Navegando por Palavras-chave "Needs Assessment"
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- ItemAcesso aberto (Open Access)O adoecer em usuários de insulina acompanhados no Programa de Automonitoramento Glicêmico: da prática assistencial à integralidade em saúde(Universidade Federal de São Paulo (UNIFESP), 2019-02-15) Dias, Ivan Wilson Hossni [UNIFESP]; Junqueira, Virginia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Diabetes Mellitus patients using insulin have singularities in the way they fall ill and in the recovery of functional normality in their daily lives. Investigating the work process of the professionals of the Glycemic Self-Monitoring Program, comparing the health needs of insulin users, can contribute to the improvement of care practices from the perspective of integrality. Objectives: subsidize healthcare practices within the scope of the Glycemic Self Monitoring Program of a Basic Health Unit based on the characterization of the health needs of individuals with DM in insulin use. Identify and characterize the health needs of individuals with DM who use insulin accompanied by the Glycemic Self Monitoring Program of a Basic Health Unit. Identify and characterize health practices within the scope of the Glycemic Self Monitoring Program in the perspective of integrality of care. Discuss with the professionals working in the GSMP the experience of the sickness of users with DM in use of insulin. Methods: qualitative design study. Two conversation wheels were carried out with insulin users followed up by the Family Health Strategy team and five semi-structured interviews with all health professionals working in the GSMP of a Basic Health Unit in the city of São Paulo. The recorded material was submitted to the technique of content analysis. Results: The process of sickness of insulin users is directly related to the obstacles that this practice imposes to social and productive normality. It is remarkable in the experience of getting sick the difficulties of reordering the vital functionality by the sick people, expressed by a behavioral tendency of resistance to the therapeutic proposals that affect the ways of life. The need for perception of the pharmacological effect on the lived body is revealed in the dimension of the insulin treatment, in the search for the recovery of the biological self, as well as the conflict subsequent to the need for insulin management inserted within a singular aesthetic of living. The group activities developed by the GSMP of the Basic Health Unit operate as a potential space for dialogical exchange between the community and health workers, an expectation that is incorporated into the distribution of inputs and management of clinical records. From the perspective of health professionals, the work process presents operational obstacles, related mainly to the divergence and articulation of information among health equipment workers. The difficulty in promoting the autonomy of the sick people has been associated with the symbolic fatalism resulting from the inability of the insulin users to reproduce technical-instrumental knowledge. Conclusion: The practice of care in the context of the Basic Health Unit finds difficulties in responding to the health needs of insulin users. The constitution of dialogical spaces with the community in the context of the GSMP and the incorporation of different knowledge in the day-to-day care showed to be relevant for the characterization of their lifestyles and thus can determine singular approaches in the planning of the care of the people in use of insulin.
- ItemAcesso aberto (Open Access)Necessidades de pacientes com transtornos do espectro da esquizofrenia como indicador de resultado na avaliação de serviços comunitários de saúde mental(Universidade Federal de São Paulo (UNIFESP), 2017-02-15) Andrade, Mario Cesar Rezende [UNIFESP]; Andreoli, Sergio Baxter [UNIFESP]; Bandeira, Marina de Bittencourt; http://lattes.cnpq.br/5161981285689911; http://lattes.cnpq.br/3330444987520974; http://lattes.cnpq.br/0634812325568520; Universidade Federal de São Paulo (UNIFESP)Objective: To study the needs of patients with schizophrenia spectrum disorders treated at community mental health services and their association with service use, adjusted for individual variables. Methods: A cross-sectional study was carried out with a probabilistic sample of 401 patients who were attended at the five Psychosocial Care Centers of the city of Santos, in a period of one year prior to data collection. Needs assessment was performed using the Camberwell Assessment of Need, applied in a structured clinical interview. This instrument 22 clinical and social needs of patients with severe disorders. Its score is obtained through the sum of the number of total, met and unmet needs besides the possibility of analyzing whether there is a need and whether it is met or unmet. Symptoms were assessed by the Positive and Negative Symptom Scale and a questionnaire of history of the disease was adapted from the Life Chart Rating Form. Hierarchical multiple regression analyzes were performed to investigate the factors associated with numbers of total and unmet needs. Hierarchical logistic regression was applied