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- ItemAcesso aberto (Open Access)Análise da viabilidade econômica da unidade móvel de um serviço de referência em oftalmologia(Conselho Brasileiro de Oftalmologia, 2005-10-01) Lima, Luiz Henrique Soares Gonçalves De; Sousa, Luciene Barbosa De [UNIFESP]; Hospital Oftalmológico de Sorocaba; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To analyse the economic viability of a mobile eye clinic of a tertiary referral Ophthalmology Service. METHODS: The amount of money spent with the purchase and construction of the unit in 2000, and the expenses with its maintenance and operation in 2001 were considered, comparing these expenses with the income obtained from appointments, supplementary tests and eye surgeries through the Sistema Único de Saúde (a health care service provided by the government), in 2001. In order to make an economic analysis, an interest rate of 10% per year and a period of depreciation of 10 years were stipulated. RESULTS: The total amount spent to buy and set up a mobile unit of Hospital Oftamológico de Sorocaba was R$ 184,140,00. The amount spent with its maintenance and operation during 2001 was R$ 28,000.00. The unit was used on average during 2 days each week in 2001 and 6492 appointments were made in this period, generating an income of R$ 32,460.00. The appointments generated complementary tests and eye surgeries making up R$ 51,540.00. Therefore, the total amount received directly with the appointments, complementary tests and eye surgeries during 2001 was R$ 84,000.00 paid by the Sistema Único de Saúde, according to values established beforehand. Using these values it is possible to make an economic analysis of this enterprise and this was done with and without money savings for depreciation, taking into account the income and the expenses. CONCLUSION: Besides attending poor communities that are located in distant neighborhoods, a mobile eye clinic can be a source of income for ophthalmologic services.
- ItemAcesso aberto (Open Access)Avaliação da resolutividade e da satisfação da clientela de um serviço de referência secundária em oftalmologia da Universidade Federal de São Paulo (UNIFESP) - UNIFESP(Conselho Brasileiro de Oftalmologia, 2003-01-01) Gentil, Rosana Maura; Leal, Sandra Maria Reis [UNIFESP]; Scarpi, Marinho Jorge [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)In developing countries blindness prevalence could be reduced if access to ophthalmic assistance for the population were not impaired by the lack of organization of the resources. Besides the primary level, organization of ocular care establishes secondary and tertiary care levels, according to the complexity of the diagnosis and treatment of the ocular diseases. The Ophthalmic Secondary Reference Center (CERESO) of the Department of Ophthalmology, Federal University of São Paulo, according to an internal flow model of assistance, selects cases of low complexity to be seen on the same day, the others being referred to the tertiary level. PURPOSE: To evaluate CERESO's resolution and its user's satisfaction. METHODS: By means of applying a questionnaire based on the resolution of the main complaint and for the client's satisfaction, a sample of 238 users was interviewed from February to July, 1998. RESULTS: CERESO's resolution degree was 85.96%; the user's satisfaction was 100%; 6.8% of the users chose CERESO because it was close to their homes; 21.3% because they could be seen on the same day; 13.9% because they were already UNIFESP patients and 58.1% because they like UNIFESP or were indicated by another patient. CONCLUSIONS: The customers were very pleased with the assistance they were given, and their major aims were achieved. The organization of the ophthalmological services, with the secondary care service establishment, would certainly have a positive impact on the solution of ophthalmic problems - especially refractive errors. For this reason, this organization would case an important public health problem.
- ItemAcesso aberto (Open Access)Construção do conhecimento e do fazer enfermagem e os modelos assistenciais(Universidade de São Paulo, Escola de Enfermagem, 2006-06-01) Lucena, Amália de Fátima; Paskulin, Lisiane Manganelli Girardi; Souza, Mariana Fernandes de [UNIFESP]; Gutiérrez, Maria Gaby Rivero de [UNIFESP]; Universidade Federal do Rio Grande do Sul Escola de Enfermagem; Universidade Federal de São Paulo (UNIFESP)This is a reflective paper focused on the origins and main characte-ristics of the epidemiological and clinical models, their connections with the health care models currently adopted in Brazil, and the construction of Nursing knowledge in this context. From this perspective, the authors propose a re-thinking of Nursing knowledge and practice, pointing out possibilities for expanding the Nursing field, as well as the boundaries and challenges to be overcome by the area professionals.
