Doutorado em Ciências da Saúde (FM)
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Navegando Doutorado em Ciências da Saúde (FM) por Por Orientador "Barbosa, Maria Alves"
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Item Qualidade de vida de gestantes com Zika virus(Universidade Federal de Goiás, 2019-11-11) Cançado, Myrella Silveira Macedo; Oliveira, Ellen Synthia Fernandes de; http://lattes.cnpq.br/3128365764211694; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Teixeira, Ricardo Antônio Gonçalves; Cardoso, Clever Gomes; Almeida, Fábio Marques de; Medeiros, MarceloIntroduction: In Brazil, the increase in cases of neurological malformations in newborns from congenital Zika virus (ZIKV) infection has led to an intensification of maternal and fetal care during and after prenatal care. Objective: To analyze the quality of life of pregnant women diagnosed with ZIKV followed in public health services, from 2017 to 2018. Methods: Cross-sectional, qualitative and quantitative study, conducted through semi-structured interviews, addressing health care, and by two questionnaires, one on profile (socioeconomic / demographic and gestational), and the other on quality of life assessment, the World Health Organization Quality of Life instrument abbreviated version (WHOQOL-bref). Quantitative data were analyzed by multiple linear regression model and qualitative data by Bardin (2011) content analysis with the aid of NVivo® version 11 software. Results: 42 pregnant women diagnosed with ZIKV participated in the study. The average age was 26.1 years (SD = ± 6.1) and the overall quality of life (QOL) was 61.5 (SD = 12). Among the domains analyzed by the WHOQOL-bref, the psychological with the highest score (69.3; SD = 15.8) and the lowest was the Environment (52.0; SD = 12.8). The parameters that contributed to the highest quality of life were being married, using contraception before the current pregnancy, having ZIKV infection in the later trimester and having a higher family income. Regarding the content analysis of the interviews, main ideas emerged which were grouped into three categories: Feelings (fear of microcephaly and faith / religiosity); Health care (access to examinations and consultations, quality of care, knowledge of ZIKV and multi-professional support) and social and family context (family support, financial resources and influence of the media). Conclusion: Quality of life obtained higher score in the psychological domain. The aspects of quality of life were deepened during the interviews whose results showed the pregnant woman's perceptions about ZIKV and the potentialities and weaknesses of public health services. The findings of this study are important for the (re) planning and strengthening of prenatal public health policies.Item Qualidade de vida e capacidade funcional de pacientes com capsulite adesiva submetidos a bloqueios do nervo supraescapular(Universidade Federal de Goiás, 2013-06-27) Fernandes, Marcos Rassi; Sousa, Ana Luiza Lima; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Brasil, Virginia Visconde; Porto, Celmo Celeno; Minamisava, Ruth; Cunha, Luis CarlosIntroduction: The simultaneous assessment of quality of life and functional capacity from the patient's self perception with adhesive capsulitis may contribute to the improvement of health care of this population. Objectives: To describe the techniques and clinical indications of suprascapular nerve block, as well as their complications, based on literature data; to assess the quality of life and functional capacity of patients with adhesive capsulitis at the beginning and end of treatment with blocks and to analyze the factors associated with satisfactory quality of life and better functional capacity. Methods: Prospective clinical study in adults and elderly patients with adhesive capsulitis submitted to weekly treatment with suprascapular nerve blocks, users of a private orthopaedic hospital, located in the city of Goiânia-GO, in the period of august 2010 to february 2012. Quality of life was assessed by the WHOQOL-BREF and functional capacity by DASH at the beginning and end of treatment. The Constant score greater than or equal to 55 points was used for the end of the blocks and the Wilcoxon test to compare the initials and finals scores of the WHOQOL-BREF and DASH. Multiple regression analysis of Poisson was carried out using satisfactory quality of life and better functional capacity as outcomes. Significance level of 5%. Results: Forty-three patients with a mean age of 54,7 years were evaluated. Better scores of quality of life and functional capacity were obtained at the end of treatment, when compared to the initials scores. Patients with age greater than 50 years old were associated with higher scores of quality of life in the physical and psychological WHOQOL-BREF domains and those with better educational