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Absenteísmo-doença entre servidores públicos municipais de Goiânia
(Universidade Federal de Goiás, 2012-02-02) Leão, Ana Lucia de Melo; Rassi Neto, Elias; Turchi, Marília Dalva; http://lattes.cnpq.br/3769826743537934; Turchi, Marília Dalva; Corrêa Filho, Heleno Rodrigues; Souza, Marta Rovery de; Rosso, Claci Fátima Weirich; Bezerra, Ana Lúcia Queiroz
Background: Sickness absence (SA), known as work disability justified by sick leave, can be an indicator of workers health status. In municipal government, like the rest of the country, the prevalence of SA and its main causes are still poorly documented, and are restricted to the analysis of some occupational groups, especially those who engage in health care or in institutions education. Estimates of the magnitude of SA vary widely and socio-demographic aspects related to nature and working conditions are among the main factors associated with the frequency and duration. Aims: To study the prevalence and the factors related to SA workers from the public sector in the municipality of Goiânia. Methods: Cross-sectional population-based study assessing prevalence and factors associated with sick leave lasting longer than three days for the health treatment from 2005 to 2010, in civil servants. Outcomes: 40.578 sick leave were assessed among 14.484 absent workers which generated 944.722 absent days. The indicators of sickness absence in that period were: prevalence of sick leave of 39.0%, higher among education professionals (47.7%) and health (41.9%), the mean duration of SA was 40 days / year per worker away and the average duration of Licenses was 23 days per episode. Predominance of female sexual workers, aged between 41 and 50 years, married, white, with high educational background, earning up to three minimal salaries, with their own house, with from 3 to 10 years of public service, having a professional bond and basically in operational tasks registered in the Municipal Secretariat of Education and Health. The main cause of sickness was mental and behavioral disorder followed by musculoskeletal diseases. The Multivariate analysis showed an association between sickness absence and the female subjects (OR 1,54 IC95%1,41-1,68), being older (OR 1,86 IC95% 1,48-2,32), married (OR 1,51 IC95% 1,13-2,02), having elementary school degree (OR 12,35 IC95% 10,39-14,69), income of up to three minimal salaries (OR 1,37 IC95% 1,21-1,55), having more working experience concerning the time(OR 3,39 IC95% 2,50-4,59), being professional in the health and educational area (OR 2,96 IC95% 2,60-3,38 and OR 2,90 IC95% 2,51- 3,36), as well as being part of the staff in the Municipal Secretariat of Education and Health (OR 1,69 IC95% 1,30-2,21 e OR 1,60 IC95% 1,23-2,09 ). Conclusions: The indicators of SA express the magnitude of this phenomenon in public service and can assist in the planning of health worker prioritizing the most vulnerable occupational groups whose socio-demographic characteristics and work organization influence on absenteeism due to illness.
Primeira infância: práticas educativas na estratégia saúde da família
(Universidade Federal de Goiás, 2012-08-28) Silva, E. A. S.; Marcelo, Vânia Cristina; http://lattes.cnpq.br/6650368201862218; Marcelo, Vânia Cristina; http://lattes.cnpq.br/6650368201862218; Toschi, Mirza Seabra; Souza, Márcia Maria de; Rocha, Dais Gonçalves; Queiroz, Maria Goretti de
Educational practices developed in the Family Healthcare Strategy (FHS) are determinants of the health-disease process from the involved population. On the other hand, these practices are influenced by the professionals’ conceptions, by the physical spaces and by the availability of materials for their execution. The healthcare workers of the family generally have technical formation in their specific areas, but lack of formation in educational techniques. The Educational Practices (EP) developed among children ranging from zero to six years old can be grouped in two clearly opposite, traditional and liberatory strands. In this age group, children are in development of the individual and therefore the acquired formation during this stage will bring consequences to their whole lives. With the aim to characterize the realization of educational practices in the early childhood, 112 workers of the FHS from the East Sanitary District (ESD) in Goiânia (GO) were surveyed. It was decided to combine quantitative and qualitative methodology within the application of a questionnaire. Also, the physical spaces of the health units that were qualified as inadequate to carry out EP were recorded in field diaries. About the conception of EP, the most highlighted factors were transferring of information, consciousness and capacitation and disease prevention. The educational practices were predominantly classified as traditional. The most pointed sources of knowledge about this theme were the undergraduation, the specialization and the construction of informal networks of experience exchanging; and, few references in relation to permanent educational activities were performed. The addressed issues were selected by the experience of the pairs or of the documents and programs vertically indicated by the Ministry of Healthcare (MH) and Municipal Secretary of Healthcare (MSH). They are collectively discussed in the conventional spaces, using the spoken language and involving participants, especially accompanying adults. The mentioned theoreticalmethodological references that had more subsides to the actions were the manuals (MH and MSH), books and articles containing information within field of action. There was reference to the use of liberatory, in addition to support in the knowledge of their peers. The evidences of effectiveness of these actions were poorly mentioned, limiting only in the observation of improvement in health indicators, being stated by the decrease in caries prevalence (by dental professionals and community agents of healthcare), empowerment of the professionals (quoted by a doctor and a dentist) and the discrete increase in adhesion to these services by the population. The necessity of supportive materials and of complementary contents to subside the developed educational activities was highly stated. The secondary education professionals claimed not having access to permanent education activities.
