Conduta do paciente hipertenso frente ao tratamento clínico

The urbanization process established in Brazilian society since the middle of last century brought changes in the population habits and customs, which was responsible for the increased of chronic diseases incidence, such as arterial hypertension, for example. Although this is a common disease nowadays, it is still difficult to establish a significant control in subjects with this disease and its consequences. This is apparently due to lack of interest to the correct plan of care developed for the treatment of this disease. The nursing consultation identifies potential problematic situations and the patient needs, setting actions that are complementary to their benefit in order to promote health. The present work aims to observe how the nursing consultation is being used as strategy for patients with arterial hypertension, and to understand the difficulties faced during treatment of these patients. For this purpose, it was performed qualitative and quantitative studies with patients from Centro Saúde Escola (CSE), Unidade Auxiliar, Faculdade de Medicina de Botucatu, UNESP, located in Botucatu, employing as methodology the Discourse of the Collective Subject and descriptive statistical analysis of quantitative results. The vast majority of consultations were held by medical professionals and it was observed that the multidisciplinary work still needs to be recognized and valued by users. The lack of knowledge of some individuals in relation to the potential and importance of the nursing consultation occurs not only for the treatment of arterial hypertension, but for the treatment and monitoring of the individual as a whole. Therefore, it is still necessary to clarify the true essence and necessity of the nursing consultation, since so important tool should be used in its entirely. Moreover, the role of the multidisciplinary team should be more discussed

Comparação de dois métodos de profilaxia dental: avaliação da pressão arterial e do conforto do paciente. Ensaio clínico controlado e randomizado

GOALS: This research evaluated the change in arterial pressure before and after two procedures of dental prophylaxis: Jet system baking soda and conventional prophylaxis and patient's opinion regarding the comfort of each one. MATERIAL AND METHOD: Were selected 32 patients with age between 18 to 30 years old, who need prophylaxis to remove biofilm and were subjected to three different types of treatment: sodium bicarbonate jet (G1), prophylaxis conventional (G2) and placebo (G3) at intervals of one month between them. Patients were divided randomly. Arterial pressure was measured by wrist digital Omron HEM – 6111. The measurements were realized in four times: before the prophylaxis, immediately the end of procedure, 15 and 30 minutes after finished of treatment. Patient comfort was measured by a Visual Analog Scale (VAS) after the end of the treatment. The data were analyzed using the variance test. The results showed that there was statistically significant difference to the comfort of the procedures. RESULTS: There was a statistically significant difference to the comfort of the procedures, and G2 and G3 better than G1. Regarding the variation of arterial pressure there was no statistically significant difference between groups. CONCLUSIONS: The methods of prophylaxis no effect on arterial pressure, but conventional prophylaxis is more comfortable than others treatments

Estudo sobre a necessidade e preferência sobre orientações de enfermagem ao paciente oncológico adulto em quimioterapia

Most cancer types are treated by antineoplastic chemotherapy, which can be performed conjointly with other treatments, such as radiotherapy and surgery. Due to its action, chemotherapy provides the possibility of cure, but it also leads to a number of adverse effects, such as myelosuppression, cutaneous and gastrointestinal toxicity, etc. Patients undergoing chemotherapy must receive constant information concerning how to prevent or minimize these effects in order to achieve better quality of life and, consequently, a more successful treatment. Hence, this study aimed at investigating the need and preference for different forms of information by oncologic patients submitted to chemotherapy. It is a cross-sectional, descriptive and quantitative study conducted at the chemotherapy division of the Botucatu School of Medicine University Hospital/SP on a sample of 50 patients older than 18 years. After previous knowledge of the study and formalization of Free Consent, the individuals answered a questionnaire containing 12 questions related to the importance attributed to the information received, from which professional and when to receive it. Data were analyzed by Fisher’s exact test and showed that 62% of the patients were females, and the remaining 38% were males of whom 46% were older than 60 years, 26% were from 50 to 60 years old, 24% from 30 to 50, and only 4% were younger than 30 years old. The patients had lymphatic (23.4%) and solid (76.6%) tumors. All the respondents reported that receiving information about the disease and its treatment was extremely important. As regards information related to side effects, 98% of patients answered that receiving it was extremely important, and only 2% answered that it was little important. Correlations were made between age, gender, and tumor type with the answers obtained for the best moment, how and from whom to receive such informatio... (Complete abstract click electronic access below)

Humanização da assistência ao paciente crítico: revisão integrativa da literatura

