MARIA INES BAPTISTELLA NEMES
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Comunicação profissional-paciente e cuidado: avaliação de uma intervenção para adesão ao tratamento de HIV/Aids(2013) BELLENZANI, Renata; NEMES, Maria Ines Baptistella; PAIVA, VeraInterventions to improve HIV/AIDS treatment adherence are often based on cognitive approaches of the health professional-patient communication and health behaviors. From a social-constructionist perspective of professional-patient communication and treatment experiences, it was assessed the implementation process of an individual psychosocial intervention, consisting of 4 encounters and informed by the conceptual frameworks of Vulnerability and Human Rights in the psychosocial dimension of Care. Taking all 16 encounters (4 encounters with each participant), the implementation process was considered ""moderately developed."" Difficulties were encountered to develop dialogic conversations and decode meanings regarding the lack of adherence in social situations integrated with interpersonal and sociocultural scenarios. Despite the predominance of guidelines and motivational incentives for patients, there were also dialogic moments of co-understanding difficulties in adherence in its different meanings in medication intake scenes. This approach to care proves to be productive to enhance adherence practices.
- Profile of the cohort of people being treated for HIV infection in the SUS, Brazil, 2015-2018(2023) SATO, Ana Paula Sayuri; NEMES, Maria Ines Battistella; ALVES, Ana Maroso; SOUZA, Evelyn Lima de; SANTOS, Barbara dos Reis; NUNES, Luceime Olivia; SANTOS, Angelica Carreira dos; KUMOW, Aline; NASCIMENTO, Felipe Parra doOBJECTIVE: To build an integrated database of individual and service data from the cohort of people who started antiretroviral therapy (ART), from 2015 to 2018, in Brazil. METHODS: Open cohort study that includes people aged 15 years or older who started ART from 2015 to 2018, with follow-up in services of the Brazilian Unified Health System (SUS), and who responded to the 2016/2017 Qualiaids national survey. The source of individual data was the related HIV database, derived from the probabilistic linkage between data from the SUS systems of diagnostic information, medication, tests, and deaths. The data source for the services was the services' response database to the Qualiaids survey. After analysis of consistency and exclusions, the database of individuals was deterministically related to the database of services. RESULTS: The cohort comprised 132,540 people monitored in 941 SUS services. Of these services, 59% are located in the Southeast region and 49% followed 51 to 500 cohort participants. The average performance of organization and management of patient care ranged from 29% to 75%. Most of the cohort participants are male, black and mixed, aged between 20 and 39 years old, and have between 4 and 11 years of schooling. Median baseline T-CD4 was 419 cells/mm3, 6% had an episode of tuberculosis, and 2% died of HIV disease. CONCLUSION: For the first time in Brazil, this cohort provides the opportunity for a joint analysis of individual factors and services in the production of positive and negative clinical outcomes of HIV treatment.
- Monitoring self-reported adherence to antiretroviral therapy in public HIV care facilities in Brazil: A national cross-sectional study(2018) SANTOS, Maria Altenfelder; GUIMARAES, Mark Drew Crosland; HELENA, Ernani Tiaraju Santa; BASSO, Caritas Relva; VALE, Felipe Campos; CARVALHO, Wania Maria do Espirito Santo; ALVES, Ana Maroso; ROCHA, Gustavo Machado; ACURCIO, Francisco de Assis; CECCATO, Maria das Gracas Braga; PRADO, Rogerio Ruscitto do; MENEZES, Paulo Rossi; NEMES, Maria Ines BatistellaIntroduction:Patient adherence to antiretroviral therapy (ART) is critical for HIV treatment success. Monitoring rates of adherence in public HIV outpatient care facilities can improve outcomes in Brazil where ART is universally available.Methods:We conducted a national cross-sectional survey of ART adherence in 2010. Participants were selected using a multistage probability sample. First, HIV outpatient care facilities were stratified according to 7 Organizational Quality Classification (OQC) groups and regions. Second, 1 or 2 facilities were selected per region for each OQC group. Finally, patients were randomly selected at each facility. In a first component, patients were invited to answer to a web-based questionnaire (WebAd-Q), a validated self-reported tool that includes 3 questions on adherence to ART in the past 7 days (time schedulingtiming, drug regimenmedication, and pill countsdose), herein named indicators of potential nonadherence (IPN). In addition, a subsample of participants were interviewed in order to obtain further data on sociodemographic and clinical characteristics (second component). The proportion of each IPN was estimated using weighted data to account for the sampling design with 95% confidence interval (CI) and descriptive analysis was carried out.Results:Fifty-five facilities were chosen and 2424 patients completed the WebAd-Q in the first component of the study, while 598 patients were interviewed for the second component. The weighted proportions of the IPN were 50.9%, 31.8%, and 19.5%, for timing, medication, and dose, respectively, while11.7% had all 3 indicators, varying from 5.9% in the Southeast and 21.9% in the Northeast regions. Overall, 61.1% of the patients had at least 1 IPN (95% CI: 58.5-63.7%). Patients reporting depression symptoms, illicit drug use and those who missed medical appointments had worse nonadherence outcomes.Conclusions:Overall, there was a high proportion of all indicators IPN and timing was the main component associated with low adherence. Although these indicators may not necessarily indicate individual nonadherence, they represent a worrisome scenario in the public Brazilian HIV care facilities. On a routine basis, these facilities can identify gaps in providing counseling and ART orientation to their clientele and develop innovative strategies to prevent nonadherence.
