Navegando por Palavras-chave "Hospitalization"

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    Acompanhantes ou infernizantes? A difícil interação entre o técnico em enfermagem e a família do paciente hospitalizado
    (Universidade Federal de São Paulo (UNIFESP), 2014) Silva, Maria Cristina Ferreira Carlos Rodrigues da [UNIFESP]; Ribeiro, Circea Amalia Ribeiro [UNIFESP]; Borba, Regina Issuzu Hirooka de [UNIFESP]; http://lattes.cnpq.br/2024656916005253; http://lattes.cnpq.br/2300731487624854; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4457085P5; Universidade Federal de São Paulo (UNIFESP)
    Este estudo, de abordagem qualitativa, teve como objetivos compreender o significado atribuído pelo técnico em enfermagem à vivência de interagir com a família do paciente hospitalizado e conhecer se o técnico em enfermagem já interagiu com algum conteúdo relacionado ao cuidado da família. Utilizou-se como referencial teórico o Interacionismo Simbólico e metodológico a Análise Qualitativa de Conteúdo. Os participantes foram nove técnicos de enfermagem de duas instituições assistenciais e, as estratégias utilizadas para a coleta de dados foram: a observação participante e a entrevista semiestruturada. A análise comparativa dos dados permitiu a identificação da categoria conceitual ACOMPANHANTES OU INFERNIZANTES? A DIFÍCIL INTERAÇÃO ENTRE O TÉCNICO EM ENFERMAGEM E A FAMÍLIA DO PACIENTE HOSPITALIZADO e revelou que o Técnico em enfermagem considera a interação com os familiares muito difícil e, até mesmo, complicada, pois estes cobram e reclamam demais quando não são atendidos de imediato, fazem algazarra e ?bagunça?, além de atrapalharem, infernizarem e fiscalizarem ao invés de ajudar, embora reconheçam a importância da presença do familiar para que o paciente seja melhor assistido e também ao próprio profissional. Por falta de conteúdo sobre o tema família em sua formação e vida profissional, o técnico em enfermagem reconhece que o único conteúdo desenvolvido foi a humanização, o que não condiz com sua realidade profissional, pois não consegue relacionar os conceitos relativos à humanização às questões da interação com a família. O estudo revelou ainda que, frente a essa situação, o técnico em enfermagem desenvolve estratégias para se relacionar sem atrito com os familiares. Reitera-se a importância da inclusão do conteúdo sobre a temática da família nos cursos de formação de técnicos em enfermagem e nas instituições de saúde.
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    Age and regional differences in clinical presentation and risk of hospitalization for dengue in brazil, 2000-2014
    (Hindawi Ltd, 2016) Burattini, Marcelo N. [UNIFESP]; Lopez, Luis F.; Coutinho, Francisco A. B.; Siqueira-, Joao B., Jr.; Homsani, Sheila; Sarti, Elsa; Massad, Eduardo
    OBJECTIVES: Dengue cases range from asymptomatic to severe, eventually leading to hospitalization and death. Timely and appropriate management is critical to reduce morbidity. Since 1980, dengue has spread throughout Brazil, affecting an increasing number of individuals. This paper describes age and regional differences in dengue's clinical presentation and associated risk of hospitalization based on more than 5 million cases reported to the Brazilian Ministry of Health from 2000-2014. METHODS: We performed a retrospective analysis of similar to 5,450,000 dengue cases, relating clinical manifestations and the risk of hospitalization to age, gender, previous infection by dengue, dengue virus serotype, years of formal education, delay to first attendance and the occurrence of dengue during outbreaks and in different Brazilian regions. RESULTS: Complicated forms of dengue occurred more frequently among those younger than 10 years (3.12% vs 1.92%) and those with dengue virus 2 infection (7.65% vs 2.42%), with a delay to first attendance >2 days (3.18% vs 0.82%) and with <= 4 years of formal education (2.02% vs 1.46%). The risk of hospitalization was higher among those aged 6-10 years old (OR 4.57
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    Analysis of the Use of Extracorporeal Circulation on the In-Hospital Outcomes of Dialytic Patients Who Underwent Myocardial Revascularization Surgery
    (Arquivos Brasileiros Cardiologia, 2016) Miranda, Matheus [UNIFESP]; Branco, João Nelson Rodrigues [UNIFESP]; Vargas, Guilherme Flora [UNIFESP]; Hossne Junior, Nelson Americo [UNIFESP]; Yoshimoto, Michele Costa [UNIFESP]; Fonseca, José Honório de Almeida Palma da [UNIFESP]; Pestana, Jose Osmar Medina [UNIFESP]; Buffolo, Enio [UNIFESP]
