Navegando por Palavras-chave "Home nursing"
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- ItemAcesso aberto (Open Access)Análise do gerenciamento de pacientes crônicos atendidos por operadora de saúde suplementar(Universidade Federal de São Paulo (UNIFESP), 2017-06-29) Sousa, Gilmar Oliveira de [UNIFESP]; Barbosa, Dulce Aparecida [UNIFESP]; Araújo, Maria Conceição Filgueiras Ferraz; http://lattes.cnpq.br/3787335681398461; http://lattes.cnpq.br/1924137485244907; http://lattes.cnpq.br/5041200088050207; Universidade Federal de São Paulo (UNIFESP)This study was carried out in a health care program of a supplementary health care provider in the southern region of Bahia, comprising a multidisciplinary team. It is a retrospective, documentary research with a quantitative approach. Data were collected in 2016 for the years 2012-2015. With the general objective of analyzing the home care program managed by a health care provider in Itabuna-Bahia and as specific objectives: to characterize the sociodemographic and clinical profile of the beneficiaries served by the program; To know the costs / year by period of the program, aiming at a better operationalization of the resources invested in the health management of the assisted population. Considering to obtain the results with effectiveness and efficiency, obtaining strategies of interventions, with actuation and valorization of the autonomy of Nursing in this process. In this study, ethical aspects were observed, preceded by the approval of the Unifesp Ethics Committee resolution number 1,592,711 / 2016 and CEP / UESC protocol number 822.937 / 2015. Results: In this period, 300 patients with chronic diseases, including diabetes, Alzheimer's disease, hypertension, chronic obstructive pulmonary disease (COPD) and / or patients underwent complex procedures (neurological and traumatologic surgeries, among others). The majority of beneficiaries attended by the program were female (59.67%); With 70 years or more (59%). As for incomplete first grade schooling was (33%); High school (22%); Higher education level (4.33%); And the family wage range between 2 to 3 minimum wages (30%), 3 to 5 minimum wages (18.33%) and retirees (49%). In relation to the costs of the health care provider with its users before and after insertion in the health care program (PAS) in the health management modality, a significant reduction of these costs is noticed. Before the PAS annual value of R $ 747,036.65 and after the PAS after the first year was R $ 281,276.42, a percentage reduction of the cost of 62.35%. Conclusion: The importance and efficacy of a chronic patient management program was observed not only for the financial health of a supplementary health care provider, but also for the health management of a population that still lacks technical and educational resources. Can make the difference in their walk in search of a quality of life and a longevity with security and using only basic resources, but primordial for their health. This study, although limited in scope, shows that a health management program in the region, in the current context of human aging, is of fundamental importance, especially for the bedridden patient. Without this, the increase in the cost of any health care provider is notorious, since the patient is adrift in the knowledge of health care, reducing the quality of life deficit, further increasing the cost of worsening health.
- ItemAcesso aberto (Open Access)Características sócio-demográficas do atendimento ao idoso após alta hospitalar na Estratégia da Saúde de Família(Universidade de São Paulo, Escola de Enfermagem, 2010-12-01) Marin, Maria José Sanches [UNIFESP]; Bazaglia, Fernanda Crizol; Massarico, Aline Ribeiro; Silva, Camila Batista Andrade; Campos, Rita Tiagor; Santos, Simone de Carvalho; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina de MaríliaThe objective of this study was o verify the sociodemographic profile of the elderly and the health care service they receive from the Family Health Strategy (FHS) after their discharge. This is a descriptive study, and data collection was performed with 67 aged individuals who were discharged in October, November and December, 2007, and lived in the area covered by the FHS of Marília (São Paulo state). Simple descriptive analysis was used for the presentation of data. The majority of the elderly are female, and their hospitalization occurred as a referral of the Emergency Room due to complication. More than two thirds report they were visited by FHS team professionals, mainly the Community Health Agent (CHA), but they suggested the team should follow up closer. In conclusion, it is necessary to develop a new health care model for the elderly after hospital discharge.
- 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.