- The QualiRede intervention: improving the performance of care continuum in HIV, congenital syphilis, and hepatitis C in health regions(2019) NEMES, Maria Ines Battistella; CASTANHEIRA, Elen Rose Lodeiro; ALVES, Ana Maroso; ADANIA, Carolina Simone Souza; LOCH, Ana Paula; MONROE, Aline Aparecida; SOUZA, Rosa Alencar; GIANNA, Maria Clara; CAMINADA, Sirlene; FARIAS, Norma Suely de Oliveira; SOUSA, Paula de Oliveira e; DOMINGUES, Carmen Silva Bruniera; SILVA, Mariliza Henrique da; CERVANTES, Vilma; YAMASHIRO, Juliana; CARACIOLO, Joselita Maria de Magalhães; SILVA, Fabiano Lima da; NEMES FILHO, Alexandre; JESUS, Gabriel Lima de; HELENA, Ernani Tiaraju de Santa; ALBIERO, José Francisco Gontan; LIMA, Marcela Soares Silveira; BELLENZANI, Renata; KEHRIG, Ruth Terezinha; VALE, Felipe Campos do; NUNES, Luceime Olivia; MENDONÇA, Carolina Siqueira; ZARILI, Thais Fernanda Tortorelli; VILELA, Mara Cristina; DANTAS, Jean Carlos de Oliveira; PAULA, Ivone de; TAYRA, Ângela; COELHO, Débora Moraes; SANTOS, Glauber Palha dos; QUEVEDO, Dulce Castro; SILVA, Marcia Aparecida da; SILVA, Iraci Batista da; NASSER, Mariana Arantes; ANDRADE, Marta Campagnoni; SANTOS, Maria Altenfelder; MERCURI, Juliana; TRINDADE, Katia Valeska; NEVES, Maria Aparecida Teixeira das; TOLEDO, Renata Villanueva Alves de; ALMEIDA, Maria Cecília Rossi de; LIMA, Iraty NunesABSTRACT Introduction: Care continuum models have supported recent strategies against sexually transmitted diseases, such as HIV and Hepatitis C (HCV). Methods: HIV, HCV, and congenital syphilis care continuum models were developed, including all stages of care, from promotion/prevention to clinical control/cure. The models supported the intervention QualiRede, developed by a University-Brazilian National Health System (SUS) partnership focused on managers and other professionals from six priority health regions in São Paulo and Santa Catarina. Indicators were selected for each stage of the care continuum from the SUS information systems and from the Qualiaids and QualiAB facility’s process evaluation questionnaires. The indicators acted as the technical basis of two workshops with professionals and managers in each region: the first one to identify problems and to create a Regional Technical Group; and the second one to design action plans for improving regional performance. Results: The indicators are available at www.qualirede.org. The workshops took place in the regions of Alto Tietê, Baixada Santista, Grande ABC, and Registro (São Paulo) and of Foz do Rio Itajaí (Santa Catarina), which resulted in regional action plans in São Paulo, but not in Santa Catarina. A lack of awareness was observed regarding the new HIV and HCV protocols, as well as an incipient use of indicators in routine practices. Conclusion: Improving the performance of the care continuum requires appropriation of performance indicators and coordination of care flows at local, regional, and state levels of management.