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RESEARCH01-01-2017
Chronic hepatitis B and D: prognosis according to Child-Pugh score
Revista Brasileira de Enfermagem. 2017;70(5):1048-1053
Abstract
RESEARCHChronic hepatitis B and D: prognosis according to Child-Pugh score
Revista Brasileira de Enfermagem. 2017;70(5):1048-1053
DOI 10.1590/0034-7167-2016-0205
Views0See moreABSTRACT
Objective:
compare chronic hepatitis B patients to those superinfected with hepatitis D virus, according to Child-Pugh score regarding disease severity.
Method:
retrospective descriptive study, performed with 59 patients followed in the ambulatory, of which 22 (37.3%) were chronically infected with hepatitis B virus (Group HBV) and 37 (62.7%) superinfected with Delta virus (Group HBV+HDV); variables of sex, age and items of Child-Pugh score were collected by consulting medical records.
Results:
out of the patients, 57.6% were male, with a mean age of 30.5 years. Score A, which indicates lesser severity, was found in 100% of group HBV and 78.4% of group HBV+HDV. Score B, which indicates greater severity, was found only in group HBV+HDV in 21.6% of the patients.
Conclusion:
by means of the Child-Pugh score, it was observed that patients with superinfection by HDV tended to present a worse prognosis.
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RESEARCH01-01-2017
Humanization in the Intensive Care: perception of family and healthcare professionals
Revista Brasileira de Enfermagem. 2017;70(5):1040-1047
Abstract
RESEARCHHumanization in the Intensive Care: perception of family and healthcare professionals
Revista Brasileira de Enfermagem. 2017;70(5):1040-1047
DOI 10.1590/0034-7167-2016-0281
Views0ABSTRACT
Objective:
Understanding perceptions of family members and healthcare professionals about humanization at the Intensive Care Unit (ICU) to direct it to an educational action.
Method:
Exploratory descriptive and qualitative study conducted in an ICU level 3 of a public hospital in Porto Alegre, RS, Brazil, with fourteen subjects, eight family members and six healthcare professionals. Data collection carried out through semi-structured interviews and focus group. Content Analysis was used.
Results:
Emerged categories were: welcoming; communication; ethical and sensible professionalism; unfavorable aspects; perception on humanization; and religiosity/spirituality.
Final considerations:
Although the subjects have expressed their perceptions about humanization in different ways, both groups pointed out the same needs and priorities to improve humanization in Intensive Care. From the results, we created a reflective manual of humanizing assistance practices for professionals, a board to facilitate communication of these professionals with patients and a guideline book for family members.
Keywords:Assistance HumanizationCritical CareHealth EducationHealth PersonnelProfessional-Family RelationshipSee more -
RESEARCH01-01-2017
Knowledge of adolescents regarding sexually transmitted infections and pregnancy
Revista Brasileira de Enfermagem. 2017;70(5):1033-1039
Abstract
RESEARCHKnowledge of adolescents regarding sexually transmitted infections and pregnancy
Revista Brasileira de Enfermagem. 2017;70(5):1033-1039
DOI 10.1590/0034-7167-2016-0531
Views0See moreABSTRACT
Objective:
To investigate the knowledge of adolescents related to sexually transmitted infections (STIs), AIDS, and pregnancy, and understand the role of school in sex education.
Method:
A qualitative descriptive study, developed through a semi-structured interview and a form for participant characterization, with 22 high school students from a public school aged 16 to 19 years. Data were submitted to content analysis.
Results:
After analysis, four thematic categories were developed: sexuality and sex education; understanding of risk behaviors; knowledge of STI/AIDS; and knowledge of and practices for prevention.
Final considerations:
This study showed the need for preventive educational actions for adolescents, because the lack of information contributes to their vulnerability. The adolescents recognize the importance of sex education; therefore it is important to implement strategies to promote and protect health in the school environment to encourage and strengthen self-care in health.
