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Item Qualidade de vida e letramento funcional em saúde de portadores de hipertensão arterial residentes na zona rural(Universidade Federal de Goiás, 2016-02-23) Bernardes, Carla de Paula; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Vila, Vanessa da Silva Carvalho; Oliveira, Lizete Malagoni de Almeida Cavalcante; Barbosa, Maria Alves; Cordeiro, Jacqueline Andréia Bernardes LeãoChronic diseases as hypertension can affect people's health-related quality of life (HRQoL) mainly if associated to inadequate health literacy. Living in a rural area difficult accessing health services. This study aimed to evaluate HRQoL and health literacy of people living with hypertension in rural areas. The descriptive study included 114 hypertensive individuals living in rural areas, who are assisted by Brazil's Family Health Strategy. It was used instruments as SF-36v2, MINICHALBrazil and the Brief Test of Functional Health Literacy in Adults (B-TOFHLA). Data were analyzed descriptively using Anova, Mann-Whitney, Kruskal-Wallis and T-Tests. The individuals were mainly female, mean age 59 years, 8 years or less of schooling. Body Mass Index indicated altered weight (≥ 25 Kg/cm2 ), even they referring daily habits changes after medical diagnose of hypertension. The lower SF-36 scales scores were “general health perceptions” (46,58) and “physical functioning” (51,10); the highest were “social functioning” (76,86) e “mental health” (72,49). MINICHAL domains scores were “mental status” (5,9) and “somatic manifestations” (3,3). There was correlation between SF-36 and MINICHAL scores. The health literacy test pointed to a inadequate health literacy for most of hypertensive individuals. Differences between man and woman were shown in most of SF-36 scales scores. Health literacy level was inadequate between the older and those with less years of schooling. It was concluded that people living with hypertension in rural areas have altered quality of life and limited health literacy. They should have easier access to health programs to receive Family Health Strategy attention, considering their literacy needs. Results suggest health professional strategy changes for hypertensive individuals living in rural areas, to effective health related care, self care and better quality of lifeItem Desempenho dos indicadores de qualidade da assistência na fase aguda do infarto do miocárdio(Universidade Federal de Goiás, 2015-03-23) Boaventura, Rafaela Peres; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Mussi, Fernanda Carneiro; Bezerra, Ana Lúcia Queiroz; Mery, Max Weyler; Oliveira, Lizete Malagoni de A. C.This study aimed to analyze the pre-hospital course of patients undergoing percutaneous myocardial reperfusion in acute myocardial infarction and evaluate the performance of health care quality indicators of myocardial infarction in these patients. This is a retrospective cohort study with convenience sample. It was analyzed 39 cases of myocardial infarction with ST segment elevation, with Delta T up to 12 hours without previous administration of fibrinolytic agents, admitted for treatment at the General Hospital of Palmas / TO in 2013. Data were collected in the pre-hospital phase in records and interview and in the in-hospital phase through secondary data. For statistical analysis we used the Shapiro-Wilk test, Student's t test and ANOVA with 5% significance level. Most were male (76.9%), with a stable partner (74.4%), with up to nine years of education (64.1%) and at least three cardiovascular risk factors (79.5%). In the pre-hospital delta T phase was high (06h34min ± 03:14) and 10.2% achieved the recommended metric. The delta T was higher among patients that did not previously recognized symptoms of AMI (mean 07h09min ± 03h12min) and lower among those who were treated during the day (mean 03h 25min ± 05h35min). In-hospital phase, 56% were admitted during the day. In 30.8% of cases the Killip Kimball was > I. Among the other infarcted walls prevailed the bottom wall. Five patients (12.8%) died. Time door-ECG and needle holder did not follow international recommendations for all variables. The early recognition of symptoms and time of care are interfering for prehospital delay. There was no statistical correlation-balloon time and door-ECG door to the profile of patients with clinical variables in the hospitalization phase. The metric assessment of infarct treatment quality indicators in the acute phase was unsatisfactory throughout the study period.Item Qualidade da assistência especializada a pessoas com diabetes mellitus e hipertensão arterial segundo o Chronic Care Model(Universidade Federal de Goiás, 2022-04-27) Borges, Dalma Alves Pereira; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Vila, Vanessa da Silva Carvalho; Vitorino, Priscila Valverde de Oliveira; Zanini, Claudia Regina de Oliveira; Rezende, Marina Aleixo DinizINTRODUCTION: Support for self-management of chronic conditions and health literacy are essential elements in the development of person-centered services. The use of integrated care models that focus on the person, and not just on the specific disease, represent a viable solution for effective care. The Chronic Care Model is a model that is based on