RESUMO
OBJECTIVE: to understand the experience of care of people with venous ulcers using an Unna's boot. METHOD: a qualitative study, based on the social phenomenology by Alfred Schütz, was carried out with 12 adults interviewed in 2015. The statements were analyzed and organized in thematic categories. RESULTS: the following categories emerged: "Unna's boot annoyance versus wound improvement", "Difficulties for accessing care with the Unna's boot", "Care for healing and preventing recurrence", and "Receiving more attention from the healthcare professional". CONCLUSION: the experience of care of people using an Unna's boot revealed the annoyance caused by this device, which was overcome due to the wound improvement. However, access to care was compromised by the lack of structure at the service, frustrating the patients' expectations regarding wound healing. The issues of these people's intersubjective universe should be considered in the management of care of venous ulcers.
Assuntos
Desenho de Equipamento/normas , Sapatos/normas , Úlcera Varicosa/terapia , Cicatrização , Idoso , Desenho de Equipamento/psicologia , Feminino , Pé/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Sapatos/efeitos adversosRESUMO
ABSTRACT Objective: to understand the experience of care of people with venous ulcers using an Unna's boot. Method: a qualitative study, based on the social phenomenology by Alfred Schütz, was carried out with 12 adults interviewed in 2015. The statements were analyzed and organized in thematic categories. Results: the following categories emerged: "Unna's boot annoyance versus wound improvement", "Difficulties for accessing care with the Unna's boot", "Care for healing and preventing recurrence", and "Receiving more attention from the healthcare professional". Conclusion: the experience of care of people using an Unna's boot revealed the annoyance caused by this device, which was overcome due to the wound improvement. However, access to care was compromised by the lack of structure at the service, frustrating the patients' expectations regarding wound healing. The issues of these people's intersubjective universe should be considered in the management of care of venous ulcers.
RESUMEN Objetivo: comprender la experiencia del cuidado de personas con úlcera varicosa utilizando la Bota de Unna. Método: estudio cualitativo, fundamentado en fenomenología social de Alfred Schütz, realizado con 12 adultos entrevistados en 2015. Testimonios analizados y organizados en categorías temáticas. Resultados: surgieron las categorías: "Incomodidad de la Bota de Unna versus mejora de la herida", "Dificultades para el acceso al cuidado con la Bota de Unna", "Cuidar para cicatrizar y prevenir recidivas" y "Recibir más atención del profesional de salud". Conclusión: la experiencia de cuidado de personas utilizando la Bota de Unna expresó la incomodidad del dispositivo, superado por la mejora de la herida. No obstante, el acceso al cuidado resultó comprometido por falta de estructura del servicio, frustrando expectativas de los participantes respecto a la cicatrización de la herida. Las cuestiones del universo intersubjetivo de estas personas deben considerarse en la gestión del cuidado de la úlcera varicosa.
RESUMO Objetivo: compreender a vivência de cuidado de pessoas com úlcera varicosa em uso da Bota de Unna. Método: estudo qualitativo fundamentado na fenomenologia social de Alfred Schütz, realizado com 12 adultos entrevistados em 2015. Os depoimentos foram analisados e organizados em categorias temáticas. Resultados: foram desveladas as categorias: "O incômodo da bota de Unna versus a melhora da ferida", "Dificuldades para o acesso ao cuidado com a Bota de Unna", "Cuidar para cicatrizar e prevenir recidivas" e "Receber mais atenção do profissional de saúde". Conclusão: a vivência de cuidado de pessoas em uso da Bota de Unna revelou o incômodo proporcionado por este dispositivo, superado pela melhora da ferida. Porém, o acesso ao cuidado foi comprometido pela falta de estrutura do serviço, frustrando as expectativas dos participantes em relação à cicatrização da ferida. As questões do universo intersubjetivo dessas pessoas devem ser consideradas na gestão do cuidado da úlcera varicosa.
Assuntos
Sapatos/normas , Úlcera Varicosa/terapia , Cicatrização , Desenho de Equipamento/normas , Sapatos/efeitos adversos , Pesquisa Qualitativa , Desenho de Equipamento/psicologia , Pé/fisiopatologia , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To determine the prevalence of onychocryptosis and onychomycosis confirmed by culture in subjects attending a Podiatric University Hospital and to describe their podiatric habits. METHOD: Cross-sectional study of prevalence. The study was carried out at the Clinic University of Podology of A Coruna University (Ferrol, Spain). Review of 1082 clinical histories, of which 170 were selected, persons who had onychocryptosis diagnosed clinically. The presence of onychomycosis confirmed by cultivation, presence of onychocryptosis through clinical diagnosis and a questionnaire was handed out of podologic habits. RESULTS: Mean age of the total sample (n = 1082) was 47.9 ± 22.1 years. Prevalence of onychocryptosis was 15.7% (n = 170) with a mean age of 54.1 ± 20.1 years and with a significantly higher affectation in women and people under 65. Prevalence of onychomycosis was 17.6% (n = 30), mean age 59.5 ± 20.5 years with greater involvement in women and people over 65 years. With regard to the questionnaire of habits, the footwear more employee was the closed, cordoned off and heel flat. The majority of the subject came to a podiatrist for the first time; walked approximately 1 hour and their daily activity made of foot with short displacements. CONCLUSIONS: A high prevalence of onychocryptosis and onychomycosis in people attending Podiatric services has been found. For its part using a type of flat or low heel and who does the care of toenails are shown as predictive variables of onychomycosis.
