Reflexões sobre o conceito de atendimento humanizado em Odontologia

Humanization at dental care is highly important due to uneven relation between scientific / technical advances in dentistry and thequality of human contact. The dental treatment goes beyond the field of scientific knowledge. Therefore, the dental treatment requiresbalance among technical skill, scientific training, and humanist vision of health promotion. Contemporarily, humanization is understoodas tripod based on user's rights, dental practice and organization of a humanized model. Curriculum integration of ethical, humanistic,scientific and technical contents is an important and current challenge on teaching / learning process for professionals at Dentistry. Thispaper aims to, guided by the literature review, to present some considerations on human care in dentistry, with emphasis on theimportance of professional /patient relationship for promoting oral health. It is suggested that dentists reflect on the urgent need ontheoretical basis of humanization and patient-professional relationship for health care.Descriptors: Humanization of Assistance; Dental Staff

Aromaterapia e Ansiedade: revisão integrativa da literatura

This study aimed at investigating, in the national and international scientific literature, how aromatherapy is used as a therapeutic tool to reduce anxiety. It is a bibliographic study that adopted integrative literature review as a method. Studies published on databases Scielo, Medline and Cinahl from 2008 to 2012 were selected. A sample of 20 scientific articles was analyzed, and of these, 13 had an experimental and a quasi--experimental design whereas 07 were systematic or integrative reviews. The synthesis of knowledge sho-wed that aromatherapy represents a safe therapeutic practice although it is still underestimated in health care practices. The construction of evidence levels was not possible due to discrepancies in the studied populations, in research designs, the various essential oils used and the different methods for aromatherapy application. The knowledge gaps identified in these studies are related to the need to develop new forms to evaluate the effectiveness of this practice, including the therapist-patient relationship and the different communication forms that are intrinsic to aromatherapy.

Regional origin and decrease of pain in patients with depressive symptoms under treatment with venlafaxine

Patient's language, tradition, conventions, and customs may all determine integration into a society and are also part of the doctor-patient relationship that influences diagnostic and therapeutic outcome. Language barrier and sociocultural disparity of Eastern and Southern European patients may hamper recovery from pain and depression compared to Middle European patients in Switzerland.

[The image of dentistry. Part 2: The ideal dentist]

Our second part of the publication entitled "The image of Dentistry" discusses the properties that correspond to the ideal image of dentistry or even the ideal scientist such as the management of the dental practice, the dentist-patient relationship and the appropriate handling of the patient's emotions such as anxiety or pain. The quality of treatment and the friendly, honest and compassionate attitude of the dentist can immediately affect the image of dentistry. Therefore, the dental professional must try to keep the balance between practice profit, staffing and patient well-being in order to fulfill both social and public health responsibilities.

[Bronchial asthma]

Patients with asthma often suffer from multiple allergies at the same time. Additionally many patients show a specific constellation of the interaction visible in the individual history, and at the same time in the actual doctor-patient relationship as well. In this short paper we will summarize the actual knowledge about the etiology of the disease, and also delineate the possible factors involved in producing the typical asthma attack. In the second part the most important therapeutic strategies are shown, with emphasis on psychosocial elements.

Moving Beyond Hastiness and Superficiality: Being an Ethical Technical Communicator via Digital Communication Technologies in Health Care

This thesis examines digital technologies used by technical communicators in healthcare settings. I show that technical communicators, who function as users, advocators and evaluators, need a useable framework for ethical engagement with digital technologies, which integrally affect the physician-patient relationship. Therefore, I apply rhetorical methodology by producing useable knowledge and phenomenological methodology by examining lived experiences of technical communicators. Substantiation comes from theories spanning technical communication, philosophy, and composition studies. Evidence also emerges from qualitative interviews with communication professionals working in healthcare; my concerns arise from personal experiences with electronic recordkeeping in the exam room. This thesis anticipates challenging the presumed theory-practice divide while encouraging greater disciplinary reciprocity. Because technical communication infuses theory into productive capacity, this thesis presents the tripartite summons of the ethical technical communicator: to exercise critically-reflective action that safeguards the physician-patient relationship by ways of using digital technologies, advocating for audiences, and evaluating digital technologies.

