Avaliação do programa de HIV/Aids na concepção dos usuários: o caso em um hospital de referência em Belém-PA

Estudo referente a avaliação do Programa de HIV/aids em um hospital de referência, na concepção dos usuários. O objetivo geral da pesquisa foi descrever a concepção dos usuários na unidade de internação e ambulatorial, sobre o programa de HIV/aids em um hospital universitário de referência na cidade de Belém-PA. Para o estudo foram traçados como objetivos específicos: apresentar as sugestões dos usuários do programa para a melhoria no desenvolvimento das atividades do programa e fornecer as ferramentas mínimas para a construção de um modelo de avaliação para o programa. No referencial foi utilizado o panorama da epidemia de HIV/AIDS, políticas de saúde no Brasil e a aids, e a avaliação de programas e serviços em saúde. O método e a abordagem foram qualitativo, descritivo do tipo estudo de caso. Foi utilizado um roteiro de entrevistas semi-estruturado sobre a temática. A pesquisa foi desenvolvida nas dependências do HUJBB, mais especificamente nos serviços do Programa de HIV/aids, em que foram entrevistados usuários do SAE e os internados na clínica de doenças infecto-parasitárias. Através da análise dos dados, foram divididas as falas em quatro categorias: caracterização do usuário quanto ao acesso ao serviço; a motivação do usuário pela qualidade do serviço; dificuldades frente às atividades e orientações do serviço; expectativas para a melhoria do programa. O resultado da pesquisa esclarece as restrições e qualidades do programa; a insatisfação do usuário no acesso ao serviço; o alto grau de motivação bem como a ausência da mesma; as principias dificuldades dos usuários em aderir as orientações e atividades do programa, como o medo de encarar a morte, a falta de recurso para chegar ao serviço, o preconceito vivido pelas pessoas com HIV/aids e a promiscuidade sexual; e as expectativas dos usuários para o programa: rapidez no atendimento, melhor infraestrutura. Conclui-se com as melhorias que podem contribuir para a qualidade de vida dos usuários, subsidiar demanda suficiente de profissionais para atender no programa e oferecer tratamento completo às pessoas que vivem com HIV/aids atendidas no programa do HUJBB.

Compreendendo a experiência de crianças e adolescentes submetidos à punção de medula óssea e lombar em centro cirúrgico de um hospital oncológico

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Adenocarcinoma gástrico T4b: experiência de 12 anos em Hospital Universitário

A neoplasia gástrica é doença heterogênea e multifatorial, com incidência e mortalidade variando geograficamente. Aproximadamente 60% dos diagnósticos em pacientes de países ocidentais ocorrem nos estádios III ou IV. Nestes doentes, o melhor tratamento consiste na realização de procedimento cirúrgico. OBJETIVO: Identificar os aspectos epidemiológicos de pacientes diagnosticados com adenocarcinoma gástrico T4b. MÉTODOS: Estudo observacional, transversal, retrospectivo, de fonte secundária, dos pacientes diagnosticados com adenocarcinoma gástrico T4b através de estadiamento patológico. Foram analisados 815 prontuários, sendo 27 pacientes estudados. As variáveis investigadas foram: aspectos demográficos, principais queixas, fatores de risco, acesso ao serviço de saúde, aspectos cirúrgicos, morbidade, mortalidade e sobrevida. RESULTADOS: Vinte e dois eram homens (81,5%) e cinco mulheres (18,5%) com idade variando de 38 a 87 e média de 58,78 anos. O tempo de acesso ao serviço, em meses, variou de 1 a 120, com média de 12,5. Os sinais e sintomas mais prevalentes foram: perda de peso 23 (85,2%), epigastralgia 22 (81,5%), vômitos 16 (59,3%) e plenitude gástrica 12 (44,4%). A frequência de acometimento das estruturas adjacentes foi: pâncreas oito (29,6%), fígado sete (25,9%), cólon transverso seis (22,2%), intestino delgado seis (22,2%), mesocólon três (11,1%), baço um (3,7%) e vesícula biliar um (3,7%). Morbidades pós-operatórias ocorreram em 51,85% dos pacientes. Houve associação significativa entre mortalidade cirúrgica e ocorrência de fístula/deiscência, choque séptico e sangramento. A sobrevida ao final de seis meses foi de 63,27%. CONCLUSÃO: A média do tempo entre início dos sintomas e acesso ao serviço de saúde especializado foi elevada. Mais da metade dos pacientes apresentaram morbidades pós-operatórias. Os pacientes que apresentaram fístula/deiscência, sangramentos e choque séptico tiveram associação significativa com mortalidade cirúrgica. A sobrevida ao final de seis meses foi de 63,27%.