the relationship between motivated and informed users and the proactive and prepared health team. However, there is evidence of gaps in the attention and care that should be provided in the care of chronic conditions, especially in hypertension and diabetes. OBJECTIVE: To characterize the quality of care provided and the health literacy conditions reported by people with arterial hypertension and diabetes mellitus in a secondary care service. METHODS: Crosssectional study, carried out in an outpatient clinic that is a reference in the care of arterial hypertension, in a large Brazilian center, where diabetes is prevalent morbidity. Eighty-two people with diabetes mellitus and arterial hypertension were evaluated, with a follow-up of at least five years and ten consultations. Sociodemographic and clinical data were obtained through a nursing consultation. The Patient Assessment of Care for Chronic Conditions - PACIC questionnaire was applied, with 20 questions and five scales. Higher scores (> 3.0) indicate a perception of greater involvement in self-management and support. Three scales from the Brazilian version of the Health Literacy Questionnaire - HLQ-Br were also used. The score of each scale indicates the person's strengths and weaknesses in relation to their health literacy. Internal consistency was evaluated; Mann-Whitney test, Spearman test and significance of 5% were applied. RESULTS: The mean age of the participants was 68.98±8.79 years, female (82.93%), with a median of 4 years of study (IQR 3 - 8). Most parents (70.73%) did not study. Less than half of the users had controlled values of glycated hemoglobin - HbA1c (34.15%) and blood pressure (36.59%). The Cronbach alpha of PACIC was 0.85 and that of HLQ-Br was 0.75. There was a positive correlation between the time of diagnosis of diabetes and HbA1c. The overall PACIC score was 3.4 (IQR 2.8-3.8) out of a high of 5.0. The highest score was evidenced on the scale of care/decision-making model (4.3) and the lowest on the scale of coordination of care/follow-up (2.8). Support for selfmanagement is assessed by the treatment adherence scores (3.0), problem-solving / follow-up contextualization (3.0), and goal setting (3.8). Those with ≥ 4 years of schooling had higher scores for Attention Coordination / Follow-up (p=0.039). Participants whose parents had some schooling had higher scores for Adherence to treatment (p=0.038), Coordination of care / Follow-up (p=0.042) and general PACIC (p=0.026). Lower scores were identified among participants who did not have HbA1c control, on the Goal Setting scale (p=0.003). Health literacy showed mean scores of 4.07 ± 0.87 on the Ability to interact with the team scale; 3.02±1.31 in Understanding the information and 2.84±1.25 in Finding good information. Male users had higher scores for interacting with professionals, finding information and understanding information (p=0.039, p=0.00 and p=0.003). Those with ≥ to 4 years of schooling had higher scores for Finding and Understanding information (p=0.002 and p< 0.001), as well as those whose parents had some schooling (p=0.036 and p=0.037). Those who were overweight had a higher score for Understanding the information (p= 0.040). There was a positive correlation between the time of diagnosis of diabetes and HbA1c and no correlation was identified between the general value of PACIC and the HLQ-Br scales. CONCLUSIONS: The quality of care was considered high according to the general PACIC, and moderate in terms of the person's participation in decision-making and the contextualization of the treatment plan. Weakness was identified in the dependence on other people to be able to access and understand written information, but the ease of involvement with professionals can favor the use of communication strategies to improve health self-management.Item Fatores associados à qualidade de vida relacionada à saúde do portador de doença renal crônica em tratamento pré-dialítico(Universidade Federal de Goiás, 2014-12-19) Cordeiro, Jacqueline Andréia Bernardes Leão; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Canhestro, Mônica Ribeiro; Barbosa, Maria Alves; Vila, Vanessa da Silva Carvalho; Freitas, Ana Tereza Vaz de SouzaChronic kidney disease is considered a worldwide public health problem because of the high mortality rates and the physical, social and emotional limitations that interfere significantly in quality of life. The evaluation of the quality of life of chronic kidney disease carrier has demonstrated commitment to many aspects of life of these individuals and it was directed mainly to patients on dialysis. The number of referrals for pre - dialysis monitoring, resulting from complications due to comorbidities such as hypertension and diabetes mellitus is growing, and it requires that the focus of assistance is not only early diagnosis and treatment of disease, but also, aspects related to subjectivity, the perceptions of individuals in relation to their well - being and quality of life (QOL). At present there is no specific instrument to assess QOL of individuals in pre- dialysis treatment. This study aimed to analyze the factors associated with QOL related to the health of the chronic kidney disease carrier in pre- dialysis treatment. An analytical cross-sectional