As the mean age of the population continues to rise, increasing attention is being given to how and where the elderly will live. Since health of this age group varies considerably, living arrangements which offer a full spectrum of services and attend to a continuum of needs have arisen over the past few decades. Called Continuing Care Retirement Communities (CCRCs), these places offer three levels of living: individual apartments, assisted living and the nursing center. Residents can move freely among these three levels as the need arises. While the educational needs of the elderly have been discussed theoretically and explored in a variety of practical contexts, no research to the author's knowledge has investigated the context of CCRCs and the population within. This study filled that gap in the literature. Framed by the seminal research of McClusky which identified five categories of educational needs of the elderly (coping, expressive, contributing, influencing and transcending), the purpose of this study was to investigate the educational needs of the residents as perceived by residents and to determine if selected demographic variables differentiated among responses; a corollary aim was to learn more about the residents' learning formats used, and current satisfaction as well as future interest in educational activities. Results of a questionnaire distributed to residents of two not-for-profit CCRCs in northern Virginia served as a data base, with a response rate of 68% for residents. The questionnaire, designed by the researcher, was validated through multiple iterations by content and process experts and piloted with a CCRC not in the study. Data were appropriately coded and analyzed using SPSS. Confidentiality of the respondents was maintained at all times. The results indicated that residents were highly educated, financially secure, and in good health. Ages range from 67 to 100 years old. Both current participation as well as future interest in educational activities was high, but only a few demographic variables seemed to differentiate responses. Educational activities dealing with coping and transcending needs seemed to take priority, involvement in self-directed learning activities was high, and when involved in programmatically organized and structured activities, the format of small groups preferred. These findings could be significant for any practical intervention implication. Implication for future research include inquiry into this growing special population; for example, the why and how of their self-directed learning projects. / Ed. D.

No description available.

As one result of the higher expected lifespan and lower fertility rate, an aging society has become an inevitable trend in many countries worldwide. According to the prediction of the newest census outcomes, China will confront an aging society around2022. An aging society requires the development and improvement of the domestic elderly care system to match the increasing caring need for all the aging people in China. This research aims to explore the critical success factors for a typical community-based aging care project – the Continuing Care Retirement Community (CCRC) in China from the perspectives of private developers. Based on the theory of the decision-making environment and the theory of planned behavior (TPB), qualitative method (semi-structured interviews) and quantitative method (questionnaire survey) are applied to collect and analyze the potential Critical Success Factors. Twenty-five critical success factors are identified and verified for China’s CCRC projects and categorized into three components. Furthermore, most private developers’ attitudes toward CCRC in China are positive and believe in a bright outlook. The findings might help private developers better understand the decision-making environment of developing and operating a CCRC in China. It may also inspire policymakers with more practical policies for the future development and operation of CCRC projects in China. / Som ett resultat av den högre förväntade livslängden och lägre fertiliteten har ett åldrande samhälle blivit en oundviklig trend i många länder världen över. Enligt förutsägelsen av de senaste folkräkningsresultaten kommer Kina att möta ett åldrande samhälle runt 2022. Ett åldrande samhälle kräver utveckling och förbättring av det inhemska äldreomsorgssystemet för att matcha det ökande omsorgsbehovet för alla åldrande människor i Kina. Denna forskning syftar till att utforska de kritiska framgångsfaktorerna för ett typiskt samhällsbaserat åldrandevårdsprojekt - Fortsatt vårdpensionsgemenskap (CCRC) i Kina ur privata utvecklares perspektiv. Baserat på teorin om beslutsmiljön och teorin om planerat beteende (TPB) tillämpas kvalitativ metod (semistrukturerade intervjuer) och kvantitativ metod (enkätundersökning) för att samla in och analysera potentiella kritiska framgångsfaktorer. Tjugofem kritiska framgångsfaktorer identifieras och verifieras för Kinas CCRC-projekt och kategoriseras i tre komponenter. Dessutom är de flesta privata utvecklares attityder till CCRC i Kina positiva och de tror på goda framtidsutsikter. Resultaten kan hjälpa privata utvecklare att bättre förstå den beslutsfattande miljön för att utveckla och driva ett CCRC i Kina. Det kan också inspirera beslutsfattare till mer praktisk politik för framtida utveckling och drift av CCRC i Kina.

