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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.
31

Parental Attitudes of Immunization in Children with Special Healthcare Needs: A Qualitative Study

Topham, Maren 01 November 2017 (has links)
Background and Purpose: Just over 15% of children under 18 years of age in the UnitedStates, or approximately 11.2 million children, are estimated to have special healthcare needs.Although children with special healthcare needs (CSHCN) make up a small percentage of thepediatric population, they account for over one third of pediatric medical care. Parental attitudesregarding immunization play a significant role in vaccination rates among children. The purposeof this research is to explore parental attitudes regarding immunization of CSHCN.Methods: This qualitative study focused on parental perceptions and beliefs aboutimmunizations for CSHCN. Sixteen participants, who were parents of CSHCN from onepediatric specialty care clinic participated in focus groups. Institutional review board approvalwas received prior to data collection.Results: While the purpose of this study was to determine the attitudes of parents ofCSHCN regarding immunizations, analysis revealed parents simply wanted to share their lifeexperiences rearing these children, with issues of immunization being secondary. Participantsdescribed the experience of caring for their CSHCN related to isolationism and the weight ofresponsibility as leader of their childs care. Additionally, the majority of parents thatparticipated viewed childhood vaccinations in a positive light. Parents acknowledged that it wasimportant for their own children to receive vaccines. Participants also recognized that it wasimportant for the community to be vaccinated in order to protect their child. However, the desirefor individualized care, at times, caused parents to disregard the immunization schedulerecommended by Center for Disease Control and Prevention.Conclusions: Health care providers can be effective and influential members of the healthcare team by engaging in community based education about vaccines, building trustingrelationships with parents and helping parents understand the need to follow the recommendedschedule for immunizations.
32

Online course to expand occupational therapy practice: education and implementation of occupational therapy in primary care

Villegas, Nicole 18 November 2016 (has links)
Primary care within the United States’ health care system is evolving to address increases in chronic conditions across the lifespan that impact individuals’ daily lives, and the health care system’s performance and cost. Even as interprofessional primary care teams aim to manage a large majority of health needs over time, these teams often lack the skilled professionals necessary to address function in daily life. Occupational therapy’s distinct value as experts in evaluation and intervention for health-related occupational development, adaptation, prevention and management can address this problem. However, continued education and additional tools are necessary in order for occupational therapists to increase their knowledge of the profession’s role in primary care, increase self-efficacy in promoting occupational therapy to stakeholders, and increase self-efficacy to utilize resources for research and establishing occupational therapy in primary care settings. The proposed online course "Occupational Therapy in Primary Care: What, Why, Where, & How?" is specifically targeted to occupational therapists to addresses these outcomes. Theoretical and historical evaluation of occupational therapy in primary care in the United States and Canada supports understanding the problem and mechanisms that can help navigate efforts to include occupational therapy in primary care. Diffusion of Innovations and Adult Learning Theory guide the course’s two-phases of development and dissemination. This project is a timely contribution to the emerging area of occupational therapy in primary care that supports the Institute for Health Care Improvements’ (IHI) Triple Aim to improve the individual experience of care, health of populations and reduce per capita cost of care.
33

Vårdteamets erfarenheter av nutrition i sen palliativ fas / The care team’s experiences of nutrition in late palliative phase