Caracterização demográfica e formas clínicas apresentadas por crianças internadas com dengue em um hospital de referência da Amazônia

Dengue tem causado epidemias de diferentes magnitudes nas últimas décadas e está presente em quase todos os Estados do Brasil, com a circulação dos quatro sorotipos diferentes, desde a introdução no país do sorotipo 4 em janeiro de 2011. O atual cenário epidemiológico do país indica a elevação das formas graves de dengue na faixa etária pediátrica. No entanto, estudos descritivos de casos da doença em crianças, que fazem referência às características epidemiológicas e clínicas, são pouco freqüentes. O presente trabalho destina-se a mostrar as características demográficas e formas clínicas apresentadas pelas crianças com idade inferior a doze anos, internadas com dengue, em um hospital de referência da Amazônia. Neste estudo, utilizou-se uma metodologia que permitisse uma busca retrospectiva, através da análise de 154 prontuários de crianças internadas com dengue no período de 2009 à 2011, no Hospital Universitário João de Barros Barreto. As variáveis analisadas foram: idade, sexo, área de residência, distribuição por municípios, sinais e sintomas, data da internação, data de início dos sintomas, forma clínica da doença e valores de plaquetas, hematócrito e enzimas hepáticas. Neste estudo, não houve diferença estatisticamente significativa entre os gêneros, e a maioria dos casos confirmados de dengue foram procedentes de municípios no interior do Pará (57,6%). A febre foi o sinal mais freqüentemente encontrado (98,7%). Petéquia foi a manifestação hemorrágica referida como mais freqüente neste estudo (76,6%). Entre os sinais de alerta para febre hemorrágica do Dengue, dor abdominal e vômitos estavam presentes em 77,3% dos pacientes. No que se refere ao tempo decorrido entre o início dos sintomas até a data da internação hospitalar, a principal característica observada neste estudo é que somente após cinco à sete dias do início do quadro clínico, os pacientes tiveram acesso ao tratamento em hospital de referência. Esses resultados mostram que é necessário reforçar os serviços básicos de saúde, a fim de fornecer diagnóstico precoce e tratamento adequado, sobretudo na faixa etária pediátrica, onde casos de dengue eventualmente são confundidos com outras viroses prevalentes na infância. Certamente, há necessidade de avaliar a eficácia dos programas de controle de dengue e aplicação de medidas específicas para áreas identificadas como prioritárias.

Nutritional status of patients with gastrointestinal cancer receiving care in a public hospital, 2010-2011

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Gerenciamento dos resíduos de serviços de saúde da Unidade de Terapia Intensiva do Pronto Socorro do Hospital das Clínicas da Faculdade de Medicina de Botucatu – UNESP

Health care waste (HCW) is the type of waste that results from activities performed in health care services during care provision to humans or animals. Presently, according to RDC 306/04, issued in 2004 by Anvisa, and Resolution no. 358/05, by CONAMA, waste groups have the following classification: Group A (biological waste), Group B (chemical waste), Group C (waste containing radionucleotides), Group D (common waste) and Group E (piercing and cutting waste). In Brazil, 149 tons of wastes are collected every day, and HCW corresponds to approximately 1% to 3 % of that total. An efficient way to adequately manage HCW is through the Health Care Waste Management Plan (HCWMP), and it is possible to reduce the risk posed by certain materials in addition to ensuring disposal in an ecologically correct and economical fashion. According to the Pan-American Health Organization (PAHO), the management process enables health care establishments to adequately manage waste. Hence, there is greater control and reduction in the health risks caused by infectious or special waste, in addition to facilitated recycling, treatment, storage, transport and final disposal of solid hospital waste in an environmentally safe fashion. To evaluate the management of HCW of Groups A and D from the Intensive Care Unit of the University Emergency Hospital - FMB - UNESP in the city of Botucatu according to the guidelines presently in force. The waste flow was followed up, and during four random days in the month of September 2011, waste was quantified by estimating daily and monthly values, according to its classification. : In 2011, the University hospital has produced an average of 57,676.8 kg/month of biological and common waste. By adding Groups A and D, during the four days, approximately 209.8 Kg of waste (202.2 Kg of Group A and 7.6 Kg of Group D) were produced in the establishment under study, which... (Complete abstract click electronic access below)