The onset of dysphagia (swallowing difficulty) is associated with increasing age and the diseases that frequently occur with increasing age. Dysphagia increases the risk of dehydration and malnutrition with subsequent declines in body composition, physical health, and quality of life. The purpose of the present study was to administer a set of valid objective and perceptual measures to document (a) physical health, and (b) nutrition and hydration, relative to (c) swallowing function in 15 self-reported healthy older women in a Continuing Care Retirement Community. Statistically significant (p < 0.05) correlations were identified between perceived physical health, emotional well-being, and reflux symptoms and objective measures of breathing capacity, blood oxygen level, and tongue strength and endurance. The consumption of a regular, unrestricted diet was significantly associated with Eating Duration and Eating Desire on the Swallowing Quality of Life (SWAL-QOL) survey. Objective measures and participants’ responses on the SWAL-QOL identified a subgroup of older adults who were experiencing swallowing difficulties. Results confirm the importance of including both objective and perceptual measures of physical health, nutrition, hydration, and swallowing function in a screening protocol for older adults in residential care to identify those at-risk for developing dysphagia. / Thesis (M.S.)--Wichita State University, College of Health Professions, Dept. of Communication Sciences and Disorders

Complex continuing care (CCC) is a healthcare setting where many patients die. Previous research has demonstrated that patient deaths can be meaningful and challenging for nurses. However, little knowledge exists regarding how the unique features of CCC influence nurses’ experiences in managing patient deaths. The objective of this study was to explore nurses’ experiences when patients die and their perceptions of support surrounding these experiences. Using interpretive description methodology, 13 memorable patient death experiences were explored in semi-structured interviews with licensed nurses (n=12) and nursing leaders (n=1). Criterion and theoretical purposeful sampling were used to develop a rich understanding of nurses’ experiences when patients die. Concurrent data collection and analysis uncovered five key intersubjective themes which described nurses’ experiences with individual deaths and how nurses’ experiences change overtime which included: (a) Professionally experiencing patients’ deaths: 'Engaging your left brain;’ (b) Personally experiencing patients’ deaths: ‘I’m a human being too;’ (c) Seeking resolution in the experience: ‘It was a good resolution;’ (d) Integrating professional and personal experiences: ‘Applying what you learn in your nursing life into your personal life and vice versa,’ and; (e) Supporting One Another in a Culture of Acknowledging Patients’ Deaths and Nurses’ Experiences: ‘They expect us just to take it, the nursing profession is like that.’ These findings suggest that nurses need support to facilitate the interpersonal and intrapersonal aspects of their experiences with patient death. This support should be grounded in a unit culture which openly accepts patient death and acknowledges nurses’ experience. Just-in-time education, peer mentorship and targeted support may further facilitate nurses’ ability to find resolution when patients die and support their on-going journey towards integrating death experiences in their lives and practice. / Thesis / Master of Science (MSc) / Complex continuing care (CCC) is a healthcare setting where many people die. Patient deaths can be difficult and sad for nurses. The goal of this study was to learn more about nurses’ experiences when patients die in CCC. Nurses were asked to share memories of when patients died in CCC. This study found that patient deaths influence nurses personally and professionally. Nurses with fewer death experiences were uncomfortable caring for dying patients. Feeling understood and having their experience recognized were meaningful ways that nurses wanted to be supported. It was very important to nurses that the deceased person was respected and nurses worried about patients’ family members. This research shows that nurses with fewer death experiences would benefit from unique education and support. It is important to support nurses by creating a culture that acknowledges death in CCC and nurses’ responses to patients’ deaths.

No description available.

Master of Science / Department of Hospitality Management and Dietetics / Carol W. Shanklin / Abstract Aging has become a focal point for several segments of the foodservice industry with the forecasted trends. Due to the link between quality of life and satisfaction with food in this population, many Continuing Care Retirement Communities (CCRCs) and retirement communities are employing individuals who have experience in the hotel/restaurant industry. The purpose of the study was to assess residents’ overall satisfaction with quality of food and quality of service in Continuing Care Retirement Communities (CCRC) and retirement communities when the facility employs a foodservice director or chef with culinary training or expertise. The research compared satisfaction based on types of foodservices provided (restaurants and café/bistros); resident characteristics such as gender and length of time residing at a facility; frequency of interaction with the chef or foodservice director; and meal plan requirement. The study was conducted in the Midwest region and included a convenience sample of Retirement Communities and CCRCs in Kansas, Missouri and Nebraska. The variables analyzed were quality of food, quality of service, atmosphere, dining venues, meal plans, and frequency of dining with overall satisfaction. Atmosphere, food quality, dining venues, and meal plans significantly influenced overall satisfaction. Residents in facilities that provided more than one dining option had a slightly lower satisfaction ratings compared to the group who had one dining option. Overall satisfaction ratings for meal plan indicated that the respondents were neutral relative to the affect of meal plan and their overall satisfaction. The frequency of dining in one of the venues was positively influenced by meal plan requirements in the facilities. Residents who had lived in the facilities less than two years rated satisfaction higher. The more frequent the chef and foodservice manager interacted with the residents the higher the rate of overall satisfaction. Foodservice directors and administrators in these facilities can use the results to understand what the customers are looking for and how to improve overall services for their residents.