Rydin, Gunilla, Ojala, Petra January 2023 (has links)
Bakgrund: Den palliativa vården är komplex och nutritionsvården är av stor vikt. Palliativ vård är inriktad på symtomlindring och ökad livskvalité, där sjuksköterskan i vårdteamet har nyckelrollen. En god relation mellan patient, närstående och vårdteamet är av största vikt för vårdens kvalité. Palliativ vård kännetecknas av tvärprofessionellt teamsamarbete.  Syfte: Syftet var att beskriva vårdteamets erfarenheter av nutritionens betydelse i sen palliativ fas. Metod: En integrativ litteraturstudie med systematiska sökningar och en deskriptiv designgenomföres. Nio artiklar inkluderades och analyserades i enlighet med Whittemore och Knafls analyssteg. Resultat: Ur resultatet identifierades tre huvudtema vilka var Skapa teamsamverkan, Skapa förutsättningar för hälsoupplevelse och Att hantera motstridiga intressen. Resultatet visar attett fungerande vårdteamsamarbete hade betydelse för planering av nutritionen. Tidig dialog med patient och närstående skapade bättre förutsättningar för en individuell vårdplan och bevarande av patientens autonomi. Det framkom att sjuksköterskor i vårdteamet kände sig ensamma om planering och bedömning av nutritionsbehandling på grund av bristande kunskap och arbetserfarenhet. Slutsats: Kunskap och erfarenhet är avgörande för att vårdteamets skall känna sig trygga i sin roll avseende nutrition i sen palliativ fas
34

Att arbeta interdisciplinärt inom smärtrehabilitering : Ett fysioterapeutiskt perspektiv / Interdisciplinary teams in chronic pain rehabilitation : A physiotherapeutic perspective

Nilsefur, Agnes, Turén, Moa January 2024 (has links)
Bakgrund: Långvarig smärta är ett komplext sjukdomstillstånd som kräver särskilda rehabiliteringsåtgärder. Ofta tillämpas ett interdisciplinärt arbetssätt vid smärtrehabilitering. Teamarbete är en viktig aspekt av det interdisciplinära arbetet. Det finns fortfarande ett begränsat antal studier som undersöker fysioterapeutens upplevelser av interdisciplinärt teamarbete. En studie som undersöker fysioterapeuters perspektiv kan bidra till ökad förståelse och kunskap inom området.   Syfte: Att undersöka fysioterapeuters upplevelser av teamarbete inom interdisciplinär rehabilitering vid långvarig smärta.  Metod: En kvalitativ studiedesign baserad på fem semistrukturerade intervjuer med fysioterapeuter som arbetat mellan ett och tolv år inom smärtrehabilitering bearbetades med kvalitativ innehållsanalys.  Resultat: Den kvalitativa innehållsanalysen resulterade i fyra kategorier och 15 underkategorier. De fyra huvudkategorierna som identifierades var följande: vikten av kommunikation vid teamarbete, organisatoriska förutsättningar som bidrar till gott samarbete, samspel en viktig grund för teamarbete och professionella och sociala färdigheter som påverkar teamarbete.  Konklusion: Resultatet från studien överensstämmer med tidigare forskning inom närliggande områden. Framgångsfaktorer vid kliniskt teamarbete kan vara utarbetade strukturer för kommunikation som reflektion och att sitta i närheten av varandra inom teamet. Olika synsätt och förändringar i teamets sammansättning kan försvåra teamarbete. För att främja ett effektivt teamarbete krävs det att individen kan samspela med andra professioner samt besitter både professionella och sociala färdigheter. / Background: Chronic pain is a complex condition that requires special attendance. Interdisciplinary care is a frequently used method in chronic pain rehabilitation. Teamwork is an important part of interdisciplinary care. Previous research considering physiotherapists' experiences in chronic pain rehabilitation is of limited extent. Hence, a study examining this topic could be of value. Purpose: The study's purpose was to explore physiotherapists' teamwork experiences in interdisciplinary rehabilitation of chronic pain.   Method: A qualitative design with semi-structured interviews was employed. Five physiotherapists that have been working in chronic pain rehabilitation between one to twelve years were recruited using convenient sampling. Qualitative content analysis was conducted to analyze the data.   Results: Four main categories and 15 subcategories were identified. The main categories described the importance of communication in teamwork, organizational structures and factors that influence teamwork, interplay between individuals in the team and how professional and social skills impact teamwork.   Conclusion: The findings in this study have previously been confirmed in studies conducted in related research areas. Well-designed structures for communication such as reflection and also having workspace close to each other within the team are suggestions for creating good teamwork. Different viewpoints among team members could be a barrier for effective teamwork as well as changes in the team constellation. An efficient teamwork is promoted when the individuals in the team are possessing both professional and social skills.
35