Análise da gestão nos distritos sanitários em Goiânia - uma proposta de descentralização
(Universidade Federal de Goiás, 2012-10-03) Souza, Maria Cláudia Honorato da Silva; Rosso, Claci Fátima Weirich; http://lattes.cnpq.br/1137218060736306; Rosso, Claci Fátima Weirich; Rocha, Dais Gonçalves; Rovery, Marta
The Sanitary Districts are the extension of the central level of the Municipal Health Department in the Health Units which are part of the process of decentralization of the municipal management. To develop assistance continuously in a solvable way it is necessary that the manager and the teams in the units and Sanitary Districts know about the flows, that partnerships are established and agreed upon. In this study we aimed to diagnose elements of the work developed in the management of the Sanitary District in the Municipal Health Department in Goiânia, Goiás. We used a descriptive exploratory research methodology with professionals working in the health field who carried out duties of directors and supervisors in the seven Sanitary Districts of the Municipal Health Department in 2011. A well-structured interview was used to collect data. Thus it was organized in a way that allowed its analysis in the SPSS 15.0 program. Data were coded to proceed with the descriptive analysis based on the theoretical frame of reference. This study was assessed and approved by the Ethics Committee for Human and Animal Research of the Clinical Hospital of the Federal University of Goiás, under Protocol number 031/2009. Twenty managers of various professional categories who represent 95% of the district directors, took part in the research at the time of the study. The results show that most managers are female between 31-50 years old, and are graduated from private universities for more than 10 years. 80% of them have active employment whereas 90% exert their management under exclusive dedication. The political appointment is the aspect which influenced 55% of the management positions. 80% of the managers participated in specific training in management. Amongst the management activities considered important, the team management was cited by many, whereas the planning was devalued. From this study we intend to consolidate proposals of ongoing training, reinforcing the aspects appointed as weak and those which are essential to good management.
Conselhos locais de saúde na atenção básica: um estudo de revisão da literatura
(Universidade Federal de Goiás, 2013-02-28) Brito, Laiz Ayres; Queiroz, Maria Goretti; http://lattes.cnpq.br/7079676967280121; Queiroz, Maria Goretti; Nunes, Maria de Fátima; Marcelo, Vânia Cristina
Local Health Councils (LHC) were institutionalized through a Federal Resolution number 333/2003 , which recognizes these institutions as mechanisms for popular participation in health , directly linked to health unities in Brazil , Basic Health Units (BHU), outpatient and hospitals. This paper aims to describe the popular participation of LHC in UBS in Brazil. This is a descriptive study of qualitative nature, which uses the integrative literature review as a strategy type like collection and data analysis. Pateman (1992) was used as theoretical reference, about the gradual scale of participation; Demo (2009), which addresses the political quality and organizational capacity from the community to participate, besides the educative function of participation (Pateman, 1992; DEMO, 2009; Freire, 2011a; 2011b; 1979). The LHC educative function in primary health care was not a priority for articles discussion, however, it was realized in the advisor member of Local Councils. In addition, the LHC plays a formative and informative role for counselors and community. In LHC prevails a false participation like barriers for whole community participation, the unfavorable positioning of health management to councils and the difficulty to information access. There is also a difficulty in organization of LHC to participate, considered as a result of incipient culture of participation among councilors and community. The criteria of policy quality participation emphasizes: representativeness, mobilization for people participation, self - support and legitimacy. We identified a low substantive representation of local councilors and the drama of isolated leadership as mobilization for people participation. The LHC also need clearer definitions about their roles, especially collective initiatives. It is suggested an educational investment in councils, which stimulates daily life and culture of participation in all stages of life.
Perfil microbiológico da cavidade nasal de trabalhadores dos setores de emergência e atendimento móvel de urgência do município de Jataí-GO
(Universidade Federal de Goiás, 2013-02-28) Paula, Cacia Regia de; Palos, Marinésia Aparecida Prado; http://lattes.cnpq.br/1151975582155991; Palos, Marinésia Aparecida Prado; Barreto, Regiane Aparecida Soares dos Santos; Bezerra, Ana Lúcia Queiroz; Tipple, Anaclara Ferreira Veiga; Sousa, Adenícia Custódia Silva e
Introduction: Interest in the subject worker safety emergency room (IF) and Mobile Emergency Service (SAMU), focused on the eventual colonization and infection related to health care (IRAs), came to fruition during the academic. Acting as nurse of those services, I had the opportunity to observe workers acting in an unsafe manner during work activities, contributing to occupational exposure to biological agents. These observations, coupled with experience in this area, led the study. Despite this problem to be elucidated in the hospital, the same does not occur in the services of SE / SAMU, pay special attention to the safety of workers reason that sparked interest in the subject. This concern is due, among others, to alert the World Health Organization, with the launch of the World Alliance for Patient Safety and greatly not forget the workers. This assumption, some concerns emerged regarding the colonization of workers SE / SAMU, to unveil indicators within the colonization of these micro-organisms resistant to antibiotics which could compromise patient safety and worker himself. Workers SE / SAMU / SMS / Jatai-Goiás are carriers of micro-organisms resistant to antimicrobials in the nasal cavity? Faced with this question outlined the following Objectives: to analyze the microbiological profile of the nasal cavity sector workers and emergency mobile service emergency department Jataí - Goiás; isolate multiresistant micro-organisms in the nasal cavity of these workers; determine the profile Antimicrobial susceptibility of the isolates; estimate the prevalence of workers colonized with resistant microorganisms; verify the compliance of workers with hand hygiene during labor; raise the predictors related to colonization of these workers by resistant microorganisms; draft a care about the safety of the worker of Emergency Services and the Mobile Emergency Care Health System in Goiás, aiming at the prevention of occupational hazards in the workplace. Methods: Cross-sectional study of epidemiological, developed in the emergency services and Mobile Emergency Care Service Jataí-Goiás. We applied an interview form to collect demographic data, knowledge and attitude of the worker in relation to aspects of colonization by multiresistant microorganisms. Then, we collected a sample specimen of the nasal cavity through swab of 51 employees, including 12 doctors, 08 nurses, 01 pharmacists / biochemists, 20 nursing staff, 01 technical radiologist, 01 biomedical, 01 biotechnologist, 01 social workers and 06 firefighters / drivers / paramedics. The tubes of BHI broth containing the swabs were incubated at 35 ° C for 18/24 hours and then the samples were plated on selective culture media and processed by automation. The colonies that developed in any of the culture media were previously identified by their macroscopic characteristics and morphological / staining and subjected to screening for the selection of the identification evidence. Results: It was found that 38 (55.9%) of workers were carriers of S. epidermidis, followed by S. aureus, S. hyicus and Proteus mirabilis, 14 (20.6%) 2 (3.0%) and 3 (4.4%) respectively. As for the resistance profile of 38 isolates, 89.4% of S. epidermidis showed ampicillin resistance, 76.3% clindamycin, erythromycin 86.8%, 86.8% and 2.6% penicillin vancomycin. Proteus Mirabilis had resistance profile of 100% to sulfametazol / trimethoprim, tetracycline 66.6% and 33.3% to ampicillin, piperacillin and gentamicin. Conclusion: The colonization by resistant antimicrobial agents in the nasal cavity of 51 (100%) workers is reality. These results indicate challenges for municipal management, to point out flaws and loopholes in the context of patient safety and worker inherent in the working environment. Therefore, the evidence presented by this research will impact the operation of a project host aimed at quality of life and safety of the worker within the service and emergency.
