A não-adesão à terapêutica antiretroviral altamente eficaz (HAART) é considerada, no plano individual, como um dos mais ameaçadores perigos para a efetividade do tratamento da pessoa com HIV/aids e para a disseminação de vírus-resistência, no plano coletivo. Assim, o objetivo deste estudo foi analisar, mediante revisão de literatura, os fatores de risco para não-adesão à HAART, além de agrupá-los e relacioná-los à pessoa em tratamento, à doença, ao tratamento e ao serviço de saúde e suporte social. A literatura aponta para a necessidade da realização de estudos que avaliem aspectos socioculturais, crenças, qualidade do serviço prestado, relações do cliente com a equipe multiprofissional e outros referentes à raça e aos efeitos colaterais dos anti-retrovirais. Estes estudos visam a favorecer o estabelecimento de estratégias que melhorem a adesão dos clientes à HAART, ao mesmo tempo em e que contribuem para a construção e exercício da cidadania.

Triple therapy was associated with side effects, which suggested that drug regimes should be reviewed. The variables related to a high risk of HIV transmission were also significant for compliance.

An exploratory descriptive study with a quantitative approach whose objective was to use indicators to evaluate the frequency and infrastructure for hand hygiene, as well as the nursing team's knowledge about the subject. Systematized observation was carried out at hospital in the state of São Paulo, Brazil of the routine activities of 33 participating professionals (nurses and technicians) as well as the application of an individual questionnaire about the subject. 1206 opportunities for hand hygiene were identified, though it was effected in only 481 (39.9%) of them. Alcohol solution was not used at any opportunity. The infrastructure indicatorfor hand hygiene was close to the ideal value (83.30%). The professionals reported a high frequency of hand hygiene, demonstrating knowledge in relation to its importance, yet contradicting the findings of the observation. It was concluded that, despite the adequate infrastructure, hand hygiene was below that expected, requiring actions and strategies to overcomes these barrier and increase the use of alcohol solution.

BackgroundDespite being curable, tuberculosis is still a stigmatized disease. Not only is TB patients’ suffering due to its clinical manifestations, but also because of society’s prejudice, embarrassing situations, and even self-discrimination. This study aims to investigate psychosocial experiences of patients who have completed tuberculosis treatment in São Carlos a municipality in the interior of São Paulo State, Brazil.MethodsThis study, of a clinical-qualitative nature, sought to understand the meanings provided by the participants themselves. Fifteen individuals, who had successfully completed tuberculosis treatment, participated in this research. The sample size was established using the information saturation criterion. Data were collected by means of interviews with in-depth open-ended questions. Data were treated by categorizing and analyzing content according to themes.ResultsRegardless of all progress, this study found that TB still causes patients to suffer from fear of transmission, social prejudice, and death. Despite the fact that the emotional support provided by families and healthcare professionals is considered essential to treatment adherence and completion, participants in this study reveal that friends and colleagues have distanced themselves from them for fear of contagion and/or prejudice. Ignorance about the disease and its transmission modes can be found in the interviewees’ statements, which seems to indicate that they have become vectors of transmission of stigma themselves. Patients’ medical leave from work during treatment may be due to both their health conditions and their attempt to avoid social/emotional embarrassment. There are accounts that TB has caused psychosocial damage to patients’ lives and that they feel more fatigue and lassitude and have begun to pay more attention to their own health.ConclusionsHealthcare workers should be aware of the ways TB treatment affect patients’ psychosocial life and develop strategies to mitigate these effects and provide opportunities for them to share their anxiety, suffering, and bio-psychosocial changes. In addition, healthcare professionals should seek to educate and, as a result, empower TB patients and their families with regard to this disease so as to break the existing vicious cycle of misinformation and prejudice.

Objective: Evaluate and correlate individual, work-related and organizational factors that influence adherence to standard precautions among nursing professionals of psychiatric hospitals in São Paulo. Method: An exploratory cross-sectional study conducted with 35 nursing professionals, using the assessment tool for adherence to standard precautions through the Likert scale, ranging from 1 to 5. Results: Knowledge of the precautions received a high score (4.69); adherence received (3.86) and obstacles (3.78), while intermediaries and the scales of organizational factors received low scores (2.61). There was a strong correlation between the magnitude adherence scale and the personal protective equipment availability (r = 0.643; p = 0.000). The training scale for prevention of HIV exposure (p = 0.007) was statistically different between the nurses and nursing assistants. Conclusion: The organizational factors negatively contributed to adherence to standard precautions, indicating that psychiatric institutions lack safe working conditions, ongoing training and management actions to control infections. Factors influencing adherence to standard precautions among nursing professionals in psychiatric hospitals * Fatores que influenciam a adesão às precauções-padrão entre profissionais de enfermagem em hospital psiquiátrico Factores que influencian la adhesión a las precauciones estándares entre profesionales de enfermería en hospital psiquiátrico DESCRIPTORS

BackgroundHealth care associated infections (HAIs) are a source of concern worldwide. No health service in any country can be considered HAI risk-free. However, there is scarcity of data on the risks to which both patients and health workers are subject in non-hospital settings. The aim of this study was to identify issues that determine the adherence of professionals to precautions for preventing transmission of microorganisms in primary health care.MethodThis was a qualitative study, using focus groups of primary health care staff, in two Brazilian municipalities. The data were analysed using content analysis.ResultsFour focus groups were conducted with 20 professionals (11 community health workers, 5 nursing assistants and 4 nurses), and the analysed content was organized into four thematic categories. These categories are: low risk perception, weaknesses in knowledge, insufficient in-service training and infrastructure limitations.Participants expressed their weaknesses in knowledge of standard and transmission based precautions, mainly for hand hygiene and tuberculosis. A lack of appropriate resources and standardization in sharps disposal management was also highlighted by the participants.ConclusionThe study points out the need to provide in-service training for professionals on the transmission of microorganisms in primary health care to ensure adequate level of risk perception and knowledge. Further recommendations include investment to improve infrastructure to facilitate adherence to precautions and to minimize the risk of disease transmission for both patients and health care workers.

This is a bibliographical study that has as its aim characterizing the Brazilian scientific production on the "Patient Care System" and visualizing its trends. A retrospective bibliogra-phical study (1990-2002) was carried out taking into consideration the items: date, title of the journal, type of research and approach of the publication. Production average was 13.4 publications/ year and articles were distributed among 23 journals, with a majority of them dealing with hospitals (63.2%). Cardiology was the theme of 17.6% of the articles, and 78.6% of them were focused on the implementation, development and evaluation of SAE models. NANDA taxonomy was men-tioned in 40.2% of the production, and Wanda Horta in 40.5%. There are still some blanks in this area of knowledge, but the increasing availability of the scientific production on this subject may help professionals in the implementation of the patient care system.

This prospective, exploratory study was performed using a quantitative approach with the objective of characterizing the healthcare tasks that involved biological risk for professionals working with the Home Care Service of the São Carlos Municipal Hospital (São Carlos, SP, Brazil). We followed 159 visits from June 2008 to January 2009. A total of 347 procedures were considered to present risks for biological exposure, categorized as follows: dressings (31.1%), capillary blood glucose monitoring (14.4%); and vascular access (3.1%). Of all subjects, 21.5% complied with hand cleansing prior to performing a procedure, 66.3% wore gloves and 83.5% disposed of sharps appropriately. In conclusion, these professionals are subject to biological risks similar to those found in the hospital environment, because they are also exposed to blood and sharps often and have a poor adherence to the standard preventive measures. Further studies to evaluate the influence of the features of the household on the referred risk should be encouraged.