Navegando por Palavras-chave "pesquisa qualitativa"
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- ItemAcesso aberto (Open Access)Bulimia e transtorno da compulsão alimentar periódica: revisão sistemática e metassíntese(Sociedade de Psiquiatria do Rio Grande do Sul, 2006-12-01) Espíndola, Cybele Ribeiro [UNIFESP]; Blay, Sergio Luis [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: The aim of this systematic review is to identify the scope of qualitative investigations on the life experience of patients with bulimia and binge eating disorder. METHODOLOGY: Searches were conducted using the following databases: PubMed, ISI, PsycInfo, Embase, LILACS and Scielo, for articles published between 1990 and 2005. Inclusion criteria were: 1) articles with main focus on bulimia or binge eating disorders; 2) original research reported in English, Spanish, French or Portuguese; 3) use of any qualitative method, such as interview, focal group or field observation. Exclusion criteria were exclusively theoretical articles and those assessing children or elderly subjects. A meta-ethnographic approach was used to synthesize the data. Each study was carefully read, and their thematic categories were interpreted and compared to the categories of all other studies. RESULTS: Fifteen studies were included of a total of 3,415 articles. Seven overlapping main themes were identified: illness representation; negative feelings (fear, guilt, anger, loneliness, loss of control); positive feelings (self-control, power); symptom function; interpersonal relationships; sociocultural context; recovery. CONCLUSIONS: Although many issues were negative, the overall experience was not reported as being only bad. Some aspects of eating disorders were considered beneficial by the patients.
- ItemAcesso aberto (Open Access)Caracterização do uso de Benzodiazepínicos nas Unidades Básicas de Saúde de Cidade Tiradentes, município de São Paulo/SP(Universidade Federal de São Paulo (UNIFESP), 2016-01-29) Bigal, Andre Luiz [UNIFESP]; Carlini, Elisaldo Luiz de Araujo [UNIFESP]; http://lattes.cnpq.br/5948335656347039; http://lattes.cnpq.br/1233550646836875; Universidade Federal de São Paulo (UNIFESP)The Medicines Benzodiazepines (BZD) are characterized as one of the classes of drugs most consumed in the world and have significant potential risk for abuse and dependence. In Brazil, several studies have shown the use of these drugs in situations that are not characterized as rational use. The aim of this study was to characterize the use and drug user psychoactive benzodiazepines in the public health service in the population of Cidade Tiradentes region of São Paulo. To achieve its goal was used a qualitative approach based on the content analysis methodology. The study was completed by a quantitative descriptive analysis. Semi-structured interviews were applied to prescribers and BZD users. The study was approved by the Ethics and Research Committee of the Federal University of São Paulo and by the Research Ethics Committee of the Municipal Health Secretariat of São Paulo. The most dispensed BZD was Clonazepam 2mg and the total of these medications dispensed in three months added 2.50 DDD / inhabitants / day. Most users were female and over 40 years. Prescribers classified use as not rational and identified abuse and dependence in everyday use. Users reported using the BZD for several years, unaware of the implications of chronic use and even basic information such as indication and duration of treatment.
- ItemAcesso aberto (Open Access)Clonazepam, um campeão de vendas no Brasil. Por quê?(Universidade Federal de São Paulo (UNIFESP), 2016-06-01) Cruz, Nelma Lourenco de Matos [UNIFESP]; Carlini, Elisaldo Luiz de Araujo [UNIFESP]; http://lattes.cnpq.br/5948335656347039; http://lattes.cnpq.br/8459051263596166; Universidade Federal de São Paulo (UNIFESP)Clonazepam, a benzodiazepine, is the leading seller in Brazil and the most consumed version of Ordinance 344/98. It is used in the treatment of central nervous system disorders including epilepsy, anxiety, social phobia, insomnia, affective bipolar disorders, panic disorders and akathisia. Clonazepam has high therapeutic efficacy, low toxicity and can lead to dependence after six to eight weeks of use – withdrawal symptoms may occur if there is abrupt discontinuation of use, even in therapeutic doses. This study aims to analyse the various reasons for high sales and consumption of the drug in Brazil. Methodology: the high consumption of clonazepam is a phenomenon of unknown causes and effects; therefore, qualitative research was employed. The focus groups of nineteen patients, five doctors and four pharmacists was formed within two research sites: Funilândia (Minas Gerais) and São Paulo (São Paulo). Interviews were conducted with semi-structured scripts and content analysis with the help of NVivo software. Results – Patients: After use of Clonazepam, patients declared feeling symptoms of sleepiness, relaxation, comfort and security. The range of dosage patients self-administer can be dependent on the emotional state of the users, who do not report taking high doses of clonazepam. The period of use of the drug among patients was up to fifteen years. Information is exchanged between users, and many of them are friends or relatives. Many of them reported being able to get a prescription for clonazepam without receiving medical consultation. Many