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Escore para priorização de atendimentos cardiológicos eletivos (EPACE): ferramenta para estratificação de risco e gestão de prioridades a nível ambulatorial / Score for prioritizing elective cardiac care (SPECC): risk stratification tool for management and priorities on an outpatient basisFrancisco, Glaucia Taborda Martins 22 August 2016 (has links)
As doenças cardiovasculares acompanham o homem desde os tempos antigos. Mas foi apenas na sociedade moderna que elas se transformaram na principal causa de mortalidade no mundo. A manutenção da saúde é eixo central para se garantir o direito à vida, definido como direito fundamental pela nossa Constituição. Assim, desenvolver uma ferramenta específica para o atendimento aos pacientes de maior risco para estas doenças contribui para que este direito fundamental seja garantido na prática. Além disso, as doenças cardiovasculares são responsáveis por impactos negativos na economia, tanto pelos custos de atendimento como pelo potencial em incapacitar uma parcela da população que está em idade produtiva. Dadas estas características vem sendo desenvolvidas estratégias de saúde pública para sua prevenção e atendimento precoce. Este estudo se propôs a criar e avaliar a eficiência de um escore para estratificação de pacientes em espera para atendimento ambulatorial eletivo de cardiologia, com vistas a identificar aqueles de maior risco. Foi aplicado num ambulatório de cardiologia do Hospital de Clinicas da UFPR, com resultados iniciais promissores. O resultado da aplicação mostrou excelente sensibilidade/especificidade em identificar os pacientes de alto risco para eventos cardiovasculares, que deveriam ter seu atendimento ambulatorial priorizado, reduzindo assim a possibilidade de eventos cardiovasculares futuros. Entretanto, para sua completa validação deve ser testado em um universo maior de pacientes. / Cardiovascular diseases follow the man since ancient times. But, it was only in modern society that they have become the main cause of mortality worldwide. Maintaining health is the central axis to guarantee the right to life, defined as fundamental right by Brazilian Constitution. So, to develop a specific tool for the patient care at higher risk related to these diseases contributes to guarantee this fundamental right in practice. In addition, cardiovascular diseases are responsible for negative impacts on the economy, by both service costs and the potential to disable a portion of the working age population. Due to these characteristics, public health strategies have been developed for its prevention and early treatment. This study aimed to create and evaluate the efficiency of a score for stratification of patients waiting for elective outpatient cardiology, for identifying those at greatest risk situation. The SPECC was applied in an outpatient cardiology at Hospital de Clinicas, UFPR, with promising initial results. Result of its application showed excellent sensitivity/specificity in identifying patients at high risk for cardiovascular events, for whom outpatient care should be prioritized, thus, reducing the possibility for future cardiovascular events. However, for a complete validation, it should be tested in a larger patient population.
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Narratief-pastorale terapie met hartpasiënteTruter, Cornelius Johannes 30 November 2002 (has links)
Text in Afrikaans / Coronary artery disease (CAD) is a life-threatening disease. When heart patients in the treatment of their disease, due to certain subjugating discourses practised by the biomedical model or biomedicine, are treated in a way that contributes to their anxiety and they feel themselves marginalised by society, then CAD becomes even more threatening. The narrative-pastoral approach of this study aims to treat heart patients in a way that has a calming effect on them that could assist them to deal with their heart disease more efficiently. This study shows how a heart patient's illness stories can be centralised by means of narrative therapy and how a pastoral and ethical attitude of love and respect can produce a climate that's conducive to better health and well-being.
I indicate how my methodology of participatory action research succeeds in making the heart patients active participants to the research project. Their active participation indicates that meaning is not created on their behalf in therapy; rather, they are responsible for the process of richer construction of meaning. I describe how the participants socially co-constructed alternative and richer descriptions of their illness. Futhermore, I point out how their richer descriptions of illness contribute to perceptible and measurable results that are of value to the heart patients. / Koronere hartvatsiekte (KHS) is 'n lewensbedreigende siekte. Wanneer hartpasiente
in die behandeling van hul siekte vanwee sekere onderdrukkende diskoerse van siekte
vanuit die biomediese model of biomedisyne s6 hanteer word dat dit spanning op hul
plaas en deur die samelewing gemarginaliseer word, word KHS des te meer gevaarlik.
