Abstract:
:This study examines renal care from the perspective of kidney transplant patients with chronic kidney disease (CKD), as well as their families. A qualitative study was performed in three cities of Uruguay. Using theoretical sampling, we selected 25 persons with CKD that were living with kidney transplants, in addition to five family members. Semi-structured interviews were held to explore the participants' perspectives, as well as content analysis. Four thematic lines were constructed from the participants' discourse: recognizing the successes of the system of care, the right to health, identifying problems in care, and formulating proposals for action. The system of care is rated as adequate, efficient, and high-quality by individuals living with kidney transplants who are young, employed, residing in the national capital of Montevideo, and covered by the private health sector. The opposite is true for retirees and pensioners, those with multiple morbidities, from inland Uruguay, covered by the public sector, and living in poverty. The participants also formulated proposals to solve the problems that were identified. In addition to acknowledging free and universal access to renal therapies to which patients feel they have the right, we conclude that kidney transplant patients assess the healthcare favorably and the agencies involved. Nevertheless, there are serious obstacles to accessing free, timely, and high-quality care. We recommend promoting strategies to incorporate proposals by patients and their families in order to improve such care and decrease social inequalities. :Resumen: Este trabajo examina la atención renal desde la perspectiva de quienes han sido trasplantados, padeciendo enfermedad renal crónica (ERC), así como la de sus familias. Se realizó un estudio cualitativo en tres ciudades de Uruguay. Utilizando un muestreo teórico, seleccionamos 25 personas con ERC que vivieran con trasplante renal, y cinco familiares. Se hicieron entrevistas semi-estructuradas para explorar las perspectivas de los participantes; así como análisis de contenido. Cuatro ejes temáticos fueron construidos a partir del discurso de los participantes: reconociendo los logros del sistema de atención, teniendo derecho a la salud, identificando problemas en la atención y formulando propuestas de acción. El sistema de atención es considerado adecuado, eficiente y de calidad por quienes viven con trasplante renal, son jóvenes, trabajadores, de Montevideo y están cubiertos por el sector sanitario privado. Lo contrario sucede con los jubilados o pensionistas, con multi-morbilidad, del interior del país, cubiertos por el sector público y viviendo en la pobreza. Los participantes también formulan propuestas para resolver los problemas identificados. Además de reconocer el acceso gratuito y universal a las terapias renales, a las cuales consideran tener derecho, concluimos que los individuos con trasplante de riñón valoran favorablemente la atención sanitaria y los organismos involucrados. Sin embargo, algunos enfrentan serios obstáculos para acceder a una atención gratuita, oportuna y de calidad. Recomendamos impulsar estrategias para incorporar propuestas de los individuos enfermos y sus familias, a fin de mejorar dicha atención y disminuir las desigualdades sociales. :Resumo: Este trabalho examina a atenção renal desde a perspectiva daqueles que foram transplantados, sofrendo insuficiência renal crônica (IRC), assim como desde a das suas famílias. Foi realizado um estudo qualitativo em três cidades do Uruguai. Utilizando uma amostragem teórica, selecionamos 25 pessoas com IRC que viveram com transplante renal, e cinco familiares. Foram realizadas entrevistas semiestruturadas para explorar as perspectivas dos participantes; assim como a análise de conteúdo. Quatro eixos temáticos foram construídos a partir da intervenção dos participantes: reconhecendo os resultados alcançados com o sistema de atenção, tendo direito à saúde, identificando problemas na assistência e formulando propostas de ação. O sistema de assistência é considerado adequado, eficiente e de qualidade por quem vive com transplante renal, são jovens, trabalhadores, de Montevidéu e estão cobertos pelo seguro de saúde privado. O oposto acontece com os aposentados ou pensionários, com multi-morbilidade, no interior do país, cobertos pelo sistema público e vivendo na pobreza. Os participantes também apresentam propostas para resolver os problemas identificados. Além disso, se reconhece o acesso gratuito e universal às terapias renais, para as quais consideram ter direito, concluímos que os indivíduos com transplante de rins valorizam favoravelmente a atenção sanitária e as instituições envolvidas. Porém, alguns enfrentam sérios obstáculos para aceder a uma atenção gratuita, adequada e de qualidade. Recomendamos incentivar estratégias para incorporar propostas dos indivíduos doentes e suas famílias, ao fim de melhorar a referida atenção e reduzir as desigualdades sociais.