Análise da tendência da cárie e influência de fatores individuais e contextuais em escolares de 12 anos em Goiânia-GO, no período de 1988 a 2010
(Universidade Federal de Goiás, 2013-08-29) Oliveira , Lorena Batista de; Bahia, Sandra Cristina Guimarães; Freire , Maria do Carmo Matias; http://lattes.cnpq.br/6056344372250078; Freire, Maria do Carmo Matias; Mohn Neto, Carlos Rodolfo; Queiroz, Maria Goretti; Nunes, Maria de Fátima; Lemos, Cristiane Lopes Simão
The monitoring of oral health and its determinants are of utmost importance for the planning and evaluation of health programs at the local level and to expand knowledge about this issue in Brazil. The aim of this study was to analyze the trend of dental caries and its association with individual and contextual factors in 12 years-old in the city of Goiânia. We conducted a cross-sectional study using data from epidemiological surveys of oral health conducted in the county from 1988 to 2010 and data from local information systems on contextual factors related to schools. For trend analysis of caries from 1988 to 2010 the Spearman correlation coefficient was used. Comparisons among Health Districts (HD) were made for the years 1994 and 2010. To analyze the association of the disease with individual and contextual factors in 2010 a multilevel analysis and log-linear regression negative binomial ratio averages were conducted, considering the complex sampling design. The dependent variable was the DMFT index and the independent variables were individual (sex, race and maternal education) and contextual related to schools (type of school, health district and the presence of oral health programs). The mean DMFT decreased 78.5% in the period, from 8.26 in 1988 to 1.78 in 2010 (r = -1.0, p ≤ 0.01) and there was a decrease of 86.8% in the decayed component, 73.3% in the missing due to caries and 41.7% in the filled teeth. There was an increase of 86.8% in the number of caries-free schoolchildren from 1994 to 2010 (r = 1.0, p ≤ .01). Children attending schools located in the HD with the worst socioeconomic indicators showed higher caries prevalence and lower percentage reductions compared with those with better indicators. In the multilevel model, female students and those whose mothers had less education, attending public schools located in districts with the worst socioeconomic indicators, and covered by the Family Heath Strategy had a higher DMFT in 2010. We concluded that there was a decrease in the prevalence of caries in Goiania from 1988 to 2010 and inequalities in the disease distribution in relation to sociodemographic factors related to individuals and school environment, which indicate the need for more effective actions seeking to reduce the inequalities, with emphasis on the school population less economically favored.
O processo do autocuidado dos portadores de diabetes mellitus tipo 2 de Jataí/GO
(Universidade Federal de Goiás, 2013-09-06) Ferri, Lucila Pessuti; Barros, Patrícia de Sá; Lemos, Cristiane Lopes Simão; http://lattes.cnpq.br/9279795437962960; Lemos, Cristiane Lopes Simão; Vilarinho Neto, Sissilia; Rosso, Claci Fátima Weirich; Cardoso, Clever Gomes
Diabetes Mellitus (DM) is a major public health problem, both because of its high prevalence, and for its complications, patients requiring a lot of care that should be incorporated into your routine. Self-care in DM is capable of promoting recommended glycemic levels and, consequently, decrease the acute and chronic complications of the disease. The aim of this study was to analyze the process of self-care in patients with DM tipo 2 enrolled in the Education Program and Control DM (PECDM) of the municipality of Jataí / GO. The main tool of this research was to collect testimonies, through semi-structured interviews. For the analysis of the interviews, the speeches were transcribed and subjected to content analysis employing the exploitation of categories, as proposed by thematic analysis of Bardin. In order to meet the objectives that guided the implementation of this study, from the thematic analysis of the transcripts of the interviews were prepared three categories: knowledge of the disease; practices and difficulties in the process of self-care and the role of self-care PECDM. The results showed that the participants have knowledge of the concept, treatment and complications of DM and mentioned that the balanced diet, regular exercise, medication, blood glucose monitoring and the use of alternative therapies are part of self-care, but despite this knowledge, we note that there are some factors that may hinder the achievement of self-care and socioeconomic difficulties, emotional state, lack of support from family and deficiency in the purchase of medicines. The PECDM has contributed satisfactorily to perform self-care for most participants, through multidisciplinary care, which ensures compliance of the ordinance inputs and medicines to patients with diabetes, educational activities and support groups, but it was found also the difficulty participants to consult with an endocrinologist and problems in therapeutic relationship between health professional and patient. Therefore, we emphasize the importance of this study for a discussion about the educational approach in the process of self-care in diabetes and among the different possibilities of realizing it, valuing the bond issue and listening, in order to provide better value for Patients with the disease.
