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Revelando contradi??es e incorporando melhores práticas no cuidado à saúde bucal de idosos
Mello, Ana Lúcia Schaefer Ferreira de;Erdmann, Alacoque Lorenzini;
Physis: Revista de Saúde Coletiva , 2007, DOI: 10.1590/S0103-73312007000100008
Abstract: this paper presents and discusses the contradictions in the process of taking care of elderly's oral health in the perspective of the complex care and the logic of complexity, based on the grounded theory methodology. nineteen people participated in the study, among elderly residents of long-term institutions, caregivers, directors, dentists and public health services managers. the emergent central category corresponds to the process of "promoting oral health of the elderly in the context of long-term care institutions". two levels were identified: one in which contradictions in the process of taking care of the elderly's oral health keeps the poor epidemiological status; and other, superior, that incorporates best practices in the structures and in the processes that form the promotion of the elderly's oral health care. to treat the elements that form the contradiction, without eliminating or disrespecting them, but working, looking for the improvement of each one, allows overcoming the contradiction, outlining the obstacle it represents. in the same way, the adoption of best practices can be considered a meta-viewpoint expressed to the elderly oral health care system, able to overcome the contradiction levels, as it is revealed here.
O ACOLHIMENTO COMO BOA PRáTICA NA ATEN O BáSICA à SAúDE
Patricia Guerrero,Ana L cia Schaefer Ferreira de Mello,Selma Regina de Andrade,Alacoque Lorenzini Erdmann
Texto & Contexto - Enfermagem , 2013,
Abstract: Se objetivó comprender el acogimiento como buena práctica de salud en la atención primaria, tras la percepción de gerentes, profesionales y usuarios, teniendo en cuenta las dimensiones diálogo, postura y reorganización de los servicios. Es una investigación descriptiva-analítica, de naturaleza cualitativa y marco teórico-metodológico de la Teoría Fundamentada. Se obtuvieron los datos a partir de entrevistas con siete coordinadores, diez profesionales y doce usuarios de centros de salud de Florianópolis-SC. En vista de las buenas prácticas, el acogimiento se convierte en un punto de intersección entre los diferentes sujetos y las prácticas de cuidado en atención primaria en el desarrollo de las dimensiones acogimiento-diálogo, acogimiento-postura, y acogimiento-reorganización de los servicios. El acogimiento provoca cambios en el proceso de trabajo, en las relaciones establecidas y en la organización de los servicios. La interconexión de la tríada reconfigura las acciones y contribuye a la consolidación de este modelo de atención.
A universidade promotora de saúde e as mudan?as na forma??o profissional
Mello, Ana Lúcia Schaefer Ferreira de;Moysés, Simone Tetu;Moysés, Samuel Jorge;
Interface - Comunica??o, Saúde, Educa??o , 2010, DOI: 10.1590/S1414-32832010005000017
Abstract: this paper discusses health promotion (hp) from the perspective of a theoretical-political, organizational and practical arrangement that is capable of influencing change processes within professional healthcare training. focusing on the concept of the health-promoting university, and particularly on the matters like intersectorality and healthy environments, historical and institutional movements for change are discussed, presenting some limits and possibilities relating to change processes in course, in the education and health sectors in contemporary brazil. incorporation of hp within professional routines allows some possibilities and spaces for change to emerge, particularly those relating to the process of implementing new pedagogical projects and national curriculum guidelines. the knowledge and new practices constructed indicate that the changes still lack strength, but point towards new strategies that may guide pedagogical actions into more potent directions, aimed towards hp and improvement of quality of life, and towards implementation of healthier and more effective public policies.
