Perception of nurses on the learning evaluation process in training programs in a São Paulo hospital

This study was carried out with nurses of a university hospital in S?o Paulo. It was aimed at understanding their perception regarding the learning evaluation process in the training sessions they attended. In order to collect data, the authors used an instrument with the guiding question: What's your perception of the learning evaluation process in training programs? The discourses were analyzed according to Bardin's referential in the content analysis modality. The results showed opinions in three categories: 1) the difficulties noticed in the evaluation process, in which time availability, negative feelings towards the evaluation and little concern for training results are challenges nurses have to overcome daily; 2) the methodology used in the evaluation process, which should consider the different learning styles, and the experience, life history and previous knowledge of the professionals being trained; and 3) the teaching-learning evaluation process as an accurate indicator of past actions and a quality control of the teaching methods adopted in the training sessions.     

Profile of newborns who underwent cardiac surgery in a private hospital in the city of São Paulo

The aim of this cross-sectional study was to characterize newborns that underwent cardiac surgery in a private hospital, a reference center in neonatal cardiac surgery, in the city of S? Paulo. Data were collected from medical reports from July, 2001 to December, 2005. Newborns with gestational age of more than 35 weeks were included in the study. Newborns that died on the first 48 postoperative hours and with other malformations were excluded. Most of the neonates were term, weighted 2500 grams or more, and underwent surgery in the first week of life. There were 24 different diagnoses identified and 14 different types of surgery performed. In the first post-operative day, all newborns had invasive devices for vital signs monitoring or for treatment and life support, which shows not only the complexity of the treatment but the need for planning and organizing health services in order to provide adequate care for these patients.     

Financial challenges to access tuberculosis treatment in Ribeirão Preto - São Paulo

The objective of this study was to analyze the financial challenges that patients have to deal with to access the Tuberculosis (TB) Care Reference Centers in Ribeir?o Preto. Adjustments were made to the Primary Care Assessment (PCAT) and an opinion poll was made with one-hundred patients following treatment and 16 health care professionals working at TB Reference Centers in Ribeir?o Preto. Anova, Kruskall Wallis and chi-square tests were used. Most patients were males and most health care professionals were female. Differences were found between Centers C and A, in that Center C (p=0.028) offers a bus pass, and in A (p=0.010) patients paid for their own transportation. The indicator medical appointment in 24 hours showed a satisfactory level. There were disagreements between the reports from patients and health professionals as to the center offering the bus pass. Patients face challenges in their treatment, such as costs with transportation or being late for work, which result in losses in the family income.     

Representation of pregnant smokers on cigarette use: a study carried out at a hospital in the interior of the state of São Paulo

This study sheds light on the smoking pregnant women's outlook on cigarette use. The Theory of Social Representations was used as a theoretical reference. For data analysis, the Collective Subject Discourse was constructed. Of the 27 women that were interviewed, 18 had finished elementary education, 8 had completed secondary education, and one had college level education; 14 had a stable union and 6 were married. Four themes emerged from the interviews: (1) starting to smoke: a natural, social practice; (2) satisfaction versus guilt; (3) shattering news: effects of smoking on pregnancy; and (4) quitting: between will and ability. Pregnant women revealed negative ideas about smoking, considering smoking the worst of addictions and a potential cause for complications to the fetus and the mother. Smoking was represented in a prejudicial manner, disregarding the existence of treatment and the need for it. Emerging difficulties were related to quitting, for which professionals, information and adequate approaches for treatment and support for achieving success are utmost necessities.     

Living conditions of persons with mental and behavioral disorders in a psychiatric hospital,São Paulo,Brazil

The objective of this study was to identify the conditions of life of patients with mental and behavioral disorders admitted to a specialized hospital in an inner city in the state of São Paulo, Brazil, and their possible relationship with inequities and social exclusion. The information about the conditions of life was gathered through medical records and structured interviews with the patients. The data collected were compared with the recent literature on the subject. We conclude that the conditions of health, life and social vulnerability are associated with changes in family and social relationships, stigma, discrimination and prejudice, and barriers to the exercise of citizenship for these patients. Findings confirm the need for equity in this group's access to the exercise of human rights.     