Prevalência e fatores associados à incapacidade funcional para atividades básicas da vida diária entre idosos de um centro de saúde da família do município de Goiânia-Go
(Universidade Federal de Goiás, 2013-10-11) Santos, Weslane Souza de Almeida; Bezerra, Ana Lúcia Queiroz; http://lattes.cnpq.br/0088227879433410; Bezerra, Ana Lúcia Queiroz; Pagotto, Valéria; Silva, Ana Elisa Bauer Camargo; Varanda, Lilian Pereira; Rosso, Claci de Fátima Weirich
NTRODUCTION: The loss of function of the body is one of the major problems of the human aging process and it can make an elderly person totally or partially dependent on others. Also it may affect their independence and quality of life. The evaluation of capacity for Basic Activities of Daily Living can straight health care for the elderly. OBJECTIVE: To investigate the prevalence and factors associated with functional disability on the basic activities of daily life of elderly. METHODS: An epidemiological analytical cross-sectional study, conducted with 252 elderly from the Family Health Strategy at the Health Family Center of Vila Mutirão in Goiânia-Go, casually selected through a random selection. All the information was taken by structured instrument having socioeconomic and demographic facts, conditions and health perception, and functional assessment scale for ADL / Katz adapted by the Department of Health. To identify the issues associated with the loss of the body function, a varied analysis was made and chi-square test was used, and when appropriated, Fisher's exact test, with Odds Ratio as an associate measure. We conducted multivariate logistic regression with the variables: sex, age, and those with p < 0.10 in the varied analysis. Pauses of 95% assurance were calculated and considered statistically significant the associations that had p < 0.05. RESULTS: 64.3% of the elderly people were female , 53.4% aged between 60 and 69 years old, 40.9% were married, 59.1% had low financial family income, 69.5% were retired, 82,9% did not have remunerated jobs . 48.0% considered their health regular, 44.0% reported having better health than other seniors of the same age, 73% reported having hypertension and 73.4 % reported visual weakening. 88.1% of the elderly people show preserved functional capacity to the development of ADL revealing autonomy and independence in the development of these activities. The occurrence of disability was 11.9% in which 7.9 % were dependent continence, 6.4% for bathing and 6 % to dress up. The factors related to disability in basic activities of daily living between older adults were: being 71 years old or more (22.2 %); being male (17.7%); having chronic disease (12.2%); be illiterate or to know how to read or write without having attended school (14.7 %); not having a paid job ( 14.4 % ); receiving more than minimum salary ( 20 % ); not living alone (9.1% ); hearing deficit ( 18.4 % ) and vision ( 12.8%) and state to having poor or very poor health (32 %). The variables that remained significant for the result of functional disability in basic activities were: being 71 years old or more; higher income than the minimum salary and supposed poor / very poor health. CONCLUSION: The study identified the ability of seniors to ADL and will allow the development of multidisciplinary care planning, especially regarding the actions for improvements in quality of life of the elderly and their family caregivers.
Dor dentária e fatores associados em crianças menores de cinco anos de Goiânia
(Universidade Federal de Goiás, 2013-10-23) Lemes, Marília Galvão Chaves; Gondim, Maria do Rosário; Freire, Maria do Carmo Matias; http://lattes.cnpq.br/6056344372250078; Freire, Maria do Carmo Matias; Moreira, Rafael da Silveira; Queiroz, Maria Goretti; COSTA, Luciane R.; Marcelo, Vânia Cristina
Dental pain in childhood is a major oral health problem because it may impact the daily activities of children and their families. Although there is a growing number of studies on this issue, those carried out in children under five years old are scarce. The aim of this study was to determine the prevalence of dental pain and associated factors in children under five years old in Goiânia-GO, Brazil. A cross-sectional, population-based household study was carried out, using data of the project "Nutritional profile of children under five years old in the city of Goiania", of the School of Nutrition (FANUT)/UFG. The sample consisted of 385 children aged two to four years. Data were collected through interviews with parents or guardians and anthropometric measures. The variables analyzed were: dental pain some time in their lives (yes/no) and demographic, socioeconomic and health-related factors. For data analysis we used descriptive statistics, bivariate and logistic regression, considering the sample weights. The prevalence of dental pain was 9.9% (CI=7.4-13.1). Children whose mothers had low education were 2.73 (p=0.034) more likely to have tooth pain that children whose mothers had more than 8 years of schooling. Children who regularly consumed artificial juice powder containing sugar were 2.13 (p=0.018) more likely to have dental pain. It was concluded that the prevalence of dental pain was considerable and associated with the level of education of the parents and the children’s industrialized juices consumption. The implementation of strategies for improving living conditions and promoting healthy eating have the potential to reduce oral health problems and impact on quality of life due to dental pain.
Indicadores utilizados em saúde bucal no Brasil
(Universidade Federal de Goiás, 2013-10-28) França, Mary Anne de Souza Alves; Pereira, Edsaura Maria; Marcelo, Vânia Cristina; http://lattes.cnpq.br/6650368201862218; Marcelo, Vânia Cristina; Campos, Cerise de Castro; Reis, Sandra Cristina Guimarães Bahia
After 25 years of the establishment of the Unified Health System (SUS, acronym in Portuguese) in Brazil, this system managers and servants have concentrated efforts to overcome the challenges concerning the provision of health services with fairness and efficiency. Planning can contribute with the management in order to avoid that actions are implemented randomly or not adequately with the reality of the population; or without prioritization. Therefore, the SUS’ managers require health indicators designed to facilitate the evaluation, measurement and representation of health status, as well as the performance of a health system. The aim of this study was to analyze the indicators used in oral health in Brazil present in the government policies and scientific articles published in the period between the years 2000 and 2012. The study was configured as a literature review in the Lilacs and SciELO database and a documentary research on the website of Brazilian Ministry of Health. The indicators that emerged from the scientific articles analyzes (n=221), were categorized into: oral health conditions, socio-economics, demographics and management. In 34% of these articles management indicators were identified, in the following topics: supply, demand and services’ performance. Among the management indicators, the most cited were: access to dental visit, reason for the use of the services and the kind of service that was used. Among the socio-economic indicators: income and human development. In the demographic, age and gender. And about the oral health condition, the DMFT and GOHAI. Regarding the documentary guidelines, the topics mentioned the Pact Indicators of Primary Care; Pacts for Health; and the National Program for Improving Access to Quality Primary Care (PMAQ, acronym in Portuguese). Among the indicators of the guidelines were reminded the coverage of the first dental appointment, the action of supervised tooth brushing and coverage of oral health teams. In the triangulation of sources, coincident indicators in the articles and in the government guidelines were identified. It is concluded that there is a variety of indicators with different forms of calculation, data collection instrument and information source. Different denominations for the indicators were found in the scientific articles; it requires a standardization of the terms related to the topic, in addition to the aspects related to its calculation method. The management must prioritize the indicators with a reliable source and easily available collection. Government guidelines brought little progress in terms of proposals for oral health indicators. Over time, new oral health indicators were established by Brazilian Ministry of Health, at the same time as others were excluded. PMAQ’s publication inserted new indicators in this field that may contribute with the management. The description of the methodological aspects of the indicators allowed the systematization of the procedures described in the various articles and ministerial publications, which contributed with knowledge on the subject, allowing the use of these indicators in professional practice of management and assistance.