    Background: Myocardial revascularization surgery is the best treatment for dyalitic patients with multivessel coronary disease. However, the procedure still has high morbidity and mortality. The use of extracorporeal circulation (ECC) can have a negative impact on the in-hospital outcomes of these patients. Objectives: To evaluate the differences between the techniques with ECC and without ECC during the in-hospital course of dialytic patients who underwent surgical myocardial revascularization. Methods: Unicentric study on 102 consecutive, unselected dialytic patients, who underwent myocardial revascularization surgery in a tertiary university hospital from 2007 to 2014. Results: Sixty-three patients underwent surgery with ECC and 39 without ECC. A high prevalence of cardiovascular risk factors was found in both groups, without statistically significant difference between them. The group "without ECC" had greater number of revascularizations (2.4 vs. 1.7
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    Aplicação de estudo caso-controle na epidemiologia das infecções hospitalares
    (Universidade Federal de São Paulo (UNIFESP), 1997) Wey, Sergio Barsanti [UNIFESP]
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    Avaliação dos efeitos da hospitalização sobre a capacidade funcional de idosos
    (Universidade Federal de São Paulo (UNIFESP), 2020-10-06) Mota, Helena Silva [UNIFESP]; Volpe, Márcia Souza [UNIFESP]; http://lattes.cnpq.br/2284535375174765; http://lattes.cnpq.br/3346578269619757; Universidade Federal de São Paulo (UNIFESP)
    O processo senil corresponde ao envelhecimento fisiológico do organismo e também pode ser definido como um declínio funcional dependente do tempo que causa perda progressiva da integridade fisiológica, função prejudicada dos órgãos e subsequente aumento da vulnerabilidade à morte. Com a perda da integridade fisiológica, a internação hospitalar decorrente de doença aguda se torna mais frequente e a internação, por sua vez, pode acelerar a perda de capacidade funcional. É importante ressaltar que o conceito de funcionalidade transcende a saúde física e reflete a interação entre as várias dimensões da saúde: biológica, individual e social. Portanto, a limitação física compromete atividades desenvolvidas pelo idoso e sua participação na sociedade, impactando negativamente na sua qualidade de vida. Fatores como, a imobilidade no leito e a pior alimentação/ingestão de nutrientes parecem estar relacionados com a perda de capacidade funcional durante o processo de internação hospitalar. O objetivo principal desse estudo foi avaliar os efeitos da hospitalização sobre a capacidade funcional de pacientes idosos. Foram incluídos pacientes internados nas enfermarias da Santa Casa de Santos, com idade igual ou superior a 65 anos, sem doença neuromuscular ou ortopédica que impeça a realização dos testes, com capacidade de caminhar independentemente previamente à internação, índice de massa corpórea < 30 kg/m2, estáveis hemodinamicamente, sem desconforto respiratório e sem expectativa de abordagem cirúrgica. Os pacientes foram avaliados entre o segundo e terceiro dia de internação e no momento da alta hospitalar. Os métodos avaliativos foram: força da musculatura respiratória, força de preensão palmar, Timed Up and Go (TUG) e índice de Barthel, utilizamos de análise descritiva através do cálculo das médias e desvio padrão. Foram avaliados 18 idosos, com idade média de 69 anos, sendo 11 do sexo masculino e 7 do sexo feminino e os resultados mostram que a força da musculatura respiratória sofreu redução ao longo da internação, na média inicial de PIMáx= 89 ± 24 cmH 2 O e final PIMáx= 82,5 ± 30 cmH 2 O e aumento na média inicial de PEMáx= 88 ± 23 cmH 2 O e final PEMáx = 94 ± 27 cmH 2 O. A média de força de preensão palmar também sofreu redução: de 20,5 ± 8 Kgf para 19,5 ± 8 Kgf. Enquanto o tempo para completar o TUG reduziu de 15,3 ± 5,6 s para 14,4 ± 5,5 s. Já o índice de Barthel não apresentou alteração significativa (médias inicial e final iguais a 91 e 90 pontos, respectivamente). Esses resultados indicam um declínio da função respiratória e da força muscular global, após um período relativamente curto de internação hospitalar. Assim, intervenções fisioterapêuticas, entre outras medidas, poderão ser adotadas para minimizar a perda de capacidade funcional de idosos internados.
