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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
271

Avaliação de satisfação dos usuários e qualidade das Próteses Parcial Removível instaladas na clínica de graduação da FOUSP entre 2010-2014 / Satisfaction evaluation and quality of removable partial dentures in the FOUSP undergraduate clinic between 2010-2014

Marcelli Soares de Souza Camargo 06 June 2016 (has links)
O objetivo deste trabalho foi avaliar a qualidade e satisfação das próteses parciais removíveis instaladas na clínica da graduação da disciplina de prótese removível no período de 2010-2014. Os pacientes que participaram da clínica nesse período foram contactados por telefone e convidados a participar da clínica de retorno da disciplina e ao mesmo tempo verificar a qualidade das próteses e a satisfação do paciente. Do total de 284 próteses instaladas nesse período, 50 foram avaliadas neste trabalho. Os pacientes que aceitaram participar da pesquisa preencheram 4 questionários: 1) TCLE, 2) Mini-mental; 3) GOHAI e 4) Anamnese da Prótese. Das próteses presentes no estudo classificaram-se em Perfeitas (sem queixa) e Problemáticas (com queixa). Após preenchido os questionários, relacionou-se a queixa principal com arco restaurado, análise da oclusão presente na prótese em função na boca, qualidade da sela, higienização da prótese e o momento em que a falha é decorrente. Como conclusão, teve-se que a queixa \"soltar sozinha\" foi a de maior destaque e está relacionada ao momento da falha pós- instalação. As próteses mal adaptadas estão relacionadas com uma qualidade de vida prejudicada e isto reforça que os retornos periódicos para controle da prótese são fundamentais para o sucesso clínico da prótese. / The objective of this study was to evaluate the quality and satisfaction of removable partial dentures installed in removable prosthesis undergraduate clinic in the 2010-2014 period. Patients attending the clinic during this period were contacted by telephone and invited to participate in the discipline of clinical and return at the same time check the quality of prosthetics and patient satisfaction. Of the total of 284 implants installed during this period, 50 were evaluated in this study. Patients who agreed to participate completed 4 questionnaires: 1) TCLE, 2) MiniMental, 3)GOHAI and 4) anamnesis of the prosthesis. Prostheses present in the study were classified in Optimal (without complaint) and Problematic (complaining). Thus, the complaint related to restored arch, occlusal analysis in the function of the prosthesis, saddle quality, denture cleaning and the time when the failure is due. In conclusion, it was that the complaint \"drop alone\" was the most prominent and is related to the time of after installation failure. Poorly adapted prostheses are associated with impaired quality of life and this reinforces that the periodic returns to the prosthesis control are fundamental for clinical success of the prosthesis.
272

Convivendo com uma ajuda que atrapalha: o significado da terapêutica medicamentosa para a pessoa com esquizofrenia / Living with help that bothers: the meaning of medication therapy for schizophrenia patients