Upplevelser av palliativ vård i hemmet under livets slutskede – ur ett anhörigperspektiv : En litteraturöversikt / Experiences of palliative home care during the final stage of life – from relative’s perspective : A Literature Review

Narto, Linda, Persson, Therese January 2015 (has links)
Bakgrund: Palliativ vård handlar om att ge stöd till patienten och anhöriga under och efter vårdtiden. De ”6 s:n” är en arbetsmodell inom palliativ vård där patienten har rätt till självbestämmande och att upprätthålla sina sociala relationer, även stöd till anhöriga ingår. Anhöriga har en betydelsefull roll i den palliativa vården, deras närvaro skapar möjlighet för den döende att vara hemma i livets slutskede. Syfte: Syftet var att beskriva anhörigas upplevelse av palliativ vård i hemmet under livets slutskede. Metod: Litteraturöversikt baserad på 15 vetenskapliga artiklar från fem olika länder med kvalitativ ansats. Resultat: Fem kategorier identifierades kopplade till anhörigas upplevelser: Palliativa teamets inträde i hemmet, anhörigas vårdansvar, den medicintekniska utrusningens inverkan på vardagslivet, känslor och konsekvenser för anhöriga samt förbättringsmöjligheter och anhörigas uppfattning om palliativ vård. Slutsats: Anledningen till anhörigas vårdansvar var löftet att få dö hemma, uppgiften upplevdes krävande och gav konsekvenser på sömnen och deras fysiska och psykiska mående. Detta var genomgående i hela litteraturöversikten. Vården i hemmet sågs som den rätta platsen att dö på för alla parter, endast en anhörig uttryckte avsky för situationen. Enligt anhöriga var stödet bra dock fanns det ett ökat behov av mer resurser för fullständig trygghet. / Background: Palliative care is about providing support to both the patient and family during and after the time of care. The “6 s:n” is a working model in palliative care where the patient has the right to self-determination and to maintain their social relationships, which includes support to relatives. Relatives have an important role in palliative care, their present creates opportunity for the dying person to be at home in the final stages of life. Aim: The aim of this study was to describe relative’s experiences of palliative home care during the final stage of life. Methods: A literature review based on 15 scientific articles from five different countries with a qualitative approach. Results: Five categories were identified related to relatives experiences: The entry of palliative home care, relatives caring role, the impact of medical technology on everyday life, feelings and consequences for relatives and also improvement opportunities and relatives comprehend about palliative home care. Conclusions: The promise was the reason for relatives caring role, the caring role was an demanding task and gave impacts on their sleep and their physical and mental needs. This was consistently throughout the whole literature review. For all parties the home was seen as the right place to die, only one relative expressed disgust for the situation. According to relatives the support was good, but to complete full security for them it was an increased need for more resources.
36

"Riscos psicossociais relacionados ao estresse no trabalho das equipes de saúde da família e estratégias de gerenciamento" / "Risks psychosocial associated with work-related stress of the teams family health and strategies of the management"