level in the physical and environmental domains. Age greater than 50 years old and higher schooling were also associated with better functional capacity of the affected shoulder. Conclusions: There are several techniques and clinical indications for the performance of the suprascapular nerve block. Although rare, complications may occur. Quality of life and shoulder functional capacity of patients with adhesive capsulitis improved at the end of the treatment with suprascapular nerve blocks, being influenced by the higher age and better educational level.Item Implantação do consultório de enfermagem para seguimento ambulatorial de pacientes em pós-operatório de doença arterial obstrutiva periférica(Universidade Federal de Goiás, 2017-08-31) Gebrim, Cyanéa Ferreira Lima; Prado, Marinésia Aparecida do; http://lattes.cnpq.br/1151975582155991; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Prado, Marinésia Aparecida do; Mrué, Fátima; Barreto, Regiane Aparecida dos Santos Soares; Bezerra, Ana Lúcia QueirozAIM: to analyse the process of the implementation of nursing office for output follow-up of postoperative patientes of peripheral obstructive arterial disease, according to the structure, process and outcome indicators. METHOD: an uncontrolled, prospective intervention study conducted from 2013 to 2016 at the outpatient clinic of a university hospital in the Brazilian Midwest. Patients admitted to the nursing office for ambulatory follow-up in the postoperative period of peripheral obstructive arterial disease participated in the study. Two instruments were used to collect the data, the first to verify the sociodemographic profile and the second to measure the Patient Satisfaction index with the quality of nursing care. For statistical analysis, we used: absolute frequencies, median, mean and standard deviation, Raw Scale with logistic binary regression, Pearson correlation coefficient. RESULTS: the structure comprised: situational diagnosis, partnerships, training of the executing team and acquisition of physical and material resources. In the process, the methodology used for the care was the systematization of nursing care and as an outcome of the implementation of nursing office, the level of satisfaction of the patients with the nursing care was evaluated. A total of 39 patients, 51,3% male, mean age 63 years, 71.8% retired, 66.7% diabetic, 84.6% hypertensive, 71.8% dyslipidemic, 51.3% smoker, 84.9% sedentary. A total of 303 nursing consultations were performed, of which 80% of the patients evaluated were discharged and 15% needed rehospitalization. Nursing care reached an index of positivity (>80%) considered safe and of quality, and a high level of the patient satisfaction (mean: 4,195 and median 4). Five postoperative complications emerged: 53,9% surgical site infection, 10,3% amputations, 7,7% pain, 2,6% sepsis and 2,6% deaths. Statistically (p<0,05) more satisfied patients with nursing care were those that presented normal nutritional status (p=0,049), who assessed their health as poor or normal (p=0,020) and did not use anti-hypertensives (p=0,031). The Pearson Coefficients showed significant correlation, with an increasing association (r>0,0) between the technical-professional, educational and nurse's confidence domains. CONCLUSION: the structure of the nursing office, signaled important indicators in relation to the nursing practice, as a systematized service model for the follow-up of patients in the postoperative period of peripheral obstructive arterial disease, positively reflecting the improvement of the patients’ health. It emphasizes the early identification of some complications and the promotion of the quality of care with the lesion, in addition to narrowing the bond between the team and the patient. It impacted on the level of patient satisfation regarding the assistance provided by the nursing office team, in the outpatient follow-up of patients in the postoperative period of peripheral obstructive arterial disease.Item Avaliação da atenção primária na perspectiva dos profissionais de saúde(Universidade Federal de Goiás, 2017-09-20) Maia, Ludmila Grego; Silva, Luiz Almeida da; http://lattes.cnpq.br/0162033338001172; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Fernandes, Marcos Rassi; Silva, Luiz Almeida da; Borges, Cristiane José; Prado, Marinésia Aparecida doIntroduction: primary care must assume the centrality of care so that the health system meets and resolves the demands and needs of the population. The quality and efficiency of this level of care must be constantly evaluated and monitored by managers. Instruments such as the Primary Care Assessment Tool (PCATool) have been used in Brazil for this purpose. It is a questionnaire that evaluates structural aspects of process and results in primary care. Objective: to evaluate primary health care from its attributes, from the perspective