Kelly Graziani Giacchero Vedana 16 December 2011 (has links)
A esquizofrenia é um transtorno mental que provoca a desorganização de diversos processos mentais. Trata-se de uma condição crônica com expressivo impacto em termos de sobrecarga pessoal e social. O tratamento medicamentoso contínuo é necessário para evitar recaídas e manter o paciente no melhor nível de funcionamento possível. Este estudo teve como objetivo compreender o significado da terapêutica medicamentosa para a pessoa com esquizofrenia, em sua perspectiva e na de seu familiar, e formular um modelo teórico sobre o fenômeno estudado. Para tanto, foi adotado como referencial teórico o Interacionismo Simbólico e, como referencial metodológico, a Teoria Fundamentada nos Dados. A pesquisa foi desenvolvida em um Serviço Ambulatorial de Clínica Psiquiátrica de um hospital universitário, um Núcleo de Saúde Mental e um CAPS II, localizados no interior do estado de São Paulo - Brasil. Pelo processo de amostragem teórica, foram selecionados para o estudo 36 pessoas com esquizofrenia e 36 familiares. A entrevista e a observação foram as principais estratégias utilizadas para a obtenção dos dados que foram coletados no período de 2008 a 2010. Os dados coletados foram transcritos e, posteriormente, analisados em três etapas: codificação aberta, axial e seletiva. Verificou-se que, ao ser acometido pela esquizofrenia, o paciente percebe-se \"vivendo dias difíceis\" e identifica no medicamento uma possibilidade de melhora. \"Pesando o custo-benefício do medicamento\" e \"identificando obstáculos e incentivos para o tratamento\" o paciente implementa estratégias \"agindo em busca de alívio\" para o sofrimento causado pela esquizofrenia ou pelo tratamento medicamentoso. Entretanto, esse indivíduo se julga \"permanecendo em um labirinto\", pois não encontra uma saída para livrar-se do transtorno e da necessidade da farmacoterapia. A experiência descrita se centraliza no fenômeno \"CONVIVENDO COM UMA AJUDA QUE ATRAPALHA\" que representa o significado da terapêutica medicamentosa para a pessoa com esquizofrenia. A teoria aqui apresentada fornece uma compreensão abrangente, contextualizada, motivacional e empática da realidade vivenciada pelo paciente. Desse modo, o presente estudo oferece subsídios para o planejamento da assistência a essa clientela e aponta elementos a serem investigados. / Schizophrenia is a mental disorder that provokes the disorganization of several mental processes. It is a chronic condition with considerable impact in terms of personal and social burden. Continuous medication treatment is needed to avoid relapses and maintain the patient at the best possible functioning level. This study aimed to understand the meaning of medication therapy for schizophrenia patients, from their own perspective and that of their relative, and to formulate a theoretical model for the study phenomenon. Therefore, Symbolic Interactionism was adopted as the theoretical framework, and Grounded Theory as the methodological framework. The research was developed at a Psychiatric Clinical Outpatient Service of a teaching hospital, a Mental Health Center and a CAPS II located in the interior of São Paulo State - Brazil. Through a theoretical sampling process, 36 schizophrenia patients and 36 relatives were selected for the study. Interview and observation were the main strategies used for data collection, between 2008 and 2010. The collected data were transcribed and later analyzed in three phases: open, axial and selective coding. It was verified that, when the schizophrenia affects them, the patients perceive that they are \"going through difficult times\" and identify the medication as a possibility for improvement. \"Weighing the cost-benefit of the medication\" and \"identifying treatment obstacles and incentives\", the patients put in practice strategies \"acting in search of relief\" for the suffering the schizophrenia or medication treatment causes. These patients, however, consider that they \"continue in a labyrinth\", as they do not find a way out to get rid of the disorder and the need for the drug therapy. The described experience centers on the phenomenon \"LIVING WITH HELP THAT BOTHERS\", which represents the meaning of the medication therapy for schizophrenia patients. The theory presented here provides a broad, contextualized, motivational and empathetic understanding of the reality these patients experience. Thus, this study offers support to plan care for these clients and appoints elements for further research.
273

Propriedades de medida da versão brasileira do Treatment Satisfaction Questionnaire for Medication - TSQM (version 1.4) em pacientes com hipertensão arterial / Measurement properties of the Brazilian version of the Treatment Satisfaction Questionnaire for Medication - TSQM (version 1.4) in patients with hypertension

