Base de dados : MEDLINE
Pesquisa : M01.276 [Categoria DeCS]
Referências encontradas : 541 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 55 ir para página                         

  1 / 541 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
[PMID]:29240371
[Au] Autor:Goldstein B; Goldfarb DS
[Ti] Título:Meeting the Needs of the Complex Older Adult Patient with Urinary Retention: A Case Study.
[So] Source:Urol Nurs;37(2):75-80, 2017 Mar-Apr.
[Is] ISSN:1053-816X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This article presents a case study of how a homebound older adult patient with urinary retention is managed by a patient-centered medical home/transitional care model. A description of how a root cause analysis can effectively improve outcomes is also provided.
[Mh] Termos MeSH primário: Pacientes Domiciliares
Assistência Centrada no Paciente
Atenção Primária à Saúde
Cuidado Transicional
Retenção Urinária/enfermagem
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Comportamento Cooperativo
Assistência à Saúde
Seres Humanos
Masculino
Autocuidado
Cateterismo Urinário
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


  2 / 541 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:29239586
[Au] Autor:Greenfield AP; Banerjee S; Depasquale A; Weiss N; Sirey J
[Ti] Título:Factors Associated With Nutritional Risk Among Homebound Older Adults With Depressive Symptoms.
[So] Source:J Frailty Aging;5(3):149-157, 2016.
[Is] ISSN:2260-1341
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: This study used the Evans model of public health determinants to identify factors associated with nutritional risk in older adults. DESIGN: The Evans model domains (physical and mental well-being, social/environmental statuses, individual choice, and economic security) were measured in a sample of homebound older adults. Regularized logistic regression analysis with LASSO penalty function was used to determine the strongest domain of the Evans model. Using traditional logistic regression, individual variables across all domains were compared to identify the significant predictors. SETTING: Older adults receiving home meal services were referred to the study by community program staff. PARTICIPANTS: Participants included 164 homebound older adults (age > 60) who endorsed at least one gateway symptom of depression. MEASUREMENTS: Measurements: Nutritional risk was determined using the Mini Nutritional Assessment. Domains of the Evans model were measured using the MAI Medical Condition Checklist, items from the IADL scale, the Structured Clinical Interview for DSM-IV Axis I Disorders, the Duke Social Support Index, living arrangements, marital status, the Alcohol Use Disorders Identification Test, items from the SCID Screening Module, and a self-report of perceived financial security. RESULTS: Poor mental well-being, defined by a diagnosis of major depressive disorder, was identified as the strongest Evans model domain in the prediction of nutritional risk. When each variable was independently evaluated across domains, instrumental support (Wald's Z=-2.24, p=0.03) and a history of drug use (Wald's Z=-2.40, p=0.02) were significant predictors. CONCLUSIONS: The Evans model is a useful conceptual framework for understanding nutritional health, with the mental domain found to be the strongest domain predictor of nutritional risk. Among individual variables across domains, having someone to help with shopping and food preparation and a history of drug use were associated with lower nutritional risk. These analyses highlight potential targets of intervention for nutritional risk among older adults.
[Mh] Termos MeSH primário: Depressão/psicologia
Pacientes Domiciliares/psicologia
Transtornos Nutricionais/epidemiologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos Transversais
Feminino
Avaliação Geriátrica
Seres Humanos
Masculino
Meia-Idade
Avaliação Nutricional
Medição de Risco
Fatores de Risco
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


  3 / 541 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28789749
[Au] Autor:Schulc E; Gothe RM; Them C; Tufan I; Mueller G
[Ti] Título:Self-Reported Questionnaire of Functional Health of Home-Dwelling Elderly People Living in Austria: Based on the Patient Questionnaire of the Standardized Assessment of Elderly People in Primary Care.
[So] Source:J Nurs Meas;25(2):238-256, 2017 Aug 01.
[Is] ISSN:1945-7049
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:AIM: The aim was to review the construct validity and reliability of a functional health assessment questionnaire (Questionnaire on Functional Health 2 [Q-FH2]). METHODS: The Q-FH2 was used to assess 344 elderly people in a home setting. A polychoric correlation matrix was applied to conduct a principal axis factor analysis with oblique rotation. The number of factors was determined using various procedures and calculated using theta coefficients to estimate ordinal reliability. RESULTS: The exploratory factor analysis supported a 4-factor solution with an explained total variance of 82%. The internal consistency showed  coefficients ranging from 0.758 to 0.854. CONCLUSION: The Q-FH2 appears to be a useful instrument to assess the multidimensionality of functional health as defined by the International Classification of Functioning, Disability and Health to determine the resources and deficits regarding the independent living of older adults and to derive appropriate consulting measures.
[Mh] Termos MeSH primário: Atividades Cotidianas
Idoso Fragilizado/psicologia
Pacientes Domiciliares/psicologia
Inquéritos e Questionários
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Áustria
Feminino
Avaliação Geriátrica
Serviços de Saúde para Idosos
Seres Humanos
Entrevistas como Assunto
Masculino
Atenção Primária à Saúde
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:170810
[St] Status:MEDLINE
[do] DOI:10.1891/1061-3749.25.2.238