Camelo, Sílvia Helena Henriques 10 May 2006 (has links)
O Programa de Saúde da Família é uma das estratégias assumidas pelo Ministério da Saúde com vista à reorganização da atenção básica à saúde. Para a execução desta prática de assistência, é necessária a estruturação de equipes multiprofissionais que correspondam às necessidades da população. Os profissionais destas equipes assumem múltiplas tarefas com alto grau de exigência e responsabilidades, e desenvolver este tipo de atividade junto à comunidade, onde a realidade do indivíduo fica muito próxima, os problemas são de diversas ordens, as limitações internas e externas incontáveis, expõem o trabalhador a riscos físicos e/ou psicossociais tornando-os pessoas vulneráveis ao estresse. Esta investigação objetivou identificar e analisar os riscos psicossociais no trabalho das Equipes de Saúde da Família do município de Ribeirão Preto e descrever as estratégias utilizadas pelos trabalhadores para amenizar os efeitos desgastantes destes riscos. Este estudo do tipo exploratório utilizou-se da abordagem qualitativa, modalidade temática. Participaram do estudo, 24 trabalhadores, dentre eles, médicos, enfermeiros, auxiliares de enfermagem e agentes comunitários de saúde. Os dados foram coletados por meio de entrevistas semi-estruturadas e a análise do material foi executada através do agrupamento e classificação das unidades temáticas em dois temas centrais, que são os “riscos psicossociais relacionados ao trabalho" e as “estratégias para o controle dos riscos psicossociais". Os riscos psicossociais encontrados foram: falta de preparo e capacitação, sobrecarga de papéis, longas horas de trabalho, conflito no trabalho em equipe, dificuldade para conciliar trabalho e família, recursos materiais e humanos insuficientes. As estratégias utilizadas para o controle destes riscos são predominantemente individuais, no entanto, o serviço tem uma reunião semanal programada com a equipe, para discussão dos problemas e sugestões, sendo considerada pelos trabalhadores um momento de alívio das tensões. No entendimento de que a realidade sanitária é dinâmica, emergem deste estudo sugestões que podem nortear a estruturação de novas Equipes de Saúde da Família: A qualificação para atuar neste campo é fundamental e deve ser iniciada nos programas de graduação e ter continuidade em serviço; a disponibilização de recursos humanos e materiais torna-se imprescindível. Um serviço de apoio aos profissionais deve, entre outras atividades, orientá-los sobre os riscos a que estão expostos. / The Program of Health Family is one of the strategies of the Health Office whose objective is the reorganization of the basic health attention. The execution of this new practice presumes the formation of professional teams that fulfil the necessity of the population. The professional of this teams carry out diverse functions with high degree of demand and responsibilities. The development of this activity besides the community, where the reality of individual is near, the problems are diverse and the limitations are present, expose the workers to the physical and psychosocial risks that can to cause stress. This investigation identified and analyzed the psychosocial risks in the work of health family teams of Ribeirão Preto city, and the control strategies utilized to alleviate fraying effects of those risks. This study had a character mainly exploratory. The participants in this study were 24 workers, among doctors, nurses, nursing auxiliary and health community agents.The analysis of the present study was based on the qualitative interpretation, thematic modality. It was employed a semi structured interview, and the analysis was performed through grouping and classification in two central themes, that are “the psychosocial risks related to the work “ and “ the strategy to the control of the psychosocial risks" . They were identified some psychosocial risks related to the job, such as: the workers are unprepared and had no skills enough, excess of bureaucracy, long journeys of work, conflicts inside of the work teams, difficulty to conciliate job and family, insufficiency of human and material resources. The strategies utilized to the relieve these risks are mainly individuals, however, the institution contribute organizing meetings weekly, to discuss problems and create suggests. It is necessary to better structure the teams of health family, using adequately qualified professionals, understanding that the sanitary reality is dynamic. The qualification on this area is fundamental, and may be initiated on the graduation programs and should continue into the service. It’s necessary the availability of human and material resources. A support service to the health professionals should to direct them about the risks which they are exposed too.
37

Adaptação trancultural e validação de instrumento de avaliação de trabalho em equipe: Team Climate Inventory no contexto da Atenção Primária à Saúde no Brasil / Cross cultural adaptation and validation of the instrument for evaluating teamwork Team Climate Inventory (TCI) in the Brazilian Primary Health Care context

