nº1643201470005505. Results: The integrative review, which aimed to evaluate the interventions of the multiprofessional team that provides the improvement of adherence to treatment after liver transplantation, initially selected 84 publications. After applying the exclusion criteria, 10 studies were selected. Four significant categories were found: educational interventions; adoption of an individual therapeutic plan; change in immunosuppressive regimen; emotional support, psychological support and strengthening of the support network. The level of nonadherence in liver transplantation was 49% and was directly related to the use of mycophenolic acid (p = 0.007) and administration of multiple doses of immunosuppressants daily (p = 0.004). No statistically significant correlations were found between non-adherence to immunosuppressive therapy and sociodemographic characteristics and other clinical variables analyzed. It was proposed a data triangulation model that evaluated the non adherence to liver transplantation under different aspects: a) direct evaluation of non adherence - through the application of a self-report instrument, associated to the perspective of the patient himself and the specialist responsible for follow-up; b) clinical evaluation, considering the serum immunosuppressive level in use, alterations of the aminotransferases, histological analysis of the graft and previous treatment for rejection; c) behavioral evaluation, which analyzed the existence of reports of therapeutic failure and absences on outpatient return. These indicators were analyzed individually and together. The theoretical essay aimed to develop a systematic reflection on adherence to treatment in the context of transplantation, based on the historicity of its concept of adherence through the construction of parallels between the concepts of adherence and health. The problem of non-adherence questions the team about its role, which requires listening to the demands that come in to everyday praxis. In this perspective, the theory of power as knowledge and participation for change of Elizabeth Barrett is emphasized, for emphasizing the subjective aspect present in health care, emphasizing the role of a dialogue and supported action in the establishment of solidarity and socio- and fostering the social role of users of transplantation actions and services. Conclusion: In view of the gaps highlighted and the results pointed out through the integrative review, it is understood that it is necessary to intensify efforts for the development of research with designs that produce strong evidences regarding the interventions adopted by the multiprofessional team capable of improving the adherence. This study showed that nearly half of the patients stopped adhering to immunosuppressive therapy after liver transplantation. Since unfavorable outcomes in transplantation are closely related to adherence failures, it is important that nurses assess this behavior during outpatient follow-up of liver transplant recipients. The application of triangulation methods to qualitatively assess noncompliance in an adult liver transplant program included 10 indicators in the analysis and identified a non-adherence level of 14.3%. At the end of the reflective study, it was possible to conclude that the phenomenon of adherence is more complex than we have traditionally described, because it depends on the subjective process that involves many questions that are not yet addressed by nurses in general. The threshold between adhesion and nonadherence is unique, even if it is influenced by plans that transcend the strictly individual, such as social, economic, political, historical and cultural.
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    Tradução, adaptação transcultural e validação do Assessment of Interprofessional Team Collaboration Scale - AITCS II para o contexto brasileiro
    (Universidade Federal de São Paulo (UNIFESP), 2019-05-03) Bispo, Emanuella Pinheiro De Farias [UNIFESP]; Rossit, Rosana Aparecida Salvador [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The World Health Organization (WHO) recognizes that Interprofessional Education is an innovative strategy that provides collaborative practice. It occurs when two or more professions learn about others, with each other, and with them self. Collaboration includes sharing, partnership, interdependence, power and involves reflection and mutual action in search of answers to users' health needs. The present study aimed to perform the translation, cross - cultural adaptation and validation of the Assessment of Interprofessional Team Collaboration Scale - AITCS II (ORCHARD, 2015) for the Brazilian context. The AITCS II is a diagnostic tool developed to measure interprofessional collaboration. It consists of 23 assertions organized in three dimensions: Partnership, Cooperation and Coordination. Data collection was performed in two studies. Study 1 implemented the methodological course for translation, crosscultural adaptation and statistical validation of AITCS II-BR. The validation followed four phases: Evaluation of conceptual and item equivalence; Evaluation of semantic equivalence; Operating Equivalence and Equivalence of Measurement. The Equivalence of Measurement was obtained with the participation of 15 professionals of different professions in two applications with interval of 15 days. Study 2 proposed to validate the AITCS II-BR scale based on the analysis of the perception of health professionals in the Northeast of Brazil regarding the level of interprofessional collaboration. 245 professionals from different health formations in the Brazilian Northeast participated in this phase. An open space was add ed to the instrument for recording potentialities, fragilities and suggestions. The contacts of the professionals were obtained from the health secretariats and universities. The instrument was hosted on an online platform and e-mail ed to professionals. A database was organized and received statistical treatment: calculation of the linear correlation coefficient (r) and the reliability of the instrument for Study 1; and for Study 2, the means of responses were classified into comfort zone, alert zone and danger zone. The data of the open space were treated with content analysis, thematic modality, in two thematic axes: Importance, challenges and possibilities of Education and Interprofessional Work; Training in Health for Interprofessional practice. We identified 189 Context Units, 211 Registration Units, and emerging categories. The results of Study 1 showed that the AITCS II-BR has content and appearance validity to evaluate the performance and interprofessional collaboration, reaching coefficients above 0.8 in the consistency and concordance indices in the three dimensions, confirming the conceptual equivalence , of items and semantics, operational equivalence and measurement. In Study 2, we found assertions with averages in zones of alertness and danger. From the open space, categories have emerged that point to difficulties in relation to dialogue and mutual trust for interprofessional collaboration. It is concluded that the AITCS II-BR has conceptual equivalence, of items and semantics, as well as operational and measurement equivalence for the Brazilian reality. There are several potential applications for scale in research, continuing education, performance assessment, and teamwork assessment.