Frailty is a dynamic process in which there is a reduction in the physical, psychological and/or social function associated with aging. The aim of this study was to identify instruments for the detection of frailty in older adults, characterizing their components, application scenarios, ability to identify pre-frailty and clinimetric properties evaluated. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), under registration number CRD42017039318. A total of 14 electronic sources were searched to identify studies that investigated instruments for the detection of frailty or that presented the construction and/or clinimetric evaluation of the instrument, according to criteria established by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). 96 studies were included in the qualitative synthesis: 51 instruments for the detection of frailty were identified, with predominantly physical domains; 40 were constructed and/or validated for use in the older adult community population, 28 only highlighted the distinction between frail and non-frail individuals and 23 presented three or more levels of frailty. The FRAGIRE, FRAIL Scale, Edmonton Frail Scale and IVCF-20 instruments were the most frequently analyzed in relation to clinimetric properties. It was concluded that: (I) there is a large number of instruments for measuring the same construct, which makes it difficult for researchers and clinicians to choose the most appropriate; (II) the FRAGIRE and CFAI stand out due to their multidimensional aspects, including an environmental assessment; however, (III) the need for standardization of the scales was identified, since the use of different instruments in clinical trials may prevent the comparability of the results in systematic reviews and; (IV) considering the different instruments identified in this review, the choice of researchers/clinicians should be guided by the issues related to the translation and validation for their location and the suitability for their context.
This work is a theoretical revision of team work in a family Health Care Program. We define team work in the health care field as a relationship network among people, power, knowledge, affection, and wishes, when there is a possibility of identifying group processes. We deal with concepts of Operational Group from the Argentinean School, which might help health professionals to get training in team work. We have visible (spoken) and invisible (unspoken) tasks within teams, which are modified and need to be combined and known. Communication, learning, the feeling of belonging, the atmosphere, the actions' pertinence for the team's purpose and power relations may help the team to get to know and analyze each other and to build a team. External supervision may help the team to turn itself into an operational team, working towards a life care project.
Investiga-se uma experiência de supervisão de equipes de saúde da família no município de Ribeirão Preto, utilizando o referencial da análise institucional e de grupo operativo de Pichon-Rivière como forma de facilitar a auto-análise e auto-gestão, num processo contínuo de construção, desconstrução e reconstrução de saberes e práticas, construção de uma grupalidade na equipe e de um projeto coletivo, com o propósito de deslocar a atenção da equipe, da produção de procedimentos para a produção de cuidado. Enfocam-se as dificuldades do supervisor em romper com as próprias matrizes de produção de procedimentos mais que de cuidados; de lidar com a divisão técnica e social do trabalho em saúde, buscando um trabalho mais democrático, participativo e de respeito às diferenças; de lidar com a questão dos preconceitos e com as pré-concepções dos trabalhadores em relação aos usuários e com a desconstrução da relação poder/saber; de apoiar a equipe na análise das implicações inerentes à própria relação de atendimento, do estabelecimento de vínculo e responsabilização que tem se mantido escondido atrás do trabalho técnico. Os aspectos assinalados como dificultadores podem ser também facilitadores pela potência de abrir-se para múltiplas possibilidades de ação e criação, ao serem analisados pela equipe.
This study aims to present the re-signification process of the meanings of nurses' clinical practice in primary care from the perspective of extended clinic and permanent education.An intervention research was carried out with the approval of an ethics committee. Nine nurses participated in reflection groups from September to December 2008 in Ribeirão Preto-SP-Brazil. The redefinition process of the meanings proposed by the institutional analysis was mapped. The results point out that the nurses perceive differences in clinical work, by acknowledging the sense of user-centered clinical practice; daily limits and tensions and the need for support from managers and the team to deal with users' problems and situations. La práctica clínica del enfermero en la atención básica: un proceso en construcción Este estudio tuvo por objetivo presentar el movimiento de dar nuevo significado a los conceptos de la práctica clínica de enfermeros en la atención básica en proceso de calificación en la perspectiva de la clínica ampliada y educación permanente. Realizamos una investigación-intervención aprobada en comité de ética. Nueve enfermeros participaron del grupo de reflexión, de septiembre a diciembre de 2008, en Ribeirao Preto, SP, en Brasil. Cartografiamos el proceso dar nuevo significado a los conceptos propuesto por el análisis institucional. Los resultados apuntan que los enfermeros perciben diferencias en el quehacer clínico, al reconocer el sentido de la clínica centrada en el usuario, los límites y tensiones de lo cotidiano y la necesidad de obtener soporte de la administración y del equipo para el manejo de situaciones y problemas de los usuarios.Identifican que necesitan abrir espacio en la planificación para realizarla. Concluimos que la práctica clínica del enfermero se viene consolidando y que los procesos colectivos de análisis posibilitan aprendizajes y la reconstrucción de las prácticas.