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RESEARCH01-01-2017
Care necessities: the view of the patient and nursing team
Revista Brasileira de Enfermagem. 2017;70(5):1026-1032
Abstract
RESEARCHCare necessities: the view of the patient and nursing team
Revista Brasileira de Enfermagem. 2017;70(5):1026-1032
DOI 10.1590/0034-7167-2016-0197
Views0ABSTRACT
Objectives:
To compare care necessities as perceived by the patient and nursing team and to investigate the sociodemographic factors associated with these perceptions.
Method:
A comparative study was conducted in units and hospitalized patients of a hospital institution in the state of São Paulo. The participants comprised 100 health professionals (50 nurses and 50 nursing technicians and auxiliaries) and 50 patients. A questionnaire was constructed and validated regarding care needs and was completed by the participants.
Results:
Considering cut-off value kappa ≥ 0.61, or that is, good and very good intervals, the greatest agreement between the perception of the patients and the nursing team was in the areas of: Care and Communication, both with 92.6% agreement; followed by Basic Care with 74.1%. The lowest value was found in the field of Care Planning and Organization, 64.3%.
Conclusion:
In a general manner, there was an agreement between the care needs from the view of the patients themselves and the nursing team.
Keywords:Determination of Healthcare NecessitiesEvaluation in NursingHospitalized PatientsNursing CareQuality of HealthcareSee more -
RESEARCH01-01-2017
Critical incidents connected to nurses’ leadership in Intensive Care Units
Revista Brasileira de Enfermagem. 2017;70(5):1018-1025
Abstract
RESEARCHCritical incidents connected to nurses’ leadership in Intensive Care Units
Revista Brasileira de Enfermagem. 2017;70(5):1018-1025
DOI 10.1590/0034-7167-2016-0137
Views0See moreABSTRACT
Objective:
The goal of this study is to analyze nurses’ leadership in intensive care units at hospitals in the state of São Paulo, Brazil, in the face of positive and negative critical incidents.
Method:
Exploratory, descriptive study, conducted with 24 nurses by using the Critical Incident Technique as a methodological benchmark.
Results:
Results were grouped into 61 critical incidents distributed into categories. Researchers came to the conclusion that leadership-related situations interfere with IC nurses’ behaviors. Among these situations they found: difficulty in the communication process; conflicts in the daily exercise of nurses’ activities; people management; and the setting of high quality care targets.
Final considerations:
Researchers identified a mixed leadership model, leading them to the conclusion that nurses’ knowledge and practice of contemporary leadership theories/styles are crucial because they facilitate the communication process, focusing on behavioral aspects and beliefs, in addition to valuing flexibility. This positively impacts the organization’s results.
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RESEARCH01-01-2017
Cross-cultural adaptation and validation of the Moral Distress Scale-Revised for nurses
Revista Brasileira de Enfermagem. 2017;70(5):1011-1017
Abstract
RESEARCHCross-cultural adaptation and validation of the Moral Distress Scale-Revised for nurses
Revista Brasileira de Enfermagem. 2017;70(5):1011-1017
DOI 10.1590/0034-7167-2016-0518
Views0See moreABSTRACT
Objective:
Cross-culturally adapt and validate the Moral Distress Scale-Revised for nurses.
Method:
Quantitative, analytical cross-sectional study conducted with 157 nurses of two hospital institutions of Southern Brazil, one public and one philanthropic. Procedures conducted: cultural adaptation of the instrument according to international recommendations; validation for the Brazilian context.
Results:
Face and content validation was considered satisfactory as assessed by a specialist committee and a pretest. The instrument demonstrated satisfactory internal consistency through frequency and intensity analysis per question in the 157 items and per subgroups of the various hospital units. Cronbach’s alpha was 0.88 for the instrument and between 0.76 and 0.94 for hospital units. Pearson’s correlation found a moderate association for moral distress among nurses.
Conclusion:
The Moral Distress Scale-Revised – Brazilian version is a valid instrument for the assessment of moral distress in nurses.
