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1.
Ciênc. Saúde Colet ; 26(10): 4569-4578, out. 2021. tab
Article in English, Portuguese | LILACS | ID: biblio-1345716

ABSTRACT

Resumo A Atenção Primária à Saúde (APS) é considerada imprescindível para a efetividade dos sistemas de saúde. O objetivo deste estudo foi avaliar a qualidade da assistência prestada na APS em um município de Pernambuco. Realizou-se um estudo exploratório através da escuta a 525 usuários utilizando questionários estruturados. A avaliação da qualidade considerou as dimensões: acessibilidade, assistência clínica, relação profissional-usuário, atividades comunitárias e estrutura. Os resultados apontam para um contexto de perpetuação das vulnerabilidades sociais e o desafio em alcançar um atendimento equitativo e universal. Os principais aspectos de insatisfação foram: dificuldade de acesso a consultas e exames especializados, tempo de espera para atendimento e possibilidade de apresentar reclamações. Por outro lado, os entrevistados apresentaram-se satisfeitos com o atendimento médico e de enfermagem, principalmente quanto ao respeito, privacidade, escuta e confidencialidade. Verificou-se que apesar dos profissionais de saúde se empenharem na prestação de um atendimento humanizado, foi evidente a fragmentação do cuidado na rede estudada, o que dificulta o seguimento adequado e oportuno ao paciente, refletindo negativamente na qualidade da assistência prestada.


Abstract Primary health care is an essential component of effective health systems. The aim of this study aim was to evaluate the quality of primary care in a city in the state of Pernambuco, Brazil. We conducted an exploratory study with 525 service users using structured questionnaires. The quality of primary care was assessed across five dimensions: accessibility, clinical care, professional-user relations, community activities and structure. The findings point to the perpetuation of social vulnerabilities and challenges in achieving equitable universal care. Dissatisfaction rates were highest in the following categories: access to specialist appointments and exams, appointment wait time, and opportunity to make complaints. However, respondents were satisfied with medical and nursing care, particularly in relation to respect, privacy, listening and confidentiality. The findings show that, although health professionals were committed to providing humanized care, fragmentation of care is evident, hampering the provision of adequate and timely follow-up and negatively affecting the quality of care.


Subject(s)
Humans , Right to Health , Perception , Appointments and Schedules , Primary Health Care , Surveys and Questionnaires
2.
Ciênc. Saúde Colet ; 26(6): 2023-2034, jun. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1278717

ABSTRACT

Resumo A existência de barreiras nos serviços de demanda agendada resulta no elevado índice de absenteísmo. O objetivo deste manuscrito é apresentar as principais características do Sistema de Agendamento Online da estratégia e-SUS APS no Brasil. O Sistema de Agendamento Online desenvolvido pelo Laboratório Bridge da Universidade Federal de Santa Catarina, o qual também desenvolve o sistema de Prontuário Eletrônico do Cidadão (PEC e-SUS APS), e permite o agendamento de consultas através do aplicativo Conecte SUS Cidadão. O PEC e-SUS APS possui, entre outros, o módulo de agenda do profissional onde são realizadas as marcações e cancelamentos de consultas, permitindo a visualização de seus horários e disponibilidades. Embora o uso de sistemas de agendamento online seja capaz de fornecer benefícios, infelizmente eles têm sido pouco explorados na APS. Os principais motivos estão relacionados com a falta de informação e capacitação dos profissionais sobre o sistema e os impactos nos serviços prestados pelos estabelecimentos de saúde da APS. A fim de garantir a maior adoção e utilização do Sistema de Agendamento Online, é necessário ampliar a divulgação do sistema de modo a instituí-lo na rotina dos serviços como um instrumento facilitador do acesso à APS.


Abstract Barriers faced by health services providing scheduled care result in high no-show rates. This article describes the main characteristics of an online appointment scheduling system incorporated into the citizens' electronic health record system (PEC e-SUS APS). Developed by the Bridge Laboratory, Federal University of Santa Catarina, which also developed the PEC e-SUS APS, the system allows patients to schedule appointments using the national patient communications hub, Conecte SUS Cidadão. The PEC e-SUS APS includes a professional's agenda module that allows patients to view available time slots and book and cancel appointments. Unfortunately, despite the benefits of online scheduling systems, their potential has been poorly exploited in Brazil. The main reasons for this include lack of information and training of health professionals on how to use the system and its potential benefits for Primary Health Care (PHC) services. Wider dissemination is needed to improve the adoption of the system and promote the routine use of this tool in health services in order to facilitate access to primary health care.


Subject(s)
Humans , Appointments and Schedules , Primary Health Care , Brazil
3.
Rev. bras. med. fam. comunidade ; 16(43): 2378, 20210126. tab, graf
Article in Portuguese | LILACS | ID: biblio-1282019

ABSTRACT

Introducción: El acceso oportuno y la continuidad de la atención son dos importantes medidas operativas para la práctica de la atención en Atención Primaria de Salud (APS). Objetivo: Realizar un estudio de demanda de un equipo de Estrategia de Salud de la Familia (ESF) que utilice el acceso avanzado (AA) como modelo para la organización de la agenda. Métodos: se trata de un análisis documental, cuantitativo, descriptivo y retrospectivo realizado en un equipo de la ESF en Río de Janeiro. Los datos 1410 se recopilaron en una hoja de cálculo de Microsoft® Excel® en Google Drive, se utilizaron en el proceso de trabajo del equipo y se tabularon y analizaron en hojas de cálculo de Microsoft Excel®. Se incluyeron registros del período de agosto y septiembre de 2017 y se excluyeron los registros en los que no se llenó el motivo de la consulta (MC). Los MC fueron codificados en base a las demandas, quejas y necesidades expresadas en las narrativas de los usuarios, y se adaptaron a la conformidad de la codificación CIAP (Clasificación Internacional de Atención Primaria). Resultados: De los 1392 registros de MC del resto de usuarios, 149 no fueron atendidos por inasistencia, reprogramación o evasión, totalizando 1243 registros analizados. Predominó el sexo femenino, con edades comprendidas entre los 55 y los 59 años, visitas realizadas en demanda espontánea, por la mañana, principalmente en las primeras horas de la recepción y con quejas generales y no específicas. Conclusión: Con AA parece haber una mayor accesibilidad para los usuarios que podrán tener acceso de primer contacto más fácilmente para resolver sus problemas. La realización del estudio de demanda permite recabar datos para la elaboración de un plan para una mejor organización de la agenda, reflejándose en un mejor servicio a la población de manera resuelta, oportuna e integral.