Silva, Mariana Charantola 10 June 2014 (has links)
Na Atenção Primária em Saúde (APS) do Sistema Único de Saúde (SUS) que tem a Estratégia Saúde da Família (ESF) como modelo estruturante, as práticas se organizam com base no trabalho em equipe. É necessário avaliar a efetividade das equipes para promover atenção integral às necessidades de saúde dos usuários e população e distinguir equipes efetivas e pseudo equipes. Na literatura internacional, identificam-se diversos instrumentos que mensuram trabalho em equipe, com destaque para o Team Climate Inventory (TCI) dos autores Neil Anderson e Michael West adaptado e validado em 11 países com bons resultados psicométricos. A escala é composta por 38 itens distribuídos em quatro fatores: participação na equipe, apoio para novas ideias, objetivos da equipe e orientação para as tarefas. Objetivos: Realizar adaptação transcultural (ATC) do instrumento TCI para língua portuguesa falada no Brasil e validar a versão adaptada com trabalhadores de saúde da APS. Método: A ATC seguiu as seguintes etapas: tradução, síntese, retrotradução, comitê com sete especialistas de APS e do método e pré-teste aplicado a 27 trabalhadores da APS. A validação foi realizada no município de Campinas-SP e participaram do estudo 497 profissionais da APS inseridos em 72 equipes (ESF e Saúde Bucal). A validade do construto foi analisada através do método confirmatório de Modelagem de Equações Estruturais (MEE), utilizando-se o método de estimação Partial Least Squares Path Modeling (PLSPM) e a confiabilidade foi testada por meio do alfa de Cronbach e da confiabilidade composta. Utilizou-se o programa SPSS versão 20.0 para as análises descritivas, o software SmartPLS versão 2.0M3 para avaliação das propriedades psicométricas do instrumento e a validade convergente por correlação com a escala Occupation Stress Indicator (OSI) que mensura satisfação no trabalho. Resultados: Na ATC o comitê de especialistas produziu a versão pré-final da escala em português aplicada para validação. Contudo problematizou dois aspectos: a sobreposição dos itens 9, 10 e 12 do fator participação na equipe e o fator objetivos da equipe no tocante à sua definição na APS. A validação mostrou que não houve sobreposição dos itens acima referidos e que a confiabilidade da escala variou entre 0.92 a 0.94 para os quatro fatores. A análise fatorial confirmatória aferiu a adequação do modelo proposto pelos autores com a distribuição dos 38 itens nos quatros fatores e a medida da correlação entre clima de trabalho em equipe e satisfação no trabalho foi significativa, embora fraca. Conclusão: A versão brasileira do TCI foi adaptada e validada no contexto de APS estudado, porém indica-se a aplicação da escala em outros cenários de APS do país, para análises de suas propriedades psicométricas. O TCI constitui uma ferramenta adequada para a avaliação do trabalho em equipe. / Primary Health Care (PHC), the Health Family Programme, work processes are organized in a teamwork basis. It is therefore needed to evaluate the effectiveness of teams to promote comprehensive responsiveness to users´ health needs and to be able to discriminate effective teams from pseudo-teams. The international literature describe different tools to measure teamwork, highlighting the Team Climate Inventory from Anderson and West, that was adapted and validated in 11 countries with good psychometric outcomes. The scale is composed by 38 items allocated in four factors: Participative safety; Support for innovation; Team objectives and Task orientation. Objectives: To perform cross cultural adaptation (CCA) of the TCI tool in Brazilian Portuguese and to validate the adapted version in Primary Health Care workers. Methods: The CCA progressed through the following phases: Translation, synthesis, back-translation, review committee of 7 PHC specialists and pre- test in 27 PHC workers. The validation was done in Campinas municipality in Sao Paulo State and comprised 497 PHC providers belonging to 72 teams from Health of the Family program and Oral Health. The validity of the construct was tested through the Structural Equation Model (SEM) using as estimating method, the Partial Least Squares Path Modeling (PLS-PM) and the reliability was tested through Cronbach´s Alpha and composite validity. The program used was SPSS v.20.0 for descriptive analysis and SmartPLS v.2.0M3 for evaluating the psychometric properties of the tool and the convergent validity through correlation with the Occupational Stress Indicator (OSI) that measures job satisfaction. Results: The specialists committee crafted the pre- final version of the Brazilian Portuguese scale used for validation. At the same time, it questioned two aspects: the overlapping of items 9, 10 and 12 of the factor `Participative Safety` and the factor `Team Objectives` as they are understood in PHC context. The validation showed that there is no overlapping of the aforementioned items and the reliability of the scale ranged from 0.92 to 0.94 for all four factors. The confirmatory factor analysis measured the adequacy of the model as formulated by the authors with 38 items and 4 factors. The convergent validation showed significant albeit weak correlation between team climate and job satisfaction. Conclusions: the Brazilian Portuguese version of the TCI was adapted and validated in the studied PHC context. It is suggested to validate it in other PHC contexts in the country for further psychometric analyses. TCI is proposed as a suitable tool for evaluating teamwork.
38