Submitted by ELAINE SAMORA CARVALHO E FRANÇA ANTUNES null (elainefantunes@yahoo.com.br) on 2018-03-26T22:21:04Z No. of bitstreams: 1 Dissertação_ELAINE SAMORA CARVALHO E FRANÇA ANTUNES_Mestrado_2018-1.pdf: 1026623 bytes, checksum: f42afea0fe898e7dde0b66cc305d5bf1 (MD5) / Approved for entry into archive by Satie Tagara (satie@marilia.unesp.br) on 2018-03-27T14:40:34Z (GMT) No. of bitstreams: 1 antunes_escf_me_mar.pdf: 1026623 bytes, checksum: f42afea0fe898e7dde0b66cc305d5bf1 (MD5) / Made available in DSpace on 2018-03-27T14:40:34Z (GMT). No. of bitstreams: 1 antunes_escf_me_mar.pdf: 1026623 bytes, checksum: f42afea0fe898e7dde0b66cc305d5bf1 (MD5) Previous issue date: 2018-02-19 / Não recebi financiamento / O Trabalho para as pessoas com deficiência é um cenário ainda permeado de muitos desafios, seja pela escolaridade, qualificação, visão associada à deficiência, aspectos familiares e a presença de benefícios. Tais condições geraram a necessidade de construção de políticas que implicassem em ações para se consolidar o direito a uma vida digna, com equiparação de oportunidades, justiça social, inserção na comunidade onde vivem, com participação em atividades sociais, educacionais, de trabalho e de lazer. Neste sentido, a presente pesquisa aborda os direitos da Pessoa com Deficiência, as normas e princípios que regem o Benefício da Prestação Continuada – BPC, além do conceito, percepções e aspectos do trabalho para as pessoas com deficiência intelectual. Teve como objetivo comparar as representações sobre o trabalho e o trabalhar em grupos de pessoas com Benefício da Prestação Continuada ativos e aqueles que optaram pela sua suspensão para ingressar no mundo do trabalho. Este estudo foi realizado em um Município do interior do estado de São Paulo, tendo 11 participantes, sendo dois grupos de cinco pessoas com deficiência intelectual: a) com benefício da prestação continuada ativo e b) com benefício da prestação continuada suspenso para trabalhar; e a assistente social responsável pelo processo de concessão do BPC e encaminhamento ao mundo do trabalho. Para coleta de dados foi utilizado um roteiro de entrevista, cuja análise foi por meio de transcrição integral e categorização dos discursos, com utilização dos discursos representativos. Na análise dos dados utilizamos o método de análise de conteúdo de Bardin. Os resultados obtidos revelaram que o BPC, enquanto benefício de proteção social é um avanço em termos de política pública assistencial, porém não se pode estimular a dependência do beneficiário e de sua família, podendo este constituir em obstáculo à inserção no mundo do trabalho. Identificou-se ainda que trabalhar modifica e impulsiona o desenvolvimento pessoal, social, inter e intrapessoal, com aquisição do sentimento de pertencimento e superação, bem como de enfrentamento das barreiras existentes na convivência entre os sujeitos, sendo apontados benefícios para além dos aspectos financeiros. A família ocupa papel preponderante na tomada de decisão, seja para obtenção do BPC ou para o ingresso no trabalho. A escolaridade e qualificação também são elementos que dificultam o ingresso das pessoas com deficiência intelectual no trabalho, requerendo políticas públicas efetivas no sentido da escolarização. Acredita-se que os resultados da pesquisa possam contribuir para compreensão dessa temática importante, mas ainda pouco estudada na literatura. / Working for people with disabilities is a scenario still permeated by many challenges, be it through schooling, qualification, vision associated with disability, family aspects and the presence of benefits. In this sense, the present research addresses the rights of the Person with Disabilities, the norms and principles that govern the Benefit of Continuing Care - BPC, besides the concept and representations of work for people with intellectual disability. In this way, it aims to identify and compare representations about work and to work in groups of people who receive the benefit of continued service with groups that have opted for the suspension of the benefit to enter the formal job market. This study was carried out in the city of, São Paulo State, Brazil, with 10 participants, divided into two groups: a) with the benefit of the continued active benefit and b) with the benefit of the continued work suspended. Also involved in the research was a social worker responsible for the BPC granting process. For the collection of data an interview script was used, whose analysis will be through integral transcription and categorization of the discourses, using the representative discourses. The method used was Bardin. The result of this study shows that the BPC as a social protection benefit is an advance in terms of public assistance policy, but it can not be stimulated by the