Estudo de caso sobre uma inovação proposta no âmbito do ensino das ciências sociais e da saúde na Universidade Federal do Rio de Janeiro, cuja relevância se evidencia pela aproximação dos segmentos ensino e serviço, e pela utilização de metodologias ativas de aprendizagem no ensino de graduação. Foram analisados cinquenta questionários que correspondem a 100% do universo pesquisado, preenchidos ao término do curso pelos estudantes que cursaram a disciplina Políticas Públicas de Saúde Mental no primeiro semestre de 2007. O estudo busca identificar a eficácia do método adotado e da articulação com a rede de assistência no alcance dos objetivos propostos no programa da disciplina.
OBJECTIVE: It was to evaluate the relationships between fatigue and excessive daytime sleepiness, sleep quality, depression and anxiety. METHODS: This was a cross-sectional study on 98 unselected adult patients with epilepsy (PWE) at a tertiary center. It used clinical-sociodemographic characteristics, fatigue measured by the SF-36 vitality subscale (VsSF-36) and the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index and Beck Depression and Anxiety Inventories. RESULTS: We observed that our patients presented vitality or fatigue similar to drivers with chronic headaches evaluated in the same city. Fatigue was related to depression, anxiety and sleep quality, but not to daytime sleepiness. A multiple linear regression analysis was conducted and we observed that fatigue was independently correlated with depression and quality of sleep. However, no significant difference was observed regarding seizure frequency or number of antiepileptic drugs. CONCLUSION: Fatigue needs to be studied more in PWE, and its risk factors need to be controlled, along with sleep quality and psychiatric disorders.
Rio de Janeiro State has one of the largest networks of psychiatric hospitals in Brazil, one of them the Dr. Eiras Paracambi Hospital (CSDE-P). In late 2000, the current Mental Health Advisory Division of the Rio de Janeiro State Health Department conducted a clinical and psychosocial census of patients hospitalized in the CSDE-P. The hospital population consisted of 1,494 individuals, the majority men (53.4%), single (81.6%), working-age (66.4%), and with limited schooling (only 11.5% with a complete primary education or more). Most had been in hospital for at least two years (77.6%), received visits from relatives (60.5%), but did not have hospital leave (73.8%). The predominant diagnoses were schizophrenia (53.6%) and mental retardation (26.4%). The main therapeutic approach was psychiatric (84.1%). Only 13.3% took part in systematic activities during the day, although 36% were in a condition to do so. CSDE-P is a mega-hospital where most patients have precarious social links, demanding treatment strategies which take this characteristic into account.
-Objective:The main aim of this study was to evaluate the knowledge, management practices and attitudes towards people with epilepsy (PWE) by a group of general practitioners (GP) and pediatrician (PD) residents. Methods: A cross-sectional study was carried out in three training hospitals, and had been selected 31 GP and 47 PD who agreed with the study. The collection of data was made by self-applied structured questionnaire. Results: Many respondents have positive values about PWE, and recognize prejudice in the population against them. The residents recognize in themselves and in the colleagues lack of knowledge about PWE, and that Medical School do not give enough importance to the study of PWE. The reference of PWE to the neurologist is a common practice among the doctors. Half of them are favorable to the idea of assuming the patients clinical management after an initial clientele appraisal by the neurologist. Conclusions: The non-neurologist doctors do not feel comfortable in managing PWE due to barriers. Our doctors complain about the undergraduate medical training related to the epilepsy. Although, there is not a clear relationship between the undergraduate medical training, referral practices and satisfaction about the management of PWE. The patients care is influenced not only by knowledge, but also by doctors' attitudes. In this way, there are other barriers, perceived or not, to providing care to PWE by the generalists, and they need to be approached in the medical undergraduate curriculum and medical continuing education.KEY WORDS: epilepsy, physician, perspectives, knowledge, attitude, education.
Perspectivas e práticas dos clínicos gerais em relação à epilepsiaRESUMO -Objetivo: Avaliar conhecimento, práticas clínicas e atitudes em relação às pessoas com epilepsia (PCE) por um grupo de clínicos gerais e pediatras. Método: Um estudo transversal foi conduzido em três hospitais de treinamento médico, onde foram selecionados 31 clínicos e 47 pediatras residentes. Os dados foram obtidos através de questionário auto-aplicado. Resultados: Os entrevistados apresentaram valores positivos em relação às PCE, mas reconheceram preconceitos da população em relação a essa clientela. Os médicos reconheceram neles próprios e nos colegas carência de conhecimentos sobre PCE, e que a Faculdade de Medicina não dá a devida importância para o estudo desses pacientes. Eles encaminham os pacientes com freqüência para os especialistas. Metade deles é favorável à idéia de assumir o manejo clínico dos pacientes após a avaliação inicial pelos especialistas. Conclusões: Os não neurologistas não se sentem confortáveis em lidar clinicamente com os PCE por causa de barreiras. Nossos médicos têm queixas sobre o ensino de graduação médica em relação ao treino clínico sobre esses pacientes. No entretanto, não existe evidente relação entre o ensino da graduação, práticas de referência, e satisfação sobre o controle clínico da clientela. Os cuidados clínicos com os pacientes são influenciados não apenas por conhecimento, mas t...
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