of professionals, checking factors of better health care between quality of services and professional qualification. Methodology: a cross-sectional study was conducted with 41 nurses and 31 physicians in the Southwest region of the state of Goiás, using interviews using the PCATool instrument. The data were analyzed in the Stata program, version 14.0. The Cronbach's alpha coefficient was used to analyze the internal consistency of the instrument's total score. Results: in the evaluation of the attributes of primary care, it was evidenced that the lower overall primary health care score was for the accessibility attribute (3.71). The bivariate analysis showed statistical difference between the variables profession and the essential, derived and general scores. Physicians of the Mais Médicos Program had higher mean scores (8.04 p = 0.001) when compared to other medical professionals and nurses. Professionals with post-graduation in any area, obtained a better score in the derived score (p = 0.021). Conclusion: a high general orientation score for primary care is observed by health professionals, with exception for the attribute accessibility. Medical professionals linked to the Mais Médicos Program obtained better average scores on all attributes. From the monitoring of the attributes of the primary attention it is possible to know the critical points that deserve intervention, as well as to evaluate if the strategic actions implemented have been effective in the scope of the primary attention.Item Perfil de pacientes intoxicados investigados no estado de Goiás entre os anos 2007 a 2012(Universidade Federal de Goiás, 2017-06-30) Oliveira, Flávia Neri Meira de; Cunha, Luiz Carlos da; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4782727E3; Barbosa, Maria Alves; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4793558E6; Barbosa, Maria Alves; Sousa, Ana Luiza Lima; Menegatti, Ricardo; Leles, Cláudio Rodrigues; Silva, Julierme Gonçalves daIntroduction: Substance, of easy access to the population, as cleaners’ substances, cosmetics, medicines and chemical’s industries products are examples for sources of intoxications. Toxicological Information Centers (CITs) informs about intoxications and register the cases in information systems (SINAVISA). The evaluation of a big data need care, because to be accomplished its necessary the use of statistics methods to monitor constantly of a big data. Objective: To perform quality control of data in variables product and “chemistry group”, and to evaluate the profile of intoxications of patients notified in SINAVISA, during the period of 2007 to 2012. Methodology: In the first moment it was evaluated the cadasters in variables product and “chemistry group” with Textual Analysis. Posteriorly was evaluated variables of 5041 investigations files of intoxications by medicines and 16333 investigations files of intoxication by medicines, cosmetics, toxic plants, cleaners’ substance, chemical’s industries products, rodenticides, foods, abuse drugs, vets products and agrotoxics, except files from intoxication by venomous’ animals, with Multiple Correspondence Analysis (MCA) and Hierarchical Cluster Analysis (HCA). Results: It was observed the presence of discordances on data of product and “chemistry group” and then corrected. In analysis of medicine observed that, children and women are the principal victims of intoxication by medicines. The “chemical groups” that more affected on children with 1 to 4 years old was antibiotics, anti-inflammatories not steroidal, antipsychotics, adrenergics agonists, hormones and anti-histaminics. The children with less than one-year-old presented intoxication with ignored products, antibacterial, sympathomimetics agonists, antagonists and anti-inflammatories. Patients with age of 20 to 29 years, female gender, intoxicated by anxiolytics, antidepressives and anticonvulsants. Analysis of 16333 investigations files observed that severe intoxications are in chemical’s group agrotoxics, as pyrethroids, organophosphates, glycine, coumarins and carbamates. The ignored products were grouped in clusters with tendency to more severity. Children with age less than 4 years old also intoxicated with acids, rodenticides, and agrotoxics, but with less frequency. Conclusion: The method was capable of corrected the errors presents in variables “chemical group” and product. Additionally, it was traced the following profile: children intoxicated with medicines antibiotics, anti-inflammatories not steroids, antipsychotics, adrenergics agonists, hormones and anti-histaminics, and young adults intoxicated with agrotoxics, rodenticides and medicines anxiolytics, anti-depressives and anticonvulsants.Item Qualidade de vida do estudante de medicina(Universidade Federal de Goiás, 2015-11-30) Oliveira, Ludmilla Marques de; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Minamisava, Ruth; Brasil, Virginia