Programa de Pós-graduação em Enfermagem e Saúde

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Competências de enfermeiros recém-graduados para gestão: desafios para a formação profissional
(Universidade Federal de Goiás, 2023-03-17) Almeida, Daniel Ribeiro de; Santos, Patrícia Tavares dos; http://lattes.cnpq.br/8052298165888796; Ribeiro, Luana Cássia Miranda; http://lattes.cnpq.br/1727326201446926; Ribeiro, Luana Cássia Miranda; Medeiros, Marcelo; Pascon, Daniela Miori
Históricamente, las enfermeras han asumido cargos de gestión en las unidades de salud, pues desde su origen, la enfermería, a través de las damas enfermeras de la época de Florence Nightingale, ha tenido la preocupación de asegurar la organización y administración de los servicios de salud. En consonancia con esto, la formación de enfermeros incorpora en su estructura curricular horas específicas para disciplinas relacionadas con la gestión, siendo una de las pocas graduaciones en el área de la salud con esta especificidad. Por lo tanto, existe la necesidad de una mayor inversión en la formación de enfermeras gestoras, respondiendo a las demandas del mercado laboral y evidenciando las lagunas existentes en el desarrollo de habilidades directivas desde la graduación hasta la práctica profesional. OBJETIVO: Describir las percepciones de las enfermeras en sus primeros cuatro años de trabajo sobre las competencias para el ejercicio de la gestión sanitaria. METODOLOGÍA: Estudio descriptivo-exploratorio con abordaje cualitativo, realizado con 14 enfermeros recién graduados de una universidad pública de Goiás. A coleta foi realizada nos meses de agosto e setembro de 2022 utilizando um roteiro semiestruturado composto por sete perguntas abertas para descrição da percepção desses enfermeiros sobre as competências para a gestão. El análisis se realizó mediante el método de análisis de contenido de Bardin y, posteriormente, mediante la clasificación jerárquica descendente, el análisis de similitud, el análisis fatorial de correlación y el muestreo de palabras mediante el software IRaMuTeQ. RESULTADOS: La mayoría de las enfermeras ocupaban puestos asistenciales, con más de dos años de formación y un tiempo de desempeño equivalente al de su formación. Enumeraron las competencias directivas adquiridas durante la graduación: comunicación, gestión de conflictos, liderazgo, trabajo en equipo, relaciones interpersonales, gestión de flujos asistenciales, gestión de recursos humanos, financieros y materiales, toma de decisiones, gestión del tiempo, formación continuada y asistencia, de acuerdo con las Directrices Curriculares Nacionales de Enfermería (DCN/ENF). Durante su desempeño profesional adquirieron las competencias de gestión de conflictos, toma de decisiones, delegación de funciones y negociación, que se sumaron a las adquiridas antes de acceder al mercado laboral. Estas competencias fueron adquiridas durante el curso de graduación, que tuvo como diferencial una estructura curricular con asignaturas específicamente centradas en cuestiones de gestión de enfermería, con una gran carga de trabajo práctico que, según ellas, desencadenó una mayor adquisición de estas competencias, la participación en actividades extracurriculares, además de que la estructura del curso fue percibida como un ejemplo en términos de formación de enfermeras gestoras. Los participantes sugirieron puntos de mejora en la matriz curricular como la inserción de nuevas materias obligatorias como seguridad del paciente, inserción de simulación realista como estrategia para el desarrollo de competencias actitudinales y aproximación con campos de pasantía en el sector privado. CONSIDERACIONES FINALES: Los participantes de este estudio relataron un conjunto de competencias de gestión desarrolladas durante la graduación que van más allá de las exigidas en la ENF-DCN y señalaron contribuciones para la mejora de las matrices curriculares de los cursos de pregrado en enfermería. Se espera que otros estudios puedan ser desarrollados en otros contextos, como instituciones de enseñanza privada.