Introduction: Timely access and continuity of care are two important operational measures for the practice of care in Primary Health Care (PHC). Purpose: Conduct a study of the demand for a Family Health Strategy (FHS) team that uses advanced access (AA) as a model for organizing the schedule. Methods: It is a documentary, quantitative, descriptive and retrospective analysis carried out in an FHS team in Rio de Janeiro. The 1410 pieces of data were collected in a Microsoft® Excel® spreadsheet in Google Drive, used in the team's work process and were tabulated and arranged in Microsoft Excel® spreadsheets. Records from August and September 2017 were included, while records in which the reason for the consultation (RC) was not filled out were excluded. The RC were coded based on the demands, complaints and needs expressed in the users' narratives, and adapted to the conformity of the ICPC (International Classification of Primary Care). Results: Of the 1392 RC records of the remaining users, 149 were not attended due to absence, rescheduling or evasion, totaling 1243 records covered. There was a predominance of the following variables: females, aged between 55 and 59 years old, spontaneous demand queries, visits in the morning, mainly in the first hours of the reception and about general and non-specific complaints. Conclusions: With AA there seems to be greater accessibility for users who receive first contact access more easily to solve their problems. Carrying out the demand study makes it possible to collect data for the elaboration of a plan for a better organization of the agenda, reflecting in a better service to the population in a resolute, timely and integral way.


Introdução: O acesso oportuno e a continuidade do cuidado são duas medidas operacionais importantes para a prática dos cuidados na Atenção Primária à Saúde (APS). Objetivo: Realizar um estudo da demanda de uma equipe da Estratégia Saúde da Família (ESF) que utiliza o acesso avançado (AA) como modelo de organização da agenda. Métodos: Trata-se de uma análise documental, quantitativa, descritiva e retrospectiva realizada em uma equipe da ESF no Rio de Janeiro. Os 1410 dados foram coletados em uma planilha do Microsoft® Excel® no Google Drive, utilizada no processo de trabalho da equipe e foram tabulados e analisados em planilhas do Microsoft Excel®. Foram incluídos os registros do período de agosto e setembro de 2017 e excluídos os registros no qual o motivo da consulta (MC) não foi preenchido. Os MC foram codificados a partir de demandas, queixas e necessidades expressas nas narrativas dos usuários, e adaptadas à conformidade da codificação da CIAP (Classificação Internacional de Atenção Primária). Resultados: Dos 1392 registros de MC dos usuários restantes, 149 não foram atendidos por motivo de falta, reagendamento ou evasão, totalizando 1243 registros analisados. Predominou o sexo feminino, faixa etária entre 55 e 59 anos, atendimentos realizados em demanda espontânea, pela manhã, principalmente nas primeiras horas do acolhimento e com queixas gerais e não-específicas. Conclusão: Com o AA parece haver uma acessibilidade maior aos usuários que poderão ter o acesso de primeiro contato mais facilmente para a resolução dos seus problemas. Realizar o estudo da demanda possibilita o levantamento de dados para a elaboração de um planejamento para uma melhor organização da agenda refletindo em um melhor atendimento à população de forma resolutiva, oportuna e integral


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Appointments and Schedules , Primary Health Care , International Classification of Diseases , Family Health Strategy , Health Services Accessibility
4.
Rev. eletrônica enferm ; 23: 1-10, 2021.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1253157

ABSTRACT

Objetivo: identificar evidências científicas acerca dos motivos de não comparecimento em consultas nos serviços de saúde materno-infantil. Método: revisão integrativa conduzida nas bases CINAHL, BDENF, Scopus, Web of Science, PubMed, EMBASE, Science Direct e BVS, sem limitação do ano de publicação, seguindo a ferramenta PRISMA. Definiu-se como população os pacientes faltosos nas consultas agendadas. Resultados: identificaram-se 308 estudos, destes selecionaram-se 63 para a leitura na íntegra e três para amostra final. Os principais motivos relacionados ao comportamento faltoso, envolveram condições socioeconômicas, acessibilidade geográfica e a compreensão dos usuários quanto à importância do comprometimento com a saúde, todas situações que podem favorecer um desfecho desfavorável ao binômio. Conclusão: concluiu-se que a escassez de artigos acerca do tema justifica a realização de novos estudos voltados ao aprofundamento acerca das dificuldades encontradas pelas famílias, a fim de traçar estratégias que auxiliem a minimizar os efeitos deletérios da falta de acompanhamento.


Objective: to identify scientific evidence about the reasons for not attending appointments at maternal and child health services. Method: integrative review conducted at the bases CINAHL, BDENF, Scopus, Web of Science, PubMed, EMBASE, Science Direct and VHL databases, without limitation of the year of publication, following the PRISMA tool. The population was defined as patients who missed scheduled appointments. Results: 308 studies were identified, 63 were selected for full reading and three for the final sample. The main reasons related to defaulting behavior involved socioeconomic conditions, geographic accessibility and users' understanding of the importance of health commitment, all situations that can favor an unfavorable outcome for the binomial. Conclusion: it was concluded that the scarcity of articles on the topic justifies further studies aimed at deepening the difficulties encountered by families, in order to devise strategies that help to minimize the harmful effects of lack of follow-up.