Liberato, Ana Carolina Sauer, 1989- 25 August 2018 (has links)
Orientadores: Roberta Cunha Matheus Rodrigues, Thaís Moreira São João / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Enfermagem / Made available in DSpace on 2018-08-25T21:11:41Z (GMT). No. of bitstreams: 1 Liberato_AnaCarolinaSauer_M.pdf: 5341011 bytes, checksum: 0c5d858565f32b94d7711881b762924b (MD5) Previous issue date: 2014 / Resumo: Este estudo avaliou a praticabilidade, aceitabilidade, efeitos teto e chão, confiabilidade e validade de construto - convergente, de grupos conhecidos e de fatores da versão brasileira do Treatment Satisfaction Questionnaire for Medication ¿ TSQM (version 1.4) em pacientes hipertensos. A amostra foi composta por 300 pacientes em seguimento ambulatorial em hospital universitário. Foram obtidos os dados de caracterização sociodemográfica e clínica e as medidas de satisfação e de adesão medicamentosa - versão brasileira da Morisky Self-Reported Measure of Medication Adherence Scale, proporção e avaliação global da adesão. O coeficiente alfa de Cronbach foi utilizado para estimar a confiabilidade no que se refere à consistência interna da medida. A validade de grupos conhecidos foi verificada por meio da ANOVA (one-way) que testou a capacidade do TSQM em discriminar satisfação entre pacientes classificados nos diferentes estágios da HAS e do teste t de Student que comparou escores do TSQM entre hipertensos com e sem hipertrofia do ventrículo esquerdo (HVE), entre os aderentes ou não à terapia medicamentosa e entre hipertensos com ou sem efeito colateral. A validade de construto convergente foi avaliada por meio da relação entre satisfação e adesão, com emprego do coeficiente de correlação parcial, ajustado para sexo, idade e escolaridade. A análise fatorial confirmatória hierárquica testou a dimensionalidade do TSQM. A validade convergente do modelo fatorial foi avaliada pela confiabilidade composta, variância média extraída (AVE) e pelas cargas fatoriais. A validade discriminante do modelo fatorial foi avaliada utilizando-se os coeficientes de correlação entre os domínios e a comparação entre AVE e as correlações múltiplas ao quadrado (Squared Multiple Correlations - SMC). A versão brasileira do TSQM demonstrou praticabilidade, aceitabilidade (99%), efeito teto principalmente no domínio Efeito colateral (89%) e evidências de confiabilidade ¿ alfa de Cronbach >0,76 em todos os domínios. A validade de grupos conhecidos foi apoiada por escores de satisfação significativamente mais elevados no domínio Eficácia entre hipertensos com melhor controle da pressão arterial (p-valor=0,01) e sem HVE (p-valor= 0,05); nos domínios Eficácia (p-valor=0,01) e Efeito Colateral (p-valor=0,03) entre hipertensos em uso de dose adequada e nos aderentes à terapia medicamentosa (p-valor=0,01 e 0,02, respectivamente), bem como nos hipertensos sem efeito colateral, em todos os domínios do TSQM. A validade convergente foi parcialmente apoiada por correlações positivas significativas de fraca magnitude entre Efeito colateral e Satisfação global e a proporção de adesão (r=0,20; p-valor=0,01; e r=0,19; p-valor=0,01, respectivamente) e por correlações significativas negativas de fraca magnitude entre o domínio Conveniência e o escore total de Morisky (r=-0,21; p=0,01). A análise fatorial confirmatória confirmou a dimensionalidade do instrumento original. A validade convergente do modelo fatorial foi confirmada por cargas fatoriais satisfatórias (>0,7), medidas de confiabilidade composta > 0,7 e AVE >0,5 para todos os domínios do TSQM. Exceto para o domínio Satisfação Global, a validade discriminante do modelo fatorial foi demonstrada entre os domínios da versão brasileira do TSQM (version 1.4). Conclui-se que a versão brasileira do TSQM é um questionário de fácil aplicação, válido e confiável para a utilização em pacientes hipertensos em atendimento ambulatorial / Abstract: This study evaluated the practicability, acceptability, ceiling and floor effects, reliability and construct validity ¿ convergent, known groups and factorial validity of the Brazilian version of the Treatment Satisfaction Questionnaire for Medication - TSQM (version 1.4) in patients with hypertension. The sample was composed of 300 patients in follow-up in an outpatient setting at a teaching hospital. Sociodemographic and clinical information, patient satisfaction and medication adherence data ¿ Brazilian version of the Morisky Self-Reported Measure of Medication Adherence Scale, proportion of adherence and global adherence were gathered. The Cronbach¿s alpha was applied to estimate the reliability regarding internal consistency. The known group validity was verified by one-way ANOVA, which tested the ability of TSQM in discriminating satisfaction among patients classified in different hypertension stages and T-student test was applied to compare hypertensive patients with and without left ventricle hypertrophy (LVH); adherents and non-adherents to medication and with and without side effects. The convergent construct validity evaluated the relation between satisfaction and adherence by the partial correlation coefficient adjusted by gender, age and schooling. The hierarchic confirmatory factorial analysis tested the TSQM dimensionality. The convergent validity of the factorial model was tested by the construct reliability (CR) and average of variance explained (AVE). The discriminant validity was evaluated by the correlation among the domains, the AVE and Squared Multiple Correlations (SMC). The Brazilian version of the TSQM demonstrated practicability, acceptability (99%), ceiling effect mainly on the Side Effect domain (89%) and evidence of reliability (internal consistency) ¿ Cronbach¿s alpha >0.76 in all domains. The known groups validity was supported by the higher satisfaction scores on the Efficacy domain among patients with better hypertension control (p-value=0.01) and without LVH (p-value=0.05); on Efficacy (p-value=0.01) and Side Effect (p-value=0.03) domains among hypertensive patients with correct dose of medication use and on the adherents to the medication therapy (p-value=0.01 and 0.02, respectively), as well as in those without side effects, in all the TSQM domains. The convergent validity was partially sustained by the significant positive correlations among side effects and global satisfaction domains and proportion of adherence (r=0.20; p-value=0.01; e r=0.19; p-value=0.01, respectively) and weak negative correlation between the Convenience domain and the total score of Morisky scale (r=-0.21; p-value=0.01). The dimensionality of TSQM was approved by the means of confirmatory factorial analysis when compared with the original questionnaire. The convergent validity of the factorial model was confirmed by satisfactory factorial loadings (>0.7), construct reliability >0.7 and AVE >0.5 for all the TSQM domains. Except for the Global Satisfaction domains, the discriminant validity was confirmed between the other domains. Finally, the Brazilian version of TSQM (version 1.4) is a questionnaire of easy application, valid and reliable when applied in patients with hypertension on outpatient settings / Mestrado / Enfermagem e Trabalho / Mestra em Ciências da Saúde
274