Aspectos facilitadores e dificultadores do trabalho em equipe de assistência ao paciente em Unidade Hospitalar de Urgências Traumáticas / Facilitators and constraints of the work in patient care team in a Hospital Emergency Trauma Unit

Azevedo, Ana Lidia de Castro Sajioro 28 May 2015 (has links)
O conhecimento do trabalho em equipe de assistência ao paciente, em unidade hospitalar de atendimento ao trauma, tanto no que se refere aos aspectos facilitadores quanto aos dificultadores desse processo, é imprescindível, diante da importância desse tipo de atendimento no contexto de atenção à saúde. Este estudo teve como objetivo analisar os aspectos que facilitam e dificultam o trabalho em equipe de assistência ao paciente em unidade hospitalar de urgências traumáticas. Trata-se de estudo descritivo, de abordagem quantitativa, utilizando a Técnica do Incidente Crítico. O estudo foi realizado em um hospital de ensino no interior do Estado de São Paulo, SP. Utilizou-se como técnica de coleta de dados a entrevista. Participaram 64 profissionais da equipe de assistência ao paciente da unidade. Os resultados evidenciaram 107 situações, sendo 56 positivas e 51 negativas, que envolveram 614 comportamentos e 267 consequências vinculadas ao trabalho em equipe na unidade. A análise dos incidentes relatados destacou que a dinâmica do trabalho em equipe é percebida como positiva no cenário. Os resultados evidenciam a necessidade de diferentes agentes dessa equipe realizarem ações integradas/articuladas e compartilhadas, nas quais sejam claras a noção de complementariedade de saberes em busca de objetivos comuns que atendam as necessidades imediatas de saúde do paciente politraumatizado. Os resultados também revelam que atendimentos aos pacientes, vítimas de trauma grave/moderado, facilitam a dinâmica do trabalho em equipe na unidade. Entende-se que isso pode decorrer de investimentos de políticas públicas e pelas diretrizes do Advanced Trauma Life Support, nos quais têm sido envidados esforços, capacitando profissionais, os quais reconhecem a finalidade que orienta o processo de trabalho e o atendimento de casos de alta gravidade com demanda imprevisível, que exigem alta tecnologia, pessoal com formação e competência técnica especializada para assistir, de forma integrada, articulada e assertiva, os casos. A integração, interação, articulação e comunicação entre a própria equipe e entre os diversos setores intra e extra-hospitalares favorecem a continuidade e integralidade do cuidado, bem como o produto final do processo de trabalho. É inegável a relevância e a clareza que os participantes dão ao trabalho em equipe nessa unidade, em especial as ações articuladas e integradas durante os atendimentos a politraumatizados graves/moderados. Fragilidades na articulação, integração e comunicação, bem como na imprevisibilidade da demanda e no despreparo de alguns profissionais foram destacados como dificultadores do trabalho em equipe no contexto da sala de trauma / The knowledge of work in patient care team, in a hospital trauma care unit, both regarding the facilitating aspects as well as the constraints of this process, is crucial, given the importance of this type of assistance in the health care context. This descriptive and quantitative study aimed to analyze the aspects that facilitate and hinder the work in patient care team in hospital emergency trauma unit, using the Critical Incident Technique. The study was conducted in a teaching hospital in the interior of the state of São Paulo, Brazil. Interview was used as data collection technique. In total, 64 professionals from the patient care team of the unit participated in study. Results evidenced 107 cases, of which 56 positive and 51 negative, involving 614 behaviors and 267 consequences linked to team work in the unit. The analysis of the reported incidents highlighted that the dynamics of team work is perceived as positive in the scenario. Results evidenced the need for different agents of the team to perform integrated/shared and coordinated actions, in which the concept of complementarity of knowledge in pursuit of common goals that meet the immediate health needs of polytrauma patients, is clear. Results also reveal that care provided to patients, victims of severe/moderate trauma, facilitate the dynamics of the team work in the unit. This may occur due to public policies\' investments and due to the guidelines of the Advanced Trauma Life Support, in which efforts have been made to train professionals, who recognize the aim that guides the work process and the provision of care in high-severity cases with unpredictable demand, which require high technology, trained staff with specialized technical competence to assist cases in an integrated, coordinated and assertive way. The integration, interaction, coordination and communication among the team itself and among the various intra and extra-hospital sectors favor the continuity and comprehensiveness of care, as well as the final product of the work process. The relevance and clarity that participants give to the team work in this unit is undeniable, especially as to coordinated and integrated actions during care to severe/moderate polytrauma patients. Weaknesses in coordination, integration and communication, as well as demand unpredictability and the unpreparedness of some professionals were highlighted as constraints of the team work in the context of trauma center
39

