Luciana Paiva

The Experiences and Consequences of a Multiple Trauma Event from the Perspective of the Patient

This was an ethnographic investigation with the aim of comprehending the meanings of the trauma experience among multiple trauma patients. The following techniques were used for data collection: direct observation, semi-structured interview and field diary. Biographical narratives were obtained from eleven trauma victims, and ten relatives as secondary informants. The data analysis considered the set of data of each participant and all data of all subjects, searching for differences and similarities. The meanings attributed to the trauma experience are associated with interrelated feelings of fear, insecurity, anger, vulnerability and suffering and to the meanings of quality of life that converge to valorize health and work appreciation and support by social networks. This analysis shows that the concepts and experiences of the trauma are conditioning factors of the health-disease process and they are essential in planning public health actions to meet the needs of individuals.Esta e uma investigacao etnografica, realizada com o objetivo de compreender os significados da experiencia do trauma entre pacientes politraumatizados. Foram utilizadas as seguintes tecnicas de coleta de dados: observacao direta, entrevista semiestruturada e diario de campo. Obtiveram-se narrativas biograficas de 11 pessoas, vitimas de traumas, e 10 familiares, como informantes secundarios. A analise dos dados considerou o conjunto dos dados de cada participante e o todo dos dados de todos os sujeitos, buscando por diferencas e similaridades. Os sentidos atribuidos a experiencia do trauma se associam a sentimentos inter-relacionados de medo, inseguranca, revolta, vulnerabilidade e sofrimento e aos significados de qualidade de vida que convergem para a valorizacao da saude, trabalho e apoio pelas redes sociais. Esta analise mostrou que as concepcoes e vivencias do trauma sao fatores condicionantes do processo saude/doenca e fundamentais para o planejamento de acoes de saude publica voltadas ao atendimento das necessidades individuais.

Experiência do paciente politraumatizado e suas consequências

This was an ethnographic investigation with the aim of comprehending the meanings of the trauma experience among multiple trauma patients. The following techniques were used for data collection: direct observation, semi-structured interview and field diary. Biographical narratives were obtained from eleven trauma victims, and ten relatives as secondary informants. The data analysis considered the set of data of each participant and all data of all subjects, searching for differences and similarities. The meanings attributed to the trauma experience are associated with interrelated feelings of fear, insecurity, anger, vulnerability and suffering and to the meanings of quality of life that converge to valorize health and work appreciation and support by social networks. This analysis shows that the concepts and experiences of the trauma are conditioning factors of the health-disease process and they are essential in planning public health actions to meet the needs of individuals.Esta e uma investigacao etnografica, realizada com o objetivo de compreender os significados da experiencia do trauma entre pacientes politraumatizados. Foram utilizadas as seguintes tecnicas de coleta de dados: observacao direta, entrevista semiestruturada e diario de campo. Obtiveram-se narrativas biograficas de 11 pessoas, vitimas de traumas, e 10 familiares, como informantes secundarios. A analise dos dados considerou o conjunto dos dados de cada participante e o todo dos dados de todos os sujeitos, buscando por diferencas e similaridades. Os sentidos atribuidos a experiencia do trauma se associam a sentimentos inter-relacionados de medo, inseguranca, revolta, vulnerabilidade e sofrimento e aos significados de qualidade de vida que convergem para a valorizacao da saude, trabalho e apoio pelas redes sociais. Esta analise mostrou que as concepcoes e vivencias do trauma sao fatores condicionantes do processo saude/doenca e fundamentais para o planejamento de acoes de saude publica voltadas ao atendimento das necessidades individuais.

