Mestrado em Ciências da Saúde (FM)
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Navegando Mestrado em Ciências da Saúde (FM) por Por Orientador "Amaral, Rita Goreti"
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Item Impacto da educação permanente dos profissionais de saúde no rastreamento do câncer do colo do útero em unidades básicas de saúde(Universidade Federal de Goiás, 2014-03-14) Amaral, Ariadne Ferreira; Tavares, Suelene Brito do Nascimento; http://lattes.cnpq.br/9547970481617204; Amaral, Rita Goreti; http://lattes.cnpq.br/3665611660713029; Amaral, Rita Goreti; Guimarães, Janaína Valadares; Ferreira, Tatyana Xavier Almeida MatteucciThe quality of cytopathology womb cervix test is important to ensure the functionality of an organized screening program. Objectives: Evaluate the impact of training of health professionals involved in the screening for cervical cancer in basic health units. Methods: Intervention study developed based on information from the requisition forms of cytopathology tests of women attending seven basic health units in the city of Goiânia-GO. The variables were the woman personal data, anamnesis, clinical examination and the identification of responsible professional for the collection, in the request form for the cytopathology womb cervix test. 21,344 requisition forms were analyzed, of these, 10,672 forms are related the period from January 2007 to April 2009, before the training, and the other 10,672 are for the period July 2010 to December 2012, after the training. Evaluating the impact of training was conducted by comparing the information contained in the requisition forms of cytopathology tests. The training conducted with health professionals was related to filling in the requisition form, collection of cytopathology test, adequacy of the sample, representation of the epithelium and conducts clinics for screening of cervical cancer having as reference the standards of the Ministry of Health. To evaluate the results of the training we used a Pearson chi-square test with significance level p < 0.05. Results: After the training there was a significant increased frequency of school completion, from 67.2% to 92.6% (p < 0.001), the telephone from 78.9% to 98.7% (p < 0.001). Cervical inspection from 86.8% to 96.6% (p < 0.001), and STDs suggestive signs, from 80.8% to 93.5% (p < 0.001). There was a reduction in the exam frequency of less than one year (p < 0.001) and one year of intervals (p < 0.001). There was a reduction in the frequency of Pap smear testing in women under 25 years of age, from 22.0% to 17.9% (p < 0.001). There was a significant increase in the proportion of satisfactory samples from 70.4% to 80.2% (p < 0.001). It was observed a reduction of obscuring factors. The desiccation frequency was 2.9% before training and 2.0% after training (p < 0.001). There was an increase in the frequency representation of endocervical cells from 79.5% to 88.5% (p < 0.001).Conclusions: After the training conducted with health professionals observed a significant improvement in completing the requisition form and Pap smear testing as the frequency and age, recommended by the Ministry of Health. Regarding the Abstract adequacy of the sample there was an increase of satisfactory samples, reducing obscuring factors and better representation of squamous and glandular epithelium.Item Impacto da atenção farmacêutica na qualidade de vida e no perfil clínico de pacientes com hipertensão arterial assistidos pela estratégia saúde de família(Universidade Federal de Goiás, 2013-10-11) Aquino, Aline Teixeira de; Lima, Dione Marçal; http://lattes.cnpq.br/4310011929664114; Amaral, Rita Goreti; http://lattes.cnpq.br/3665611660713029; Amaral, Rita Goreti; Garrote, Clévia Ferreira Duarte; Zampieri , Ana Lúcia Teixeira de CarvalhoIntroduction: Pharmaceutical care is a practice model that allows direct interaction between the pharmacist and the patient and the healthcare team. This practice uses the pharmacotherapeutic follow-up as a tool in the identification and resolution of Drug Related Problems, which can contribute to rational drug use and collaborate with achieving positive clinical outcomes that minimize the physical and psychosocial impact that chronic diseases and their treatment can promote the quality of life of patients. Objective: The aim of this study was to evaluate the impact of pharmaceutical care on quality of life and on clinical profile of patients with hypertension, assisted by the Family Health Strategy. Methods: Was conducted a longitudinal intervention study involving 29 patients with hypertension who were assisted by the Family Health Strategy of two Basic Health Units at the sanitary district north in the city of Goiânia - GO. They received pharmacotherapeutic follow-up for 12 months, through systematized, pre-schedule and documented home visits. Were included patients that had at least two of the following inclusion criteria: blood pressure greater than or equal to 140x90 mm Hg, using three or more drugs, change in the therapeutic regimen two or more times in the last year , presence of co-morbidities, and history of non-adherence to antihypertensive therapy. Data collection was performed using follow-up pharmacotherapeutic reports, visits reports and form registration of clinical and laboratory parameters, “Mini Cuestionario de Calidad de Vida en Hipertensión Arterial” (Minichal) and Morisky-Green-Levine Questionnaire. The variables studied were the socio economic and demographic profile, clinical profile, lifestyle, Drug Related Problems, adherence to