Valida??o de instrumento de avalia??o das condi??es de saúde bucal de idosos institucionalizados
Gon?alves, Lucia Hisako Takase;Mello, Ana Lúcia Schaefer Ferreira de;Zimermann, Karoline;
Escola Anna Nery , 2010, DOI: 10.1590/S1414-81452010000400026
Abstract: this study aimed to bring for the brazilian reality, through translation and validation, the oral health assessment tool, of chalmers et al. (2005), which propose a tool for nursing professionals to evaluate the oral health conditions of institutionalized elderly people, followed by the definition of the daily care needs and the direction for accomplishment of specific dental procedures. the instrument, in english, was translated to the portuguese language. the stages of reverse/back translation and analysis were followed by a committee of 10 experts invited to validate the instrument according to the semantic, idiomatic, cultural and conceptual equivalences. in the sequence, the instrument was submitted to the analysis by 21 nursing professionals of a long term care institution to manifest their opinions on content, presentation, reading/clarity and practical application of the instrument. it is presented to the nursing professionals a diagnostic and direction tool with relationship to the oral health of the elderly demands in long term care institutions.
El cuidado a la salud bucal del anciano: buenas prácticas fundamentadas en el paradigma de la promoción de la salud
Schaefer Ferreira de Mello,Ana Lúcia; Reibnitz Junior,Calvino; Lorenzini Erdmann,Alacoque;
Gerokomos , 2009, DOI: 10.4321/S1134-928X2009000200003
Abstract: it presents the elaboration of a theoretical-practical referential of good oral health care practices to the aged population, based on the principles of health promotion (hp). the methodological referential adopted was grounded theory. the theoretical-practical referential is described to guide the development of oral health care actions to the aged, in consonance with the hp paradigm defended in the ottawa charter according to five areas. it is necessary to consider these care practices, that conform the theoretical-practical referential here detailed, as an objective to reach, to contribute to the sustained progress in the quality of the care and, consequently, promote a transformation in oral health conditions during life course.
Melhores práticas em sistemas locais de saúde: sob foco, a saúde bucal do idoso
Mello, Ana Lúcia Schaefer Ferreira de;Moysés, Samuel Jorge;
Physis: Revista de Saúde Coletiva , 2010, DOI: 10.1590/S0103-73312010000300006
Abstract: this study aimed to apply the best practices for the elderly's oral health care through the theoreticalmethodological framework "interactive domain model of best practices in health promotion", which considers the interaction of domains (underpinnings, understanding of the environment and practice), as an action-research. an intervention at the best practice referential in a local health system was carried out through a systematic and critical reflection by the actors involved with local governance, examining its potential to transform current practices according to the principles of health promotion. data were collected from focal groups formed by managers, health professionals and the elderly (20 subjects). the best practices were suggested built on the principles of the national health service, family health strategy and health promotion. the process of development of best practices is based on the expectation that a higher oral health standard for the elderly could be reached by means of a change in organizational practices, as well as in health, research and evaluation practices. the possible change depends on the willingness of the actors involved as regards the careful consideration and analysis of current behaviors, procedures and scenarios. the driving force for the continuous improvement of practices is the commitment of the local governance with the principles of health promotion. it was possible to build an indicative set of practices on oral health of the elderly and to generate useful knowledge to afford the approach of the theoretical models to the reality, with a view to the transformation of such practices.
Saúde bucal do idoso: por uma política inclusiva
Mello, Ana Lúcia Schaefer Ferreira de;Erdmann, Alacoque Lorenzini;Caetano, Jo?o Carlos;
Texto & Contexto - Enfermagem , 2008, DOI: 10.1590/S0104-07072008000400010
Abstract: this article is part of an oral health care investigation carried out in nursing homes. it aims to relate the meaning of oral health care among the institutionalized elderly to questions of public policy, given the current national context of the implementation of health and oral hygiene policies. it is a qualitative study based on the grounded theory. the two sample groups were composed of three elderly people, four caregivers, two nursing personnel, and three administrators in the first, with three dentists, three civil service managers, and one administrator in the second. after re-reading the data collected through open interviews and comparative analysis, the category inserting elderly oral health care in the political-organizational dimension encompasses health/oral health public policies. in spite of legal guarantees, increased resources, and expansion of the services, the implementation of public policies which include the elderly in oral health actions is incipient to assuring a public-state-governmental commitment and to transforming epidemiological reality.