  4 / 541 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28658111
[Au] Autor:Jing LW; Wang FL; Zhang XL; Yao T; Xing FM
[Ad] Endereço:Nursing and Rehabilitation College, North China University of Science and Technology, Tangshan, Hebei, China.
[Ti] Título:Occurrence of and factors influencing elderly homebound in Chinese urban community: A cross-sectional study.
[So] Source:Medicine (Baltimore);96(26):e7207, 2017 Jun.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Studies on the occurrence of homebound and the factors influencing it are available. However, the study of community homebound in China is still in its preliminary stage. No previous studies about this issue are available. This study aims to assess the occurrence of and factors influencing homebound elderly in Chinese communities and to provide a basis for effective intervention and prevention of homebound elderly people.One sample community from three provinces was randomly selected. Investigations were performed on the selected communities and 2180 elderly people were chosen as the research subjects. Unified survey scales were used. Home visit and face-to-face interviews were performed to ensure that no single qualified survey respondent was missed.The rate of morbidity in homebound elderly Chinese community was found to be 15.49% and it gradually increased with age, and also with a lower education or poorer Activities of Daily Living (ADL). Single factor analysis showed that general situation, living habits, physical condition, mental condition, society, social support, and other factors affected the occurrence of community homebound elderly. Women were more likely to be homebound than men (P < .05). Having a spouse or high income reduced the rate of morbidity in the homebound elderly (P < .05). Multifactor regression analysis revealed that poor ADL, depression, hearing impairment, being old, no exercise, and low social support are the main influencing factors.Appropriate measures should be taken based on the specific influencing factor to prevent the occurrence of homebound.
[Mh] Termos MeSH primário: Pacientes Domiciliares
[Mh] Termos MeSH secundário: Atividades Cotidianas
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
China
Estudos Transversais
Depressão/epidemiologia
Análise Fatorial
Feminino
Perda Auditiva/epidemiologia
Pacientes Domiciliares/estatística & dados numéricos
Seres Humanos
Entrevistas como Assunto
Modelos Logísticos
Masculino
Meia-Idade
Prevalência
Estilo de Vida Sedentário
Fatores Sexuais
Apoio Social
População Urbana
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170718
[Lr] Data última revisão:
170718
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170629
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007207


  5 / 541 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28129087
[Au] Autor:Xiang X; Brooks J
[Ad] Endereço:a School of Social Work , University of Michigan , Ann Arbor , Michigan , USA.
[Ti] Título:Correlates of Depressive Symptoms among Homebound and Semi-Homebound Older Adults.
[So] Source:J Gerontol Soc Work;60(3):201-214, 2017 Apr.
[Is] ISSN:1540-4048
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study aimed to provide a national profile of homebound and semi-homebound older adults with depressive symptoms and to compare risk factors of depressive symptoms by homebound status. A sample of 1,885 homebound and semi-homebound older adults was selected from Round 1 of the National Health and Aging Trends Study (NHATS). The prevalence of depressive symptoms was 43.9% in homebound older adults and 28.1% in semi-homebound older adults, representing over 830,000 and 1.4 million individuals in the population, respectively. Nearly two-thirds of homebound and over half of semi-homebound older adults with clinically significant depressive symptoms also had significant anxiety symptoms. Results from logistic regression showed that younger age, certain medical morbidities, severity of functional limitations, and pain were common risk factors for depressive symptoms among homebound and semi-homebound older adults. Some differences in the risk factor profile emerged between the homebound and the semi-homebound populations. Alleviating the burden of depression in the semi-homebound population may focus on early prevention that considers the diversity of this population. Home-based, integrated programs of health and mental health services that simultaneously address the medical, psychiatric, and neurologic comorbidities and disabilities of homebound older adults are needed to meet the complex needs of this population.
[Mh] Termos MeSH primário: Depressão/psicologia
Pacientes Domiciliares/psicologia
[Mh] Termos MeSH secundário: Atividades Cotidianas/psicologia
Idoso
Idoso de 80 Anos ou mais
Depressão/epidemiologia
Depressão/etiologia
Feminino
Pacientes Domiciliares/estatística & dados numéricos
Seres Humanos
Modelos Logísticos
Masculino
Prevalência
Psicometria/instrumentação
Psicometria/métodos
Fatores de Risco
Inquéritos e Questionários
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170128
[St] Status:MEDLINE
[do] DOI:10.1080/01634372.2017.1286625