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    O Brincar como recurso de enfrentamento da hospitalização e a visão dos familiares
    (Universidade Federal de São Paulo (UNIFESP), 2018-12-11) Ribeiro, Kamilla Mariano Macedo [UNIFESP]; Silva, Carla Cilene Baptista da [UNIFESP]; http://lattes.cnpq.br/7118155019861351; http://lattes.cnpq.br/3591898420148246
    Introdução: O diagnóstico de câncer na infância é devastador para a família e para a criança, assim o brincar apresenta um papel fundamental no enfrentamento da hospitalização e da doença, o que torna relevante compreender como a atividade do brincar contribui com esse processo e qual a visão dos pais frente a esse instrumento. Objetivo: O projeto buscou compreender a percepção dos pais sobre a importância do brincar e das atividades lúdicas propostas pelo Projeto de Extensão da UNIFESP – PROENCC, durante o processo de hospitalização de seus filhos. Metodologia: Trata-se de uma pesquisa de caráter qualitativo descritivo que foi realizada no ambulatório de oncologia pediátrica na Irmandade Santa Casa da Misericórdia, Santos/ SP (ISCMS), com o uso de entrevistas semiestruturadas realizadas com a amostra de 7 pais de crianças hospitalizadas, com idades entre 5 e 13 anos. Os dados foram categorizados a partir da Analise de Conteúdo temática de Minayo (2010). A pesquisa foi aprovada pelo CEP da UNIFESP, sob número CAEE 83197918.0.0000.5505. Resultados e Discussão: Quanto aos núcleos temáticos que surgiram nas entrevistas sobre o brincar, os pais o analisam de duas maneiras distintas a primeira como sendo atividade que permite o desenvolvimento infantil e a segunda forma como sendo um instrumento de cuidado paliativo, visto que o contexto hospitalar interfere na maneira como os mesmos enxergam o brincar. Com relação ao núcleo temático finais de semana, ficou claro que todos os participantes não concordam que a brinquedoteca fique fechada nos finais de semanas, pois isso gera impactos negativos em seus filhos. Já o núcleo temático referente às atividades propostas pelo projeto de extensão teve como resultado o reconhecimento positivo pelos pais das atividades propostas pelas estudantes aos seus filhos. Considerações finais: As questões trazidas pelos pais a partir das entrevistas, mostraram como o brincar pode ser um recurso fundamental para o enfrentamento da hospitalização, contudo é necessário realizar intervenções em prol dessa atividade, visto que existem momentos em que a criança é privada de brincar, podendo acarretar impactos negativos na criança durante o processo de hospitalização.
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    A compreensão do processo de hospitalização a partir de narrativas das crianças
    (Universidade Federal de São Paulo, 2019-11-29) Fugimoto, Vitor Koichi Iwakura [UNIFESP]; Cipullo, Marcos Alberto Taddeo [UNIFESP]; Jurdi, Andrea Perosa Saigh [UNIFESP]; http://lattes.cnpq.br/4140547211703368; http://lattes.cnpq.br/6282653423509113; http://lattes.cnpq.br/3944579496708487; Universidade Federal de São Paulo (UNIFESP)
    O processo de adoecimento é um evento desagradável e a internação hospitalar é um agravante. O hospital é visualizado como um ambiente hostil, pois não oferece condições suficientes para que a criança se sinta acolhida. O objetivo é entender a compreensão das sobre seu processo de adoecimento e hospitalização. Foram selecionadas aleatoriamente três crianças, de 7 a 11 anos, internadas na enfermaria pediátrica do Sistema Único de Saúde em hospital geral de um município da Baixada Santista, durante novembro de 2017 a janeiro de 2018. Foi utilizada a entrevista semiestruturada, gravada, associada ao Procedimento de Desenho–Estória com tema, sendo que os resultados mostraram para a visão das crianças de que o hospital é um local que entristece e adoece as pessoas, porém é importante para que possam melhorar de suas doenças e receberem alta.
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    As concepções dos profissionais de enfermagem que atuam na internação psiquiátrica em hospital geral
    (Universidade Federal de São Paulo (UNIFESP), 2014-11-26) Hildebrandt, Leila Mariza [UNIFESP]; Marcolan, Joao Fernando [UNIFESP]; http://lattes.cnpq.br/5449589014899461; http://lattes.cnpq.br/8447333498388101; Universidade Federal de São Paulo (UNIFESP)
    A partir do arcabouço legislativo, os municípios têm sido convocados a planejar e organizar ações que envolvam a assistência no campo da Saúde Mental, com vistas a atender as pessoas nos seus locais de convívio. Nesse cenário, o hospital geral se constitui em importante espaço de atenção à pessoa com transtorno mental no momento em que os sintomas estão agudizados. Em muitas situações, o fazer dos profissionais de Enfermagem pode estar permeado por concepções sociais e históricas comprometidas. Este estudo verificou a percepção de profissionais de Enfermagem acerca da internação psiquiátrica em hospital geral. Objetivos: compreender as concepções de profissionais de Enfermagem que assistem pessoas com transtorno mental internadas em unidades psiquiátricas de hospitais gerais sobre a internação psiquiátrica nessas instituições; analisar os elementos que influenciaram as concepções dos trabalhadores de Enfermagem em relação à internação psiquiátrica em hospital geral; verificar o conhecimento dos profissionais de Enfermagem acerca das políticas de Saúde Mental vigentes no Brasil. Método: Trata-se de pesquisa qualitativa que adotou como abordagem metodológica a Análise de Conteúdo e