Computerized system for managing nursing care indicators at Hospital São Paulo

Indicators are tools that permit to define parameters that will be used to make comparisons between a result and its expected value, as well as to add a value of judgement in this regard. The purpose of this study is to describe the experience of a group of nurses in the development of a computerized system to manage nursing care indicators at Hospital S?o Paulo. Four stages were used to implement the indicator management system: developing a nursing care indicator handbook; performing a manually registered pilot test; developing the computerized system; and performing the pilot test of the computerized system in eleven units at the hospital.     

Blood transfusion utilization and recipient survival at Hospital das Clinicas in São Paulo, Brazil

BACKGROUND: The characteristics of blood recipients including diagnoses associated with transfusion and posttransfusion survival are unreported in Brazil. The goals of this analysis were: 1) to describe blood utilization according to clinical diagnoses and patient characteristics and 2) to determine the factors associated with survival of blood recipients. STUDY DESIGN AND METHODS: A retrospective cross‐sectional analysis was conducted on all inpatients in 2004. Data came from three sources: The first two files consist of data about patient characteristics, clinical diagnosis, and transfusion. Analyses comparing transfused and nontransfused patients were conducted. The third file was used to determine survival recipients up to 3 years after transfusion. Logistic regression was conducted among transfused patients to examine characteristics associated with survival. RESULTS: In 2004, a total of 30,779 patients were admitted, with 3835 (12.4%) transfused. These patients had 10,479 transfusions episodes, consisting of 39,561 transfused components: 16,748 (42%) red blood cells, 15,828 (40%) platelets (PLTs), and 6190 (16%) plasma. The median number of components transfused was three (range, 1‐656) per patient admission. Mortality during hospitalization was different for patients whose admissions included transfusion or not (24% vs. 4%). After 1 year, 56% of transfusion recipients were alive. The multivariable model of factors associated with mortality after transfusion showed that the most significant factors in descending order were hospital ward, increasing age, increasing number of components transfused, and type of components received. CONCLUSION: Ward and transfusion are markers of underlying medical conditions and are associated with the probability of survival. PLT transfusions are common and likely reflect the types of patients treated. This comprehensive blood utilization study, the first of its kind in Brazil, can help in developing transfusion policy analyses in South America.     

The prevalence of headache among elderly in a low-income area of São Paulo, Brazil

There are scarce data about headache prevalence and its characteristics among elderly people. The aim was to carry out a cross-sectional study to determine the 1-year prevalence of tension-type and migraine headaches in people >65 years old in the city of São Paulo, Brazil. All 1615 people living in the study catchment area who agreed to participate in the study answered a questionnaire based in the International Headache Society criteria. Prevalence (mean and 95% confidence interval) of any type of headache in the last year was 45.6% (43.2, 48.0). Prevalence of tension-type headache in the last year was 33.1% (30.8, 35.4): 28.1% (24.6, 31.6) for men and 36.4% (33.4, 39.4) for women; for migraine headaches, prevalence in the last year was 10.6% (9.1, 12.1): 5.1% (3.4, 6.8) for men and 14.1% (11.9, 16.3) for women. One-year prevalence rates of headaches, and especially of migraine headaches, are very high among the elderly in Brazil.     

Maternal and perinatal outcomes of an alongside hospital birth center in the city of São Paulo, Brazil

The aim of this study was to describe the maternal and perinatal results of care in the alongside hospital birth center Casa de Maria (CPN-CM), located in the city of S?o Paulo. The random sample included 991 women and their newborns, attended between 2003 and 2006. The results showed that 92.2% of women had a companion of her choice during childbirth and the practices commonly used were shower or immersion bath (92.9%), amniotomy (62.6%), walking (47.6%), massage comfort (29.8%) and episiotomy (25.7%). Regarding newborns, 99.9% of them had Apgar scores =7 in the fifth minute, 9.3% received aspiration of the upper airway, no one needed to be intubated and 1.4% were removed to the hospital. The model of care in the CPN-CM provides maternal and perinatal outcomes expected for low obstetric risk women, and means a safe option and less interventionist model in normal childbirth.     