patients also tried to stop the use of the drug, but were not able to. All of them reported never having received guidance from pharmacists, and only a few received instruction from doctors. Doctors: The main stated reason for prescribing the drug to patients was “renewing a previous prescription from another doctor”. They also declared that were aware of the dosage flexibility, but that the patients do not abusive it. Doctors trust the drug and find it safe, believing that patients use Clonazepam in order to treat ‘problems’. Pharmacists: Pharmacists do not feel co-responsible for the prescription of Clonazepam. They believe that the control of sales of the drug is inefficient and easy to get around – there have been sales of the drug without the correct prescription produced. One of the pharmacists in the study declared that they sell the drug without prescription, something that was witnessed during during the interview. Pharmaceutical laboratories - were not forthcoming in their interest to be a part of the research, and they refused the invitation to participate. Conclusions: The abuse and misuse of Clonazepam is a public health problem. The results of the research indicate failure in the use, the prescription, and the control of sales of Clonazepam. It is necessary to restructure systems that monitor the production, prescription and sales of the drug. Refresher training for health professionals should be encouraged in order to promote rational and sensible use of medicines, especially in the case of psychotropic medicine. Finally, there should be further promotion of actions aimed at users of Clonazepam seeking to educate them about the benefits and risks of using such drugs, self-medication and appropriate use of medicines.
- ItemAcesso aberto (Open Access)Crack na cidade de São Paulo: acessibilidade, estratégias de mercado e formas de uso(Faculdade de Medicina da Universidade de São Paulo, 2008-01-01) Oliveira, Lúcio Garcia de [UNIFESP]; Nappo, Solange Aparecida [UNIFESP]; Centro de Informações sobre Saúde e Álcool; Universidade Federal de São Paulo (UNIFESP)BACKGROUND: In Brazil, survey data have pointed to an increase in crack cocaine lifetime use, possibly due to changes on its accessibility, market strategies and ways of use. OBJECTIVE: To identify such issues in the crack cocaine culture of use, in São Paulo, according to the user point of view. METHODS: An intentional sample was selected, composed by crack users (n = 45) and former users (n = 17). Recruited through key-informants and chain sampling methods, each participant was submitted to an in-depth semi-structured interview. RESULTS: Nowadays, as reported by interviewees, it is quite simple to get crack cocaine, especially through new market strategies as crack cocaine delivery. Rocks have been replaced by crack powder, the cheapest and easily changeable crack cocaine. Although makeshift aluminum pipes are the commonest way of use, others have been identified, among them, shotgun and the combined use with tobacco or marijuana. DISCUSSION: Although preliminary in nature, this study points that crack cocaine quality, market strategies and ways of use have changed, implying in potential heath risks to users suggesting its utilization to the health public policies and intervention methods updating.
- ItemAcesso aberto (Open Access)Entre o técnico e o humano: vivências e questionamentos de farmacêuticos hospitalares da cidade de São Paulo através de narrativas de história oral de vida(Universidade Federal de São Paulo (UNIFESP), 2015-05-08) Rossello, Gabriel Barreto [UNIFESP]; Gallian, Dante Marcello Claramonte [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The Clinical pharmacist is a professional who aims to take care of drug therapy of patients in hospital environments. This work aimed to raise a discussion on the actuality of these professionals working in the area of the Pharmacy Service in hospitals of São Paulo city; understanding their place in the current context of health care, their expectations and demands. A qualitative study was developed based on the Oral History of life as appropriate methodological approach to achieve our goals. We conducted seven interviews, which followed a set of procedures required by Oral History: recording of interviews; preparation of the written document: transcript and narrative creation; conference and written document validation; analysis and return of the final product. In this way, through open interviews made to professionals of hospital pharmacy service, data has been generated that subsequently underwent analysis based on the phenomenological model of immersion and crystallization. Through the life history of employees it was possible to identify the following issues: the difficulty in choosing the pharmaceutical profession; the important questions about the current educational models; why pharmaceutical care presents itself as an attractive alternative although the implementation and consolidation in the public health system is difficult, and finally, how the hospital pharmacist has conquered space in hospitals. These findings have given space to approach the discussion on the humanization and the dehumanization as a theme emerging in the profession. The results obtained are of great importance to rethink the educational approaches and the implementation of public policies involving the insertion of pharmacists in hospital health care.