Soroprevalência de sarampo entre pediatras de um hospital-escola

INTRODUCAO: Em 1996-1997 ocorreu no Estado de Sao Paulo uma epidemia de sarampo. Uma das estrategias de controle da Secretaria do Estado da Saude foi a vacinacao dos profissionais da saude. Nesse sentido objetivou-se avaliar a soroprevalencia de sarampo entre os pediatras. METODOS: Foram colhidas 150 amostras de sangue de medicos pediatras voluntarios, as quais foram submetidas ao teste de ELISA. Um questionario sobre historia de sarampo e situacao vacinal foi respondido pelos pediatras estudados. RESULTADOS: A maioria dos pediatras 147/150 tinha titulos protetores; sendo 80,3% sem e 19,7% com historia pregressa de sarampo. Em 2% dos pediatras as sorologias foram negativas. Nos sem historia de doenca, 67% afirmavam terem sido vacinados e 33% apesar de apresentarem titulos protetores ignoravam sua situacao vacinal. Dos 79 medicos vacinados, 81% tinham recebido a vacina ha pelo menos 25 anos e mantido titulos protetores. Dos 3 com sorologias negativas, um referia vacinacao anterior. CONCLUSOES: Apesar da elevada soroprevalencia para sarampo, 2% de pessoas susceptiveis podem constituir grupo de risco para aquisicao e disseminacao da doenca em situacao epidemica.OBJECTIVE A measles outbreak occurred in S. Paulo state, during 1996 and 1997, resulting in 20,921 cases. Forty seven percent of the cases occurred in people between 20 and 29 years of age, and one of the control strategies of the Department of Health was the vaccination of health care workers. The prevalence of antibodies against measles among the hospital pediatricians was investigated. METHODS One hundred and fifty samples were taken from volunteer pediatricians to test for measles antibodies using ELISA. A questionnaire about their having had measles and the vaccine was filled out. RESULTS Of the 150 doctors, 122 (81.4%) were female and 28 (18.6%) male, of between 23 and 46 years of age (mean and median 27 years). The majority (98%-147/150) had protective levels of antibodies against measles (>100 UI/ml); 118 (80.3%-118/147) without and 29 (19.7%-29/147) with a history of measles. Only 3 pediatricians (2%-3/150), had negative serology, 2 without and 1 with a history of measles. Out of the 118 without history of measles, 79 (67%-39/118) in spite of the protective level of antibodies against measles, did not know if they, had been vaccinated. Out of the 79 vaccinated pediatricians, 64 (81%-64/79), had been vaccinated 25 years before, and still maintained protective levels of antibodies. Of the 3 doctors with negative serologies only one declared that he had been vaccinated. CONCLUSIONS Measles seroprevalence among pediatricians of this hospital is high, especially due to preceding vaccination. On the other hand, the 2% of pediatricians with negative serology, in an epidemic situation could constitute a significant population for the acquisition and dissemination of the disease.

Anxiety, depression, resilience and self-esteem in individuals with cardiovascular diseases

Objetivos: analisar as relacoes entre os sintomas ansiosos e depressivos, resiliencia e autoestima com as caracteristicas sociodemograficas e clinicas; correlacionar resiliencia e autoestima com a idade e o tempo da doenca; analisar associacoes entre ansiedade e depressao com as medidas de resiliencia e autoestima em individuos com doencas cardiovasculares. Metodo: estudo correlacional, realizado em Hospital de Ensino de grande porte do interior do Estado de Sao Paulo. A populacao era constituida por pacientes adultos internados com doencas cardiovasculares. Uma amostra consecutiva e nao probabilistica foi constituida por 120 pacientes. As variaveis de interesse foram avaliadas pela Escala Hospitalar de Ansiedade e Depressao, Escala de Resiliencia e Escala de Autoestima de Rosenberg. Resultados: os sintomas de ansiedade e depressao estavam presentes em 32,5% e 17,5% dos pacientes, respectivamente e foram associados ao sexo feminino (p = 0,002; p = 0,022). As manifestacoes de depressao foram associadas a presenca de comorbidades (p = 0,020). Pacientes mais resilientes nao apresentaram sintomas depressivos (p < 0,001) e, as mulheres ansiosas, foram menos resilientes (p = 0,042). Os maiores escores de autoestima estiveram presentes em pacientes com ansiedade e depressao. Os homens apresentaram maior resiliencia e menor autoestima quando comparados as mulheres. Conclusao: pacientes com ansiedade e depressao foram menos resilientes e apresentaram maior autoestima.ABSTRACT Objectives: to analyze the relationship between anxiety and depression symptoms, resilience and self-esteem with sociodemographic and clinical characteristics; correlate resilience and self-esteem with age and duration of the disease; check associations between anxiety and depression with measures of resilience and self-esteem among individuals with cardiovascular diseases. Method: correlational study conducted in a large university hospital in the interior of the state of São Paulo, Brazil. The population was composed of adult inpatients with cardiovascular diseases. A non-probabilistic consecutive sample was composed of 120 patients. Variables of interest were assessed using the Hospital Anxiety and Depression Scale, Resilience Scale, and Rosenberg Self-Esteem Scale. Results: anxiety and depression symptoms were present in 32.5% and 17.5% of the patients, respectively, and were associated with the female sex (p = 0.002; p = 0.022). Manifestations of depression were associated with the presence of comorbidities (p = 0.020). More resilient patients did not present depression symptoms (p < 0.001) and anxious women were more resilient (p = 0.042). The highest scores regarding self-esteem were present in patients with anxiety and depression. Men presented higher resilience and lower self-esteem compared to women. Conclusion: patients with anxiety and depression were less resilient but presented higher self-esteem.