o referencial teórico das Políticas de Saúde Mental. A pesquisa foi desenvolvida em três hospitais gerais, localizados na região norte do Rio Grande do Sul. Dois deles contavam com unidades psiquiátricas fechadas e um com unidade psiquiátrica aberta. A coleta de dados se deu por meio de entrevista semiestruturada e observação sistemática. O projeto de pesquisa foi aprovado pelo Comitê de Ética da Universidade Federal de São Paulo, mediante o Parecer nº 60721. Resultados: Os sujeitos que integraram a pesquisa foram 30 profissionais de Enfermagem vinculados a unidades psiquiátricas e duas psicólogas, coordenadoras de duas unidades psiquiátricas. Obtivemos duas categorias com respectivas unidades temáticas. A primeira versa sobre questões relativas à formação dos profissionais de Enfermagem, o preconceito em relação à assistência psiquiátrica em hospital geral e sua repercussão na assistência de Enfermagem. A segunda aborda aspectos relacionados às políticas de Saúde Mental nos locais de internação psiquiátrica em hospital geral. Conclusão: A Enfermagem, nos hospitais gerais pesquisados, vinculada ao campo da Saúde Mental, apresentou fragilidades na atenção à pessoa com transtorno mental e sua família e requer investimentos na sua formação, tanto na esfera acadêmica como educação permanente, com vistas a qualificar e, consequentemente, reduzir o preconceito e melhorar a assistência prestada a esse contingente populacional. Ressaltamos que as Políticas de Saúde Mental não têm sido implementadas de forma efetiva nas instituições hospitalares, locais da pesquisa, com reflexos na organização estrutural e funcional dos serviços, o que demanda envolvimento das equipes de Saúde e dos gestores das instituições para que a mesma seja colocada em prática. Ainda, identificamos dificuldades de encaminhamentos após a alta hospitalar da pessoa com transtorno mental pela falta da rede de atenção em Saúde Mental na região em que o estudo foi desenvolvido.
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    Conflito no desempenho do papel de mãe em estudos com mães de recém-nascidos hospitalizados: revisão integrativa
    (Universidade de São Paulo, Escola de Enfermagem, 2012-04-01) Carmona, Elenice Valentim [UNIFESP]; Coca, Kelly Pereira [UNIFESP]; Vale, Ianê Nogueira do; Abrão, Ana Cristina Freitas de Vilhena [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Campinas (UNICAMP)
    The hospitalization of a newborn separates mother and child at a time when their contact is essential for developing the mother's role. Therefore, mothers tend to feel incapable of meeting their child's needs, and face difficulties in dealing with their personal feelings and the demands of their family. The objective of this study was to identify the defining characteristics of the nursing diagnosis Conflict in performing the role of mother in studies addressing the experience of being a mother in the neonatal unit. This is an integrative literature review, which utilized 15 qualitative studies published between 2004 and 2009, in journals indexed in the Latin American and Caribbean Health Sciences Literature and on the Medical Literature and Retrieval System Online. This diagnosis is a nursing phenomenon to be studied by neonatal nurses so they are able to recognize and propose interventions to meet the mothers' needs, considering that nine out of ten defining characteristics were identified in the mothers' statements.
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    Costs of hospitalization in preterm infants: impact of antenatal steroid therapy
    (Soc brasil pediatria, 2016) Ogata, Joice Fabiola Meneguel [UNIFESP; Fonseca, Marcelo Cunio Machado [UNIFESP]; Miyoshi, Milton Harumi [UNIFESP]; Almeida, Maria Fernanda Branco de [UNIFESP]; Guinsburg, Ruth [UNIFESP]
    Objective: To estimate the costs of hospitalization in premature infants exposed or not to antenatal corticosteroids (ACS). Method: Retrospective cohort analysis of premature infants with gestational age of 26-32 weeks without congenital malformations, born between January of 2006 and December of 2009 in a tertiary, public university hospital. Maternal and neonatal demographic data, neonatal morbidities, and hospital inpatient services during the hospitalization were collected. The costs were analyzed using the microcosting technique. Results: Of 220 patients that met the inclusion criteria, 211 (96%) charts were reviewed: 170 newborns received at least one dose of antenatal corticosteroid and 41 did not receive the antenatal medication. There was a 14-37% reduction of the different cost components in infants exposed to ACS when the entire population was analyzed, without statistical significance. Regarding premature infants who were discharged alive, there was a 24-47% reduction of the components of the hospital services costs for the ACS group, with a significant decrease in the length of stay in the neonatal intensive care unit (NICU). In very-low birth weight infants, considering only the survivors, ACS promoted a 30-50% reduction of all elements of the costs, with a 36% decrease in the total cost (p = 0.008). The survivors with gestational age < 30 weeks showed a decrease in the total cost of 38% (p = 0.008) and a 49% reduction of NICU length of stay (p = 0.011). Conclusion: ACS reduces the costs of hospitalization of premature infants who are discharged alive, especially those with very low birth weight and < 30 weeks of gestational age. (C) 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.
