Patients' comfort

APRESENTAÇÃO

BITENCOURT, Fábio, org. Ergonomia e conforto humano: uma visão da arquitetura, engenharia e design de interiores. Editora Rio Books, Rio de Janeiro, 2011, 195 p.: il. Color.

A descoberta da contribuição à melhor qualidade de vida é
uma das funções implícitas na função social que a ciência da ergonomia
tem como responsabilidade. A própria origem da ergonomia reflete
necessidades fundamentais voltadas para a função trabalho, destacando que a realização da atividade deve estar adequada a cada individuo, ao mesmo tempo em que a compreensão das exigências e limitações humanas deve-se perceber explicitamente.

À ergonomia cabe considerar as limitações humanas e
torná-las evidentes, com base no conhecimento sobre fisiologia, antropometria e biomecânica. Reconhecer ao mesmo tempo, que a nossa capacidade de realizar trabalho deve ser compatível com as condições de conforto que permitam segurança, bem estar e possibilitem a promoção de saúde e não a determinação de doenças.

Eis um desafio aos profissionais da ergonomia e aos interessados em
conhecer o tema.

Aqui, profissionais de áreas diversas do conhecimento apresentam suas
contribuições e reflexões sobre este assunto, abordagem que está
inserida em todo o ambiente onde haja a presença do ser humano.

Conectar os elos de conhecimento ergonômico com a prática funcional de
cada pessoa é também um papel ao qual o componente saúde deve
vir como resultado. Esta é uma forma de aprendizado para viver melhor,
e, por conseqüência, poder viver mais e com qualidade.




Fábio Bitencourt






“Eu sustento que a única finalidade da ciência está em aliviar a canseira da existência humana”

Bertolt Brecht, dramaturgo e poeta alemão, (1898-1956).

TEXTO CONTRACAPA

Este é um livro que visa aproximar os interesses no conhecimento dos que lidam com o planejamento do ambiente (arquitetos, engenheiros e designers, em especial) e  com a necessidade de promoção de qualidade de vida a partir do que a Ergonomia possa contribuir.  Da mesma forma, pode ser uma leitura de interesse geral para quem apenas deseja conhecer a ergonomia e rever seus conceitos em relação à saúde, conforto, bem estar e segurança.

Se a abordagem sobre qualidade de vida pode parecer um tema distante, ao conhecer a Ergonomia percebemos o quanto podemos contribuir e usufruir desta recente ciência surgida na primeira metade do século XX. Aliás, uma ciência com data marcada para seu inicio, embora com referencias históricas vinculadas ao nascimento da vida humana.

Aqui está apresentada uma visão multidisciplinar com especialistas de diversas áreas do conhecimento: arquitetura, engenharia, design, fisioterapia, pedagogia, fisiologia, administração e suas experiências profissionais.

Conhecer as interfaces ergonômicas pode contribuir para uma nova forma de pensar e agir o projeto oferecendo as condições mais adequadas a cada indivíduo.  Aliás, principio fundamental da ergonomia, adequar o trabalho ao homem.


Fábio Bitencourt

BITENCOURT, Fábio. Arquitetura do ambiente de Nascer: reflexões e recomendações projetuais de arquitetura e conforto ambiental. Rio de Janeiro: Rio Books, 2008, 129 p.; il.

Este livro traz como proposta principal apresentar reflexões e recomendações de soluções projetuais para o estabelecimento de padrões de eficiência energética e do conforto ambiental do centro obstétrico e cirúrgico, local destinado ao parto e ao nascimento em maternidades.As altas taxas de mortalidade materna e infantil registradas no Brasil, relacionadas a questões do perfil assistencial do parto e do nascimento, têm desencadeado diferentes programas visando à humanização da atenção obstétrica. São registradas proporções significativas de partos cirúrgicos (cesarianas), muito acima do recomendado pela OMS – Organização Mundial de Saúde, o que caracteriza um modelo de assistência com o uso de excessiva tecnologia e intervenção médica.
As contribuições de qualidade para o ambiente de nascer que a arquitetura pode promover consideram prioritariamente, os estudos de adequações das condições de iluminação naturais e artificiais, o tratamento higro-térmico, a pesquisa da melhoria das condições acústicas e os aspectos visuais que conformam o espaço construído. São apresentados também, os aspectos facilitadores de acessibilidade e os componentes ergonômicos que podem agregar valores de conforto e saúde aos diversos usuários – a parturiente, os profissionais de saúde e os visitantes. - de um centro obstétrico. A concepção arquitetônica para o conforto e adequado funcionamento do centro obstétrico, é um fator que pode  desempenhar um significativo  papel  na qualificação e humanização dos processos e no estabelecimento de atitudes de valorização do parto normal.

