5 research outputs found
Idosos com demência: conhecimentos e atitudes dos médicos nas unidades de saúde
OBJETIVO: Descrever os conhecimentos e atitudes dos médicos generalistas da rede básica de saúde da cidade de São Paulo em relação a pacientes com demência e identificar padrões de atitudes. MÉTODOS: Foram sorteadas aleatoriamente 10% das unidades básicas de saúde da cidade de São Paulo (n = 45), distribuÃdas proporcionalmente em seis coordenadorias regionais de saúde. Foram entrevistados até dois médicos generalistas em cada unidade, obtendo-se ao todo 81 médicos entrevistados. Eles responderam à versão traduzida e adaptada transculturalmente para o Brasil de dois questionários britânicos, o knowledge quiz (conhecimentos sobre demências) e o attitude quiz (atitudes frente ao paciente dementado), além de um questionário sociodemográfico e ocupacional para o entendimento do perfil dos médicos generalistas que atuam na atenção primária. Realizaram-se análise descritiva dos dados, análise fatorial dos principais componentes do attitude quiz e estudo de associação entre atitudes e conhecimentos, além do teste de regressão linear múltipla para determinar a relação entre o perfil ocupacional e de conhecimento em demência sobre os padrões de atitudes. RESULTADOS: Os médicos entrevistados tinham mediana de tempo de formado de cinco anos; 35,8% trabalhavam exclusivamente com atenção primária, e menos de 40% tinham concluÃdo, ou estavam cursando, residência médica ou especialização. Os médicos mostraram um conhecimento menor sobre diagnóstico de demência do que sobre a epidemiologia da doença e seu manejo terapêutico. Suas atitudes em relação a pacientes dementados resultaram em quatro fatores: otimismo proativo, otimismo delegador, desalento implÃcito e desalento explÃcito. O estudo de regressão mostrou que a atitude de desalento explÃcito diminui quanto maior for a jornada de trabalho semanal do médico nas unidades, e que a atitude otimista delegadora do médico diminui na mesma situação. CONCLUSÕES: O investimento em capacitação é fundamental para melhorar o desempenho do médico no campo da demência na atenção primária.OBJECTIVE: To describe the knowledge and attitudes of general practitioners of the basic health network of the city of São Paulo in relation to patients with dementia and identify patterns of attitudes. METHODS: A total of 10% of the basic health units in the city of São Paulo (n = 45) were randomly distributed into six regional health coordination centers. Up to two general practitioners were interviewed in each unit, with a total of 81 physicians interviewed. They answered the translated and cross-culturally adapted version for Brazil of two British questionnaires, the knowledge quiz (knowledge about dementias) and the attitude quiz (attitude towards the patient afflicted with dementia), as well as a sociodemographic and occupational questionnaire to understand the profile of general practitioners working in primary care. Descriptive data analysis, factor analysis of the main components of the attitude quiz and study of association between attitudes and knowledge were performed, in addition to the multiple linear regression test to determine the relationship between occupational profile and knowledge about attitude patterns in dementia. RESULTS: The physicians interviewed had a median of five-year graduation time; 35.8% worked exclusively with primary care, and less than 40% had completed, or were attending, medical residency or specialization. Physicians showed a lower knowledge about the diagnosis of dementia than about the epidemiology of the disease and its therapeutic management. Their attitudes towards patients afflicted with dementia resulted in four factors: proactive optimism, delegated optimism, implicit dismay, and explicit dismay. The regression study showed that the attitude of explicit dismay decreases the longer the weekly working hours of the physician in the units, and that the delegated optimistic attitude of the physician decreases in the same situation. CONCLUSION: Investment in training is essential to improve physicians’ performance in the field of dementia in primary care
Mild cognitive impairment and progression to dementia of Alzheimer's disease