Utilização de medicamentos por idosos com diabetes do município de Goiânia, Goiás
(Universidade Federal de Goiás, 2013-10-30) Nunes, Marcus Vinicius Oliveira; Silva, Ana Elisa Bauer de Camargo; http://lattes.cnpq.br/8388407861788466; Silva, Ana Elisa Bauer de Camargo; Reis, Adriano Max Moreira; Provin, Mércia Pandolfo; Minamisava, Ruth; Weirich, Claci Fátima
Introduction. In Brazil, the percentage of elderly people is increasing considerably over the years. As a consequence, it is observes the increasing of chronical diseases such as diabetes mellitus. It is a disease that requires special attention, because it exposes elderly people to a long care period and to the continued use of medicines, sometimes using multidrugs. Moreover, elderly people are often affected by other comorbidities, by complications of the disease and its treatment. Objective. Analyze the use of medicines by the elderly people with diabetes mellitus in the city of Goiania, Goias, Brazil. Methodology. It is a population-based cross-sectional study carried out with a sample of 173 elderly individuals with diabetes mellitus and medications referred, selected by cluster. Data were collected by household interviews from December 2009 to April 2010 and they were analyzed by the Software Stata 12.0. The identified medicines were classified according to the Anatomical Therapeutic Chemical classification of the World Health Organization. The study was approved by Ethics Committee of the Federal University of Goias . Results. The mean age of old people with diabetes mellitus was 72.5 years and 61.8% were female. The most used medicines were acetylsalicylic acid (20.2%), enalapril (19.1%), dipyrone (13.3%), simvastatin (13.3%), levothyroxine sodium (12.7%), captopril (11.0%), atenolol (11.0%), hydrochlorothiazide (10.4%), losartan (9.8%) and paracetamol (9.8%). Approximately two thirds of the subjects used drugs for treatment of diabetes mellitus, and biguanides, sulfonylureas and insulins that have been most frequently used, showing respective values of 37.0%, 34.7% e 15.0%. Insulin alone was used in 7.5% of the elderly. It was found that 20.2% of the subjects used glibenclamide, an inappropriate medicine for old people. Exclusively oral antidiabetic therapy was observed in 51.5% of the individuals: 68.5% oral monotherapy and 31.5% combined oral therapy. The exclusive use of oral antidiabetic occurred with the utilization of metformin in monotherapy (15.6%), glibenclamide in monotherapy (11.0%) and combined therapy using metformin and glibenclamide (8.1%). The polypharmacy frequency was 38.7%. It was observed that women, unmarried, aged over 75 years and those who were not engaged in physical activity, hypertensive individuals, dyslipidaemic and those who had any hospitalization in the last 12 months had a higher median number of drugs used (p <0.05). However, after multivariate analysis hypertension was he only variable with statistical significance. Older people with diabetes mellitus and hypertension had 3.28 times more likely to use five or more medications than those without hypertension. Conclusion. This study allowed us to identify the profile of utilization of medicines by elderly people with diabetes mellitus as well to verify that metformin, alone or in combination, was the drug most often used for diabetes mellitus and indicated factors that may compromise the safety of antidiabetic pharmacotherapy in this population. Thus, health actions need to be developed, it is essential the work of the pharmacist in the multidisciplinary team to promotion of rational use of medicines and ensuring the safety of the elderly with diabetes mellitus.
Caracterização da investigação laboratorial de casos suspeitos de dengue no estado de Goiás
(Universidade Federal de Goiás, 2013-11-01) Licks, João Guilherme da Silva; Oliveira, Ellen Synthia Fernandes de; http://lattes.cnpq.br/3128365764211694; Oliveira, Ellen Synthia Fernandes de; Cardoso, Clever Gomes; Teixeira, Ricardo Antonio Gonçalves; Bahia, Sandra; Siqueira Júnior, João Bosco
The economic impact of dengue is quite significant, with considerable medical and hospital expenses, vector control and loss of work days. Laboratory confirmation of dengue cases is essential to the identification of the serotype circulating responsible for epidemics. Thus, the dengue surveillance system must be constantly reviewed and updated, contributing for planning and decision making in order to contain the outbreak and prevent damage to the population. This study aimed to characterize the laboratory investigation, taken by the public laboratories of the surveillance system of the state of Goiás, for confirmation of suspected cases of dengue in the health regions. An observational cross-sectional, quantitative study was conducted, analyzing secondary data; and primary data collected with the application of a mixed questionnaire. Additional data were obtained by information from the laboratory test system of the Central Public Health Laboratory of Goiás. The state is divided into 17 health regions, being the Central region the most populous. Two regions are devoid of dengue diagnosis laboratory, two regions are with 2 labs each and the others are with just one each. The Central region was the one that had the highest number of reported cases and deaths due to dengue in the studied period; it’s being also the region with the highest estimated annual and monthly tests performed by laboratory. The study included 73 Coordinators of Epidemiological Nuclei Surveillance from 15 health regions. 100% of the participants in all regions, except the Oeste II and Serra da Mesa, said that they conduct sampling to confirm the diagnosis of dengue. In nine regions most participants informed conduct sampling of every suspected case. In all regions the state laboratory predominated as the reference for the diagnosis of dengue. As the flow of receiving laboratory results, the most frequent was to be transferred to the state and this transfer to the county. Regarding the time of receipt of test results was more frequent the interval of 16 to 30 days for serology. For virus isolation, RT-PCR and immunohistochemistry, most participants ignored this question. The Central Public Health Laboratory of Goiás held, in 2011, 8.723 tests for the diagnosis of dengue, responding the Central region for most of them. As for the serotypes isolated in the state in 2011, the Central region was the only one to present the four circulating serotypes, different from the other regions that showed a single serotype. From these results, it is concluded that the network of laboratories performing diagnosis of dengue in the state is not decentralized in practice, because the majority of participants reported the state laboratory as the reference. We also conclude that it’s not distributed by observing the number of counties, total population, reported cases, deaths and estimated demand for laboratory tests, because of the big difference in these numbers in regions with the same quantitative of laboratories. It is suggested that the distribution of the network should be reconsidered aiming at a better response of the laboratory component of the surveillance.
