Health Unity Research Articles

A vivência da gravidez na adolescência no âmbito familiar e social

Aim: to analyze the experience of teenage pregnancy in the context of a family and social. Method: a descriptive study, developed o a primary care health unity. Criteria inclusion were pregnant adolescents between 10 and 19 years. Eight pregnant women participated. Research project was approved by the Committee of Ethics in Research under the number 00554512.0.0000.5346. Data collection will be performed through a narrative interview, between March and June 2012, and analyzed by using the content analysis technique with thematic. Results: both families and partners of the teenagers, are supporters of the pregnancy, even though, the first pregnancy discover caused doubt and anxiety to teenagers. Final Considerations: the study provides a contribution to the knowledge on teenage pregnancy, family participation and its importance in this phenomenon for source of support.

Labour law treatment of health, work ability and personal integrity of the employees

Health and working ability are assumptions of entering into and the existence of labour relations. The purpose of entering into and the existence of labour relations is in the organised and meaningful work, in the interest of the employer and the employee. The main obligation of the employee is to do their work personally in accordance with their health and work abilities. With regards to the said abilities, the employee is accepted to the work, and protection and maintaining of these abilities is the assumption of the survival and long lasting of the employment. This makes legitimate the need that the health and work ability be protected by law in a suitable way. To that effect, we can talk about protection of health of the employees and safety at work. Since health does not only mean the absence of illness, but also the overall social security of the employees at work and in connection with work, this and issue of insurance of different risks that follow work of the employee fall into measures of health protection. Finally, not only manpower, as an organic unity of health and work abilities, takes part in labour relations, but also the entire personality of the employee with the overall personal (moral and ethical) integrity, which also on its part requires appropriate labour law treatment and protection (ban on discrimination, harassment, abuse, protection of personal data, etc.).

Interdisciplinary approach to health care modernization

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Organização da demanda de um Centro de Especialidades Odontológicas

INTRODUÇÃO: A Atenção Secundária em saúde bucal no Brasil ainda é um assunto pouco pesquisado. OBJETIVO: Analisar a resolubilidade dos serviços odontológicos do Sistema Único de Saúde, com base na referência para a atenção secundária e a contrarreferência à atenção primária. METODOLOGIA: Trata-se de um estudo descritivo, quantitativo, que utilizou dados secundários coletados dos prontuários dos pacientes atendidos no Centro de Especialidades Odontológicas de um município do Estado de São Paulo. RESULTADO: Do total de 1030 prontuários analisados, verificaram-se 1236 procedimentos referenciados para atenção especializada. Destes, 86,4% deram entrada na Unidade Básica de Saúde por livre demanda e 50,4% (n=623), para especialidade de Endodontia. Houve evasão de 2,2% (n=28) já na primeira consulta especializada. Nos pacientes que deram início ao tratamento especializado, foram realizados 1.208 procedimentos no Centro de Especialidades Odontológicas, tendo sido 62,6% (n=757) concluídos e contrarreferenciados para a Atenção Primária, que finalizou 61,1% (n=463) dos procedimentos. Para a conclusão do tratamento, considerando o tempo no Centro de Especialidades Odontológicas e na Atenção Básica, houve variação de acordo com a especialidade: Periodontia, 62 dias (dp= ±68), e Endodontia, 71 dias (dp= ±51,8), sendo necessárias três consultas em média, independentemente da especialidade. CONCLUSÃO: O Centro de Especialidades Odontológicas referencia, contrarreferencia e atende à maioria da demanda, independentemente da especialidade. Porém, ainda há muita evasão durante o tratamento odontológico, servindo de alerta para os gestores desenvolverem métodos de controle dos pacientes atendidos, com vistas à diminuição de gastos e ao aumento da resolutividade dos serviços, com a conclusão dos tratamentos iniciados.

Percepções de usuários e trabalhadores de saúde sobre a implantação do acolhimento em uma unidade de saúde em Porto Alegre-RS, Brasil

