Leila Bernarda Donato Göttems

Oferta e demanda por média complexidade/SUS: relação com atenção básica

This work aims at investigating the supply and demand of the medium-complexity services from the Federal District and surrounding municipalities from the state of Goias. Our hypothesis is that the services organization offer of primary care (PC) from the Federal District (DF) and its surroundings overloads the medium-complexity services (MC), contributing to less equity in terms of communities access. Our objective is to analyze the demand for MC (medium-complexity) services in DF (Federal District) and its relation with PC (Primary Care); to quantify the origin, health problem, reason, transportation time and performed procedures of the ones who go to the Federal District hospitals; to set up priorities of managerial changes in the Brazilian Health System (SUS) in order to have more access to users. The evaluation was triangulation of methods, and complementing qualitative and quantitative approaches. The study of the offer via the analysis of SUS information systems, and the demand through a survey with 1,585 users of seven hospitals of the Federal District. There is a sub utilization of services offer at the Federal District, with duplicity of basic actions among hospitals and other health centers. It is recommended a revision in the health services regionalization and hierarchy of the Federal District and Goias, as well as more investments on implementation of technology to primary care.

A enfermagem brasileira e a profissionalização de nível técnico: análise em retrospectiva

El articulo presenta analisis en retrospectiva de la trayectoria recorrida por la enfermeria brasilena en elproceso de profesionalizacion de los trabajadores de nivel tecnico y proporcionar algunas pistas sobre los rumbosdel desarrollo profesional. La sintesis de la reflexion indica que la educacion profesional de nivel tecnico enenfermeria, al ocupar a lo largo de mas de cuatro decadas la agenda de las politicas publicas, produjo acumulacionintelectual y conceptual, sirviendo de referencia para la formulacion de nuevas acciones dirigidas para los demasprofesionales de nivel tecnico que desarrollar cuidados directos a la poblacion. Indica tambien que, tras elPROFAE, hubo un rediseno del problema de la calificacion profesional de enfermeria, recolocando en debate lanecesidad de mejorar la calidad de los procesos formativos y de la oferta extensiva de formacion continuada alos trabajadores ya inclusos en el trabajo, para hacer constantes cambios en el sistema de salud brasileno.DESCRIPTORES: graduacion en auxiliar de enfermeria; educacion en enfermeria; recursos humanos en saludThis article presents a retrospective analysis of the Brazilian Nursing concerning the professionalization of workers at technical level. It also provides some indication about the trends of professional education. There is a clear indication of increased intellectual and conceptual accumulation in the four decades the professional education in nursing at technical level has been part of the public policy agenda. This experience serves as reference for the formulation of new actions directed to other professionals of technical level who deliver direct care to the population. The study shows that there was reformulation of the nursing professional qualification issue, including in the discussion the need to improve the quality of educational processes and extensive supply of continuous education to workers already inserted in the process, in order to keep the constant changes in the Brazilian Health system.

Safety culture in the operating room of a public hospital in the perception of healthcare professionals