dependency of the beneficiary and his family. It also points out that working modifies and fosters cognitive, social, inter and intrapersonal development, acquisition of the feeling of belonging, overcoming of attitudinal barriers in the coexistence between the subjects, with benefits that are beyond financial aspects. The family plays a predominant role. In decision making, either to obtain the BPC or to enter work. Schooling and qualification are also elements that make it difficult for people with intellectual disabilities to enter work, requiring effective public policies towards schooling. It is believed that the results of the research can contribute to the understanding of this important topic, but still little studied in the literature.

Diante da necessidade de mudança do paradigma do sistema de saúde e uma maior coerência entre o serviço ofertado e as condições de saúde da população, vários países tem buscado a reconfiguração de seus sistemas e/ou novos modelos de organização da gestão. No Brasil, vem sendo instituídas as Redes de Atenção à Saúde (RAS) e como referencial teórico operacional de gestão nesta nova organização se destacam a Gestão da Clínica e a Clínica Ampliada. A Continuidade do Cuidado é um dos elementos principais desse novo paradigma, assim, novos modelos assistenciais surgem em resposta. Os Cuidados Continuados Integrados (CCI) é uma experiência internacional exitosa, de um novo modelo assistencial que se situa nos desenhos de atenção entre o hospital geral e a atenção primária. Está sendo implantado no Brasil, aonde assume a denominação de Cuidados Prolongados e se insere na Rede de Atenção às Urgências e Emergências. OBJETIVO: O presente trabalho tem por objetivo estudar a Unidade de Cuidados Prolongados (UCP), como uma estratégia de atenção no Sistema Único de Saúde (SUS), identificando o processo de trabalho de unidades de um projeto piloto, sob as referências da Gestão da Clínica e da Clínica Ampliada. MÉTODOS: Trata-se de estudo transversal, qualitativo quanto a abordagem, descritivo e exploratório quanto aos objetivos. O trabalho foi elaborado em três etapas complementares, sendo observação (etapa 1), análise de documentos (etapa 2) e aplicação de questionário estruturado composto de 82 assertivas, dividido em 6 blocos temáticos (trabalho em equipe, fluxo do usuário, prática clínica, estrutura / ambiente / materiais, gestão da qualidade e satisfação profissional). O instrumento foi aplicado aos trabalhadores da UCP de dois municípios do Estado de São Paulo (passo 3), que concordaram em participar da pesquisa (N de 26 participantes, 13 de cada unidade em estudo). A análise de dados foi realizada para compreender a organização do fluxo de trabalho e a percepção de trabalhadores e funcionários sobre a instituição, o processo e sua satisfação. A análise das respostas foi realizada calculando a escala média (RM) para a escala de Likert, medindo o grau de concordância dos participantes, em relação ao assertivo. Atribuiuse um valor de 1 (total discordância) a 5 (total concordância) correlacionando as variáveis estudadas intra e interunidades, buscando significação nas variações. RESULTADOS E DISCUSSÃO: foram identificados o desenho assistencial desenvolvido por ambas unidades, desde o referenciamento do usuário de acordo com o modelo de atenção estudado, até seu contra-referenciamento para a atenção básica, além do processo de trabalho e organização da equipe. Através da aplicação do questionário, identificou-se que os profissionais têm a tendencia à satisfação em ii relação aos 6 blocos temáticos (3,1 a 4,3), entretanto com variações significativas em assertivas individuais, em todos os blocos. CONCLUSÃO: O modelo de atenção estudado apresenta evidências de resultados positivos que estão em alinhamento com a literatura estudada, apresentando um design funcional dentro dos princípios do SUS. A articulação deste modelo na RAS ainda é um ponto a ser melhorado. De acordo com as percepções dos profissionais que compõem o trabalho em equipe, devem ser alcançadas melhorias em todos os tópicos estudados, a fim de preencher toda a operação com as propostas de gestão clínica e a clínica ampliada. / Several countries have sought the reconfiguration of their systems and/or new management organization models when faced with the need to change the paradigm of the health system and greater coherence between the delivered services and the health conditions of the population. In Brazil, the establishing of Health Care Networks (RAS) are in course. Clinical Management and the Extended Clinic are the highlights of the theoretical concepts for the operational management of this new arrangement. Continuity of Care is one of the main elements of this new paradigm, so innovative care models emerge in response. Integrated