Caracterização da demanda do pronto socorro do Hospital das Clínicas da Faculdade de Medicina de Botucatu - UNESP

The demand for health services can be understood as an application needs the user has. The inability to use the outpatient services and limited supply of these make it possible for users to browse sites that focus attention on a greater possibility of entry doors, in which first-aid centers and hospital emergency match this profile, distorting the flow of patients in the network through an inverse demand of the movement hierarchy. Added to this, the burden of care in these services results in overcrowding and poor quality of care. Evaluate the demand of the visits occurred in the Emergency Room of the Hospital of the Medical School of Botucatu / UNESP (PS - HC - FMB / UNESP) during June-July 2010. A transversal, descriptive and retrospective. For data collection sheet was used in the proposed Service unit and the data it was filled out the form with the necessary items for the search. Made an exploratory analysis and frequency distributions for categorical variables of the form. Females predominated (56%) and aged 61 years or older with 30%. 96.5% were owned by DRS VI, and 62.5% of Botucatu. The attendance by the physician on duty and corresponded to 57.7% among the 23 medical specialties, Gastric (7.0%), Cardiology (4.5%), Medical (4.4%), urology (4.2%) and Pulmonology (4.1%) were the ones that stood out. The medical procedures performed that stood out were X-ray (46.4%) and electrocardiogram (ECG) (42.3%) and in most specialty care occurred, only the daily consultation with the patient. It was possible to characterize, so the demand for PS - HC - FMB / UNESP for the period June- July 2010, The predominance of the elderly shows that come along with aging diseases and addictions, causing a greater need for health services. Moreover, this study showed that the high number of visits is related to both the daily demands that the tertiary hospital has the same transformation... (Complete abstract click electronic access below)

Perfil epidemiológico de parturientes submetidas à cesariana na maternidade de um hospital escola de Botucatu-SP

During the pregnancy process, the maternal organism commonly undergoes changes. Such changes follow the normal course of pregnancy; however, some maternal or fetal factors can interfere with pregnancy and adversely affect its outcomes, thus triggering what is referred to as high-risk pregnancy, which is responsible for increasing maternal, fetal or newborns’ morbimortality rates1,2. One of the obstetric alternatives for a safe resolution of this pregnancy type is the caesarean section. Nevertheless, an expressive increase in the number of caesarean sections has been observed worldwide, and they are, many times, unnecessarily indicated8. The world Health Organization (WHO) recommends that the total number of caesarean sections in relation to the total number of deliveries performed at health service should be a maximum of 15% 11, a limit that is easily surpassed in various services. To outline the epidemiological profile of pregnant women submitted to caesarean sections at a reference health care service in the city of Botucatu-SP. This is a cross-sectional, retrospective, exploratory, descriptive, quantitative study. The target population consisted of one hundred pregnant women assisted in this institution, who had been submitted to caesarean sections in 2010 and were randomly selected to compose the sample. In the analyzed period, there were 1,189 deliveries, of which 601 (50.5%) were natural deliveries, 588 (49.4%) were caesarean sections. As regards maternal age, 76% were in the age range of 19 to 36 years. A high percentage of patients (27%) had not completed elementary education and did not have a paid job; 67% were homemakers. Most of the participants were married (56%); 34% of the women were primiparas, but 19% were in their fourth or more pregnancies. Concerning prenatal care, little was found, since many of them had consultations out of the institution which were not recorded... (Complete abstract click electronic access below)

Percepção do enfermeiro quanto a sua satisfação no contexto de trabalho em um hospital estadual

With the increasing competitiveness of organizations in search of customers, it is essential that the pursuit of quality becomes a prerequisite for the survival of healthcare organization, is necessary to have working conditions that encourage both personal and professional satisfaction. This study aims to investigate the perception of nurses regarding their satisfaction in the context of work in a State Hospital and contribute to the reflection on the internal customer satisfaction as an important indicator of quality of health services that interfere with quality of care. We used the qualitative method, on phenomenology, with nurses from a state hospital that had at least one year of experience in the institution. Through interviews, it was revealed that satisfaction is related to the literature and is influenced by factors such as human resources, practice nurses, Teamwork, Perception of the patient, professional recognition, physical and material resources and rewarding work, and these themes unfold quality and satisfaction both personally and for organizations