Infecção pelo vírus da hepatite A em mulheres transgêneras: prevalência e fatores associados
(Universidade Federal de Goiás, 2022-02-07) Almeida, Mayara Maria Souza de; Souza, Márcia Maria de; http://lattes.cnpq.br/6954087338926237; Souza, Márcia Maria de; Guimarães, Rafael Alves; Caetano, Karlla Antonieta Amorim; Galvão, Marli Teresinha Gimeniz; Vieira, Maria Aparecida da Silva
Hepatitis A virus (HAV) infection is a serious public health problem, and transgender women constitute a group that is still stigmatized and quite vulnerable to communicable infections. This study aimed to investigate the epidemiological profile of hepatitis A virus infection in transgender women in Goiás. Cross-sectional, analytical study, carried out between March 2018 and August 2019, with 440 trans women being recruited, in which the sampling technique was used Respondent Driven Samplin. All women participated in data collection through a structured questionnaire and were tested using serological markers for anti-HAV (IgG-IgM) by enzyme immunoassay (ELISA). Bivariate and multivariate analyzes were performed using logistic regression in order to identify factors associated with HAV. More than half self-declared transsexual (66.3%), with a positive marker for anti HAV-IgG (75.6%), single (82.7%), aged between 22 and 30 years, self-declared black/ brown (71.6%), educational level between 10 and 12 years of study (61.3%) and monthly income between R$ 1,000.00 and R$ 3,000.00. Women aged between 20 and 30 years were 6.37 times more likely to have had previous contact with the virus. Those who had less than 10 years of formal education were 5.81 times more likely to be positive for anti-HAV IgG compared to other ages. Although there was no statistically significant association for anti-HAV positivity, some risky sexual and non-sexual behaviors deserve attention, such as sex work, oral and oroanal sex, non-use of condoms, considerable number of weekly sexual partners and group sex, in addition to the use of illicit drugs and prior arrest. The results showed that very young people may be more likely to be exposed to the infection and the shorter the time of schooling, the less knowledge and information about protection and prevention measures for HAV. And there is a need for prevention programs for communicable infections in this population, such as guaranteeing and facilitating access to the hepatitis A vaccine and health education actions regarding preventive and behavioral measures.
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 Diniz
INTRODUCTION: 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.
Pesquisa participante baseada na comunidade: estratégias de formação de redes na proteção ao uso abusivo de drogas
(Universidade Federal de Goiás, 2019-12-20) Dias , Paula Cândida da Silva; Munari, Denize Bouttelet; http://lattes.cnpq.br/8409035360598716; Munari, Denize Bouttelet; Staciarrini , Jeanne Marie Rodrigues; Souza, Adenicia Custodia Silvia e; Caixeta, Camila Cardoso; Medeiros , Marcelo
The abusive use of psychoactive substances is no longer just a public health problem but became a complex issue, which involves the social, economic and political context. For this reason, when thinking about health promotion and prevention of problems related to drug abuse, it is essential to develop actions including the community, the space where people live. Strengthening community resources and expanding public policies and interventions based not only on moral control for drug use can reduce risk. This study aimed to describe the construction of strategies for the formation of protection networks against the abuse of alcohol and other drugs in a community. This is a Community-Based Participant Survey (CBPR), conducted in a neighborhood in the municipality of Aparecida de Goiânia, State of Goiás, Brazil, and participants were community members interested in discussing the problem of alcohol and other drugs abuse and seeking means to reduce risks to this situation. Community leaders of the neighborhood, workers from various areas and residents who joined a Community Advisory Committee (CBPR) participated. Data were collected between June 2017 and July 2018 and followed the steps provided in the assumptions of CBPR, which establish the conduct of the research in an interactive and cyclical way. Data were recorded, transcribed and discussed along with CAC in terms of content, results and developments that were necessary. In addition, the team of researchers performed descriptive and analytical analysis of the data, and the results were organized around a central theme: Strategies for the formation of networks of protection against drug abuse in the context of CBPR. Four topics were identified: The approach for community partnership training; Formation of the Community Advisory Committee; Identification and prioritization of problems related to protective and risk factors for drug use in the community; and Planning and implementation of actions in the community, results achieved and contributions to sustainability. The results of the actions undertaken in and with the community demonstrate the construction of a network in the community context, which organized strategies to deal with the issue studied in a systemic way, whose sustainability indicators allow to affirm that CBPR is an important strategy of cultural intervention that values people in its territory as an important dimension of psychosocial care. The study presents an example of how to build strategies for the formation network for drug abuse prevention in the community context from the perspective of CBPR, pointing out contributions to the community, science, the training of professionals and researchers. The results of this study broaden our view on the production of health care, with a close relationship between researcher, community and students, and draw attention to the fine line between protecting the other and living collectively.