Subject(s)
Secondary Care , Appointments and Schedules , Maternal-Child Health Services
5.
Rev. SPAGESP ; 21(2): 66-82, jul.-dez. 2020.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1125732

ABSTRACT

Este artigo se propõe a discutir os desafios na formação para o trabalho com grupos e o papel dos coordenadores, com base na experiência de coordenação de grupos de sala de espera realizado em uma Unidade Básica de Saúde, a partir de um estágio de graduação em Psicologia. Através de recortes do diário de campo, buscamos discutir a mediação grupal nesse contexto de intervenção, ressaltando possibilidades, expectativas e dificuldades vivenciadas. Considerando a escassez de trabalhos publicados com relação à temática de grupos em sala de espera e ênfase em grupos informativos, o presente trabalho buscou ampliar a discussão para grupo enquanto processo, expondo reflexões sobre nossa postura e intervenções, discussões ampliadas para pensar coordenação de grupos e formação profissional.


This article proposes to discuss the challenges in training for group work and the role of coordinators, based on the experience of coordinating groups in a waiting room held in a Basic Health Unit, from a graduation internship in Psychology. Through field diary clippings, we sought to discuss group mediation in this context of intervention, highlighting possibilities, expectations, and difficulties experienced. Considering the scarcity of studies regarding the theme of groups in the waiting room, besides an emphasis on informative groups, this study aimed to expand the discussion to the group as a process, exposing reflections on our posture and interventions, extended discussions to think coordinating groups and professional qualification.


Este artículo se propone discutir los desafíos en la formación para el trabajo con grupos y el papel de los coordinadores, con base en la experiencia de coordinación de grupos de sala de espera realizado en una Unidad Básica de Salud, a partir de una etapa de graduación en Psicología. A través de recortes del diario de campo, buscamos discutir la mediación grupal en ese contexto de intervención, resaltando posibilidades, expectativas y dificultades vivenciadas. Considerando la escasez de trabajos publicados con relación a la temática de grupos en sala de espera y énfasis en grupos informativos, el presente trabajo buscó ampliar la discusión para grupo en cuanto proceso, exponiendo reflexiones sobre nuestra postura e intervenciones, discusiones ampliadas para pensar coordinación de grupos y formación profesional.


Subject(s)
Humans , Appointments and Schedules , Posture , Role , Training Support , Health Centers , Negotiating , Medical Care , Professional Training , Internship and Residency
6.
Ciênc. Saúde Colet ; 25(4): 1389-1400, abr. 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1089536

ABSTRACT

Resumo Na Atenção Primária à Saúde (APS) acesso e integralidade são fortemente influenciados pela coordenação do cuidado, que por sua vez recebe impacto positivo da articulação de ações de telessaúde para a telerregulação da assistência. Criamos uma metodologia de telerregulação (Projeto RegulaSUS) baseada em protocolos específicos firmemente alicerçados em evidências. A partir de dados do sistema de regulação e do TelessaúdeRS exploramos os efeitos do RegulaSUS na APS e no acesso ao cuidado especializado. A metodologia foi capaz de criar protocolos abrangentes, com expressiva redução média da fila de consultas especializadas de 30% em 360 dias. Reduziu o tempo de espera na marcação de consultas em especialidades clínicas (mediana de 66 dias), mas não em cirúrgicas. Tempos de espera nos casos mantidos em fila variaram de forma inversa, aumentado em especialidades clínicas e diminuindo em cirúrgicas. O uso de teleconsultorias espontâneas aumentou com a exposição dos profissionais ao RegulaSUS. A intervenção tem potencial na integração de sistemas de saúde, principalmente em países de baixa e média renda, e faz com que a telessaúde atue como metasserviço, construindo redes eficientes, qualificadas e equânimes.


Abstract In Primary Health Care (PHC), access, and integrality are strongly influenced by the coordination of care, which in turn receives a positive impact from the articulation of telehealth actions for teleregulation of care. We created a teleregulation method (RegulaSUS Project) based on specific protocols firmly grounded in scientific evidence. From data of the regulatory system and TelessaúdeRS, we explored the effects of RegulaSUS on PHC and access to specialized care. This method set comprehensive protocols, with a significant mean reduction of 30% in the specialized visits queue over 360 days. It reduced waiting time for medical clinical visits (median of 66 days) but not for surgical appointments. Waiting times for queued cases varied inversely, increasing for clinical and declining for surgical specialties. The use of teleconsultations unrelated to regulation increased with the exposure of professionals to RegulaSUS. The intervention evidence potentiality in the integration of health systems, mainly among low- and middle-income countries, and makes telehealth act as a meta-service, building efficient, qualified, and equitable networks.


Subject(s)
Humans , Primary Health Care/organization & administration , Telemedicine/organization & administration , Health Services Accessibility/organization & administration , Appointments and Schedules , Primary Health Care/statistics & numerical data , Referral and Consultation/organization & administration , Referral and Consultation/statistics & numerical data , Time Factors , Brazil , Waiting Lists , Telemedicine/statistics & numerical data , Capacity Building , Data Analysis , Health Services Accessibility/statistics & numerical data
7.
Santa Tecla, La Libertad; ITCA Editores; ene. 2020. 42 p. ^c28 cm.ilus., tab., graf..
Monography in Spanish | LILACS, BISSAL | ID: biblio-1222448

ABSTRACT

El software desarrollado en este proyecto tiene como propósito controlar y ejecutar medidas de prevención hacia enfermedades definidas. Por medio del estudio de gestión de controles médicos, se diseñó la automatización de los procesos de la Unidad de Salud de Conchagua. El software cuenta con un módulo de gestión de citas en el cual se pueden agendar las consultas y controles de los pacientes, permitiendo además reprogramarlas en casos de ser requerido. De igual forma le permite al médico contar con una vista a manera de agenda en la que puede verificar si un día en concreto tiene pacientes ya registrados para atender. Con la implementación del sistema, la Unidad de Salud de Conchagua, La Unión, contará con una plataforma que incluirá la información del niño o la niña como nombre completo, edad, residencia, entre otros datos importantes, además tendrá la capacidad de almacenar más de 1,000,000 de expedientes clínicos.