The increase in life expectancy in the Brazilian population raises questions about the preparation of the public health system in identifying elderly patients with signs of cognitive impairment. Currently, as a consequence of the long duration of preclinical phase of Alzheimer's disease, efforts of early detection have been emphasized. Clinical dementia presents an important impact on the individual's caregivers, family, society and economy. Identifying individuals who already have some cognitive impairment, despite remaining functional, as well as analyzing associated comorbidities, constitutes an opportunity to analyze possibilities for future interventions. Dementias are clinical conditions that impose a burden on the health system with its high costs, whereas the identification of individuals with cognitive impairment without dementia can aid patients and their families to plan the future and mitigate costs. This narrative revision can provide general practitioners with more information on the subject.Univ Fed Sao Paulo, UNIFESP, Escola Paulista Med, Psychiat Dept, Sao Paulo, SP, BrazilUniv Estadual Paulista, UNESP, Fac Med Botucatu, Dept Internal Med,Geriatr, Botucatu, SP, BrazilFMB Unesp, Botucatu, SP, BrazilUniv Sao Paulo, Sao Paulo, BrazilHosp Santa Marcelina, Neurol Residency Program, Sao Paulo, BrazilUniv Sao Paulo, Grp Neurol Cognitiva & Comportamento, Sao Paulo, SP, Brazil|Univ Sao Paulo, Ctr Referencia Disturbios Cognit Ceredic, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, UNIFESP, Escola Paulista Med, Psychiat Dept, Sao Paulo, SP, BrazilWeb of Scienc
Conhecimentos E Atitudes Dos Médicos Generalistas Das Unidades Básicas De Saúde Da Cidade De São Paulo Frente A Pacientes Com Demência
Objectives: To Describe The Knowledge And Attitudes Of The General Practitioners Of The Primary Health Care Network In The City Of São Paulo In Relation To Patients With Dementia And To Identify Which Medical Standards Of Attitudes Are Associated With Greater Knowledge About The Subject. Methods: Ten Percent Of The Basic Health Units Of The City Of São Paulo (N = 45), Distributed Proportionally In 6 Regional Health Coordination Units, Were Randomly Selected To Collect Data. Interviews Were Planned With The Two General Practitioners Who Worked In Each Unit, Obtaining A Total Of 81 Physicians Interviewed From The 90 Predicted (9 Refusals); They Answered The Transculturally Translated Version Of The Brazilian Questionnaire For 2 British Questionnaires, The Knowledge Quiz And The Attitude Quiz (Attitudes Towards The Demented Patient), As Well As A Socio-Demographic And Occupational Questionnaire For Understanding The Profile Of General Practitioners Working In Primary Care. A Descriptive Analysis Of Data, The FacObjetivos: Descrever Os Conhecimentos E Atitudes Dos Médicos Generalistas Da Rede Básica De Saúde Da Cidade De São Paulo Em Relação A Pacientes Com Demência E Identificar Que Padrões De Atitudes Dos Médicos Estão Associados A Maior Conhecimento Sobre O Tema. Métodos: Dez Por Cento Das Unidades Básicas De Saúde Da Cidade De São Paulo (N=45), DistribuÃdas Proporcionalmente Nas 6 Coordenadorias Regionais De Saúde Foram Sorteadas Aleatoriamente Para A Coleta De Dados. Foram Previstos Entrevistas Com Os 2 Médicos Generalistas Que Trabalhavam Em Cada Unidade, Obtendo-Se Ao Todo 81 Médicos Entrevistados Dos 90 Previstos (9 Recusas); Eles Responderam À Versão Traduzida E Adaptada Transculturalmente Para O Brasil De 2 Questionários Britânicos, O Knowledge Quiz (Conhecimentos Sobre Demências) E O Attitude Quiz (Atitudes Frente Ao Paciente Dementado), Além De Um Questionário Sócio-Demográfico E Ocupacional Para O Entendimento Do Perfil Dos Médicos Generalistas Que Atuam Na Atenção Primária. Realizou-Se Uma Análise DescrDados abertos - Sucupira - Teses e dissertações (2018
Mild cognitive impairment and progression to dementia of Alzheimer's disease
The increase in life expectancy in the Brazilian population raises questions about the preparation of the public health system in identifying elderly patients with signs of cognitive impairment. Currently, as a consequence of the long duration of preclinical phase of Alzheimer's disease, efforts of early detection have been emphasized. Clinical dementia presents an important impact on the individual's caregivers, family, society and economy. Identifying individuals who already have some cognitive impairment, despite remaining functional, as well as analyzing associated comorbidities, constitutes an opportunity to analyze possibilities for future interventions. Dementias are clinical conditions that impose a burden on the health system with its high costs, whereas the identification of individuals with cognitive impairment without dementia can aid patients and their families to plan the future and mitigate costs. This narrative revision can provide general practitioners with more information on the subject.Univ Fed Sao Paulo, UNIFESP, Escola Paulista Med, Psychiat Dept, Sao Paulo, SP, BrazilUniv Estadual Paulista, UNESP, Fac Med Botucatu, Dept Internal Med,Geriatr, Botucatu, SP, BrazilFMB Unesp, Botucatu, SP, BrazilUniv Sao Paulo, Sao Paulo, BrazilHosp Santa Marcelina, Neurol Residency Program, Sao Paulo, BrazilUniv Sao Paulo, Grp Neurol Cognitiva & Comportamento, Sao Paulo, SP, Brazil|Univ Sao Paulo, Ctr Referencia Disturbios Cognit Ceredic, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, UNIFESP, Escola Paulista Med, Psychiat Dept, Sao Paulo, SP, BrazilWeb of Scienc