INTRODUÇÃO: Este estudo aborda os usos e os sentidos da ferramenta do acolhimento na organização e na redefinição dos processos de atenção em saúde bucal. OBJETIVO: Avaliar a percepção dos usuários e dos trabalhadores de saúde do Centro de Extensão Universitária da Vila Fátima (CEUVF) sobre a implantação do acolhimento no acesso ao serviço de saúde bucal, por meio de uma abordagem metodológica qualitativa. METODOLOGIA: Trata-se de uma pesquisa qualitativa com amostra intencional de cinco usuários cadastrados e cinco trabalhadores de saúde do Centro de Extensão Universitária da Vila Fátima (CEUVF) - PUCRS, unidade de ensino e saúde vinculada à rede pública do município de Porto Alegre. Por meio de entrevistas semiestruturadas e subsequente análise de conteúdo, objetivou-se descrever e avaliar a percepção de usuários e de trabalhadores de saúde sobre o acolhimento frente a conceitos, como: acesso, universalidade, resolutividade, humanização, integralidade e reorientação do modelo de atenção. RESULTADO: A análise de implantação do acolhimento revelou entraves e dificuldades relatados pelos atores envolvidos neste processo. Há dificuldades em garantir o acesso universal, mesmo após a implantação do acolhimento, sendo que a resolutividade garantida por este dispositivo ainda é um ideal a ser alcançado. O acolhimento significou uma mudança na atenção à saúde prestada no CEUVF, mais humanizada e integral.

THE CRACK USER AND THE CARE NETWORK: INTERVENTIONS AT THE UNIFIED HEALTH SYSTEM IN SOUTHERN BRAZIL

Crack consumption is being a problem that challenges health systems all over the world. In Brazil, changes in public policies were trying to organize the net of services that deal with this public. This paper presents how the public health system is organized and what are the interventions adopted in the different services that attend crack users. Using Ecological Insertion, researchers followed the everyday interventions at different services during three months (in each place). All the observations were registered in field diaries that were qualitatively analyzed. The data collection happened in three hospitals, six psychosocial attention centers, and five basic health unities in Paranhana Valley, southern Brazil. These services are distributed in different levels of attention in the health system. Results show that treating crack users still is a challenge for the system. The services must work integrated and adequate to the user demands. The multidisciplinary work is fundamental (involving psychiatry, psychology, social work and physical education). Different treatment approaches are needed, keeping the crack dependents and their family attended. The general hospital is the preferential therapeutic strategy. The basic health unities do not recognize their responsibility with this public and the psychosocial centers has the feeling that what are offered doesn’t attend the dependent demand. Despite the efforts to provide quality service, professional specialization and commitment with the patients are aspects that must be improved. Key words: crack cocaine, health care (Public Health), psychology, social, public policy.

O trabalho dos agentes comunitários de saúde em evidência: uma análise com foco na atividade

Esta pesquisa pretendeu fazer uma análise dos processos de trabalho dos Agentes Comunitários de Saúde (ACS) que atuam na Unidade de Saúde da Família (USF) Ilha das Caieiras, situada numa região periférica de uma capital do Sudeste do Brasil. Ela fornece serviços de saúde à população residente em um complexo de cinco bairros, cujo território abrange cerca de 2.300 famílias, sendo dividido em áreas, para atuação de uma Equipe de Saúde da Família e microáreas para atuação de cada ACS. Onze ACS que atuam na USF pesquisada têm seu trabalho prescrito conforme a concepção de gestão da Estratégia de Saúde da Família. Trata-se de uma pesquisa qualitativa em que se utilizou a analítica cartográfica de pesquisa, sendo esta apoiada na construção de diários de campo e na atividade. O trabalho dos ACS foi analisado sob o ponto de vista da atividade, com base no referencial teórico-analítico da Ergologia e da Ergonomia da Atividade. Pode-se afirmar que a construção social do território abrangido pela USF influencia sobremaneira o trabalho dos ACS e a produção de saúde da população. Há muitas variabilidades a serem geridas e, as condições de realização desse serviço são particularizadas pelo contexto socioeconômico, o que demanda "usos de si" no trabalho vivo e em atividade dos ACS.

Prevalência de enteroparasitas em crianças atendidas em unidades básicas de saúde em uma cidade do sul do Brasil

Helminthes and enteric protozoa are serious problem of public health in developing countries. This study analyzed the prevalence of intestinal parasites in preschool children attend at basic health unities (BHS) in the city of Rio Grande, Rio Grande do Sul, Brazil. Stool samples collected from 144 children were analyzed, from October 2009 to March 2010. The observed prevalence rate for enteroparasites was 17.4 %, including eggs of nematodes Ascaris lumbricoides (11.1 %) and Trichuris trichiura (6.3 %), and cysts of protozoan Giardia lamblia (4.9 %). Also, cysts of protozoa considered as non-pathogenic, such as Entamoeba coli, Endolimax nana and Enteromonas hominis were found in 28.5 % of children. Regarding to the BHSs prevalence, in BHS-1 was detected a positivity of 36.4 %, 11.1 % in BHS-3, 14.8 % in BHS-4, 8 % in BHS-5 and 19.2 % in BHS-6. No positivity was detected in the stool samples from BHS-2. The prevalence of intestinal parasites registered in the studied population suggests the occurrence of probable conditions for re-infection, and the need to implement the basic sanitation procedures and programs which will provide an improvement in the life quality of these children.