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    Desfechos de tratamento de tuberculose em pacientes hospitalizados e não hospitalizados no município de São Paulo
    (Sociedade Brasileira de Pneumologia e Tisiologia, 2011-12-01) Perrechi, Mirtes Cristina Telles [UNIFESP]; Ribeiro, Sandra Aparecida [UNIFESP]; Centro Universitário das Faculdades Metropolitanas Unidas; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To compare inpatient and outpatient treatment of tuberculosis, in terms of outcomes, in the city of São Paulo, Brazil, as well to determine which variables are most frequently associated with hospitalization. METHODS: A prospective, longitudinal study carried out between January and December of 2007, at two large hospitals and at outpatient clinics, in two regions of the city of São Paulo. For inpatients, data were collected with a structured questionnaire. Additional data were obtained from the São Paulo State Department of Health Tuberculosis Database. RESULTS: Of the 474 patients included in the study, 166 were inpatients, and 308 were outpatients. The multivariate analysis showed that hospitalization for tuberculosis was associated with hospital/emergency room diagnosis of tuberculosis (OR = 55.42), with HIV co-infection (OR = 18.57), with retreatment (OR = 18.51), and with having previously sought treatment at another health care facility (OR = 12.32). For the inpatient and outpatient groups, the overall cure rates were 41.6% and 78.3%, respectively, compared with 30.4% and 58.5% for those who were co-infected with HIV, whereas the overall mortality rates were 29.5% and 2.6%, respectively, compared with 45.7% and 9.8% for those who were co-infected with HIV. CONCLUSIONS: Among inpatients, tuberculosis appears to be more severe and more difficult to diagnose, resulting in lower cure rates and higher mortality rates, than among outpatients. In addition, tuberculosis patients co-infected with HIV have less favorable outcomes.
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    Direct variable cost of the topical treatment of stages III and IV pressure injuries incurred in a public university hospital
    (Elsevier Sci Ltd, 2017) Chacon, Julieta M. F. [UNIFESP]; Blanes, Leila [UNIFESP]; Borba, Luis G. [UNIFESP]; Rocha, Luis R. M. [UNIFESP]; Ferreira, Lydia M. [UNIFESP]
    Aim: to estimate the direct variable costs of the topical treatment of stages III and IV pressure injuries of hospitalized patients in a public university hospital, and assess the correlation between these costs and hospitalization time. Materials and methods: Forty patients of both sexes who had been admitted to the Sao Paulo Hospital, Sao Paulo, SP, Brazil, from 2011 to 2012, with pressure injuries in the sacral, ischial or trochanteric region were included. The patients had a total of 57 pressure injuries in the selected regions, and the lesions were monitored daily until patient release, transfer or death. The quantities and types of materials, as well as the amount of professional labor time spent on each procedure and each patient were recorded. The unit costs of the materials and the hourly costs of the professional labor were obtained from the hospital's purchasing and human resources departments, respectively. Spearman's correlation coefficient and the Mann-Whitney and Kruskal-Wallis tests were used for the statistical analyses. Results: The mean topical treatment costs for stages III and IV PIs were significantly different (US$ 854.82 versus US$ 1785.35
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    Estudo da Fase Intra-hospitalar da Revascularizacao Cirurgica do Miocardio em Pacientes Dialiticos
    (Sociedade Brasileira de Cardiologia - SBC, 2014-03-01) Miranda, Matheus; Hossne Junior, Nelson Americo [UNIFESP]; Branco, João Nelson Rodrigues [UNIFESP]; Vargas, Guilherme Flora [UNIFESP]; Fonseca, José Honório de Almeida Palma da [UNIFESP]; Pestana, Jose Osmar Medina [UNIFESP]; Juliano, Yara; Buffolo, Enio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de Santo Amaro
    Background:Coronary artery bypass grafting currently is the best treatment for dialytic patients with multivessel coronary disease, but hospital morbidity and mortality related to procedure is still high.Objective:Evaluate results and in-hospital outcomes of coronary artery bypass grafting in dialytic patients.Methods:Retrospective unicentric study including 50 consecutive and not selected dialytic patients, who underwent coronary artery bypass grafting in a tertiary university hospital from 2007 to 2012.Results:High prevalence of cardiovascular risk factors was observed (100% hypertensive, 68% diabetic and 40% dyslipidemic). There was no intra-operative death and 60% of the procedures were performed off-pump. There were seven (14%) in-hospital deaths. Postoperative infection, previous heart failure, cardiopulmonary bypass, abnormal ventricular function and surgical re-exploration were associated with increased mortality.Conclusion:Coronary artery bypass grafting is feasible to dialytic patients although high in-hospital morbidity and mortality. It is necessary better understanding about metabolic aspects to plan adequate interventions.