- ItemAcesso aberto (Open Access)Estratégias desenvolvidas por usuários de crack para lidar com os riscos decorrentes do consumo da droga(Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro, 2010-01-01) Ribeiro, Luciana Abeid [UNIFESP]; Sanchez, Zila van der Meer [UNIFESP]; Nappo, Solange Aparecida [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVES: The aim of this study was to identify, from the perspective of crack users, what are the strategies used to minimize or avoid the risks associated with consumption of crack. METHOD: A qualitative research method was used, developed through semi-structured in depth interviews. It was interviewed a criterion sample composed of 30 crack users, selected through key informants and distributed in eight different chains. The interviews were verbatim transcribed, entered and analyzed in NVivo 8 software. Data was analyzed by content analysis technique. RESULTS: Respondents believe that the greatest risks of dependence on crack cocaine are related to the psychic effects of the drug like craving, transient paranoid symptoms and depressive symptoms - and those stemming from the illegality of it, such as the police and issues relating to trafficking. However, the risk of physical complications of consumption has hardly been mentioned. The strategies focused on control of the psychic effects, mainly by consumption of alcohol and marijuana. To deal with the consequences of the unlawful drug they showed concern about how to relate to the dealers and police officers. CONCLUSIONS: The strategies developed by crack users are focused on trying to protect their selves against violence and to relief from unpleasant psychic effects - mainly craving and transient paranoid symptoms. These strategies may seem effective in the short term. However, showed long-term risks, such as alcohol and marijuana dependence.
- ItemSomente MetadadadosA experiência dissociativa no trauma: uma abordagem qualitativa(Universidade Federal de São Paulo (UNIFESP), 2015-06-26) Mattos, Patricia Ferreira [UNIFESP]; Mello, Marcelo Feijo de Mello [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Peritraumatic dissociation has been considered an important feature to development of post-traumatic stress disorders, but this concept still remains unclear. Studies on the concept of dissociation are rare and prospective studies during or immediately after a trauma event are scarce. Most of them are retrospective, based on standardized questionnaires and carried out long after the trauma event. In order to adequately explore the peritraumatic dissociative phenomenon, we considered the nature of conscious human experience and the subjectivity of our object of study. We interviewed eight patients, victims of urban violence up to 1 month after the traumatic event. The interviews? content were compared, analyzed and encoded according to the Grounded Theory. The reported alterations by these individuals were coded on (A) their perceptions about the inner world, (B) the outer world, (C) as well as the impressions of third-party including the examiner?s observations. Patients manifested entire intermeshed experiences of feelings, expressions, beliefs and actions, all permeated with biographical details, but not integrated enough to allow their perceptual experience to be congruent, consistent and meaningful as the experience of being/existing. Peritraumatic dissociative experience presented itself as a failure in the capacity to synthesize the emerging signs of the inner (their mind/body unit) and outer world (other people and objects, including the space-time flow structure) in a consistent and meaningful way, departing from intact cognitive-perceptual tools. Adequate and faithful distinctions of a concept are the fundamental basis for classification, research and treatment. This finding implies on critical positioning to manage peritraumatic dissociation.
- ItemSomente MetadadadosPaternidade e o diagnóstico de anomalia fetal não letal: um estudo qualitativo(Universidade Federal de São Paulo (UNIFESP), 2016-11-28) Oliveira e Silva, Roberta Carvalho de [UNIFESP]; Pares, David Baptista da Silva Pares [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Studies about the paternal attitude towards the diagnosis of fetal anomalies are scarce. The transition to parenthood is a process that involves a number of changes in a man?s life, both individual and in the relationship with his wife/partner and the family as a whole, and that requires several adjustments and shifts. The objective of this paper is to describe the expectations about the paternity, to check the feelings resulting from the diagnosis of nonlethal fetal anomalies, and to identify existing concerns after the diagnosis of nonlethal fetal anomaly and changes in the relationship with the wife/partner after the diagnosis. This is a qualitative study previously approved by the institution?s ethics committee. A total of 20 fathers who were waiting for their prenatal appointment in the Outpatient Clinic of Fetal Medicine of the Department of Obstetrics of Escola Paulista de Medicina-Unifesp were interviewed from August 2014 to July 2015. Data was collected through semi-structured interviews and treated based on a categorical thematic content analysis. The results addressed the following topics: paternity, involvement during pregnancy, communication with the baby, feelings about the diagnosis, problem sharing and conflicts arising from the diagnosis. These cores of meaning gave rise to the following categories: inexperience; paternal reference; learnings after the diagnosis; desire; care; available time; sadness/sense of powerlessness; unfairness; uncertainty; fear of miscarriage; concerns with the wife/partner; search for information; life change; acceptance/hope. Conclusion: Regarding the diagnosis of fetal anomaly, it?s important that the father receives psychological follow-up by the health team so that he can express his feelings and relieve his suffering with a view to facilitating his emotional growth and strengthening the connection of the mother-father-baby triad.