Triage in an adult emergency service: patient satisfaction

OBJECTIVE Assess the degree of patient satisfaction with triage in the adult emergency service of a public hospital. METHOD Exploratory, descriptive, cross-sectional study with a quantitative approach. Three hundred patients were interviewed and the data were analyzed using descriptive statistics based on sociodemographic variables and those related to patient satisfaction. RESULTS There was a predominance of women, with elementary education and a mean age of 41 years. Most of the interviewees reported being satisfied in regard to the following items: timely service, embracement, trust, environment (comfort, cleanliness and signage), humanization (courtesy, respect, and interest), timely referral/scheduling of appointments and care expectations. CONCLUSION There was a high level of patient satisfaction, evidenced by the strong association of user satisfaction with the items investigated. OBJETIVO Avaliar o grau de satisfação dos usuários no setor de Acolhimento com Classificação de Risco do Pronto-Socorro Adulto de um hospital público. MÉTODO Pesquisa exploratória, descritiva e transversal com abordagem quantitativa. Foram entrevistados 300 usuários e os dados foram analisados por meio de estatística descritiva a partir de variáveis sociodemográficas e as relacionadas à satisfação do usuário. RESULTADOS Houve predominância do sexo feminino, nível de escolaridade fundamental e idade média de 41 anos. A maioria dos entrevistados respondeu estar satisfeito em relação aos itens: agilidade no atendimento; acolhimento; confiança; ambiência (conforto, limpeza, sinalização), humanização (educação, respeito e interesse); agilidade no encaminhamento/agendamento de consulta e expectativa sobre o serviço. CONCLUSÃO Verificou-se elevado grau de satisfação dos usuários, evidenciada pela forte associação da satisfação do usuário com os itens investigados.

Experiencia del paciente politraumatizado y sus consecuencias

This was an ethnographic investigation with the aim of comprehending the meanings of the trauma experience among multiple trauma patients. The following techniques were used for data collection: direct observation, semi-structured interview and field diary. Biographical narratives were obtained from eleven trauma victims, and ten relatives as secondary informants. The data analysis considered the set of data of each participant and all data of all subjects, searching for differences and similarities. The meanings attributed to the trauma experience are associated with interrelated feelings of fear, insecurity, anger, vulnerability and suffering and to the meanings of quality of life that converge to valorize health and work appreciation and support by social networks. This analysis shows that the concepts and experiences of the trauma are conditioning factors of the health-disease process and they are essential in planning public health actions to meet the needs of individuals.Esta e uma investigacao etnografica, realizada com o objetivo de compreender os significados da experiencia do trauma entre pacientes politraumatizados. Foram utilizadas as seguintes tecnicas de coleta de dados: observacao direta, entrevista semiestruturada e diario de campo. Obtiveram-se narrativas biograficas de 11 pessoas, vitimas de traumas, e 10 familiares, como informantes secundarios. A analise dos dados considerou o conjunto dos dados de cada participante e o todo dos dados de todos os sujeitos, buscando por diferencas e similaridades. Os sentidos atribuidos a experiencia do trauma se associam a sentimentos inter-relacionados de medo, inseguranca, revolta, vulnerabilidade e sofrimento e aos significados de qualidade de vida que convergem para a valorizacao da saude, trabalho e apoio pelas redes sociais. Esta analise mostrou que as concepcoes e vivencias do trauma sao fatores condicionantes do processo saude/doenca e fundamentais para o planejamento de acoes de saude publica voltadas ao atendimento das necessidades individuais.