Hospital rooms may exacerbate or reduce patients' stress. According to Ulrich's (1991) theory of supportive design, the hospital environment will reduce stress if it fosters perceptions of control (PC), social support (SS), and positive distraction (PD). An experimental study was conducted to test this theory. Participants were asked to imagine a hospitalization scenario and were exposed to one of 8 lists of elements that the hospital room would provide selected to facilitate PC, SS, PD, or 1 of all the possible combinations of these elements. Results confirmed Ulrich's theory. Participants expected significantly less stress in the situations where all (or only PD and SS) elements were present. Meditational analyses confirmed that the number of elements in the hospital room affects expected stress through the perceptions of how much positive distraction and social support it is perceived to provide, but not through the perception of the level of perceived control available.

The present case study discusses about the Primary Health Care system of Kerala and the Government’s innovative step to promote the
Primary Health Centres to Family Health Centres. The case study also deliberates about the FHC working model and its superiority over the
current PHCs in the areas of manpower, OP time, lab services, nursing services, social security projects etc. and the transformation of PHCs
to a well-functioning PHC, thereby it can become a model for other states.

Introduction
As a response to the anti-malarial drug resistance situation, the
World Health Organisation (WHO) recommends that treatment
policies for falciparum malaria  in all countries experiencing
resistance to monotherapies should be combination therapies,
preferably those containing an arteminisin derivative (ACT-artemisinin-based combination therapy).
Methodology
A retrospective quantitative study was designed to examine case
records of patients treated for malaria in a tertiary health hospital
in Jos, Northern part of Nigeria between August and December
2012. Questionaires were also distributed to doctors working
within the hospital environment. Data on demographic, clinical
features of disease, diagnostic procedures and drug administration
were collected from the patients' records.
Results
Case record files of 130 patients were selected, 80.7% of the
patients were prescribed antimalarial drugs. 55.2% of patients
admitted for malaria were males, 44.8% were between 21-50 years
of age. Fever (35.2%) was the most common presenting symptom,
71.4% of the patients had diagnostic blood slides. Antimalarial
drugs were prescribed for malaria and malaria associated with
other disease conditions, artemisinin and lumefantrine was the
most prescribed antimalarial agent. 44.0% of these drugs were
prescribed by trade names, 29.0% were administered orally. The
most antimalarial drug prescribed for prevention of malaria in
pregnant women was sulfadoxine-pyrimethamine, all the
practitioners followed current WHO guidelines  , half of the
clinicians would prescribe parenteral antimalarial drugs for severe
and cerebral malaria, laboratory and clinical assessment were used
for malaria diagnosis, 71.4% of the physicians adhered to hospital
guidelines.
Conclusion
This study indicates the implementation of artemisinin
combination therapy in a public health facility; however the
success of this new treatment policy would depend on patient
adherence to recommendations and provision of ACTs at
subsidized costs in Nigeria.

Introduction
As a response to the anti-malarial drug resistance situation, the
World Health Organisation (WHO) recommends that treatment
policies for falciparum malaria in all countries experiencing
resistance to monotherapies should be combination therapies,
preferably those containing an arteminisin derivative (ACTartemisinin-
based combination therapy).
Methodology
A retrospective quantitative study was designed to examine case
records of patients treated for malaria in a tertiary health hospital
in Jos, Northern part of Nigeria between August and December
2012. Questionaires were also distributed to doctors working
within the hospital environment. Data on demographic, clinical
features of disease, diagnostic procedures and drug administration
were collected from the patients' records.
Results
Case record files of 130 patients were selected, 80.7% of the
patients were prescribed antimalarial drugs. 55.2% of patients
admitted for malaria were males, 44.8% were between 21-50 years
of age. Fever (35.2%) was the most common presenting symptom,
71.4% of the patients had diagnostic blood slides. Antimalarial
drugs were prescribed for malaria and malaria associated with
other disease conditions, artemisinin and lumefantrine was the
most prescribed antimalarial agent. 44.0% of these drugs were
prescribed by trade names, 29.0% were administered orally. The
most antimalarial drug prescribed for prevention of malaria in
pregnant women was sulfadoxine-pyrimethamine, all the
practitioners followed current WHO guidelines , half of the
clinicians would prescribe parenteral antimalarial drugs for severe
and cerebral malaria, laboratory and clinical assessment were used
for malaria diagnosis, 71.4% of the physicians adhered to hospital
guidelines.
Conclusion
This study indicates the implementation of artemisinin
combination therapy in a public health facility; however the
success of this new treatment policy would depend on patient
adherence to recommendations and provision of ACTs at
subsidized costs in Nigeria.