Eventos adversos na utilização do cateter venoso central de inserção periférica em um hospital público infantil
(Universidade Federal de Goiás, 2013-11-08) Sá, Jaciane Soares de; Bezerra, Ana Lúcia Queiroz; http://lattes.cnpq.br/0088227879433410; Bezerra, Ana Lúcia Queiroz; Castral, Thaíla Corrêa; Silva, Ana Elisa Bauer de Camargo
The Catheter Peripherally Inserted Central is a device used in intravenous therapy in neonatal intensive care units and pediatric and in neonatal intermediate care units, which promotes venous access safe for a long time and with a low rate of infection, however, the use of this technology by being a complex process, may be subject to adverse events. The aim of the study was to analyze the use of central venous catheter peripherally inserted into a child public hospital from the perspective of nurses, identify and classify the events in the stages of the process of insertion, maintenance and removal of PICC and verify the procedures adopted in these events and the consequences for patients. Descriptive analysis was performed of the results, with minimum and maximum for continuous variables and absolute and relative frequencies for categorical variables. Qualitative data were grouped and categorized by approaching answers. Results The results showed a predominance of females with an average age between 24-58 years and 5 or more years of professional performance, function and institution. The working day was 30 hours per week and 53.8% were specialists with training course for handling PICC. 84.6% witnessed some kind of adverse event, 57.7% in the insertion, highlighting the difficulty of progression / closing valve / capillary fragility; 84.6% in keeping with an obstruction of the catheter 61.5% EA as mentioned, caused by the blood reflux, drug incompatibility, poor permeabilization and lack of washing (flushing) of the catheter; and 15.4% in recession, caused by rupture / breakage of the catheter. The adopted clinical management were the exchange of venous access, monitoring, traction of the catheter and pressure dressing in case of bleeding. The consequences for patients were prolonged length of stay in the service, need to complement therapy and new IV line installation. The results signaled the size of adverse event occurrences in the safe use of PICC, the safety measures and quality of patient care, requiring the training of nursing professionals, combined with a policy of promoting continuing education activities and formulation strategies to minimize flaws and building a professional and institutional culture of safety.
Qualidade de vida e sobrecarga de trabalho de cuidadores do serviço de atenção domiciliar de Goiânia, Goiás
(Universidade Federal de Goiás, 2013-11-25) Guerra, Heloísa Silva; Souza, Marta Rovery de; Almeida, Nilza Alves Marques; http://lattes.cnpq.br/2486258562480055; Almeida, Nilza Alves Marques; Souza, Dayse Cristine Dantas Brito Neri de; Brasil, Virginia Visconde; Palos, Marinésia Aparecida Prado
The increase in life expectancy and the decrease in the mortality rate have resulted in changes in the epidemiological profile with the predominance of chronic noncommunicable diseases and global changes in the health care system. Regarding brazilian reality, due to socioeconomic factors of families the role of the caregiver, in general, is generated in the home environment. The caregiver, to assume a role for which usually is not prepared, may suffer with the workload and compromise the life quality. Thus, the aim of this study was to analyze the life quality related to health and workload of caregivers of the users of the Service Home Care (SAD, in Portuguese) in the city of Goiânia- Goiás.This is an analytical cross-sectional study, conducted with caregivers in the households of SAD’s users in Goiânia-GO. For this study were selected caregivers with age equal or above18 years, literate and performing the function as aleading caregiver for at least two months. The data were collected through interviews with application of the tools for the characterization of the caregiver, burden evaluation (ZBI - Zarit Burden Interview ) and evaluation of quality of life related to health - HRQL ( SF -36 - The Medical Outcomes Study 36 - Item Short - Form Health Survey).In these analyses were calculated averages, standard deviation with their corresponding interval of 95% of confidence, and multiple linear regression by the backward selection method and Pearson correlation. The values of P<0.05 were considered significant for all analyzes. Among the 95 interviewed caregivers, the average age was 49,7 years old (±13,0), most of them were female (97,9%), married (57,9%) first-degree relatives or spouse (74,7%), they devoted more than 12 hours a day to caring activity (69.5%), do not benefit from weekly rest (84,2%), had at least one health problem (86,3%) and informally exerted the activity of care (97,9%). In HRQOL evaluation, caregivers had lower average scores for Vitality (39.2) dimension of the SF-36 and in the burden evaluation the average was 33,8.Themain factors associated with decreased HRQL of caregivers were age, health problems such back pain, anxiety and depression and the time they already had in the function of caring. Higher scores of overload evaluated by ZBI were associated with the fact that the caregiver does not have a weekly rest, and present back pain problems and depression. There was a negative and statistically significant correlation between HRQL and work overload for all dimensions of the SF -36, suggesting that the higher the overload, worse the quality of life of caregivers of SAD. It follows that there is impairment in the quality of life of the caregivers of SAD’s users, due to the level of work overload. Given this, it must be observed the need of a higher performance of home care teams, through integral actions with caregivers, in order to lessen the impact of care giving on their health and quality of life.