This study aimed at analyzing the scientific production on health care humanization in intensive-care and emergency units based on publications in national journals. Therefore, this is an integrative review of the national literature. The online database Literatura Latino-Americana do Caribe em Ciências da Saúde - Literature in the Health Sciences in Latin America and the Caribbean (LILACS) based on the Health Virtual Library (BVS) platform was used to select articles. The final sample in this review consisted of 21 articles. The presentation of results and data discussion was descriptively performed and divided into three themes: communication with relatives and the team, caregiver humanization and, finally, the difficulties faced to implement humanization. As regards communication, it is seen by the authors as a fundamental strategy to ensure quality in intensive care, and it is placed as a central axis in the humanization policy. Concerning caregiver humanization, the physical and mental overload resulting from the work process in these units are factors that interfere with personal relations between team members as well as with that between team members and patients. Among the difficulties faced for implementing humanized care for critical patients are the units’s physical and organizational structures, technology and health care professionals’ education, which is centered on the biomedical model. It was concluded that communication is considered to be fundamental for humanization of the care provided to critical patients, since it allows for the development of a network of meanings between patients, the team, families and the establishment. In order to implement care with humanized actions in urgency and emergency sectors, particularly in ICUs, it is necessary to change organizational culture and value health care professionals

Participação da família no tratamento de paciente em diálise peritoneal

Dramatic changes occur in the lives of patients on peritoneal dialysis and his family life, changing lifestyle, professional and social activities. Considering the important role of family in treatment, is crucial for nurses to know how these families perceive their role as caregivers and their difficulties and needs, in the process of peritoneal dialysis. The approach chosen for the study was the phenomenological method, based on Merleau-Ponty, who proposes to understand the human experience, from the description of those who lived it. The study findings show that in the beginning of treatment, family members, feel impacted with the disease severity and eager to become responsible for maintenance treatment, fearing not match the expectations.Guided by staff, appear confident in taking care and deal with the difficulties and complications of treatment, supported by professionals. However, resent the great changes in their social activities and work, his life turns out to be quite limited, due to the dedication to a sick family member. Many feel overwhelmed because they are not supported by other family members. Some envision a future outlook for renal transplant, others seem skeptical, given the long waiting list, especially when advanced age of the sick family member. These results suggest the need for individualized attention to family caregivers, and to encourage the family to organize itself and develop a joint work. In this sense, the design of health care, taking care with the focus of the family, it seems highly appropriate in preparing the plan of family orientation, this is defined as a dynamic unity, which, working in harmony, can contribute positively in the treatment of health a sick member

O efeito da musicoterapia na qualidade de vida e nos sintomas depressivos do paciente em hemodiálise

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Desperdício de dieta enteral em UTI: análise de modo de falhas e efeitos de danos ao paciente grave

Pós-graduação em Enfermagem (mestrado profissional) - FMB

A importância das classes socias na relação médico-paciente: adesão ao pré-natal

This article is focused in the understanding of how can social classes influence in prenatal, throughout the patient medical relationship as well as the many aspects surrounding. In the first chapter, reflected about the adherence to prenatal and considerations in gestational period when dealing with public health treatment offer by SUS. Next chapter, patient medical relationship is addressed as a relationship classes, over questioning how this relationship use to be in front of disadvantaged extracts, focused in prenatal. In the third chapter, the patient medical relationship is analyzed throughout the patient vision, pointing the many factors that can induce the success of a therapeutic. In the last chapter, there are reflections about whereby health professionals upgrading, as well as the improve of basic health care networks are necessary to a larger prenatal adherence.

Reabilitação oral de paciente com síndrome da combinação: relato de caso

The Combination Syndrome represents an important pathologic condition of the masticatory system that requires a complex rehabilitation treatment. The presence of flaccid mucosa is one of the most common features due to bone resorption of the pre-maxilla caused by anterior hyperfunction of the mandibular teeth on the maxillary complete denture, where the impact of oclusal loading in this region results in movement of the maxillary prosthesis into the ridge, resulting in increased resorption of the residual ridge, internal misfit and loss of the retention of the maxillary complete denture. The presence of flaccid mucosa, in such cases, leads to problems of support and stability of the maxillary complete denture, which can be treated by surgical reduction of the thickness of the tissue or using specific techniques of fabrication of prostheses. This article describes the oral rehabilitation of a patient with the Combination Syndrome where the surgical reduction of flaccid mucosa was not performed, using a modified technique of functional impression in two steps, with the objective of generating forces and less distortion in flaccid mucosa during functional impression.