Visconde; Oliveira, Lizete Malagoni Almeida Cavalcante; Chaveiro, NeumaThe Medical School is both a backdrop of accomplishments and dreams, but also where academics are faced with stressors that require hard adaptation processes. It is important to know both of these factors to characterize the health of the medical student, and thus enable the development of methodological strategies to mitigate the effects of these factors on those individuals considered to be at higher risk, improving the quality of life of this population. Objective: To evaluate the quality of life of medical students, and to identify factors associated with reduction of the scores of their domains. Methods: We conducted an epidemiological study of descriptive, analytical and cross-sectional. To do this research, we chose a medical school of a private university in the central-western Brazil. Four hundred and eighty-eight students spread from first to fifth grade participated in the study. A meeting was held in the very educational institution where the students individually answered the WHOQOL-BREF instrument, complying with WHO recommendations for implementation, and also responded to the socio-demographic questionnaire. The study was approved by the Ethics Committee of the Federal University of Goiás. Results: No physical activity influenced the four domains of quality of life. Alone, scores of physical domain were reduced when associated with female gender, older age and need for family economic aid; the psychological domain, the stage in which the student was in progress; the social field was impaired among students who attended high school in public school or who were not in some kind of relationship. Environmental domain scores were reduced among students of full age, in later periods of the course, I had no home, whose mother had no higher education or whose parents did not live together. Conclusion: The quality of life of medical students, when evaluated by the WHOQOL-BREF, found that female sex, older age, need for family economic aid, no physical activity, among others, as significant factors associated with lower scores of fields of quality of life, and the lack of physical activity the only factor associated with a reduction of the scores of all domains of quality of life, having been the most significant finding. The quality of life of medical students is committed to all areas, increasingly over the course of medical training, and each domain is associated with factors that can be interpreted as vulnerable conditions for these scholars. It is recommended to carry out further studies that may support these findings and strengthen policies aimed at this group of students.Item O sofrimento psíquico na formação médica: percepções e enfrentamento do estresse por acadêmicos do curso de Medicina(Universidade Federal de Goiás, 2014-10-29) Pereira, Maria Amélia Dias; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Lima, Fátima Maria Lindoso da Silva; Teixeira, Ricardo Antonio Gonçalves; Oliveira, Lizete Malagoni Almeida Cavalcante deIn this research the object of study was the psychic suffering of the medicine students. The general goal was to discuss stressors e possible abuses or violences of the medical course according to the perception of medicine students from a public university in the center west part of Brazil, analyzing the contributions of an elective course offered in the medical school, in which stress coping strategies were explored. The project is in accordance with the ethics aspects of Resolution 466/12. It is a descriptive-exploratory using the qualitative approach characterized as case study. The sample was 33 medicine students in 2011 and 76 in 2013. The data collection was made through focus groups, semi-structured questionnaires and notes from the teachers during the time spent with the students. The data was registered, organized and analyzed with the use of a software that support qualitative analysis called WebQDA. The analysis of the content was based on the methodology of Bardin. The results were presented in articles about the stress factors with the following categories: curriculum, evaluations, relation with teachers, support structure, interpersonal relations, professional perspectives, personal expectations, fear and insecurity, the coping strategies divided in distractions and relief or comprehension and resolution; the way the students deal with pain were characterized as negation and escape or reflexive and the violence and abuse during the medical course were seen as abuse of power or institutional fragilities; the perceptions about the changes after doing the elective about the coping strategies include more self-reflection, improvement in assertiveness and communication. It was concluded that among other stressors is the excessive work load, too much content