Predictors of health care professionals' attitudes towards involvement in safety-relevant behaviours

BACKGROUND Patients can make valuable contributions towards promoting the safety of their health care. Health care professionals (HCPs) could play an important role in encouraging patient involvement in safety-relevant behaviours. However, to date factors that determine HCPs' attitudes towards patient participation in this area remain largely unexplored. OBJECTIVE To investigate predictors of HCPs' attitudes towards patient involvement in safety-relevant behaviours. DESIGN A 22-item cross-sectional fractional factorial survey that assessed HCPs' attitudes towards patient involvement in relation to two error scenarios relating to hand hygiene and medication safety. SETTING Four hospitals in London PARTICIPANTS   Two hundred sixteen HCPs (116 doctors; 100 nurses) aged between 21 and 60 years (mean: 32): 129 female. OUTCOME MEASURES Approval of patient's behaviour, HCP response to the patient, anticipated effects on the patient-HCP relationship, support for being asked as a HCP, affective rating response to the vignettes. RESULTS HCPs elicited more favourable attitudes towards patients intervening about a medication error than about hand sanitation. Across vignettes and error scenarios, the strongest predictors of attitudes were how the patient intervened and how the HCP responded to the patient's behaviour. With regard to HCP characteristics, doctors viewed patients intervening less favourably than nurses. CONCLUSIONS HCPs perceive patients intervening about a potential error less favourably if the patient's behaviour is confrontational in nature or if the HCP responds to the patient intervening in a discouraging manner. In particular, if a HCP responds negatively to the patient (irrespective of whether an error actually occurred), this is perceived as having negative effects on the HCP-patient relationship.

La antropología filosófica en odontología mínimamente invasiva

La Odontología Mlnimamente lnvasiva (OMI) es una de las orientaciones que presentan un futuro favorable en la producción de teoría y la mejora de los procedimientos terapéuticos. Estimamos que se trata de un conjunto integrado de conocimientos teórico-practicas que implica un posicionamiento innovador en tanto filosofía de trabajo en odontología. Consideramos que OMI implica una serie de nociones de orden filosófico, las que presentamos en este trabajo. La finalidad es colaborar en el posicionamiento teórico en el ámbito de los procesos de intervención y en la relación profesional-paciente. Esta producción se refiere al eje temático de las concepciones de la Antropología Filosófica con relación a los modelos de salud y el concepto de filosofía de trabajo en OMI. La metodología utilizada ha sido la revisión de material bibliográfico, dentro del modelo cualitativo de interpretación.

Clínica de odontología : la orientación hacia el paciente

En el ámbito de la relación profesional odontólogo-paciente, se verifica la tendencia hacia la consideración del lugar que ocupa el paciente como sujeto portador de derechos, lo que se complementa con un modelo de teorías y acciones orientadas primero hacia la salud y luego hacia la enfermedad. Proponemos, a modo de introducción, una perspectiva interdisciplinaria basada en la imbricación de factores de orden socio-cultural y una filosofía de trabajo centrada en el reconocimiento del rol de paciente como sujeto que demanda acciones en favor de su salud.

Treinamento de habilidades sociais com universitários da área de fonoaudiologia: análise de conteúdo