  6 / 541 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28034332
[Au] Autor:De Coster A
[Ad] Endereço:Editor.
[Ti] Título:Renewing focus on health and wellbeing in the community.
[So] Source:Br J Community Nurs;22(1):645, 2017 Jan 02.
[Is] ISSN:1462-4753
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Enfermagem em Saúde Comunitária
Educação em Enfermagem
Moral
Enfermeiras de Saúde Comunitária/psicologia
[Mh] Termos MeSH secundário: Acidentes por Quedas/prevenção & controle
Fadiga
Necessidades e Demandas de Serviços de Saúde
Pacientes Domiciliares
Seres Humanos
Linfedema/genética
Saúde Bucal
Estresse Psicológico
Transição para Assistência do Adulto
[Pt] Tipo de publicação:EDITORIAL; INTRODUCTORY JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170221
[Lr] Data última revisão:
170221
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:161231
[St] Status:MEDLINE
[do] DOI:10.12968/bjcn.2017.22.1.645


  7 / 541 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28034327
[Au] Autor:Critchlow D
[Ad] Endereço:Senior Dental Officer, Northeast London NHS Foundation Trust, Dental Department, Grays Health Centre.
[Ti] Título:Part 2: Oral health care for the housebound patient.
[So] Source:Br J Community Nurs;22(1):650-657, 2017 Jan 02.
[Is] ISSN:1462-4753
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Oral disease can have a significant impact on the health and wellbeing of the housebound patient. The aetiology of oral conditions such as dental caries and periodontal disease have been well investigated and there is a solid evidence base in how to best prevent their progress. The Department of Health document Delivering better oral health: an evidence-based toolkit for prevention is a valuable resource that outlines the current best preventative evidence in the form of practical advice for clinicians and patients. This article aims to distil and present this advice for the benefit of community nurses. It will identify areas of particular importance for people with additional needs, particularly the elderly and infirm. Outlining how to best tailor preventative advice and treatment for this patient group.
[Mh] Termos MeSH primário: Assistência Odontológica/métodos
Cárie Dentária/prevenção & controle
Placa Dentária/prevenção & controle
Pacientes Domiciliares
Neoplasias Bucais/prevenção & controle
Saúde Bucal
Higiene Bucal/métodos
Doenças Periodontais/prevenção & controle
[Mh] Termos MeSH secundário: Idoso
Cariostáticos/uso terapêutico
Placa Dentária/terapia
Higienizadores de Dentadura/uso terapêutico
Prática Clínica Baseada em Evidências
Fluoretos/uso terapêutico
Seres Humanos
Antissépticos Bucais
Guias de Prática Clínica como Assunto
Autocuidado
Cremes Dentais
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Cariostatic Agents); 0 (Denture Cleansers); 0 (Mouthwashes); 0 (Toothpastes); Q80VPU408O (Fluorides)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170221
[Lr] Data última revisão:
170221
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:161231
[St] Status:MEDLINE
[do] DOI:10.12968/bjcn.2017.22.1.650


  8 / 541 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27876403
[Au] Autor:Jones MG; Ornstein KA; Skovran DM; Soriano TA; DeCherrie LV
[Ad] Endereço:Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA. Electronic address: mgj9001@nyp.org.
[Ti] Título:Characterizing the high-risk homebound patients in need of nurse practitioner co-management.
[So] Source:Geriatr Nurs;38(3):213-218, 2017 May - Jun.
[Is] ISSN:1528-3984
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:By providing more frequent provider visits, prompt responses to acute issues, and care coordination, nurse practitioner (NP) co-management has been beneficial for the care of chronically ill older adults. This paper describes the homebound patients with high symptom burden and healthcare utilization who were referred to an NP co-management intervention and outlines key features of the intervention. We compared demographic, clinical, and healthcare utilization data of patients referred for NP co-management within a large home-based primary care (HBPC) program (n = 87) to patients in the HBPC program not referred for co-management (n = 1027). A physician survey found recurrent hospitalizations to be the top reason for co-management referral and a focus group with nurses and social workers noted that co-management patients are typically those with active medical issues more so than psychosocial needs. Co-management patients are younger than non-co-management patients (72.31 vs. 80.30 years old, P < 0.001), with a higher mean Charlson comorbidity score (3.53 vs. 2.47, P = 0.0001). They have higher baseline annual hospitalization rates (2.27 vs. 0.61, P = 0.0005) and total annual home visit rates (13.1 vs. 6.60, P = 0.0001). NP co-management can be utilized in HBPC to provide intensive medical management to high-risk homebound patients.
[Mh] Termos MeSH primário: Pacientes Domiciliares/psicologia
Profissionais de Enfermagem
Atenção Primária à Saúde/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Doença Crônica
Feminino
Grupos Focais
Serviços de Assistência Domiciliar
Visita Domiciliar
Seres Humanos
Masculino
Equipe de Assistência ao Paciente
Readmissão do Paciente
Atenção Primária à Saúde/organização & administração
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:161124
[St] Status:MEDLINE