Reabilitação oral de paciente com sequela cirúrgica utilizando a técnica da zona neutra: relato de caso clínico

Objective and Case report: The purpose of this paper is to describe the neutral zone technique in a patient with oral deformity on the right labial commissure due to the resection of an oral cancer, enhancing the difficulty resulting from mouth limited opening and the use of tissue conditioner material to determine the neutral zone. Complete denture was obtained through this technique, providing good retention and stability which made functional rehabilitation feasible to patient of his or her masticatory function. Final considerations: The neutral zone technique in complete dentures will determine a specific intraoral area for tooth position and denture base contour where the forces generated by lips, cheeks and tongue are neutralized. The objective of this technique is to provide an alternative approach for patients who presented an historic instability of lower complete denture: atrophic ridge, oral deformities and also with disorder problems. An oral rehabilitation using this technique improves comfort to the patient providing retention and stability of mandibular complete dentures.

Prótese metalocerâmica associada à prótese metaloplástica implantossuportada em paciente desdentado total

The use of different methods and materials should be considered during the planning of implant-supported prostheses. Complications such as fractures of the acrylic resin base, wear and fracture of teeth can occur frequently, creating the need for careful planning for each patient, which can make the selection of the type of treatment more complex. Thus, this article describes the oral rehabilitation of a completely edentulous patient with bimaxillary fixed implant-supported prosthesis, with complaints on aesthetics, loss of vertical dimension and fracture of acrylic resin teeth of the upper arch. After the restoration of vertical dimension, his dentures were replaced with new bimaxillary implant-supported fixed prostheses, ceramic and acrylic resin were used as veneering material for maxilla and mandible, respectively. At the end of the treatment, the patient received bimaxillary flat occlusal splints to protect the teeth and implants of possible parafunctional habits. The approach for the treatment allowed a quick and effective resolution, with aesthetic and functional outcomes very favorable for the patient.

O cuidador de paciente com neoplasia cerebral maligna primária: os desafios do cuidado

Patients with primary malignant brain tumor endure several motor and cognitive dysfunctions, demanding the presence of a caregiver even more because the time necessary for their assistance increases considerably. Usually this task is performed by a family relative, whose activities include taking care of the patient’s personal hygiene, escorting them to medical appointments, managing their money and performing their housework. All of this overwhelms the caregiver both physical and psychologically. This bibliographic research intends to analyze the role in which a caregiver plays in the quality of life of those kinds of patients, the complications of such task, the caregivers’ needs and the daily life of those terminal patients. It was used CAPES, PubMed and Google Academic databases for researching articles related to family caregivers who assisted adult patients with primary malignant brain tumor. The study concluded that being a caregiver of patients in such conditions harms one’s quality of life, with consequences such as stress, insomnia, financial problems and lack of social support. Theirs needs include: having someone to talk to about the matter, attending programs for reducing stress and increasing their knowledge about the disease. In advanced phases of the condition, the patient shows great mobility problems, aphasia and regular seizures, which end up overwhelming the caregiver. The level of quality of life found was above other types of cancer’s caregivers. Therefore, they represent a group with special needs, which should be especially handled by health professionals.

Uma proposta de psicoterapia breve para paciente com escoriação psicogênica

Psychogenic Excoriation is a psychodermatosis characterized by skin alterations connected to mental processes, which are more common in women. It generates a considerable physical and psychosocial discomfort to the patient, because of the skin lesions. These patients assume to injure their own skin, and it differentiates this diagnosis from the factual dermatitis. This acknowledgement facilitates the insertion of these patients in psychotherapeutic processes, including fast psychotherapy, which can benefit them, especially in hospital contexts such as hospital ambulatories specialized in dermatology. Fast dynamic psychotherapies are described, analyzed and recommended to a psychogenic excoriation patient while introducing the process plan indicated to her. It relates to the clinical study of cases with medical records, psycho interviews and results of the FPI (Factor Personality Inventory). Based on these data, a fast psychotherapy is suggested with defined focus, aim and time, with a therapeutic plan according to what’s recommended in this type of treatment. The main objective is the symptom alleviation besides self-knowledge and insights, clarifying the most important identified psychodynamic conflicts. It’s also suggested that the suggested fast psychotherapy process could well result in important therapeutic gains to the analyzed patient.