Quality of life in women with HIV/AIDS in a municipality in the state of São Paulo

High potency antiretroviral therapy brings benefits to people with HIV/AIDS, related to survival, chronicity and quality of life. The objective of this quantitative and cross-sectional study was to assess the quality of life of women with HIV/AIDS, using the WHOQOL--HIV bref and its association with sociodemographic variables. The study was performed in outpatient clinics specialized in care to HIV/AIDS patients. Of the 106 interviewed women, 99.1% were heterosexual and 92.4% were infected sexually. Among the domains of quality of life, spirituality had the highest score (65.7), followed by physical (64.7), psychological (60.6), social relationships (59.5). Level of independence (58.6) and environment (54.5) scored the lowest. The factors low socioeconomic and educational levels were associated with different domains of quality of life, showing the relationship between quality of life and living conditions. Challenges persist in the scope of social, affective and financial relations, which require effective interventions regarding empowerment of women with HIV/AIDS.     

Physical disability,recent illnesses and health self-assessment in a population-based study in São Paulo,Brazil

Objectives.?To investigate health self-assessment and to estimate the prevalence of chronic diseases and recent illnesses in people with and without physical disabilities (PD) in the state of São Paulo, southeastern Brazil.

Study design.?A Cross-sectional study comprising two population-based health surveys conducted in 2002 and 2003.

Methods.?A total of 8317 persons (165 with PD) were interviewed in the two studies. Variables concerning to health self-assessment; chronic disease and recent illness were compared in the people with and without PD. Negative binomial regression was used in the analysis.

Results.?Subjects with PD more often assessed their health as poor/very poor compared to non-disabled ones. They reported more illnesses in the 15 days prior to interview as well as more chronic diseases (skin conditions, anaemia, chronic kidney disease, stroke, depression/anxiety, migraine/headache, pulmonary diseases, hypertension, diabetes, arthritis/arthrosis/rheumatic conditions and heart disease). This higher disease prevalence can be either attributed to disability itself or be associated to gender, age and schooling.

Conclusions.?Subjects with PD had more recent illnesses and chronic diseases and poorer health self-assessment than non-disabled ones. Age, gender, schooling and disability have individual roles in disease development among disabled people.     

Implementation of computerized material management system at the University of São Paulo University Hospital

This is an experience report on the process of implementing a computerized materials management system at the University Hospital of the University of S?o Paulo. The system was called Materials Management System (SGM). The process comprised four phases: choice of the model and information tool; restructuring of the logistic materials process at the hospital; restructuring of the support areas and establishment of the SGM system itself. A study carried out at the Surgical Center after the establishment demonstrated that, when comparing materials consumption and inventories in the SGM with the Traditional System, the consumed quantity and the cost of inventory materials at the Unit decreased.     

Adult ostomy patients in the city of São Paulo: a study of specialized equipment costs

This study was aimed at analyzing the monthly cost of the use of specialized equipment by ostomy patients. It is a retrospective study carried out at two Outpatient Health Centers in S?o Paulo. The data were collected in 635 records of adult ostomy patients assisted in June of 2005. For the costs, the data were obtained in electronic databases and official publications from the State of S?o Paulo Health Secretary, and the results were submitted to the Kolmogorov-Smirnov, Mann-Whitney, Kruskal-Wallis, Bonferroni and Spearman tests. Most of the individuals were female (51%), aged > or = 60 years, with temporary colostomy (64.5%). The average monthly cost was US$ 51.0 per patient, higher for cancer urostomy patients with permanent stomas, with neoplasia in the urinary tract and assisted by the service with a therapist nurse. Statistically significant correlation between the monthly cost and the time with stoma was found. This study has contributed for the assessment of the cost of ostomy patients in the State of S?o Paulo.     

Nursing work at a day hospital in João Pessoa-Paraíba from the perspective of the psychiatric reform

This is the report of an investigation that was carried out in order to apprehend themes that explain nursing work at a day hospital in Jo?o Pessoa, State of Paraíba, in the perspective of the psychiatric reform. The authors used the referential of dialectical and historical materialism and work as an analytical category. The empirical material was analyzed through the technique of discourse analysis. The study revealed a coincident theme--to change the model of traditional psychiatric assistance--and, in this sense, the work of nursing incorporates, in addition to its formal, technically specialized quality, a political quality, thus indicating a new meaning to the nursing work process.