to identify factors related to the following clinical needs: psychotic symptoms, information and psychological distress. Results: The average number of total needs (attended + unmet) was 5.85 (3.09) and the number of unmet needs was 2.91 (2.55). These numbers were shown to be associated only with sociodemographic and clinical indicators of severity, showing no association with the use of services. The presence of the need related to psychotic symptoms was associated with a higher level of positive symptoms and non-involvement of the family in the treatment, while na unmet need was again associated with a higher level of these symptoms and a dissatisfaction with the medication used. The presence of information need was associated with lower educational level, higher age at onset and monitoring of medication use by the family, while na unmet need was associated with noninvolvement of the family in the treatment, although this model was not statistically significant. The need related to psychological distress was associated with the presence of suicidal thoughts in the last year, greater general psychopathology, use of psychotherapy in the last year and absence of psychosocial rehabilitation activities, while an unmet need was again associated with a higher level of psychopathology and the lack of follow-up of the patient in the treatment by a family member. Conclusion: The present study pointed to the needs assessment as a possible outome measure in Brazilian mental health services, associated to the use of these services. This occurred mainly in the analysis of patients' specific clinical needs. The results also reinforced the role of family members in meeting patients' needs. These findings seem to contribute to the production of outcome measure which are relevant to mental health services in Brazil, where there is still no systematic and continuous evaluation of mental health care.
- ItemSomente MetadadadosNecessidades de saúde de pessoas transgênero, travestis e não-binárias: possibilidades e desafios para a enfermagem(Universidade Federal de São Paulo (UNIFESP), 2019-03-28) Pereira, Nayla Rodrigues [UNIFESP]; Horta, Ana Lucia De Moraes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Despite media evidence regarding the health demands of travesti, transgender and nonbinary people, studies in health research, specifically in nursing, do not address the diversity and specificities of this population. In Brazil, the health care setting for this population was named the Transsexualizing Process and is based on the medical diagnosis of transsexuality. Concerning at health care needs from a collective perspective, not much was known from a depathologizing framework. Even less have described in the literature on the role of nursing during patient assessment and care delivery. The main objective of this study is to identify the health needs of people who experience the process of gender affirmation. Method: This is a qualitative, descriptive and exploratory study, divided into three phases. For the selection of participants, the concept of purposeful sampling was used, with emphasis on variation, seeking the highest diversity possible for the group selected. Data collection was performed using the semi-structured interview. All interviews were transcribed and the data analysis was performed with the MAXQDA software tool. The systematization of the empirical material used the concept of the theoretical framework of the thematic analysis. Results: Twenty people participated in the study, being 11 trans men, three trans women, a travesti, a transfeminine, a man, a woman, a non-binary trans man and a crossdresser. During the analysis process, the categories emerged were: Health Needs of trans, transvesti and non-binary people (which included the topics: need for good living conditions, need for access to health technologies and PAG, need for bonding with health professionals and the need for self-care and body autonomy for the trans person) and the health conceptualization. The nursing practice were highlighted in the empirical material, as its performance humanizes care, promote user embracement and cares for the body in transition along the nursing consultations. Discussion: Health needs are diverse and addressed various spheres of social life. The issues of good living conditions were highlighted by the vulnerability of the population. In general, these demands have not been satisfied by health services and the research results have confirmed evidence found in previous studies such as barriers to access to health, unpreparedness of professionals to care for a trans person, and difficulties in legal recognition of their name. Discrimination and violence marked the results, mainly for denied access to health care and fulfilling the population needs. There is still a lack of evidence about of the practices performed by nursing during the process of gender affirmation. Conclusion: The health needs of travesti, transgender and non-binary people are diverse, correlated to other social markers. Nursing appears as a co-participant in the process of recognition and satisfaction of these needs, requiring further studies in the area from a collective health perspective.