Os efeitos do lian gong em hipertensos assistidos em Unidade de Saúde da Família do município de Parnaíba, Piauí

To understand the effects of Lian Gong in hypertensive users of Family Health Unity. Methods: A descriptive qualitative study, involving 20 volunteers, regardless of gender, aged 45 to 70 years residing in the city of Parnaiba-PI, Brazil. The intervention was performed in quiet and noise-free environment, from August to September 2011, three times per week, with a total of 30 sessions. We used the tool Focus Group at the beginning and end of the intervention. We applied the technique of thematic analysis of the Collective Subject Discourse (CSD) using three methodological approaches: main idea, key expressions and CSD. Basic statistics operations were used (percentages) to quantify the lines. Results: Before the intervention, the group reported having hypertension perceived by the manifestation of physical symptoms and / or psychic symptoms based on the diagnosis and treatment rejection, revealing a superficial level of knowledge or misinformation about the disease. After the intervention, improvement in physical and emotional symptoms, social relationships and family was reported, as well as the difficulty of changing habits, which can be alleviated with the interdisciplinary support and continuation of exercise. Final Thoughts: The practice of Lian Gong was effective for improving the physical and emotional state of hypertensive patients and may be an adjuvant therapy to control hypertension in primary health care

A participação de Idosos em Atividades Recreativas em Itabuna/BA


 
 
 
 O objetivo desse estudo, de natureza quali-quantitativa, foi verificar a concepção de indivíduos idosos em relação às atividades recreativas, identificando as principais motivações, barreiras encontradas e benefícios advindos à sua participação em tais atividades. Foi aplicada uma entrevista semi-estruturada a 96 sujeitos entre 60 a 87 anos, de ambos os sexos e todos freqüentadores de uma unidade básica de saúde da cidade de Itabuna/BA. Os dados coletados foram analisados descritivamente, utilizando- se a técnica de Análise de Conteúdo Temático. 
 
 
 

Percepções de um grupo de idosos frente ao fato de não consultarem regularmente o cirurgião-dentista

Ainda existe no imaginário coletivo a ideia de que idosos não necessitam de assistência odontológica, pois são em sua maioria desdentados e usuários de dentaduras. Assim, a pergunta desta pesquisa é: Qual o motivo que faz com que muitos idosos não consultem regularmente o cirurgião-dentista? O objetivo foi levantar e analisar os motivos que fazem com que idosos cadastrados em uma Unidade de Saúde da Família não consultem regularmente o dentista. Trata-se de uma pesquisa descritiva exploratória de abordagem metodológica quanti-qualitativa realizada por meio de entrevistas domiciliares semiestruturadas aplicadas em 149 idosos cadastrados em uma Unidade de Saúde da Família na cidade de Ribeirão Preto,SP. Os dados foram analisados e sistematizados por meio da técnica da Análise de Conteúdo, e para a análise quantitativa foram realizadas análises bivariadas com associações significantes baseadas em valor de p<0,05. Houve associação estatisticamente significante entre visita ao dentista e idade (p=0,025), e observou-se que idosos com idades mais avançadas relataram ir menos ao dentista. Alguns dos motivos alegados foram: medo, dificuldade financeira, falta de tempo, além de falta de sintomatologia dolorosa nos dentes devido ao uso de dentaduras. Concluiu-se que os motivos alegados estão associados a aspectos sociais e culturais que devem ser analisados frente ao cuidado na atenção primária à saúde.

Adesão ao tratamento de idosos com hipertensão em uma unidade básica de saúde de João Pessoa, Estado da Paraíba

The principal strategy to avoid the complications of the high blood pressure is based on the medicamental treatment and not medicamentally. However the result or therapeutic failure depends on the adhesion that for his time consists of the principal challenge. Aimed analyze the adhesion to the medicamental treatment and not medicamentally for old with arterial high blood pressure. Study of the descriptive, where 25 patients above 60 years in the unity of health, in 2008, in João Pessoa, Paraíba State. Regarding medicamental adhesion, 12 tells to do correct use of the medication whereas 13 stops taking the medication, among the principal reasons for not adhesion to the medicamental treatment told by the informants they were the oblivion (10); the absence of symptoms (8); and the desmotivação (7); between others. Considering the non-medicamental variables, it was obtained that you punish four were considered totally followers to the therapeutics, followers 19 partially and only not followers revealed 2. As for the difficulties to follow the treatment, 12 of the users reported how being the continuation of the diet and the changes in the way of life. The obtained results indicate a low adhesion to the treatment anti-hypertensive and suggest strategies that make easy a better adhesion to the measures of control of the hypertension.