Objective: to evaluate the perception of healthcare professionals about the safety culture in the operating room of a public hospital, large-sized, according to the domains of the Safety Attitudes Questionnaire (SAQ). Method: descriptive, cross-sectional and quantitative research, with the application of the SAQ to 226 professionals. Descriptive data analysis, instrument consistency and exploratory factor analysis. Results: participants were distributed homogeneously between females (49.6%) and males (50.4%); mean age of 39.6 (SD±9.9) years and length of professional experience of 9.9 (SD±9.2) years. And Cronbachs ( of 0.84. It was identified six domains proposed in the questionnaire: stress perception (74.5) and job satisfaction (70.7) showed satisfactory results; teamwork environment (59.1) and climate of security (48.9) presented scores below the minimum recommended (75); units management perceptions (44.5), hospital management perceptions (34.9) and working conditions (41.9) presented the lowest averages. Conclusions: the results showed that, from the perspective of the professionals, there is weakness in the values, attitudes, skills and behaviors that determine the safety culture in a healthcare organization.Objetivo: evaluar la percepcion de los profesionales de la salud acerca de la cultura de seguridad en el centro quirurgico de un hospital publico, de tamano especial, de acuerdo con los dominios del Cuestionario de Actitudes de Seguridad (CAS). Metodo: investigacion descriptiva, transversal, cuantitativa, con aplicacion del CAS a 226 profesionales. Analisis descriptivo de datos, consistencia del instrumento y analisis factorial exploratorio. Resultados: los participantes se distribuyeron de forma homogenea en el sexo femenino (49,6%) y masculino (50,4%); promedio de edad de 39,6 (DE±9,9) anos y tiempo de actuacion de 9,9 (DE±9,2) anos. Y ( de Cronbach de 0,84. Se determinaron los seis dominios propuestos por el cuestionario: percepcion del estres (74,5) y satisfaccion en el trabajo (70,7) mostraron resultados satisfactorios; clima de trabajo en equipo (59,1) y seguridad (48,9) presentaron puntuaciones por debajo del minimo recomendado (75); percepciones de gestion de la unidad (44,5), gestion hospitalaria (34,9) y condiciones de trabajo (41,9) presentaron las puntuaciones medias mas bajas. Conclusiones: los resultados mostraron que, desde la perspectiva de los profesionales, hay fragilidad en los valores, actitudes, habilidades y comportamientos que determinan la cultura de seguridad en una organizacion de salud

Jogo (IN)DICA-SUS: estratégia lúdica na aprendizagem sobre o Sistema Único de Saude

This article questions whether educational gaming technology used in learning about the Unified Health System (SUS) benefits imagination, fun, spontaneity and reflection in the training of health professionals. The objectives were to develop the (IN)DICA-SUS board game, centered on the dialog between health policies and play; to analyze the components of fun, pleasure, formative aspects of learning, the emotions and the game tactics in the development of the (IN)DICA-SUS game; and to identify indicator variables for playability in educational technologies for health. This was exploratory, descriptive research with a quantitative and qualitative approach, of the case study type. Test matches were undertaken with 160 participants, involving the administration of a questionnaire, participant observation, content analysis and the Pearson statistical test. The indicator variables for the playability of the educational technologies for health include the pleasure and tension in the game. The (IN)DICA-SUS game brings together inventive and sharing characteristics to optimize multiple learning and goes beyond teaching about the Unified Health System, although it starts from that.This article questions whether educational gaming technology used in learning about the Unified Health System (SUS) benefits imagination, fun, spontaneity and reflection in the training of health professionals. The objectives were to develop the (IN) DICA-SUS board game, centered on the dialog between health policies and play; to analyze the components of fun, pleasure, formative aspects of learning, the emotions and the game tactics in the development of the (IN)DICA-SUS game; and to identify indicator variables for playability in educational technologies for health. This was exploratory, descriptive research with a quantitative and qualitative approach, of the case study type. Test matches were undertaken with 160 participants, involving the administration of a questionnaire, participant observation, content analysis and the Pearson statistical test. The indicator variables for the playability of the educational technologies for health include the pleasure and tension in the game. The (IN)DICA-SUS game brings together inventive and sharing characteristics to optimize multiple learning and goes beyond teaching about the Unified Health System, although it starts from that. DESCRIPTORS: Professional education in public health. Learning. Nursing education.

Fatores associados à atenção domiciliária: subsídios à gestão do cuidado no âmbito do SUS

The identification of variables associated with the type of home care (HC) of the users of the Unified Health System (UHS) contributes to the management of care in the Health Care Network (HCN). The objective was to identify variables associated with HC users in Basic Health Units (BHU) selected from Belo Horizonte. It was a transversal study in two BHU with all users (n=114) in HC in the covered area. We used a multiple logistic regression analysis for selection (stepwise) of significant variables. Greater clinical involvement of users (OR=27.47), a sad emotional state (OR=24.36), risk for pressure ulcer bythe Braden scale (OR=7.6) and semidependence by the Katz ADL index (OR=63.8) were obtained and were strongly associated with the type of HC (p<0.05). Variables based on the social, family and clinical context of the subjects subsidized the integral approach and decision-making of the healthcare team.