Estratégias de avaliação do letramento em saúde na América latina e Caribe: revisão de escopo
(Universidade Federal de Goiás, 2024-03-05) Lima, Edmila Lucas de; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Vila, Vanessa da Silva Carvalho; Paula, Cristiane Cardoso de; Rocha, Priscilla Roberta Silva; Cardozo , Roxana Isabel
Cultural and linguistic diversity, socioeconomic inequalities, health organization and systems in Latin America and the Caribbean interact and influence people's health literacy. Knowing how the population's health literacy (HL) of this region has been assessed can contribute to adapting the conduct of health professionals. Objective: to map the strategies used to assess health literacy in the Latin American and Caribbean population. Method: this scoping review adopted the methodological assumptions of the JBI and as eligibility criteria the primary studies in full that used strategies to evaluate the population HL of Latin America and the Caribbean, without time limitation and with restriction of the Latin-Roman alphabet. In July 2023 the sources MEDLINE, CINAHL, SCOPUS, Web of Science, EMBASE, SCIELO, LILACS, BDENF, IBECS, among others from the BVS Portal and gray literature (Google Scholar) were accessed. Results: 228 articles were included, the majority of which (82.4%) came from studies carried out in Brazil, Mexico, Chile and Peru. Observational and methodological studies predominated. The majority was conducted in hospitals and outpatient settings, in adults, adolescents, the elderly and children, especially those with chronic diseases. The temporal distribution was between 2009 and 2023, with an exponential rise from 2019 onwards. Most studies evaluated general HL and among those with specific content, oral/oral HL stood out. 110 LS assessment strategies were identified, and the most used were translated, culturally adapted and/or validated tools (S-TOFHLA; SAHL-S/SAHLPA-18; SAHLSA-50 and the NVS) who evaluated HL functional aspects, were applied in person, without time and application restrictions. Most studies adopted a broad and general concept of LS and Brazil has used five terms to identify HL in the country. Conclusion: HL evaluation in Latin America and the Caribbean has been carried out with varied strategies, which differ in the methodological approaches adopted. The evidence presented can collaborate and offer guidance for the development of reliable and effective tools that respond to Latin American and Caribbean population needs. Efforts and investments must be made in the development of national tools, which guarantee adequacy, cultural competence and meet the specificities of the region. Reliable results can produce effective interventions in promoting health and sustainable development.
Concentração de melatonina no leite humano, qualidade do sono e saúde mental materna: estudo transversal
(Universidade Federal de Goiás, 2024-03-05) Oliveira, Flávia Silva e; Guimarães, Janaína Valadares; http://lattes.cnpq.br/0986934969522024; Mota, Dalete Delalibera Faria de Correa; http://lattes.cnpq.br/1684517331855276; Vieira, Flaviana Vely Mendonça; http://lattes.cnpq.br/5199507174724803; Vieira, Flaviana Vely Mendonça; Amaral, Fernanda Gaspar do; Ruiz, Mariana Torreglosa; Gomes, Patrícia Rogrigues Lourenço; Arrais, Alessandra da Rocha
Oliveira FS. Melatonin Concentration in Human Milk, Sleep Quality, and Maternal Mental Health: Cross-Sectional Study [thesis]. Goiânia: Faculdade de Enfermagem/UFG; 2023. p. 196. INTRODUCTION: Melatonin is an endogenous hormone present in human milk and plays a crucial role in regulating the circadian rhythm. Its association with mood disorders and sleep disturbances during the postpartum period is still underexplored. OBJECTIVE: To investigate the association between melatonin concentration in human milk and the quality of sleep, presence of depressive symptoms, anxiety, and maternal stress in the postpartum period. METHODOLOGY: A cross-sectional study was conducted with 84 women in the postpartum period in the public healthcare system. Data collection took place between June 2021 and December 2022, with participants approached in the postpartum ward of the maternity unit. Human milk samples were collected through manual expression between 6 a.m. and 9 a.m. on day 14 postpartum. The samples were stored at -80°C and analyzed using an enzymelinked immunosorbent assay (ELISA). Sociodemographic, obstetric, and neonatal data were collected, and questionnaires on postpartum depression (Edinburgh Postnatal Depression Scale, EPDS), anxiety, stress (Depression, Anxiety, and Stress Scale, DASS-21), and sleep quality (Pittsburgh Sleep Quality Index, PSQI) were administered. Statistical analysis included measures of central tendency and dispersion, bivariate Poisson regression, and multivariate modeling, with p < 0.05 considered statistically significant. RESULTS: The median melatonin concentration was 4.90 pg/ml (Q1: 2.78; Q3: 13.61). Depressive symptoms were reported by 22.6% of the women, anxiety symptoms by 39.3%, stress symptoms by 38.1%, and sleep disturbances by 63.1%. In the multivariate analysis, associations were found between melatonin concentration ≤ 4.90 pg/ml, planned pregnancy (RP: 1.21; 95% CI: 1.04 - 1.42; p = 0.015), and anxiety symptoms (RP: 1.18; 95% CI: 1.02 - 1.37; p = 0.030). Postpartum depressive symptoms were associated with paid employment (RP: 2.58; 95% CI: 1.20 - 5.52; p = 0.015), stress symptoms (RP: 3.84; 95% CI: 1.04 - 14.21; p = 0.044), and sleep disturbances (RP: 3.07; 95% CI: 1.13 - 8.33; p = 0.027). Significant associations were also observed between stress symptoms and unplanned pregnancy (RP: 3.06; 95% CI: 1.16 - 8.12; p = 0.024), anxiety symptoms (RP: 3.06; 95% CI: 2.06 19 - 7.80; p < 0.001), and postpartum depressive symptoms (RP: 1.93; 95% CI: 1.12 - 3.33; p = 0.017). For anxiety symptoms, an association was found with stress symptoms (RP: 1.19; 95% CI: 1.53 - 7.26; p = 0.002) and newborn weight (RP: 1.00; 95% CI: 1.00 - 1.01; p = 0.004). The presence of sleep disturbances was associated with the number of people in the household (RP: 0.71; 95% CI: 0.54 - 0.94; p = 0.015). CONCLUSION: Melatonin concentration in human milk was higher than the daytime levels reported in the literature. The association between melatonin and anxiety symptoms emphasizes the importance of identifying modifiable factors during the perinatal period. The relationship between mood disorders and sleep disturbances suggests a simultaneous or precedence interaction between these conditions.
Letramento em saúde de profissionais do Serviço de Atenção Domiciliar
(Universidade Federal de Goiás, 2021-09-30) Santos, Laidilce Teles Zatta; Brasil, Virginia Visconde; http://lattes.cnpq.br/1940761888797180; Brasil, Virginia Visconde; Vila, Vanessa da Silva Carvalho; Cordeiro, Jacqueline Andréia Bernardes Leão; Butrico, Gabriela Ferreira de Oliveira; Borges Junior, Laerte Honorato
Introduction: Home Care has become an important possibility for the Brazilian Unified Health System to respond to the population's health needs, as it includes actions in health promotion, diseases prevention and treatment, rehabilitation, and palliative care, that occur at home, aiming the continuation of care and integration with the Health Care Networks. This covers the way in which services make information, resources, support and health environments available and accessible to different people, that is, it is the responsibility of the services to meet health literacy (HL) demands of people, including users and healthcare professionals in this process. All people have some type of difficulty in accessing health services, as well as in understanding the information they receive. Professionals must develop clear and easy-to-understand communication skills using the HL principles, both in their own health care and to provide adequate assistance in the Home Care Service. Objective: To evaluate health literacy conditions among professionals enrolled in a Home Care Service. Method: Analytical cross-sectional study, conducted with professionals at Home Care Service in Goiânia / GO. Data collection was accomplished, using a sociodemographic questionnaire and the Brazilian version of the Health Literacy Questionnaire (HLQ-Br). Simple descriptive analysis was performed for sociodemographic variables, mean calculation of scores and reliability of the HLQ-Br, Mann Whitney; Kruskal-Wallis; Cohen's d and Spearman's correlation. Results: Twenty-nine home care service professionals participated in the study; the majority were female; with a mean age of 39.9 ± 8.5 years; there was a predominance of the nursing team; most