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RESEARCH01-01-2017
Sexual orientation and quality of life of people living with HIV/Aids
Revista Brasileira de Enfermagem. 2017;70(5):1004-1010
Abstract
RESEARCHSexual orientation and quality of life of people living with HIV/Aids
Revista Brasileira de Enfermagem. 2017;70(5):1004-1010
DOI 10.1590/0034-7167-2016-0420
Views0See moreABSTRACT
Objective:
To analyze whether sexual orientation affects the quality of life of people living with HIV/Aids (PLWHA).
Method:
A cross-sectional analytical study was carried out with 146 PLWHA in Teresina, capital city of the state of Piauí, in 2013, by means of the WHOQOL-HIV-bref. Descriptive analysis and multiple linear regression were used for data analysis.
Results:
There was a prevalence of men (63.7%), non-heterosexual (57.0%), aged between 19 and 39 years (89%). Of the total, 75.5% mentioned presence of negative feelings, such as fear and anxiety, and 38% reported have suffered stigma. With regard to the dimensions investigated, the most affected were “environment” and “level of independence”. Non-heterosexual orientation was negatively associated with quality of life in almost all dimensions.
Conclusion:
Living with HIV/Aids and having a non-heterosexual orientation have a negative impact on quality of life.
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RESEARCH01-01-2017
Prevention of chronic complications of diabetes mellitus according to complexity
Revista Brasileira de Enfermagem. 2017;70(5):996-1003
Abstract
RESEARCHPrevention of chronic complications of diabetes mellitus according to complexity
Revista Brasileira de Enfermagem. 2017;70(5):996-1003
DOI 10.1590/0034-7167-2016-0080
Views0ABSTRACT
Objective:
To assess the prevention by primary health care providers of chronic complications of diabetes mellitus according to the complex thinking theoretical approach.
Method:
Evaluative research based on the complex thinking theoretical approach. The following techniques for data collection were used: interviews with 38 participants; observation in collective and individual appointments; and analysis of medical records of people with diabetes. The triangulation applied for data analysis was the ATLAS.ti software.
Results:
The prevention and management of chronic complications of diabetes did not meet the requirements set forth by ministerial public policies aimed at this population. Systematic monitoring to prevention of chronic complications showed significant gaps.
Final considerations:
Primary health care did not consider preventive actions for diabetes mellitus complications. This context was marked by disjunctive, fragmented, and dissociated practices types of care targeted to the totality of the assisted people.
Keywords:Assessment of Health ServicesChronic DiseaseComplications of DiabetesDiabetes MellitusPrimary Health CareSee more
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ORIGINAL ARTICLE12-16-2024
Complexities of nursing in healthcare waste management in hospitals
Revista Brasileira de Enfermagem. 2024;77(6):e20230391
Abstract
ORIGINAL ARTICLEComplexities of nursing in healthcare waste management in hospitals
Revista Brasileira de Enfermagem. 2024;77(6):e20230391
DOI 10.1590/0034-7167-2023-0391
Views0See moreABSTRACT
Objectives:
to understand how healthcare waste management is developed by nursing professionals in hospitals.
Methods:
qualitative research, whose theoretical and methodological frameworks were Complexity Theory and Grounded Theory. Thirty-two nursing professionals from a public hospital in Rio de Janeiro participated in the study. Semi-structured interviews were used.
Results:
nursing affects healthcare waste management multidimensionally. Shortage of materials and work overload were identified as factors that influence professionals’ decision-making and increase the risk of improper waste disposal. The lack of knowledge on the subject also influences nursing practice. However, professionals value actions related to hazardous waste.
Final Considerations:
nursing professionals recognize themselves in healthcare waste management and understand the need to develop systemic awareness for sustainable practice.
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ORIGINAL ARTICLE12-16-2024
Predisposing factors for symptoms of anxiety, depression, and insomnia in university students
Revista Brasileira de Enfermagem. 2024;77(6):e20230387
Abstract
ORIGINAL ARTICLEPredisposing factors for symptoms of anxiety, depression, and insomnia in university students
Revista Brasileira de Enfermagem. 2024;77(6):e20230387
DOI 10.1590/0034-7167-2023-0387
Views0See moreABSTRACT
Objectives:
to characterize the sociodemographic and psychological aspects of university students who sought psychiatric care at a Student Support Center of a Federal University and to analyze associations between mental health issues and predisposing factors.
