ABSTRACT
Objetivo: Compreender o processo de contrarreferenciamento farmacoterapêutico na rede de cuidados, a partir das experiências de profissionais de saúde. Método: Estudo qualitativo, fundamentado na sociologia compreensiva, desenvolvido em um hospital de ensino, sendo entrevistados 14 profissionais de saúde. A coleta de dados ocorreu, por meio de entrevistas, realizadas a partir de um roteiro semiestruturado. Realizou-se análise de conteúdo e identificação de categorias. Resultados: Identificaram-se as categorias os "des"caminhos do referenciamento e em busca de um contrarreferenciamento possível, em que o contrarreferenciamento apresenta-se como uma ação frágil, influenciado pelo medo da reinternação, questões de acesso e, principalmente, fragilidade dos processos de comunicação. Quanto às possibilidades de melhoria, têm-se preparação da alta com antecedência, reconhecimento das subjetividades dos pacientes e fortalecimento da comunicação. Considerações finais: O contrarreferenciamento é construído a partir das relações e vivências dos atores sociais, sendo que ocasiona impacto no processo de cuidado, devendo ser fortalecido(AU)
Objective: Understanding the perception that professionals about the process of pharmaceutical referencing of patients in the health system. Methodology: Case study based on a qualitative approach. The setting was a general teaching hospital, and the subjects were 14 health professionals. The data collection were done through interviews guided by a semi structured script. Results: The referencing was heterogeneous, taking into account relationships and subjectivities; it caused feelings of fear about readmission, pharmacotherapy unavailability, possible inability for the patient to purchase the drugs, and the fragility of communication. The professionals also pointed out possibilities to improve referencing such as to prepare a patient for discharge well in advance, implement referencing and recognition of patients' subjectivity mechanisms. Conclusion: referencing is built from the relationships and experiences of those involved. It is an action that impacts the care process and can be strengthened in the institution chosen for this study(AU)
Objetivo: Comprender el proceso de contrarreferencia farmacoterapéutica en la red de asistencia médica Método: Estudio cualitativo, desarrollado en un hospital universitario, con 14 profesionales de la salud. La recopilación de datos se realizó por medio de entrevistas, realizadas con un guión semiestruturado. Resultado: Se identificaron las categorías, los "des"caminos de referencia y en busca de una posible contrarreferencia, donde la contrarreferencia se presenta como una acción frágil, influenciada por el miedo a la readmisión, en asuntos de acceso y en la fragilidad en los procesos de comunicación. En cuanto a las posibilidades de mejora, existe la preparación previa del alta, el reconocimiento de las subjetividades de los pacientes y el fortalecimiento de la comunicación. Consideraciones finales: La contrarreferencia se construye a partir de las relaciones y experiencias de los actores sociales, lo que tiene un impacto en el proceso de atención médica, y debe ser fortalecido(AU)
Subject(s)
Humans , Male , Female , Nursing , Continuity of Patient Care , Delivery of Health Care , Drug Utilization , Hospital Care , Health Services AccessibilityABSTRACT
RESUMO Objetivo: describir la experiencia de los pacientes que transitan de hemodiálisis a diálisis peritoneal. Método: estudio cualitativo fenomenológico con nueve entrevistas semiestructuradas, entreseptiembre de 2017 a mayo de 2018. Criterios de inclusión: autonomía para la diálisis peritoneal, cambio de terapia renal sustitutiva y permanencia mínima de dos meses en la antigua y nuevaterapia renal. Criterios de exclusión: hemodiálisis domiciliaria y deterioro psíquico o cognitivo. Um paradigma de codificación deductivo-inductivo reveló cinco categorías principales. Resultados: la transición denotó separarse de una vida dependiente de terceros y experimentarcambios de vida, y ajustes para gestionar la terapia domiciliaria. Conclusión: la experiencia vivida movilizó recursos para adquirir una identidad integradora fluida, renaciendo un rol caracterizado por satisfacción personal y responsabilidad con el autocuidado.
RESUMO Objetivo: descrever a experiência de pacientes que fazem a transição da hemodiálise para a diálise peritoneal. Método: estudo fenomenológico e qualitativo, com nove entrevistas semiestruturadas, de setembro de 2017 a maio de 2018. Critérios de inclusão: autonomia para diálise peritoneal, troca de modalidade da terapia de substituição renal e permanência mínima de dois meses na antiga e na nova terapia renal. Critérios de exclusão: hemodiálise domiciliar e comprometimento mental ou cognitivo. Um paradigma de codificação dedutivo-indutivo revelou cinco categorias principais. Resultados: a transição denota a possibilidade de abandonar a dependência de terceiros e experimentar mudanças na vida, realizando ajustes para gerenciar a terapia domiciliar. Conclusão: a experiência vivida mobilizou recursos para adquirir uma identidade integradora fluida, assumindo um papel caracterizado pela satisfação e responsabilidade pessoal com o autocuidado.
ABSTRACT Objective: To describe the experience of the patients transitioning from haemodialysis to peritoneal dialysis. Method: A phenomenological and qualitative study conducted with nine semi-structured interviews between September 2017 and May 2018. Inclusion criteria: Autonomy for peritoneal dialysis, change of substitutive renal therapy, and minimum permanence of two months in the previous and new renal therapies. Exclusion criteria: Home haemodialysis and psychic or cognitive impairment. A deductive-inductive codification paradigm revealed five main categories. Results: The transition denoted separation from life depending on others and experimenting life changes, as well as adjustments to manage home therapy. Conclusion: The experience mobilized resources to acquire a fluent and integrative identity, with a role being re-born characterized by personal satisfaction and responsibility in self-care.
ABSTRACT
Transitional care is an important step in the process of treating disease. Medication risk during this period of time has become a public safety issue and attracted more attention. It not only threatens patients' health, but also increases the unnecessary cost of medical resources. Through systematically analyzing the medication risk in each link of the transition care, this paper discusses the strategies to improve the medication risk management of patients in the process of transition, and provides references for improving the level of rational medication use and optimizing the allocation of medical resources in transition care.
ABSTRACT
@#Introduction: A smooth transition of healthcare for young people with chronic illnesses from paediatric to adult healthcare services is important to ensure optimal outcome. At the moment, there are no standard guidelines to assess a patient's readiness to transfer care. Methods: A cross-sectional study using a self-administered questionnaire, adapted from UNC (University of North Carolina) TRxANSITION self-assessment tool was conducted to evaluate patients’ transition care readiness in paediatric haematology and paediatric diabetes clinic. Results: A total of 80 patients (37 thalassaemia and 43 diabetes) with the mean age of 21.2 (SD±4.3) years, were recruited during the 3-month study period. Majority of the patients have basic knowledge regarding their medications, and were able to comply with their follow-up. The mean total score obtained by the respondents on this questionnaire was 15.3 (SD±3.59). Self-management skills and knowledge on disease were the two poorly scored section; with mean score of 3.78 (SD±1.38) and 4.28 (SD±1.20) respectively. Overall, only 21 (26.2%) respondents obtained high score (score above 75th percentile). Seventy-five percent of the respondents admitted that they were not ready for transfer to an adult healthcare service yet at the time of the study. Conclusion: We suggest that patients with high score should be prepared for transition to adult facility whereas those with a low score need to be identified to ensure provision of continuous education.
ABSTRACT
Transition care is the important conditioin,which helps children of chronic diseases enter from paediatrc care to adult care.At present,transtion care has become a hot topic overseas,but it hasn't been thought seriously in China.Now this paper reviews the causes,essential aspects and current situation of transition care,as well as its assignments to patients,parents,doctors and hospitals respectively.