Navegando por Palavras-chave "Home care services"
Agora exibindo 1 - 3 de 3
Resultados por página
Opções de Ordenação
- ItemAcesso aberto (Open Access)Cartografia do Processo de Cuidado num Serviço de Atenção Domiciliar(Universidade Federal de São Paulo (UNIFESP), 2017-08-03) Pozzoli, Sandra Maria Luciano [UNIFESP]; Cecilio, Luiz Carlos de Oliveira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: The practice of caring for sick people in their homes refers to immemorial times. Since the last century, due to the aging of the population, there has been a growing institutionalization of such practice in home care services, which had assumed very different models and work processes in different countries. The main objective of this research was to know the process of care in the Home Care Service (SAD) of a medium-sized municipality in the State of São Paulo as a component of the Emergency and Urgency Network (RUE). Method: It is a case in which I take on a cartographic ethos in every way of the research, participating in the routine of SAD and recording in a field diary the daily scenes. I also have recorded interviews with caregivers and a hospital nurse, and I have conducted a focus group with Primary Care nurses (AB). As a data analysis strategy, the first approximation of the empirical material was the definition of Cutting Plans, that is, intentional cuts made from elements or components of home care policy. In the second analytical approach, there are the Visibility Plans, that are scenes of the daily life that reveal the complex relationships between the prescribed work (that the official policy defines) and the actual work (that is how care is performed by the teams in their concrete conditions of work). Results and Discussion: Through the cutting plans and visibility plans, it was possible to identify problems related to management, in particular those that establish limits for the team work; limitations in the use of the information system; the positive aspects and also the tensions present in the multiprofessional work; the conflicts present in the daily work; deficiencies in the training of workers; the isolation of SAD in relation to other health equipment; the limitations of AB to effectively support SAD; the overload of the caregiver and the inescapable need of strategies to support their work and elements of the patient universe, marked by the loss of autonomy and often by the lack of perspective of future building, showing human vulnerability in different perspectives and the sense that each family gives to the suffering experienced by the dependent family member of long-term care. Conclusions: The study evidenced that home care is a model of innovative care, if assumed by the health system with sufficient human resources, materials, equipment, transportation and agile and flexible information system to include real information. Caregivers suggested that care must to be integrated among professionals and with other points of the Health Care Network (RAS). There are difficulties for AB to assume this model of care, and the experience indicated the need of social support services to contribute to the quality of life of the caregiver.
- ItemAcesso aberto (Open Access)Concordância de observações sobre a capacidade funcional de idosos em assistência domiciliar(Faculdade de Saúde Pública da Universidade de São Paulo, 2005-08-01) Ricci, Natalia Aquaroni [UNIFESP]; Kubota, Maristela Tiemi [UNIFESP]; Cordeiro, Renata Cereda [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To assess the agreement between measures of caregiver's perception and health provider's direct observation of performance in daily living activities among home care elderly patients. METHODS: Performance observations were carried out among 40 elderly patients and their respective caregivers were interviewed. During home visits, data on caregiver's perception were collected by an independent observer using the Functional Independence Measure (FIM) instrument. Health providers evaluated elderly patients on their functional capacity in six dimensions: self-care, sphincter control, mobility, walking, communication and social cognitive skills. RESULTS: Intraclass correlation coefficient (ICC) showed an excellent agreement in all dimensions and the highest total FIM score was 0.95. Only the dimensions self-care and mobility showed a bias error between measures (signal test: p<0.001). Bias errors were not found when Bland-Altman graphic was applied. CONCLUSIONS: The agreement between health provider's and caregiver's measures demonstrated a good interaction between program team and caregivers, which is of great importance on evaluating and treating elderly patients. The results also suggest that when a valid and reliable instrument such as FIM is used, there is a high reproducibility of measures, even for different types of evaluations.
- ItemSomente MetadadadosNutritional and microbiological quality of commercial and homemade blenderized whole food enteral diets for home-based enteral nutritional therapy in adults(Churchill Livingstone, 2018) Vieira, Maricy Machado Cavalca [UNIFESP]; Santos, Valdirene Francisca Neves dos [UNIFESP]; Bottoni, Andrea [UNIFESP]; Morais, Tania Beninga de [UNIFESP]Background & aims Serious nutritional and contamination risks may be involved in the preparation of blenderized tube-feeding diets and in the handling of commercial diets. Their nutritional and microbiological quality in home settings is unknown. The objective of this study was to assess the nutritional and microbiological quality of commercial enteral and homemade blenderized whole foods diets intended to adult patients in home nutritional therapy. Methods In a cross sectional study, 66 samples of commercial (CD) and noncommercial (NCD) enteral diets were collected at the homes of patients in home enteral nutritional therapy, 33 of each type. Commercial diets were either powder (PCD; n = 13) or liquid (LCD; n = 20). The samples were analyzed in laboratory to assess their nutritional and microbiological quality. Anthropometric data of mid upper arm circumference (MUAC) and triceps skinfold (TST) thickness were obtained from the patients' medical records. Results NCD presented significantly lower values for protein, fat, fiber, carbohydrate and energy while water content was significantly higher. PCD and LCD did not show any statistically significant differences between them. In the NCD, the values measured for macronutrients and energy corresponded to less than 50% of the prescribed values (except for fat). In CD, protein value was about 20% more than the prescribed value; fat and energy values corresponded to approximately 100% of the prescription, while carbohydrate corresponded to 92%. Regardless the type of the diet, prevalence of undernutrition was high in both groups though patients of the NCD presented a higher percentage. Samples of NCD complied significantly less with the microbiological standards; only 6.0% complied with the standard for coliform bacteria. Escherichia coli was detected in 10, 2, and 2 samples of NCD, PCD and LCD, respectively. Conclusions Homemade blenderized enteral diets showed low values of energy and macronutrients, delivered less than 50% of the prescribed values and had high levels of bacterial contamination.