Além do aprendizado de conhecimentos básicos e técnicos, promover competência social e habilidades interpessoais de universitários da área da Saúde torna-se fundamental para o desenvolvimento de relações saudáveis e produtivas no contexto acadêmico e na linha do cuidado. O campo das Habilidades Sociais, uma área da Psicologia, tem fornecido fundamentação desde a metodologia de avaliação de repertório social, até programas de Treinamento de Habilidades Sociais (THS) em contextos educacionais. Atualmente, é crescente o interesse em pesquisas qualitativas na Saúde por englobar o universo de significados, motivos, crenças, valores e atitudes, correspondendo a um espaço mais profundo das relações humanas. Objetivos: Investigar do ponto de vista qualitativo o programa de THS com universitários, oferecido pela disciplina de Psicologia III no Curso de Fonoaudiologia; descrever as potencialidades e dificuldades do repertório de HS conforme a autopercepção dos universitários; identificar os ganhos percebidos pelos universitários ao longo do programa de THS; analisar a relação entre o THS com o autoconhecimento nas relações interpessoais e na relação profissional-paciente. Metodologia: Participaram desta pesquisa 22 universitários, com faixa etária entre 19 e 21 anos de ambos os sexos, que cursavam o segundo ano do Curso de Fonoaudiologia de uma Instituição de Ensino Superior do interior paulista. Empregaram-se abordagem qualitativa e análise de conteúdo dos relatos produzidos pelos universitários no 1o, 8o e 15o encontros do THS e das sínteses (8o e 15o). Resultados: Foram identificadas três temas para análise: \"A importância do conhecimento teórico/técnico para a formação do fonoaudiólogo\", \"A importância do THS no contexto acadêmico e para a prática clínica\" e \"Avaliação dos universitários sobre os efeitos do THS\". No que se refere ao conhecimento teórico/técnico, os relatos apontaram a importância de que este seja desenvolvido de maneira contínua, valorizando as metodologias ativas empregadas. Quanto ao treinamento, os participantes descreveram maior prevalência de potencialidades e dificuldades das habilidades assertivas nos relacionamentos interpessoais do contexto acadêmico. Também foi apontada maior dificuldade de empatia com colegas e na comunicação com professores. No contexto profissional, as dificuldades permearam a ansiedade de falar em público e ser assertivo ao trabalhar em grupo. Quanto aos ganhos identificados, prevaleceu a assertividade com os dois interlocutores envolvidos nesta pesquisa; porém, todas as habilidades sociais tiveram resultados considerados positivos nos dois contextos, destacando a comunicação empática com paciente como facilitadora do processo terapêutico. O THS foi avaliado positivamente, pois permitiu a identificação de potencialidades, dificuldades e ganhos no repertório de HS no contexto acadêmico, sendo apontado como uma forma de preparação para a prática clínica, promovendo o autoconhecimento, o desenvolvimento de comportamentos socialmente habilidosos e a generalização para outros contextos. Conclusão: A inserção do THS na formação profissional de universitários na Fonoaudiologia mostrou-se bastante promissora ao ampliar o repertório de habilidades e competências para além do conhecimento teórico/técnico, tendo o autoconhecimento papel central neste processo, culminando com mudanças de comportamento na vida pessoal e profissional. Salienta-se a relevância do THS em cursos de graduação na área da Saúde, pelo contexto da relação profissional-paciente.

Patients' and professionals' views on managing fibromyalgia

BACKGROUND: Managing fibromyalgia is a challenge for both health care systems and the professionals caring for these patients, due, in part, to the fact that the etiology of this disease is unknown, its symptoms are not specific and there is no standardized treatment. OBJECTIVE: The present study examines three aspects of fibromyalgia management, namely diagnostic approach, therapeutic management and the health professional-patient relationship, to explore specific areas of the health care process that professionals and patients may consider unsatisfactory. METHODS: A qualitative study involving semistructured interviews with 12 fibromyalgia patients and nine health professionals was performed. RESULTS: The most commonly recurring theme was the dissatisfaction of both patients and professionals with the management process as a whole. Both groups expressed dissatisfaction with the delay in reaching a diagnosis and obtaining effective treatment. Patients reported the need for greater moral support from professionals, whereas the latter often felt frustrated and of little help to patients. Patients and professionals agreed on one point: the uncertainty surrounding the management of fibromyalgia and, especially, its etiology. CONCLUSION: The present study contributes to a better understanding regarding why current management of fibromyalgia is neither effective nor satisfactory. It also provides insight into how health professionals can support fibromyalgia patients to achieve beneficial results. Health care services should offer greater support for these patients in the form of specific resources such as fibromyalgia clinics and health professionals with increased awareness of the disease.