Satisfação do paciente com os cuidados de enfermagem : adaptação cultural e validação do Patient Satisfaction Instrument

Oliveira, Acacia Maria Lima de 26 February 2004 (has links)
Orientador: Edineis de Brito Guirardello / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-04T03:23:24Z (GMT). No. of bitstreams: 1 Oliveira_AcaciaMariaLimade_M.pdf: 5400295 bytes, checksum: 9cdb377799ce85db56adcce9afe05b04 (MD5) Previous issue date: 2004 / Resumo: Resumo o processo de hospitalização pode acarretar para o paciente um distanciamento do seu convívio familiar. O fato de permanecer, mesmo que temporariamente, em um ambiente estranho ao seu convívio, com normas e rotinas a que não está habituado e a expectativa com relação ao tratamento, podem gerar sentimentos de insatisfação com relação ao cuidado recebido. A satisfação do paciente com o cuidado de enfermagem, foi definida por RISSER (1975) como sendo o grau de congruência entre as expectativas do paciente e sua percepção sobre o cuidado recebido. Estudos sobre satisfação do paciente na cultura brasileira utilizam-se de uma abordagem genérica, de modo a não valorizar a satisfação do paciente com a assistência de enfermagem. Sendo assim, é importante utilizar instrumentos de medida específicos para avaliar a satisfação do paciente quanto aos cuidados de enfermagem. Considerando a inexistência de instrumentos para este fim, o presente estudo teve por objetivo traduzir e validar o Patient Satisfaction Instrument (PSI), desenvolvido por Hinshaw e Atwood (1982), para a cultura brasileira. É um instrumento composto de 25 itens que aborda situações do cuidado de enfermagem, agrupados em três domínios: Educacional, Profissional e Confiança. O procedimento metodológico de adaptação utilizado seguiu as etapas de: a) tradução do instrumento para a língua portuguesa; b) tradução de volta para a língua original; c) julgamento por um comitê de juízes e d) pré-teste da versão final do instrumento, o qual denominou-se Instrumento de Satisfação do Paciente (ISP). Participaram do estudo 211 pacientes, internados em clínicas médicocirúrgicas de dois hospitais do município de São Paulo. Na análise da confiabilidade do instrumento, obteve-se alta consistência interna para todos os itens do instrumento (a= 0,88) e para os domínios Educacional (a= 0,66) e Confiança a= 0,79). Apenas para o domínio Profissional, obteve-se um coeficiente alfa de Cronbach de 0,62. Quanto a validade de constructo, a análise de fator exploratória mostrou que, apesar da medida de adequação da amostra ter sido estatisticamente significante, (MSA= 0,84), o critério utilizado para selecionar fatores com auto valor maior que 1 demonstrou sete fatores que explicaram 62% variância total. Os resultados da análise de fator confirmatória mostraram que apenas o RMR, obteve valores aceitáveis (0,10). Os resultados desse estudo indicam que o PSI traduzido para a nossa cultura pode ser utilizado para medir satisfação do paciente. Entretanto, é necessário que este instrumento seja aplicado em outras populações com características semelhantes para testar os itens que não foram consistentes na amostra estudada / Abstract: The hospitalization process may keep the patient distant from their family. The fact of being in an unfamiliar setting, even for a short period, with established rules and routines that they are not used to and the expectations concerning the treatment, may bring about dissatisfactions. Patient Satisfaction with nursing care was defined by RISSER (1975) as the congruence degree between the patient expectations and their perception concerning the care provided. Studies on patient satisfaction in Brazil adopt a generic approach and do not give value to patient satisfaction with the nursing care. Based on that, it is important to use specific measurement instruments in order to assess the patient satisfaction with the nursing care. As there are no instruments with this purpose, the present study aimed at translating and validating the Patient Satisfaction Instrument (PSI) developed by Hinshaw and Atwood (1982) to the Brazilian culture. The PSI is constituted of 25 items that cover situations related to the nursing care grouped in three domains: Educational, Professional and Trust. The methodological procedure used were a) translation of the instrument into Portuguese; b) back-translation to English c) committee review; d) test of the pre-final version. 211 patients admitted in medical-surgical clinics in two hospitais in São Paulo city made part of the study. The analysis of its reliability scored high internal consistence in ali items (a=0.88), and for Educational domains (oc=0.66); and Trust (oc=0.79). Only for the Professional domain it scored Cronbach's alfa (oc=0.62). In relation to construct validity, the exploratory factor analysis showed that besides the adequacy measure of the sampling been statistically significant (MSA=0,84), the criteria used to select the factors with an eigenvalue of 1.00 or above demonstrate seven factors that explained 62% of the total variance. The results of confirmatory factor analisys showed that only the root mean-squared residual (RMR), met the criteria standards (0.10). The results of this study indicate that the PSI translated to Brazilian culture can be used to measure patient'satisfaction. However, it is necessary to point out that it is important to apply this instrument to other populations with characteristics similar to the ones in the present study in order to review the items which were not consistent in the studied samples / Mestrado / Enfermagem e Trabalho / Mestre em Enfermagem
275

Medical compared with surgical management in induced abortions and miscarriages

Niinimäki, M. (Maarit) 24 November 2009 (has links)
Abstract Each year approximately 11,000 induced abortions are performed in Finland, the majority of these women being younger than 25 years of age. Medical abortion with the antiprogestin mifepristone and the prostaglandin analogue misoprostol is increasingly being used instead of surgical method (dilatation of cervix and uterine evacuation with instruments). Similarly, miscarriages can be treated with medical or surgical management. Still, clinical outcomes of the medical treatment of miscarriage are not well established, and various different regimens exist. The aim of this study was to investigate the frequency and risk factors of repeat abortions and immediate post-abortal complications, focusing especially on the impact of the method of abortion. National health registries were used as a data source. Another part of the study was aimed at comparing the efficacy, acceptability and cost-effectiveness of the medical and surgical treatment of miscarriage. In national cohort, the risk of repeat abortion was associated with sociodemographic characteristics (parity, previous abortion, low socioeconomic status, being unmarried but cohabiting or single), but not with the method of abortion. The risk of repeat termination of pregnancy decreased with age, among women living in rural area, and when intrauterine devices or sterilization were planned for future contraception. The overall incidence of adverse events was 4-fold greater in the medical compared to the surgical abortion cohort. Hemorrhage and incomplete abortion were more common following medical abortion, but the incidence of infections did not differ. Medical and surgical treatment of miscarriage were compared in a randomized setting; the efficacy of the treatment did not differ. Medically treated patients were less satisfied with the treatment and had experienced more pain. In the cost analysis, the primary costs of the surgical treatment were higher, but more unexpected events and complications increased the secondary costs in the medical group. In summary, medical abortion offered a good alternative to surgical method without increasing the risk of repeat abortions, but with an increased risk of short-term adverse events. The medical method was efficient in treating miscarriages, and the majority of women were satisfied with the treatment. Neither of the methods was economically superior in treating miscarriage.
276