- ItemAcesso aberto (Open Access)Educação para o autogerenciamento de pacientes com câncer de cabeça e pescoço apoiada em multimídia(Universidade Federal de São Paulo (UNIFESP), 2017-10-26) Hortense, Flavia Tatiana Pedrolo [UNIFESP]; Domenico, Edvane Birelo Lopes De [UNIFESP]; Bergerot, Cristiane Decat; http://lattes.cnpq.br/4394065755397984; http://lattes.cnpq.br/9590895567864681; http://lattes.cnpq.br/4611985668712695; Universidade Federal de São Paulo (UNIFESP)Head and neck cancer (CA/HN) is among the ten most frequent in Brazil, reaching about 1.7% of the population. The treatments can result in functional and aesthetic deficiencies, depending on location and staging. Educational interventions should be developed to assist patient in the process of adaptation and generation of selfmanagement skills. Objectives: to build, validate the content of an educational program based on the principles of self-management, directed to patients with CA/HN, and to evaluate the effectiveness of this program in a comparative way, and through a reception study. Method: study of mixed nature, divided into three steps: (1) methodological study, for the construction and validation of a script for the development of learning objects, (2) experimental study, randomized and controlled, to evaluate the educational intervention based on the usual action versus the multimedia, through the instruments Functional Assessment of Cancer Therapy-Head and Neck (FACT-H & N) and Hospital Anxiety and Depression Scale (HADS) in four time points, from the beginning of the treatment to the follow-up period (12 months) and (3) qualitative study to evaluate the educational material developed on the basis of the principle of the reception study. The results were analyzed according to the study design of each step. Results: in the first step, the script was approved by 99 percent of all health professionals. The kappa free-marginal statistical test presented a value of 0.68%, giving a substantial agreement, resulting in the production of a printed manual and an educational video. In the second, the control group (GC) reported gradual decrease on the quality of life (QOL) scores over the time points, while the experiment group (GE) has increased progressively their scores. The prevalence of anxiety and depression (AD) symptoms was low in both groups, next to those described in the literature. The correlation was significant between the presence of AD symptoms and poor QOL. GC patients showed significant worsening in social/family well-being and on the prevalence of additional concerns related to CA/HN, while the GE presented decrease on anxiety symptoms and increase on emotional well-being. In the last step, the educational material was evaluated as satisfactory for the subject sequence, length, language and images used. Participants have attested that the educational materials helped in the development of skills for self-management. Conclusion: the steps adopted for the construction and validation of the content, and for the development of educational materials were effective, appropriate and capable of reproduction. The different criteria used for the educational material evaluation indicated and highlighted the benefit of this educational action. It was observed that patients have opted for a better adaptive response to the illness. In addition, the assessment routine brought indicators that guided the team working. The educational material was considered appropriate for the target population and capable of generating skills for self-management.
- ItemAcesso aberto (Open Access)Puerpério e psicose: o que sabemos sobre ?(Universidade Federal de São Paulo, 2021) Silva, Larissa Rosa Calhau [UNIFESP]; Honorato, Tabata Galindo [UNIFESP]; Avezani, Amanda Carolina Franciscatto [UNIFESP]; http://lattes.cnpq.br/5277720344607905; http://lattes.cnpq.br/1331252434870580; http://lattes.cnpq.br/2525965231887777Introduction: The puerperal period is referred to as a time of intense vulnerability, the woman, to the occurrence of perinatal disorders, including Puerperal Psychosis (PPP). With abrupt and unexpected presentations, his clinic often requires hospitalization and immediate treatment, due to the negative impact on establishing the link between the binomial, in addition to the probability of occurrence of infanticide and maternal suicide. Objective: Conduct a survey about psychopathological aspects of puerperal psychosis. Methodology: This is an integrative literature review, using the PICO strategy, with the guiding question "What is the health care for women with puerperal psychosis and the impact on the mother-infant bond?" Discussion: Puerperal psychosis is a psychiatric emergency, developed from multiple factors, including biological, hereditary and hormonal. The complexity in the face of the clinical picture and the therapeutic suitability in caring for patients with PPP, highlights the need for specific strategies for the psychological recovery of the puerperal woman. Based on the prevalence of the subjects of this research, axes were stratified such as: Early diagnosis and the role of nurses (a), Social support networks and Reproductive and mental health of women with PPP. Conclusion: The limitation of research on psychopathology reports the insufficient knowledge and preparation of health professionals about the proper treatment and assistance to women with PPP. The objective of early diagnosis helps to minimize the harm to the newborn's cognitive and emotional development, as well as allowing the reconnection of the link between the binomial. It is therefore necessary to invest in scientific research on psychopathology and its effective strategies to adapt the outcome of the clinical condition, as well as access to mental health services and the support network of the puerperal woman with PPP.