A lecture, given at STEP3 – THIRD SUMMER SCHOOL ON THEORIES IN ENVIRONMENTAL PSYCHOLOGY, focuses on the environmental aspects of hospital building and how architectural design can affect positively/negatively the condition of patients and visitors.
The lecture analyzes the transition from ‘the functional approach’ where the patient was seen as a passive object, a raw material, to more complex visions where the architectural design deals with wider and more complex requirements relating to the experiences, passions, dreams and fears of real people.
The lecture presents recommendations and examples related to humanization and the users’ psychological requirements which focuses the architectural design practice on the research of users’ psychological comfort through the study of shapes, lights, colors, acoustic conditions and, in a broader sense, all of the elements that can play an active role for a ‘high-touch’ environment.

Objective: To investigate the effects of 3 dissimilar suspension systems on participants' satisfaction and perceived problems with their prostheses. Design: Questionnaire survey. Setting: A medical and engineering research center and a university biomedical engineering department. Participants: Persons with unilateral transtibial amputation (N=243), using prostheses with polyethylene foam liner, silicone liner with shuttle lock, and seal-in liner. Interventions: Not applicable. Main Outcome Measures: Descriptive analyses were performed on the demographic information, satisfaction, and prosthesis-related problems of the study participants. Results: The results showed significant differences between the 3 groups regarding the degree of satisfaction and perceived problems with the prosthetic device. Analyses of the individual items revealed that the study participants were more satisfied with the seal-in liner and experienced fewer problems with this liner. The silicone liner with shuttle lock and seal-in liner users reported significant differences in maintenance time compared with the polyethylene foam liner. Users of the silicone liner with shuttle lock experienced more sweating, while those who used the seal-in liner had greater problems with donning and doffing the device. Conclusions: The results of the survey provide a good indication that prosthetic suspension is improved with the seal-in liner as compared with the polyethylene foam liner and silicone liner with shuttle lock. However, further prospective studies are needed to investigate which system provides the most comfort and the least problems for participants. © 2012 American Congress of Rehabilitation Medicine.

www.sciencedirect.com/science/article/pii/S0003999312003218

Manual de Conforto Ambiental em Estabelecimentos Assistenciais de Saúde

O Manual de Conforto Ambiental em Estabelecimentos Assistenciais de Saúde faz parte das Publicações de Tecnologia em Serviços de Saúde e vem a atender a necessidade de conhecimento sobre técnicas e práticas que resultem em ambientes propícios à recuperação do corpo humano. Soma-se também, às práticas de prevenção e segurança dos estabelecimentos de saúde vindo ao encontro das práticas relativas à Segurança do Paciente.
A Agência Nacional de Vigilância Sanitária (ANVISA), coordenadora do Sistema Nacional de Vigilância Sanitária (SNVS), pretende com este Manual, trazer orientações referentes ao Conforto Ambiental nos Serviços de Saúde do país. O foco da publicação são os riscos associados aos denominados “edifícios doentes”, aqueles nos quais há maior probabilidade de adoecimento de seus usuários. As ações do Serviço Nacional de Vigilância Sanitária (SNVS) baseiam-se na prevenção e no controle de riscos decorrentes do meio ambiente, da produção e circulação de bens e da prestação de serviços de saúde.
O Manual foi elaborado por meio do Termo de Cooperação n. 64 com a OPAS – Organização Pan Americana de Saúde, com a contratação de técnico renomado na área de atuação para redação do documento.
Espera-se que esta publicação seja um instrumento de apoio aos profissionais, que acrescente conhecimento na função projetual e na elaboração de soluções ambientais para os trabalhadores, pacientes e acompanhantes dos estabelecimentos de saúde.

Objective: Background reliable information about the prevalence of
dyslipidemia in hypertensive and non hypertensive diabetic patients
in local region is essential to the development of regional health
policies for prevention and control of this condition. An attempt was
made in Puducherry region to examine the lipid profile parameters in
the diabetic patients with and without hypertension and thereby to
create awareness on the importance of closely watching their lipid
parameters frequently from the age of 30-70.  Method:  Totally case
sheets of 105 Puducherry patients are referred covering hypertensive
and non hypertensive diabetic patients. To ascertain the significance
of each parameters student’s t-test has been done. Results: It is found
that el evated serum triglycerides (TG), very low density lipoprotein
(VLDL) and Cholesterol/High density lipoprotein Ratio
(CHOL/HDL) but normal cholesterol, low density lipoprotein (LDL)
and HDL in diabetic patients of all age groups. In both gender Serum
triglycerides are significantly elevated in diabetics of all age groups
compared to non diabetics. Plasma VLDL is significantly elevated in
female diabetic patients between the age group of 30-40 years and
60-70 years compare to non diabetics and other age groups. Plasma
VLDL is significantly elevated in male diabetic patients also between
the age group of 30-50 years compare to non diabetics and other age
groups.  Conclusion:  Serum TG and VLDL was found to be more
significantly increased in diabetic patients with  hypertension
compared to without hypertension. Similarly serum TG is also
elevated in non diabetic hypertensive patients.