SIGNIFICADO DAS CONDICIONALIDADES DO PROGRAMA BOLSA FAMÍLIA PARA BENEFICIÁRIOS ACOMPANHADOS NUMA ESTRATÉGIA SAÚDE DA FAMÍLIA EM CAMPINA GRANDE – PB

The Family Grant Program (FGP) holds conditional cash transfer to guarantee human rights to adequate food and reduce social inequalities. Objective: In this respect, the aim of this study was to analyze the meaning of conditionalities of the FGP for its beneficiaries. Material and methods: a descriptive study using qualitative approach was conducted with 24 women accompanied by legal representatives of the FGP in a Family Health Unity, in Campina Grande, PB, from June to July 2009. The study subjects were selected intentionally and delimited by the saturation method, and guided interviews were used for data collection. Content analysis proposed by BARDIN (2009) was utilized for data analysis. Results: the categories identified were: regularity in receiving the benefit, access to consumer goods, impact of conditionalities and benefit x health. Conclusion: The FGP is an important initiative of the National Policy for Social Assistance and the regularity in receiving benefit has contributed to the beneficiary families so that they can plan their spending in favor of improved family satisfaction, favoring the purchase of consumer goods, encouraging attendance at health service and education as well as access to specialized health services and medicines that are unavailable in the public healthcare system. DESCRIPTORS Poverty. Family Health. Income.

O controle das consultas odontológicas dos bebês por meio da carteira de vacina: avaliação de um programa-piloto desenvolvido na Estratégia Saúde da Família em Ponta Grossa (PR, Brasil)

This study evaluated a concept-program developed in the area of a Family Health Unity, which monitored, for two years, the returns of infant children to regular attendance by the dentist, through their vaccines cards. A cross-sectional study was conducted, involving a convenience sample of 123 children aged 12 to 36 months, residents in the area. Data were collected during a campaign of immunization, in 2007, through a questionnaire answered by parents, vaccines cards checking, and clinical examination of children. The results showed that 81% of the examined children were registered in the FHU for dental care; from them, 95% had entered before reaching one year of life, having vaccines cards registration. It was also found that 50% of the children had visited the dentist more than once per year of life and 58% of them returned for dental appointments in the year before the survey. The prevalence of dental caries was lower in this group of children (17%), than in the group without frequent returns, or the one not registered in the FHU (26%). It was concluded that the vaccines card can be a useful tool for tracking the frequency of babies to dentist.

An experience of jungian group psychotherapeutic assistance, with an emphasis in the corporal dimension, in the context of brazilian public health system

This study investigated the relevance of using a modality of Jungian group psychotherapy according to Sandor’s bodyorganismic method, in view of the demand for mental health presented by users of a Basic Health Unity of SUS – the Brazilian UnifiedHealth System. Tree open psychotherapy groups were composed having seven adult patients and observed for a year. The qualitativeanalysis of results based on the comparison between the dynamics of these three groups, confronting the points of convergence betweenthem. We concluded that this kind of psychotherapy made possible a greater opening and adhesion to the psychotherapeutic process,with the establishment of very solid bonds of confidence. The following psychosocial transformations were observed in the period ofa year: a greater definition and integration of the physical image of subjects and groups; a reduction or elimination of initial physicalsymptoms; modifications as for the form of thinking about the social-economic conditions and how to act in this context; a greateropening to social contact and to physical interaction by patients, as well as a recovering of subjects work capacity and creative potential.

Trachoma Rapid Assessments in Unity and Northern Bahr-el-Ghazal States, Southern Sudan

