Barbara Turini

Comunicação no ensino médico: estruturação, experiência e desafios em novos currículos médicos

This article relates an experience of a group of teachers of the Integrated Medical Course of the State University of Londrina in teaching communication in the Skills Module. The awareness of the importance of communication skills not only in the doctor-patient relationship but also in the evolution of diseases led to the design of a module with progressive difficulties throughout the first years of the course. The content of the module ranges from observation of patients in the waiting room to discussions on how to transmit information, treatment adherence and management of special groups of patients in different stages of life. The methods used include observation of patients, interviews, group discussions, role-playing, films, round tables, conferences and statements of patients. The evaluation occurs in two parts: formative and cognitive. The training of communication skills is aimed at developing the ability of the student to establish a good doctor-patient relationship, history taking and transmission of information and at promoting treatment adherence.

Interação ensino, serviços e comunidade: desafios e perspectivas de uma experiência de ensino-aprendizagem na atenção básica

Teaching, Care and Community Interaction Practical Activities are curricular modules of the medical course of the State University of Londrina aimed at early introduction of students to the Family Health Program in order to give them the opportunity to understand the determinants of the health-disease process, the importance of health promotion and preventive actions and of the local health services. The activities are developed in the first four years of the medical course in modules of about 140 hours, with sequential contents structured in concept maps ranging from knowledge about the covered neighborhood to medical activities making part of primary care. The most evident results include diversification of the teaching-learning scenario, early contact of the students with the primary care system and development of skills involving the doctor-patient relationship and patient-centered care. Among the challenges is the need to make the work in the local health services more attractive to students, teachers and local health teams.

Cobertura e fatores associados com a realização do exame Papanicolaou em município do Sul do Brasil

Purpose: to verify the coverage and factors associated with Papanicolaou (Pap) testing in Londrina (PR), Brazil. Methods: this is a cross-sectional study, carried out in 2004, in microareas of five Basic Health Units (BHU) of Londrina. One or two microareas from each BHU were selected and a list of all women aged 20-59 years resident in these places, was made through search in the Basic Attention Information System, the women being then visited and interviewed. Those with a Pap test in the last three years were considered as having an updated examination, and the remaining as delayed. The association of some factors with the examination situation was investigated. Data analysis was performed using Epi-Info 6.04d. Results: Pap smear coverage among the 513 participants of the study was 80.7%, ranging from 71.5% to 88.4%. Delay in taking the test was higher (p<0.05) among women who worked only at home (22.4% as compared with 14.3% among those who worked outside), and among those who belonged to D/E social classes (24.9%) as compared to C (17.5%) and A/B (8.3%) classes. The proportion who ignored the next test date was higher (p<0.01) among those who had the last Papanicolaou testing at a BHU (14.7%), as compared to those who had been attended privately or by a health insurance company (5.8%). Conclusion: the coverage of Pap smear in the studied areas can be considered satisfactory, although there is a need of improving compliance with Pap test, mainly among women who are the poorest and who work only at home.

O ensino de psiquiatria, habilidades de comunicação e atitudes no currículo integrado do curso de Medicina da Universidade Estadual de Londrina

This article describes an experience of teaching psychiatry, communication skills, and attitudes in an integrated medical curriculum at the Londrina State University. The concept map of the thematic module of mental disorders and of behavior were proposed as a strategy promoting interdisciplinary meaningful learning of Psychiatry. Psychiatric knowledge is acquired through problem-based learning. Communication skills and attitudes are taught in different ways, with patients, with simulated patients, using videos, case reports, role-playing, and work in small groups. The methods used for evaluating the knowledge in psychiatry, the communication skills and the attitudes include summative and formative assessment designed to give the student a feedback on his progress in objective structured clinical examination (Osce), portfolios, and case reports. The psychiatric knowledge, communication skills, and attitudes are assimilated depending on meaningful learning as a teaching method and on the way the students are evaluated in their medical practice.

Desnutrição e aproveitamento escolar: estudo entre escolares da primeira série do primeiro grau da zona urbana periférica de Londrina, PR, Brasil

Estudaram-se 450 escolares da periferia de Londrina, PR, Brasil, com o objetivo de demonstrar uma possivel associacao entre desnutricao e aproveitamento escolar. Destes 450 escolares, 227 eram do sexo masculino e 223 do feminino. A incidencia de desnutricao foi de 34,89%. Das criancas desnutridas, apenas 56,69% obtiveram rendimento satisfatorio, em comparacao aos 73,88% das criancas eutroficas, demonstrando uma relacao significativa entre desnuiricao e aproveitamento escolar. As criancas desnutridas provinham de familias com baixa renda mensal bruta per capita em maior proporcao que as eutroficas. O aproveitamento escolar mostrou estar mais relacionado ao gasto mensal per capita em alimentacao do que a renda mensal bruta per capita.Four hundred and fifty first graders from the peripheric urban area of Londrina were studied with the objective of demonstrating a possible association between malnutrition and school failure. In this series of 450 children, 227 were male and 223 were female. The incidence of malnutrition was 34,89%. Of the undernourished children, only 56,69% had a satisfactory outcome in comparison with 73,88% of the eutrophic children, thus demonstrating a significant relation between malnutrition and school failure. The undernourished children belonged to families with a low per capita gross monthly income, in a greater proportion than the eutrophic ones. School failure was shown to be more closely related to per capita month expenditures in food rather than with the per capita gross monthly income itself.