to be learned, exams, seminars and numerous group works, big responsibilities, insecurity and fear of failing, competitive environment, verbal abuse, violence in the freshmen’s hazing. As examples of the coping strategies there are: going out with friends, searching support from religion, physical activities, doing other things apart from university, support from family/friends, sharing the difficulties. Many react to pain by denying it. After doing the elective course the majority of the students reported less stress symptoms than in the begging of the semester, more use of coping strategies, considering the course as an useful moment to learn new techniques with a higher self-reflection and they realized positive changes in their own life. The elective discipline meant theoretical and practical learning, brought benefits from the class itself, moments of reflection and psychic and emotional changes.Item Conhecimento dos profissionais e usuários da atenção básica sobre a doença pulmonar obstrutiva crônica(Universidade Federal de Goiás, 2014-09-03) Queiroz, Maria Conceição de Castro Antonelli Monteiro de; Moreira, Maria Auxiliadora Carmo; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Moreira, Maria Auxiliadora Carmo; Silva, Nilzio Antonio da; Pereira, Edna Regina Silva; Rêgo, JozéliaChronic respiratory diseases represent a major public health problem worldwide. Affect quality of life, physical disability and generating large socioeconomic impact. Often chronic obstructive pulmonary disease (COPD) is underdiagnosed. Delayed diagnosis may be related to inappropriate use of diagnoses and / or procedures lack of knowledge about the disease among health professionals and the general population. The aim of this study was to analyze the prevalence and factors associated with awareness of COPD among health professionals and primary care SUS users of a city of the Midwest factors. Methods: The study was analytical, observational, cross-sectional, conducted in basic health units, comprising the Health Centers (CS) and 26 Family Health Centers (CSF). Health professionals and users were interviewed using adapted with open and closed questions form. To assess knowledge of COPD among users of the units, we used an adapted structured form. 674 users, 95 doctors, 62 nurses and 30 managers in 12 CS and 26 CSF were interviewed between May 2013 and February 2014 Results: Of the 674 users interviewed, 84.3% reported knowing the term or the term COPD pulmonary emphysema; 9.2% reported knowing the term COPD. Dyspnea was the most frequent symptom attributed to COPD (70.6%). Regarding the main sources of knowledge about COPD, 43.1% of users reported the media and 36.4%, familiar with the disease. Among the 95 physicians interviewed, 28 (29.5%) had satisfactory knowledge about the diagnosis of COPD. Regarding the use of resources for the diagnosis of the disease (symptoms and spirometry), spirometry was mentioned by doctors (81.1%), then cited chest radiography (72.6%) and symptoms (51.6%) . Among the 62 nurses interviewed, 6.5% got the expected prevalence of COPD; 61.0% knew two risk factors (tobacco and wood); approximately 60.5% gave the expected response in relation to the recognition of two main associated diseases; 63.0% made the referral to the correct locations of spirometry. 30 managers, of which 48.3% had training in health were interviewed; all reported no units in its statistics on this disease; 13.0% and underestimated, overestimated the 54.8%, while 25.8% did not know what the expected response in relation to the reported prevalence of COPD; all identified tobacco, 64.5% and also wood smoke as risk factors for disease; 74.2% reported referral to the correct location for spirometry; 86.6% did not know what proportion of patients who had no access to treatment prescribed by the doctor. Conclusion: The prevalence of awareness of COPD is low among health professionals in primary care. The term COPD is unknown to most users, as opposed to the term emphysema. The prevalence of basic knowledge about the disease was lower among users. One of the sources of knowledge of COPD cited less frequently by users were physicians. The results of this study indicate possible causes of underdiagnosis of COPD in the population treated in primary care and may assist health managers to implement intervention projects that increase the rate of early diagnosis and treatment in COPD.Item Participação em grupo de promoção da saúde e qualidade de vida de idosos(Universidade Federal de Goiás, 2014-03-28) Santos, Leidiene Ferreira; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Farias, Glaucea Maciel de; Oliveira, Lizete Malagoni de Almeida Cavalcante; Chaveiro, Neuma; Brasil, Dra Virginia ViscondeINTRODUCTION: the growth of the elderly population set up a worldwide phenomenon. In this scenario it is essential the establishment of strategies that