antihypertensive therapy and quality of life. For descriptive statistics were used mean, standard deviation and measures of absolute and relative frequency. For statistical tests were used the McNemar parametric test, odds ratio, and linear mixed models, generalized mixed models, linear mixed models. The threshold for statistical significance set at p <0.05, with a confidence interval of 95%.Results: The results showed that there was a reduction in the number of drug-related problem of security, increased self-reported adherence to antihypertensive treatment. There was improvement in quality of life related to the somatic manifestations domain and its correlation with the reduction in the number of drug-related problem of security. There was a significant reduction in abdominal circumference of female patients, there were found correlation between the quality of life for the somatic manifestations domain and the clinical outcomes of diastolic blood pressure, triglycerides and abdominal circumference. Just the diastolic blood pressure showed correlated with mental state domain of quality of life. There was a positive correlation between interventions directed to the patient related with the medications domain and the changes in the clinical results for fasting glucose. The life style domain presented correlation with systolic and diastolic blood pressure. Conclusions: The results showed that the pharmaceutical care reduced the number of security Drug Related Problems, improved quality of life related to the somatic manifestations domain. There was an increase in adherence to antihypertensive treatment declared by patients; however this did not influence the improvement of quality of life. Furthermore, the results revealed that there was a significant reduction in the women's measures abdominal circumference; that the pharmaceutical interventions directed to the patient influenced in the clinical results of fasting glucose, systolic and diastolic blood pressure; and that the changes observed in the clinical outcomes of diastolic blood pressure, triglycerides and abdominal circumference impacted on the quality of life related to the somatic manifestations.Item Avaliação do impacto da implantação do método de revisão rápida de 100% na garantia da qualidade dos exames citopatológicos do colo do útero(Universidade Federal de Goiás, 2016-03-17) Magalhães, Juliana Cristina; Manrique, Edna Joana Cláudio; http://lattes.cnpq.br/7574704691846518; Amaral, Rita Goreti; http://lattes.cnpq.br/3665611660713029; Amaral, Rita Goreti; Tavares, Suelene Brito do Nascimento; Guimarães, Janaina ValadaresBackground: One of the big problems that cytopathology laboratories face in their routine are false negative (FN). A way to minimize these FN results and increase the Pap smears sensitivity is the implementation of methods of internal quality control. Objective: To evaluate the impact of the implementation of 100% rapid review method (RR 100%) in the Pap smears quality assurance, checking the cytopathology results, the FN results detection frequency and quality indicators. Methods: Cross-sectional study whose sample was composed of the number of tests performed in the years 2004 (4.943) and 2013 (6.278) totaling 11,221 tests, using data from the Information System Cervical Cancer. The quality internal control information were collected from the archives of the center of clinical analyses. Were evaluated the variables: cytopathology results, FN results’ detection frequency and quality indicators [positivity rate, percentage of tests compatible with atypical squamous among abnormal tests (%ASC/abnormal tests), atypical squamous/squamous intraepithelial lesion ratio (ASC/SIL) and percentage of tests compatible with high-grade squamous intraepithelial lesion (%HSIL/satisfactory)]. The variables were analyzed in the year that was implemented the RR 100%, 2004, and after ten years of implementation, 2013, and were analyzed descriptively through the absolute and relative frequencies. To check the impact of the implementation of RR 100% was used chi-square test with 5% significance level. Results: From the 4,943 cytopathology tests performed in 2004, 4,818 (97,47%) were satisfactory and 125 (2,53%) were unsatisfactory. In the year 2013, 6,278 tests were analyzed, 6,050 (96,37%) satisfactory and 228 (3,63%) unsatisfactory for analysis. The borderline atypia, atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells, cannot exclude a high-grade squamous intraepithelial lesion (ASC-H) increased from 1.00% and 0.10%, respectively, in 2004 to 2.93% and 3.37%, respectively, in 2013. High-grade squamous intraepithelial lesion (HSIL) increased from 0.64% in 2004 to 4.55% in 2013. From the 275 tests classified as HSIL in 2013, 20 (7,27%) were identified by the RR 100%. Thirty (16,95%) of 177 ASC-US, 37 (18,14%) of 204 ASC-H and 13 (8,07%) of 161 low-grade squamous intraepithelial lesion, were also identified through RR 100%. There was a significant increase (p ≤ 0.05) in the FN results detection frequency categorized as ASC-US and ASC-H and as HSIL after ten years of implementation of the RR 100%. About the quality indicators, the positivity rate increased from 3.9% to 13.7%. The %ASC/abnormal tests and ASC/SIL increased from 28.2% and 0.4 respectively, to 45.8%, and 0.9, respectively. The %HSIL/satisfactory increased from 0.6% to 4.5%. Conclusions: the results of this study showed that RR 100% method is efficient to ensure the Pap smears quality, with an improvement in the detection of atypical and precursor lesions, and in the quality indicators.