Continuing Care (CCI) is a successful international experience of a novel care model located in the design of care between the general hospital and primary care. It has been implemented in Brazil, denominated by the name of Extended Care and it is part of the Care Network for Urgencies and Emergencies. OBJECTIVE: The aim of this work is to study the Extended Care Unit (UCP), as a care strategy in the Unified Healthcare System (SUS), identifying the workflow of pilot UCP healthcare units, under the references of Clinical Management and Extended Clinic. METHODS: This is a cross-sectional study, with qualitative approach, descriptive and exploratory regarding the objectives. The work was elaborated in three complementary stages, being observation (step 1), analysis of documents (step 2) and application of structured questionnaire composed of 82 assertions, divided into 6 thematic blocks (teamwork, users\' flow, clinical practice, structure / environment / materials, quality management and professional satisfaction). The instrument was applied to UCP workers of two municipalities of the State of São Paulo (step 3), which have agreed to participate of the research (N of 26 participants, 13 of each unit under study). The data analysis was performed in order to understand the organization of the workflow and the perception of workers and staff about the institution, the process, and their satisfaction. Analysis of the responses was performed by calculating the Mean Ranking (RM) for Likert scale, measuring the degree of agreement of the participants, in relation to the assertive. It was assigned values of 1 (total disagreement) to 5 (total concordance) correlating the intra and inter-unit variables studied, seeking significance in the variations. RESULTS AND DISCUSSION: The design of patient assistance carried out by both units were identified, from user referral according to the model of care studied, until their counter-referral for primary care, as well as the workflow process and the team organization. Based on the application of the questionnaire, it was identified that professionals have the tendency to satisfaction in relation to the 6 thematic blocks (3,1 to 4,3), however with significant variations in individual assertives, in each block. iv CONCLUSION: The care model studied presents evidence of positive outcomes that are in alignement with the literature studied, presenting a functional design inside the SUS principles. The articulation of this model in RAS is still a point to be improved. According to the perceptions of the professionals that compose the teamwork, improvements must be achieved in every topic studied, in order to fill the whole operation with the proposals of the clinical management and the extended clinic.

Diante da necessidade de mudança do paradigma do sistema de saúde e uma maior coerência entre o serviço ofertado e as condições de saúde da população, vários países tem buscado a reconfiguração de seus sistemas e/ou novos modelos de organização da gestão. No Brasil, vem sendo instituídas as Redes de Atenção à Saúde (RAS) e como referencial teórico operacional de gestão nesta nova organização se destacam a Gestão da Clínica e a Clínica Ampliada. A Continuidade do Cuidado é um dos elementos principais desse novo paradigma, assim, novos modelos assistenciais surgem em resposta. Os Cuidados Continuados Integrados (CCI) é uma experiência internacional exitosa, de um novo modelo assistencial que se situa nos desenhos de atenção entre o hospital geral e a atenção primária. Está sendo implantado no Brasil, aonde assume a denominação de Cuidados Prolongados e se insere na Rede de Atenção às Urgências e Emergências. OBJETIVO: O presente trabalho tem por objetivo estudar a Unidade de Cuidados Prolongados (UCP), como uma estratégia de atenção no Sistema Único de Saúde (SUS), identificando o processo de trabalho de unidades de um projeto piloto, sob as referências da Gestão da Clínica e da Clínica Ampliada. MÉTODOS: Trata-se de estudo transversal, qualitativo quanto a abordagem, descritivo e exploratório quanto aos objetivos. O trabalho foi elaborado em três etapas complementares, sendo observação (etapa 1), análise de documentos (etapa 2) e aplicação de questionário estruturado composto de 82 assertivas, dividido em 6 blocos temáticos (trabalho em equipe, fluxo do usuário, prática clínica, estrutura / ambiente / materiais, gestão da qualidade e satisfação profissional). O instrumento foi aplicado aos trabalhadores da UCP de dois municípios do Estado de São Paulo (passo 3), que concordaram em participar da pesquisa (N de 26 participantes, 13 de cada unidade em estudo). A análise de dados foi realizada para compreender a organização do fluxo de trabalho e a percepção de trabalhadores e funcionários sobre a