"A complexidade da dor da criança e do adolescente com câncer hospitalizados e as múltiplas dimensões do seu cuidar" / The complexity of pain in hospitalized children and adolescents with cancer and the multiple dimensions of their care

Menossi, Maria José 06 July 2004 (has links)
A dor é uma das principais causas de sofrimento humano, comprometendo a qualidade de vida das pessoas e refletindo no seu estado físico e psicossocial. Em crianças e adolescente com câncer a dor pode ser causada pela própria doença, pelo tratamento e pelos procedimentos, potencializada pelo medo, ansiedade e incerteza. Tendo em vista as múltiplas dimensões que envolvem a dor da criança e do adolescente com câncer e que a caracteriza como um fenômeno complexo, os objetivos do presente estudo são descrever as vivências dos profissionais de saúde no cuidado à criança e ao adolescente com câncer em situações de dor, durante o processo de hospitalização, e analisá-las buscando fundamentação em algumas idéias acerca da complexidade enfocadas por Edgar Morin. Nesta pesquisa, de natureza qualitativa, utilizou-se a entrevista como recurso de coleta de dados. Participaram do estudo 16 profissionais da equipe de saúde do setor de onco-hematologia pediátrica de um hospital-escola do município de Ribeirão Preto. Os dados empíricos indicam que os profissionais reconhecem a importância da avaliação da dor, mas sua operacionalização é percebida como um desafio. Apontam as limitações do uso de escalas e no manejo da dor destacam como primordial a abordagem farmacológica. Manifestam sentimentos de impotência, angústia e sofrimento com a situação de dor. Permitem também vislumbrar possibilidades apresentadas pelos próprios profissionais, tais como a composição de equipes fixas integradas em um trabalho interdisciplinar e o envolvimento da família no cuidado. Os resultados apontam ainda para a necessidade de distinguir os múltiplos enfoques dos profissionais e compor uma unidade de cuidado em que esses enfoques sejam articulados de forma a atender ao cuidado das múltiplas dimensões da dor em crianças e adolescentes com câncer. Para que essa unidade de cuidado seja viabilizada ressalta-se a necessidade de articulação de todos os profissionais envolvidos no atendimento às situações de dor da criança e do adolescente com câncer hospitalizado por meio de um projeto comum, construído conjuntamente. / Pain is one of the main causes of human suffering, affecting people’s quality of life and reflecting in their physical and psychosocial condition. In children and adolescents with cancer, pain can either be caused by the disease itself, by the treatment or by the procedures and is reinforced by fear, anxiety and uncertainty. In view of the multiple dimensions involved in pain of children and adolescents with cancer, which characterize it as a complex phenomenon, this study aims to describe the experiences of health professionals in care for children and adolescents with cancer in pain situations during the hospitalization process and analyze them on the basis of some of Edgar Morin’s ideas of complexity. This qualitative research used interviews as a data collection instrument. Study participants were 16 professionals from the pediatric blood cancer health team of a school hospital in Ribeirão Preto, Brazil. Empirical data point out that, although the professionals recognize the importance of pain evaluation, its operationalization is seen as a challenge. They point towards the limitations of using pain scales and highlight the basic importance of the pharmacological approach for pain coping. Participants show feelings of powerlessness, anguish and suffering in view of the pain situation of children and adolescents with cancer. They also disclose possibilities, such as the composition of fixed teams, integrated in an interdisciplinary service, and family involvement in care. Results also indicate the need to distinguish between multiple professional focuses and to establish a care unit that allows for the articulation of these focuses, so as to attend to the multiple pain dimensions of children and adolescents with cancer. With a view to the practicability of this care unit, we highlight the need for articulation between all professionals involved in care for pain situations in hospitalized children and adolescents with cancer, through a common and jointly constructed project.
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Estudo de Reuniões de Equipe Geral em um Hospital-Dia Psiquiátrico. / Study of general team meetings at a psychiatric day hospital.

