Navegando por Palavras-chave "Pneumonia aspirativa"

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    Análise da fase faríngea da deglutição em indivíduos submetidos à cricohioidoepiglotopexia: Aspecto em “cascata” e angulação do hióide
    (Universidade Federal de São Paulo (UNIFESP), 2006-12-31) Catelan, Silvia Rovath César [UNIFESP]; Lederman, Henrique Manoel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose:. To describe anatomically the swallowing pattern on individuals underwent supracricoid partial laryngectomy (SCPL) reconstructed by cricohyoidoepiglottopexy (CHEP) technique and analyze the angulation of the hyoid bone as a risk factor for aspiration. Methods: Thirteen individuals, 11 males and 2 females were studied, and the median age was 63,5 (48 to 79). They underwent to SCPL-CHEP between March 1997 and September 2002, and were submitted to an Imaging Dynamic Swallowing Study (IDSS) in 2002 at the Imaging Diagnostic Department of the Sâo Paulo Federal University. Softwares Shortcut Premier 6.5 and Photoshop (Adobe) were used to capture and digitalize the selected images which were analyzed through visual observation. The angulations measurements of the hyoid bone were obtained using the software Image J of the National Institute of Health (NIH), running in a HP Pavilion zf1130 computer. The images were analyzed frame by frame by a radiologist and two speech patologists. Results: The study has revealed a cascade pattern of swallowing resultant from the remanescent structures position during oral and pharyngeal swallowing phases. Five individuals presented tracheal aspiration. The lower limit for the angulation of the hyoid bone for the individuals without aspiration was 60°. Conclusion: The individuals who underwent to a SCPL-CHEP presented a cascade swallowing pattern. The occurrence of tracheal aspiration was related to the angulation of the hyoid bone post-operatory.
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    Processo educacional interprofissional participativo de prevenção de broncoaspiração: perspectiva da andragogia
    (Universidade Federal de São Paulo (UNIFESP), 2018-08-30) Motoyama, Caio Sussumu de Macedo [UNIFESP]; Tanaka, Luiza Hiromi [UNIFESP]; Santana, Carmen Lúcia Albuquerque de [UNIFESP]; http://lattes.cnpq.br/6606709740942303; http://lattes.cnpq.br/9047748805998095; http://lattes.cnpq.br/8114846502789870; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Interprofessionality presents itself as a condition of integrality in health care, as a result of the effort and confluence of various knowledge of the concrete and singular space of the health service, with work organized in a cooperative way, contemplating activities and routines that reflect learning with and on the different members of the health team. Knowing possibilities of constructive and dialogued interaction implies knowing the totality of the work process. Objective: To understand and analyze the educational process in a participatory interprofessional format, in an andragogical perspective, through the implementation of an educational action to prevent bronchoaspiration in an intensive care unit of a university hospital in São Paulo. Method: Research of qualitative approach in which the methodological strategy of action research was used. An educational action was implemented through interprofessional focus groups, composed of nurses, physiotherapists, speech therapists, physicians, nutritionists and nursing technicians, for the collective construction of a protocol for the prevention of bronchoaspiration, based on the theory of andragogy. Subsequently, an interprofessional training was carried out on the protocol with the collaborators of the ICU multiprofessional team. At the evaluation stage, a comparative study was carried out between the pre- and post-educational activities in which the data collection of the care involving the prevention of bronchoaspiration was carried out by means of a questionnaire, systematic observation of the bedside and analysis of medical records. And the techniques of individual interviews and focus group with the multiprofessional team and with the collaborators who participated in the training. Results: The meetings through focus groups and interviews showed that the interaction provided by the educational action brought greater understanding of the interprofessional educational process and strengthened the awareness of the importance of establishing learning relationships in the work team, motivating the team in the search for strategies to intensify this educational interprofessional exchange, through the proposal of organization deliberated by the group to carry out periodic multiprofessional visits. The objective data after the educational action showed significant statistical differences, such as the increase in the performance of nurses and nursing technicians in the questionnaires, as well as a significant evolution in the performance of bronchoaspiration prevention actions in the systematic observation in the field, such as standardization of the fate given to the residual gastric volume, and in the medical record, on the measurement of cuff pressure and oral hygiene. The good performance of these nursing professionals can be attributed to the fact that the training was carried out from the andragogical perspective and from the interprofessional perspective. Final considerations: Adult learning has a greater potential for success, from the organization of actions using formats that favor dialogue, through teaching-learning techniques that observe andragógical principles. The construction of educational actions in the interprofessional format may be an even more promising path when these andragogical concepts are observed.