Cirurgias seguras salvam vidas: aplicação e avaliação do checklist sugerido pela OMS em cirurgias infantis de um hospital escola

The World Health Organization (WHO) has created a program “Safe Surgery Saves Lives”, focusing on reduce and minimize life threatening or cause serious risk to health for patients submitted to a surgery. This primary goal for this presented study is to apply the checklist from the WHO´s program for children´s surgery in a public university hospital, located in the countryside of São Paulo State, Brazil. Having the responses from professionals surgery´s team, there is an opportunity for evaluation of the features and easiest parts, which are filled in a quickly and in a easy way; focus, supporting and assistance; issues, such as lack of time for filling in, and viability of application of this protocol considering the improvement of the cross functions relationship, and quality of services, providing better assistance and support to the patient

Qualidade de vida do trabalhador de enfermagem de um hospital Estadual

The search for quality of life (QOL) is now an ideal among thousands of people worldwide and is currently the subject has been studied in different areas of knowledge. Thus, one can perceive it in different dimensions, each with its due importance to people's lives. The verification of quality indexes of work life (QWL) may provide information on factors that directly interfere with the satisfaction and personal motivation and collective, with reflections on the structure and excellent service. To this end, we carried out a study to know the characacteristics of quality of life of nursing professionals in a state hospital in São Paulo State, based on short range of quality of life of the World Health Organization (WHOQOL-BREF). This work is a study with a quantitative approach, cross-sectional descriptive and exploratory data analysis using descriptive statistics, involving a sample of 281 nurses who answered the scale for measuring quality of life, composed of four areas: physical, psychological, social relationships and environment. In the study, these areas were related to the professional position, and shift work. There was a satisfactory quality of life in the study population in different areas of WHOQOL-BREF. There was no statistically significant changes in quality of life among the variables. It follows that the population presented data consistent with an adequate quality of life, thus making relevant to addressing the quality of life of nursing in a healthcare organization which has as fundamental to the pursuit of quality through the accreditation process second hospital established by the National Accreditation Organization (ONA) that aims at establishing and implementing a process of improving health care, thereby stimulating the services to achieve higher standards of quality

Anemia and hemoglobinopathies in pregnant women attended in a public hospital

Objectives: to identify the demographic profile and frequency of anemia and hemoglobinopathies, as a basis for future implementation of actions aimed at pregnant women in the public health domain. Method: this is a cross-sectional study developed with pregnant women attended in a university hospital at Mato Grosso do Sul, Brazil. Blood samples were collected for the erythrogram analysis for detection of anemia and selective and specific tests for abnormal hemoglobin. The patients regarded as indigenous and mentally ill, as well as inmates, were excluded from the research, as they represent a vulnerable population which needs a cohort different from that of the sample. For data collection, a particular questionnaire was used. The research was approved by the Ethics Committee of Universidade Federal de Mato Grosso do Sul (UFMS), under the Protocol 873/2006. Results: of the 215 pregnant women under study, 20% were adolescents; 36.3% had incomplete primary education; 53.0% were non-Caucasian; 43.3% were from Campo Grande, Mato Grosso do Sul, Brazil; and 21.1% were of European descent. 17.7% had some type of anemia and, in the evaluation of hemoglobinopathies, 4.7% of patients were detected with some abnormal hemoglobin, with the following frequencies: 3.3% with HbAS; 0.9% with HbAC; and 0.5% with intermediate β-thalassemia. Conclusion: the frequencies of anemia and hemoglobinopathy found in these pregnant women showed the importance of early diagnosis, revealing indicators able to provide a basis for preventive and assistance actions for adequate clinical monitoring, reducing maternal and neonatal morbimortality in the public health services. Descriptors: pregnant women; anemia; hemoglobinopathies; public health; nursing.

Comportamento informacional de profissionais no domínio da saúde: um estudo junto ao Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo

Pós-graduação em Ciência da Informação - FFC

Caracterização clínica, demográfica e nutricional de pacientes oncológicos atendidos em um hospital público - 2008

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Integrated pest management programme in hospital environment

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)