The software developed in this project was made with the purpose to control and execute preventive measures towards defined diseases. Through the study of management of medical controls, the automation of the processes of Unidad de Salud de Conchagua was designed. The software has an appointment management module in which patient consultations and controls can be scheduled, also allowing them to be reprogrammed when necessary. In the same way, it allows the doctor to have a view in the way of an agenda in which he can verify if a specific day has patients already registered to attend. With the implementation of the system, the Unidad de Salud de Conchagua, will have a platform that will include the child's information such as full name, age, residence, among other important data, and will also have the capacity to store more than 1,000,000 clinical records.


Subject(s)
Appointments and Schedules , Software , Records , Information , Referral and Consultation , Automation , Control
8.
Yonsei Medical Journal ; : 251-256, 2020.
Article in English | WPRIM | ID: wpr-811470

ABSTRACT

PURPOSE: This study aimed to evaluate the validity of the Western Ontario and McMaster Universities Arthritis Index Short Form (WOMAC-SF) for the assessment of musculoskeletal disorders. We evaluated whether WOMAC-SF correlated with the World Health Organization Disability Assessment Schedule 12 (WHODAS-12) and Kaigo-Yobo questionnaires for assessing health-outcomes in Korea.MATERIALS AND METHODS: This cross-sectional study used data from the Namgaram-2 cohort. WOMAC, WOMAC-SF, WHODAS-12, and Kaigo-Yobo questionnaires were administered to patients with musculoskeletal disorders, including radiology-confirmed knee osteoarthritis (RKOA), sarcopenia, and osteoporosis. The relationships among WOMAC-SF, WHODAS-12, and Kaigo-Yobo scores were analyzed by stepwise multiple regression analysis.RESULTS: WOMAC-SF was associated with the WOMAC questionnaire. The results of confirmatory factor analysis for the hypothesized model with two latent factors, pain and function, provided satisfactory fit indices. WOMAC-SF pain and function were associated with RKOA. Kaigo-Yobo was associated with WOMAC-SF pain (B=0.140, p=0.001) and WOMAC-SF function (B=0.042, p=0.004). WHODAS-12 was associated with WOMAC-SF pain (B=0.679, p=0.003) and WOMAC-SF function (B=0.804, p<0.001).CONCLUSION: WOMAC-SF was validated for the evaluation of low extremity musculoskeletal disorders and health-related quality of life in a community-based population. Furthermore, we confirmed that WOMAC-SF were reflective of disability and frailty, which affect health outcomes.


Subject(s)
Appointments and Schedules , Arthritis , Cohort Studies , Cross-Sectional Studies , Extremities , Humans , Korea , Ontario , Osteoarthritis, Knee , Osteoporosis , Quality of Life , Sarcopenia , World Health Organization
9.
Article in English | WPRIM | ID: wpr-811207

ABSTRACT

BACKGROUND: This study aimed to compare the pain levels during anesthesia and the efficacy of the QuickSleeper intraosseous (IO) injection system and conventional inferior alveolar nerve block (IANB) in impacted mandibular third molar surgery.METHODS: This prospective randomized clinical trial included 30 patients (16 women, 14 men) with bilateral symmetrical impacted mandibular third molars. Thirty subjects randomly received either the IO injection or conventional IANB at two successive appointments. A split-mouth design was used in which each patient underwent treatment of a tooth with one of the techniques and treatment of the homologous contralateral tooth with the other technique. The subjects received 1.8 mL of 2% articaine. Subjects' demographic data, pain levels during anesthesia induction, tooth extractions, and mouth opening on postoperative first, third, and seventh days were recorded. Pain assessment ratings were recorded using the 100-mm visual analog scale. The latency and duration of the anesthetic effect, complications, and operation duration were also analyzed in this study. The duration of anesthetic effect was considered using an electric pulp test and by probing the soft tissue with an explorer.RESULTS: Thirty patients aged between 18 and 47 years (mean age, 25 years) were included in this study. The IO injection was significantly less painful with lesser soft tissue numbness and quicker onset of anesthesia and lingual mucosa anesthesia with single needle penetration than conventional IANB. Moreover, 19 out of 30 patients (63%) preferred transcortical anesthesia. Mouth opening on postoperative first day was significantly better with intraosseous injection than with conventional IANB (P = 0.013).CONCLUSION: The IO anesthetic system is a good alternative to IANB for extraction of the third molar with less pain during anesthesia induction and sufficient depth of anesthesia for the surgical procedure.


Subject(s)
Anesthesia , Anesthetics , Appointments and Schedules , Carticaine , Female , Humans , Hypesthesia , Jupiter , Mandibular Nerve , Molar, Third , Mouth , Mucous Membrane , Needles , Pain Measurement , Prospective Studies , Tooth , Tooth Extraction , Tooth, Impacted , Visual Analog Scale
11.
Article in English | WPRIM | ID: wpr-782069

ABSTRACT

14). Depressive mood and anxiety symptom were significantly worse in 3S compare to EOD. The sleep disturbance by ISI score had significant correlations with depressive mood and anxiety symptoms for both EOD and 3S (EOD: rho=0.57, rho=0.57, 3S: rho=0.37, rho=0.33 respectively). Chronotype type in shift workers had no significant correlation with sleep disturbance, depressive mood, nor anxiety symptom. However, after adjustment, the eveningness chronotype have relationship to the depressive mood in shift workers.CONCLUSIONS: Sleep disturbances are more frequent in shift workers than DW. Depressive mood and anxiety symptoms were frequently reported in 3S, then EOD. Different shift schedules cab be a determinant of depressive mood and anxiety symptom.


