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Participação do usuário com diabetes mellitus tipo 2 na produção de cuidado na rede de atenção básica; Participation of the patient with type 2 diabetes mellitus in the primary health care

Oliveira, Nunila Ferreira de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 18/12/2014 PT
Relevância na Pesquisa
46.08%
A prevalência do Diabetes mellitus tipo 2 (DM2) está em ascensão por todo mundo; no Brasil é considerado um problema de saúde pública. O tratamento visa controle glicêmico e depende prioritariamente de mudanças de hábitos de vida - tratamento não medicamentoso (TNM), podendo associar terapêutica medicamentosa (TM), e requer acompanhamento contínuo de saúde. Esse acompanhamento deve ser realizado prioritariamente nos serviços de Atenção Básica, com suporte de outros pontos da rede de atenção à saúde quando necessário. O presente trabalho tem objetivo de analisar a participação das pessoas com DM2 no processo de cuidado frente acompanhamento em uma Unidade Básica de Saúde (UBS), localizada no município de Ribeirão Preto, SP. Pesquisa quantiqualitativa, norteada pelo referencial teórico do processo de trabalho em saúde, com coleta de dados realizada em duas etapas: a primeira com obtenção de dados a partir das fichas de cadastro do HIPERDIA da UBS Amendoeira em Flor e segunda, realizada junto a pessoas cadastradas no HIPERDIA e com consulta médica agendada, sendo convidadas 64 pessoas, e após a utilização de critérios de exclusão e o consentimento destas, permaneceram 25 pessoas junto com as quais foi realizada coleta de dados por meio de observação não participante de atendimento na UBS e entrevista semiestruturada no domicílio. Para a realização da pesquisa...

Partners or partisans? Patient participation at Marylebone Health Centre.

Pietroni, P; Chase, H D
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /08/1993 EN
Relevância na Pesquisa
46.14%
This paper outlines some of the issues which arose for patients and professionals involved in patient participation projects at the Marylebone health centre in London. It describes the projects undertaken and focuses on the practical implications of working with rather than for patients. Dilemmas surrounding patient participation are discussed, including the ways volunteers are rewarded, how doctors and patients can share knowledge, how participation is affected by professional boundaries, and why a regular group meeting may not necessarily be the best way to involve patients in decision making. The successes of patient participation are also highlighted.

Increasing patient participation using an extended consultation: an inner city study

Bird, Anthony; Cobb, Jenny; Walji, Mohamed T.I.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /05/1988 EN
Relevância na Pesquisa
46.08%
An inner city practice in Birmingham has developed a new style of extended consultation to increase patient participation in primary care, based on previous initiatives in the practice, in particular allowing patients access to medical records, adopting an open reception style, and including consultations with a nurse practitioner. In a three stage consultation lasting approximately 30 minutes patients were offered a session with a receptionist for assisted access to medical records, a session of 15-20 minutes with a doctor or nurse and a self help session with a receptionist. This extended consultation was welcomed by patients, who showed a marked degree of participation, and it also increased the satisfaction and cooperation of project staff. This type of consultation provides a model for increasing patient participation in general practice.

What the patient wants from patient participation

Hutton, Alan; Robins, Sally
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /03/1985 EN
Relevância na Pesquisa
45.96%
In a general practice with an existing patient participation group, a survey of patients was undertaken to ascertain knowledge of and interest in the group. It was hoped that this might avoid the failure that had befallen other groups of this type. Analysis of the questionnaire provided useful information: there was interest in the group, with a potential attendance of almost three-quarters of the respondents. There was a clear lack of knowledge about the functions of the group, but the evidence was that if the desired activities were to be arranged and publicized they would be well attended.

Patient participation in primary health care

Graffy, Jonathan P.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /09/1980 EN
Relevância na Pesquisa
66.16%
Patient participation groups have been established in about 20 practices, six of which were visited. They did not conform to a particular model but each had adapted to local circumstances. As well as giving patients a say in the practice, they were involved in health education, voluntary work, and campaigns for better secondary care facilities, although these activities were influenced by the way the groups were elected. The emphasis was on participation rather than patient power and their constructive approach to improve services made patient participation a valuable innovation.