Adherence to best care practices in normal birth: construction and validation of an instrument*

OBJECTIVE To describe the stages of construction and validation of an instrument in order to analyze the adherence to best care practices during labour and birth. METHOD Methodological research, carried out in three steps: construction of dimensions and items, face and content validity and semantic analysis of the items. RESULTS The face and content validity was carried out by 10 judges working in healthcare, teaching and research. Items with Content Validity Index (CVI) ≥ 0.9 were kept in full or undergone revisions as suggested by the judges. Semantic analysis, performed twice, indicated that there was no difficulty in understanding the items. CONCLUSION The instrument with three dimensions (organization of healthcare network to pregnancy and childbirth, evidence-based practices and work processes) followed the steps recommended in the literature, concluded with 50 items and total CVI of 0.98.OBJETIVO Describir las etapas de construccion y validacion de un instrumento para analisis de la adhesion a las buenas practicas en la atencion al parto y nacimiento. METODO Investigacion metodologica, realizada en tres etapas: elaboracion de dimensiones e items, validacion aparente y de contenido y analisis semantico de los items. RESULTADOS La validez aparente y de contenido fue realizada por 10 jueces que actuan en la asistencia, ensenanza e investigacion. Los items con Indice de Validez de Contenido (IVC) ≥ a 0,9 fueron mantenidos integramente o sofrieron revisiones conforme a las sugerencias de los jueces. El analisis semantico, llevado a cabo dos veces, senalo que no habia dificultad en la comprension de los items. CONCLUSION El instrumento con tres dimensiones (organizacion de la red de atencion al parto y nacimiento, practicas basadas en evidencias cientificas y procesos laborales) siguio las etapas recomendadas en la literatura, finalizado con 50 items e IVC total de 0,98.

The (IN)DICA-SUS game: a strategy of game-based learning on the Unified Health System

This article questions whether educational gaming technology used in learning about the Unified Health System (SUS) benefits imagination, fun, spontaneity and reflection in the training of health professionals. The objectives were to develop the (IN)DICA-SUS board game, centered on the dialog between health policies and play; to analyze the components of fun, pleasure, formative aspects of learning, the emotions and the game tactics in the development of the (IN)DICA-SUS game; and to identify indicator variables for playability in educational technologies for health. This was exploratory, descriptive research with a quantitative and qualitative approach, of the case study type. Test matches were undertaken with 160 participants, involving the administration of a questionnaire, participant observation, content analysis and the Pearson statistical test. The indicator variables for the playability of the educational technologies for health include the pleasure and tension in the game. The (IN)DICA-SUS game brings together inventive and sharing characteristics to optimize multiple learning and goes beyond teaching about the Unified Health System, although it starts from that.This article questions whether educational gaming technology used in learning about the Unified Health System (SUS) benefits imagination, fun, spontaneity and reflection in the training of health professionals. The objectives were to develop the (IN) DICA-SUS board game, centered on the dialog between health policies and play; to analyze the components of fun, pleasure, formative aspects of learning, the emotions and the game tactics in the development of the (IN)DICA-SUS game; and to identify indicator variables for playability in educational technologies for health. This was exploratory, descriptive research with a quantitative and qualitative approach, of the case study type. Test matches were undertaken with 160 participants, involving the administration of a questionnaire, participant observation, content analysis and the Pearson statistical test. The indicator variables for the playability of the educational technologies for health include the pleasure and tension in the game. The (IN)DICA-SUS game brings together inventive and sharing characteristics to optimize multiple learning and goes beyond teaching about the Unified Health System, although it starts from that. DESCRIPTORS: Professional education in public health. Learning. Nursing education.