study was developed in three nephrology clinics of large hospitals in the city of Goiânia/Goiás, with 130 patients in stage IV and V of chronic kidney disease. Data collection was done through the application of socio - demographic - clinical - laboratory questionnaire and the specific QOL instrument for kidney disease, KDQOL -SF. A total of 57.7% of patients were male and the group average age was approximately 64 years old. Most patients were classified as stage 4 (69.2%) and some had no schooling (54.6 %). Among the comorbidities detected hypertension was more prevalent, followed by diabetes mellitus and 28.5% of patients had hemoglobin levels lower than expected. The dimensions of quality of life "the professional role" (25.38) and "the physical function" (28.08) showed lower values while "the stimulus by the clinic staff" (88.37) and "the cognitive function" (86.00) had the highest average. QOL is more compromised in women and in patients with five or more children who do not work and have no income, who are obese, hypertensive and show alterations especially in urea and creatinine. It was shown that QOL is influenced by chronic kidney disease, especially when there is change in laboratory parameters which control may extend the start of dialysis therapy or even minimize possible organic misfits. The KDQOL -SF was adequate to evaluate the QOL of individuals in pre- dialysis treatment. The gaps shown by the assessment of QOL in this study showed the importance of care to the kidney patient in the pre- dialysis phase, requiring more effective attention to the subjective demands. This could be achieved if the individual is taught to manage his condition, and it is essential a multidisciplinary monitoring to consider the level of patient understanding, so he can transform the information provided in benefits for his own health.Item A efetividade de escovas descartáveis e submetidas à desinfecção para a higiene bucal em pacientes ventilados mecanicamente: ensaio clínico(Universidade Federal de Goiás, 2019-04-30) Gonçalves, Fernanda Alves Ferreira; Torres, Ieda Maria Sapateiro; http://lattes.cnpq.br/0836649494981715; Campos, Cerise de Castro; http://lattes.cnpq.br/9109822142576433; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Souza, Adenícia Custódia Silva e; Roriz, Virgílio Moreira; Melo, Dulcelene de Sousa; Tipple, Anaclara Ferreira VeigaINTRODUCTION: Invasive ventilatory and intubated patients are dependent on the nursing team. The mechanical removal of the biofilm with toothbrush is the first option, but after single use it can be contaminated by microorganisms from the oral cavity, as well as from the external environment. The use of the brush should be associated with chemical control of chlorhexidine digluconate, which is semi-critical and requires high level disinfection or be discarded. Peracetic acid is a high-level disinfectant, but has not been tested for use on toothbrushes. AIM: To compare the effectiveness of the use of disposable toothbrushes and disinfection with peracetic acid used for oral hygiene (OH) of patients under mechanical ventilation. MATERIALS AND METHODS: Randomized-controlled clinical trial performed at an intensive care unit of a public hospital in Goiânia / GO. Data were collected from 31 patients, intubated and under mechanical ventilation, between June 2017 and August 2018. The patients were divided into Control Group (OH with disinfected brushes) and Intervention Group (HB with brushes discarded). A dental evaluation was performed on day 1. Saliva collection was performed on day 1, day 3 and day 5 for counting of colony forming units (CFU). HB was performed twice a day, for up to five days, with 0.12% CHX gel and disinfected or discarded brushes. RESULTS: At admission, patients presented poor oral hygiene, periodontal disease, periodontitis and gingivitis. Most of the participants were male, with a mean age of 59.0 ± 14.4 years and mean of 19 teeth. Throughout the days of HB there was a decreasing tendency of buccal and lingual biofilms, however, there was no significant reduction of UFC, with no difference between the groups that used disposable brushes and disinfected brushes. In relation to the bacteria isolated on the fifth day, there was homogeneity in both groups, with predominance of Pseudomonas aeruginosa, Enterococcus faecium, Klebsiella pneumoniae and Staphylococcus haemolyticus. CONCLUSIONS: There was no difference in tooth and tongue brushing, performed with single use brushes, discarded or disinfected at each use. The important thing is to brush properly, following established protocols.Item Conhecimento e letramento funcional em saúde de pacientes em tratamento pré-dialítico de um hospital de ensino(Universidade Federal de Goiás, 2014-09-26) Moraes, Katarinne Lima; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Vila, Vanessa da Silva Carvalho; Medeiros, Marcelo; Canhestro, Mônica Ribeiro; Souza, Márcia MariaCaring for those who have chronic kidney disease (CKD) has been limited to the proper handling of the kidney disease symptomatogly, underestimating the attention demands in the initial stages of the illness. Clear, individualized and specific information about the infirmity and prognosis are essential to slow and/or prevent the dialysis