Promoting patient participation and shortening cancer consultations: a randomised trial

Brown, R F; Butow, P N; Dunn, S M; Tattersall, M H N
Fonte: Nature Publishing Group Publicador: Nature Publishing Group
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.01%
Patient participation in medical consultations has been demonstrated to benefit their subsequent psychological well being. Question asking is one way in which patients can be active. We investigated 2 means of promoting cancer patient question asking. One was the provision of a question prompt sheet to patients prior to their initial consultation with their oncologist. The second was the active endorsement and systematic review of the question prompt sheet by their oncologist. 318 patients with heterogeneous cancers, seeing one of 5 medical and 4 radiation oncologists for the first time, were randomised to either receive or not receive a question prompt sheet. Doctors were randomised to either proactively address or passively respond to the question prompt sheet in the subsequent consultation. Anxiety was assessed prior to the consultation. Consultations were audiotaped and content analysed. Anxiety was assessed again immediately following the consultation. Within the next 10 days patients completed questionnaires assessing information needs, anxiety and satisfaction and were given a structured telephone interview assessing information recall. Patients provided with a question prompt sheet asked more questions about prognosis compared with controls and oncologists gave significantly more prognostic information to these patients. Provision of the question prompt sheet prolonged consultations and increased patient anxiety; however...

Reconsidering Patient Participation in Guideline Development

van de Bovenkamp, Hester M.; Trappenburg, Margo J.
Fonte: Springer US Publicador: Springer US
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.13%
Health care has become increasingly patient-centred and medical guidelines are considered to be one of the instruments that contribute towards making it so. We reviewed the literature to identify studies on this subject. Both normative and empirical studies were analysed. Many studies recommend active patient participation in the process of guideline development as the instrument to make guidelines more patient-centred. This is done on the assumption that active patient participation will enhance the quality of the guidelines. We found no empirical evidence, however, to support this assumption. Moreover, the studies show that patients experience several difficulties in the participation process, which cannot solely be traced back to flawed practices. Given this poor track record we conclude that the plea to actively involve patients in the guideline development process should be reconsidered.

Patient Participation: Current Knowledge and Applicability to Patient Safety

Longtin, Yves; Sax, Hugo; Leape, Lucian L.; Sheridan, Susan E.; Donaldson, Liam; Pittet, Didier
Fonte: Mayo Foundation for Medical Education and Research Publicador: Mayo Foundation for Medical Education and Research
Tipo: Artigo de Revista Científica
Publicado em /01/2010 EN
Relevância na Pesquisa
46.28%
Patient participation is increasingly recognized as a key component in the redesign of health care processes and is advocated as a means to improve patient safety. The concept has been successfully applied to various areas of patient care, such as decision making and the management of chronic diseases. We review the origins of patient participation, discuss the published evidence on its efficacy, and summarize the factors influencing its implementation. Patient-related factors, such as acceptance of the new patient role, lack of medical knowledge, lack of confidence, comorbidity, and various sociodemographic parameters, all affect willingness to participate in the health care process. Among health care workers, the acceptance and promotion of patient participation are influenced by other issues, including the desire to maintain control, lack of time, personal beliefs, type of illness, and training in patient-caregiver relationships. Social status, specialty, ethnic origin, and the stakes involved also influence patient and health care worker acceptance. The London Declaration, endorsed by the World Health Organization World Alliance for Patient Safety, calls for a greater role for patients to improve the safety of health care worldwide. Patient participation in hand hygiene promotion among staff to prevent health care—associated infection is discussed as an illustrative example. A conceptual model including key factors that influence participation and invite patients to contribute to error prevention is proposed. Further research is essential to establish key determinants for the success of patient participation in reducing medical errors and in improving patient safety.

Participatory decision making, asthma action plans, and use of asthma medication: A population survey