Subject(s)
Anxiety , Appointments and Schedules , Depression , Firefighters , Humans , Sleep Initiation and Maintenance Disorders
12.
Braz. oral res. (Online) ; 34: e84, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132669

ABSTRACT

Abstract The present study sought to evaluate the impact of quarantine resulting from the coronavirus disease 2019 (COVID-19) pandemic on dental appointments and patients' positions and concerns regarding their ongoing dental treatment. Patients from private dental clinics answered an online questionnaire anonymously regarding their treatment, availability and willingness to attend dental appointments, and concerns about contamination. Descriptive statistics of the responses were performed with percentages and responses were compared between sexes, regions, and other aspects using the chi-squared test. Five hundred ninety-five patients (412 females and 183 males; mean age: 38.21 years) answered the questionnaire. Most patients reported they were receiving dental treatment (orthodontics) and would attend to a dental appointment; meanwhile, those patients not receiving treatment would not attend or would visit only in the case of an emergency. Males reported to be calmer than females, who were more anxious and afraid; as such, males reported more willing to go a dental appointment while, in general, females were not worried about how quarantine could affect dental treatment. Patients actively undergoing treatment and orthodontic patients were more concerned about a delay in treatment. There was a significant association between feelings about the COVID-19 pandemic and the level of willingness to attend a dental appointment. The quarantine recommended due to the COVID-19 pandemic was shown to have an impact on dental appointments and the anxiety levels of patients, since there was a significant association between patients' feelings and their willingness to attend a dental appointment. Overall, patients undergoing dental treatment and orthodontics were more willing to attend an appointment and were more concerned about an increase in treatment duration.


Subject(s)
Humans , Male , Female , Adult , Anxiety , Appointments and Schedules , Pneumonia, Viral/psychology , Quarantine , Coronavirus Infections/psychology , Dentistry , Surveys and Questionnaires , Pandemics , Betacoronavirus , SARS-CoV-2 , COVID-19
13.
Article in English | LILACS, BBO | ID: biblio-1056895

ABSTRACT

Abstract Objective: To determine the effect of a proactive telephone-based scheduling strategy to improve dental service utilization rate in primary healthcare. Material and Methods: A retrospective study was carried out based on the dental appointments' records of a primary healthcare center before-strategy and after-strategy periods. The variables studied for both periods were the number of dental appointments requested, dental appointments undergone, no-shows, and available quotas. Data collection was performed by two researchers between May and June 2018. Descriptive statistics were used to calculate the absolute and relative frequencies. Results: A total of 10,193 records of dental appointments were registered within the two periods. After-strategy period, dental appointments undergone increased by 16,7%, no-shows decreased by 3%, and available quotas decreased by 21.3%. Conclusion: A proactive telephone-based scheduling strategy increased the dental service utilization rate in primary healthcare.


Subject(s)
Appointments and Schedules , Primary Health Care , Public Health Dentistry/education , Dental Health Services , Chile/epidemiology , Retrospective Studies
14.
Article in English | LILACS, BBO | ID: biblio-1056889

ABSTRACT

Abstract Objective: To measure the heart rate (HR) and the behavior of children and teenagers with Down Syndrome (DS) during the dental appointment. Material and Methods: Two groups (n = 52), of both genders, aged 2-14 years, matched by age group were formed: study group (SG) - individuals with DS and control group (CG) - normotypical school children. The participants were submitted to clinical examination and prophylaxis. An oximeter was used to measure the HR at five moments of the dental consultation: before entering the practice room (T0), when sitting in the dental chair (T1), during the clinical examination (T2), during prophylaxis (T3) and immediately after prophylaxis (T4). Behavior, classified according to the Frankl Scale, was observed at T3. Mann Whitney, Kruskal-Wallis, Dunn and Pearson's Chi-square tests were used to analyze and compare variables (significance level at 5%). Results: In SG, a significant difference in HR was observed according to the moment of dental appointment (p<0.001 SG; 0.3385 CG). The highest HR value in SG was observed at T3 (median 110.00; IIQ 96.00-124.00), the only moment significantly different (p<0.001) from HR values for CG. A difference in behavior between groups (p<0.001) was also observed. Conclusion: HR of individuals with DS varied throughout the dental appointment, and they also had a higher prevalence of uncooperative behavior.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Behavioral Symptoms/psychology , Cross-Sectional Studies/methods , Down Syndrome , Dental Offices , Heart Rate , Monitoring, Physiologic , Appointments and Schedules , Referral and Consultation , Brazil/epidemiology , Chi-Square Distribution , Cross-Sectional Studies , Statistics, Nonparametric
15.
Article in English | LILACS | ID: biblio-1092139

ABSTRACT

ABSTRACT Objective: To assess demographic data and characteristics of children and adolescents with pediatric chronic diseases (PCD), according to the number of specialties/patient. Methods: We performed a cross-sectional study with 16,237 PCD patients at outpatient clinics in one year. Data were analyzed by an electronic data system, according to the number of physician appointments for PCD. This study assessed: demographic data, follow-up characteristics, types of medical specialty, diagnosis (International Statistical Classification of Diseases and Related Health Problems - ICD-10), number of day hospital clinic visits, and acute complications. Results: Patients followed by ≥3 specialties simultaneously showed a significantly higher duration of follow-up compared to those followed by ≤2 specialties [2.1 (0.4-16.4) vs. 1.4 (0.1-16.2) years; p<0.001] and a higher number of appointments in all specialties. The most prevalent medical areas in patients followed by ≥3 specialties were: Psychiatry (Odds Ratio - OR=8.0; confidence interval of 95% - 95%CI 6-10.7; p<0.001), Palliative/Pain Care (OR=7.4; 95%CI 5.7-9.7; p<0.001), Infectious Disease (OR=7.0; 95%CI 6.4-7.8; p<0.001) and Nutrology (OR=6.9; 95%CI 5.6-8.4; p<0.001). Logistic regressions demonstrated that PCD patients followed by ≥3 specialties were associated with high risk for: number of appointments/patient (OR=9.2; 95%CI 8.0-10.5; p<0.001), day hospital clinic visits (OR=4.8; 95%CI 3.8-5.9; p<0.001), emergency department visits (OR=3.2; 95%CI 2.9-3.5; p<0.001), hospitalizations (OR=3.0; 95%CI 2.7-3.3; p<0.001), intensive care admissions (OR=2.5; 95%CI 2.1-3.0; p<0.001), and deaths (OR=2.8; 95%CI 1.9-4.0; p<0.001). The diagnosis of asthma, obesity, chronic pain, and transplant was significantly higher in patients followed by ≥3 specialties. Conclusions: The present study showed that PCD patients who required simultaneous care from multiple medical specialties had complex and severe diseases, with specific diagnoses.