Methods:
a retrospective analysis of 103 medical records was conducted. The statistical analysis consisted of two steps: a descriptive analysis and a predictive analysis using the Logistic Regression Model.
Results:
the majority of the students were female. Symptoms of anxiety, depression, and insomnia were the main reasons for seeking care. Students who reported having emotional difficulties that negatively impacted their studies and those who had undergone some form of health treatment showed a higher probability of experiencing anxiety symptoms. Notable correlations were found between anxiety and emotional difficulties, depression and diarrhea, and insomnia and a sedentary lifestyle.
Conclusions:
symptoms of anxiety, depression, and insomnia led students to seek psychiatric care at the university. Understanding the predisposing factors for mental health issues in university students can inform care strategies and promote academic success.
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ORIGINAL ARTICLE12-16-2024
Educational technology to empower patients as participants in their care
Revista Brasileira de Enfermagem. 2024;77(6):e20230359
Abstract
ORIGINAL ARTICLEEducational technology to empower patients as participants in their care
Revista Brasileira de Enfermagem. 2024;77(6):e20230359
DOI 10.1590/0034-7167-2023-0359
Views0See moreABSTRACT
Objectives:
to build and validate an educational technology to empower patients as participants in their own care.
Methods:
methodological study to develop an educational technology based on the elaboration, validation, and evaluation that were carried out in five stages at a teaching hospital in Amazonas. The study was carried out from 2019 to 2022, with the participation of 19 judges specialized in patient safety and 72 patients admitted to the hospital’s medical and surgical clinics, the study setting.
Results:
the agreement between the judges obtained an overall index of 0.85, being considered validated. The overall analysis of the booklet obtained an assessment of the level of agreement above 85%.
Final Considerations:
the educational technology presented here was validated and suitable for promoting patient/professional rapprochement and consolidating health care in a way that increases the patient’s ability to contribute to their treatment and prevent the occurrence of adverse events.
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REVIEW12-16-2024
Strategies for expanding vaccination coverage in children in Brazil: systematic literature review
Revista Brasileira de Enfermagem. 2024;77(6):e20230343
Abstract
REVIEWStrategies for expanding vaccination coverage in children in Brazil: systematic literature review
Revista Brasileira de Enfermagem. 2024;77(6):e20230343
DOI 10.1590/0034-7167-2023-0343
Views0See moreABSTRACT
Objectives:
to identify the strategies found in the literature for increasing vaccination coverage among children in Brazil. It is justified mainly by the current scenario of falling vaccination coverage.
Methods:
systematic literature review. The search was carried out in the Pubmed (MEDLINE), Embase and Scopus databases, following the PRISMA guidelines.
Results:
initially, 4,824 results were returned. In the end, 6 studies were included for narrative synthesis using the SWiM methodology. Of these, 50% dealt with studies related to the Bolsa Família Program (PBF). The others explored strategies for approaching parents directly, Rapid Vaccination Monitoring (MRV) and the Community Health Agents Program (PACS). The PBF did not guarantee compliance with the conditionality of keeping vaccinations up to date. The MRV and PACS are effective strategies, especially because they allow active search for absentees.
Conclusions:
we conclude that more publications are needed on strategies to increase vaccination coverage among children in Brazil.
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ORIGINAL ARTICLE12-16-2024
The nursing practice environment and hospital sociotechnical complexity: a mixed-methods study
Revista Brasileira de Enfermagem. 2024;77(6):e20230315
Abstract
ORIGINAL ARTICLEThe nursing practice environment and hospital sociotechnical complexity: a mixed-methods study
Revista Brasileira de Enfermagem. 2024;77(6):e20230315
DOI 10.1590/0034-7167-2023-0315
Views1See moreABSTRACT
Objectives:
to analyze the relationship between the nursing practice environment and hospital sociotechnical complexity as perceived by nurses.