Adams, R.; Appleton, S.; Wilson, D.; Ruffin, R.
Fonte: Marcel Dekker Inc Publicador: Marcel Dekker Inc
Tipo: Artigo de Revista Científica
Publicado em //2005 EN
Relevância na Pesquisa
45.98%
Use of controller asthma medication and possession of asthma action plans remains suboptimal. Our aim was to investigate the association of the propensity of physicians to involve patients in their care (participatory decision-making style) and their asthma management in a representative population sample of 3015 adults. Current doctor-diagnosed asthma was reported by 393 (13.0%). People who rated their doctors as more participatory were significantly more likely to report more regular use of controller medications and possession of a written asthma action plan, but not less asthma morbidity. Possession of a written action plan was associated with more participatory interactions (OR 2.3; 95% CI 1.1– 4.7, for upper tertile scores compared to lowest tertile); more severe symptoms (OR 4.8; 95% CI 1.7–13.0), being female (OR 2.2; 95% CI 1.2– 4.3), those with higher education, and residence outside the metropolitan area (OR 2.1; 95% CI 1.1– 4.0). Increasing patient participation in their own care is associated with better asthma management, independent of asthma symptoms. Longitudinal studies are needed to examine if increasing participation in decisions can also improve asthma outcomes.; Robert J. Adams, Sarah Appleton, David H. Wilson and Richard E. Ruffin; This is an electronic version of an article published in Journal of Asthma...

An advance notification letter increases participation in colorectal cancer screening

Cole, S.; Smith, A.; Wilson, C.; Turnbull, D.; Esterman, A.; Young, G.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2007 EN
Relevância na Pesquisa
46.13%
Objectives: To determine the impact of novel invitation strategies on population participation in faecal immunochemical test (FIT)-based colorectal cancer (CRC) screening. Setting A community screening programme in Adelaide, South Australia. Methods: In total, 2400 people aged 50–74 years were randomly allocated to one of four CRC screening invitation strategies: (a) Control: standard invitation-to-screen letter explaining risk of CRC and the concept, value and method of screening; (b) Risk: invitation with additional messages related to CRC risk; (c) Advocacy: invitation with additional messages related to advocacy for screening from previous screening programme participants and (d) Advance Notification: first, a letter introducing Control letter messages followed by the standard invitation-to-screen. Invitations included an FIT kit. Programme participation rates were determined for each strategy relative to control. Associations between participation and sociodemographic variables were explored. Results: At 12 weeks after invitation, participation was: Control: 237/600 (39.5%); Risk: 242/600 (40.3%); Advocacy: 216/600 (36.0%) and Advance Notification: 290/600 (48.3%). Participation was significantly greater than Control only in the Advance Notification group (Relative risk [RR] 1.23...

Demographic, social cognitive and social ecological predictors of intention and participation in screening for colorectal cancer

Gregory, T.; Wilson, C.; Duncan, A.; Turnbull, D.; Cole, S.; Young, G.
Fonte: BioMed Central Ltd. Publicador: BioMed Central Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
46.08%
Background: Previous research points to differences between predictors of intention to screen for colorectal cancer (CRC) and screening behavior, and suggests social ecological factors may influence screening behavior. The aim of this study was to compare the social cognitive and social ecological predictors of intention to screen with predictors of participation. Methods: People aged 50 to 74 years recruited from the electoral roll completed a baseline survey (n = 376) and were subsequently invited to complete an immunochemical faecal occult blood test (iFOBT). Results: Multivariate analyses revealed five predictors of intention to screen and two predictors of participation. Perceived barriers to CRC screening and perceived benefits of CRC screening were the only predictor of both outcomes. There was little support for social ecological factors, but measurement problems may have impacted this finding. Conclusions: This study has confirmed that the predictors of intention to screen for CRC and screening behaviour, although overlapping, are not the same. Research should focus predominantly on those factors shown to predict participation. Perceptions about the barriers to screening and benefits of screening are key predictors of participation...

Patient participation in general practice: who participates?

Agass, M; Coulter, A; Mant, D; Fuller, A
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /05/1991 EN
Relevância na Pesquisa
46.03%
A postal survey of 4066 men and women aged between 16 and 64 years was carried out in a general practice in Oxfordshire which had a patient participation group, established in 1972. The aim of the survey was to ascertain the knowledge and use of the group among adults aged 16-64 years. The adjusted response rate was 73%. Despite the length of the group's existence only 45% of these patients were aware of it and only 7% had ever attended a meeting. Awareness of the group and sometime attendance were significantly less in men, patients aged between 16 and 29 years, those in social classes 4 and 5, single people and those who smoked. Patients who consulted more than four times per year were more likely to be aware of the group than less frequent consulters. The possible reasons for the unrepresentative nature of the patients attending the group are discussed, together with implications for practice policies and development. Various strategies for making the group more representative are proposed, including advertising within the practice and elsewhere, and the formation of special interest groups for patients with defined medical and social needs, in the hope that this will make the concept of patient participation more relevant.