RESUMO Objetivo: Avaliar dados demográficos e características de crianças e adolescentes com doenças crônicas pediátricas, de acordo com o número de especialidades/paciente. Métodos: Realizou-se um estudo transversal com 16.237 pacientes com doenças crônicas pediátricas durante um ano. A análise foi feita em um sistema eletrônico, de acordo com número de consultas médicas para doenças crônicas pediátricas. Este estudo avaliou dados demográficos, características do seguimento, tipos de especialidades médicas, diagnóstico (10ª Revisão da Classificação Estatística Internacional de Doenças e Problemas Relacionados com a Saúde - CID-10), número de visitas e complicações agudas. Resultados: Os pacientes acompanhados por três ou mais especialidades simultaneamente tiveram seguimento de maior duração comparados com aqueles seguidos por ≤2 especialidades [2,1 (0,4-16,4) vs. 1,4 (0,1-16,2) anos; p<0,001], bem como maior número de consultas em todas as especialidades. As áreas médicas mais comuns em pacientes acompanhados por ≥3 especialidades foram: psiquiatria (Odds Ratio - OR=8,0; intervalo de confiança de 95% - IC95% 6-10,7; p<0,001); dor/cuidados paliativos (OR=7,4; IC95% 5,7-9,7; p<0,001); doenças infecciosas (OR=7,0; IC95% 6,4-7,8; p<0,001); nutrologia (OR=6,9; IC95% 5,6-8,4; p<0,001). As regressões logísticas mostraram que os pacientes com doenças crônicas pediátricas seguidos por ≥3 especialidades tinham alto risco para: maior número de consultas/paciente (OR=9,2; IC95% 8,0-10,5; p<0,001); atendimentos em hospital-dia (OR=4,8; 95%IC3,8-5,9; p<0,001); atendimentos em pronto-socorro (OR=3,2; IC95% 2,9-3,5; p<0,001); hospitalizações (OR=3,0; IC95%2,7-3,3; p<0,001); internação em terapia intensiva (OR=2,5; IC95% 2,1-3,0; p<0,001); óbitos (OR=2,8; IC95%1,9-4,0; p<0,001). Os diagnósticos de asma, obesidade, dor crônica, transplante e infecção do trato urinário foram mais frequentes nos pacientes seguidos por três ou mais especialidades. Conclusões: O presente estudo mostrou que pacientes com doenças crônicas pediátricas que necessitaram de múltiplas especialidades médicas simultaneamente apresentavam doenças complexas e graves, com diagnósticos específicos.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Young Adult , Chronic Disease/epidemiology , Aftercare/trends , Ambulatory Care/statistics & numerical data , Medicine/standards , Palliative Care/statistics & numerical data , Appointments and Schedules , Psychiatry/statistics & numerical data , Brazil/epidemiology , Communicable Diseases/epidemiology , Prevalence , Cross-Sectional Studies , Critical Care/statistics & numerical data , Death , Emergency Service, Hospital/statistics & numerical data , Pain Management/statistics & numerical data , Hospitalization/statistics & numerical data , Medicine/statistics & numerical data , Nutrition Disorders/epidemiology
16.
Article in English | LILACS | ID: biblio-1057219

ABSTRACT

ABSTRACT Objective: To assess demographic data and characteristics of children and adolescents with pediatric chronic diseases (PCD), according to the number of specialties/patient. Methods: We performed a cross-sectional study with 16,237 PCD patients at outpatient clinics in one year. Data were analyzed by an electronic data system, according to the number of physician appointments for PCD. This study assessed: demographic data, follow-up characteristics, types of medical specialty, diagnosis (International Statistical Classification of Diseases and Related Health Problems - ICD-10), number of day hospital clinic visits, and acute complications. Results: Patients followed by ≥3 specialties simultaneously showed a significantly higher duration of follow-up compared to those followed by ≤2 specialties [2.1 (0.4-16.4) vs. 1.4 (0.1-16.2) years; p<0.001] and a higher number of appointments in all specialties. The most prevalent medical areas in patients followed by ≥3 specialties were: Psychiatry (Odds Ratio - OR=8.0; confidence interval of 95% - 95%CI 6-10.7; p<0.001), Palliative/Pain Care (OR=7.4; 95%CI 5.7-9.7; p<0.001), Infectious Disease (OR=7.0; 95%CI 6.4-7.8; p<0.001) and Nutrology (OR=6.9; 95%CI 5.6-8.4; p<0.001). Logistic regressions demonstrated that PCD patients followed by ≥3 specialties were associated with high risk for: number of appointments/patient (OR=9.2; 95%CI 8.0-10.5; p<0.001), day hospital clinic visits (OR=4.8; 95%CI 3.8-5.9; p<0.001), emergency department visits (OR=3.2; 95%CI 2.9-3.5; p<0.001), hospitalizations (OR=3.0; 95%CI 2.7-3.3; p<0.001), intensive care admissions (OR=2.5; 95%CI 2.1-3.0; p<0.001), and deaths (OR=2.8; 95%CI 1.9-4.0; p<0.001). The diagnosis of asthma, obesity, chronic pain, and transplant was significantly higher in patients followed by ≥3 specialties. Conclusions: The present study showed that PCD patients who required simultaneous care from multiple medical specialties had complex and severe diseases, with specific diagnoses.