BackgroundTrachoma is thought to be endemic over large parts of Southern Sudan, but empirical evidence is limited. While some areas east of the Nile have been identified as highly endemic, few trachoma surveys have been conducted in the remainder of the country. This study aimed to determine whether trachoma constitutes a problem to public health in Northern Bahr-el-Ghazal and Unity State, both located west of the Nile.Methods and Principal FindingsTrachoma rapid assessments (TRA) were conducted between July and September 2009. Seven villages in Northern Bahr-el-Ghazal State and 13 villages in Unity State were surveyed; an average of 50 children (age 1–9 years) and 44 women (age 15 years and above) were examined per village. Samples for analysis using the APTIMA Combo-2 nucleic acid amplification test (NAAT) were collected from participants with active trachoma in eight villages in Unity State. In Northern Bahr-el-Ghazal State, only three children with active trachoma (trachomatous inflammation follicular (TF) and/or trachomatous inflammation intense (TI)) and two women with trichiasis (TT) were found, in two of the seven villages surveyed. In Unity State, trachoma was endemic in all thirteen villages surveyed; the proportion of children with active trachoma ranged from 33% to 75% between villages, while TF in children ranged from 16% to 44%. Between 4% to 51% of examined women showed signs of TT. Samples from active trachoma cases tested using the NAAT were positive for Chlamydia trachomatis infection for 46.6% of children and 19.0% of women.ConclusionsTrachoma presents a major problem to public health Unity State, while the disease is of low priority in Northern-Bahr-el-Ghazal State. Implementation of a population-based prevalence survey is now required in Unity State to generate baseline prevalence data so that trachoma interventions can be initiated and monitored over time.

O processo de trabalho em saúde e a produção do cuidado em uma unidade de saúde da família: limites ao acolhimento e reflexos no serviço de emergência

This study examines the work process of a Family Health Unity (USF) in a small municipality, inland the state of Rio de Janeiro. We would like to start with the question of what is causing the population registered in a family health program to look for the Emergency Service (SE) of a General Hospital. Semi-structured individual interviews were conducted with doctors who worked on duty and users in the Emergency Service and group interviews with users of a Family Health Unit and its staff. In addition, information was also collected by participant observation. The theoretical fields of Health Management and Psycho-sociology were the grounds of this research. It was concluded that the "modus operandi" of the USF, the geographical and organizational accessibility, and the technological apparatus of the SE ended up leading the population to seek the General Hospital emergency service of the municipality mentioned in this study in acute situations of suffering and distress.

A INTERAÇÃO EXISTENTE EM EQUIPES QUE ATUAM NA ESTRATÉGIA DE SAÚDE DA FAMÍLIA E AS FAMÍLIAS POR ELAS ATENDIDAS

Uma das propostas da Estratégia Saúde da Família é promover assistência integral às famílias, de forma que hajauma interação adequada entre os profissionais de saúde e as pessoas no nível individual, familiar e coletivo. Este estudo temcomo objetivo identificar o tipo de interação existente entre esses profissionais e as famílias atendidas nas Unidades deSaúde da Família de um município no interior de Minas Gerais. Os dados foram obtidos por meio de entrevistas estruturadas,gravadas para posterior análise baseada no método de análise de conteúdo. Os resultados foram divididos em quatro formasde interação: visitas domiciliares, consultas, comunicação e trabalho dos agentes comunitários de saúde. Com este trabalho,conclui-se que a interação entre profissionais de saúde e famílias contribui para o trabalho da ESF.

Trabalho na atenção básica: integralidade do cuidado em saúde mental

Este estudo tem por objetivo cartografar o cuidado ao usuário com necessidades no campo da saúde mental em uma Unidade Básica de Saúde, analisando o trabalho em equipe à luz da integralidade das ações de saúde. Seus participantes são trabalhadores de saúde, de diferentes profissões, que fazem parte dos processos de trabalho em saúde mental do serviço. A técnica de coleta de dados utilizada foi o fluxograma analisador. Os resultados nos mostram que, na Unidade Básica, os fluxos conectivos entre os diversos trabalhadores - e entre estes e os usuários - vêm produzindo e proliferando vários e distintos espaços coletivos de trocas, possibilitando ações de saúde alinhadas à perspectiva da integralidade, através de uma compreensão ampliada do processo saúde-doença mental, construída pela valorização das relações humanas e das subjetividades envolvidas no espaço do trabalho em saúde.

P0524 A REVIEW OF THE DIAGNOSIS AND MANAGEMENT OF HYPOKALEMIA

in upper left limb (4/5). She was transferred to Neurosurgery Department to stereotaxic biopsy and five days after had deteoration of conscience level (Glasgow Coma Scale 11, E3 V3 M5), with acute hydrocephaly in CT and emergency surgery for ventriculoperitoneal shunt and in a second time cerebral biopsy. The patient died four days after. Discussion/conclusion: This case-study shows the importance of medicine semiology, which conduce to an immediately diagnosis, avoiding all the complementary exams. It enhance the internist as the manager of any health unity, capable of creating more economical and suitable alternatives. This quick and fatal evolution in a disease of indolent natural history announce the importance of familiar screening and genetic counselling. Many patients in Psychiatric Institutions have organic disease which should be always excluded.