Notificação de violência contra a mulher na rede pública de saúde de Goiânia- Goiás
(Universidade Federal de Goiás, 2013-11-27) Nogueira, Elza Gomes Finotti; Almeida, Nilza Alves Marques; Souza, Marta Rovery de; http://lattes.cnpq.br/1155042579123151; Souza, Marta Rovery de; Silva, Maria Aparecida Alves da; Rosso, Claci Fátima Weirich
Violence is a phenomenon that has always been part of human experience and has been emphasizing between the main causes of morbidity and mortality worldwide. Since 1993 the World Health Organization recognizes in violence a public health problem. In 2010, the Ministry of Health of Brazil recorded 27,176 notifications of cases of domestic violence, sexual and/or other violence. According to the data, the characteristics of victims of violence against women are: young adult, married or in a consensual union, resident of urban zone, higher education and white color. In relation to the likely perpetrator of the assault, mostly committed by a male person and that have closed relationship with the victim, provided that spouse or ex-spouse. Therefore, it should be noted the importance of the Brazilian public policies to combat violence against women and the institution of compulsory notification within the Health System in Brazil. The present study aimed to analyze the knowledge of professionals about the notification of cases of violence against women in the Municipal Health Secretariat of Goiânia-Goiás/Brazil. A qualitative study of exploratory type, whose study population consisted of professionals involved with attention to women in situation of violence and/or epidemiological surveillance of violence in three hierarchical levels of the Secretariat. It was used for data collection the interview and documentary research in written records and fingerprints of trainings addressing the subject of notification of violence against women. Considering the manifestations of the professionals interviewed in relation to the understanding of the role of the professional in the attention to women in situation of violence, one realizes that some procedures reported go beyond purely technical questions of assistance, especially to motivate to get support, receive, listen and observe, offer support and inspire confidence. Most professionals understand that the notification is mandatory, have epidemiological and purpose must be carried out by who does the attendance, even anonymously, evidencing compliance with what the law calls for the notification. As for the professionals ' knowledge about the reference flows and opposite-reference and existence of Protocol, it can be observed that there is a consensus, especially on the existence of the Protocol. Some understand the role of Network of Care for Children, Adolescents and Women in Situations of Violence, emphasizing the articulation of institutions, training of professionals and the support service of the Health Unit. Regarding training for the notification of cases of violence against women, professionals recognize the need of updates. With the documentary research found a significant quantitative educational events or courses, however, without subsidies to verify that meet National Policy for Continuing Education in Health (PNEPS), in force since 2004. In this way, it is considered that the training of professionals must fit the guidelines of PNEPS, and their records need to be qualified. Regarding the Network of Care for Children, Adolescents and Women in Situations of Violence is considered necessary a continuous, comprehensive disclosure of their actions to the professionals.
Avaliação do perfil dos pacientes atendidos com ferimentos por arma de fogo em um hospital da Rede Viva Sentinela
(Universidade Federal de Goiás, 2013-12-05) Maciel, Paulo Roberto; Souza, Marta Rovery de; http://lattes.cnpq.br/1155042579123151; Souza, Marta Rovery de; Rassi, Marcos; Rosso, Claci Fátima Weirich; Soares, Meire Incarnação Ribeiro; Barros, Patrícia de Sá
The world violence is currently responsible , according to the World Health Organization (WHO) , more than 5 million deaths each year , and for every person who dies as a result of violence , many suffer from physical or mental sequelae resulting from injuries . In Brazil a serious problem closely linked to violence is the use of firearms . In the state of Goiás the death rate resulting from its use is troubling figuring therefore as a severe public health problem. To describe the sociodemographic profile of people with gunshot wounds treated at a big Emergency Hospital localized in Goiânia-Goiás-Brazil . Descriptive observational study with non-probability sample of convenience. Participants were inpatients in a big Emergency Hospital, with gunshot wounds in the period from January to March of 2013. Project approved by the Ethics Committee in Research of Emergency Hospital of Goiânia, 182123/2013. The study included 150 patients who suffered injuries from firearms lodged in a large hospital of Goiás It can be seen that the higher prevalence of injuries occurred in the victims were male (94.7 %), young people (67,3 %), nonwhite (72,0 %) and with incomes of up to two minimum wages (51,3 %). They are mostly people who are self-employed or salaried construction (62,3 %), with schooling up to 9 years (elementary school), and 120 of them (80,0%) were users of alcohol or drugs. This study identified that a large number of victims of gunshot wounds admitted for treatment are: young men, users of drugs or alcohol and the motivation for such injury has relation to drug traffic and debts. An approach from violence from the perspective of public health becomes important to analyze and identify data on its distribution and its social determinants.
Desempenho de serviços de saúde baseado em inquérito de base populacional
(Universidade Federal de Goiás, 2013-12-10) Neves, Carlos Magno; Rosso, Claci Fátima Weirich; http://lattes.cnpq.br/1137218060736306; Rosso, Claci Fátima Weirich; Souza Junior, Paulo Roberto Borges de; Souza, Marta Rovery de
Several authors have sought to understand the variables that shape health services in the SUS and its management, seeking to support the management with information that may contribute to the defragmentation of the system. In this sense the performance of health systems is of major importance for management of this sector. The evaluation of the performance of the health systems is of major importance for the management of the referred sector. With this purpose stands out the population based health surveys, which are being widely used in other countries, and in Brazil they have been gradually used by some government sectors, due to their legitimacy to assess the health status of the population and the health care service provided from the users’ point of view. OBJECTIVE: To analyze the performance of the health services in the municipalities of the northern part of the Integrated Region of Development of the Federal District and surrounding areas from the perspective of the residents. METHODOLOGY: A descriptive epidemiological study using a population-based household survey. An already validated questionnaire was applied, which was submitted to a digital format with the use of an electronic artifact Pocket Hp iPAQ116 The statistical analysis was performed using a SPSS software version 19.0, on which data were crossed and simple frequencies were performed with 95 % confidence interval. RESULTS: From 521 participants, 59.50 % are aged between 18 to 40, 53.93 % are female, being 54.70% of the majority of brown skin color . About the Basic Attention AB1 66.60 % of households were registered in units of the family health, and 33.39 % of residents reported not having health care support, 46.25% residents reported consultation with a physician, 67.63 % of those paid by SUS, also 86.27 % of 51 admissions were provided by SUS, and 82.36 % of the health service users seek predominantly for SUS , and 59.19 % not primarily sought the Primary Care. CONCLUSION: Were recorded a young adult population with a female majority was registered, The provision of health services, are recorded at CNES and enrolls 138 public health services or private contracted by SUS, without however posses or contract a high complexity hospital service, which is presented only in the municipality of Planaltina de Goiás. The gateway service recommended by the federal government to AB, is not perceived as such by the population.