Assuntos
Unhas Encravadas/epidemiologia , Onicomicose/epidemiologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Onicomicose/microbiologia , Prevalência , Distribuição por Sexo , Sapatos/normas , Espanha/epidemiologia , Fatores de Tempo , CaminhadaRESUMO
This paper presents a method for implementing multifunctional work teams in a footwear company that followed the Taylor/Ford system for decades. The suggested framework first applies a Learning Curve (LC) modeling to assess whether rotation between tasks of different complexities affects workers' learning rate and performance. Next, the Macroergonomic Work Analysis (MA) method (Guimarães, 1999, 2009) introduces multifunctional principles in work teams towards workers' training and resources improvement. When applied to a pilot line consisting of 100 workers, the intervention-reduced work related accidents in 80%, absenteeism in 45.65%, and eliminated work related musculoskeletal disorders (WMSD), medical consultations, and turnover. Further, the output rate of the multifunctional team increased average 3% compared to the production rate of the regular lines following the Taylor/Ford system (with the same shoe model being manufactured), while the rework and spoilage rates were reduced 85% and 69%, respectively.
Assuntos
Indústrias/organização & administração , Curva de Aprendizado , Sapatos , Análise e Desempenho de Tarefas , Brasil , Eficiência Organizacional , Humanos , Indústrias/normas , Sapatos/normasRESUMO
CONTEXT: Wearing inappropriate shoes can cause biomechanical imbalance, foot problems, and pain and induce falls. OBJECTIVE: To verify the prevalence of wearing incorrectly sized shoes and the relationship between incorrectly sized shoes and foot dimensions, pain, and diabetes among older adults. DESIGN: A cross-sectional study. PARTICIPANTS: 399 older adults (227 women and 172 men) age 60 to 90 y. MAIN OUTCOME MEASURES: The participants were asked about the presence of diabetes, pain in the lower limbs and back, and pain when wearing shoes. Foot evaluations comprised the variables of width, perimeter, height, length, first metatarsophalangeal angle, the Arch Index, and the Foot Posture Index. The data analysis was performed using a 2-sample t test and chi-square test. RESULTS: The percentage of the participants wearing shoe sizes bigger than their foot length was 48.5% for the women and 69.2% for the men. Only 1 man was wearing a shoe size smaller than his foot length. The older adults wearing the incorrect shoe size presented larger values for foot width, perimeter, and height than those wearing the correct size, but there were no significant differences between the groups with respect to the Arch Index and the Foot Posture Index. Incorrectly sized shoes were associated with ankle pain in women but not with diabetes. Men were more likely to wear incorrectly fitting shoes. The use of correctly sized shoes was associated with back pain in women. CONCLUSIONS: The use of incorrectly sized shoes was highly prevalent in the population studied and was associated with larger values for foot width, perimeter, and height and with ankle pain.
Assuntos
Diabetes Mellitus/epidemiologia , Pé/anatomia & histologia , Dor/etiologia , Sapatos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Artrometria Articular , Fenômenos Biomecânicos , Brasil/epidemiologia , Estudos Transversais , Feminino , Pé/fisiologia , Marcha , Humanos , Masculino , Pessoa de Meia-Idade , Postura , Prevalência , Fatores de Risco , Sapatos/efeitos adversos , Sapatos/normas , Inquéritos e QuestionáriosRESUMO
The primary goal in the treatment of diabetic foot ulcers is to obtain wound closure as expeditiously as possible and prevent the recurrence of foot wounds due to neuropathy, foot deformity, and poor circulation. Interventions that bring about the quick resolution of afoot wound and reduce the rate of recurrence have been shown to lower the risk of developing a secondary infection and decrease the incidence of lower extremity amputation in the diabetic patient.
Assuntos
Humanos , Fenômenos Biomecânicos , Pé Diabético/terapia , Sapatos/normas , Desenho de Equipamento , Neuropatias Diabéticas/terapia , Promoção da Saúde , Pé Diabético/fisiopatologiaRESUMO
The goal of this paper is to provide an overview of common foot problems seen in diabetic individuals. Initial therapeutic intervention such as debridement ofpre-ulcerative lesions may prevent limb-threatening ulcerations from occurring. It is also essential that an understanding of the foot deformity and imbalance responsible for the high ulcerating pressures be identified and addressed for long-term treatment of these patients. The nature of compensatory foot imbalance with recommended re-alignment and balance therapies to prevent pathologic foot compensation and principles of padding and specific off-loading techniques are highlighted. Evaluation and therapy of often neglected digital deformities and treatment of nail pathology are reviewed.
Assuntos
Humanos , Pé Diabético/terapia , Sapatos/normas , Autocuidado , Desbridamento/métodos , Desenho de Equipamento , Prevenção Primária , Pé Diabético/fisiopatologia , Unhas Malformadas/terapiaRESUMO
The goal of this paper is to provide an overview of common foot problems seen in diabetic individuals. Initial therapeutic intervention such as debridement ofpre-ulcerative lesions may prevent limb-threatening ulcerations from occurring. It is also essential that an understanding of the foot deformity and imbalance responsible for the high ulcerating pressures be identified and addressed for long-term treatment of these patients. The nature of compensatory foot imbalance with recommended re-alignment and balance therapies to prevent pathologic foot compensation and principles of padding and specific off-loading techniques are highlighted. Evaluation and therapy of often neglected digital deformities and treatment of nail pathology are reviewed.
Assuntos
Pé Diabético/terapia , Sapatos/normas , Desbridamento/métodos , Pé Diabético/fisiopatologia , Desenho de Equipamento , Humanos , Unhas Malformadas/terapia , Prevenção Primária , AutocuidadoRESUMO
The primary goal in the treatment of diabetic foot ulcers is to obtain wound closure as expeditiously as possible and prevent the recurrence of foot wounds due to neuropathy, foot deformity, and poor circulation. Interventions that bring about the quick resolution of afoot wound and reduce the rate of recurrence have been shown to lower the risk of developing a secondary infection and decrease the incidence of lower extremity amputation in the diabetic patient.