Medicalização em um serviço público de Saúde Mental: um estudo sobre a prescrição de psicofármacos

News of the fifth version of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) bringing an enlarged listing of diagnostic possibilities has fomented discussion concerning the tendency, recognizable in contemporary psychiatric practices, of including ordinary suffering of everyday life in psychiatric diagnosis and submit same to psychopharmacological treatment. The present paper brings to this discussion data obtained from field research about the prescription of psychopharmacs in the psychiatric care of a public mental health service. The results reveal that the psychiatry of the service keeps practically all of its users under prescription, and that medical discharge is extremely rare. The paper organizes elements critical to this practice and concludes that due to its inadequacy as to the objectives of promotion of personalized care concerned with autonomy and citizenship, present in the current national guidelines for public policies in mental health.

Responsabilidade socioambiental: conhecimento dos profissionais da saúde sobre o gerenciamento de resíduos no serviço público

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Qualidade de vida de cirurgiões-dentistas que atuam no serviço público

Introduction: The quality of life of dentists has worsened over time, due to increased risks of labor and competitiveness in the labor market. However, there are only few studies about it. Objective: Investigate the perception of quality of life of dentists working in public service. Methods: In order to accomplish that, a cross-sectional study survey was conducted with 52 dentists of the professional permanent staff of the Municipal Health Service. The data were collected through structured questionnaire, validated, self-administered, proposed by the World Health Organization (WHO) in its shortened version, WHOQOL-Bref. Descriptive statistics and multiple regression were conducted, taking 95% as the confidence interval that characterizes the sample and the calculation of scores for each domain. Results: There was predominance of female subjects (76.9%) the majority of them aged 25 to 35 years (48.7%). Most professionals consider their quality of life good (82.7%), and were satisfied with their health (71.2%). Considering the measures of central tendency and dispersion, the physical domain (13.8) and Environment (13.8) had the lowest mean scores. All areas affected equally poor quality of life of research participants. The facets that showed the lowest values were the physical environment with 39.71 points and 53.92 points to financial resources. Conclusion: The majority of professionals were satisfied with their health and considered their quality of life good.

Parâmetros assistenciais em saúde bucal: comparação entre duas programações do atendimento clínico no serviço público

Objective: To compare two forms of scheduling clinical dental care for the oral health teams (OHT) included in the strategy of family health, regarding productive aspects of assistance. Methods: Two OHT worked concurrently, using two methods of clinical care: the parameter recommended by the Ministry of Health Ordinance No. 1101, 2002, which establishes 03 dental visits per hour (c/h) per team, and a Testing model, with 02 c/h, being each method applied for a period of 615 hours. The quantitative data was collected in OHTs’ daily production spreadsheets, covering the following items: the number of dental visits (initial, for maintenance and for emergency procedures), procedures performed, consumption of material and sterilization cycles. Data was compared and statistically analyzed through the BioStat 5.0 by applying the paired t-test (p <0.05). Results: Under the Ministerial method and the Testing model, were performed, respectively, 288 and 365 first dental visits, 921 and 686 return dental visits, 167 and 172 emergency dental attendances, with 469 and 110 fouls, 212 and 327 treatments were finished and 2501 and 3046 dental procedures were realized. Among eleven analyzed consumables, five were consumed in smaller quantities in the Testing model: gloves (9%), anesthesia (38%), anesthetic needle (34%), suture material (24%) and aspirators (11%), while the six remaining items presented similar consumption rates between the two models. Conclusions: The testing model revealed to be more productive and economical.

Gerenciamento de resíduos odontológicos no serviço público

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

O conhecimento das funções e a formação dos auxiliares odontológicos atuantes no serviço público de saúde de municipios do noroeste paulista

The aim of this study was to evaluate the knowledge of Hygienists (TSB) and Dental Auxiliaries (ASB) in relation to their roles regulated by Law number 11.889, December 24th, 2008, and formation of them and capacitating received before they had been admitted in public health system. It’s a transversal and descriptive study where the target population were TSB and ASB (N=76) that works in public service from 5 cities of the DRS II-SP. Data collection was performed by semi-structured instrument with opened and closed questions. The answer rate was 90.79% (n=69). The results showed that the majority of professional know part of their duties (56%) Near half of them had formation course (47.8%). In relation to information received during formation courses, 80% stated had received all information necessary to actualization of knowledge, however, 84% stated to feel necessity to actualize their knowledge to develop their works, 58% of professionals said that they don’t receive capacitating after they had been admitted. It was possible to conclude that the majority of professionals know part of their roles, has formation course and the majority don’t receive capacitating when they are admitted in public health system, however, it was observed that a part of them don’t have specific formation yet and don’t know part of their roles according to current legislation

A importância de ações estratégicas de gestão de pessoas no manejo do estresse e de estressores ocupacionais

The introducing of new technologies at work contexts forces the contemporary organizations to search new structures and productive processes, as well as new management models, mainly personnel management. A strong pressure by positive results can favour health problems concerning to stress, which is caused by a highly competitive environment; studies reveals that stress is a present reality at organizations nowadays. The presence of stress on workers cause harm to organizations (due to absenteeism increasing, turnover, interpersonal conflicts, etc.) and individuals, whose life quality can be decreased. This text intends to highlight the importance of identifying stress presence on workers and eventual stressors at workplaces, with the objective of, through management strategies, propose interventions guided to promote occupational health and welfare. Identifying eventual stressors at workplaces becomes an essential task, because those signs predispose the stress presence on workers. Therefore, discovering them is a strategic way to preventing and managing of occupational stress. This text also proposes to show some personnel management strategies which can favour the prevention of occupational stressors, as well as interventions on them.

Câncer de mama feminino: aspectos clínicos e patológicos dos casos cadastrados de 2005 a 2008 num serviço público de oncologia de Sergipe

OBJETIVOS: conhecer os aspectos clínicos e patológicos dos casos de câncer de mama feminino cadastrados num serviço público de oncologia de Sergipe. MÉTODOS: procurou-se fazer uma associação do estadiamento com as características presentes nos tumores. A coleta de dados foi realizada em 165 prontuários de mulheres cadastradas no período de 2005 a 2008 no ambulatório de oncologia do Hospital Cirurgia, localizado em Aracaju-Sergipe, por meio de formulário de coleta de dados, em 2009. RESULTADOS: identificou-se o carcinoma ductal invasivo como o tipo de neoplasia mamária mais frequente com 80,8% dos casos; 76 (46,1%) neoplasias foram diagnosticadas em estádio avançado (IIB, III e IV) e a mastectomia prevaleceu como tipo de cirurgia utilizado no tratamento independente do estadiamento. Quanto aos receptores hormonais todos apresentaram associação com o grau do estádio e, ainda, notou-se que a positividade do estrogênio e progesterona é fator de proteção para um pior prognóstico. CONCLUSÃO: é notável que os casos de câncer de mama estudados apresentam maior agressividade biológica, cursando com pior prognóstico, considerando o estádio clínico. Fazem-se necessárias ações de detecção precoce voltadas ao câncer de mama na atenção básica de Sergipe para redução da morbi-mortalidade, melhora da sobrevida e qualidade de vida entre as mulheres acometidas por essa neoplasia.

Idade no diagnóstico e no início da intervenção de crianças deficientes auditivas em um serviço público de saúde auditiva brasileiro

INTRODUÇÃO: Quanto mais precoce o diagnóstico e intervenção da deficiência auditiva, menor será o impacto para o desenvolvimento das habilidades cognitivas, auditivas e de linguagem da criança. OBJETIVO: Caracterizar a idade no diagnóstico e no início da intervenção da perda auditiva e o acompanhamento de crianças atendidas em um serviço público de saúde auditiva brasileiro - Espaço Reouvir do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. MÉTODO: Estudo retrospectivo com informações de 166 prontuários de crianças no que se refere a: gênero; etiologia, tipo, grau e lateralidade da deficiência auditiva; idade do diagnóstico e da adaptação do Aparelho de Amplificação Sonora Individual (AASI) e acompanhamento no serviço. RESULTADOS: A amostra foi composta por 56% homens e 44% mulheres. A etiologia predominante foi a de origem multifatorial. A perda auditiva do tipo neurossensorial ocorreu em 88,6% dos casos. O grau de perda auditiva moderado foi o de maior ocorrência (30,7%), simetria entre as orelhas foi encontrada em 69,9% dos casos e perda auditiva unilateral em 2,4%. A idade média no diagnóstico foi de 5,46 anos e na intervenção de 6,86 anos. Um total de 96,98% das crianças já havia completado o processo de adaptação e 78,32% permaneciam em acompanhamento. CONCLUSÃO: O Programa Reouvir - HCFMUSP ainda recebe crianças, seja para o diagnóstico e/ou para a intervenção, de maneira tardia. Entretanto, ainda assim faz-se possível à realização do acompanhamento de um número significativo de crianças usuárias de AASI, possibilitando um processo de adaptação mais efetivo.