Carla Ponte

Introdução: Os contactos não presenciais entre médicos de família e pacientes são componente chave da acessibilidade aos cuidados. Objetivos: Determinar a frequência de utilização do telefone e e-mail entre os médicos de família de Matosinhos e os seus pacientes, bem como as atitudes perante este tipo de contactos. Métodos: Estudo transversal sobre um censo aos médicos de família de Matosinhos, por aplicação de questionário anónimo, de autopreenchimento, em papel. Tratamento de dados com estatística descritiva. Resultados: Obtiveram-se 81 questionários preenchidos (taxa de resposta de 90,0%). Todos os médicos de família referem usar o telefone com pacientes, mas 1/3 nunca/raramente usa o e-mail. A maioria considera que o uso do telefone e e-mail com pacientes é uma sobrecarga, que não tem tempo para esses contactos, mas que facilita a gestão da lista/consulta. A maioria considera também que usaria mais o telefone e o e-mail se pudessem fazer registos em tempo real e que usaria mais ...

Objectives: To quantify the time spent by family physicians (FP) on tasks other than direct patient contact, to evaluate job satisfaction, to analyse the association between time spent on tasks and physician characteristics, the association between the number of tasks performed and physician characteristics and the association between time spent on tasks and job satisfaction. Design: Cross-sectional, using time-and-motion techniques. Two workdays were documented by direct observation. A significance level of 0.05 was adopted. Setting: Multicentric in 104 Portuguese family practices. Participants: A convenience sample of FP, with lists of over 1000 patients, teaching senior medical students and first-year family medicine residents in 2012, was obtained. Of the 217 FP invited to participate, 155 completed the study. Main outcomes measured: Time spent on tasks other than direct patient contact and on the performance of more than one task simultaneously, the number of direct patient contacts in the office, the number of indirect patient contacts, job satisfaction, demographic and professional characteristics associated with time spent on tasks and the number of different tasks performed, and the association between time spent on tasks and job satisfaction. Results: FP (n=155) spent a mean of 143.6 min/day (95% CI 135.2 to 152.0) performing tasks such as prescription refills, teaching, meetings, management and communication with other professionals (33.4% of their workload). FP with larger patient lists spent less time on these tasks (p=0.002). Older FP (p=0.021) and those with larger lists (p=0.011) performed fewer tasks. The mean job satisfaction score was 3.5 (out of 5). No association was found between job satisfaction and time spent on tasks. Conclusions: FP spent one-third of their workday in coordinating care, teaching and managing. Time devoted to these tasks decreases with increasing list size and physician age

Introducao: A lombalgia e um motivo frequente de consulta em Medicina Geral e Familiar. A sua prevalencia e conhecida em varios paises atingindo valores elevados, o que torna a lombalgia um problema de saude publica. Objectivos: Determinar a prevalencia de lombalgia nos utentes adultos do Centro de Saude Senhora da Hora; caracterizar a lombalgia; analisar a sua relacao com caracteristicas sociodemograficas dos doentes; descrever a conduta terapeutica assumida. Metodos: Estudo analitico transversal na populacao de adultos entre 18 e 65 anos de idade, inscritos no C.S. Senhora da Hora. Amostra aleatoria de 300 pessoas. Foi aplicado um questionario por entrevista telefonica. Procedeu-se a analise atraves de estatistica descritiva e estatistica inferencial (teste de _2). Nivel de significância 0,05. Resultados: A prevalencia de lombalgia foi de 49%. Foi caracterizada por 39,3% dos individuos como tendo uma duracao de um dia a uma semana e com intensidade 4 a 7 na escala de dor por 67% d...

Introduction: Self-monitorization of capillary glycemia of type 1 and type 2 diabetics in insulin therapy is effective, resulting in an improvement of the glycemic control. However, in those that do not take insulin, this procedure is controversy. The aim of this work is to conduct an evidence-based revision on the role of self-monitorization of capillary glycemia in these diabetics. Methodology: A systematic revision was conducted in MEDLINE, Cochrane Library, Bandolier, Medscape, Tripdatabase, DARE and EBM Resources, from 1989 to May 2005. Studies that evaluated the following characteristics were included: glycemic control measured by glycosylated hemoglobin (Hb A1c) and/or postprandial glycemia and/or quality of life. Eight randomized clinical trials (RCT’s), two Cohort Studies, one case-control study, four meta-analysis and two evidence-based guideline were included. Results: Self-monitorization of capillary glycemia global effect showed a statistically significant reduction of ...