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    Fatores associados à internação hospitalar de crianças menores de cinco anos, São Paulo, SP
    (Faculdade de Saúde Pública da Universidade de São Paulo, 2002-06-01) Caetano, Jozana do Rosário de Moura; Bordin, Isabel Altenfelder Santos [UNIFESP]; Puccini, Rosana Fiorini [UNIFESP]; Peres, Clovis de Araujo [UNIFESP]; Universidade Federal do Rio Grande do Norte Departamento de Pediatria; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: In developing countries acute respiratory infection (ARI) is the leading cause of hospitalization among children under five years of age. Their underprivileged life conditions and restricted access to health care services are important determining factors. The objective of the study was to assess hospital morbidity and to identify factors associated to hospitalization of children under five years of age. METHODS: A data set derived from a cross-sectional study on health conditions of children under five years of age in the city of Embu, a county located in the metropolitan region of São Paulo, Brazil, was used. The inclusion criteria were one child per family (random selection). The exclusion criteria were missing data on any study variable. The sample size was 893 children. Data was collected using household interviews with mother or caretaker. Statistical analysis was performed using logistic regression models to identify factors associated with hospitalization. RESULTS/CONCLUSIONS: Sixty-five (7.7%) children were hospitalized. Of them, 41.5% were admitted with a respiratory tract disease, mainly due to an ARI (27.7 %). Factors associated to hospitalization included: low birth weight; perinatal problems; chronic illness; death of a sibling under the age of five; grandmother as day caretaker; living in overcrowded places, and mother's higher educational level.
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    Formação do pedagogo para atuar na classe hospitalar: desafios e perspectivas
    (Universidade Federal de São Paulo, 2016) Bonfim, Evandro Luiz Soares; Rossit, Rosana Aparecida Salvador; http://lattes.cnpq.br/3333865775403342; http://lattes.cnpq.br/2651509091401748
    The Hospital Pedagogy is a branch into the Pedagogy field comprising the procedures needed for a long-term teaching for children and adolescents who are sick and hospitalized for a period exceeding 15 days. Praxis and specific teaching techniques are expected, which requires the formation of educators prepared to meet this demand. Although official documents report on the educator´s performance in different settings of the traditional classroom in regular schools, professional formation at the undergraduate level is still incipient to prepare this professional to work in hospital settings. This is a descriptive qualitative study, aiming to analyze the perception of educators in relation to the training received to work in hospital settings, challenges and perspectives. The project was approved by the Ethics Committee of UNIFESP under Opinion No. 1267627/2015. After visiting in loco to confirm the institutions that developed activities in hospital classes, the electronic addresses of 10 heads of the respective services were obtained. The positive feedback was received from nine hospitals. Among the18 educators contacted, eight professionals with training in pedagogy participated of the study. They all agreed with the terms of the research and they met criteria to work in hospital settings in the school attendance of children and adolescents in treatment of chronic diseases. Data collection was conducted through semi-structured interviews held in a place and time the participants chose, ensuring a quiet environment and with little outside interference. The interviews lasted an average 60 minutes, all recorded and transcribed in full immediately after the performance. After transcription of all interviews, data were analyzed in relation to content analysis in the thematic mode. Reading was performed to obtain the values implied in the statements; they all were organized into a summary table to identify the Context Units, Registration Units and categorization from the significances acquired from speaking. Two oriented nuclei were previously defined: "the role of the educator and the training to work in hospitals" and “proposals for the improvement of pedagogical practices in hospitals", of which eight categories and 31 subcategories emerged The results allowed to identify relevant aspects to act in a long-term teaching of children and adolescents in hospital, being possible to know, beyond the initial or continuing education, experiences of pedagogical praxis, the sensitivity of educators in hospital settings, their fears, anxieties, questions about the professional performance and the importance of this professional as part of health teams in hospitals. The educational product was developed with training strategies that may contribute to the education of educators to work in hospital settings, particularly in hospital classes
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    Functional status change in older adults undergoing coronary artery bypass surgery
    (Associação Paulista de Medicina - APM, 2011-03-01) Guimarães, Márcio Niemeyer Martins De Queiroz; Almada Filho, Clineu De Mello [UNIFESP]; Quinta D'Or Hospital; Universidade Federal de São Paulo (UNIFESP)
    CONTEXT AND OBJECTIVE: Increased life expectancy has resulted in growing numbers of elderly patients undergoing heart surgery. This study aimed to identify changes in functional status among older adults undergoing coronary artery bypass grafting. DESIGN AND SETTING: Prospective observational cohort study conducted at a level IV private hospital in Brazil. METHODS: Patients were assessed using the Katz and Lawton scales and the Functional Independence Measure before admission, at hospital discharge and one month after discharge. Repeated-measurement analysis of variance was used. RESULTS: Two patients died during hospitalization. Among the 31 patients included, the Functional Independence Measure ranged from 121.7 ± 7.4 (pre-admission) to 91.1 ± 20.5 (discharge) and 109.0 ± 21.7 (one month after discharge); the Katz scale from 5.92 ± 0.32 to 4.18 ± 1.04 and 5.13 ± 1.30; and the Lawton scale from 24.3 ± 4.6 to 12.8 ± 2.0 and 16.5 ± 4.6 (P = 0.0001). When subgroups with (18) and without (13) complications were compared, the Functional Independence Measure (P = 0.085) showed a trend, although not significantly, toward recovery one month after discharge. Delirium and blood transfusion were the intercurrent events found. There was a correlation between the scales and age (P = 0.008), APACHE II (P = 0.051), EuroSCORE (P = 0.064), intensive care unit stay (P = 0.024) and overall hospital length of stay (P = 0.040). CONCLUSION: The Functional Independence Measure proved to be a promising tool for monitoring the functional status of elderly patients undergoing coronary artery bypass grafting, especially in the subgroup with complications.
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    Health-related quality of life and self-esteem among burn patients
    (H m p communications, 2016) Zorita, Liliane do Amaral [UNIFESP]; Blanes, Leila [UNIFESP]; Veiga, Daniela Francescato [UNIFESP]; Augusto, Fabiana da Silva [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]
    Objective. The aim of this study was to assess health-related quality of life and self-esteem in adult burn survivors in Brazil. Materials and Methods. This multicenter, cross-sectional analytical study was conducted with 30 adult burn survivors (56.7% were male), 6-24 months postburn, recruited from-3 outpatient burn clinics in the city of Sao Paulo, Brazil. Half of the burn injuries (50%) were caused by flammable liquids. The mean burn size was 21% of total body surface area. The Short-Form 36 Health Survey (SF-36) and the Rosenberg Self-Esteem Scale/Escola Paulista de Medicina at the Federal University of Sao Paulo were used to assess health related quality of life and self-esteem, respectively. Statistical analysis was performed using Student's t test, analysis of variance (ANOVA), Tukey's test, Kruskal-Wallis test, Dunn's multiple comparison test, and Spearman's correlation coefficient. Results. The results showed men reported significantly higher SF-36 scores on the role of emotional (P = 0.023) and mental health (P = 0.047) domains when compared with women. Individuals who abused alcohol had lower scores on bodily pain (P= 0.025), vitality (P= 0.041), mental health (P =0.023), and self-esteem scores (P = 0.044) compared with nondrinkers, and illicit drug users reported lower bodily pain scores (P = 0.008) compared with nonusers. Conclusion. Women, alcohol abusers, and drug users reported the lowest health-related quality of life and self-esteem among survivors of burn injuries. The assessment of health-related quality of life and self-esteem may contribute to the planning of interventions aimed to minimize the impact of burns on the daily life-of this population.
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    High Rate of Viral Identification and Coinfections in Infants with Acute Bronchiolitis
    (Hospital Clinicas, Univ São Paulo, 2010-01-01) Nascimento, Milena Siciliano [UNIFESP]; Souza, Andrea Vieira de [UNIFESP]; Ferreira, Adriana Vada de Souza; Rodrigues, Joaquim Carlos [UNIFESP]; Abramovici, Sulim; Silva Filho, Luiz Vicente Ferreira da; Hosp Israelita Albert Einstein; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: To determine the viruses and risk factors associated with hospital and intensive care unit (ICU) admissions in infants with acute bronchiolitis.INTRODUCTION: Bronchiolitis is a major cause of morbidity in infants. Widespread use of molecular-based methods has yielded new insights about its etiology, but the impact of viral etiologies on early outcomes is still unclear.METHODS: Seventy-seven infants with bronchiolitis who were under two years of age and visited an emergency unit were included. Using molecular-based methods, samples were tested for 12 different respiratory viruses. Logistic regression models were used to identify clinical and virological variables associated with the main endpoints: hospital admission and ICU admission.RESULTS: We identified at least one virus in 93.5% of patients, and coinfections were found in nearly 40% of patients. RSV was the most common pathogen (63.6%), followed by rhinovirus (39%). Identification of RSV was only associated with an increased risk of hospital admission in the univariate model. Younger age and enterovirus infection were associated with an increased risk of hospital admission, while atopy of a first-degree relative showed a protective effect. Prematurity was associated with an increased risk of admission to the ICU. Coinfections were not associated with worse outcomes.CONCLUSIONS: Molecular-based methods resulted in high rates of viral identification but did not change the significant role of RSV in acute bronchiolitis. Younger age and enterovirus infection were risk factors for hospital admission, while prematurity appeared to be a significant risk factor for admission to the ICU in acute viral bronchiolitis.