consider the characteristics of old age and are aimed at maintaining the biopsychosocial health and quality of life of the elderly. Searches recommend the use of group activities as a tool that promotes learning that encourage socialization, make possible interpersonal relationships, contributes to adaptation and change in living habits of the elderly. But for that, this activity must meet the assumptions of group dynamics, ie, being implemented in response to the needs of the group members. GENERAL OBJECTIVE: to analyze the participation in group of health promotion as a strategy to improve the quality of life in elderly. METHODS: quantitative research approach, performed with elderly enrolled in a Primary Care Unit Family Health, participants (G1) and nonparticipants (G2) of group health promotion. Data were collected from june to october 2012, using an instrument with sociodemographic questions, and the WHOQOL-BREF and WHOQOL-OLD. Subsequently were entered and analyzed in software Stata version 11.0. To evaluate factors associated with QoL, were used multiple linear regression. The level of significance was set at 5 %. RESULTS: the elderly group G1 had higher mean of QoL scores in all domains of the WHOQOL-BREF, not being statistically significant only the result obtained in the psychological domain. The lowest score for the two groups, G1 and G2, in the WHOQOLBREF, was obtained in the field "environment" (G1: 60.2 ±11.2, G2: 50.5 ±12.2). The G1 group also had higher mean scores and statistically significant in facets "Past, present and future activities" (G1: 69.7, SD: 11.7, G2: 59.2, SD: 15.0) and "Social participation" (G1: 72.4 ±11.2, G2: 55.6 ±16.3). Join group was significantly associated with better QoL scores in the "physical", "social relations" and "environment" domains, and the facets "Past, present and future activities" and "Social participation”. CONCLUSION: participation in group of health promotion supports improvements to various aspects of QoL of the elderly, especially those related to social inclusion and establishment/maintenance of interpersonal relationships. Thus the group is a resource that should be used by health professionals to promote and protect the health of the elderly because it allows break situations of loneliness and gives opportunity to forge new bonds of friendship and social support networks.Item Qualidade dos registros de enfermagem em prontuários após ação educativa em uma instituição pública de saúde(Universidade Federal de Goiás, 2017-12-04) Silva, Ludimila Cristina Souza; Prado, Marinésia Aparecida; http://lattes.cnpq.br/1151975582155991; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Porto, Celmo Celeno; Brasil, Virginia Visconde; Prado, Marinésia Aparecida; Bezerra, Ana Lúcia QueirozRecords in hospitalized patients' records are important for the communication of health professionals for continuity of care, cost measurement, quality assessment, as well as providing legal actions for teaching and research. Objective: To evaluate the quality of nursing records in patient records after an educational action. Methodology: An analytical descriptive study performed in Neonatal, Maternal and Child Intensive Care Units, with analysis of 45 charts, before and after an educational intervention, which lasted eight hours. To evaluate the quality, the Nursing Annotations Audit Form (HADDAD, 2004) was used. After the data collection, the data were analyzed using the STATA software. Results: The main nonconformities found in the records were: incorrect or incomplete records, illegible letters or erasures and absence of records. Among the nonconformities was the inadequate completion of the cases evaluated before and after the educational intervention. However, the means inherent to complete, incomplete and unfilled information were significantly better after the educational intervention (p> 0.05). The categories, identification data (PP = 81.16%) and execution of medical orders (PP = 89.13%), presented higher adequacy indexes with respect to the complete records. However, the nursing prescription (PP = 6.76%) overcame the nonconformities in the question of incorrect filling of records in patients' records. Conclusion: The educational action signaled positive results regarding the effectiveness of records in medical records, evidencing the importance of qualification of health professionals. Based on these evidences, a permanent education program is recommended, with the objective of qualifying professionals regarding the requirements of the work process, such as the elaboration of standardized protocols, the habit of recording the actions in a complete and objective manner, printed, among other aspects. Intervention actions can raise awareness among professionals about competence, commitment to safety and continuous improvement of the quality of care provided to the patient.