In hierdie studie gaan dit oor 'n narratief-pastorale benadering wat hartpasiente op 'n
kalmerende manier hanteer sodat hulle kan kom tot 'n meer doeltreffende hantering
van hul hartsiekte. Hierdie studie toon aan hoe hartpasiente se siekteverhale deur
middel van narratiewe terapie gesentreer word en hoe 'n etiese en pastorale gesindheid
van liefde en respek 'n klimaat skep wat bevorderlik is vir beter gesondheid en
welwese.
Ek dui aan hoe my metodologie van deelnemende aksienavorsing daarin geslaag het
om die hartpasiente aktiewe deelnemers te maak aan die navorsingsprojek. Hul
aktiewe deelname impliseer dat betekenis nie in terapie vir hulle geskep word nie,
maar dat hulle self skeppend betrokke is in die proses van ryker betekeniskonstruering.
Ek beskryf hoe die deelnemers altematiewe en ryker beskrywings van
hul siekte sosiaal ko-konstrueer. Ek dui verder aan hoe hul ryker beskrywings van
siekte bydra tot sigbare en meetbare resultate wat vir hartpasiente van waarde is. / Practical Theology / D. Th. (Praktiese Teologie)
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Narratief-pastorale terapie met hartpasiënteTruter, Cornelius Johannes 30 November 2002 (has links)
Text in Afrikaans / Coronary artery disease (CAD) is a life-threatening disease. When heart patients in the treatment of their disease, due to certain subjugating discourses practised by the biomedical model or biomedicine, are treated in a way that contributes to their anxiety and they feel themselves marginalised by society, then CAD becomes even more threatening. The narrative-pastoral approach of this study aims to treat heart patients in a way that has a calming effect on them that could assist them to deal with their heart disease more efficiently. This study shows how a heart patient's illness stories can be centralised by means of narrative therapy and how a pastoral and ethical attitude of love and respect can produce a climate that's conducive to better health and well-being.
I indicate how my methodology of participatory action research succeeds in making the heart patients active participants to the research project. Their active participation indicates that meaning is not created on their behalf in therapy; rather, they are responsible for the process of richer construction of meaning. I describe how the participants socially co-constructed alternative and richer descriptions of their illness. Futhermore, I point out how their richer descriptions of illness contribute to perceptible and measurable results that are of value to the heart patients. / Koronere hartvatsiekte (KHS) is 'n lewensbedreigende siekte. Wanneer hartpasiente
in die behandeling van hul siekte vanwee sekere onderdrukkende diskoerse van siekte
vanuit die biomediese model of biomedisyne s6 hanteer word dat dit spanning op hul
plaas en deur die samelewing gemarginaliseer word, word KHS des te meer gevaarlik.
In hierdie studie gaan dit oor 'n narratief-pastorale benadering wat hartpasiente op 'n
kalmerende manier hanteer sodat hulle kan kom tot 'n meer doeltreffende hantering
van hul hartsiekte. Hierdie studie toon aan hoe hartpasiente se siekteverhale deur
middel van narratiewe terapie gesentreer word en hoe 'n etiese en pastorale gesindheid
van liefde en respek 'n klimaat skep wat bevorderlik is vir beter gesondheid en
welwese.
Ek dui aan hoe my metodologie van deelnemende aksienavorsing daarin geslaag het
om die hartpasiente aktiewe deelnemers te maak aan die navorsingsprojek. Hul
aktiewe deelname impliseer dat betekenis nie in terapie vir hulle geskep word nie,
maar dat hulle self skeppend betrokke is in die proses van ryker betekeniskonstruering.
Ek beskryf hoe die deelnemers altematiewe en ryker beskrywings van
hul siekte sosiaal ko-konstrueer. Ek dui verder aan hoe hul ryker beskrywings van
siekte bydra tot sigbare en meetbare resultate wat vir hartpasiente van waarde is. / Philosophy, Practical and Systematic Theology / D. Th. (Praktiese Teologie)
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