journal_name
Cad Saude Publicajournal_title
Cadernos de saude publicaauthors
Mercado-Martínez FJ,Levin-Echeverri Rdoi
10.1590/0102-311X00160416subject
Has Abstractpub_date
2017-10-26 00:00:00pages
e00160416issue
10eissn
0102-311Xissn
1678-4464pii
S0102-311X2017001005008journal_volume
33pub_type
杂志文章abstract::Brazil has reported an increase in the incidence of both gestational and congenital syphilis, posing a serious public health problem in the country. The study aimed to analyze the relationship between the supply of syphilis diagnosis and treatment in primary care and the incidence rates of gestational and congenital s...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00074519
更新日期:2020-03-23 00:00:00
abstract::The study aims to describe body phenotypes estimated by multivariate technique for the assessment of nutritional status in adolescence during the process of sexual maturation. The sample consisted of 833 schoolchildren 10 to 15 years of age, selected by complex sampling in Piracicaba, São Paulo State, Brazil. Body phe...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00057217
更新日期:2018-03-12 00:00:00
abstract::This study aims to improve the health of rural Amazonian communities through the development and application of a participatory ecosystem approach to human health assessment. In the study area marked seasonal fluctuations dictate food availability, water quality and disease outbreak. Determining the causal linkages be...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2001000700028
更新日期:2001-01-01 00:00:00
abstract::This article takes an ethical approach to briefly analyze current therapeutic guidelines in Brazil for cases diagnosed as "ambiguous genitalia" (one of the "disorders of sexual development", DSD) in intersex children. Except when there is clear risk to the infant's life, there is no medical or institutional consensus ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311x00168613
更新日期:2014-10-01 00:00:00
abstract::This article contends that the distinction between clinical care (illness) and prevention of future disease is essential to the practice of quaternary prevention. The authors argue that the ongoing entanglement of clinical care and prevention transforms healthy into "sick" people through changes in disease classificat...
journal_title:Cadernos de saude publica
pub_type: 杂志文章,评审
doi:10.1590/0102-311X00012316
更新日期:2016-10-20 00:00:00
abstract::This paper deals with the impact of night work from a gender perspective, through a field study at a factory employing men and women on the night shift. It is based on data for hours of sleep over the course of several weeks, socio-demographic data, and job information, using a semi-structured interview. The methodolo...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2001000300018
更新日期:2001-05-01 00:00:00
abstract::The city of Rio de Janeiro, Brazil, shows high potential receptiveness to the introduction, dissemination, and persistence of dengue transmission. The pattern of territorial occupation in the municipality produced a heterogeneous and diverse mosaic, with differential vector distribution between and within neighborhood...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00186615
更新日期:2017-03-30 00:00:00
abstract::The central theme of the 5th National Congress on Social and Human Sciences in Health held by ABRASCO in São Paulo, Brazil, in 2011 was The Place of Social Sciences in Public Health, fostering a broad process of reflection on the scope and importance of this area's contributions to the field of public health. The arti...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2012001400016
更新日期:2012-12-01 00:00:00
abstract::Data from Brazilian national surveys conducted since the 1970s have indicated an increase in the prevalence of overweight/obesity. The two most frequently cited causes of this trend have been dietary changes and reduction in physical activity, characterizing a "contemporary Western lifestyle". The objective of this pa...
journal_title:Cadernos de saude publica
pub_type: 杂志文章,评审
doi:10.1590/s0102-311x2004000300006
更新日期:2004-05-01 00:00:00
abstract::Leptospirosis is an endemic disease in the State of Rio Grande do Sul, Brazil, and presents a broad diversity of exposure routes, reservoirs, etiological agents, and clinical features. The main objective of this work is to identify transmission areas and possible ecological components of leptospirosis transmission. Th...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2003000500007
更新日期:2003-09-01 00:00:00
abstract::This article provides a literature review of dental care models in Brazil, with a specific focus on the Incremental System. Other models that appeared in the research were the Inversion of Care, Early Dental Care, and Family Health Programs. The various authors analyzed the pros and cons, origins, program principles, ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章,评审
doi:10.1590/s0102-311x2008000200002
更新日期:2008-02-01 00:00:00
abstract::The aim of this study was to identify spatial-temporal clusters of high and low diabetes-related mortality from 1990 to 2012 in Argentina. This was a spatial-temporal retrospective ecological study in the population older than 34 years living in Argentina, according to sex, from 1990 to 2012. The spatial units of anal...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00169615
更新日期:2017-02-13 00:00:00
abstract::The epidemiology of dengue in the municipality of Campinas, São Paulo, Brazil, was studied in 1998 using a randomized sero-epidemiological survey. Epidemiological surveillance data from 1996-2003 were also analyzed, with an emphasis on virological surveillance. 1,260 individuals participated in the survey and had bloo...
journal_title:Cadernos de saude publica
pub_type: 杂志文章,随机对照试验
doi:10.1590/s0102-311x2007000300025
更新日期:2007-03-01 00:00:00
abstract::The purpose of this article is to describe several chronological milestones in institutionalizing the evaluation of public programs and policies in France from a governmental perspective and in the health sector, situating such references in the international context. The institutional nature of evaluation implies int...