Adesão às precauções padrão em um hospital de ensino

Objetivo: verificar os fatores associados e o nivel de adesao as precaucoes padrao dos profissionais de enfermagem do setor de clinica medica de um hospital de ensino. Metodo: estudo quantitativo, transversal, analitico, realizado com 54 profissionais de enfermagem, por meio da aplicacao da Escala Psicometrica de Adesao as Precaucoes Padrao, traduzida e validada para o portugues do Brasil. Resultados: o escore global de adesao foi intermediario (4,41); nao houve correlacao estatisticamente significativa entre adesao e categoria profissional (p=0,404) e com o tempo de exercicio profissional (p= 0,612). Verificou-se correlacao do item Lava as maos apos a retirada de luvas descartaveis (p=0,026) com profissionais com tempo de trabalho, na area, superior a 10 anos. Conclusao: a adesao as medidas de precaucao padrao pela equipe de enfermagem foi intermediaria, nao tendo diferenca estatisticamente significativa em relacao a categoria profissional e ao tempo de exercicio profissional.

Content validation of the nursing diagnosis Nausea

This study aimed to evaluate the content validity of the nursing diagnosis of nausea in the immediate post-operative period, considering Fehring’s model. Des...This study aimed to evaluate the content validity of the nursing diagnosis of nausea in the immediate post-operative period, considering Fehrings model. Descriptive study with 52 nurses experts who responded an instrument containing identification and validation of nausea diagnosis data. Most experts considered the domain 12 (Comfort), Class 1 (Physical Comfort) and the statement (Nausea) adequate to the diagnosis. Modifications were suggested in the current definition of this nursing diagnosis. Four defining characteristics were considered primary (reported nausea, increased salivation, aversion to food and vomiting sensation) and eight secondary (increased swallowing, sour taste in the mouth, pallor, tachycardia, diaphoresis, sensation of hot and cold, changes in blood pressure and pupil dilation). The total score for the diagnosis of nausea was 0.79. Reports of nausea, vomiting sensation, increased salivation and aversion to food are strong predictors of nursing diagnosis of nausea.

Análisis bacteriológico del jabón líquido para uso hospitalario

This study aimed to perform a bacteriological analysis of the liquid soap used during the process of hand hygiene of health professionals in the hospitalization units in a Teaching Hospital in the countryside of Minas Gerais, MG, Brazil. It is a quantitative, exploratory and cross-sectional research. Data were collected from July to August 2014, to a total of 75 samples from different units of the hospital. After preparation, the samples were sent to microbiological analysis, and the growth of microorganisms or its absence was verified, as well as the contamination of the analyzed product. The data obtained allowed to conclude that the products standardized in this institution have the desired effectiveness and encourage other studies to be made.

Adherence to standard precautions in a teaching hospital

Objetivo: verificar os fatores associados e o nivel de adesao as precaucoes padrao dos profissionais de enfermagem do setor de clinica medica de um hospital de ensino. Metodo: estudo quantitativo, transversal, analitico, realizado com 54 profissionais de enfermagem, por meio da aplicacao da Escala Psicometrica de Adesao as Precaucoes Padrao, traduzida e validada para o portugues do Brasil. Resultados: o escore global de adesao foi intermediario (4,41); nao houve correlacao estatisticamente significativa entre adesao e categoria profissional (p=0,404) e com o tempo de exercicio profissional (p= 0,612). Verificou-se correlacao do item Lava as maos apos a retirada de luvas descartaveis (p=0,026) com profissionais com tempo de trabalho, na area, superior a 10 anos. Conclusao: a adesao as medidas de precaucao padrao pela equipe de enfermagem foi intermediaria, nao tendo diferenca estatisticamente significativa em relacao a categoria profissional e ao tempo de exercicio profissional.