Percepção dos médicos sobre o curso facilitadores de Educação Permanente em Saúde

Continuing Health Education is a strategy in Brazil that uses problems in healthcare practice as the object of reflection by health teams. To deal with the lack of conceptual and operational command over Continuing Health Education, a course was proposed for facilitators in continuing education. The course was conducted in Londrina, Parana State, in which 14 physicians participated. In order to analyze their opinions of the course and its repercussions on their work and healthcare practice, the 11 physicians that finished the course were interviewed using a semi-structured questionnaire. The analysis involved tabulation of the closed questions, and the content of the open questions was- Permanent Healthcare Education. analyzed using thematic analysis. According to these physicians, Continuing Health Education con- Health Work. sists of the following: reflection on daily problems, teamwork, and meaningful learning. Important changes fostered by the course included: expansion of the links between healthcare professionals, democratization of management, grasp of information systems, expansion of analytical capacity, and improvement of healthcare practice. The facilities and difficulties pertained mainly to a firm infrastructure (physical space, time, material, and support), but participants also highlighted issues related to teamwork, like motivation, interest, and participation.

Conhecimento e atitudes de pediatras em relação à cárie dentária

Atualmente a atencao odontologica precoce tem sido enfatizada, pois atitudes e praticas adquiridas nos primeiros anos de vida tornam-se resistentes a mudancas. Devido ao maior contato com seus pacientes, o pediatra e profissional importante na transmissao de orientacoes relacionadas a saude bucal. O presente estudo teve como objetivo verificar conhecimentos e atitudes de medicos pediatras atuantes em Londrina - PR, em relacao a promocao de saude bucal de criancas por eles atendidas. Dados foram coletados mediante questionario, abordando aspectos referentes a formacao dos dentes e doenca carie. Sobre a carie dentaria, 28,8% dos pediatras nao informaram qual sua etiologia, enquanto 48,1% afirmaram a transmissibilidade da doenca. Os resultados observados sugerem que os pediatras apresentam atitudes e praticas positivas em relacao a saude bucal, mas que informacoes sobre carie dentaria precisam ser reforcadas.

Conocimiento y actitudes de pediatras en relación a caries dental

Atualmente a atencao odontologica precoce tem sido enfatizada, pois atitudes e praticas adquiridas nos primeiros anos de vida tornam-se resistentes a mudancas. Devido ao maior contato com seus pacientes, o pediatra e profissional importante na transmissao de orientacoes relacionadas a saude bucal. O presente estudo teve como objetivo verificar conhecimentos e atitudes de medicos pediatras atuantes em Londrina - PR, em relacao a promocao de saude bucal de criancas por eles atendidas. Dados foram coletados mediante questionario, abordando aspectos referentes a formacao dos dentes e doenca carie. Sobre a carie dentaria, 28,8% dos pediatras nao informaram qual sua etiologia, enquanto 48,1% afirmaram a transmissibilidade da doenca. Os resultados observados sugerem que os pediatras apresentam atitudes e praticas positivas em relacao a saude bucal, mas que informacoes sobre carie dentaria precisam ser reforcadas.

Knowledge and attitudes of pediatricians in relation to dental caries

Atualmente a atencao odontologica precoce tem sido enfatizada, pois atitudes e praticas adquiridas nos primeiros anos de vida tornam-se resistentes a mudancas. Devido ao maior contato com seus pacientes, o pediatra e profissional importante na transmissao de orientacoes relacionadas a saude bucal. O presente estudo teve como objetivo verificar conhecimentos e atitudes de medicos pediatras atuantes em Londrina - PR, em relacao a promocao de saude bucal de criancas por eles atendidas. Dados foram coletados mediante questionario, abordando aspectos referentes a formacao dos dentes e doenca carie. Sobre a carie dentaria, 28,8% dos pediatras nao informaram qual sua etiologia, enquanto 48,1% afirmaram a transmissibilidade da doenca. Os resultados observados sugerem que os pediatras apresentam atitudes e praticas positivas em relacao a saude bucal, mas que informacoes sobre carie dentaria precisam ser reforcadas.