No / Aims and objectives; We report findings from a qualitative study to identify patient views of community hospital care. We consider how far these were in accord with the hospital staffs' views. This constituted part of a wider randomized controlled trial (RCT). The methodological challenges in seeking to identify patient satisfaction and in linking qualitative findings with trial results are explored. Design A sample of 13 patients randomized to the community hospital arm of the RCT joined the qualitative study. Official documentation from the hospital were accessed and six staff interviewed to identify assumptions underlying practice. Results Analysis of interviews identified a complex picture concerning expectations These could be classified as ideal, realistic, normative and unformed. The hospital philosophy and staff views about service delivery were closely in harmony, they delivered rehabilitation in a home-based atmosphere. The formal, or 'hard', process of rehabilitation was not well understood by patients. They were primarily concerned with 'soft' or process issues ¿ where and how care was delivered. Conclusions We identify a model of community hospital care that incorporates technical aspects of rehabilitation within a human approach that is welcomed by patients. If patients are to be able to participate in making informed decisions about care, the rationale for the activities of staff need to be more clearly explained. Recommendations are made about the appropriate scope of qualitative findings in the context of trials and about techniques to access patient views in areas where they have difficulty in expressing critical impressions.

Submitted by Frederico Azevedo (fazevedo@cdts.fiocruz.br) on 2010-11-11T11:51:50Z No. of bitstreams: 1 Dissertação Rosane Abdala.pdf: 817833 bytes, checksum: d9e4285465ac47138c85adec6c0c948e (MD5) / Made available in DSpace on 2010-11-11T11:51:50Z (GMT). No. of bitstreams: 1 Dissertação Rosane Abdala.pdf: 817833 bytes, checksum: d9e4285465ac47138c85adec6c0c948e (MD5) Previous issue date: 2005 / No Brasil, como no resto do mundo, a incidência de intoxicações e envenenamentos constitui um grave problema de saúde pública. Especialmente para esse segmento, a importância de se dispor, a tempo e a hora, de informações fidedignas é condição primordial para se traçar estratégias eficazes e efetivas de vigilância epidemiológica e sanitária. “Qualidade dos dados”, com toda a complexidade envolvida no conceito, passa então a ocupar lugar de destaque na agenda das políticas públicas, inclusive para o Brasil. Para investigar uma faceta da qualidade dos dados sobre intoxicações e envenenamentos no país, o foco do presente estudo está centrado nos Centros de Informação e Assistência Toxicológica, uma das principais fontes para notificação e registro de tais casos, os quais fornecem dados que são consolidados pelo Sistema Nacional de Informações Tóxico- Farmacológicas – SINITOX. Partindo do pressuposto que a padronização é uma das principais variáveis que impactam a qualidade dos dados coletados pelo SINITOX, o estudo visa analisar a maneira como esses Centros interpretam e registram cada um dos eventos a eles notificados, dentro de uma abordagem metodológica que buscou ressaltar a importância da padronização nos processos de registro dos casos. Os resultados apontam para o baixo grau de padronização dos dados que chegam ao SINITOX, ressaltando a importância de se desenhar estratégias que minimizem tal problema, contribuindo assim para minimizar as ocorrências deste agravo à saúde em nossa sociedade. / In Brazil, as in the rest of the world, human poisoning constitutes a serious problem of public health. Readily available and reliable information in this field are essential to the full implementation of epidemiological and sanitary surveillance and to establish efficient and effective strategies of control. The continuous improvement of data quality and consistency ─ no doubt, a permanent challenge ─ has a key role in the definition of sound public policies. To assess the accuracy of Brazilian data on human poisonings, the present study explores data from a network of Toxicological Information and Assistance Centers, one of the main sources of such data in Brazil. Data are consolidated by the National Poison Information System – SINITOX. Assuming that standardization is one of the main procedures that influence the quality of the data collected and analyzed by SINITOX, the study assesses the operations of the Centers affiliated to the SINITOX carry out to interpret and register the events reported to them. A detailed case study highlights the procedures used to standardize case reports. Our findings made evident an insufficient degree of standardization of data received by SINITOX. We emphasize the need to design strategies to improve standardization, aiming to develop a reliable system and to minimize the harms associated to human poisoning in Brazil.