RESUMO Objetivo: Avaliar dados demográficos e características de crianças e adolescentes com doenças crônicas pediátricas, de acordo com o número de especialidades/paciente. Métodos: Realizou-se um estudo transversal com 16.237 pacientes com doenças crônicas pediátricas durante um ano. A análise foi feita em um sistema eletrônico, de acordo com número de consultas médicas para doenças crônicas pediátricas. Este estudo avaliou dados demográficos, características do seguimento, tipos de especialidades médicas, diagnóstico (10ª Revisão da Classificação Estatística Internacional de Doenças e Problemas Relacionados com a Saúde - CID-10), número de visitas e complicações agudas. Resultados: Os pacientes acompanhados por três ou mais especialidades simultaneamente tiveram seguimento de maior duração comparados com aqueles seguidos por ≤2 especialidades [2,1 (0,4-16,4) vs. 1,4 (0,1-16,2) anos; p<0,001], bem como maior número de consultas em todas as especialidades. As áreas médicas mais comuns em pacientes acompanhados por ≥3 especialidades foram: psiquiatria (Odds Ratio - OR=8,0; intervalo de confiança de 95% - IC95% 6-10,7; p<0,001); dor/cuidados paliativos (OR=7,4; IC95% 5,7-9,7; p<0,001); doenças infecciosas (OR=7,0; IC95% 6,4-7,8; p<0,001); nutrologia (OR=6,9; IC95% 5,6-8,4; p<0,001). As regressões logísticas mostraram que os pacientes com doenças crônicas pediátricas seguidos por ≥3 especialidades tinham alto risco para: maior número de consultas/paciente (OR=9,2; IC95% 8,0-10,5; p<0,001); atendimentos em hospital-dia (OR=4,8; 95%IC3,8-5,9; p<0,001); atendimentos em pronto-socorro (OR=3,2; IC95% 2,9-3,5; p<0,001); hospitalizações (OR=3,0; IC95%2,7-3,3; p<0,001); internação em terapia intensiva (OR=2,5; IC95% 2,1-3,0; p<0,001); óbitos (OR=2,8; IC95%1,9-4,0; p<0,001). Os diagnósticos de asma, obesidade, dor crônica, transplante e infecção do trato urinário foram mais frequentes nos pacientes seguidos por três ou mais especialidades. Conclusões: O presente estudo mostrou que pacientes com doenças crônicas pediátricas que necessitaram de múltiplas especialidades médicas simultaneamente apresentavam doenças complexas e graves, com diagnósticos específicos.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Young Adult , Chronic Disease/epidemiology , Aftercare/trends , Ambulatory Care/statistics & numerical data , Medicine/standards , Palliative Care/statistics & numerical data , Appointments and Schedules , Psychiatry/statistics & numerical data , Brazil/epidemiology , Communicable Diseases/epidemiology , Prevalence , Cross-Sectional Studies , Critical Care/statistics & numerical data , Death , Emergency Service, Hospital/statistics & numerical data , Pain Management/statistics & numerical data , Hospitalization/statistics & numerical data , Medicine/statistics & numerical data , Nutrition Disorders/epidemiology
18.
Int. j. odontostomatol. (Print) ; 13(3): 321-324, set. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1012430

ABSTRACT

RESUMEN: La duración de los tratamientos de ortodoncia siempre ha sido una de las mayores preocupaciones, tanto en los pacientes como en los Ortodoncistas. El proposito de esta investigacion fue determinar la magnitud de las inasistencias a los controles por parte de los pacientes y como estas y otras variables, influyen en la duración de los tratamientos de Ortodoncia en el Centro de Salud Familiar (CESFAM) Dr. Victor Manuel Fernandez, Servicio de Salud de Concepcion, Chile. Se realizo un estudio descriptivo, de tipo transversal, retrospectivo, en el que se utilizaron las fichas clínicas de todos los pacientes que fueron dados de alta por los Ortodoncistas del CESFAM Dr. V. M. F. durante el año 2017. La tabulación se realizó en Microsoft Excel y el análisis estadístico se hizo en InfoStat 17. Se incluyeron 246 pacientes, con una edad de ingreso promedio de 13,6 años. La maloclusion predominante fue la Clase I de Angle (71 %). Estos pacientes tuvieron una duracion de tratamiento promedio de 33,9 meses. Se concluyó que a mayor cantidad de inasistencias, el tratamiento de ortodoncia tuvo una duración mayor.


ABSTRACT: The duration of orthodontic treatments has always been one of the biggest concerns, both in patients and for orthodontists. The purpose of this investigation was to determine the magnitude of the absences to the controls of the patients and how they influence the duration of the orthodontic treatments in the CESFAM Dr. Victor Manuel Fernandez, Concepcion, Chile. A descriptive, cross-sectional, retrospective study was carried out, in which the clinical records of all patients discharged by the Orthodontists of CESFAM Dr. V.M.F. during the year 2017 were analyzed. The tabulation was performed in Microsoft Excel and the statistical analysis was carried out in InfoStat 17. In total, 246 patients were included, with an average age of admission of 13.6 years. The predominant malocclusion was Class I of Angle (71 %). These patients had an average treatment duration of 33.9 months. It was further concluded that the length of orthodontic treatment, was also affected by the increased number of times patients failed to show for treatment.