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    Impact of a poison control center on the length of hospital stay of poisoned patients: retrospective cohort
    (Associacao Paulista Medicina, 2011-01-06) Galvão, Tais Freire; Silva, Marcus Tolentino; Silva, Carolina Dalene; Barotto, Adriana Melo; Gavioli, Izabela Lucchese; Bucaretchiv, Fabio; Atallah, Álvaro Nagib [UNIFESP]; Univ Fed Amazonas UFAM; Minist Hlth; Universidade Federal de Santa Catarina (UFSC); Fdn Estadual Prod & Pesquisa Saude FEPPS; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP); Brazilian Cochrane Ctr
    CONTEXT AND OBJECTIVE: Poison control centers play an essential role in caring for poisoned patients, albeit without secure funding for their activities. The aim here was to investigate differences in length of hospital stay among poisoned patients, between those who received remote assistance from a poison control center and those who did not.DESIGN AND SETTING: A retrospective cohort including all poisoned patients hospitalized at an emergency service in Manaus between 2005 and 2007 was set up, and the local poison control center database was checked to see whether they received such assistance.METHODS: Patients presenting a known toxic agent, with less than 12 hours since exposure and without severe comorbidities, were selected. Their severity of poisoning was evaluated by two independent reviewers and divergences were resolved by another reviewer.RESULTS: One hundred and ninety-eight patients were included. Those who received remote assistance from a poison control center stayed in hospital on average for 3.43 days less than those without poison control center assistance (95% confidence interval, CI: -6.10 to -0.77). Seventy was assessed in the cases of 90 patients: there was no statistical difference in severity between the patients with and without poison control center assistance (P > 0.5).CONCLUSION: Patients with remote assistance from a poison control center had a shorter length of stay then patients without this aid. The poison control center may have reduced the length of stay of the poisoned patients.
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    Impacto do controle da asma em diferentes faixas etárias em cinco países da América Latina
    (Universidade Federal de São Paulo (UNIFESP), 2018-03-29) Alith, Marcela Batan [UNIFESP]; Gazzotti, Mariana Rodrigues [UNIFESP]; Jardim, José Roberto [UNIFESP]; Nascimento, Oliver Augusto [UNIFESP]; http://lattes.cnpq.br/4320654878656075; http://lattes.cnpq.br/2225674564595145; http://lattes.cnpq.br/5901080332011696; http://lattes.cnpq.br/9675877186943572; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Asthma is defined as a heterogeneous disease, usually characterized by chronic airway inflammation and is classified as controlled, partially controlled and uncontrolled. Patients with uncontrolled asthma are at greater risk for hospitalizations and visits to emergencies, and have a greater impact in their daily life. Objectives: To evaluate asthma control, the use of health resources and asthma negative impact on physical aspects in patients with different age in five Latin American countries. Methods: The Latin America Asthma Insight and Management (LA AIM) study, conducted in 2011, was carried out in Argentina, Brazil, Mexico, Venezuela and Puerto Rico. Patients with a medical diagnosis of asthma were interviewed, directly in those with 18 years or older and through the parents in those between 12 and 17 years. The questionnaire consisted of 53 questions related to five main domains of asthma: symptoms; impact of asthma on life; perception of asthma control; exacerbations; and treatment/medication. Results: A total of 2,167 asthmatics were interviewed in Argentina (19.9%), Brazil (18.6%), Mexico (24.5%), Puerto Rico (18.6%) and Venezuela (18.4%). The three studied groups (12-17years, >17-40 years and > 40 years) presented a large percentage of patients with partially controlled and uncontrolled asthma. Venezuela had 74% chance of having partially and uncontrolled asthma (p=0.03) in relation to Mexico as reference. Patients who had a significant chance of having controlled asthma were the ones in use of asthma control medication (three times more chance, p=0.01) and in use of rescue medication in the last four weeks (13 times more chance, p=0.001). Regarded to health resources utilization, there was no association with asthma control in the studied countries. Asthmatics with sleep limitations had 72% higher chance of having uncontrolled asthma (p=0.002). Conclusions: We concluded that in the three age groups studied there was a poor asthma control with no difference among the countries; Venezuela was the most likely country to have uncontrolled asthma; patients who used control and rescue medications were the ones with the highest chance of having controlled asthma; there was no difference among countries in relation to asthma control and the use of health resources utilization (emergency visit to the doctor's office, hospitals or clinics, hospital and ICU admission); and sleep limitation was the only symptom associated with higher chance of having uncontrolled asthma.