Methods:
a sequential explanatory mixed-methods study was conducted in a hospital in southern Brazil. The Brazilian version of the Practice Environment Scale-Nursing Work Index and the Complexity Characterization Questionnaire were administered to 132 nurses. Subsequently, semi-structured interviews were conducted with 18 participants, and the data were subjected to thematic analysis. Data integration was achieved through a connection approach.
Results:
the nursing practice environment was found to be favorable, except in the subscale concerning Staffing and Resource Adequacy, where complexity was present in the activities. The three emerging categories explained human and technical aspects related to complexity in the practice environment, quality of care, and patient safety. Unexpected variability was inversely correlated with the practice environment.
Conclusions:
the study results indicate a relationship between these constructs, with implications for the quality and the safety of care.
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ORIGINAL ARTICLE12-16-2024
Factors associated with maternal well-being during childbirth among postpartum women in Minas Gerais
Revista Brasileira de Enfermagem. 2024;77(6):e20230304
Abstract
ORIGINAL ARTICLEFactors associated with maternal well-being during childbirth among postpartum women in Minas Gerais
Revista Brasileira de Enfermagem. 2024;77(6):e20230304
DOI 10.1590/0034-7167-2023-0304
Views0See moreABSTRACT
Objectives:
to analyze the factors associated with maternal well-being during childbirth among postpartum women in Minas Gerais.
Methods:
a cross-sectional study nested within a cohort was conducted with postpartum women in a municipality of Minas Gerais. The Maternal Well-being in Childbirth Scale 2 was used. The prevalence of maternal well-being during childbirth was estimated. The magnitude of the association between maternal distress and care practices was estimated using the Prevalence Ratio (PR), applying Poisson regression.
Results:
a total of 183 postpartum women aged between 15 and 46 years participated, with 26.2%, 27.9%, and 45.9% reporting excellent, adequate, and poor well-being during childbirth care, respectively. Maternal distress was more prevalent among women who underwent cesarean sections (PR = 1.60) and those who did not receive breastfeeding information (PR = 1.59).
Conclusions:
a high prevalence of maternal distress during childbirth was observed, associated with cesarean delivery and the lack of breastfeeding information.
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ORIGINAL ARTICLE12-16-2024
Prevalence and factors associated with musculoskeletal pain among hospital cleaning staff
Revista Brasileira de Enfermagem. 2024;77(6):e20230237
Abstract
ORIGINAL ARTICLEPrevalence and factors associated with musculoskeletal pain among hospital cleaning staff
Revista Brasileira de Enfermagem. 2024;77(6):e20230237
DOI 10.1590/0034-7167-2023-0237
Views0RESUMO
Objetivos:
verificar a prevalência e os fatores associados à dor musculoesquelética em trabalhadores do serviço hospitalar de limpeza.
Métodos:
estudo transversal, realizado com trabalhadores de limpeza de um hospital de ensino do Sul do Brasil. Utilizaram-se questionário com variáveis sociodemográficas, laborais e de saúde, o Nordic Musculoskeletal Questionnaire e o Diagrama de Corlett e Manenica. Realizou-se análise bivariada.
Resultados:
participaram 149 trabalhadores. Prevaleceu dor musculoesquelética na coluna lombar no último ano (65,8%) e últimos sete dias (42,3%). Constataram-se associações entre automedicação e dor na parte inferior das costas (p=0,020) e ombros (p=0,026); sedentarismo, oito horas de sono diárias e dor nos tornozelos (p=0,041) e pés (p=0,039); ex-tabagismo, uso de medicamento e dor nos punhos (p=0,015) e mãos (p=0,004).
Conclusões:
prevaleceram lombalgias associadas a hábitos de saúde e vida. Um programa de educação em saúde e recomendações de melhorias nos processos de trabalho podem minimizar a exposição à dor musculoesquelética.