participants have other jobs and work approximately 12 hours / day; parents with education at or above high school; personal and family income greater than six minimum wages (Brazilian currency); and have been working at the Home Care Service for approximately six years. The lowest scores obtained were in Scale 2 “Enough information for health care”, Scale 4 “Social support to health care” and Scale 3 “Active management of health” (Part 1); and in Scale 7 “Navigating the healthcare system” and Scale 6 “Ability to actively engage with healthcare providers” (Part 2). The highest scores obtained were Scale 5 “Assessment of health information” (Part 1) and Scale 9 “Understanding health information well enough to know what to do” (Part 2). Conclusions: This study is a pioneer in evaluating the HL of professionals linked to SAD in Brazil and can collaborate to strengthen this service at the national level and indirectly contribute to the quality of life of patients, in the proposal that it is “Better at Home”. It allowed for reflection on the HL assumptions with professionals working in the SAD and will collaborate with the dissemination of the theme of health literacy among the group, as a tool in assertive communication and in the care of one's own health. The dissemination of these results can contribute to the performance of interventions in the service following the HL assumptions, as well as encouraging the inclusion of HL in undergraduate and graduate health curricula.
Prevalência e fatores associados à sífilis em populações vulneráveis em tempos de pandemia Covid-19
(Universidade Federal de Goiás, 2024-03-12) Silva Filho, Gabriel Francisco da; Teles, Sheila Araújo; http://lattes.cnpq.br/4975298732179917; Teles, Sheila Araújo; Cardoso, Juliana Lamaro; Caetano , Karlla Antonieta Amorim
During the COVID-19 pandemic, programs and services for the diagnosis, treatment, and prevention of sexually transmitted infections (STIs) were interrupted or slowed down to redirect material and human resources to control the health crisis, thus compromising the global strategy to eliminate syphilis as a public health problem. Our study addressed this gap during the pandemic and tracked syphilis in vulnerable populations. The aim of this study was to evaluate the prevalence and risk factors associated with syphilis in socially and economically vulnerable population groups in Goiânia, Goiás. The studied population consisted of 635 individuals living in Goiânia, Goiás: LGBTQIAP+ people, immigrants and refugees, homeless people, and recyclable waste collectors. All participants were interviewed about sociodemographic data and risk behaviors for STIs. Subsequently, blood samples were collected and tested for anti-T. pallidum using a rapid test (RT), and positive samples were subjected to the VDRL test, using commercial kits. Syphilis was considered for those who tested positive in the RT and active syphilis for those with VDRL titers ≥ 1/8. Non-parametric tests were used for data analysis, as appropriate. Poisson regression analysis was used to identify variables associated with syphilis. The analysis was conducted by subgroups, specifying the differences existing in each population. P-values < 0.05 were considered statistically significant. Most individuals were male (53.2%), single (58.8%), and black or brown (75.9%). The median age, years of schooling, and monthly income were 33 years, 10 years of study, and R$ 1,200.00, respectively. The overall prevalence of syphilis was 17%, ranging from 7.6% in immigrants/refugees to 36.7% in LGBTQIA+ people. The prevalence of active syphilis was 5%, ranging from 1.8% in recyclable waste collectors to 15.2% in LGBTQIA+ people. The analysis of factors associated with syphilis revealed a higher prevalence of STIs in all studied subgroups. For recyclable waste collectors, older age, female gender, and illicit drug use were variables associated with syphilis, while for homeless people, education was a protective factor and transactional sex was a predictor of syphilis. The results of this study confirm the high prevalence of syphilis in socioeconomically vulnerable populations. However, the specificities of each subgroup should be considered in the planning and implementation of STI prevention strategies.

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