journal_title:Cadernos de saude publica
pub_type: 历史文章,杂志文章
doi:10.1590/s0102-311x1999000200002
更新日期:1999-04-01 00:00:00
abstract::In the late 2000s, the expansion of Emergency Care Units (UPAs) in Brazil's policy for provision of urgent healthcare included hiring a large contingent of health professionals. This article analyzes government strategies for workforce management and the profile of these professionals in the UPAs in the State of Rio d...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00170614
更新日期:2016-02-01 00:00:00
abstract::This article debates the principal guidelines and procedures that shape HIV/AIDS prevention in Portugal, focusing on risk reduction in the two major scenarios for spread of the epidemic: sexuality and injection drug use. The analysis views the risks of infection as expressions of practices that are densely interwoven ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00129715
更新日期:2016-06-20 00:00:00
abstract::No consensus has been reached concerning the definition of criteria and standards for evaluating the decentralization of actions by municipal health surveillance systems. With the aim of developing and validating an objective image for municipal health surveillance that would correspond to an appropriate system for th...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2009001000011
更新日期:2009-10-01 00:00:00
abstract::A case-control study was conducted to investigate risk factors for hysterectomy among women using the public health system in Northeast Brazil. The cases were 373 women aged 30-54 years that had undergone elective hysterectomy for benign pelvic conditions. Controls were 742 women with preserved uterus selected from pu...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2003000800022
更新日期:2003-01-01 00:00:00
abstract::An external quality assessment in coproparasitology was carried out in 77 laboratories from Havana City. A questionnaire and ten plastic vials with different intestinal parasites in a small nylon bag, duly sealed, were sent to each laboratory. Answers were collected during the 72 hours after delivery. Results were ana...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::This article describes changes in the public, nonprofit, and private components of the health care networks and health insurance and health plan companies in Brazil, based on the accumulated knowledge concerning the gains and obstacles in the Brazilian Unified National Health System (SUS) and differences between polic...
journal_title:Cadernos de saude publica
pub_type: 历史文章,杂志文章
doi:10.1590/0102-311X00067218
更新日期:2018-08-06 00:00:00
abstract::The sense of pleasure that arises from engagement in activities is a fundamental factor for wellbeing in the elderly. Brazil lacks an instrument to evaluate older people's involvement in pleasant activities. An American instrument was located in the international literature (The California Older Person's Pleasant Even...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311x00130212
更新日期:2013-12-01 00:00:00
abstract::This study's objective was to evaluate quality of life in older adults living with HIV/AIDS and the associations with socio-demographic, economic, and clinical characteristics, using a cross-sectional design. Data were collected on demographics, disease history, and economic status according to the Brazilian Economic ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311x00095613
更新日期:2014-07-01 00:00:00
abstract::The aim of this study was to characterize the methodology of data collection on physical activity using accelerometry in two birth cohorts (2004 and 1993) in Pelotas, Rio Grande do Sul State, Brazil, at the 6-7 and 18-year follow-up visits, respectively. During visits to the study headquarters for a health evaluation,...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2013000300013
更新日期:2013-03-01 00:00:00
abstract::The aim of this study was to investigate the relationship between inadequate nutrient intake, oral health and family cohesion. This was a cross-sectional study with a sample of 887 non-institutionalized elderly people from Vitória, Espírito Santo State, Brazil. Oral examination was performed by trained and calibrated ...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2011000100012
更新日期:2011-01-01 00:00:00
abstract::The aim of the current article is to explore central features of Anísio Teixeira's "thought-action" approach in order to help overcome the current crisis in health personnel training. First, the article summarizes Teixeira's life and work, assessing his institutional legacy and its impact on the historical scenario in...
journal_title:Cadernos de saude publica
pub_type: 传,历史文章,杂志文章
doi:10.1590/0102-311XET011214
更新日期:2014-12-01 00:00:00
abstract::Cross-sectional surveys were performed in 1993 and 2000 on Japanese-Brazilians (n = 328) of both sexes, aged 40 to 79 years in 1993, living in Bauru, São Paulo State. Both surveys examined food intake using food frequency questionnaires. Dietary intake in both surveys was compared to Wilcoxon tests according to gender...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2006001100017
更新日期:2006-11-01 00:00:00
abstract::This article analyzes the spatial distribution of homicide rates in Minas Gerais State, Brazil, using data from the Ministry of Health Mortality Information System (SIM/MS) from 1996 to 2000. Population data used to calculate rates were also obtained from the Brazilian Ministry of Health. Minas Gerais has a large terr...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/s0102-311x2004000500021
更新日期:2004-09-01 00:00:00
abstract::This paper offers a critical review of the theoretical literature on the relationship between the production of scientific knowledge and its use in policy formulation and implementation. Extensive academic output, using a diversity of approaches and analytical frameworks, has sought to systematize knowledge transfer c...
journal_title:Cadernos de saude publica
pub_type: 杂志文章,评审
doi:10.1590/s0102-311x2006001300002
更新日期:2006-01-01 00:00:00
abstract::This study aimed to estimate the incidence of self-reported hearing loss among the elderly in the city of São Paulo, Brazil, and identify associated risk factors. A longitudinal study based on a representative sample of individuals aged 60 years and over interviewed in 2000 was conducted in 2006. The sample was obtain...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:
更新日期:2013-04-01 00:00:00
abstract::Brazil is among the countries of the world with the most dengue cases. Case reporting systems are essential for monitoring the disease's evolution, but few reporting forms are properly completed. Knowledge of the patients' schooling level is important for understanding the role of social inequality in the risk of illn...
journal_title:Cadernos de saude publica
pub_type: 杂志文章
doi:10.1590/0102-311X00187219
更新日期:2020-10-26 00:00:00