treatment. However, people who suffer chronic illnesses have difficulties obtaining information, and also in turning the health information into knowledge, which means they have limited Functional Health Literacy (FHL). There are no evidences about the competence in FHL of the people who have chronic kidney disease regarding predialysis treatment, as well as about the influence of this competence on the knowledge concerning the disease in this stage. This study aimed to analyse the health literacy and the knowledge of the patients in predialysis treatment about the CKD. Transversal study done with 60 people suffering with chronic kidney disease in predialysis situation, treated at a teaching hospital in Goiânia, Brazil, between 2013-2014. To collect data we used the tool of Canhestro (2010) to measure knowledge, the Brazilian version of the Brief Test of Functional Health Literacy in Adults (B-THOFLA) to identify the FHL and a sociodemographic and clinic instrument. The sociodemographic variables were presented through simple descriptive statistics. Tests for correlations of Pearson and Chi-squared and models of linear regression were applied to find the connections among the variables. Most of the interviewed people were female, age average 62,17±14,66 years old, in the third and fourth stages of CKD (67%) and had and average time of treatment in the nephrology ambulatory of 59,55±51,00 months. All the interviewed people presented insufficient health literacy, with an average of right answers of the itens of 30,85±13,01. The majority (57,70%) presented insufficient knowledge about their disease and treatment. Worse levels of education were a predictive factor for worse scores in FHL, and the insufficient knowledge was linked to aging and cognitive compromise. We could not observe association between the worst scores of knowledge and the ones of functional health literacy. The conclusion is that the chronic renal patients presented an inadequate level of functional health literacy and insufficient knowledge concerning the treatment of the CKD and the disease itself. These results may help the creation of educational programs for people with CKD, in order to facilitate the access and the understanding of the information related to health, and therefore make it possible for people to take proper decisions about their wellness.Item Letramento em saúde de cuidadores vinculados ao Serviço de Atenção Domiciliar de Goiânia/GO(Universidade Federal de Goiás, 2020-05-29) Soares, Thales Antônio Martins; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Vila, Vanessa da Silva Carvalho; Borges Júnior, Laerte HonoratoINTRODUCTION: Health literacy (LS) refers to the skills and capacity of individuals and populations to access, understand and use health information to promote, maintain and make health decisions. Home caregivers with HL limitations are prone to fail in home care due to problems related to poor communication, incomplete health information, inadequate education, limited access to health services and lack of continuity of care. It is believed that the caregiver's HL can influence the way he cares for the person under his responsibility. There are no studies that investigate the LS of home caregivers linked to home care programs, using a multidimensional instrument. OBJECTIVE: to determine the HL conditions of caregivers of people linked to the Home Care Service of Goiânia / Goiás, Brazil. METHODOLOGY: cross-sectional study carried out between March and June 2019 in Goiânia / Goiás, with 90 caregivers linked to the municipality's Home Care Service, interviewed with a sociodemographic questionnaire and the Brazilian version of the Health Literacy Questionnaire (HLQ-Br). Measures of central tendency and dispersion, HLQ reliability and the Mann Whitney, Kruskal-Wallis tests were used to compare the variables. RESULTS: most caregivers were female (90.0%), had a steady partner (58.89%), lived in the home of those they cared for (75.6%), had a reading habit (57.8% ), was an informal caregiver (91.1%), had parents without schooling (44.2%), studied nine years or more (53.3%) in a public school (84.4%) and had a personal income of up to one minimum wage (72.2%). The type of caregiver, reading habit, living with the patient, having a family income greater than a minimum wage and education of the caregiver and their parents, influenced the HLQ-Br scores. The lowest score in part 1 of the HLQ-Br was found on the “Active health caregiver” scale and the highest on the “Social support for health” scale. In part 2, the lowest score is found on the “Navigating the health system” scale and the highest on the “Understanding health information and knowing what to do” scale. CONCLUSIONS: Income, education and reading habits influenced most HLQ scales. The results can guide the actions of health professionals, who must use the HL construct in their practice. This health indicator helps to improve guidelines for home caregivers, and consequently improve the quality of care. New studies should be carried out to broaden the understanding of HL in this context, to identify how to reduce situational demands, including how services can contribute. LS is broader than the ability to read and understand. It implies the ability to act.