The use of cusum analysis in the early detection and management of hospital bed occupancy crises

Objective: To assess the value of cusum analysis in hospital bed management. Design: Comparative analysis of medical patient flows, bed occupancy, and emergency department admission rates and access block over 2 years. Setting: Internal Medicine Services and Emergency Department in a teaching hospital. Interventions: Improvements in bed use and changes in the level of available beds. Main outcome measures: Average length of stay; percentage occupancy of available beds; number of patients waiting more than 8 hours for admission (access block); number of medical patients occupying beds in non-medical wards; and number of elective surgical admissions. Results: Cusum analysis provided a simple means of revealing important trends in patient flows that were not obvious in conventional time-series data. This prompted improvements in bed use that resulted in a decrease of 9500 occupied bed-days over a year. Unfortunately and unexpectedly, after some initial improvement, the levels of access block, medical ward congestion and elective surgical admissions all then deteriorated significantly. This was probably caused by excessive bed closures in response to the initial improvement in bed use. Conclusion: Cusum analysis is a useful technique for the early detection of significant changes in patient flows and bed use, and in determining the appropriate number of beds required for a given rate of patient flow.

Satisfaction with primary care:the perspectives of people with schizophrenia

Background. Schizophrenia affects up to 1% of the population in the UK. People with schizophrenia use the National Health Service frequently and over a long period of time. However, their views on satisfaction with primary care are rarely sought. Objectives. This study aimed to explore the elements of satisfaction with primary care for people with schizophrenia. Method. A primary care-based study was carried out using semi-structured interviews with 45 patients with schizophrenia receiving shared care with the Northern Birmingham Mental Health Trust between 1999 and 2000. Results. Five major themes that affect satisfaction emerged from the data: the exceptional potential of the consultation itself; the importance of aspects of the organization of primary care; the construction of the user in the doctor-patient relationship; the influence of stereotypes on GP behaviour; and the importance of hope for recovery. Conclusion. Satisfaction with primary care is multiply mediated. It is also rarely expected or achieved by this group of patients. There is a significant gap between the rhetoric and the reality of user involvement in primary care consultations. Acknowledging the tensions between societal and GP views of schizophrenia as an incurable life sentence and the importance to patients of hope for recovery is likely to lead to greater satisfaction with primary health care for people with schizophrenia.

O processo ensino-aprendizagem e suas conseqüências na relação professor-aluno-paciente.

This study deals with the ethical and human aspects present in the teaching-learning process within the dentists' formation. It arises from the growing need for professionals involved with the quality of the services they provide for the population in health care centers. In this research a qualitative approach was used and data was obtained by means of focal groups, interviews and participative observation. The sample consisted of 28 dentistry students and 33 patients attended at the dentistry course. According to the results, it was shown that the main problems are the excess of authority in the teacher-student-patient relationship and the dissociation of the body-mind-spirit as seen in the biomedical model health practice. These findings show the future professionals' insufficient abilities for developing a satisfactory relationship with their patients and the need of considering these aspects during their formation.

O processo ensino-aprendizagem e suas conseqüências na relação professor-aluno-paciente.

This study deals with the ethical and human aspects present in the teaching-learning process within the dentists' formation. It arises from the growing need for professionals involved with the quality of the services they provide for the population in health care centers. In this research a qualitative approach was used and data was obtained by means of focal groups, interviews and participative observation. The sample consisted of 28 dentistry students and 33 patients attended at the dentistry course. According to the results, it was shown that the main problems are the excess of authority in the teacher-student-patient relationship and the dissociation of the body-mind-spirit as seen in the biomedical model health practice. These findings show the future professionals' insufficient abilities for developing a satisfactory relationship with their patients and the need of considering these aspects during their formation.