Why patient participation groups stop functioning: general practitioners' viewpoint.

Mann, R G
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 19/01/1985 EN
Relevância na Pesquisa
46.03%
Out of the 87 patient participation groups that were known to the National Association for Patient Participation as having been established by the end of 1983, 17 (25%) are not functioning. The general practitioners concerned with these non-functioning groups were interviewed to identify problems that they had had in keeping the group going and to seek possible explanations for the problems. Fourteen of the groups had stopped functioning in part owing to lack of interest by patients. Groups become non-functioning often in the first year of starting up, and this may be because of the nature of the practice population that they seek to represent.

Clinician and cancer patient views on patient participation in treatment decision-making: a quantitative and qualitative exploration

Pieterse, A H; Baas-Thijssen, M C M; Marijnen, C A M; Stiggelbout, A M
Fonte: Nature Publishing Group Publicador: Nature Publishing Group
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.22%
Patient participation in treatment decision-making is being increasingly advocated, although cancer treatments are often guideline-driven. Trade-offs between benefits and side effects underlying guidelines are made by clinicians. Evidence suggests that clinicians are inaccurate at predicting patient values. The aim was to assess what role oncologists and cancer patients prefer in deciding about treatment, and how they view patient participation in treatment decision-making. Seventy disease-free cancer patients and 60 oncologists (surgical, radiation, and medical) were interviewed about their role preferences using the Control Preferences Scale (CPS) and about their views on patient participation using closed- and open-ended questions. Almost all participants preferred treatment decisions to be the outcome of a shared process. Clinicians viewed participation more often as reaching an agreement, whereas 23% of patients defined participation exclusively as being informed. Of the participants, ⩾81% thought not all patients are able to participate and ⩾74% thought clinicians are not always able to weigh the pros and cons of treatment for patients, especially not quality as compared with length of life. Clinicians seemed reluctant to share probability information on the likely impact of adjuvant treatment. Clinicians should acknowledge the legitimacy of patients' values in treatment decisions. Guidelines should recommend elicitation of patient values at specific decision points.

Patients' Perceptions of Nurses' Behaviour That Influence Patient Participation in Nursing Care: A Critical Incident Study

Larsson, Inga E.; Sahlsten, Monika J. M.; Segesten, Kerstin; Plos, Kaety A. E.
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.13%
Patient participation is an important basis for nursing care and medical treatment and is a legal right in many Western countries. Studies have established that patients consider participation to be both obvious and important, but there are also findings showing the opposite and patients often prefer a passive recipient role. Knowledge of what may influence patients' participation is thus of great importance. The aim was to identify incidents and nurses' behaviours that influence patients' participation in nursing care based on patients' experiences from inpatient somatic care. The Critical Incident Technique (CIT) was employed. Interviews were performed with patients (n = 17), recruited from somatic inpatient care at an internal medical clinic in West Sweden. This study provided a picture of incidents, nurses' behaviours that stimulate or inhibit patients' participation, and patient reactions on nurses' behaviours. Incidents took place during medical ward round, nursing ward round, information session, nursing documentation, drug administration, and meal.

Professional attitudes to patient participation groups: an exploratory study

Wood, J.; Metcalfe, D. H. H.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /09/1980 EN
Relevância na Pesquisa
66.11%
An exploratory study of the development of patient participation groups in general practice and general practitioners' attitudes towards them suggests that many general practitioners may not yet be aware of this innovation and may at first react negatively to the idea. This response stems in part from misconceptions about the origins and functions of these groups, a failure to see their relevance to professional objectives, and a fear that they will threaten general practitioners' autonomy and status. In contrast, general practitioners who have formed groups believe they have an important contribution to make to their developing role and have been encouraged by their experience so far. Therefore, at present, patient participation groups should neither be rejected out of hand, nor welcomed as a panacea.

Patient Participation in Surgical Treatment Decision Making from the Patients' Perspective: Validation of an Instrument

Heggland, Liv-Helen; Øgaard, Torvald; Mikkelsen, Aslaug; Hausken, Kjell
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.03%
The aim of this paper is to describe the development of a new, brief, easy-to-administer self-reported instrument designed to assess patient participation in decision making in surgical treatment. We describe item generation, psychometric testing, and validity of the instrument. The final scale consisted of four factors: information dissemination (5 items), formulation of options (4 items), integration of information (4 items), and control (3 items). The analysis demonstrated a reasonable level of construct validity and reliability. The instrument applies to patients in surgical wards and can be used to identify the health services that are being provided and the areas that could strengthen patient participation.