Satisfação profissional de enfermeiros de um hospital da rede pública de Goiânia
(Universidade Federal de Goiás, 2013-12-10) Borges, Jackeline Lemes; Bezerra, Ana Lucia Queiroz; http://lattes.cnpq.br/0088227879433410; Bezerra, Ana Lúcia Queiroz; Melo, Maria Aparecida de Souza; Bezerra, Nelson Barbosa
This is an exploratory descriptive cross-sectional study with a quantitative approach , conducted with 47 nurses in a public hospital in Goiânia . The instrument used was a questionnaire Index of Work Satisfaction of Stamps (1997), translated, adapted and validated for Portuguese by Lino (1999). The questionnaire is self-administered and self-explanatory, composed of paired comparisons that allow the identification of the importance of each component to job satisfaction and attitude scale, Likert, which helps identify job satisfaction perceived by the subjects as to the components Autonomy, Interaction, Professional Status, Organizational policies, Pay and Task Requirements. Data were analyzed using SPSS version 18.0. To assess the internal consistency Cronbach's alpha was used. Most of the nurses interviewed were women, married, with some specialization, with less than five years on the job , with more than one employment and effective. The component considered most important to the job satisfaction of nurses was the Pay and least Autonomy. The Professional Status was identified as the one that most influenced the satisfaction regarding their current job, and compensation as the least satisfaction. Index of Work Satisfaction among nurses was 9.77 and the Professional Status showed the highest real level of satisfaction, followed by Interaction, Organizational policies, Autonomy, Task Requirements and Pay. It can be considered that the high level of satisfaction with the professional status of nurses showed motivation to the perception of the importance and recognition of their work by the same category and own patients. The adoption of an instrument, from what was used in this study could be extended to the whole multidisciplinary team, is an alternative to the monitoring of this indicator in public health institutions in Goiânia, contributing to decision making by hospital managers in search of improved quality of care .
Mortalidade materna em adolescentes no municipio de Goiânia no periodo de 2002 a 2011
(Universidade Federal de Goiás, 2013-12-20) Borges, Celma Dias; Souza, Marta Rovery de; http://lattes.cnpq.br/1155042579123151; Souza, Marta Rovery de; Martins, Cleusa Alves; Almeida, Alves Marques; Minamisava, Ruth; Palos, Marinésia Aparecida P.
In addition to the common causes of death for both sexes, women are victimized by problems related to sexuality and reproduction. These problems become more severe for teenagers, as they are more likely to die than women greater than 20 years of age by a pregnancy-related, preventable death in most cases. The greater vulnerability of adolescents to these deaths is hinged to the material conditions of life and the rights recommended for this age group over the past decades depends one effective public politics. The aim of this study was to analyze maternal mortality in adolescents, in Goiânia, in the period 2002-2011. It is an observational, descriptive study conducted in the city of Goiânia, Brazil. The population included all maternal deaths of women aged between 10 and 49 years old in the city of Goiânia in the period 2002-2011, data collected from records of the death certificate and tokens Research Women and Maternal Death in the Municipal Health of Goiânia and structured in Microsoft Excel. The results showed no differences between the mortality profile of adolescents and women of all ages. Noteworthy is the proportion of unknown data for almost all variables, however, between the recorded data was prevalent age of 18, black color, low education and direct obstetric causes of maternal deaths. The conclusion from these findings is that age itself does not differ from the profile of maternal mortality among adolescents and women of all ages, but regardless of age where they occur, these deaths are a serious violation of human rights of women to be preventable in 92% of cases, and that the situation of vulnerability of adolescents to be recognized in practice as a condition for any teen is a victim of this type of death.
Percepção de discentes de medicina sobre o feedback na avaliação formativa
(Universidade Federal de Goiás, 2014-02-12) Pricinote, Sílvia Cristina Marques Nunes; Pereira, Edna Regina Silva; http://lattes.cnpq.br/4503589425013098; Pereira, Edna Regina Silva; Costa, Nilce Maria da Silva Campos; Moreira, Maria Auxiliadora Carmo
In education, feedback can be defined by information provided by an agent that can be a teacher, a mate, a book, oneself or an experience about certain aspects of the student's performance or knowledge. Feedback creates awareness of learning, for it emphasizes deviations among the desired goals and the actual results, encourages changes and indicates the appropriate behavior, promoting individual's motivation to repeat the correct action. The aim of this research was to analyze the student’s perception of the meaning of feedback in formative assessment, and, therefore, know how it is delivered. This is a qualitative research. Data were collected via focus groups with fourth year or eighth term students at three medical schools in the state of Goiás. Thematic analysis revealed eight major themes: understanding of feedback by the students, frequency of the received feedback, impact of feedback in the teaching and learning process, the perception of the feedback received, characteristics of received feedback, factors related to the occurrence of feedback, characteristics of the teacher to provide feedback and characteristics of the student to receive feedback. We realize that the students, in spite of their difficulty to conceptualize, can understand partially what feedback means, because there is no concept of internal feedback. On the other hand, they can recognize the importance of feedback for their learning process and they are receptive to effective feedback. However, they are unhappy with the low frequency and the lack of regulation of this tool. It is observed that the practice of feedback needs to be improved in the teaching and learning environment of the students, regardless of the institution or curriculum. Teachers should be stimulated to give feedback, as well the students should be stimulated to seek it, so that it is regular and continuous practice in educational environments.

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