se dando, transmite uma característica dinâmica, um processo que pode ser criativo, transformador, revolucionário. Por outro lado, esta distinção pode parecer contraditória, uma vez que ato e modo se complementam, não sendo passíveis de separação. O acolhimento em si implica em um ato produzido no momento do atendimento, e ao mesmo tempo far-se-á em um modo específico de realizá-lo. Na perspectiva da organização e planejamento de serviços de saúde,
Autonomy and control and also a tenuous relationship between tutorship and autonomy were highlighted, in the plan of organization. In conclusion, the program was an important device that suffered captures/overcoding but also produced changes in practice. Movimientos de la educación permanente en salud desencadenados a partir de la formación de facilitadoresSe tuvo por objetivo cartografiar los movimientos de educación permanente en salud, en la región de Araraquara, Sao Paulo, Brasil, iniciados a partir del curso de Facilitadores de Educación Permanente en Salud, del Ministerio de la Salud y Escuela Nacional de Salud Pública. Es un estudio de abordaje cualitativo, sustentado por el referencial teórico del análisis institucional en la línea esquizoanalítica, siendo los datos recolectados mediante grupos operativos con alumnos terminando el referido curso. Los resultados fueron agrupados en dos planos: micropolítica y organización. Con relación a la micropolítica, apuntan que hubo producción de diferentes conceptos sobre educación permanente y diferentes formas de institucionalización de la misma. En el plano de la organización se destacan la autonomía y el control y también la tenue relación entre tutela y autonomía.Concluimos que el curso fue un importante dispositivo que sufrió capturas, pero también produjo cambios en las prácticas.Descriptores: Educación; Política de Salud; Formación de Recursos Humanos. IntroductionThis study, based on the theoretical methodological framework of institutional schizoanalysis Based on significant learning, the PHE also proposes that this analysis be developed through dialogue, in round tables addressing the problems and difficulties faced in the routine in which care is developed, in management, in the training of professionals to work in the Brazilian Health System and in social participation and control (4)(5)(6)(7) . PHE operates in the micropolitics of the work process and, from this perspective, it involves the molar (macro) and molecular (micro) levels not as opponents, but 413 www.eerp.usp.br/rlae Fortuna CM, Franceschini TRC, Mishima SM, Matumoto S, Pereira MJB.as expressions of the routines of policies, economies, desires and ways of living (2,8) .To disseminate and encourage conversation tables within the PHE throughout the country, the MH triggered several strategies, among them, training PHE facilitators (8) . The ministry sought to inspire workers, managers, professors, students and users of the health system to play a role in which they would facilitate and coordinate dialogue and reflection about the work performed in round tables, thereby causing discomfort and at the same time promoting a re-invention of collectives moving toward the principles of the Single Health System (SUS) (4,8) . The program to train PHE facilitators introduced a device -the PHE round table (4,6,8) , which is an arrangement capable of producing a new and innovative way of working in health but which could also be apprehended by the established movements (8) .Therefore, this study maps t...
Bras Enferm, Brasília 2009 9 9 9 9 setset-setset-set-out; out; out; out; out; 6 6 6 6 62 2 2 2 2( ( ( A enfermagem no Brasil no conte A enfermagem no Brasil no conte A enfermagem no Brasil no conte A enfermagem no Brasil no conte A enfermagem no Brasil no contexto da força de trabalho em saúde: perfil e legislação xto da força de trabalho em saúde: perfil e legislação xto da força de trabalho em saúde: perfil e legislação xto da força de trabalho em saúde: perfil e legislação xto da força de trabalho em saúde: perfil e legislação La enfermería en Brasil en el contexto de la fuerza de trabajo en salud: perfíl y legislación Nursing in Brazil in the context of the work force of the health: profile and legislation Maria José Bistafa P Maria José Bistafa P Maria José Bistafa P Maria José Bistafa P Maria José Bistafa Pereira ereira ereira ereira ereira RESUMO RESUMO RESUMO RESUMO RESUMO Este artigo parte da referência da enfermagem como prática social, apóia-se na categoria trabalho para abordar a força de trabalho em enfermagem no Brasil. Resgata historicamente a conformação do seu perfil vinculada à organização mais geral do setor saúde do país. O perfil do trabalhador relaciona-se à finalidade que se imprime ao processo de trabalho em saúde. Entendemos que as forças em movimento no contexto da saúde são contingenciadas, mas que seus atores organizados podem imprimir direções determinadas pelo âmbito técnico, ético e político. Lançamos o convite para a reflexão sobre quais perfis de enfermagem defendemos e queremos para os múltiplos Brasis. Destacamos características do trabalhador de enfermagem generalista, assinalando que para esta formação serão necessários novos arranjos de poderes e saberes que poderão construir outros perfis e contornos para o trabalho em saúde e para a enfermagem, de forma mais comprometida com os princípios do Sistema Único de Saúde. Descritores Descritores Descritores Descritores Descritores: Enfermagem; Conhecimentos atitudes e práticas em saúde; Força de trabalho, Enfermagem em saúde pública.(ABSTRACT ABSTRACT ABSTRACT ABSTRACT ABSTRACT This article approaches nursing as a social practice, grounded in the work category to address the nursing work force in Brazil. It recovers the historical arrangement of its profile associated to the most general organization of the health sector in the country. Workers' profile is related to the aim of the health work process. Authors understand that the moving forces in the health context are restricted, but its organized actors can give directions determined by the technical, ethical and political ambits. Readers are invited to reflect on which nursing profiles are supported and targeted to the multiple Brazils. The characteristics of generalist nursing workers are highlighted, evidencing that new power and knowledge arrangements will be necessary for this training. This can build other profiles and outlines to health work and nursing, more committed with the principles of the Unified Health System. Descriptors Descriptors Descriptors Descriptors Descr...
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