Scherer, Edson Arthur 07 December 1999 (has links)
O presente estudo, configurado como uma pesquisa naturalística conduzida pela observação, teve como objetivos caracterizar as reuniões de equipe geral do hospital-dia da disciplina de psiquiatria da FMRP-USP quanto à temática, participação verbal dos integrantes e utilização do tempo, descrever sua inserção no serviço e levantar subsídios que permitam o melhor entendimento e utilização destas reuniões em diferentes contextos. Foram discutidos 46 assuntos em 21 reuniões observadas, 36 sugeridos pela equipe fixa e 10 pelos estagiários médicos. A equipe fixa teve maior participação verbal, tendo prevalecido a ocupação do tempo pelos docentes em 12 reuniões e pelos técnicos de nível superior em 7. Em 18 das reuniões estudadas houve correspondência entre os temas discutidos e as situações diárias registradas nas semanas que antecederam as mesmas. As reuniões em 11 dos encontros e a coordenação em 13 foram avaliadas como produtivas pelos observadores. Os achados mostram que estas reuniões se configuram como grupos operativos inseridos regularmente no serviço. As relações de poder e as diferenças de experiência e conhecimentos técnicos entre os diversos profissionais pareceram contribuir para a maior ou menor participação nas reuniões. Por ser um espaço favorecedor de trocas, sugere-se a utilização destas reuniões em outros serviços de saúde que trabalhem com equipes de assistência. / The present study, configured as a naturalistic research conducted by observation, had as objectives characterize the general team meetings of the day hospital of the psychiatry discipline of the FMRP-USP as for themes, members verbal participation and using of time, describing its insertion at the service and raising subsidies that allow a better understanding and using of this meetings in different contexts. There where discussed 46 subjects in 21 observed meetings, 36 suggested by the permanent group and 10 by the medical trainees. The permanent group had greater verbal participation, having prevailed the occupation of time by the professor in 12 meetings and by the superior level technicians in 7. In 18 of the studied meetings there was correspondence between the discussed themes and the diary situations registered at the weeks that antecedent them. The meetings in 11 encounters and the co-ordination in 13 were evaluated as productive by the observers. The findings show that this meetings configure as operative groups inserted regularly at the service. The power relations and the differences of experience and technical knowledge between the different professionals seems to contribute to a greater or lesser participation at the meetings. By being a benefit place to exchange views, we suggest the utilization of these meetings in other health services that work with team assistance.

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