- ItemAcesso aberto (Open Access)Política pública de redução de danos: estudo etnográfico em uma entidade do terceiro setor (ETS) na cidade de São Paulo(Universidade Federal de São Paulo (UNIFESP), 2015-10-04) Costa, Regis Cicero da [UNIFESP]; Pereira, Pedro Paulo Gomes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)This research aimed to analyse how the É de Lei acts out with the health politics for alcohol and others drugs as named Harm Reduction (HR). It observed and followed the actions of the workers of É de Lei in the way to handle and signify the life and bodies of its assisted, considering the way of workers understand the HR. About the methodology, it treats the qualitative research realized in the Assisted Center É de Lei utilizing de interviews with its professionals who act out with the vulnerable population in the street situation and the population that assists, that lives fixed or is in the region named Cracolândia in the city of São Paulo. The found results were: A) The important role of the É de Lei in the constitution of the public politics in health under the perspective of HR; B) The bond of the assisted individuals by the HR workers during the service afforded a (re)construction of the affective attachment. The worked collective activities offered the facility of the process of renew the citizenship; C) The HR faces the conflicts to get legitimacy that is configured, nowadays, between two contradictory main directions of services in the capital of the state; D) The conflict to get resources and to reduce the stigmas of the practices in HR, the É de Lei searched to redesign its Cross-Category to an institution that expresses, mainly, by the culture; E) Among the challenges to make the work at É de Lei with HR, the question ?border? as a side effect and undesirable, is reaffirmed in its actions and while knowledge production and F) The observation that HR is controversial health politics because it is in the opposite of the prohibitionist paradigm, designing up as a new ethical paradigm, clinical and political for the public and collective health.
- ItemSomente MetadadadosO sentido da maternidade em gestantes portadoras de transplante renal: uma abordagem fenomenológica(Universidade Federal de São Paulo (UNIFESP), 2015-12-31) Belardi Neto, Vera Lucia Lotufo [UNIFESP]; Sass, Nelson Sass [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The literature on research with pregnant kidney transplant in the field of psychology is quite sparce, since the possibility of getting pregnant is recent for these women. This study aimed to understand how the psychological sense of motherhood to these women who have submitted kidney transplantation in the Hypertention and Nephropaty Ambulatory at the Paulista Medicine School, EPM-UNIFESP. We used the phenomenological hermeneutics method by collecting speeches of fourteen pregnant kidney transplantation women with average of 27,5 years were included in the study; all patients investigated beyond the 20th week of pregnancy to delivery, followed-up between 2011 and 2012. The analysis of the narratives followed guidance of qualitative research and hermeneutics of meaning through non-directive interviews and the research question. The results shows: 50% of them believe that conception is God?s will, 60% of them felt ambivalence of feelings (hapiness and fear of death or fear of the graft loss), 28,5% of women consider that to be pregnant is a power of women, 85,71% consider that pregnant brings feelings of greatness, hapiness for the new life that is being born. Conclusion: pregnant kidney transplanted know the risks of pregnancy, are afraid of complications such as graft loss, maternal or fetal death, however they still choose to be mothers because brings feelings of hapiness and greatness. We observed the importance of the couple be guided and monitored through pregnancy by the health team.
- ItemAcesso aberto (Open Access)O uso de filmagem em pesquisas qualitativas(Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo, 2005-10-01) Pinheiro, Eliana Moreira [UNIFESP]; Kakehashi, Tereza Yoshiko; Angelo, Margareth; Universidade Federal de São Paulo (UNIFESP); Universidade do Grande ABC; Universidade de São Paulo (USP)Considering advancements in data collection methods, we explore the use of videotaping in qualitative research. This bibliographical study aims at developing reflections on the possibilities of using videotapes in research and at providing material to researchers. The video is used as an instrument of data collection and generation. We mention technical aspects, such as the utilization of a mobile or fixed camera. By means of the latter, the authors report their experience, emphasizing compliance with the neutrality principle and the possibility of editing the images obtained as a means of generating new data. The authors highlight that it was possible to detect contradictions between discourse and behavior through the use of videotaping and interviews. The authors also discuss the ethical principles set by CNS Resolution 196/96 and other ethical questions, whose solutions should be based on the agreement between researchers and subjects.