Navegando por Palavras-chave "transplantes"

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    Guia de boas práticas para departamento hospitalar e ambulatorial de oftalmologia
    (Universidade Federal de São Paulo (UNIFESP), 2016-12-21) Traverso, Maria Rossana Almeida [UNIFESP]; Rodrigues, Eduardo Buchele [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    This project was conceived in order to develop a good practice guide directed to the Department of Ophthalmology, which aims to facilitate the access to the good practice information that involve all procedures used in hospitals and clinics, correlating them with the current regulations. Sectors of the Department of Ophthalmology were considered, focusing on procedures regulated by Rules of the Federal, State and / or Municipal to then critically analyze and interpret the regulatory rules, consisting of laws, decrees, resolutions, guidelines and ordinances relevant to the department of ophthalmology and medical staff involved. Regulated procedures were described by preparing the Good Practice Guide for Hospital and Clinical Department of Ophthalmology and distributed in 8 chapters, which correspond to different categories of procedures adopted in the hospital and clinical department of ophthalmology. At a later stage, through the analysis of the Good Practice Guide for Hospital and Clinical Department of Ophthalmology, it was elaborated a checklist to be filled by doctors and/or professionals working in the hospital and / or clinical Department of Ophthalmology as a tool to help them in the control of the compliance with applicable rules. Evaluating the activities carried out in hospitals and clinical ophthalmology departments, correlating them with regulatory issues and good practice, a total of 17 Resolutions, 6 Ordinances, 2 Laws, 1 Decree, 1 Procedure, 1 Script, 1 Informative and 3 guides were identified, which were used as a reference for obtaining the information necessary for the preparation of the Good Practice Guide for Hospital and Clinical Department of Ophthalmology. Through the guide to good practice for hospital and clinical department of ophthalmology, the access to information necessary to ensure the quality and safety of services becomes easier.
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    Mensuração da adesão aos medicamentos imunossupressores em pacientes adultos no pós transplante renal
    (Universidade Federal de São Paulo (UNIFESP), 2016-08-31) Leite, Renata Fabiana [UNIFESP]; Roza, Bartira de Aguiar Roza [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Adherence to treatment regimen following transplantation is a multidimensional phenomenon determined by the interaction of five agents namely: health staff, social and economic, the treatment, the patient and the disease. Various methods, in order to detect non-adherence (NA) in transplantation patients, have been suggested in the literature, but there is no single method that is considered efficient. Objective: measure adherence to immunosuppressive medications in the post renal transplantation by using the Scale Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS). Method: The sample consisted in adult patients in post-renal transplant, which had stayed at least four full weeks at home after hospital discharge and outpatient care. They were evaluated by the BAASIS instrument: the intake of prescribed medication; days using the correct dose; time within 25% of the prescribed time; break from medication; ingestion time exceeding 24 hours; dose changes on their own, complexity of prescribed doses, perception of the patient towards treatment, creatinine levels, blood levels of immunosuppressive medications. The basic and clinical forms were used to identify possible causes of decreased adherence and the relation with patient?s survival. Results: 181 patients with renal transplantation (TXR), the mean age at the time of visit to outpatient care center follow-up was 44.2 years (DP4 = 13.4 years), noting the minimum age was 18 years, and the maximum was 74, 43.1 % of patients were of brown skin (mulatto), 53.6% were married, 64.7% had family income between 1 and 4 minimum wages, 38.7% had high school education. Regards the participation in economic life in the family group were 29.8% of sickness assistance and 31.0% retirement, they were used 1.3 (SD = 0.7) different types of means of transport especially the bus (38%) and ambulance (31.8%) for outpatient care visits, 41.4% of patients had BMI 25.81 kg / m2, the outpatient follow-up was 276.8 weeks (5.3 years), 92.8 % underwent dialysis and 49.2% received kidney transplantation from deceased donor (TXRF). Only 4.4% had a caregiver, 7.2% in outpatient pharmaceutical monitoring and 1.7% had RAC. The average time to separate the medication is 3.62 minutes. Regards adherence, the brown skin patients had 100% compliance. Married patients had the highest percentage of adherence compared to other patients. The autonomous group and obese group showed 30.8% and 20% of the NA sample. The adherence to immunosuppressant drugs in the past four weeks was more than 94%, that is, never stopped taking several consecutive doses of immunosuppressive medications (Q2) and never took a lower dose of their medications than prescribed by the doctor (Q4). Additionally, 87.8% of patients showed never forget to take immunosuppressive medications ever (Q1). But the item that deals with delay in medications (Q3) had the lowest percentage of answer ?'never" compared to the other items - 64.1% reported never having experienced such a situation. Overall, 58.6% answered "never" in the four items pointing total adherence, 18.8% failed to adhere to one of the four situations once a month. So it has to be 41.4% failed to adhere to one of the four situations in the past four weeks. Conclusion: This study showed that patients who had difficulties to have adherence were white, living alone (separated, divorced), obese, unemployed or self-employed, probably because they had a very fragile routine or lack of it in their lives. A significant part of the sample, i.e. 41.4% failed to adhere to the immunosuppressant drugs in one of four situations in the last 4 weeks of the BAASIS questionnaire. No differences in measures of creatinine values in the items of the same questionnaires were found. We conclude that we should focus efforts on direct and indirect issues surrounding adherence, going beyond the comprehension, closer to reality, the active participation of the individual in their treatment. With this scenario, we could develop strategies that lead them to higher levels of adherence. Thus, the study leads us to believe that adherence and persistence are synonymous for success in transplant (TX).