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Previous issue date: 2015-04-24 / Objetivo: avaliar os fatores determinantes da morbimortalidade em unidade de
terapia intensiva obst?trica (UTIO) e
relacion?
-
los ?s
compet?ncias
profissionais dos estudantes da gradua??o do curso de medicina
e dos
residentes de Ginecologia e Obstetr?cia de
um hospital universit?rio. M?todos:
estudo observacional de corte transversal com 492 gestantes ou pu?rperas e
261 alunos e residentes
durante outubro de 2013 a setembro de 2014
. Foram
selecionadas pacientes internadas na UTIO no per?odo de um ano, sendo
informadas sobre as propostas do estudo e realizada aplica??o do
question?rio. A an?lise foi feita atrav?s do Microsoft Excel 2013 e GraphPad6.
Foram empregados testes
x
2
para verificar associa??o entre os fatores de risco
para morbi
-
mortalidade materna e
testes
t
de student
para avaliar
compet?ncias dos alunos da gradua??o e residentes referentes ao teste
cognitivo e ao
Mini
-
cex.
Resultados:
Foram encontrados como riscos relativos
significativamente elevados para desenvolvimento de
near miss
quando
comparada a morbidade materna grave, a ra?a n?o
-
branca (OR=2,527;
RR=2,342); pacientes casadas (OR=7,968; RR=7,113), escolaridade at? 2?
grau incompleto (OR=3,177; RR=2,829), procedente do interior (OR=4,643;
RR=4,087), renda familiar menor que 1 sa
l?rio m?nimo (OR=7,014; RR=5,554),
dist?rbios hipertensivos gestacionais (OR=16,35; RR=13,27), realiza??o do
pr?
-
natal (OR=5,023; RR=4,254) e a via de parto ces?rea (OR=39,21;
RR=31,25). Na an?lise cognitiva, foi notada uma diferen?a significativa nas
perf
ormances dos estudantes sobre o tema (3,75 ? 0,93, 4,03 ? 0,94 e 4,88 ?
0,35 m?dias e desvios padr?es dos acad?micos, internos e residentes,
respectivamente; p < 0,01) e no Mini
-
cex mostrando um melhor desempenho
global dos residentes quando comparados aos
alunos da gradua??o.
Conclus?es: Quest?es socioecon?micas, cl?nicas e assistenciais mostraram
-
se
relacionados ? preval?ncia de
near miss
, revelando a import?ncia de
interven??es amplas para melhorar estes indicadores. Sugere
-
se, tamb?m,
uma maior inser??o
curricular do tema nas disciplinas do curso m?dico, tendo
em vista a import?ncia de se evitar a
near miss
atrav?s da adequa??o no
?mbito da educa??o m?dica. / Objective: Evaluate the determinants of morbidity and mortality in an obstetric
intensive care unit and professional medical skills of students/residents at a
university hospital. Methods: observational cross
-
sectional with 492
pregnant/pue
rperal women and 261 students/residents. Patients were admitted
to the obstetric intensive care unit during a year, being informed about the
proposals of the study and a questionnaire was applied. The analysis was
performed using Microsoft Excel 2013 and G
raphPad6. Chi
-
square tests were
used to evaluate risk factors and student t test evaluates resident/students'
skills concerning the cognitive test and the Mini
-
Cex. Results: the main risk
factors to near miss were: non
-
white race (OR = 2.527; RR = 2.342)
; marital
status(married women) (OR = 7.968; RR = 7.113) , schooling (primary) (OR =
3.177 ; RR = 2.829) , from country town (OR = 4.643 ; RR = 4.087), low income
(OR = 7014 ; RR = 5.554) , gestational hypertensive disorders (OR = 16.35 ;
RR = 13.27) , re
alization of pre
-
natal (OR = 5.023 ; RR = 4.254) and C
-
section
before labor(OR = 39.21 ; RR = 31.25). In cognitive/Mini
-
cex analysis were
noted significant difference in the performance of students on the subject (3.75
? 0.93, 4.03 ? 0.94 and 4.88 ? 0.35).
We still observed the best performance of
residents, when compared to graduation students (p < 0.01). Conclusions: the
prevalence of near miss was associated with socioeconomic/clinics factors and
care issues, revealing the importance of interventions to
improve these
indicators. In addition, we suggest a better curriculum insertion of this subject in
the medical Course disciplines due the importance to avoid the near miss
through of adequacy of medical education.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/20257 |
| Date | 24 April 2015 |
| Creators | Souza, Maria Aparecida Cardoso de |
| Contributors | 42252725400, Girondi, Juliana Balbinot Reis, 01635028973, http://lattes.cnpq.br/4293198625231827, Medeiros, Robinson Dias de, 24262153487, http://lattes.cnpq.br/5790887167696618, Oliveira, Ana Katherine da Silveira Gon?alves de |
| Publisher | Universidade Federal do Rio Grande do Norte, SEM PROGRAMA, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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