Subject(s)
Humans , Male , Female , Adolescent , Community Health Centers , Orthodontic Appliances, Fixed , Molar , Appointments and Schedules , Database Management Systems/instrumentation , Software , Chile , Public Health , Models, Statistical , Treatment Outcome , No-Show Patients/statistics & numerical data , Duration of Therapy , Malocclusion
19.
Av. enferm ; 37(2): 198-207, mai.-ago. 2019. graf
Article in Portuguese | LILACS, BDENF, COLNAL | ID: biblio-1038776

ABSTRACT

Resumo Objetivo: compreender o quotidiano nas salas de vacinação sob a ótica do profissional de Enfermagem. Materiais e métodos: estudo de casos múltiplos holístico-qualitativo, fundamentado na sociologia compreensiva do quotidiano com 56 participantes de quatro microrregiões da Região Ampliada Oeste de Minas Gerais, Brasil. Resultados: a falta de vacina, a informatização, a comunicação e o horário de funcionamento da sala de vacinação interferem no quotidiano e na assistência prestada ao usuário. As ações realizadas na sala de vacinação implicam diretamente na confiança que os usuários têm no profissional. Surge a integralidade da atenção na sala de vacinação e esse espaço como um lugar para a construção do vínculo. Conclusões: aspectos inerentes ao profissional e à estrutura, organização, apoio e educação permanente influenciam o quotidiano do trabalho seguro na vacinação e nas coberturas vacinais. Faz-se necessário incorporar a supervisão sistematizada do enfermeiro nas salas de vacinação e a educação permanente dos profissionais.


Resumen Objetivo: comprender la cotidianidad de las salas de vacunación desde la óptica del profesional de enfermería. Materiales y métodos: estudio de casos múltiples holístico-cua-litativo, fundamentado en la sociología comprensiva y de lo cotidiano con 56 participantes de cuatro micro-rregiones de la Región Ampliada Oeste de Minas Gerais, Brasil. Resultados: la falta de vacunación, la informatización, la comunicación y el horario de funcionamiento de la sala de vacuna interfieren en la vida cotidiana y en la asistencia al usuario. Las acciones en sala de vacuna implican directamente la confianza de los usuarios hacia el profesional. Surge la integralidad de la atención en la sala de vacuna y ese espacio como un lugar para la construcción del vínculo. Conclusiones: aspectos inherentes al profesional y a la estructura, organización, apoyo y educación permanente influyen en la cotidianidad del trabajo seguro en vacunación y en las coberturas vacunales. Se hace necesario incorporar la supervisión sistematizada del enfermero en las salas de vacuna y la educación permanente de los profesionales.


Abstract Objective: to understand the everyday life in the vaccination rooms from the perspective of the nursing professional. Materials and methods: study of holistic and qualitative multiple cases, based on comprehensive and everyday life sociology, with 56 participants from four microregions of the Expanded West Region of Minas Gerais, Brazil. Results: the lack of vaccination, computerization, communication and operation schedule of vaccination room interfere in the everyday life and in the assistance to the user. Actions in vaccination room directly involve confidence from users towards professional. There arises the integrality of attention in the vaccination room, and that space as a place for the construction of the link. Conclusions: aspects inherent to the professional and the structure, organization, support and continuing education influence the everyday life of the safe work on vaccination and vaccine coverage. It is necessary to incorporate the systematic supervision of the nurse in the vaccination rooms and continuing education of professionals.


Subject(s)
Humans , Appointments and Schedules , Attention , Brazil , Vaccines , Vaccination , Vaccination Coverage , Trust , Nurses
20.
Ciênc. Saúde Colet ; 24(5): 1915-1923, Mai. 2019. tab, graf
Article in English | LILACS | ID: biblio-1001815

ABSTRACT

Abstract Missed appointments have a great economic, social and administrative impact on the management of public health services. This research aimed to study factors associated with non-attendance to the first appointments of pediatric patients in secondary dental care services in the city of Curitiba, Brazil. A cross-sectional study was performed using secondary data from the electronic health records of the Curitiba Municipal Secretary of Health. The study included all children (0-12 years) referred to secondary dental clinics in the years 2010 to 2013. Data were analyzed by the chi-square test and Pearson linear trend chi-square (α = 0.05). Binary logistic regression models were built. Data from 1,663 children were assessed and the prevalence of non-attendance was 28.3%. The variables associated with the non-attendance in inferential analysis (p < 0.05) and in the final model were the household income per capita (95% CI: 1.93-2.82) and the waiting time in virtual queue (95% CI: 1.000-1.002). Socioeconomic aspects and the waiting time in virtual queue, should be considered in the strategic planning of health services as they may influence the attendance of pediatric patients in secondary dental referral service.


Resumo O não comparecimento a consultas tem um grande impacto no gerenciamento dos serviços de saúde pública. O objetivo foi avaliar os fatores associados ao não comparecimento às primeiras consultas de pacientes pediátricos nos serviços de atenção secundária em saúde bucal na cidade de Curitiba, Brasil. Um estudo transversal foi desenvolvido com dados secundários obtidos de cadastros eletrônicos da Secretaria Municipal de Saúde de Curitiba. Participaram crianças de 0 a 12 anos de idade encaminhadas para atenção secundária nos anos de 2010 a 2013. Os dados foram analisados pelos testes de qui-quadrado de Pearson e qui-quadrado de tendência linear (α = 0,05). Foram constituídos modelos de regressão logística binária. Foram analisados os dados de 1.663 crianças. A prevalência de não comparecimento às primeiras consultas foi de 28,3%. As variáveis que estiveram associadas ao não comparecimento na análise inferencial (p < 0,05) e no modelo final foram a renda per capita familiar (95% CI: 1,93-2,82) e o tempo de espera em fila virtual (95% CI: 1,000-1,002). Aspectos econômicos e o tempo de espera em fila virtual devem ser considerados no planejamento estratégico dos serviços públicos de saúde bucal, pois podem influenciar o comparecimento de pacientes na atenção secundária.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Appointments and Schedules , Waiting Lists , Dental Care/statistics & numerical data , No-Show Patients/statistics & numerical data , Referral and Consultation , Socioeconomic Factors , Time Factors , Secondary Care , Brazil , Cross-Sectional Studies , Electronic Health Records
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