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- ItemSomente MetadadadosAvaliação do rastreamento das atipias celulares de colo de útero em mulheres assistidas na atenção básica(Universidade Federal de São Paulo (UNIFESP), 2016-11-30) Yoshikawa, Jamile Mika [UNIFESP]; Gabrielloni, Maria Cristina Gabrielloni [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The aim of this study is to evaluate the cellular atypia screening in uterine cervical of women attended in primary health care; to evaluate the epidemiological profile of women who have variation in the result of uterine cervical cytopathology exam; identify the prevalence and characteristics of uterine cervical lesion and evaluate the process of tracking cellular atypia in uterine cervical following the time between the specimen collection and the result, the professional performance, the time between the result and the medical appointment, treatment and outcome. This is an observational, cross-sectional and retrospective study through the analysis of 190 women medical records who had atypical cells of the uterine cervical on the outcome cytopathology exam between 2012-2014 in a Basic Health Unit located in the North of São Paulo city. The results show that women have poor or no education, are unmarried, not pregnant and living with a minimum wage per month. The medical exam was carried out preferably by nurses. Twenty four days were the elapse time between the examination and the results outcome in UBS and 2 months for the medical appointment. The most common atypical cells were ASC - US (57.4%), LSIL (23.2%) and ASC-H, AGC HSIL were less than 5%. The professional procedure after the result of the last cervical cytopathology was proper to 51.1% of women, 41.1% not proper and 7.9% had no procedure. There was a relation between professional procedure and the last cervical cytology (p <0.001) outcome. It can be concluded that a national electronic system for tracking with the access to the previous history of the patient should be implanted; an archive for the correct follow-up and treatment, considering the examinations, from the specimen collection, results and procedure to assess the process quality, effectiveness and cost benefit.
- ItemAcesso aberto (Open Access)Efetividade de cursos por educação à distância na capacitação de profissionais de saúde, assistência social e líderes religiosos/comunitários para realizar triagem do uso de drogas e intervenções breves(Universidade Federal de São Paulo (UNIFESP), 2014-08-27) Carneiro, Ana Paula Leal [UNIFESP]; Souza-Formigoni, Maria Lucia Oliveira de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Excessive use of alcohol and other drugs is associated with health and psychosocial risks. To reduce drug use and associated problems, different techniques have been proposed to deal with users who report to health services, among them the Screening of substance use associated with Brief Interventions (SBI). However, there are no studies showing their effectiveness when applied by professionals trained through Distance Learning courses (DL). Objective: This study aimed at evaluating the use and effectiveness of SBI techniques applied by health professionals or social workers trained by the DL course SUPERA (“Sistema para detecção do Uso abusivo e dependência de substâncias Psicoativas: Encaminhamento, intervenção breve, Reinserção social e Acompanhamento”), as well as to assess the use of SBI by religious or community leaders trained by the DL course Faith in Prevention (“Fé na Prevenção - Prevenção de Uso de Drogas por Instituições Religiosas e Movimentos Afins”). Methods: Both courses were developed by the teams of UDED (“Unidade de Dependência de Drogas”) from the “Departamento de Psicobiologia” and “Departamento de Informática em Saúde” (DIS) of the “Universidade Federal de São Paulo” (UNIFESP), in partnership with the “Secretaria Nacional de Políticas Sobre Drogas” (SENAD), which sponsored them. This study used data provided by the participants when they enrolled in the courses and data recorded in the course website. All professionals approved in the courses SUPERA (1st to 4th editions) and Faith in Prevention (1st and 2nd editions) were invited to participate (N=21,799). From these, 4,354 accepted it and undertook an online survey about their satisfaction with the course, the use of SBI and if they had been acting as multipliers of the knowledge acquired. In a sample of 201 patients (treated in health or social care services by 25 professionals trained by SUPERA course) we evaluated the effectiveness of the SBI applied. Out of these patients, 79 participated in a follow-up evaluation to measure whether there was a reduction in drug use associated problems. Results: Most of the participants in the SUPERA course were health professionals who worked at “Centro de Atenção Psicossocial” (CAPS), in the “Estratégia de Saúde da Família” (ESF) or in the social service network. They were from all Brazilian states and most of them were women, with 36 ± 10 years (average ± SD). The "Faith in Prevention" participants were from religious institutions, therapeutic communities or Non-Governmental Organizations (NGOs), from all Brazilian states, mostly men, with 40 ± 10 years (average ± SD). Most of the professionals (80%) were satisfied with the course, 40-50% had used the SBI techniques and 80% had acted as multipliers of the knowledge acquired. A significant association was observed among the use of SBI, level of motivation, support from leadership and feeling capable to provide SBI after the course. The leadership support was strongly associated with acting as multipliers. Patients who received the SBI applied by those professionals reported a significant reduction in their substance use related problems: Alcohol (before: 15 ± 12 / after: 12.5 ± 10, p = 0.04), cocaine/ crack (before: 13 ± 8 / after: 4 ± 9, p = 0.003) or benzodiazepines (before: 2 ± 6 / after: 0 ± 3, p = 0.01) and evaluated the information and intervention received as satisfactory. Conclusion: The courses were positively evaluated by the participants and the SBI applied by them was effective in reducing problems associated with the use of psychoactive substances, with positive changes in the areas of health, social, personal and/or professional life.