Keywords:Dor MusculoesqueléticaSaúde do TrabalhadorServiço Hospitalar de LimpezaServiços HospitalaresTranstornos Traumáticos CumulativosSee more
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RESEARCH06-01-2015
Perceptions of adolescent students about drugs
Revista Brasileira de Enfermagem. 2015;68(3):517-523
Abstract
RESEARCHPerceptions of adolescent students about drugs
Revista Brasileira de Enfermagem. 2015;68(3):517-523
DOI 10.1590/0034-7167.2015680320i
Views0See moreABSTRACT
Objective:
To analyze the perceptions of adolescent public school students about drugs.
Method:
Qualitative approach of focus groups with 16 adolescent students. The data collected were analyzed by means of content analysis, leading to the following categories: meaning of drugs; living with drug use; opinions, beliefs and attitudes toward drug use; and preventing drug abuse in adolescence.
Results:
The adolescent students know about some drugs, and associate their use with delinquent and criminal behavior. The students identifi ed factors that lead to drug abuse, such as easy access, use by family and friends, idleness, dropping out of school and the characteristic vulnerability of adolescence.
Conclusion:
the results point to the need for educational activities in the context of where the adolescents live, including school, community and family environments, to support and to minimize their vulnerability.
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RESEARCH06-01-2015
Cognitive stimulation for older people with Alzheimer’s disease performed by the caregiver
Revista Brasileira de Enfermagem. 2015;68(3):510-516
Abstract
RESEARCHCognitive stimulation for older people with Alzheimer’s disease performed by the caregiver
Revista Brasileira de Enfermagem. 2015;68(3):510-516
DOI 10.1590/0034-7167.2015680319i
Views0See moreABSTRACT
Objective:
to learn the infl uence of cognitive therapy at home, conducted by the caregivers of older people with Alzheimer’s Disease.
Method:
a case study was developed with fi ve older people with Alzheimer’s Disease and their caregivers. The stages of research development were: orientation with the caregivers; selection of older people and caregivers; approach of the study subjects at home; weekly meetings and reapplication of tests to follow up the cognitive function of the participants.
Results:
in three months it was possible to identify improved cognition, verifi ed by the result of the Mini-Mental State Examination (MMSE). The scores of the other tests (KATZ, LAWTON, CLOCK TEST and VFT) remained the same.
Conclusion:
this strategy can be considered a light technology of nursing care for older people with dementia. When providing this care with the support of a nurse, caregivers re feel less anxious and understand the disease better.
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RESEARCH06-01-2015
Anxiety and spirituality in university students: a cross-sectional study
Revista Brasileira de Enfermagem. 2015;68(3):504-509
Abstract
RESEARCHAnxiety and spirituality in university students: a cross-sectional study
Revista Brasileira de Enfermagem. 2015;68(3):504-509
DOI 10.1590/0034-7167.2015680318i
Views0See moreABSTRACT
Objective:
to study anxiety and spirituality and the relationship between them in university students.
Method:
the State-Trait-Anxiety Inventory (STAI) and Pinto and Pais-Ribeiro Spirituality Scales were used for data collection.
Results:
six hundred and sixty-nine students participated in the study, of whom 91.5% had moderate and high levels of trait anxiety and 92.9% of state anxiety; 93.8% had high spirituality scores. The multiple linear regression test showed a signifi cant relationship between anxiety and the presence of physical discomfort, unusual body movements, and the need for treatment. Furthermore, higher levels of anxiety were associated with the female gender, the lack of leisure activities, and low levels of optimism in the spirituality scale.
Conclusion:
it is important to develop strategies for coping with anxiety, which in turn can be oriented toward protective factors such as spirituality.
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RESEARCH06-01-2015
Nursing guidance on bed baths to reduce anxiety
Revista Brasileira de Enfermagem. 2015;68(3):497-503
Abstract
RESEARCHNursing guidance on bed baths to reduce anxiety
Revista Brasileira de Enfermagem. 2015;68(3):497-503
DOI 10.1590/0034-7167.2015680317i
Views0See moreABSTRACT
Objective:
to evaluate the effectiveness of a nursing guidance protocol to reduce the anxiety of patients with acute coronary syndrome undergoing bed bath, and the correlation of vital signs with state-anxiety.