  9 / 541 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27641001
[Au] Autor:Soones T; Federman A; Leff B; Siu AL; Ornstein K
[Ad] Endereço:Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
[Ti] Título:Two-Year Mortality in Homebound Older Adults: An Analysis of the National Health and Aging Trends Study.
[So] Source:J Am Geriatr Soc;65(1):123-129, 2017 Jan.
[Is] ISSN:1532-5415
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To determine the association between homebound status and mortality. DESIGN: Cross-sectional. SETTING: Annual, in-person interviews. PARTICIPANTS: A nationally representative sample of community-dwelling, Medicare beneficiaries aged 65 and older enrolled in the National Health and Aging Trends Study between 2011 and 2013 (N = 6,400). MEASUREMENTS: Two-year mortality and prevalence of homebound status in the year before death are described using three categories of homebound status: homebound (never or rarely left home in the last month), semihomebound (left home with assistance, needed help or had difficulty), and nonhomebound (left home without help or difficulty). RESULTS: In unadjusted analyses, 2-year mortality was 40.3% in homebound participants, 21.3% in those who were semihomebound and 5.8% in those who were nonhomebound. Homebound status was associated with greater 2-year mortality, adjusted for sociodemographic characteristics, comorbidities, and functional status (hazard ratio = 2.08; 95% confidence interval = 1.63-2.65, P < .001). Half of older community-dwelling Medicare beneficiaries were homebound in the year before death. CONCLUSION: Homebound status is associated with greater risk of death independent of functional impairment and comorbidities. To improve outcomes for homebound older adults and the many older adults who will become homebound in the last year of life, providers and policymakers need to extend healthcare services from hospitals and clinics to the homes of vulnerable individuals.
[Mh] Termos MeSH primário: Pacientes Domiciliares/estatística & dados numéricos
Mortalidade
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Doença Crônica/epidemiologia
Comorbidade
Estudos Transversais
Demência/epidemiologia
Depressão/epidemiologia
Pessoas com Deficiência/estatística & dados numéricos
Feminino
Seres Humanos
Masculino
Medicare
Estados Unidos/epidemiologia
Populações Vulneráveis
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160920
[St] Status:MEDLINE
[do] DOI:10.1111/jgs.14467


  10 / 541 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27461941
[Au] Autor:De-Rosende Celeiro I; Santos-Del-Riego S; Muñiz García J
[Ad] Endereço:Department of Health Sciences, University of A Coruña, A Coruña, Spain; Service of Dependence and Personal Autonomy, Xunta de Galicia, A Coruña, Spain. Electronic address: ivan.de.rosende.celeiro@udc.es.
[Ti] Título:Homebound status among middle-aged and older adults with disabilities in ADLs and its associations with clinical, functional, and environmental factors.
[So] Source:Disabil Health J;10(1):145-151, 2017 Jan.
[Is] ISSN:1876-7583
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Homebound status is associated with poor health, comorbidity, and mortality and represents a major challenge for health systems. However, its prevalence among people with disabilities in the basic activities of daily living (ADLs) is unknown. OBJECTIVES: The objectives were to: (1) examine the prevalence of the homebound status among middle-aged and older adults with disabilities in ADLs, and (2) identify its clinical, functional, and environmental determinants. METHODS: This study included 221 community-dwelling subjects, aged ≥50 years, who applied for long-term care services at the Office for Legal Certification of Long-term Care Need of Coruña (Spain). Each subject had a disability in ADLs and was interviewed by a trained examiner in the subject's home. The participants were considered homebound if they remained inside their home during the previous week. MEASURES: Demographic, clinical, functional, and environmental factors. Multiple logistic regression was used to determine the factors associated with homebound status. RESULTS: The prevalence of homebound status was 39.8%. A multivariate analysis revealed that the presence of architectural barriers at the home entrance (stairs [OR: 6.67, p < 0.001] or a heavy door [OR: 2.83, p = 0.023]), walking ability limitations (OR: 3.26, p = 0.006), and higher age (OR: 1.05, p = 0.04) were associated with homebound status. CONCLUSIONS: Homebound status is a highly prevalent problem among middle-aged and older adults with disabilities in ADLs. Architectural factors in the home and walking ability limitations seem to be important predictors, suggesting that health care interventions should target home adaptations and mobility skills as a means to preventing or decreasing homebound status.
[Mh] Termos MeSH primário: Atividades Cotidianas
Estruturas de Acesso
Pessoas com Deficiência
Pacientes Domiciliares
Assistência de Longa Duração
Limitação da Mobilidade
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Feminino
Pacientes Domiciliares/estatística & dados numéricos
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Razão de Chances
Espanha
Caminhada
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160728
[St] Status:MEDLINE



página 1 de 55 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde