Submitted by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2018-03-22T20:42:18Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) hellen_lilliane_cruz.pdf: 1979684 bytes, checksum: aeec38f943d5d28b666426a307585456 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2018-03-29T14:04:17Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) hellen_lilliane_cruz.pdf: 1979684 bytes, checksum: aeec38f943d5d28b666426a307585456 (MD5) / Made available in DSpace on 2018-03-29T14:04:17Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) hellen_lilliane_cruz.pdf: 1979684 bytes, checksum: aeec38f943d5d28b666426a307585456 (MD5) Previous issue date: 2017 / A maioria das doen?as cr?nicas s?o consideradas problemas de sa?de p?blica, e s?o conhecidas mundialmente como as principais causas de ?bitos e interna??es hospitalares. A hipertens?o arterial sist?mica e o diabetes mellitus est?o inclu?dos neste grupo, representando as principais causas de morte em todo o Brasil. Considerando seus m?ltiplos fatores, ? necess?rio repensar os modelos assistenciais. Para isso estrat?gias para promover acesso ao cuidado prim?rio, t?m sido desenvolvidas, com o objetivo de garantir a seguran?a do paciente, no uso do medicamento. Portanto, o objetivo deste estudo foi identificar as caracter?sticas dos sistemas de informa??es de sa?de e prontu?rios m?dicos, para analisar os sinais de seguran?a do pacientes com doen?a cr?nica na aten??o prim?ria de Diamantina, Minas Gerais. A pesquisa consistiu em um estudo transversal, descritivo observacional de associa??o e explorat?rio. A an?lise de dados mostra uma cobertura populacional de 94,1%; m?dia consulta m?dica de 0,76 consultas/ano; dentre os atendimentos, 23,1% foram destinados aos usu?rios hipertensos e 7,30% aos diab?ticos; no sistema hospitalar foi registrada 12,2% das interna??es por condi??es sens?veis a aten??o prim?ria sendo a angina respons?vel por 18,9% das interna??es. Nos prontu?rios m?dicos, a m?dia de idade do paciente foi de 62,1 ? 14,3 anos. O n?mero de cuidados b?sicos de enfermagem (95,5%) prevaleceu e as consultas m?dicas foram de 82,6%. A polifarm?cia foi registrada em 54,0% da amostra e a revis?o das listas de medicamentos revelou que 67,0% dos medicamentos inclu?am pelo menos um risco. Os riscos mais comuns foram: intera??o medicamentosa (57,8%), risco renal (29,8%), risco de queda (12,9%) e duplicidade terap?utica (11,9%). Os fatores associados ? hist?ria de erros de medicamentos foram doen?as cr?nicas e polifarm?cia, que persistiram em an?lises multivariadas, com doen?as cr?nicas RP ajustadas, diabetes RP 1.55 (95% IC 1.04-1.94), diabetes / hipertens?o RP 1.6 (95% IC 1.09-1.23) e polifarm?cia RP 1,61 (95% IC 1,41-1,85), respectivamente. Os resultados indicam que a aten??o prim?ria como coordenadora da rede de aten??o ? sa?de de Diamantina, para doen?as cr?nicas, ? complexa e precisa ser reestruturada. Para isso ? necess?rio sincronizar os servi?os de sa?de por meio da transfer?ncia e processamento de informa??es, para alcan?ar o objetivo comum fornecer cuidado continuo e centrado no paciente. / Disserta??o (Mestrado) ? Programa de P?s-gradua??o em Ci?ncias Farmac?uticas, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2017. / Most chronic diseases are some of the main public health problems, and they have been known worldwide to be the main causes for deaths and hospital admissions. Systemic arterial hypertension and diabetes mellitus are included in this group, accounting for the main death causes all over Brazil. Considering their multiple risk factor, it is necessary to rethink the assist models. For this, strategies to promote access to primary care have been developed with objective of ensuring patient safety in the use of the drug. Therefore, the purpose of this study was to identify and determine characteristics of health information systems and medical records, to analyze safety signs of patients with chronic disease in the primary care of Diamantina, Minas Gerais. The research consisted of a cross-sectional study, observational descriptive of association and exploratory. Data analysis shows that a population coverage was 94.1%; the average medical consultation was 0.76 consultations/year; among the visits, 23.1% were for hypertensive and 7.30% for diabetics; in the hospital system, 12.2% of hospitalizations were registered to conditions that were sensitive to primary care, and angina was responsible for 18.9% of admissions. In the medical records, the patients the mean age of patient was 62.1 ? 14.3 years. The number of basic nursing care (95.5%) prevailed and physician consultations were 82.6%. Polypharmacy was recorded in 54.0% of sample, and review of the medication lists by a pharmacist revealed that 67.0% drug included at least one risk. The most common risks were: drug-drug interaction (57.8%), renal risk (29.8%), risk of falling (12.9%) and duplicate therapies (11.9%). Factors associated with medications errors history were chronic diseases and polypharmacy, that persisted in multivariate analysis, with adjusted RP chronic diseases, diabetes RP 1.55 (95%IC 1.04-1.94), diabetes/hypertension RP 1.6 (95%CI 1.09-1.23) and polypharmacy RP 1.61 (95%IC 1.41-1.85), respectively. The results of this study indicate that primary care as the coordinator of health care network of Diamantina, for chronic diseases, is complex and needs to be restructured. For this is necessary to synchronize health services by transferring and processing information, for to achieve the common objective of providing continuous and patient-centered care.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-03-03T20:30:21Z No. of bitstreams: 1 ClarissaAndiraXavierESilva_DISSERT.pdf: 989946 bytes, checksum: af3b49e7dc7e045b144a309b03efdf2d (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-03-08T22:11:38Z (GMT) No. of bitstreams: 1 ClarissaAndiraXavierESilva_DISSERT.pdf: 989946 bytes, checksum: af3b49e7dc7e045b144a309b03efdf2d (MD5) / Made available in DSpace on 2016-03-08T22:11:38Z (GMT). No. of bitstreams: 1 ClarissaAndiraXavierESilva_DISSERT.pdf: 989946 bytes, checksum: af3b49e7dc7e045b144a309b03efdf2d (MD5) Previous issue date: 2014-09-26 / A reforma psiqui?trica consiste num processo que busca desconstruir a l?gica excludente provocada pelas interna??es, proporcionando aos sujeitos estrat?gias de reinser??o social. Nesse sentido, a aten??o b?sica, atrav?s da Estrat?gia de Sa?de da Fam?lia - ESF vem, progressivamente, tornando-se espa?o estrat?gico nas interven??es em sa?de mental, configurando-se como campo de pr?ticas e produ??o de novos modos de cuidado. Nesta perspectiva, em Areia Branca-RN vem ocorrendo um processo de implementa??o dessa proposta, atrav?s da articula??o da rede de Aten??o Psicossocial e da Estrat?gia Sa?de da Fam?lia/ESF. As discuss?es acerca da implementa??o da aten??o integral ? sa?de mental no munic?pio de Areia Branca avan?am significativamente. Por?m, esta discuss?o n?o tem sido capaz de provocar mudan?as na pr?tica. Ao partir da concep??o de que a articula??o entre sa?de mental e aten??o b?sica ? um desafio a ser enfrentado atualmente, que a melhoria da assist?ncia prestada e a amplia??o do acesso da popula??o aos servi?os com garantia de continuidade da aten??o dependem da efetiva??o dessa articula??o, estabeleceu-se como objetivo de pesquisa: investigar como se d? a rela??o entre as equipes de ESF e a equipe de CAPS na aten??o ? sa?de mental no munic?pio de Areia Branca ? RN a partir dos discursos dos profissionais. Para tanto, tiveram-se como objetivos espec?ficos: Conhecer a demanda em sa?de mental existente no munic?pio de Areia Branca ? RN atendida pela ESF; Identificar limites e dificuldades na rela??o entre as equipes da ESF e do CAPS; Identificar potencialidades para articula??o entre as equipes da ESF e do CAPS para a constitui??o da RAPS local. Tratou-se de um estudo descritivo-explorat?rio, com desenho metodol?gico de natureza qualitativa, cujos sujeitos foram profissionais da Estrat?gia Sa?de da Fam?lia, profissionais do Centro de Aten??o Psicossocial e o respons?vel pela condu??o/gest?o da sa?de mental no munic?pio. Como instrumentos de pesquisa foram utilizadas observa??es informais, entrevista semiestruturada e grupos focais. As informa??es obtidas foram analisadas considerando a an?lise de conte?do de Bardin, o que possibilitou discutir a pertin?ncia do referencial te?rico com os dados obtidos atrav?s da observa??o e interpreta??o da articula??o entre a Estrat?gia de Sa?de da Fam?lia e a rede de Aten??o Psicossocial no munic?pio de Areia Branca-RN. Por um lado, registrou-se intensa demanda em sa?de mental advinda de usu?rios e de seus familiares e/ou cuidadores. Por outro, verificaram-se que apesar de existir alguns avan?os com rela??o a percep??es sobre sa?de mental, existem ainda pr?ticas, hist?rica e contextualmente arraigadas, que atuam como obst?culos para a resposta efetiva a essa demanda na perspectiva da desinstitucionaliza??o. Nesse sentido, considera-se importante ressaltar que as equipes da Estrat?gia de Sa?de da Fam?lia devem ser capacitadas para garantir a pr?tica de sa?de com integralidade e a incorpora??o ? rede de sa?de mental do munic?pio. Essa capacita??o deve ocorrer atrav?s da educa??o permanente em sa?de. / The antimanicomial psychiatric reform is a process that seeks to deconstruct the exclusionary logic caused by hospitalizations, providing strategies for social reintegration of individuals. In this sense, the primary care through the Family Health Strategy - FHS comes progressively becoming strategic space in mental health interventions, configured as a field of practice and production of new modes of care. In this perspective, there has been a process of implementing this proposal in the Areia Branca City/RN, through the articulation of Psychosocial Care Network and the Family Health Strategy / ESF. However, this process has not been able to bring changes in practices. From the view that the relationship between mental health and primary care is a challenge currently being faced, that improving the care provided and the expansion of the access to services with guaranteed continuity of care depend on the effectiveness of this joint, established themselves as research objective: To investigate how is the relationship between the FHS team and CAPS team in care mental health in the town of Areia Branca - RN from the speeches of professionals. And if you had specific purposes: 1) Know the demand in existing mental health in the town of White Sand - RN served by FHS; 2) Identify limits and difficulties in the relationship between the ESF teams and CAPS; 3) Identify potential for linkages between ESF teams and CAPS for the establishment of local RAPS. This was a descriptive, exploratory study with a qualitative methodological design, whose subjects were professionals from the Family Health Strategy, professionals Psychosocial Care Center and responsible for the conduct / management of mental health in the municipality. The research tools used informal observations, semistructured interviews and focus groups were used. The data obtained were analyzed for the content analysis of Bardin, allowing discuss the relevance of the theoretical framework with data obtained through observation and interpretation of the relationship between the Family Health Strategy and the network of Psychosocial Care in Areia Branca-RN. On the one hand, there was strong demand for mental health arising from users and their families and / or caregivers. On the other, it was verified that although there is some progress with regard to perceptions of mental health, there are still practical, historical and contextually rooted, which act as barriers to effective response to this demand in view of deinstitutionalization. In this sense, it is considered important to emphasize that the teams of the Family Health Strategy should be trained to ensure the health practice with integrity and incorporating the mental health network in the municipality. This training must occur through continuing health education.

Made available in DSpace on 2014-12-17T15:39:01Z (GMT). No. of bitstreams: 1 LaisBB_DISSERT.pdf: 4153066 bytes, checksum: b629cf83014e7a5061ed66d61adbd8b6 (MD5) Previous issue date: 2013-04-12 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The present study aims to meet the attention given to women with mental health needs in specialized services for the fight against violence against women, as well as psychosocial care network in the municipality of NatalRN. It is a qualitative research characterized as research-intervention that took place in the year 2011. The study started in the Centre of Reference in which individual semi-structured interviews were carried out directed to the coaching staff and manager, in order to know the care offered in relation to the aforementioned clientele. From the Reference Centre were identified through analysis of registration records, the routes traversed by users through the network of psychosocial care and hospital network. After the identification of the same were visited two day-care Centers, two psychiatric hospitals, a basic health Unit and the local shelter. In these organizations was investigated the reception and procedures offered to users in situations of violence, the knowledge of policies for women and the coordination with the attention to women, through interviews with semi-structured individual scripts directed to professionals. The interviews were analyzed taking as starting point the theoretical framework of French Institutional Analysis, which includes the assumption of events analysers for the critical reading of dimensions introduced in the practices of care of the teams that took part in the study. The survey results revealed difficulties on the part of the same host of users with this profile, both in the face of violence as services in mental health services. This fact led to the lack of support under the guarantee of their rights, ceasing the possibilities of confronting the situations of violence, as well as in the context of mental health care / O presente estudo tem como finalidade conhecer o acolhimento e aten??o dispensados ?s mulheres com demandas em sa?de mental nos servi?os especializados para o enfrentamento da viol?ncia, bem como pela rede de aten??o psicossocial no munic?pio de Natal/RN. Trata-se de uma pesquisa qualitativa caracterizada como pesquisainterven??o realizada no ano de 2011. O estudo se iniciou no Centro de Refer?ncia no qual foram realizadas entrevistas semiestruturadas individuais direcionadas ? equipe t?cnica e gestora, objetivando-se conhecer os cuidados ofertados em rela??o ? clientela supracitada. A partir do Centro de Refer?ncia foram identificados, por meio da an?lise de fichas de cadastro, os itiner?rios percorridos pelas usu?rias atrav?s da rede de aten??o psicossocial e rede hospitalar. Ap?s a identifica??o dos mesmos foram visitados dois Centros de Aten??o Psicossocial, dois Hospitais Psiqui?tricos, uma Unidade B?sica de Sa?de e a Casa Abrigo local. Nestes equipamentos investigou-se o acolhimento e procedimentos oferecidos ?s usu?rias em situa??o de viol?ncia, o conhecimento das pol?ticas para mulheres e a articula??o com a rede de aten??o ?s mulheres, por meio de entrevistas com roteiros semi-estruturados individuais direcionadas aos profissionais de refer?ncia. As entrevistas foram analisadas tendo como ponto de partida o referencial te?rico da An?lise Institucional francesa, o qual prev? a elei??o de analisadores para a leitura cr?tica das dimens?es institu?das nas pr?ticas de cuidados das equipes que fizeram parte do estudo. Os resultados da pesquisa revelaram dificuldades por parte das mesmas no acolhimento das usu?rias com este perfil, tanto nos servi?os de enfrentamento ? viol?ncia quanto nos servi?os de sa?de mental. Tal fato ocasionava a desassist?ncia no ?mbito da garantia dos seus direitos, cessando as possibilidades de enfrentamento das situa??es de viol?ncia, bem como de cuidados no ?mbito da sa?de mental