Avalia??o da saúde bucal de idosos por enfermeiros: validade e confiabilidade do instrumentO ASBTO
Mello, Ana Lúcia Schaefer Ferreira de;Zimermann, Karoline;Gon?alves, Lucia Hisako Takase;
Revista Gaúcha de Enfermagem , 2012, DOI: 10.1590/S1983-14472012000200007
Abstract: the aim of the study was to apply the oral health assessment tool (ohat) for determination of the reliability and validity indexes, when utilized by nursing staff. the ohat was administered to 50 elderly individuals. the exams were performed in different periods of times by a nurse and a dental surgeon (ds). the determination of internal consistency was verified through cronbach's alpha coeficient and anova. for the determination of stability and reliability, the percentage agreement and kappa test were considered. there was no statistical difference among the final averages obtained by the ds and the nurse (p=0.41). there was a higher internal consistency in the exams performed by the ds. the kappa value of the instrument reached 0.46, being considered moderate. the ohat instrument can be used by nurses as a screening tool; however, previous training is needed for criteria standardization.
El cuidado a la salud bucal del anciano: buenas prácticas fundamentadas en el paradigma de la promoción de la salud Oral health care of the aged: good practices based on health promotion paradigm
Ana Lúcia Schaefer Ferreira de Mello,Calvino Reibnitz Junior,Alacoque Lorenzini Erdmann
Gerokomos , 2009,
Abstract: Presenta la elaboración de un referente de buenas prácticas del cuidado a la salud bucal a la población anciana, basado en la Promoción de la Salud (PS). El método adoptado fue el de la Teoría Fundamentada en los Datos. El referencial teórico-práctico se describe para guiar el desarrollo de acciones en consonancia con el paradigma de la PS según la Carta de Ottawa y sus cinco áreas. Es necesario considerar estas prácticas de cuidado como un objetivo a alcanzar y contribuir al progreso sostenido en la calidad del cuidado y la transformación en las condiciones de salud bucal durante el curso de la vida. It presents the elaboration of a theoretical-practical referential of good oral health care practices to the aged population, based on the principles of Health Promotion (HP). The methodological referential adopted was Grounded Theory. The theoretical-practical referential is described to guide the development of oral health care actions to the aged, in consonance with the HP paradigm defended in the Ottawa Charter according to five areas. It is necessary to consider these care practices, that conform the theoretical-practical referential here detailed, as an objective to reach, to contribute to the sustained progress in the quality of the care and, consequently, promote a transformation in oral health conditions during life course.
Saúde bucal do idoso: por uma política inclusiva
Ana Lúcia Schaefer Ferreira de Mello,Alacoque Lorenzini Erdmann,Jo?o Carlos Caetano
Texto & Contexto - Enfermagem , 2008,
Abstract: El presente artículo forma parte de una investigación sobre el cuidado a la salud bucodental, realizada en residencias geriátricas. Su objetivo es relacionar el significado del cuidado a la salud bucodental del anciano, institucionalizando los asuntos referentes a las políticas públicas, en el actual contexto nacional de implementación de políticas de salud/salud bucal. Se trata de un estudio cualitativo basado en la Grounded Theory. Participaron del estudio tres ancianos, cuatro cuidadores, dos enfermeros y tres administradores (primer grupo del muestreo); y, tres dentistas, tres gestores públicos y un administrador (segundo grupo del muestreo). Después de la relectura de los datos de las entrevistas y del análisis comparativo, la categoría: Insertando el cuidado a la salud bucodental del anciano en la dimensión político-organizacional incluyó las políticas públicas de salud/salud bucal. A pesar de las garantías legales, del crecimiento de los recursos y de la expansión de los servicios, la implementación de políticas públicas que incluyan al anciano en las acciones de salud bucodental es incipiente para garantizar el compromiso público-estadual y gubernamental que transforme la realidad epidemiológica.
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