Development and validation of an instrument for evaluating the ludicity of games in health education

OBJECTIVE Developing and validating an instrument to evaluate the playfulness of games in health education contexts. METHODOLOGY A methodological, exploratory and descriptive research, developed in two stages: 1. Application of an open questionnaire to 50 graduate students, with content analysis of the answers and calculation of Kappa coefficient for defining items; 2. Procedures for construction of scales, with content validation by judges and analysis of the consensus estimate by Content Validity Index(CVI). RESULTS 53 items regarding the restless character of the games in the dimensions of playfulness, the formative components of learning and the profiles of the players. CONCLUSION Ludicity can be assessed by validated items related to the degree of involvement, immersion and reinvention of the subjects in the game along with the dynamics and playability of the game.OBJECTIVE Developing and validating an instrument to evaluate the playfulness of games in health education contexts. METHODOLOGY A methodological, exploratory and descriptive research, developed in two stages: 1. Application of an open questionnaire to 50 graduate students, with content analysis of the answers and calculation of Kappa coefficient for defining items; 2. Procedures for construction of scales, with content validation by judges and analysis of the consensus estimate byContent Validity Index(CVI). RESULTS 53 items regarding the restless character of the games in the dimensions of playfulness, the formative components of learning and the profiles of the players. CONCLUSION Ludicity can be assessed by validated items related to the degree of involvement, immersion and reinvention of the subjects in the game along with the dynamics and playability of the game.

Educação em Enfermagem: qualidade, inovação e responsabilidade

La educacion en enfermeria con calidad, innovacion y responsabilidad, capaz de forjar un diseno de politica y profesional, requiere la interpretacion de la realidad compleja de la sociedad contemporanea en sus multi-ples posibilidades de nuevas formas de relacion social, de intercambio de conocimientos e informacion y de la diversidad de la condicion humana en constante transformacionA educacao em enfermagem com qualidade, inovacao e responsabilidade, capaz de forjar um projeto politico--profissional, requer a interpretacao da realidade complexa da sociedade contemporânea em suas multiplas pos-sibilidades e de novos modos de relacoes sociais, de partilha de conhecimento e informacao e da diversidade da condicao humana em constante transformacao

Síndrome de Stevens-Johnson e Necrólise Epidérmica Tóxica em um hospital do Distrito Federal

Este estudio tuvo como objetivo analizar aspectos demograficos y clinicos de clientes con diagnostico de Sindrome de Stevens Johnson (SSJ) y Necrolisis Epidermica Toxica (NET), asi como la identificacion de las acciones de los profesionales de la salud para el manejo de reacciones adversas a medicamentos (RAM) en un hospital publico del Distrito Federal. Se realizo investigacion descriptiva, retrospectiva con enfoque cuantitativo. Datos recogidos de prontuarios clinicos de los 22 clientes ingresados con diagnostico de SJS y NET, de enero de 2005 a septiembre de 2012. Fueron analizados utilizando estadistica descriptiva. De estos casos, 9 fueron diagnosticados con NET, 7 con SJS; habia mas mujeres (14); edad entre 21 y 40 anos (10); 21 se curaron; predominaran los antiepilepticos (10). Fue observado que hay fragilidad en registros clinicos en los prontuarios y en las acciones de monitoreo de las RAM en este servicio de salud.This study aimed to analyze demographic and clinical aspects of patients diagnosed with Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), as well as identifying the actions of health professionals for the management of Adverse Drug Reactions (ADR) in a public hospital in Distrito Federal, Brazil. A descriptive and retrospective research was held, with quantitative approach. Data collected from all the records of 22 patients admitted with diagnosed with SJS and TEN, from January 2005 to September 2012. Data were analyzed using descriptive statistics. Of these cases, 9 were diagnosed with NET and 7, with SJS; there were more females (14); aged from 21 to 40 years (10); 21 were cured; the drugs more used were the antiepileptic ones (10). Fragility in clinical registers and in the actions to monitor the cases of ADR in this health service was observed.