instituição, o processo e sua satisfação. A análise das respostas foi realizada calculando a escala média (RM) para a escala de Likert, medindo o grau de concordância dos participantes, em relação ao assertivo. Atribuiuse um valor de 1 (total discordância) a 5 (total concordância) correlacionando as variáveis estudadas intra e interunidades, buscando significação nas variações. RESULTADOS E DISCUSSÃO: foram identificados o desenho assistencial desenvolvido por ambas unidades, desde o referenciamento do usuário de acordo com o modelo de atenção estudado, até seu contra-referenciamento para a atenção básica, além do processo de trabalho e organização da equipe. Através da aplicação do questionário, identificou-se que os profissionais têm a tendencia à satisfação em ii relação aos 6 blocos temáticos (3,1 a 4,3), entretanto com variações significativas em assertivas individuais, em todos os blocos. CONCLUSÃO: O modelo de atenção estudado apresenta evidências de resultados positivos que estão em alinhamento com a literatura estudada, apresentando um design funcional dentro dos princípios do SUS. A articulação deste modelo na RAS ainda é um ponto a ser melhorado. De acordo com as percepções dos profissionais que compõem o trabalho em equipe, devem ser alcançadas melhorias em todos os tópicos estudados, a fim de preencher toda a operação com as propostas de gestão clínica e a clínica ampliada. / Several countries have sought the reconfiguration of their systems and/or new management organization models when faced with the need to change the paradigm of the health system and greater coherence between the delivered services and the health conditions of the population. In Brazil, the establishing of Health Care Networks (RAS) are in course. Clinical Management and the Extended Clinic are the highlights of the theoretical concepts for the operational management of this new arrangement. Continuity of Care is one of the main elements of this new paradigm, so innovative care models emerge in response. Integrated Continuing Care (CCI) is a successful international experience of a novel care model located in the design of care between the general hospital and primary care. It has been implemented in Brazil, denominated by the name of Extended Care and it is part of the Care Network for Urgencies and Emergencies. OBJECTIVE: The aim of this work is to study the Extended Care Unit (UCP), as a care strategy in the Unified Healthcare System (SUS), identifying the workflow of pilot UCP healthcare units, under the references of Clinical Management and Extended Clinic. METHODS: This is a cross-sectional study, with qualitative approach, descriptive and exploratory regarding the objectives. The work was elaborated in three complementary stages, being observation (step 1), analysis of documents (step 2) and application of structured questionnaire composed of 82 assertions, divided into 6 thematic blocks (teamwork, users\' flow, clinical practice, structure / environment / materials, quality management and professional satisfaction). The instrument was applied to UCP workers of two municipalities of the State of São Paulo (step 3), which have agreed to participate of the research (N of 26 participants, 13 of each unit under study). The data analysis was performed in order to understand the organization of the workflow and the perception of workers and staff about the institution, the process, and their satisfaction. Analysis of the responses was performed by calculating the Mean Ranking (RM) for Likert scale, measuring the degree of agreement of the participants, in relation to the assertive. It was assigned values of 1 (total disagreement) to 5 (total concordance) correlating the intra and inter-unit variables studied, seeking significance in the variations. RESULTS AND DISCUSSION: The design of patient assistance carried out by both units were identified, from user referral according to the model of care studied, until their counter-referral for primary care, as well as the workflow process and the team organization. Based on the application of the questionnaire, it was identified that professionals have the tendency to satisfaction in relation to the 6 thematic blocks (3,1 to 4,3), however with significant variations in individual assertives, in each block. iv CONCLUSION: The care model studied presents evidence of positive outcomes that are in alignement with the literature studied, presenting a functional design inside the SUS principles. The articulation of this model in RAS is still a point to be improved. According to the perceptions of the professionals that compose the teamwork, improvements must be achieved in every topic studied, in order to fill the whole operation with the proposals of the clinical management and the extended clinic.