Analysis of Health Related Financial Flows and Patient Satisfaction with Private Health Care in the Czech Republic / Analýza finančních toků spojených se zdravotnictvím a spokojenost pacientů se zdravotní péčí poskytovanou v soukromě vlastněných nemocnicích v České republice

Supová, Aneta January 2016 (has links)
This Master Thesis focuses on the structure of health related financial flows and patient satisfaction with privately owned hospitals in the Czech Republic. The main aim was to provide a general overview of health care system in the Czech Republic, to describe how the health care system is financed, and to find out if patients hospitalized in privately owned hospitals are more satisfied with the care provided in this type of hospitals. Having analyzed the major statistical reports from the WHO, EU, and the Institution of Health Information and Statistics of the Czech Republic, the theoretical part provided a comprehensive summary of health care, health financial flows, and pricing of health treatments. The practical part, on the other hand, shows distribution of health costs among differently aged people in the form of contribution/expenditure ratio. Finally, the results of the questionnaires conducted among patients in privately owned hospitals enabled to conclude that patients in the Czech Republic are still not fully aware of the difference between privately and publically owned hospitals.
277

Continuity of care : a study of alternate forms of intervention

Doll, Richard P. January 1987 (has links)
The aim of this study is to determine the effect of two approaches of social work intervention, a continuity approach, and a team approach, upon the three dependent variables of subject satisfaction, control, and mood. In order to determine differences in outcome, subjects were administered psychological tests to determine changes in their reported sense of control and mood (hopelessness) in relation to their response to the diagnosis and treatment of cancer. At follow-up, subjects also completed a questionnaire designed to determine their satisfaction with social work services received. The amount of time spent in contact with social workers was also assessed at this time. The analysis of the relationship between these variables revealed that there were no statistically significant differences between the study groups; subjects were equally satisfied with the two approaches in social work intervention, and there were no major differences between the reported changes in mood and control by the subjects in the study groups. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate
278

Do elderly clients in an acute care hospital perceive they are treated with dignity and respect

Steckler, Josephine January 1990 (has links)
The purpose of this study was to investigate whether elderly clients in an acute care setting perceived themselves as being treated with dignity and respect, and whether clients with a higher socioeconomic status are more likely than clients with a lower socioeconomic status to be treated with dignity and respect. Sixty-two elderly clients who had been in hospital at least five days, were alert and oriented during their hospitalization, and could speak English were selected for the study. Using a convenience sampling technique, the clients were selected from medical and surgical units of two major teaching hospitals. They were interviewed within three days after discharge to respond to items on a questionnaire selected from the Medicus Quality Assurance Tool. The results of the study show that elderly clients may not perceive that they are consistently treated with dignity and respect. Older clients (75+ years) are less likely than younger older clients (65-74) to be treated with dignity and respect, and elderly clients with a lower socioeconomic status and women, are less likely to be treated with dignity and respect. / Applied Science, Faculty of / Nursing, School of / Graduate
279

O processo ensino-aprendizagem para o candidato ao transplante de fígado / The teaching-learning process for liver transplant candidates