Method:
randomized clinical trial study. The sample consisted of 120 patients. The intervention group received a nursing guidance protocol about bed bath and the control group received the unit’s routine information. The STAI-State scale was used to assess anxiety, and data were collected at three times: immediately after informing the patients about the bed bath; immediately after interventions; and immediately after the bath.
Results:
the intervention group presented signifi cantly lower state-anxiety compared to the control group (p<0.001) after the intervention.
Conclusion:
the nursing orientation was effective to reduce anxiety in patients with acute coronary syndrome undergoing bed bath.
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RESEARCH06-01-2015
Body language in health care: a contribution to nursing communication
Revista Brasileira de Enfermagem. 2015;68(3):490-496
Abstract
RESEARCHBody language in health care: a contribution to nursing communication
Revista Brasileira de Enfermagem. 2015;68(3):490-496
DOI 10.1590/0034-7167.2015680316i
Views0See moreABSTRACT
Objective:
to classify body language used in nursing care, and propose “Body language in nursing care” as an analytical category for nursing communication.
Method:
quantitative research with the systematic observation of 21:43 care situations, with 21 members representing the nursing teams of two hospitals. Empirical categories: sound, facial, eye and body expressions.
Results:
sound expressions emphasized laughter. Facial expressions communicated satisfaction and happiness. Eye contact with members stood out in visual expressions. The most frequent body expressions were head movements and indistinct touches.
Conclusion:
nursing care team members use body language to establish rapport with patients, clarify their needs and plan care. The study classifi ed body language characteristics of humanized care, which involves, in addition to technical, non-technical issues arising from nursing communication.
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RESEARCH06-01-2015
Health promotion in supplementary health care: outsourcing, microregulation and implications for care
Revista Brasileira de Enfermagem. 2015;68(3):482-489
Abstract
RESEARCHHealth promotion in supplementary health care: outsourcing, microregulation and implications for care
Revista Brasileira de Enfermagem. 2015;68(3):482-489
DOI 10.1590/0034-7167.2015680315i
Views0See moreABSTRACT
Objective:
to analyze health promotion programs in the supplementary health care.
Methods:
This was a multiple case study with a qualitative approach whose data were obtained from interviews with coordinators of providers contracted by the corporations of health insurance plans in Belo Horizonte, Minas Gerais. The data were submitted to Critical Discourse Analysis.
Results:
Home care has been described as the main action in the fi eld of health promotion transferred to the providers, followed by management of patients and cases, and the health education.groups. The existence of health promotion principles is questionable in all programs. Outsourcing is marked by a process with a division between cost and care management. Implications of this process occur within admission and interventions on the needs of the benefi ciaries.
Conclusions:
Statements revealed rationalization of cost, restructuring of work, and reproduction of the dominant logic of capital accumulation by the health insurance companies.
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RESEARCH06-01-2015
Gateway to the diagnosis of tuberculosis among elders in Brazilian municipalities
Revista Brasileira de Enfermagem. 2015;68(3):467-473
Abstract
RESEARCHGateway to the diagnosis of tuberculosis among elders in Brazilian municipalities
Revista Brasileira de Enfermagem. 2015;68(3):467-473
DOI 10.1590/0034-7167.2015680313i
Views0See moreABSTRACT
Objective:
to analyze the factors associated with the gateway of the health systems of Brazilian municipalities for the diagnosis of tuberculosis in older people.
Method:
survey study type, with a sample of 91 elders, in a population with 706 cases of tuberculosis. Data were collected by means of an instrument based on the Primary Care Assessment Tool (PCAT) adapted for tuberculosis care, emphasizing the gateway variable. Variables were categorized and compared between primary health care (PHC) and specialized care (SC) services. Bivariate analysis and the Chi-square association test were used.
Results:
a statistically signifi cant association (p = 0.0001) was found between the fi rst health service sought and the unit that diagnosed tuberculosis, showing better performance of specialized care services in the diagnosis.
Conclusion:
it is necessary to improve primary health care services to tackle delayed diagnosis of tuberculosis in older people.
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