Patient participation: A qualitative study of immigrant women and their experiences

Brämberg, Elisabeth Björk; Nyström, Maria; Dahlberg, Karin
Fonte: CoAction Publishing Publicador: CoAction Publishing
Tipo: Artigo de Revista Científica
Publicado em 09/02/2010 EN
Relevância na Pesquisa
46.25%
Patient participation in healthcare is a neglected area of interest in the rather extensive amount of research on immigrant so-called Selma patients in Swedish health care as well as worldwide. The aim is to explore the phenomenon “patient participation” in the context of the Swedish health care from the perspective of immigrants non-fluent in Swedish. A phenomenological lifeworld approach was chosen. Data were collected from patients within a municipal home care setting in Sweden. Eight women agreed to participate. In seven interviews, an interpreter was necessary for the translation of the interview. Five authorized interpreters were used. Data were analysed in accordance to a descriptive phenomenological method for caring research. The analysis led to an essence of the phenomenon with three constituents, “to experience participation,” “to refrain from participation,” and “to be deprived of participation.” Patient participation from the perspective of immigrant women means that patients are involved and active in their own health and caring processes. For these women, it is particularly important to have the opportunity to express themselves. Patient participation presupposes professional caregivers who act in a way that increases the patients' opportunities to take part. A skilled interpreter is often necessary in order to enable the patient participation.

Construindo a participação social no SUS: um constante repensar em busca de equidade e transformação; Building social participation on the Brazilian Health System: a constant rethinking that seeks fairness and transformation

Coelho, Juliana Sousa
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; Formato: application/pdf
Publicado em 01/05/2012 POR
Relevância na Pesquisa
46.04%
Trata-se de um ensaio que expõe reflexões sobre a busca e o exercício da participação social no Sistema Único de Saúde (SUS), compreendendo seu conceito como as diferentes ações dos grupos sociais que influenciam a formulação, execução, fiscalização e avaliação das políticas públicas. Por isso o fato de a comunidade participar no sistema de saúde é visto como condição fundamental para o exercício pleno da saúde, capaz de promover equidade e de transformar a atenção à saúde. As ações de construir a cidadania e formar sujeitos coletivos são tomadas como fundamentos para a conquista de espaços democráticos e de direitos sociais. Mapeou-se a normatização atual referente à participação popular, considerando seus avanços, mas explicitando também suas fragilidades, principalmente no que tange aos conselhos e conferências de saúde. No ambiente dos espaços institucionais de participação, foram destacados elementos necessários para consolidar e efetivar a participação popular, como a relação entre os atores e a comunicação para a socializar as informações e conhecimentos em saúde. Busca-se também problematizar o assunto, trazendo à tona alguns dos obstáculos e críticas relativos à participação social. Pretende-se...

Shared Decision Making in Breast Cancer Womens' Attitudes

Martín-Fernández,Roberto; Abt-Sacks,Analía; Perestelo-Perez,Lilisbeth; Serrano-Aguilar,Pedro
Fonte: Ministerio de Sanidad y Consumo Publicador: Ministerio de Sanidad y Consumo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2013 EN
Relevância na Pesquisa
45.99%
Background: The patient autonomy and the greater role for women with breast cancer in the decisions about their health are recent issues in healthcare. The objective of this work is to identify and characterize the elements that influence them in treatment decisions. Methods: A phenomenological type qualitative study. Theoretical Sampling included 70 women diagnosed with breast cancer. 45 semi structured interviews and 3 focus groups were performed between October 2009 and July 2010 in 15 regions of Spain. The analysis was based on the principles of grounded theory with the support of Atlas.ti v6.1. Results: Patients are likely to take an active or passive role regarding decision-making depending on different variables such as their age, the information available, their self-assessment as capable agents to make decisions and the relative importance given to physical appearance. As the disease progresses, it can cause a change in women attitude, from an initially passive attitude to a more active role. The attitude of health professionals concerning shared decision-making and the information they offer determines patient participation while the family plays an essential role as a support or reinforcement of decisions made by patients. Conclusions: The patients' attitude regarding the decision-making of patients is very variable...