Karina Dal Sasso Mendes 28 June 2010 (has links)
O transplante de fígado é considerado o tratamento de eleição para o paciente com doença hepática progressiva, irreversível e terminal, o qual não encontra outro tipo de tratamento. O ensino é uma importante estratégia para o preparo dos candidatos ao transplante de fígado e constitui-se como papel relevante do enfermeiro. Para a condução da presente investigação adotou-se os pressupostos de Gagné e Ohler. O objetivo geral delimitado foi analisar o conhecimento de candidatos ao transplante de fígado, antes e depois da implementação de uma intervenção educativa. A investigação foi conduzida em duas fases. Na primeira fase realizou-se um estudo descritivo para identificar as características sócio-demográficas, clínicas e as necessidades de informação dos candidatos. Na segunda fase procedeu-se um estudo piloto, para analisar o conhecimento dos candidatos antes e depois da aplicação da intervenção educativa, e avaliar a satisfação destes com as informações recebidas. Frente a uma casuística de 55 candidatos na primeira fase, observou-se uma predominância do sexo masculino, com idade média de 50,25 anos, média de 8,49 anos de estudo, 70,91% dos sujeitos estavam afastados de atividades laborais e a renda predominante foi de dois a seis salários mínimos. A maioria dos candidatos era CHILD B, com MELD médio de 14,91 pontos, 72,72% estavam acima do peso e apresentavam uma evolução da doença crônica do fígado de 101,21 meses em média. A maioria da amostra apresentava cirrose causada por vírus e alcoolismo. O tempo médio de fila de espera foi de 1199,58 dias. Dentre as principais manifestações clínicas, destacou-se a presença de ascite (58,18%), varizes esofágicas (81,82%), encefalopatia hepática (50,91%) e hemorragia digestiva prévia (47,27%). As necessidades de informação relacionadas com o período pré-operatório foram as que obtiveram as pontuações médias maiores. As complicações após o transplante e os cuidados necessários após o transplante também foram necessidades de informação indicadas como relevantes pelos candidatos. Diante de uma amostra de 15 pacientes para a segunda fase do estudo, observou-se um ganho cognitivo significativo após a intervenção, com uma melhora de quase 20% no desempenho dos candidatos (p<0,05). Em relação à satisfação dos candidatos, observou-se uma avaliação positiva da satisfação com as informações recebidas. As informações que geraram índices maiores de satisfação foram relacionadas ao período pós-operatório e os cuidados necessários por toda a vida. A relação entre o conhecimento após a intervenção e o grau de satisfação mostrou uma correlação significativa (p<0,05). O estudo fornece evidências de que a provisão de informações de qualidade é capaz de aumentar o conhecimento e proporcionar satisfação para os candidatos ao transplante de fígado. / Liver transplant is considered the preferred treatment for patients with progressive, irreversible and terminal liver disease, who cannot find any other treatment type. Teaching is an important strategy to prepare liver transplant candidates and represents a relevant role for nurses. This research is based on Gagné and Ohlers premises. The general aim was to analyze liver transplant candidates knowledge before and after an educative intervention. The research was conducted in two phases. First, a descriptive study was carried out to identify the candidates sociodemographic and clinical characteristics and information needs. In the second phase, a pilot study was performed to analyze the candidates knowledge before and after the educative intervention, as well as to assess their satisfaction with the information they received. The sample comprised 55 candidates: a majority were men; the average age was 50.25 years and average education 8.49 years; 70.91% of subjects were on leave from their job and the predominant income was between two and six minimum wages. Most candidates were CHILD B, the mean MELD score was 14.91 points, 72.72% were overweight and the average evolution of the chronic liver diseases was 101.21 months. Most patients in the sample presented cirrhosis caused by virus and alcoholism. The mean waiting time for a transplant was 1199.58 days. The main clinical manifestations included ascites (58.18%), esophageal varices (81.82%), hepatic encephalopathy (50.91%) and previous digestive hemorrhage (47.27%). Information needs related to the preoperative period obtained the highest mean scores. Candidates also indicated information needs related to post-transplant complications and necessary care. In a sample of 15 patients for the second phase, significant cognitive gain was observed after the intervention, with an almost 20% improvement in candidates performance (p<0,05). Candidates satisfaction with the information they received was assessed positively. Higher satisfaction levels were found for information related to the postoperative period and care needed across the lifetime. Significant correlation was found (p<0.05) between knowledge after the intervention and satisfaction level. This research evidences that providing quality information can increase liver transplant candidates knowledge and give them satisfaction.
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Information about primary care physicians considered most useful by managed health care consumers

Webb, Janet Marie 01 January 1997 (has links)
No description available.

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